Management Of Healthcare Institutions Research Articles

Technology and Unemployment for Executives in Hospitals

Updated September 4, 2014.-----------------------------------------------------------------------------RETRACTION: The paper “Technology and Unemployment for Executives in Hospitals” by Jayr Figuereido, published in vol 7 (3) 2012, has been retracted by the editors because significant parts of the paper were plagiarized and without proper citation to the publication “Gondim, S. M. G., Estramiana, J. L. A., Luna, A. d. F., Oliveira, T. S. S. d., & Souza, G. C. d. (2010). Atribuicoes de causas ao desemprego e valores pessoais. Estudos de Psicologia (Natal), 15, 309-317”. This strong determination was taken by the editorial committee in order to correct this misbehavior and to compensate the detriment caused to the academic community. Apologies are offered to our readers for not having spotted this problem during the edition process. We are constantly introducing more tools in our editorial process in order to avoid plagiarism and abuses like the presented in this case. It is in our greatest concern to preserve the academic integrity of our publication.---------------------------------------------------------------Abstract: This study aims to investigate how managers of health care institutions explain the causes of unemployment, and how this explanation is related to their personal and family values, in accordance with Schwartz’s theoretical model. For that, we used two questionnaires: one analyzes the explanations for unemployment, and the other one is the Portrait Values Questionnaire (PVQ 21 – short version). Employed and formerly unemployed workers do not show any significant differences in explaining the causes of unemployment. On the other hand, regarding values, formerly unemployed workers show universalism and benevolence, values related to the self-transcendence dimension. Employed workers, in turn, show values of security, related to the conservatism dimension. The conclusion is that, even though technological innovations can affect the quality and quantity of employment, it does not determine its results, especially when we consider the national economy.

Decentralization of health services in India: barriers and facilitating factors.

In India, the process of decentralization of health services started taking shape in the mid-1990s. Systemic reforms envisaged delegation of administrative and financial responsibilities at district level for management of health-care institutions in 23 states of India in 1999. Subsequently, some of these reforms became part of the National Rural Health Mission (NRHM) launched in 2005. This study aims to document the process of decentralization in health services with special reference to the barriers and facilitating factors encountered during formulation and implementation of reform policies. Secondary data were reviewed, health facilities were observed, and semi-structured interviews of the key actors involved in decentralization were carried out in Haryana (India). Political and bureaucratic commitment to reforms was found to be the most important facilitating factor. Orientation training on decentralized administrative structures and performance-based resource distribution were the other important facilitators. Structural changes in administrative procedures led to improvement in the financial management system. Significant improvement in the public health infrastructure was observed. From 2004 to 2008, the state government increased the budget of health sector by nearly 60%. Frequent changes in the top administration at the state level hampered the decentralization process. Districts having a dynamic administrative leadership implemented decentralization more effectively than the rest. Decentralization of financial resources has improved the functioning of health services to some extent. Major policy decisions on decentralization of human resource management, increase in financial allocation, and greater involvement of community in decision-making are required.

Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis.

BackgroundProviding health care services in Africa is hampered by severe scarcity of personnel, medical supplies and financial funds. Consequently, managers of health care institutions are called to measure and improve the efficiency of their facilities in order to provide the best possible services with their resources. However, very little is known about the efficiency of health care facilities in Africa and instruments of performance measurement are hardly applied in this context.ObjectiveThis study determines the relative efficiency of primary care facilities in Nouna, a rural health district in Burkina Faso. Furthermore, it analyses the factors influencing the efficiency of these institutions.MethodologyWe apply a two-stage Data Envelopment Analysis (DEA) based on data from a comprehensive provider and household information system. In the first stage, the relative efficiency of each institution is calculated by a traditional DEA model. In the second stage, we identify the reasons for being inefficient by regression technique.ResultsThe DEA projections suggest that inefficiency is mainly a result of poor utilization of health care facilities as they were either too big or the demand was too low. Regression results showed that distance is an important factor influencing the efficiency of a health care institutionConclusionsCompared to the findings of existing one-stage DEA analyses of health facilities in Africa, the share of relatively efficient units is slightly higher. The difference might be explained by a rather homogenous structure of the primary care facilities in the Burkina Faso sample. The study also indicates that improving the accessibility of primary care facilities will have a major impact on the efficiency of these institutions. Thus, health decision-makers are called to overcome the demand-side barriers in accessing health care.

Towards hospital standardization in Europe

There is no simple tool to assess compliance with common national and European directives, guidance and professional advice on the management of healthcare institutions. Despite evidence of unacceptable variations in the protection of patient and staff safety little attention has been given to harmonizing the way services are organized and managed. Existing systems which define organizational standards, or assess compliance with them, are not in a position to extend this activity into or across national borders in Europe. Certification, accreditation and licensing programmes are too variable to provide a common basis for consistent assessment. Consensual standards would inevitably be minimal if they were to achieve acceptance by all or a majority of member state governments; they would not be standards for excellence or help the majority of organizations to improve performance. This paper proposes the development of a framework and measurement tool, initially for hospitals, which could be used for self-assessment or peer review to demonstrate compliance with European legislation, guidance and public expectations without infringing national responsibilities. A common code of management practice could be developed through a process similar to that adopted for clinical practice guidelines by the European commission-funded project on appraisal of guidelines research and evaluation. In practice, the legal relationships between member states and intergovernmental organizations inhibit the harmonization of management practice across-borders. Faster progress to higher levels of performance would be achieved by voluntary, non-regulatory cooperation of enthusiasts to define, measure and improve the quality of healthcare in European hospitals.

Management of Nigerian health care institutions: A cross sectional survey of selected health institutions in Abuja Nigeria

Health services management, which is described as the process of mobilizing and deploying resources for the efficient provision of effective health services, has taken the center stage in business discussions across the globe. Poor management is unanimously blamed for the diminishing fortunes of most health industries. The present study was designed to review the managerial skills of health administrators and their effects on health care services in Nigeria. It was also programmed to test the assumption that poor management is a direct consequence of poor management training and skills. Using an exploratory cross-sectional survey, self administered questionnaires were administered to managers of health care institutions in Abuja, Nigeria, and data were analyzed using standard statistical techniques. Most Nigerian health managers lacked adequate management knowledge and skills. The analysis established a significant relationship between unidentifiable leadership styles/administrative training and poor management of Nigerian health institutions (X2 = 9.68, p < 0.005). Training and improvement of management skills of health care managers will significantly ameliorate managerial problems of the health institutions (X2 = 56.85, p < 0.001), and a contingent management technique (CMT) among other recommendations for an effective and efficient health care industry is hereby proposed. Key words: Contingent management, health care, health managers, management, Nigeria.

Decentralization and health care in the former Yugoslav Republic of Macedonia

Since its independence in 1991, the Republic of Macedonia became a highly centralized state, with most relevant decisions taken at the central level in Skopje, resembling the highly centralized system, which once characterized Former Yugoslavia. As agreed in the Framework Agreement, which ended six months of internal conflict, the Macedonian Government will decentralize public services delivery, including social protection, health, education, and infrastructure over the course of the next few years. Within health care, it is argued that by placing policy-making authority and operating control closer to the client, decentralization will reduce some of the inequities in service provision and inefficiencies present within the current centrally controlled system. In principle, local voters will have more information on the price and quality of services, thereby increasing competition in the sector and strengthening the private sector. The emphasis on market incentives resulting in greater efficiency and better management of health care institutions is viewed as one of the benefits of privatization. Critics of decentralization and the subsequent privatization of public services fear it may result in an erosion of quality and consistency across regions, leaving some regions, cities, villages and potentially vulnerable groups worse off than others. The paper argues that if the institutional weaknesses in Macedonia have not been addressed, decentralisation could result in further excluding the rural population from health care provision. Similarly, the need for a clear delineation of responsibilities and functions among different levels and institutions is outlined.

Training in adult intensive care medicine in Spain

Spain. Likewise incorrectly Table 2 states that a physician can become qualified as a critical care specialist in Spain by subspecializing in this area while acquiring the specialist training in anesthesiology; as noted above, subspecialties are not legally recognized. Table 2 also misleadingly states that anesthesiologists receive 3–12 months’ training in critical care medicine. In fact, the vast majority of accredited training centers provide far less training in critical care, and anesthesiology residents dedicate only a few months of their 4-year program to intensive care medicine. It is clearly impossible to acquire the knowledge, skills, and aptitudes required of a critical care specialist in this way. Since the introduction of intensive care medicine as a legally recognized medical specialty in Spain nearly 30 years ago, the Spanish model of a 5-year residency program has become firmly established. The Spanish model of intensive medicine has proven to be efficient and is increasingly recognized as such by managers of healthcare institutions. More than 98% of public healthcare institutions and fully 100% of private hospitals with intensive care units relegate the care of critically ill patients to physicians having completed the 5-year residency program in intensive care medicine. Likewise, the role of postsurgical recovery areas under anesthesiologists’ care is for reanimation rather than for critically ill patients in most hospitals. For historical reasons that are not relevant to the purpose of this letter, critical care areas staffed solely/chiefly by anesthesiologists do exist in a few centers, but it is misleading to consider these situations to represent the norm or even a normal variant in intensive care medicine in Spain [2]. References

Risk Management in Health Care Institutions: A Strategic Approach, 2nd ed.

Journal For Healthcare Quality: May 2004 - Volume 26 - Issue 3 - p 56 doi: 10.1111/j.1945-1474.2004.tb00498.x

Temporal Reference Frameworks and Nurses' Work Organization

Drawing on a qualitative study exploring registered nurses' time management in health care institutions in the United Kingdom, this article reports the findings of the research, as far as they relate to the notion of temporal reference frameworks. The research suggests that temporal reference frameworks function to form background expectancies, which are of major influence in the way in which registered nurses manage their time. Temporal reference frameworks are usually implicit, socially constructed and give meaning to nurses' experiences of time. As such, they act to underpin practical knowledge and to function as time controls. Existing at different levels - individual, team and organizational - the article provides a focus as to how the temporal reference frameworks can match and relate with each other, or clash and as such be a source of conflict and tension.

El informe de la Organización Mundial de la Salud 2000: un juego de ordenador políticamente incorrecto

The World Health Organization Report 2000 is aimed at supporting an evidence-based development of health care systems in the world. The report has brought about a significant political and academic debate. This article reviews the contribution of the WHO Report to current health care policy, as well as analyzes and comments the main published critiques. Through a commented compilation of the health care reforms implemented over the last fifteen years in the world, WHO shifts radically its traditional position supporting now universal access to health care and a strong government's conduction role, but within a financial risk sharing environment, public and private co-operation and deregulation of the public management of health care institutions. WHO ranks in this report the 191 countries according to their health care systems' goal attainment and performance using a very weak, obscure and artificial methodology which has been opposed internationally. WHO is, however, committed to continue this initiative without apparently any major changes in the general and methodological approach.

Backstage in the theatre

Observations undertaken in the operating theatre suggested that the social environment, and certain forms of staff behaviour could be explained using the space analysis developed by Erving Goffman (1969) in The Presentation of Self in Everyday Life. In the study reported in this paper the theatre department was found to be a strongly 'backstage' area. However, it was also found that there were limits to this analysis, and these are explained within this article. Some practical suggestions as to how this analysis might be helpful in the management of health care institutions and the education of health care professionals are made.

Risk Management in Health Care Institutions: A Strategic Approach

Risk Management in Health Care Institutions: A Strategic Approach

Book Review : Risk Management in Health Care Institutions—Strategic Approach

Book Review : Risk Management in Health Care Institutions—Strategic Approach

Strategies for technology management in clinical engineering.

Clinical and Biomedical Engineering managers are in a position to utilize their management skills and apply analytical strategies to identify and capture cost savings opportunities in their institutions. To do so, however, they may be required to expand their scope and extend beyond what may have been their traditional areas of responsibility. This paper examines how management skills, techniques, and strategies were applied to establish a program to manage the repair of rigid and flexible surgical scopes. The program resulted in substantial cost savings, as well as other significant quantitative and qualitative benefits, and further demonstrated the value of proper technology management in healthcare institutions.

Productivity and Performance Management in Health Care Institutions

Productivity and Performance Management in Health Care Institutions

Productivity and Performance Management In Health Care Institutions

Productivity and Performance Management In Health Care Institutions

Unionization by Salaried Physicians and the Managerial-Employee Exclusion: The Need for a Modified Approach by the National Labor Relations Board

The increased concern with cost-containment and the cost-efficient delivery of medical services has led to fundamental changes in the management of health care institutions over the past few decades. Health care is becoming concentrated in large facilities, since they are perceived to have the resources to plan cost-efficient allocation and utilization of medical services. In the past, physicians provided most of the executive and administrative leadership in American health care facilities and used them primarily for the private practice of medicine. Today, professional administrators and bureaucrats run these institutions as large corporate entities. Moreover, more and more physicians are taking salaried positions, due in large part to the oversupply of doctors that developed during the 1970s and 1980s. In fact, some observers believe that in the near future, the majority of physicians will be “employees” of some kind.