Abstract
BackgroundEffective human resources management plays a vital role in the success of health-care sector reform. Leaders are selected for their clinical expertise and not their management skills, which is often the case at the middle-management level. The purpose of this study was to examine the situation in some fields that involve working with people in health-care organizations at middle-management level.MethodsThe study included eight state-owned hospitals in Slovenia. A cross-sectional study included 119 middle managers and 778 employees. Quota sampling was used for the subgroups. Structured survey questionnaires were administered to leaders and employees, each consisting of 24 statements in four content sets evaluated on a 5-point Likert-type scale. Respondents were also asked about the type and number of training or education programmes they had participated in over the last three years. Descriptive statistics, two-way analysis of variance, Pearson’s correlation coefficient and multiple linear regression were used. The study was conducted from March to December 2008.ResultsStatistically significant differences were established between leaders and employees in all content sets; no significant differences were found when comparing health-care providers and health-administration workers. Employment position was found to be a significant predictor for employee development (β = 0.273, P < 0.001), the leader–employee relationship (β = 0.291, P < 0.001) and organizational motivation (β = 0.258, P < 0.001). Area of work (β = 0.113, P = 0.010) and employment position (β = 0.389, P < 0.001) were significant predictors for personal involvement. Level of education correlated negatively with total scores for organizational motivation: respondents with a higher level of education were rated with a lower score (β = -0.117, P = 0.024). Health-care providers participate in management programmes less frequently than do health-administration workers.ConclusionEmployee participation in change-implementation processes was low, as was awareness of the importance of employee development. Education of employees in Slovenian hospitals for leadership roles is still not perceived as a necessary investment for improving work processes. Hospitals are state owned and a national strategy should be developed on how to improve leadership and management in Slovenian hospitals.
Highlights
The ability of a health-care system to provide safe, highquality, effective, patient-centred services depends on sufficient well-motivated and appropriately skilled personnel operating within service delivery models that optimize their performance [1]
A two-way analysis of variance was performed for each total score, with the two intergroup factors being the type of work performed and respondent’s position
We found a surprisingly low desire among employees to be actively involved in changeimplementation processes (MHC = 3.64, standard deviation (SD) = 0.93; mean health administration (MHA) = 3.79, SD = 1.06), leaders expressed a conviction that their employees were given the opportunity to be actively involved (MHC = 4.23, SD = 0.69; MHA = 4.43, SD = 0.65)
Summary
The ability of a health-care system to provide safe, highquality, effective, patient-centred services depends on sufficient well-motivated and appropriately skilled personnel operating within service delivery models that optimize their performance [1]. Since all health care is delivered by people, effective human resources management will play a vital role in the success of health-sector reform [3]. Microsystems in health care, as defined by Nelson et al [4], are small teams working together on a regular basis to serve the needs of a discrete subpopulation of patients. In a microsystem such as a hospital ward, managing the diversity of professional cultures might be the key factor for establishing interdependent ward teams and increasing satisfaction, which leads to improved quality of care [5]. Effective human resources management plays a vital role in the success of health-care sector reform. The purpose of this study was to examine the situation in some fields that involve working with people in health-care organizations at middle-management level
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