scholarly journals The Competency Movement in Public Hospitals: Analysing the Competencies of Hospital Executive Managers

2021 ◽  
pp. 22-43
Author(s):  
Mehtap ÇAKMAK BARSBAY ◽  
Mustafa Kemal ÖKTEM
Keyword(s):  
Assessment Tool ◽  
Management Training ◽  
Healthcare Management ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Healthcare Organizations ◽  
Self Assessment ◽  
Cross Sectional ◽  
Hospital Managers ◽  
Executive Managers

"Our primary aim was to provide a quantitative snapshot relying on a self-assessment tool developed for the local healthcare environment and formal tasks for top-level executive hospital managers of public healthcare organizations. We used a cross-sectional and descriptive mixed study design that targeted the nationwide population of 701 top-level managers in public hospitals in 2015 in Turkey. As the first step, position description content analysis was conducted based on document analysis to explore their legal tasks and statements, and the job requirements for an executive management position in public hospitals. Second, before designing the data-collection instrument, we conducted four meetings and group discussions with several hospital managers – with and without medical backgrounds – and five academics who were part of healthcare management and public administration departments. Lastly, we built upon past efforts and the literature, and constructed a questionnaire. The managers are fully responsible for the healthcare quality, medical, nursing, administrative issues and financial performance of the facility. The participants perceived that they were competent in most of the competencies. The participants’ mean total competency score was 81%, and the competency gap between the required and current competency levels differed from 13% to 22%. This research provides deep insight into the competencies perceived by hospital executive managers in a developing country context. Our results have several practical implications for both healthcare policymakers and new executive hospital managers. There is an urgent need for follow-up self-assessment for competencies and ongoing management training programs."

scholarly journals Beijing Friendship Hospital Osteoporosis Self-Assessment Tool for Elderly Male (BFH-OSTM) vs Fracture Risk Assessment Tool (FRAX) for identifying painful new osteoporotic vertebral fractures in older Chinese men: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ning An ◽  
Ji Sheng Lin ◽  
Qi Fei
Keyword(s):  
Assessment Tool ◽  
Roc Curves ◽  
Cross Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
Fracture Group ◽  
Friendship Hospital ◽  
Fracture Risk Assessment Tool ◽  
Older Chinese ◽  
Sensitivity Specificity

Abstract Background To compare the validation of four tools for identifying painful new osteoporotic vertebral compression fractures (PNOVCFs) in older Chinese men: bone mineral density (BMD), Asian osteoporosis self-assessment tool (OSTA), World Health Organization fracture risk assessment tool (FRAX) (without BMD) and Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OSTM). Methods A cross sectional study was conducted from 2013 to 2019. A total of 846 men aged ≥50 were included and were divided into two groups: Fracture Group (patients with PNOVCFs underwent percutaneous vertebroplasty surgery) and Non-Fracture Group (community dwelled subjects for healthy examination). All subjects accepted a dual-energy X-ray BMD test and a structured questionnaire. The results of BMD, OSTA, FRAX and BFH-OSTM scores were assessed and receiver-operating characteristic (ROC) curves were generated to compare the validity of four tools for identifying PNOVCFs. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Results There were significant differences including BMD T score (femoral neck, total hip and L1-L4), OSTA, FRAX and BFH-OSTM scores between Fracture group and Non-fracture group. Compared to BMD and OSTA, BFH-OSTM and FRAX had better predictive value, the sensitivity, specificity and AUC value are 0.841, 81.29%, 70.67% and 0.796, 74.85%, 78.52%, respectively. Compared with FRAX, the BFH-OSTM has a better AUC value. Conclusions Both BFH-OSTM and FRAX can be used to identify POVCFs, However, BFH-OSTM model may be a more simple and effective tool to identify the risk of POVCFs in Chinese elderly men.

scholarly journals Diversity issues in Nigeria’s healthcare sector: implications on organizational commitment. A cross-sectional study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 852 ◽  
Author(s):  
Ayodotun Stephen Ibidunni ◽  
Tomike Olawande ◽  
Maxwell Olokundun ◽  
Charles Iruonagbe ◽  
Iyanu Adelekan
Keyword(s):  
Job Satisfaction ◽  
Statistical Analysis ◽  
Organizational Commitment ◽  
Structural Equation ◽  
Affective Commitment ◽  
Cross Sectional Study ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Healthcare Organizations ◽  
Cross Sectional

Background: Workplace diversity is increasingly gaining the attention of healthcare organizations, especially in developing countries like Nigeria. However, little is understood from existing literature about how workforce diversity affects employees’ satisfaction and organisational commitment in the workplace. Consequently, this paper showed the direct and mediating relationships between diversity of workforce, job satisfaction and employee commitment to the organization. Methods: Copies of the structured questionnaire have been given to 133 public healthcare employees in Nigeria’s Ministry of Health in Lagos state.  Statistical analysis for the study included descriptive measures and multi-variate analysis, using structural equation modelling. Results: Outcomes from statistical analysis supports direct and mediating relationships between the research variables. Gender and ethical diversity had significant influences on job satisfaction at r = 0.35 (p < 0.05) and r = 0.28 (p < 0.05) respectively. The following mediating relationships were also statistically confirmed: job satisfaction related with affective commitment (r = 0.41, p < 0.05) and normative commitment (r = 0.26, p < 0.05). Conclusions: Based on the results of the statistical analysis, the study concludes that there is a relationship between diversity of employees and job satisfaction, diversity of employees and organizational commitment and the influence of work satisfaction on organizational commitment.

scholarly journals Publicly funded interfacility ambulance transfers for surgical and obstetrical conditions: A cross sectional analysis in an urban middle-income country setting

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241553
Author(s):  
Paul Truche ◽  
Rachel E. NeMoyer ◽  
Sara Patiño-Franco ◽  
Juan P. Herrera-Escobar ◽  
Myerlandi Torres ◽  
...  
Keyword(s):  
Surgical Care ◽  
Healthcare Facility ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Publicly Funded ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Timely Access ◽  
Surgical Conditions

Introduction Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. Methods A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained from the single municipal ambulance agency providing publicly funded ambulance transfers in the city. Interfacility transfers were defined as any patient transfer between two healthcare facilities. We identified the number of transfers for patients with surgical conditions and categorized transfers based on patient ICD-9-CM codes. We compared surgical transfers from public vs. private healthcare facilities by condition type (surgical, obstetric, nonsurgical), transferring physician specialty, and transfer acuity (code blue, emergent, urgent and nonurgent) using logistic regression. Results 31,659 patient transports occurred over the 13-month study period. 22250 (70.2%) of all transfers were interfacility transfers and 7777 (35%) of transfers were for patients with surgical conditions with an additional 2,244 (10.3%) for obstetric conditions. 49% (8660/17675) of interfacility transfers from public hospitals were for surgical and obstetric conditions vs 32% (1466/4580) for private facilities (P<0.001). The most common surgical conditions requiring interfacility transfer were fractures (1,227, 5.4%), appendicitis (913, 4.1%), wounds (871, 3.9%), abdominal pain (818, 3.6%), trauma (652, 2.9%), and acute abdomen (271, 1.2%). Conclusion Surgical and obstetric conditions account for nearly half of all urban interfacility ambulance transfers. The most common reasons for transfer are basic surgical conditions with public healthcare facilities transferring a greater proportion of patient with surgical conditions than private facilities. Timely access to an initial healthcare facility may not be a reliable surrogate of definitive surgical care given the substantial need for interfacility transfers.

scholarly journals Brachial-Ankle Pulse Wave Velocity is Associated With the Risk of Osteoporosis: A Cross-Sectional Evidence From A Chinese Community-Based Cohort

2020 ◽  
Author(s):  
Kun Tang ◽  
Qiao Zhang ◽  
Nianchun Peng ◽  
Ying Hu ◽  
Shujing Xu ◽  
...  
Keyword(s):  
High Risk ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Assessment Tool ◽  
Self Assessment ◽  
Community Based ◽  
Cross Sectional ◽  
The Relationship

Abstract Background: Association of arterial stiffness and osteoporosis has been investigated in Chinese population. However, the relationship between arterial stiffness and osteoporosis by measuring brachial-ankle pulse wave velocity (baPWV) and the Osteoporosis Self‐assessment Tool for Asia (OSTA) index is not established. The object of this study was to evaluate possible associations between baPWV and the risk of osteoporosis and bone fracture among a population of Chinese. Whether baPWV can be used as a predictor of osteoporosis on OSTA was further assessed. Methods: This study was cross-sectional in design. Of 3,984 adults aged 40 years and older in the Yunyan district of Guiyang (Guizhou, China) who underwent both OSTA and baPWV measurements within one month , 1,407 were deemed eligible for inclusion (women: 1,088, men: 319) . Results: The mean baPWV was 1,475 ± 302 cm/s (range,766-3,459cm/s). baPWV in 110 individuals with high risk of osteoporosis (OSTA index < -4) was higher than that of individuals with non-high risk (1,733 ± 461 cm/s versus 1,447 ± 304 cm/s, P<0.001). OSTA index was negatively correlated with baPWV（ρ = -0.296，P < 0.001）after adjusting for age, sex, body mass index, waist circumference, diastolic blood pressure and creatinine clearance rate. baPWV was an independent predictor for the presence of high risk of osteoporosis (β = -0.001, P < 0.001) and the optimal baPWV cut-off value for predicting the presence of high risk of osteoporosis and fracture was 1,693 cm/s. The AUC was 0.722 (95% confidence interval [CI], 0.667‐0.777; P < 0.001). Conclusions: We conclude that arterial stiffness measured by baPWV is well correlated with the severity of osteoporosis evaluated by OSTA. baPWV index may be a valuable tool for identifying individuals with risk of developing osteoporosis.

Cross-sectional evaluation of emergency care capacity at public hospitals in Zambia

2019 ◽  
Vol 36 (10) ◽  
pp. 620-624 ◽  
Author(s):  
Chancy Chavula ◽  
Jennifer L Pigoga ◽  
Muhumpu Kafwamfwa ◽  
Lee A Wallis
Keyword(s):  
Emergency Care ◽  
Assessment Tool ◽  
Public Hospitals ◽  
Rapid Expansion ◽  
Cross Sectional ◽  
Middle Income ◽  
Delivery Of Care ◽  
Signal Functions ◽  
District Hospitals ◽  
Care Assessment

ObjectivesThe last decade has seen rapid expansion of emergency care systems across Africa, although they remain underdeveloped. In Zambia, the Ministry of Health has taken interest in improving the situation and data are needed to appropriately guide system strengthening efforts. The Emergency Care Assessment Tool (ECAT) provides a context-specific means of measuring capacity of healthcare facilities in low- and middle-income countries. We evaluated Zambian public hospitals using the ECAT to inform resource-effective improvements to the nation’s healthcare system.MethodsThe ECAT was administered to the lead clinician in the emergency unit at 23 randomly sampled public hospitals across seven of Zambia’s 10 provinces in March 2016. Data were collected regarding hospitals’ perceived abilities to perform a number of predefined signal functions - life-saving procedures that encompass the need for both skills and resources. Signal functions (36 for intermediate facilities, 51 for advanced) related to six sentinel conditions that represent a large burden of morbidity and mortality from emergencies. We report the proportion of procedures that each level of hospital was capable of, along with barriers to delivery of care.ResultsAcross all hospitals, most of the level-appropriate emergency care procedures could be performed. Intermediate level (district) hospitals were able to perform 75% (95% CI 73.2 to 76.8) of signal functions for the six conditions. Among advanced level hospitals, provincial hospitals were able to perform 68.6% (67.4% to 69.7%) and central hospitals 96.1% (95% CI 93.5 to 98.7) Main failures in delivery of care were attributed to a lack of healthcare worker training and availability of consumable resources, such as medicines or supplies.ConclusionZambian public hospitals have reasonable capacity to care for acutely ill and injured patients; however, there is a need for increased training and improved supply chains.

scholarly journals What Ibero-American hospitals do when things go wrong? A cross-sectional international study

2020 ◽  
Vol 32 (5) ◽  
pp. 313-318
Author(s):  
José Joaquín Mira ◽  
Irene Carrillo ◽  
Ezequiel García-Elorrio ◽  
Daniela Campos D E Andrade-Lourenção ◽  
Patricia Campos Pavan-Baptista ◽  
...  
Keyword(s):  
Action Plan ◽  
International Study ◽  
Public Hospitals ◽  
Future Research ◽  
Strategic Action ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Private Hospitals ◽  
Hospital Managers ◽  
Depth Analysis

Abstract Objective To know what hospital managers and safety leaders in Ibero-American countries are doing to respond effectively to the occurrence of adverse events (AEs) with serious consequences for patients. Design Cross-sectional international study. Setting Public and private hospitals in Ibero-American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Portugal and Spain). Participants A convenience sample of hospital managers and safety leaders from eight Ibero-American countries. A minimum of 25 managers/leaders from each country were surveyed. Interventions A selection of 37 actions for the effective management of AEs was explored. These were related to the safety culture, existence of a crisis plan, communication and transparency processes with the patients and their families, attention to second victims and institutional communication. Main Outcome Measure Degree of implementation of the actions studied. Results A total of 190 managers/leaders from 126 (66.3%) public hospitals and 64 (33.7%) private hospitals participated. Reporting systems, in-depth analysis of incidents and non-punitive approaches were the most implemented interventions, while patient information and care for second victims after an AE were the least frequent interventions. Conclusions The majority of these hospitals have not protocolized how to act after an AE. For this reason, it is urgent to develop and apply a strategic action plan to respond to this imperative safety challenge. This is the first study to identify areas of work and future research questions in Ibero-American countries.

scholarly journals Evaluating equity in healthcare: pilot implementation of a self-assessment tool

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Chiarenza ◽  
D Domenig ◽  
S Cattacin
Keyword(s):  
Quality Of Care ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
The Self ◽  
Vulnerable Groups ◽  
Service Users ◽  
Cross Sectional Survey ◽  
Self Assessment ◽  
Cross Sectional

Abstract Background Several sets of standards aiming at improving access and quality of care for service users have been published in recent years. Certain standards focused on improving healthcare providers’ responsiveness to specific target groups. The general goal of this research was to improve organisations’ awareness of equity standards that are not focused on specific groups, but on all contributing factors that put vulnerable groups at risk of exclusion. The specific objective was to evaluate the degree of compliance with a set of equity standards in 52 health care organisations from 16 countries. Methods A self-assessment tool (SAT) was developed to allow healthcare organisations to measure their capacity to provide equitable care for service users. The SAT indicates the main areas that should be addressed: equity in policy; equitable access and utilisation; equitable quality of care; equity in participation; promoting equity. A cross-sectional survey addressing participants from pilot-organisations was used for data collection, concerning both the self-reported compliance score with the standards, as well as the additional information provided to support the score assigned. Data were analysed quantitatively as well as qualitatively. Results The findings confirm that healthcare providers do invest in improving equity in the access and delivery of services to vulnerable groups. However, many health organisations have inadequate strategies to address inequities and are insufficiently engaged in improving equity in participation and promoting equity outside the organisation. Conclusions The participating organisations reported a significant impact from use of the self-assessment tool: some received the support from regional/national authorities to continue working on improving equity in healthcare; others linked the equity standards to existing performance-measurement strategies; others invested in new frameworks to improve service users engagement. Key messages The implementation of the SAT contributes to a self-reflective process, involving health professionals and managers, in which gaps and potential improvements are identified. Pilot organisations utilised the SAT as part of a process of increasing their awareness of equity issues and changing their organisational culture.

scholarly journals Patient and healthcare provider knowledge, attitudes and barriers to handover and healthcare communication during chronic disease inpatient care in India: a qualitative exploratory study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028199 ◽  
Author(s):  
Claire Humphries ◽  
Suganthi Jaganathan ◽  
Jeemon Panniyammakal ◽  
Sanjeev K Singh ◽  
Shifalika Goenka ◽  
...  
Keyword(s):  
Healthcare Provider ◽  
Information Exchange ◽  
Inpatient Care ◽  
Medical Information ◽  
Communicable Disease ◽  
Healthcare Management ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Medical Documents ◽  
Healthcare Communication

Objectives1) To investigate patient and healthcare provider (HCP) knowledge, attitudes and barriers to handover and healthcare communication during inpatient care. 2) To explore potential interventions for improving the storage and transfer of healthcare information.DesignQualitative study comprising 41 semi-structured, individual interviews and a thematic analysis using the Framework Method with analyst triangulation.SettingThree public hospitals in Himachal Pradesh and Kerala, India.ParticipantsParticipants included 20 male (n=10) and female (n=10) patients with chronic non-communicable disease (NCD) and 21 male (n=15) and female (n=6) HCPs. Purposive sampling was used to identify patients with chronic NCDs (cardiovascular disease, chronic respiratory disease, diabetes or hypertension) and HCPs.ResultsPatient themes were (1) public healthcare service characteristics, (2) HCP to patient communication and (3) attitudes regarding medical information. HCP themes were (1) system factors, (2) information exchange practices and (3) quality improvement strategies. Both patients and HCPs recognised public healthcare constraints that increased pressure on hospitals and subsequently limited consultation times. Systemic issues reported by HCPs were a lack of formal handover systems, training and accessible hospital-based records. Healthcare management communication during admission was inconsistent and lacked patient-centredness, evidenced by varying reports of patient information received and some dissatisfaction with lifestyle advice. HCPs reported that the duty of writing discharge notes was passed from senior doctors to interns or nurses during busy periods. A nurse reported providing predominantly verbal discharge instructions to patients. Patient-held medical documents facilitated information exchange between HCPs, but doctors reported that they were not always transported. HCPs and patients expressed positive views towards the idea of introducing patient-held booklets to improve the organisation and transfer of medical documents.ConclusionsHandover and healthcare communication during chronic NCD inpatient care is currently suboptimal. Structured information exchange systems and HCP training are required to improve continuity and safety of care during critical transitions such as referral and discharge. Our findings suggest that patient-held booklets may also assist in enhancing handover and patient-centred practices.

Prediction of the financial performance of Ontario hospitals: A Test of Environmental Determinist and Adaptationist Perspectives

1996 ◽  
Vol 9 (3) ◽  
pp. 137-155 ◽  
Author(s):  
L. Narine ◽  
G. Pink ◽  
P. Leatt
Keyword(s):  
Environmental Factors ◽  
Financial Performance ◽  
Financial Distress ◽  
Cross Validation ◽  
Structural Characteristics ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Policy Makers ◽  
Hospital Size ◽  
Hospital Managers

While other industries for many years have been concerned with the problem of financial distress, it is only recently that this issue has become a matter of interest to hospital managers, policy makers, and the general public. However, the determinants of hospital financial performance are neither well studied nor understood. The objectives of this study were to identify factors that affect the financial performance of Ontario hospitals and to construct a model that could be used to predict financial performance in the future. A number of organization and environmental factors that could influence financial performance were postulated and then tested for their statistical impact and predictive ability. Cross-sectional data over the 3-year-period 1986–1988 for 223 Ontario public hospitals were used. The first 2 years of data served as a derivation sample for hypothesis testing and development of a predictive model. The third year of data was used as a holdout sample for cross validation. Information on the variables investigated came from secondary sources, in particular Statistics Canada's Annual Hospital Returns. Univariate analyses revealed distressed hospitals were more likely to earn more revenues from non-government sources, to be non-teaching institutions and have longer chronic lengths of stay, and to be found in areas with higher per capita incomes, number of females in the population, physician supply, and area wage rates. A five variable prediction model was developed which accounted for 25% of the variance in financial performance in the derivation sample and on cross validation dropped to 21%. The model identified greater hospital size, older plants, higher technological complexity, more intensive care services, and location in areas with more females to be significant predictors of financial distress. Overall, environmental factors (community and structural characteristics) were more important in influencing financial performance. The implication for hospital managers is to underscore that an important dimension of successful leadership requires they remain outwardly focused and involved in managing the external environment. For policy makers the need is to develop funding formulae which encourage efficiency and are also responsive to differences in community and structural characteristics across hospitals.

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