Hospital Administrators Research Articles

Effect of Resource Orientation on Service Delivery of Public Level Four Hospitals in Kakamega County Kenya

Purpose: The study established the effect of resource orientation on service delivery of Level Four Public Hospitals in Kakamega County, Kenya Methodology/Approach: Mixed research design comprising of a descriptive and causal were applied. Targeted 304 comprising of 162 nurses, 135 Hospitals office staff and 7 Hospital Administrators. The study sample size was 173 using Yamane formulae. The study applied stratified and simple random sampling technique. Structured questionnaires aided in data collection. Pilot study was done at Sabatia District hospital in Vihiga County. Reliability was tested using Cronbach Alpha while validity was tested using content validity. SPPs versio 23 was used for effective descriptive as well as inferential statistics. Findings: The study found out that customer orientation had a significant influence on service delivery (t-statistic=7.489. Implications: Important to medical practitioners, government Authorities, and management of hospitals in managing strategic orientation plans for service delivery. The study recommends that customers orientation should be prioritized since it enhances service delivery.

Effect of Flexi-Time on the Performance of X Hospital Administration employees in Batu City, East Java, Indonesia: Mediating Role of Work-Life Balance and Job Satisfaction

Research Aims: The objectives of this research are to investigate the impact of flextime on the performance of administrative employees at Hospital X in Batu City, East Java, Indonesia, and to examine the mediating roles of work-life balance and job satisfaction. Specifically, the study aims to determine the direct and indirect effects of flextime on employee performance, analyze the relationships between flextime, work-life balance, and job satisfaction, and identify the factors influencing the effectiveness of flextime arrangements. The research aims to provide insights into the implementation of flextime policies that enhance employee performance, work-life balance, and job satisfaction, ultimately contributing to improved organizational outcomes. Design/methodology/approach: The population in this study was all administrative personnel of Hospital X Batu City, East Java. Indonesia The sampling technique uses proportional random sampling with a sample of 112 respondents. Data were collected through questionnaires with Likert scales. The data is then analyzed using SEM-PLS with the help of SmartPLS application. Research Findings: The results of this study show that flexi-time has an effect on employee performance, while work-life balance and job satisfaction have an effect on mediating employee performance. Based on the results of flexi-time research is the result of the development of work-life balance that improves employee performance effectively and efficiently. Work-life balance and job satisfaction act as partial mediations on the effect of flexi-time on employee performance. Theoretical Contribution/Originality : The theoretical contribution of this research lies in its comprehensive examination of the impact of flextime on the performance of administrative employees at Hospital X in Batu City, East Java, Indonesia. The study explores the mediating role of work-life balance and job satisfaction in this relationship, providing valuable insights into the factors that influence employee performance in the hospital sector. This contribution is significant, as it addresses a pressing issue in the healthcare industry and offers practical recommendations for hospital administrators seeking to optimize employee performance and overall organizational Keywords: Flexi-time, work-life balance, job satisfaction, employee performance, hospital sector

Does the time spent in retirement improve health? An IV-Poisson assessment on the incidence of cardiovascular diseases

In recent decades, pension reforms have been implemented to address the financial sustainability of social security systems, resulting in an increase in the retirement age. This adjustment has led to ongoing debates about the relationship between retirement and health.This study investigates the impact of time spent in retirement on the risk of cardiovascular disease (CVD) in Italy. It uses a comprehensive dataset that includes socioeconomic, health, and behavioural risk factors, which is linked to administrative hospitalisation and mortality registers. To address the potential endogeneity of retirement, we employ an instrumental variables approach embedded in a Poisson rate model.The results show that, on average, years spent in retirement have a beneficial effect on the risk of CVD for both men and women. Each additional year spent in retirement reduces the incidence of such diseases by about 17% for men and 29% for women. Stratified analyses and robustness tests show that the benefits of retirement appear to be more robust and pronounced in men and in certain groups, particularly men in manual occupations or with poor ergonomic conditions at work.These results highlight that delaying access to retirement may lead to an increased burden of CVD in the older population. In addition, the protective effect of retirement on the development of CVD among workers with poorer ergonomic conditions underlines the different impact of increasing the retirement age on different categories of workers and the need for targeted and differentiated policies to avoid hitting the more vulnerable.

A Resident Led Newsletter Is a Powerful Communication Tool.

Communication with stakeholders for a graduate medical education (GME) program depends on shared visual and written content. Residency training programs are embracing social media as a communication channel. However, curated information that may only be viewed by subscribers or followers is difficult to archive and may appear overwhelming to novice users. An electronic, printable newsletter may be a unique communication tool for training programs to share information among residents, faculty, and hospital administration. We published a monthly electronic newsletter sent to all residents, teaching faculty, and additional stakeholders in our internal medicine residency program. We conducted an electronic anonymous survey and sent it to all residents in February 2023 and January 2024. The survey consisted of 5 questions to assess the satisfaction level of the newsletter. Sixty of 232 (25.9%) residents completed the survey. Of those, 44 (73.3%) residents were very satisfied regarding overall satisfaction, 39 (65.0%) residents were very satisfied with the overall content, and 42 (70.0%) residents were very satisfied with the timeliness of the information presented. Thirty-six (60%) residents reported the importance of having a resident-led newsletter. We found an overall high satisfaction level in a resident-led newsletter based on a survey completed by residents within our program. Most survey respondents deemed resident leadership crucial for the newsletter. We also received strong positive feedback from key stakeholders ranging from hospital administration to residency applicants.

Income gap between male and female psychiatric nurses in China: A national survey.

To investigate gender differences in the actual and expected income among psychiatric nurses in China. Although studies have shown that male nurses earn more than female nurses in other countries, there are no published data regarding gender income differences among psychiatric nurses in China. We conducted a cross-sectional study involving 41 representative psychiatric hospitals in China. Demographic, income, and job-related data were analyzed using the inverse probability of treatment weighting (IPTW) based on the propensity score. The sample included 9256 psychiatric nurses, and nearly four-fifths (79.3%) were female. Males earned slightly higher average monthly incomes than female nurses, while initial analysis showed no significant overall gender income difference (p>0.05). Notably, most participants (92.5%) desired an income increase of at least 10%, with over half (56.2%) expressing significant dissatisfaction with their current income. After adjustment using propensity score combined with IPTW, females in the junior and mid-level groups had significantly lower income than their male counterparts (all p<0.01), despite having different night shift patterns. However, there were no significant gender differences in actual or expected income among senior-level psychiatric nurses (p>0.05). A majority of psychiatric nurses in China express dissatisfaction with their current incomes and expect higher incomes. Male nurses earned significantly more than female nurses in the junior and mid-level professional groups, potentially due to their differences in night shifts. Policymakers and hospital administrators should optimize the income structures of nurses and develop targeted policies to address the gender income gap. Improving nurse income has the potential to enhance motivation and satisfaction within the profession.

Assessment of Factors and Level of Patient Satisfaction in Out-patient Department of a Private Hospital

Background: Measurement of patient satisfaction in the outpatient department (OPD) of a hospital can be used to evaluate and redesign the process of caregiving and to improve the quality of services. Sometimes study findings depend on the setting.Objectives: a) To identify the factors associated with the patient's experience, and satisfaction about health care services of Out-patient department(OPD) of Khwaja Yunus Ali Medical College Hospital receives multidisciplinary health services. b) To measure the satisfaction level regarding doctors, health assistance, and other auxiliary staff working in OPD to help patients.Materials and Methods: A cross-sectional study was conducted among 914 patients of age ranging from 1 to 80 years selected randomly from OPD between January 2021 and May 2021. A self-designed semi-structured questionnaire was developed to assess patients' satisfaction with health care services. Statistical analysis was done by online computer software.Results: Overall 92.23 % of the patients were satisfied with the behaviour of the doctors and 75.93 % were satisfied with the services of other staff, and the remaining 7.77% were unsatisfied with doctors' behaviour and 24 % with other staff services respectively.Conclusions: The percentages of unsatisfied patients were deficient. Various deficiencies should always be covered by the hospital administration that will turn into a good result of improvement in the hospital services for more satisfaction of the patients. KYAMC Journal Volume: 14, No: 04, January 2024: 234-239.

From crisis to care: A phenomenological exploration of how frontline nurses lived the onset of the coronavirus disease 2019 pandemic.

This paper explores how frontline nurses experienced the onset of the coronavirus disease (COVID-19) pandemic to provide appropriate care during a global health crisis. A qualitative descriptive phenomenological study. The sample consisted of 13 frontline nurses from Turkey, working in intensive care units, inpatient clinics and emergency unit. Data were collected online through face-to-face interviews based on a semi-structured interview guide. Data were analysed using thematic analysis. Nurses experienced certain difficulties in the continuous use of protective personal equipment, communication both with patients and colleagues, administrative processes. Besides, they experienced exhaustion, reduced job satisfaction and certain physical complaints. Hospital administrators and health policy makers should effectively manage human and hospital resources effectively and solve nurses' problems in times of crisis, such as pandemics. Understanding the challenges faced by frontline nurses during the onset of the COVID-19 pandemic may help healthcare practitioners and policy makers to implement targeted interventions, support mechanisms and resource allocation strategies that enhance the well-being of frontline nurses and optimise patient care delivery during health crises.

Logistics and administration-related stressors among young physicians working in the emergency medicine (EM) department and their perceived job satisfaction in EM department across hospitals of India: a nationwide multicentric digital survey

ObjectiveEmergency medicine (EM) is a growing specialty in India with the board approving training programme commencing only since 2009. This study aimed to identify the challenges faced by EM department...

The Unfolding Model of Voluntary Turnover: An Analysis and Evaluation.

Background and Purpose: Hospital nurse turnover is a global concern. This author aims to analyze and evaluate the unfolding model of voluntary turnover (UMVT) theory, initially theorized by Lee and Mitchell in 1991, to determine its current usage related to nursing turnover. Methods: A literature search was conducted using the search phrases "unfolding theory of turnover" and "unfolding model of voluntary turnover" to identify empirical evidence. Full-text, English-only journals that primarily utilized the UMVT theory on nurses or other service industries were selected for inclusion. Of the 57 articles identified, 11 were deemed appropriate for analysis. The six steps outlined by Walker and Avant (2019) were used for theory analysis, while Bedow's (2017) points of internal and external criticisms were used to evaluate the theory. Results: The UMVT theory has been tested on a variety of populations, including nurses. This has resulted in new insights into profession-specific turnover and understanding one's decision-making process related to turnover. Despite its decreased usage in the past decade, this theory still underscores benefits for hospital administrators to better understand nursing turnover. Although this theory is not currently ideal for explaining turnover in all populations, such as new graduate nurses or more irrational decision-makers, continued testing of the theory may provide new knowledge regarding voluntary turnover in nursing and highlight areas for refinement. Implications for Practice: The UMVT theory has demonstrated an ability to understand turnover in a variety of professions but remains underresearched internationally. Therefore, new opportunities to test this theory globally are present.

Nurse middle managers’ proactive work behavior: antecedents and consequences on innovative work behavior and job performance

PurposeHealthcare organizations require more proactive behaviors from nursing professionals. However, nurse managers’ proactivity has rarely been analyzed in the literature and little is known about the antecedents and consequences of their proactive behavior at work. This study examines the relationships between job characteristics (i.e. job autonomy and job variety), psychological empowerment, proactive work behavior and job effectiveness indicators (i.e. innovative work behavior, job performance). We tested a model in which psychological empowerment and proactive work behavior sequentially mediate the relationship between job characteristics and job effectiveness.Design/methodology/approachA cross-sectional study was conducted among nurse middle managers from a French hospital (N = 321). A hypothetical model was developed based on existing theory. Structural equation modeling was used to test the hypotheses.FindingsResults show that psychological empowerment and proactive work behavior fully mediate the relationship between job characteristics and innovative work behavior, and partially mediate the relationship between job characteristics and job performance.Originality/valueThis study provides insights for understanding how job characteristics can contribute to fostering the proactivity of nurse middle managers and how their proactive work behavior can be positively related to innovative work behavior and job performance. Findings raise several implications for hospital administrators and upper management seeking new ways to enhance nurse middle managers' proactive work behavior and push further their effectiveness at work.

EFFECTIVENESS OF ADMINISTRATIVE SERVICES AT ANANDA BEKASI HOSPITAL CONCERNING THE LEVEL OF PATIENT OR COMMUNITY SATISFACTION

As a health service institution such as a hospital, its responsibility is to provide services that meet the health needs of the community. Quality service health own roles important in increase health and well-being whole public. The aim of this research is to examine the effectiveness of administrative services at Ananda Bekasi Hospital and its impact on the level of community satisfaction. Through a comprehensive approach, this research evaluates hospital administration processes, including the registration process, patient data management, and communication with patients. Data was collected through interviews and observations to measure public perceptions of administrative services. The method used is by analyzing data to understand the contributing factors to levels satisfaction community as well as recommendations for improvements that can be made by Ananda Bekasi Hospital. Research results indicated that effectiveness service administration at Bekasi City Hospital had an impact positive to levels satisfaction public.

Linkage of administrative family court care proceedings and hospital records for mothers in England: linkage accuracy and cumulative incidence of family court care proceedings after a first live birth

IntroductionLinkage of public law family court care proceedings (CP) data to all women giving birth in NHS hospitals in England allows calculation of the cumulative incidence of CP involvement for mothers with first children born. ObjectivesTo assess linkage accuracy and determine the 10-year cumulative incidence of CP after a first live birth (FLB) for population subgroups. MethodNHS England linked records for mothers in Cafcass (Children and Family Court Advisory and Support Service) involved in CP (2007-2021) to all mothers with a delivery in England using Hospital Episode Statistics (HES: 1997-21). We calculated match rates and assessed indirect evidence of potential false positive and missed links. We used survival analyses to estimate cumulative incidence of CP within 10 years overall and for five-year maternal age groups at first live birth. ResultsOf 120,937 mothers involved in CP, 6.6% (n = 8,010) were excluded due to missing postcode or date of birth, or age &lt; 15 or &gt; 50. Of the remaining 112,927 mothers, 92,891 (82.8%) were linked to a HES delivery record. Match rates were lowest for mothers with an ethnic minority background, older at first case, or residing in Greater London, but improved over time. Of 3,572,737 mothers with a FLB, 38,462 had CP involvement. The cumulative incidence of CP at 10 years from FLB was 1.31% (95% Confidence Interval [CI]; 1.29-1.32) overall and highest in mothers aged 15--19 years (6.79%, 95% CI: 6.69-6.89) and those living in the most deprived areas (2.47%, 95% CI: 2.43-2.51). ConclusionOne in 77 of all mothers and one in 15 aged less than 20 at first live birth were involved in CP within 10 years. Linkage error may underestimate the incidence of CP for mothers in London or with an ethnic minority background.

Health informatics to enhance the healthcare industry's culture: An extensive analysis of its features, contributions, applications and limitations

BackgroundHealth informatics is a fast-growing area in the healthcare sector. It concerns the technologies, tools, equipment, and procedures required to gather, store, retrieve, and use health data and medical data. Healthcare informatics provides patients, nurses, hospital administrators, physicians, insurance providers, and other stakeholders with electronic access to medical records through health information technologies (HIT). Health informatics combines nursing science with data science and analytical disciplines to gather, handle, interpret, and convey data, bringing together specialists and making health information accessible and meaningful. MethodsThis research is an outcome of an extensive scopic review, which has been conducted by identifying research and development through search keywords such as “Health informatics,” “Technologies,” and “Healthcare” from databases of Scopus, PubMed, Google Scholar, ResearchGate, and other research platforms. Further, the most relevant papers are identified and studied. FindingsThis paper explores health informatics, its technologies, and their need in the present healthcare domain. It also identifies vital aspects, characteristics, and versatile contributions of health informatics to the healthcare sector. Further, the paper identifies and discusses significant health informatics applications in the healthcare field. Patients' health information can be effectively analysed individually or in groups using health informatics technologies to meet diverse requirements. InterpretationEffective use of health informatics improves practice management as information is quickly shared among healthcare professionals, patients and other stakeholders. Healthcare informatics specialists' knowledge of utilising data to assist choice-making and creating best practices. It enables healthcare organisations to identify specific data offering the appropriate information for the given therapy, procedure, or training. Informatics in healthcare also addresses issues at the macro level of the organisation and also at the personal level of patient care via innovative technologies and best practices.

Challenges of Family-Centered Care in a Neonatal Intensive Care Unit during the Visitation Restrictions After COVID-19 Pandemic Peak: A Qualitative Study of Parents’ and Nurses’ Perspectives

Family-centered care is crucial for parent-infant bonding and collaborative healthcare in neonatal intensive care units. COVID-19 visitation restrictions have hindered this care’s effectiveness and posed challenges in Thai units. This study, conducted in a southern Thailand hospital, explored nurses’ and parents’ perspectives on implementing family-centered care during restricted visitation policies, providing globally applicable insights. An exploratory-descriptive qualitative approach was used, involving semi-structuredinterviews with ten nurses and ten parents to explore their nuanced perspectives from June to August 2023. The interviews were conducted face-to-face, individually, using a semi-structured interview guide, and the transcripts were analyzed using thematicanalysis to identify significant themes. Findings from this study comprised five themes: 1) Having a mindset to involve parents in care, 2) Parents receiving psychological support, 3) Challenges of communication, 4) Negative impact of restricted visiting times, and 5) Accommodating flexible visiting hours in exceptional circumstances. Providing the best possible care for infants requires an adaptable and flexible approach to meet each family’s unique needs. Additionally, healthcare providers need to explore how they can implementfamily-centered care effectively during visiting restrictions in the NICU in different contexts. Further research is necessary to investigate the practical implementation of this by nurses and how hospital administrators can support it in Thai neonatal intensive care units under policies restricting family visits.

Expanding Integrated Physiatric Care: A Method to Building Capacity in Physical Medicine and Rehabilitation.

Siloed and episodic care delivery is often not equitable, high-quality, or sustainable. Transitioning from separate care settings, with potentially divergent care models, to an integrated care model is not always straightforward. Some experiences in expanding collaborative care between physiatrists and other healthcare providers for a variety of patient populations and care settings within a university physical medicine and rehabilitation (PM&R) division are shared as a means to inspire the uptake of care integration initiatives more broadly within the specialty. After an initial survey of care integration across multiple clinical sites, the university division: highlighted successful integrated care models; discussed integrated care models at every divisional retreat; reached out to clinicians in other specialties to collaboratively explore expansion; developed a "one-pager" on what physiatrists do; and invited collaborative specialists from integrated clinics to PM&R national and/or international meetings. Since 2019, divisional activity in integrated care has grown and evolved substantially. Future work will focus on: further expansion of integrated clinical care; scholarly evaluation of integrated care models; expansion of academic activity resulting from integration; and advocacy to healthcare providers, hospital administrators, and health system funders about the potential value of care integration in improving rehabilitation outcomes.

Investigating Nurses’ and Nurse Managers’ Experiences During the COVID-19 Pandemic: A Phenomenological Study

Background: Türkiye is ranked close to last among OECD countries in terms of the ‘number of nurses per 1,000 people’. Nurses and nurse managers already devotedly provided services under difficult conditions during normal periods before the pandemic, and this became even harder during the pandemic. Therefore, it is important to investigate the experiences of nurses and nurse managers during the pandemic to make improvement in nursing care for future possible pandemics. Objective: This study aimed to explore the experiences of nurses and nurse managers during the COVID-19 pandemic. Method: The study used the phenomenological qualitative approach. The sample consisted of 14 nurse managers and 14 nurses who were working during the COVID-19 pandemic. Data were collected via online voice and video calls using a semi-structured interview form. The findings were reported in accordance with the consolidated criteria for reporting qualitative research. Results: Following analysis of the data, the attitudes of nurse managers and nurses in Türkiye related to the COVID-19 pandemic challenges and experiences divided into three themes: “Communication”, “Training”, and “Working Conditions/Environment”. Conclusion: In the study, nurses emphasized that their work environments were negatively impacted during the COVID-19 pandemic. Additionally, it was concluded that nurse managers exerted significant efforts to facilitate communication, to meet nurses’ needs for training, and to improve staff nurses’ working conditions. Some nurses noted that hospital administrators and nursing service managers provided social and psychological support. The study also revealed that the sensitivity and genuine approach of nurse managers enhanced nurses’ resilience. Nurse managers’ management skills and nurses’ experiences during the pandemic provide valuable insights and evidence for effectively managing future pandemics and similar disasters.

Work engagement among nurses in the context of the COVID-19 pandemic: A systematic review.

Despite nurses receiving education on how to respond during crises, the stress and demands arising from unprecedented situations, such as the COVID-19 pandemic, may affect their work engagement. To appraise and synthesize studies examining work engagement among nurses in the context of the COVID-19 pandemic. It is a systematic review in which three databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed. Ethical approval was not required for this systematic review. A total of 21 studies were included. The results were classified into three categories: (1) levels and meanings of work engagement, (2) the relationship of work engagement with various factors, and (3) measures to enhance work engagement. The review revealed that nurses' work engagement varied from moderate to high. Factors such as education level and work schedule flexibility influenced their engagement. Positive associations were found between work engagement and job satisfaction, intention to stay, and organizational support, while stress and workload showed negative relationships. The crucial role of health policymakers, hospital administrators, and nurse managers in acting ethically, creating favorable working conditions and fostering nurses' work engagement was emphasized.

Addressing Healthcare Disparities through Community-Based Hospital Management Initiatives

Addressing healthcare disparities among underserved communities has become a pressing concern for healthcare providers and policymakers alike. This study aims to investigate the role of community-based hospital management initiatives in mitigating healthcare disparities and improving access to quality care. Utilizing a qualitative research approach, the study employs a multiple case study methodology to explore successful community-based hospital management initiatives implemented in various regions. Data was collected through semi-structured interviews with hospital administrators, healthcare professionals, and community stakeholders, as well as document analysis of hospital policies and reports. The findings reveal that community-based hospital management initiatives, such as community health worker programs, culturally tailored healthcare services, and collaborative partnerships with local organizations, can effectively address healthcare disparities by enhancing healthcare accessibility, cultural competence, and community engagement. However, the study also highlights challenges faced by hospitals, including limited resources, language barriers, and social determinants of health that require a multifaceted approach. The research concludes that community-based hospital management initiatives have the potential to bridge the gap in healthcare disparities, but their success relies on strong leadership, sustainable funding, and a genuine commitment to community empowerment and collaborative efforts with various stakeholders.

Gratitude and depressive symptoms in Chinese nurses: From a self-determination theory perspective.

A common psychological problem among nurses is depression, potentially affecting their well-being and job performance. It is vital to explore how to alleviate nurses' depressive symptoms. The current research explored the mediating impact of basic psychological needs satisfaction on the link of gratitude with depressive symptoms. The nurses in this study were from mainland China. A total of 724 subjects completed an online questionnaire, which included measures of depressive symptoms, basic psychological needs satisfaction and gratitude. Our research found that gratitude was negatively linked to depressive symptoms. Furthermore, basic psychological needs satisfaction had a partial mediation effect on the link of gratitude with depressive symptoms after controlling for five demographic variables. These results suggest that gratitude may influence depressive symptoms via basic psychological needs satisfaction. Our study found that basic psychological need satisfaction partially mediates the gratitude-depression relationship in nurses. The result means that hospital administrators and nurse leaders should design gratitude interventions to alleviate nurses' depressive symptoms. They also help nurses decrease depressive symptoms by creating an environment that meets their basic psychological needs.

Relationship between profitability and financial factors of hospitals after a period of austerity and health care reforms: evidence from Greece

PurposeThe reduction of government expenditure in the healthcare system, the difficulty of finding new sources of funding and the reduction in disposable income per capita are the most important problems of the healthcare system in Greece over the last decade. Therefore, studying the profitability of health structures is a crucial factor in making decisions about their solvency and corporate sustainability. The aim of this study is to investigate the effect of economic liquidity, debt and business size on profitability for the Greek general hospitals (GHs) during the period 2016–2018.Design/methodology/approachFinancial statements (balance sheets and income statements) of 84 general hospitals (GHs), 52 public and 32 private, over a three-year period (2016–2018), were analyzed. Spearman’s Rs correlation was carried out on two samples.FindingsThe results revealed that there is a positive relationship between the investigated determinants (liquidity, size) and profitability for both public and private GHs. It was also shown that debt has a negative effect on profitability only for private GHs.Practical implicationsIncreasing the turnover of private hospitals through interventions such as expanding private health insurance and adopting modern financial management techniques in public hospitals would have a positive effect both on profitability and the efficient use of limited resources.Originality/valueThese results, in conjunction with the findings of the low profitability of private hospitals and the excess liquidity of public hospitals, can shape the appropriate framework to guide hospital administrators and government policymakers.