Results-Oriented Hospital Administration: Barriers and Perspectives of Synergies in a Public Hospital in Peru
César Antonio Bonilla-Asalde, Elizabeth Adrianzen, José Jáuregui, Jesús Quiroz, Errol Camacho, Oriana Rivera-Lozada
846
ABSTRACT
Aim. To determine the barriers and synergy
perspectives in the implementation of results-oriented hospital administration
in a public hospital in Peru.
Methods: Mixed study, with a descriptive and
cross-sectional designed survey administered to 97 staff members of a public
hospital in Callao, Peru, five in-depth interviews and two focus groups. The
studied dimensions were: strategic planning, budgeting for results, management
by process, meritocratic civil service and knowledge management. We undertook
an exploratory analysis and obtained central tendency and dispersion measures
with the quantitative data. The qualitative analysis was conducted following
the Grounded Theory procedures.
Results: A critical view of the hospital's
management and a favorable attitude towards change prevailed among the staff.
Barriers in all areas of exploration were identified, the most important were:
inadequate forms of planning and budget management, deficiencies in personnel
management and control mechanisms, and dysfunctions in organizational culture
and political context.
Conclusions: The introduction of
results-oriented hospital administration implies anticipating and addressing
structural and circumstantial problems of the institutions, with emphasis on
improving technical competences for strategic and budgetary planning, adopting
a participatory approach, facilitating information flow, establishing effective
monitoring and control systems, and transforming the organizational culture.
Keywords (DeCS): Hospital
administration; Health Policy, Planning and
Management; Strategic planning; Resources management.
ABSTRACT
Aim. To determine the barriers and synergy
perspectives in the implementation of results-oriented hospital administration
in a public hospital in Peru.
Methods: Mixed study, with a descriptive and
cross-sectional designed survey administered to 97 staff members of a public
hospital in Callao, Peru, five in-depth interviews and two focus groups. The
studied dimensions were: strategic planning, budgeting for results, management
by process, meritocratic civil service and knowledge management. We undertook
an exploratory analysis and obtained central tendency and dispersion measures
with the quantitative data. The qualitative analysis was conducted following
the Grounded Theory procedures.
Results: A critical view of the hospital's
management and a favorable attitude towards change prevailed among the staff.
Barriers in all areas of exploration were identified, the most important were:
inadequate forms of planning and budget management, deficiencies in personnel
management and control mechanisms, and dysfunctions in organizational culture
and political context.
Conclusions: The introduction of
results-oriented hospital administration implies anticipating and addressing
structural and circumstantial problems of the institutions, with emphasis on
improving technical competences for strategic and budgetary planning, adopting
a participatory approach, facilitating information flow, establishing effective
monitoring and control systems, and transforming the organizational culture.
Keywords (DeCS): Hospital
administration; Health Policy, Planning and
Management; Strategic planning; Resources management.