scholarly journals Influence of leadership skills on effectiveness of departmental leadership in Mogotio Sub County hospitals in Kenya

2020 ◽  
Vol 9 (5) ◽  
pp. 66-73
Author(s):  
Saul Kipkoech Kiptingos ◽  
Paul Omato Gesimba ◽  
David Gichuhi
Keyword(s):  
Sampling Method ◽  
Research Study ◽  
Leadership Skills ◽  
Health Sector ◽  
Management Training ◽  
Public Hospitals ◽  
Leadership Skill ◽  
The Public ◽  
Departmental Leadership ◽  
Senior Administration

Previous work in Kenyan public hospitals has revealed leadership gaps and poor communication between senior administration and lower cadres as an impediment to achieving better practice. Management training for senior health professionals has been recognized as a priority and is now being provided. The research study explored the influence of leadership skills on effective departmental leadership in Mogotio Sub County. The study used descriptive designs and targeted 32 hospitals consisting of 185 managerial staff in Mogotio Sub County. The stratified random sampling method was used to generate a sample of 126 respondents. Data was collected from this sample using questionnaires and analyzed descriptively and inferentially with the use of SPSS version 24. The correlation analysis determined there is a positive and statistically significant association between leadership skills and effective departmental leadership (r=756, p=.000). This verdict was reinforced by the linear regression results (β=.286, p=.001). The study concludes that leadership skill greatly helps improve effective departmental leadership in the public health sector. The study recommends that hospitals ought to emphasize mentoring leaders in the clinical setup in order to improve the effectiveness of leadership at the departmental level. There is a need to inculcate leadership training into the hospitals’ culture. 

scholarly journals Detailed cost of robotic-assisted surgery in the Australian public health sector: from implementation to a multi-specialty caseload

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Fixed Costs ◽  
Tertiary Referral Hospital ◽  
Robotic Assisted ◽  
The Public ◽  
Robotic Assisted Surgery ◽  
Specific Implementation ◽  
Theatre Utilisation

Abstract Background A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs. Results Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (Interquartile range (IQR): $15,445 to $32,199). The RAS specific costs were $8828 (46%) made up of fixed costs including $4691 (24%) implementation and $2290 (12%) maintenance, both of which are volume dependent; and $1848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.

The Role of Management Accounting Systems in Public Hospitals and the Construction of Budgets

2016 ◽  
pp. 366-389
Author(s):  
Carla Marina Pereira de Campos ◽  
Lúcia Lima Rodrigues ◽  
Susana Margarida Faustino Jorge
Keyword(s):  
Management Accounting ◽  
Health Sector ◽  
Public Hospitals ◽  
Public Funds ◽  
Accounting Systems ◽  
The Public ◽  
Management Accounting Systems ◽  
Alternative Approaches ◽  
Traditional Approaches

The role of management accounting systems (MAS) in the construction of budgets in the public health sector has been one of the least studied topics in the international literature. Furthermore, several studies have confirmed the loss of relevance of traditional approaches to budgeting due to the need to implement techniques that are more performance-oriented. Since public hospitals are organisations that depend significantly on public funds, with substantial impacts on governments' budgets, the pressure for reducing expenditures is strong, causing increased difficulties in hospital management. In order to analyse the role of MAS in the preparation of hospital budgets, this chapter presents a literature review on this topic. This review allows to understand the loss of relevance of traditional budgeting techniques and to present alternative approaches. In this process, the implementation of different kinds of budgeting is heavily influenced by governments and professionals. Nevertheless, the research on this topic is still very scarce, evidencing the need to continue studying it.

scholarly journals Competing Multiple Accountability Mechanisms and Public Administrators’ Responses in the Health Sector in Kenya

2020 ◽  
Vol 10 (2) ◽  
pp. 213
Author(s):  
Karumba, Kenneth
Keyword(s):  
Health Sector ◽  
Public Hospitals ◽  
Public Administrators ◽  
Hospital Administrators ◽  
The Public ◽  
Case Study Design ◽  
Complex Concept ◽  
Professional Accountability ◽  
Accountability Mechanism

Accountability in public sector is a complex concept. Public administrators are held accountable by multiple mechanisms of accountability. It is unclear in the public health sector in Kenya which of the four mechanisms of hierarchical, professional, legal and political accountability dominates accountability responses of hospital administrators. The objective of this study was to assess which among the competing multiple accountability mechanism is accorded priority in the health sector in Kenya. The study adopted a case study design targeting hospital administrators from 36 public hospitals in 14 Counties in Kenya. The study found out that professional accountability tend to be given precedence over other forms of public accountability in ordinary conditions and hierarchical accountability under crisis situations. The study concluded that hospital administrators are confronted with all the four mechanisms, but their intensity on accountability vary.

scholarly journals Is there a role for podiatric surgeons in public hospitals? An audit of surgery to the great toe joint in Victoria, 1999–2003

2009 ◽  
Vol 33 (4) ◽  
pp. 690 ◽  
Author(s):  
Priscilla Ribonson ◽  
Mark F Gilheany
Keyword(s):  
Elective Surgery ◽  
Health Sector ◽  
Public Hospitals ◽  
Frequency Data ◽  
Great Toe ◽  
Surgical Skill ◽  
Orthopaedic Surgeons ◽  
The Public ◽  
Joint Surgery ◽  
Type Of Surgery

This project aimed to describe and compare the frequencies of procedures performed by podiatric surgeons and orthopaedic surgeons for elective surgery to the great toe joint, an area of identified clinical need. The objective was to determine whether podiatric surgeons in the Australian context possess a surgical skill set which can be utilised in the public health sector. The Medicare Benefits Schedule (Medicare Australia) was reviewed to identify all codes relating to great toe joint surgery and frequency data were obtained for the period July 1999 to June 2003. A separate audit of the activity of Victorian podiatric surgeons was conducted. During the 4 years in Victoria, the number of procedures performed on this joint by 152 orthopaedic surgeons was 5882. Two podiatric surgeons in Victoria performed 1260 operations on this joint over this period (17.6% of great toe joint surgery on average each year in the private sector). Utilising orthopaedic workforce figures and on a per-surgeon basis, during this period the podiatric surgeons performed this type of surgery between 2 and 16 times more often than the orthopaedic surgeons, and consideration should be given to using these skills in the public sector to address the growing demand.

scholarly journals Measuring and Assessing the Wealth Influence on the Efficiency of the Health System through the Private Sector

2020 ◽  
Vol 31 (4) ◽  
pp. 437-449
Author(s):  
Mina Fanea-Ivanovici ◽  
Marius-Cristian Pană ◽  
Mihail Dumitru Sacală ◽  
Cristina Voicu
Keyword(s):  
Public Health ◽  
Private Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Quality Of Services ◽  
Private Hospitals ◽  
The Public ◽  
Public Health Sector ◽  
Private Health Sector

The aim of the paper is to provide an analysis of the dynamics of the public and private health sectors in Romania. Using descriptive statistics, it first investigates whether the public health sector follows the reformation trends suggested by official strategies and reports, and to what extent the private health sector is a viable alternative to the public one, by analysing the demand for private inpatient services. We look into the reduction in the occupancy degree in public hospitals as a means to increase the efficiency of public health expenditures, which represents one way to reform the public health sector. We also find that the increase in the occupancy degree in private hospitals is negatively correlated with the quality of services provided by public hospitals, but positively correlated with population wealth. Increase in the occupancy degree in private hospitals is an indicator of poor quality of services in public hospitals. It can also be explained by increasing expectations and requirements of beneficiaries as a reflection of increase in wealth and of their will to preserve their health capital. Using regression models, the paper then proposes the Wealth-Health Index, a composite indicator to explore the connection between wealth and health and the dynamics of the private health sector. Investment in physical infrastructure and the size of medical staff in the private sector is positively correlated with wealth increase.

scholarly journals Detailed Cost of Robotic-assisted Surgery in the Australian Public Health Sector: From Implementation to a Multi-specialty Caseload

2020 ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Fixed Costs ◽  
Tertiary Referral Hospital ◽  
Robotic Assisted ◽  
The Public ◽  
Robotic Assisted Surgery ◽  
Specific Implementation ◽  
Theatre Utilisation

Abstract Background: A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods: A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs.Results: Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (IQR: $15,445 to $32,199). The RAS specific costs were $8,828 (46%) made up of fixed costs including $4,691 (24%) implementation and $2,290 (12%) maintenance, both of which are volume dependent; and $1,848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions: There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.

scholarly journals Development of a financial management competency framework for nurse managers at selected public hospitals in KwaZulu-Natal, South Africa

2018 ◽  
Author(s):  
◽  
Nellie Naranjee
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Financial Management ◽  
Management Training ◽  
Public Hospitals ◽  
Theory Approach ◽  
Management Skills ◽  
Health Care Organisation ◽  
The Public ◽  
Kwazulu Natal

Background In the South African context, the Nurse Manager (NM) is responsible for and manages the nursing side of the health care organisation. Public hospitals face the challenges of poor management, underfunding, deteriorating infrastructure and poor standards. The consequences are that NMs have to do more with less. This necessitates that the NMs should have the competencies and skills to enable them to use the existing resources more efficiently and equitably and be able to manage and contain costs within their departments. However, NMs do not necessarily have financial management skills and competencies to manage the current health care financial situation. This then highlights the need for financial preparation of all NMs. Aim The aim of the study was to explore the financial management roles of NMs in their current work environments, identify financial management development needs necessary for NM practice, and ultimately to develop a financial management framework to improve the skills of NMs. Methodology A qualitative, grounded theory approach was used to explore the financial management skills and competencies and developmental needs of NMs. Nursing Managers, Financial Managers, Operational Managers and Chief Executive Officers of public hospitals in KwaZulu-Natal participated in the study. The data was collected by means of interviews. The sample size for the interviews was guided by data saturation and comprised 18 participants. Findings The study findings revealed that NMs are involved in financial management activities within the hospitals. However, they do not necessarily have the requisite financial management skills and competencies to function in their financial roles. From the findings the researcher was able to propose and develop a framework to improve the financial management competencies of NMs in the public sector. It was concluded that NMs do indeed practice financial management and therefore require the relevant knowledge, skills and competencies. Recommendations include the development of a financial management training programme to be implemented based on the identified needs of NMs in the public sector. Another recommendation is that undergraduate and post graduate nursing programmes include financial management programmes that would be relevant and applicable to the specific financial management activities that nurses practice daily.

The Role of Management Accounting Systems in Public Hospitals and the Construction of Budgets

2016 ◽  
pp. 289-312
Author(s):  
Carla Marina Pereira de Campos ◽  
Lúcia Lima Rodrigues ◽  
Susana Margarida Faustino Jorge
Keyword(s):  
Management Accounting ◽  
Health Sector ◽  
Public Hospitals ◽  
Public Funds ◽  
Accounting Systems ◽  
The Public ◽  
Management Accounting Systems ◽  
Alternative Approaches ◽  
Traditional Approaches

The role of management accounting systems (MAS) in the construction of budgets in the public health sector has been one of the least studied topics in the international literature. Furthermore, several studies have confirmed the loss of relevance of traditional approaches to budgeting due to the need to implement techniques that are more performance-oriented. Since public hospitals are organisations that depend significantly on public funds, with substantial impacts on governments' budgets, the pressure for reducing expenditures is strong, causing increased difficulties in hospital management. In order to analyse the role of MAS in the preparation of hospital budgets, this chapter presents a literature review on this topic. This review allows to understand the loss of relevance of traditional budgeting techniques and to present alternative approaches. In this process, the implementation of different kinds of budgeting is heavily influenced by governments and professionals. Nevertheless, the research on this topic is still very scarce, evidencing the need to continue studying it.

scholarly journals Social Case Work Practices As A Strategy For Patients Welfare In Public Hospitals of Karachi: A Description Of Experience

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Sakina Riaz ◽  
Naheed Abrar ◽  
Saima Akhtar Malick
Keyword(s):  
Research Study ◽  
Public Hospitals ◽  
Exploratory Research ◽  
Work Practices ◽  
Review Of The Literature ◽  
Clinical Practices ◽  
The Public ◽  
Current Health ◽  
Case Work ◽  
Current Health Care System

This study is divided into five sections and covers a brief overview of the clinical practices of Social Case Work as a strategy for patient’s welfare in the Public Hospitals of Karachi. In section one, the concept of Social Case Work in Pakistani pedagogical scenario and Social Case Work’s contribution to the current health care system is discussed. The second section of the study covers the review of the literature. The succeeding section, i.e. section III stated the methodology adopted to derive the results of the study. The results of this study, based on the analysis ended by applying the proposed methodology have been argued in section IV. In the concluding section, conclusions and recommendations were presented. In this exploratory research study, the qualitative methods have employed to understand the reasons which are responsible for de-value of Social Case Work Practices in the public hospitals in Karachi.

scholarly journals An Assessment of the Influence of Working Environment on Service Delivery in the Public Health Sector in Nyeri County, Kenya

2020 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Mary W Theuri ◽  
Stephen Macharia ◽  
Alice Kamau ◽  
◽  
◽  
...  
Keyword(s):  
Public Health ◽  
Service Delivery ◽  
Health Workers ◽  
Health Sector ◽  
Public Hospitals ◽  
Working Environment ◽  
Future Research ◽  
P Value ◽  
The Public ◽  
Public Health Sector

Globally, the health sector is an area that any government must focus on since health is a right of every human being. Kenya particularly initiated the idea of devolution and the Big Four Agenda to ensure service delivery to citizens was achieved. Nevertheless, the situation in the public health sector has been encountering challenges due to dissatisfaction of personnel culminating in strikes. The objective of this study was to explore the effect of the working environment on service delivery in the health sector in Nyeri County, Kenya. The study was guided by the person–environment fit theory. The descriptive cross-sectional research design was used. The target population was derived from public hospitals in Nyeri County. Proportionate stratified random sampling was utilized, where 141 respondents were targeted, comprising doctors, clinical officers, and nurses. Data was collected using a closedended questionnaire. A pilot study was conducted at Mukurwe-ini Hospital to enhance the validity and reliability of the data-collection instrument. A Cronbach alpha coefficient of 0.7 was used to ascertain the reliability of the instrument. Data was analyzed using descriptive and inferential statistics from the 78.7% respondents. The findings established that the working environment had positive and significant effects on service delivery (β1 = 0.476, p-value = 0.000) at the 5% level of significance, hence rejecting the null hypothesis. The study further established that the public health sector in Kenya should address the drug shortage, medical staff working hours, and machine maintenance as they would adversely affect quality of service delivery. The study recommends that the public health sector should provide health workers a conducive working environment and all necessary tools and equipment to enable them to discharge their duties effectively with a view to enhance service delivery to patients. Future research should focus on the importance of on–the-job training for effective service delivery in the public health sector.

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