Training hospital managers for strategic planning and management: a prospective study

BMC Medical Education

Ulrich Laaser⁴  Vladimir Vasic¹  Jelena Marinkovic²  Milena Santric-Milicevic³  Dejana Vukovic³  Vesna Bjegovic-Mikanovic⁵  Zorica Terzic-Supic³ 

[1]Department of Statistics and Mathematics, Faculty of Economics, University of Belgrade, Belgrade, Serbia

[2]Institute of Medical Statistics and Informatics, University of Belgrade, School of Medicine, Belgrade, Serbia

[3]Institute of Social Medicine, University of Belgrade, School of Medicine, Belgrade, Serbia

[4]Section of International Public Health (S-IPH), Faculty of Health Sciences, University of Bielefeld, Bielefeld, Germany

[5]Centre-School of Public Health and Management, University of Belgrade, School of Medicine, Belgrade, Serbia

关键词: Professional development;    Strategic planning;    Hospital management;    Learning outcome;    Training;   

Others  :  1138454
DOI  :  10.1186/s12909-015-0310-9

 received in 2014-06-11, accepted in 2015-02-17,  发布年份 2015

【 摘 要 】

Background

Training is the systematic acquisition of skills, rules, concepts, or attitudes and is one of the most important components in any organization’s strategy. There is increasing demand for formal and informal training programs especially for physicians in leadership positions. This study determined the learning outcomes after a specific training program for hospital management teams.

Methods

The study was conducted during 2006 and 2007 at the Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade and included 107 participants involved in the management in 20 Serbian general hospitals. The management teams were multidisciplinary, consisting of five members on average: the director of the general hospital, the deputy directors, the head nurse, and the chiefs of support services. The managers attended a training program, which comprised four modules addressing specific topics. Three reviewers independently evaluated the level of management skills at the beginning and 12 months after the training program. Principal component analysis and subsequent stepwise multiple linear regression analysis were performed to determine predictors of learning outcomes.

Results

The quality of the SWOT (strengths, weaknesses, opportunities and threats) analyses performed by the trainees improved with differences between 0.35 and 0.49 on a Likert scale (p < 0.001). Principal component analysis explained 81% of the variance affecting their quality of strategic planning. Following the training program, the external environment, strategic positioning, and quality of care were predictors of learning outcomes. The four regression models used showed that the training program had positive effects (p < 0.001) on the ability to formulate a Strategic Plan comprising the hospital mission, vision, strategic objectives, and action plan.

Conclusion

This study provided evidence that training for strategic planning and management enhanced the strategic decision-making of hospital management teams, which is a requirement for hospitals in an increasingly competitive, complex and challenging context. For the first time, half of state general hospitals involved in team training have formulated the development of an official strategic plan. The positive effects of the formal training program justify additional investment in future education and training.

【 授权许可】

   
2015 Terzic-Supic et al.; licensee BioMed Central.

【 参考文献 】

• [1]David F: Strategic Management. Merrill Publishing Company, Columbus; 1989.
• [2]Liu CF, Rubenstein LV, Kirchner JE, Rortney JC, Parkins MW, Ober SK, et al.: Organizational Cost of Quality Improvement for Depression Care. Health Serv Res 2009, 44:225-44.
• [3]Pettersen IJ, Nyland K: Management and control of public hospitals-the use of performance measures in Norwegian hospitals, a case-study. Int J Health Plann Manage 2006, 21:133-49.
• [4]Garcia CM, de Val PI: Strategies and performance in hospitals. Health Policy 2004, 67:1-13.
• [5]McKee M, Helay J: Hospitals in a changing Europe. Open University Press, Buckingham; 2002.
• [6]Kim TH, Thompson JM: Organizational and market factors associated with leadership development programs in hospitals, a national study. J Healthc Manag 2012, 57:113-31.
• [7]Byars LL, Rue LW, Zahra SA: Strategic Management: Formulation and Implementation. Irwin, Chicago; 1996.
• [8]Lingham T, Richley B, Rezania D: An evaluation system for training programs, a case study using a four-phase approach. Career Dev Int 2006, 11:334-51.
• [9]Davies S: Health services management education: why and what? J Health Organ Manag 2006, 20:325-34.
• [10]Gregory D, Baigelman W, Wilson IB: Hospital economics of the hospitalist. Health Serv Res 2003, 38:905-18.
• [11]Hanlon NT: Sense of place, organizational context and the strategic management of publicly funded hospitals. Health Policy 2001, 58:151-73.
• [12]Goldstein IL, Ford JK: Training in organizations. Wadsworth, Belmont CA; 2002.
• [13]Pappas JM, Flaherty KE, Wooldridge B: Tapping into hospital champions – strategic middle managers. Health Care Manage Rev 2004, 29:8-6.
• [14]Geertshuis S, Holmes M, Geertshuis H, Clancy D, Bristol A: Evaluation of workplace learning. J Workplace Learn 2002, 14:11-8.
• [15]Collins BD: Performance-level evaluation methods used in management development studies from 1986 to 2000. Hum Resource Dev Rev 2002, 1:91-110.
• [16]Kirkpatrick D: Revisiting Kirkpatrick’s four – level model. American Society for Training and Development, Alexandria VA; 1996.
• [17]Mann S, Robertson IT: What should training evaluations evaluate? JEIT 1996, 20:14-20.
• [18]Rummler GA, Branche A: Improving Performance: How to Manage the White Space on the Organization Chart. Jossey Bass, San Francisco; 1995.
• [19]Wang GG, Wilcox D: Training evaluation, knowing more than is practiced. ADHR 2006, 8:528-39.
• [20]Kim CY, Cho SH: Institutionalization of quality improvement programs in Korean hospitals. Int J Qual Health Care 2000, 12:419-23.
• [21]Moller L, Mallin P: Evaluation Practices of instructional designers and organizational supports and barriers. PIQ 1996, 9:82-92.
• [22]Collins BD: Organizational performance: the future focuses of leadership development. J Leader Stud 2000, 7:43-54.
• [23]Philips PP, Philips JJ: Symposium on the evaluation of training. Int J Train Dev 2001, 5:240-7.
• [24]Unger JP, Marchal B, Green A: Quality standards for health care delivery and management in publicly oriented health services. Int J Health Plann Manage 2003, 18:s79-S88.
• [25]McCarthy M: Serbia rebuilds and reforms its health-care system. Lancet 2007, 369:360.
• [26]Markovic R, Vasic M, Segar C, Deljanin Z, Rancic N, Marjanovic S: Need for systematic education and training in health care management in the Republic of Serbia. Ata Fac Med Naiss 2009, 26:143-9.
• [27]O’Rourke M, Lukic N, Jones M, McCarley N: Management training and education to strengthen the nursing profession in Serbia. Manag Health 2011, 15:20-4.
• [28]Matovic Miljanovic S, Jankovic S: The international community and the reconstruction of health care in South Eastern Europe. J Public Health 2006, 14:246-56.
• [29]Nelson BD, Dierberg K, Scepanovic M, Mitrovic M, Vuksanovic M, Milic L, et al.: Integrating quantitative and qualitative methodologies for the assessment of health care systems, emergency medicine in post-conflict Serbia. Health Serv Res 2005, 5:1-11. BioMed Central Full Text
• [30]Zakon o komorama zdravstvenih radnika. Sluzbeni glasnik RS” br. 107/2005 i 99/2010. [http://www.paragraf.rs/propisi/zakon_o_komorama_zdravstvenih_radnika.html]
• [31]Zakon o zdravstvrnoj zastiti. Sluzbeni glasnik RS” br. 107/05, 72/09 – dr. zakon, 88/10, 99/10, 57/11, 119/12, 45/13 – dr. zakon i 93/2014. [http://www.paragraf.rs/propisi/zakon_o_zdravstvenoj_zastiti.html]
• [32]Lammintakanen J, Kivinen T, Kinnunen J: Managers’ perspectives on recruitment and human resource development practices in primary health care. Int J Circumpolar Health 2010, 69:462-9.
• [33]McHugh M, Johnston K, McClelland D: HRM and the management of clinicians within the NHS. Int J Public Sector Man 2007, 20:314-24.
• [34]Terzic Supic Z, Bjegovic V, Marinkovic J, Santric Milicevic M, Vasic V: Hospital management training and improvement in managerial skills, Serbian experience. Health Policy 2010, 96:80-9.
• [35]Ministry of Health of the Republic of Serbia. Finalized projects. International projects; 2007 [http://www.zdravlje.gov.rs/showpage.php?id=79]
• [36]Weihrich H: The TOWS matrix–a tool for situation analysis. Long Range Plann 1982, 15:54-66.
• [37]Vankova D, de Leeuw E: Public health human capacity building in Bulgaria – theory and application of SWOT analysis. I-JPHE 2001, 3:B 18-48.
• [38]van Wijngaarden JDH, Scholten GRM, van Wijk KP: Strategic analysis for health care organizations, the suitability of the SWOT-analysis. Int J Health Plann Manage 2012, 27:34-49.
• [39]Bernroider E: Factors in SWOT analysis applied to micro, small–to–medium, and large software enterprise: an Austrian study. Emerg Med J 2002, 20:562-73.
• [40]Klijn PH, van Stel HF, Quittner AL, van der Net HJ, Doeleman W, van der Schans CP, et al.: Validation of the Dutch cystic fibrosis questionnaire (CFQ) in adolescents and adults. J Cyst Fibros 2004, 3:29-36.
• [41]Yuksel I, Dagdeviren M: Using the analytic network process (ANP) in a SWOT analysis – a case study for a textile firm. Inform Sci 2007, 177:3364-82.
• [42]Expert Advisory Group: Principles of an evaluative approach to quality assurance. New Zealand Qualifications Authority, Auckland; 2007.
• [43]Pravilnik o pokazateljima kvaliteta zdravstvene zastite. Sluzbeni glasnik RS” br. 107/05. Clan 19. Zakon o zdravstvrnoj zastiti. „Sluzbeni glasnik RS” br. 107/05. [http://www.zdravlje.gov.rs/tmpmz-admin/downloads/zakoni1/Pravilnik_pracenje_kvaliteta.pdf]
• [44]Mennicken R, Kuntz L, Schwierz C: The trade-off between efficiency and quality in hospital departments. J Health Organ Manag 2011, 25:564-77.
• [45]Zuckerman AM: Advancing the state of the art in healthcare strategic planning. Front Health Serv Manage 2006, 23:3-1.
• [46]Adams J: Successful strategic planning: creating clarity. J Healthc Inf Manag 2005, 19:24-31.
• [47]Bart CK, Hupfer M: Mission statements in Canadian hospitals. J Health Organ Manag 2004, 18:92-110.
• [48]Forbes DJ, Seena S: The value of a mission statement in an association of not-for-profit hospitals. Int J Health Care Qual Assur Inc Leadership Health Serv 2006, 19:409-19.
• [49]Flessa S: Hospitals development plans: a new tool to break ground for strategic thinking in Tanzanian hospitals. Eur J Health Econ 2005, 6:s322-33.