Competencies Gap in Hospital Management in Tehran, Iran: A Cross-sectional Survey

Abstract

Competent managers are essential to the efficient, effective and responsive of hospitals. This study aims to determine the competencies gaps in hospital management. This cross-sectional survey was carried out using a self-administered questionnaire among 127 hospital managers in the Iran. The questionnaire included 61 items and 11 dimensions. Participants were completed on a five-point scale ranging the level of importance that each proposed competency had in their job and to indicate their proficiency in each skill. Managers felt most competent in terms of legal and ethical issues, health delivery, planning, change management. People management, leadership and strategic management and problem-solving were rated as being most important for the efficient and effective management of hospitals. The gaps were highest for people management (–0.97), leadership and strategic management (–0.82) and problem-solving (–0.80). The least skill gaps were in the areas of legal and ethical issues (–0.31), health service delivery (–0.32) and change management (–0.43). The findings of this study reflect the reality of the management in Iran and the needs of managers and will be helpful in the conceptualization, design and delivery of hospital management programmes aimed at improving current and future management and management capacity in the hospital in Iran.

<p>Leadership and Management Competencies for Hospital Managers: A Systematic Review and Best-Fit Framework Synthesis</p>

“…[1][2][3] In addition, inequities in health, lack of access to quality health care and a poorly skilled health workforce represent some of the major challenges facing many countries in the Eastern Mediterranean Region. 4,5 As a result, reforms have been implemented to improve the effectiveness and efficiency of service delivery at the organizational level including streamlining the management structure, focusing more on performance improvement and benchmarking service outcomes. 6,7 The changing healthcare landscape and requirements of service delivery require a new skillset for health professionals; therefore, a novel managerial approach is needed to lead and manage such transition and consolidation.…”

Developing competent public hospital managers: a qualitative study from Iran

“…Empirical evidence has also shown that managerial competencies are useful for monitoring and improving the performance of managers (Levenson et al, 2006) and improving the productivity of organisations (Macpherson and Holt, 2007). However, the application of such framework in Iran has been limited, most likely due to the lack of understanding of competency and task requirements for hospital managers (Kakemam and Dargahi, 2019b;Kalhor et al, 2016b). The effectiveness and benefits of current formal and informal management training in building hospitals managers' management capacity is doubtful (Kalhor et al, 2016b;Lankarani et al, 2013).…”

“…Furthermore, evidence indicates that managers may not have a full understanding of the complexities of the hospital sector and the health system and how different sectors in the same health system interact (Kalhor et al, 2016b;Lankarani et al, 2013) and lack strategic thinking capacity. The selection of hospitals managers in Iran is still primarily based on social connections rather than open and competitive procedures: a matter of "who you know" rather than what you know and what you are good at (Kakemam and Dargahi, 2019b;Kalhor et al, 2016b).…”

Managers’ Competences in Private Hospitals for Investment Decisions during the COVID-19 Pandemic

“…The hierarchy in charge of the hospital is established at the top of the organizational chart, in the form of shared power with the board of directors. The manager's role becomes relevant as the healthcare sector focuses on management of the population and relations with stakeholders [7] and can help in the response capacity and sustainability of health services [10].…”

“…A great majority of national health systems present serious financing problems, largely due to the change in the demographic paradigm and the introduction of new technology, which results in steadily increasing expenditure. According to Siskou et al [8], increased private expenditure on health and development of the sector are associated with the increased demand for services and the shortage of resources and public funding, leading the private sector to fill the gap through increased investment [9,10], but various studies…”