Developing senior hospital managers: does ‘one size fit all’? – evidence from the evolving Chinese health system

Abstract

Background: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency. Methods: A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan,

A Call for Leadership and Management Competency Development for Directors of Medical Services—Evidence from the Chinese Public Hospital System

“…Level II hospitals are equivalent to secondary care facilities based in urban areas. Level 3 hospitals are tertiary care facilities usually based in a large metropolitan center [ 6 ].…”

“…In a medically dominated healthcare system, clinical directors have primary control of medical practices, determine the structure and arrangements of care delivery, and manage the entire system [ 5 ]. However, this may not be the case in the less well developed and medically dominated system in China [ 6 ].…”

“…However, as only a small proportion of managers have the opportunity of formal management training as a mean to advancing their management careers, even in a well-developed health system such as Australia [ 13 ], informal training and development become critical. Hence, the development of a health service management workforce requires a combination of formal education such as university degree programs focusing on health service management/administration, informal training and development with more short-term and flexible approaches to management workforce development, and in-service training, mentoring and coaching [ 6 , 9 ]. Participation in networking activities, seminars and conferences is also a widespread approach for professional development and skill enhancement [ 14 ].…”

“…The study confirmed that 65% of all hospital executives are clinical directors with a medical degree with a further 28% of hospital executives (mainly Directors of Nursing) with nursing qualifications. Less than 6% of all hospital executives (mainly Directors of Administration) came from neither medical nor nursing backgrounds [ 6 ].…”

“…Although the National Health Commission requires all health services managers to receive management training, meeting such requirements has proven challenging. Liang et al (2020a) summed up these challenges as the following: lack of agreed management standards and requirements; irrelevance of postgraduate training in management competency development; the absence of requirement of management qualifications for management positions, and the inability of embedding the assessment of management competence and management outcomes in regular performance appraisal of hospital managers providing limited incentives for continuous management training and development [ 6 ].…”