This study examined the formative impact of general practice appraisals through a questionnaire given to GPs who had undergone appraisal at a primary care trust in Wessex, UK. The study found that appraisals increased GPs' confidence, improved patient care, and contributed to delayed retirement. Appraisals helped identify clear and achievable learning goals in areas like clinical skills, practice management, and personal development. Regular appraiser training and experience with multiple appraisals helped increase GPs' comfort with the process. The study provides insight into the educational benefits of appraisals when separated from revalidation requirements.
Health Informatics Journal - Balanced ScorecardJulius Veracion
The document summarizes the design and evaluation of a balanced scorecard for the health information management department at a large urban hospital in Canada. The creation of the balanced scorecard involved 6 months of planning, development, implementation, and evaluation. Key steps included aligning the scorecard with the hospital's strategy, identifying relevant metrics, gathering staff input, and conducting an evaluation survey. The majority of health information management staff agreed that the balanced scorecard is a useful reporting and management tool, supporting the success of developing it for the department. The process used to identify metrics can help other health information management departments create their own balanced scorecards.
the use of programme planning and social marketing models by a state public h...LisaIndah1
This document summarizes a case study that investigated the use of structured program planning models and social marketing principles within a state public health agency, the North Carolina Division of Public Health (NCDPH). Through interviews and surveys of program planners, the study found that while program planning was generally supported, few used a specific model or had a standardized planning process. Employees varied in their motivation, opportunity, and ability to use planning models and social marketing, with some seeing more barriers than others. Key factors that facilitated or hindered their use included individual understanding and skills, interpersonal support, and organizational resources and policies.
Running head DELIVERABLES AND CRITICAL SUCCESS FACTORS 1 .docxtodd271
Running head: DELIVERABLES AND CRITICAL SUCCESS FACTORS 1
Deliverables and Critical Success Factors
Chamberlain College of Nursing
Student Name here
NR 631: Nurse Executive Concluding Graduate Experience
September/October 2018
DELIVERABLES AND CRITICAL SUCCESS FACTORS 2
Deliverables and Critical Success Factors
Project deliverables and critical success factors (CSF’s) play an important role to
successful project management. Following a large number of hospital acquired pressure injuries
(HAPI) (Stage 2 or greater) acquired by patients while in the care of one of the units within the
Critical Care Division (Medical Intensive Care Unit, Surgical Intensive Care Unit, Cardiac
Intermediate Care Unit, or Neuro-Trauma Intermediate Care Unit) during the preceding fiscal
year – a decision to implement HRO (high-reliability) principles in conjunction with traditional
HAPI prevention strategies as a strategy to reduce HAPI was made.
HAPI’s can be a source of discomfort, pain, and altered body image for a patient. HAPI
development can negatively impact patient experience. Some studies estimate that the
prevalence of HAPI development within Critical Care could be as high as 43% (Krapfl, Langin,
Pike, & Pezzella, 2017). HAPI development within Critical Care can be extremely costly – costs
which will not be reimbursed by Centers for Medicare and Medicaid Services (CMS) (Boyle,
Bergquist-Beringer, & Cramer, 2017). Most HAPI’s are highly preventable and as clinicians -we
have an ethical and moral responsibility to prevent harm to our patients. In the paper below,
discussion surrounding project deliverables, critical success factors (CSF’s), and summarized
conclusion will be provided.
Project Deliverables
Project deliverables, for the HAPI prevention plan utilizing HRO principles in critical
care, include the following: scope statement, project charter, literature review, formal
communication plan, and critical success factors plan. The scope statement is developed at the
start of project planning; however, should be continuously reviewed and updated as
applicable. This is a crucial document for project planning and provides a comprehensive
DELIVERABLES AND CRITICAL SUCCESS FACTORS 3
outline of the project including project objectives, justification, implementation plan, resources
needed, project timeline, and measures of success (project goals/expected outcomes). Successful
resource planning, as detailed within a project scope statement, can be evaluated through
teamwork, organizational culture/receptivity to change, leadership support, development of
business plan/project vision, effective communication, and identification of project champions
(Orouji, 2016). These aspects can be measure through surveys (pre and post project) as well as
through organizational culture of safety surveys and employee engagement/satisfaction
surveys. Ad.
Cropped Paperbag Encompassing both comfort and style,.docxmydrynan
Cropped Paperbag: Encompassing both comfort and style, the paperbag is the perfect statement trouser without losing commercial viability. Cropped lengths are key. Also great with business causal.
o r i g i n a l a r t i c l e
Preventing Central Line–Associated Bloodstream Infections: A
Qualitative Study of Management Practices
Ann Scheck McAlearney, ScD, MS;1,2 Jennifer L. Hefner, PhD, MPH;1 Julie Robbins, PhD, MHA;1 Michael I. Harrison, PhD;3
Andrew Garman, PsyD, MS4,5
objective. To identify factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated
bloodstream infections.
design. Extensive qualitative case study comparing higher- and lower-performing hospitals on the basis of reduction in the rate of central
line–associated bloodstream infections. In-depth interviews were transcribed verbatim and analyzed to determine whether emergent themes
differentiated higher- from lower-performing hospitals.
setting. Eight US hospitals that had participated in the federally funded On the CUSP—Stop BSI initiative.
participants. One hundred ninety-four interviewees including administrative leaders, clinical leaders, professional staff, and frontline
physicians and nurses.
results. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting
to zero” infections. Although all sites reported this goal, at the higher-performing sites the goal was explicitly stated, widely embraced, and
aggressively pursued; in contrast, at the lower-performing hospitals the goal was more of an aspiration and not embraced as part of the strategy
to prevent infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level
commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
We present these strategies for prevention of healthcare-associated infection as a management “bundle” with corresponding suggestions for
implementation.
conclusions. Some of the variance associated with CLABSI prevention program outcomes may relate to specific management practices.
Adding a management practice bundle may provide critical guidance to physicians, clinical managers, and hospital leaders as they work to
prevent healthcare-associated infections.
Infect Control Hosp Epidemiol 2015;36(5):557–563
Central line–associated bloodstream infections (CLABSIs)
increase risk of prolonged hospitalization, morbidity, and
death, and result in substantial financial and nonfinancial
costs to health systems and society.1–3 CLABSI rates can be
significantly reduced by implementing a “bundle” of 5 clinical
practices: full-barrier precautions, chlorhexidine antiseptic
and sterile dressing, optimal vein selection, improved hand
hygiene, and prompt removal of unnecessary central line
catheters.2,4,5 This bundle, combined with dedicated line
insertio.
Assessment of healthcare providers’ collaboration at governmental hospitalsiyad shaqura
This is the presentation of master thesis in public health which was about the assessment of healthcare providers collaboration at governmental hospitals in Gaza Governorates in Palestine.
Lessons from pfm in the health sector finalHFG Project
Over the past five years, the Health Finance and Governance (HFG) project has supported over 35 countries and programs in their efforts to strengthen public financial management (PFM) systems. Activities have been tailored to address key priorities within a health system context, and have ranged from improving financial data systems to conducting costing exercises, financial analyses, and capacity-building workshops. Across these activities, several lessons have emerged.
Insights in this brief stem from analysis of over 200 HFG financing activities; interviews with stakeholders from Ukraine and Vietnam; and experience from cross-cutting program activities. These lessons are shared as a resource for fellow implementing partners, country practitioners, and donor agencies. As the project ends, this brief considers the global context and established frameworks for PFM alongside the contributions of the HFG experience, and suggests a way forward.
Myanmar Strategic Purchasing 5: Continuous Learning and Problem SolvingHFG Project
This is the fifth in a series of briefs examining practical considerations in the design and implementation of a strategic purchasing pilot project among private general practitioners (GPs) in Myanmar. This pilot aims to start developing the important functions of, and provide valuable lessons around, contracting of health providers and purchasing that will contribute to the broader health financing agenda. More specifically, it is introducing a blended payment system that mixes capitation payments and performance-based incentives to reduce households’ out-of-pocket spending and incentivize providers to deliver an essential package of primary care services.
This study examined the formative impact of general practice appraisals through a questionnaire given to GPs who had undergone appraisal at a primary care trust in Wessex, UK. The study found that appraisals increased GPs' confidence, improved patient care, and contributed to delayed retirement. Appraisals helped identify clear and achievable learning goals in areas like clinical skills, practice management, and personal development. Regular appraiser training and experience with multiple appraisals helped increase GPs' comfort with the process. The study provides insight into the educational benefits of appraisals when separated from revalidation requirements.
Health Informatics Journal - Balanced ScorecardJulius Veracion
The document summarizes the design and evaluation of a balanced scorecard for the health information management department at a large urban hospital in Canada. The creation of the balanced scorecard involved 6 months of planning, development, implementation, and evaluation. Key steps included aligning the scorecard with the hospital's strategy, identifying relevant metrics, gathering staff input, and conducting an evaluation survey. The majority of health information management staff agreed that the balanced scorecard is a useful reporting and management tool, supporting the success of developing it for the department. The process used to identify metrics can help other health information management departments create their own balanced scorecards.
the use of programme planning and social marketing models by a state public h...LisaIndah1
This document summarizes a case study that investigated the use of structured program planning models and social marketing principles within a state public health agency, the North Carolina Division of Public Health (NCDPH). Through interviews and surveys of program planners, the study found that while program planning was generally supported, few used a specific model or had a standardized planning process. Employees varied in their motivation, opportunity, and ability to use planning models and social marketing, with some seeing more barriers than others. Key factors that facilitated or hindered their use included individual understanding and skills, interpersonal support, and organizational resources and policies.
Running head DELIVERABLES AND CRITICAL SUCCESS FACTORS 1 .docxtodd271
Running head: DELIVERABLES AND CRITICAL SUCCESS FACTORS 1
Deliverables and Critical Success Factors
Chamberlain College of Nursing
Student Name here
NR 631: Nurse Executive Concluding Graduate Experience
September/October 2018
DELIVERABLES AND CRITICAL SUCCESS FACTORS 2
Deliverables and Critical Success Factors
Project deliverables and critical success factors (CSF’s) play an important role to
successful project management. Following a large number of hospital acquired pressure injuries
(HAPI) (Stage 2 or greater) acquired by patients while in the care of one of the units within the
Critical Care Division (Medical Intensive Care Unit, Surgical Intensive Care Unit, Cardiac
Intermediate Care Unit, or Neuro-Trauma Intermediate Care Unit) during the preceding fiscal
year – a decision to implement HRO (high-reliability) principles in conjunction with traditional
HAPI prevention strategies as a strategy to reduce HAPI was made.
HAPI’s can be a source of discomfort, pain, and altered body image for a patient. HAPI
development can negatively impact patient experience. Some studies estimate that the
prevalence of HAPI development within Critical Care could be as high as 43% (Krapfl, Langin,
Pike, & Pezzella, 2017). HAPI development within Critical Care can be extremely costly – costs
which will not be reimbursed by Centers for Medicare and Medicaid Services (CMS) (Boyle,
Bergquist-Beringer, & Cramer, 2017). Most HAPI’s are highly preventable and as clinicians -we
have an ethical and moral responsibility to prevent harm to our patients. In the paper below,
discussion surrounding project deliverables, critical success factors (CSF’s), and summarized
conclusion will be provided.
Project Deliverables
Project deliverables, for the HAPI prevention plan utilizing HRO principles in critical
care, include the following: scope statement, project charter, literature review, formal
communication plan, and critical success factors plan. The scope statement is developed at the
start of project planning; however, should be continuously reviewed and updated as
applicable. This is a crucial document for project planning and provides a comprehensive
DELIVERABLES AND CRITICAL SUCCESS FACTORS 3
outline of the project including project objectives, justification, implementation plan, resources
needed, project timeline, and measures of success (project goals/expected outcomes). Successful
resource planning, as detailed within a project scope statement, can be evaluated through
teamwork, organizational culture/receptivity to change, leadership support, development of
business plan/project vision, effective communication, and identification of project champions
(Orouji, 2016). These aspects can be measure through surveys (pre and post project) as well as
through organizational culture of safety surveys and employee engagement/satisfaction
surveys. Ad.
Cropped Paperbag Encompassing both comfort and style,.docxmydrynan
Cropped Paperbag: Encompassing both comfort and style, the paperbag is the perfect statement trouser without losing commercial viability. Cropped lengths are key. Also great with business causal.
o r i g i n a l a r t i c l e
Preventing Central Line–Associated Bloodstream Infections: A
Qualitative Study of Management Practices
Ann Scheck McAlearney, ScD, MS;1,2 Jennifer L. Hefner, PhD, MPH;1 Julie Robbins, PhD, MHA;1 Michael I. Harrison, PhD;3
Andrew Garman, PsyD, MS4,5
objective. To identify factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated
bloodstream infections.
design. Extensive qualitative case study comparing higher- and lower-performing hospitals on the basis of reduction in the rate of central
line–associated bloodstream infections. In-depth interviews were transcribed verbatim and analyzed to determine whether emergent themes
differentiated higher- from lower-performing hospitals.
setting. Eight US hospitals that had participated in the federally funded On the CUSP—Stop BSI initiative.
participants. One hundred ninety-four interviewees including administrative leaders, clinical leaders, professional staff, and frontline
physicians and nurses.
results. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting
to zero” infections. Although all sites reported this goal, at the higher-performing sites the goal was explicitly stated, widely embraced, and
aggressively pursued; in contrast, at the lower-performing hospitals the goal was more of an aspiration and not embraced as part of the strategy
to prevent infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level
commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
We present these strategies for prevention of healthcare-associated infection as a management “bundle” with corresponding suggestions for
implementation.
conclusions. Some of the variance associated with CLABSI prevention program outcomes may relate to specific management practices.
Adding a management practice bundle may provide critical guidance to physicians, clinical managers, and hospital leaders as they work to
prevent healthcare-associated infections.
Infect Control Hosp Epidemiol 2015;36(5):557–563
Central line–associated bloodstream infections (CLABSIs)
increase risk of prolonged hospitalization, morbidity, and
death, and result in substantial financial and nonfinancial
costs to health systems and society.1–3 CLABSI rates can be
significantly reduced by implementing a “bundle” of 5 clinical
practices: full-barrier precautions, chlorhexidine antiseptic
and sterile dressing, optimal vein selection, improved hand
hygiene, and prompt removal of unnecessary central line
catheters.2,4,5 This bundle, combined with dedicated line
insertio.
Assessment of healthcare providers’ collaboration at governmental hospitalsiyad shaqura
This is the presentation of master thesis in public health which was about the assessment of healthcare providers collaboration at governmental hospitals in Gaza Governorates in Palestine.
Lessons from pfm in the health sector finalHFG Project
Over the past five years, the Health Finance and Governance (HFG) project has supported over 35 countries and programs in their efforts to strengthen public financial management (PFM) systems. Activities have been tailored to address key priorities within a health system context, and have ranged from improving financial data systems to conducting costing exercises, financial analyses, and capacity-building workshops. Across these activities, several lessons have emerged.
Insights in this brief stem from analysis of over 200 HFG financing activities; interviews with stakeholders from Ukraine and Vietnam; and experience from cross-cutting program activities. These lessons are shared as a resource for fellow implementing partners, country practitioners, and donor agencies. As the project ends, this brief considers the global context and established frameworks for PFM alongside the contributions of the HFG experience, and suggests a way forward.
Myanmar Strategic Purchasing 5: Continuous Learning and Problem SolvingHFG Project
This is the fifth in a series of briefs examining practical considerations in the design and implementation of a strategic purchasing pilot project among private general practitioners (GPs) in Myanmar. This pilot aims to start developing the important functions of, and provide valuable lessons around, contracting of health providers and purchasing that will contribute to the broader health financing agenda. More specifically, it is introducing a blended payment system that mixes capitation payments and performance-based incentives to reduce households’ out-of-pocket spending and incentivize providers to deliver an essential package of primary care services.
This document summarizes research conducted to develop an internal communications plan for the Department of Pathology and Laboratory Medicine at the Hospital of the University of Pennsylvania. The research found that the department needs better mechanisms for information to flow both top-down and bottom-up, as well as across different labs and divisions. A survey found that line-level staff want more communication from leadership and rely on emails rather than management for information. The plan developed two phases to increase feedback, communication about changes, knowledge sharing, employee engagement, and cross-department communication.
Health Informatics - An International Journal (HIIJ) hiij
The Health Management Information System (HMIS) is an essential core component in framing the national health system. To operate six core components synchronically and to manage them successfully inside the health system, HMIS and communication are also placed centrally. However, the unworthy problems of HMIS data have been significantly affected by several characteristics. Among these characteristics, the organizational factors need to be considered as important issues. This systematic review aims to examine what organizational factors are determining the HMIS data quality in LMICs after 2005. Two independent reviewers selected 38 eligible primary published papers from 22 LMICs through three popular online sources: MEDLINE and PubMed, HINARI, and Google and Google Scholar. This finding mainly highlighted that weak organizational structuring and processing, less organizational learning development regarding HMIS, unavailability of HMIS resources, poor governance, and political issues impacted the HMIS data quality in LMICs.
A retrospective review of the Honduras AIN-C program guided by a community he...HFG Project
Factors that influence performance of community health workers (CHWs) delivering health services are not well understood. A recent logic model proposed categories of support from both health sector and communities influence CHW performance and program outcomes. This logic model has been used to review a growth monitoring program delivered by CHWs in Honduras, known as Atención Integral a la Niñez en la Comunidad (AIN-C). A retrospective review of AIN-C was conducted through a document desk review and supplemented with in-depth interviews. Documents were systematically coded using the categories from the logic model, and gaps were addressed through interviews. Authors reviewed coded data for each category to analyze program details and outcomes as well as identify potential issues and gaps in the logic model.
Running Head VAH PLAN REDUCTION OF VETERANS WAIT TIME .docxtoltonkendal
Running Head: VAH PLAN: REDUCTION OF VETERANS WAIT TIME 1
VAH PLAN: REDUCTION OF VETERANS WAIT TIME 3
Stakeholders
Stakeholder Analysis and Communication Plan
It will be important to partner with the organizations stakeholders for the development of a comprehensive patient care with no delays in treatment. The organization has a variety of stakeholders and partners e.g. Association of American Medical Colleges, Centers for Medicare and Medicaid Services Office of Minority Health and Human Rights Campaign just to name a few ( U.S Department of Veterans Affairs, 2017).The government, employees, lenders and interest groups among others are also key stakeholders who will impact positively on the project. Stakeholders such as interest groups, government agencies, lenders, and employees have the power to influence the quality care and experience for veterans. A thorough evaluation of the project will be required to enhance in the identification of the motivation and expectations of the key stakeholders before communication is done. The current situation at VAH is alarming due to increased death rates and therefore the project basis hopes to get positive feedback and support from the key and concerned stakeholders (Thompson, 2016). Upon understanding the main aims of the project and identifying the key aspects to be communicated to stakeholders, passing of the information will be done mainly in writing where the key issues will be addressed, desired approach to problem-solving and the expected outcomes.
References
U.S Department of Veterans Affairs. (2017). Partners and Stakeholders. Retrieved 02 28, 2018, from Office of Health Equity: https://www.va.gov/HEALTHEQUITY/Partners_Stakeholders.asp
Thompson, R. (2016). Stakeholder Analysis. Retrieved 02 28, 2018, from MindTools.com: https://www.mindtools.com/pages/article/newPPM_07.htm#Interactive
please look at the Mind Tool I posted in the Main Forum. That was what you were supposed to use for this assignment per the Business Plan paper. Be sure to complete it for your final business plan.
Part 3: Stakeholder Analysis and Communication Plan
Complete a stakeholder analysis to identify and prioritize the various stakeholders. Refer to the "Stakeholder Analysis - Winning Support for Your Projects," resource (located on the Mind Tools website) and complete all steps.
(https://www.mindtools.com/pages/article/newPPM_07.htm#Interactive
Include a communication plan for disseminating your action plan for all of the stakeholders. Which strategies do you plan to utilize and why? Your plan should demonstrate how you plan to use various types of communication channels to implement the plan.
In addition, explain how the communication plan addresses what you are hoping to achieve with your strategic goal.
While APA format is not required for the body of this assignment, solid academic writing is expe ...
Project OverviewThe course project is designed to provide studen.docxbriancrawford30935
Project Overview
The course project is designed to provide students with an opportunity to write a risk management plan specific to the banking industry. The project provides students with the opportunity to investigate the different aspects of business risk and risk management. It is also designed to help students assess their ability to analyze different aspects of financial decision making.
Due Date
Your final project is due in Module 06. There will be individual assignments along the way. The module they are due is noted in the time line below.
Time Line
Module
Assignment
01
Bank Risk Types and Trends
02
Identify Banking Risks
03
Mitigating Bank Risks
04
Bank Credit Risks
05
Bank Lending Practices
06
Risk Capital at a Bank and FINAL Project Submission
Requirements
Your final risk management plan must be 12 - 15 pages long. Your plan should have an introduction with a thesis statement. The body of your plan should be divided into at least 6 subject headings corresponding to your assignments in Modules 1 - 6. Your plan should have a conclusion that summarizes the main points and leaves the reader with a final thought. Your plan should be supported by research from at least 15 different sources. Include both in text citations and a References page in APA format.
Evaluation
Each assignment leading up to the final assignment is evaluated and graded independently. Your instructor will provide specific grading criteria for each step of the project prior to its due date
Running head: COMMUNICATION PLAN 1
COMMUNICATION PLAN 2
Communication Plan
Tiffiany Cooper
Grand Canyon University: LDR-620 Leading as a Manager
August 15, 2016
Communication plan
A communication plan refers to a set of strategies that are employed to give a vivid description of how one intends to communicate the results that they have obtained from a certain kind of an evaluation conducted. One of the strategies that I plan to utilize in my action plan is the formal communication channels to implement the plan. This refers to a channel of communication where the message is passed through means that are predefined (Sehgal, & Khetarpal, 2006). Although this channel of communication is slow, it has a high level of formality, and it is also very reliable in the passing of the message. In the implementation of the action plan, I will make use of the formal communication channel to pass the message to the doctors on the importance of ensuring that the patients who have been given the discharge orders have been discharged within the specified time frame.
The other strategy that I will employ in the implementation of my action plan is the informal communication. This refers to a channel of verbal communication whereby the interchange of the information does not make use of any specific channel. .
Clinical Assignment Quality Improvement Final Project GoalWilheminaRossi174
Clinical Assignment: Quality Improvement Final Project
Goal:
· Combine your Quality Improvement Project Part 1 through Part 3 and finalize the Quality Improvement Project.
· Compose a conclusion for your Quality Improvement Project.
Content Requirements:
1. A description of the clinical issue to be addressed in the project.
2. An assessment of clinical issue that is the focus of the quality improvement project.
3. A SWOT (strengths, weaknesses, opportunities, threats) analysis for the project. Analysis of the strengths, weaknesses, opportunities, and threats related to the quality improvement process.
4. An outline of the action plan for the project.
5. Discuss stakeholders and decision makers who need to be involved in the quality improvement project.
6. Discuss resources including budget, personnel and time needed for the quality improvement project.
7. Discuss potential strategies for implementation and evaluation.
8. Conclusion
Submission Instructions:
· Refine your Quality Improvement Project Part 1, Part 2, and Part 3 based on your instructor's feedback.
· The paper is to be clear and concise, and students will lose points for improper grammar, punctuation and misspelling.
· The final project is to be 8 - 12 pages in length and formatted per current APA, excluding the title, abstract and references page.
· Incorporate a minimum of 12 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
· Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
Running Head: QUALITY IMPROVEMENT PROJECT 3
QUALITY IMPROVEMENT PROJECT
Part 3
June 20, 2021
Quality Improvement Project
Action Plan
Outline
-Defining the scope of the recruitment work plan, nursing residency enhancement, and career development projects.
-Allocation of responsibilities to stakeholders of the project departments.
-Estimate and create workable timelines and activities for each team.
-Note down the budget for the project.
The project involves an action plan to ensure quality improvement in the nursing profession. It is based on the fact that there is a significant shortage of nursing practitioners, which directly affects their quality of service. The action plan itself involves defining the nature of the recruitment work plan, which will be in connection to the newly graduated nurses with no experience and using their feedback on the job to determine if they will retain them. The work plan will involve questionnaire interviews, group sessions, and one-on-one interviews about the state of the job as the nurse continues.
The action plan will also include research on the state of nursing residency facilities at different medical institutions and later crafting proposals to the medical center and the government department involved in their nursing residency facilities with recommendations. Th ...
Measuring What Counts in HIS - Balanced ScorecardsSudhendu Bali
This study aimed to develop a balanced scorecard (BSC) for a tertiary care private university hospital in Pakistan using a modified Delphi technique. An expert panel of clinicians and hospital managers identified and rated potential performance indicators according to importance, scientific soundness, relevance to strategy, feasibility, and modifiability. Of an initial 50 indicators, the panel selected 20 indicators across the four BSC domains of financial, customer, internal processes, and learning/growth. The resulting scorecard will be implemented to monitor performance, address measurement issues, and enable benchmarking with other settings. This represents one of the first attempts to implement BSC in a low-income country hospital setting.
Introduction
Planning
Definitions
Components
Types of health planning
Steps in planning process
Introduction
Planning
Definitions
Components
Types of health planning
Steps in planning process
Evaluation
Definitions..
Types
Steps in evaluation
Frame work for evaluation of public health program.
Conclusion.
References.
Discussion 1 Leadership Theories in Practice.docxbkbk37
1) The document discusses leadership theories and their effectiveness when applied in practice. It provides resources on transformational leadership and examines how well formal theories are implemented.
2) The author reflects on leadership behaviors from selected resources and examples of leaders effectively using skills like emotional intelligence and transformational leadership.
3) The effectiveness of applying these theories in impacting organizations is considered, with examples of both successes and limitations in real-world implementation.
A Process-Centered Approach to the Description of Clinical Pathways Forms and...Lisa Graves
This document summarizes a study that examined the forms of presentation of clinical pathways that physicians require in hospital information systems and electronic medical records. The study found that physicians need the presentation of clinical pathways to change depending on the phase of diagnosis and treatment. It identified some of the main factors that determine the choice of clinical pathway presentation. While not conclusive, the study provides initial directions for further research on optimal interface design in systems that support dynamic management of clinical pathways.
A Process-Centered Approach to the Description of Clinical Pathways Forms and...Jessica Navarro
This document summarizes a study that examined the forms of presentation of clinical pathways that physicians require in hospital information systems and electronic medical records. The study found that physicians need the presentation of clinical pathways to change depending on the phase of diagnosis and treatment. It identified some of the main factors that determine the choice of clinical pathway presentation. While not conclusive, the study provides initial directions for further research on optimal interface design in systems that support dynamic management of clinical pathways.
Evaluation of egypt population project eppkehassan
This document provides an independent evaluation of Parts A and B of the Egypt Population Project (EPP). It finds that the EPP achieved several objectives including breaking down social barriers to family planning, improving service provision, increasing contraceptive prevalence and vaccinations. It analyzes the effectiveness of project components like social change agents and microloans. Challenges included sustainability after phasing out funds. Lessons learned included the importance of partnerships and decentralized management. Further interventions were still needed in some communities.
Developing comprehensive health promotion - MedCrave Online PublishingMedCrave
As the global prevalence of obesity and chronic diseases continues to rise, the need for effective health promotion programs is imperative. Whilst research into effectiveness of health promotion programs is needed to improve population health outcomes, translation of these research findings into policy and practice is crucial. Translation requires not only efficacy data around what to implement, but also information on how to implement it.
http://medcraveonline.com/MOJPH/MOJPH-02-00007.pdf
The document discusses key concepts in health planning including:
1. The importance of health planning and different types and levels of planning.
2. The planning process which involves situation analysis, priority setting, option appraisal, programming, implementation, monitoring and evaluation.
3. Effective plans involve participation, are comprehensive, flexible, updated, realistic and time-phased. Planning helps balance views and formalize decisions.
The document discusses exploring clinical service lines of hospitals as business models for organizational and societal flourishing. It outlines a research process used to redesign the adult mental health outpatient services at a hospital using a Flourishing Business Canvas workshop. The workshop helped identify challenges with the current model and informed the creation of a new patient journey map to improve experiences.
Running head: QUALITY IMPROVEMENT
Quality improvement 1
Introduction
Health care system consists of various areas that have different functions, and these areas need improvement from time to time to improve the quality of services offered. One of these areas is health care literacy of patients especially the least served; it is defined as the ability of people to access, process and understand basic health information (Lie et al., 2012). An elaborate quality improvement is needed to ensure the provision of quality services. Therefore in a quality improvement plan, each and everyone has a role to play. From the board of directors, middle to department staff in data collection and reporting, reporting implementation progress, orientation and education of staff about the plan and finally evaluation of the plan. Comment by Earl: ok
Roles
Board of directors need to review the quality improvement plan, once approved oversee its implementation by CEO, directors, managers and the staff. Executive leadership oversees the implementation of the plan by the staff. The quality improvement committee analyzes the performance data, evaluates the data and determines the effectiveness of the plan, and makes recommendations on the progress. Medical staffs implement the quality improvement plan. Middle management manages staff and ensures implementation of the plan and is answerable to the executive leadership. The departmental staff handles ensuring that they play their specific role required of them in the implementation of the plan that involves their department (Barrera Jr et al., 2013). Comment by Earl: Discuss roles specific to your project in depth – this is too generic
Data collection and data reporting
Quality improvement committee handles data collection and reporting. The committee should collect data, evaluate and analyzes it and make the necessary recommendations. If the plan is adopted, they determine the functionality of the plan and what changes need to be made to ensure its effectiveness. Comment by Earl: Be specific; explore in more depth
The board of management responsible for reviewing the recommendations and decides whether to adopt them or not. Once they approve they give a go-ahead for its implementation. The management team will take the responsibility of overseeing its implementation.
Changes implemented
There are various changes that need to be implemented to improve health literacy among patients, especially in the underserved population. Firstly is to promote universal access to health information. There needs to be readily accessible health either through their Internet or read materials such as brochures to every patient and should be presented in the simplest manner for the patients to understand..
Co-located or embedded case management is a critical component of value-based care. The role of case managers has changed significantly over the past 25 years as the healthcare system has shifted from fee-for-service to value-based. Case managers are now seen as integral members of care teams in primary care offices, hospitals, and other settings. Having case managers embedded directly in these settings, rather than just co-located, has been shown to lead to more successful programs and better patient outcomes. As value-based programs and medical home models have expanded, the need for embedded case managers has grown substantially.
This document discusses the relationship between research evidence and decision making in the context of health system reform. It makes three key points:
1) While decisions are influenced by many factors besides evidence, good research can guide decision makers towards better policies by highlighting issues and limiting discretion. However, evidence must also be seen as an empowering tool.
2) Health system reform is currently widespread as countries address both old and new health challenges. Reform processes need research to illuminate unknowns, and a research agenda should be integral to every reform initiative.
3) Essential National Health Research (ENHR) has an important role by ensuring research priorities are participatory and address national problems. ENHR can contribute to reform at
The document discusses the role of DNP-prepared healthcare leaders and their positive impact on healthcare systems through improved patient outcomes, innovation, and influence. It also discusses strategies for implementing evidence-based guidelines in clinical practice, including identifying issues, searching for evidence, applying evidence, and evaluating impacts. Barriers to implementation include lack of training, unclear roles, and lack of buy-in from stakeholders. Overcoming barriers requires effective communication, collaboration, and addressing resistance to change by emphasizing benefits to patients and staff. Additional resources like meeting spaces and educational materials may be needed.
This standardized position description is for an Army Nurse (Clinical/Case Management) at grade GS-12. The nurse serves as a case manager on a multidisciplinary team, providing assessment, planning, implementation, coordination, evaluation and monitoring of patient care. Key responsibilities include developing plans of care for beneficiaries, facilitating communication between healthcare providers, and empowering patients to make informed healthcare decisions. The nurse also oversees nursing practice, develops clinical guidelines, and identifies strategies to improve access, quality and cost-effectiveness of care.
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
IT Risk Factors: Identify and mitigate risks related to your IT infrastructure.
Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
Clarity on Compliance: Clear up misconceptions and understand the reality of HIPAA regulations.
Ensure your compliance strategy is up-to-date and effective. Enroll now and be prepared for the 2024 HIPAA audits.
Enroll Now to secure your spot in this crucial training session and ensure your HIPAA compliance is robust and audit-ready.
https://conferencepanel.com/conference/hipaa-training-for-the-compliance-officer-2024-updates
This document summarizes research conducted to develop an internal communications plan for the Department of Pathology and Laboratory Medicine at the Hospital of the University of Pennsylvania. The research found that the department needs better mechanisms for information to flow both top-down and bottom-up, as well as across different labs and divisions. A survey found that line-level staff want more communication from leadership and rely on emails rather than management for information. The plan developed two phases to increase feedback, communication about changes, knowledge sharing, employee engagement, and cross-department communication.
Health Informatics - An International Journal (HIIJ) hiij
The Health Management Information System (HMIS) is an essential core component in framing the national health system. To operate six core components synchronically and to manage them successfully inside the health system, HMIS and communication are also placed centrally. However, the unworthy problems of HMIS data have been significantly affected by several characteristics. Among these characteristics, the organizational factors need to be considered as important issues. This systematic review aims to examine what organizational factors are determining the HMIS data quality in LMICs after 2005. Two independent reviewers selected 38 eligible primary published papers from 22 LMICs through three popular online sources: MEDLINE and PubMed, HINARI, and Google and Google Scholar. This finding mainly highlighted that weak organizational structuring and processing, less organizational learning development regarding HMIS, unavailability of HMIS resources, poor governance, and political issues impacted the HMIS data quality in LMICs.
A retrospective review of the Honduras AIN-C program guided by a community he...HFG Project
Factors that influence performance of community health workers (CHWs) delivering health services are not well understood. A recent logic model proposed categories of support from both health sector and communities influence CHW performance and program outcomes. This logic model has been used to review a growth monitoring program delivered by CHWs in Honduras, known as Atención Integral a la Niñez en la Comunidad (AIN-C). A retrospective review of AIN-C was conducted through a document desk review and supplemented with in-depth interviews. Documents were systematically coded using the categories from the logic model, and gaps were addressed through interviews. Authors reviewed coded data for each category to analyze program details and outcomes as well as identify potential issues and gaps in the logic model.
Running Head VAH PLAN REDUCTION OF VETERANS WAIT TIME .docxtoltonkendal
Running Head: VAH PLAN: REDUCTION OF VETERANS WAIT TIME 1
VAH PLAN: REDUCTION OF VETERANS WAIT TIME 3
Stakeholders
Stakeholder Analysis and Communication Plan
It will be important to partner with the organizations stakeholders for the development of a comprehensive patient care with no delays in treatment. The organization has a variety of stakeholders and partners e.g. Association of American Medical Colleges, Centers for Medicare and Medicaid Services Office of Minority Health and Human Rights Campaign just to name a few ( U.S Department of Veterans Affairs, 2017).The government, employees, lenders and interest groups among others are also key stakeholders who will impact positively on the project. Stakeholders such as interest groups, government agencies, lenders, and employees have the power to influence the quality care and experience for veterans. A thorough evaluation of the project will be required to enhance in the identification of the motivation and expectations of the key stakeholders before communication is done. The current situation at VAH is alarming due to increased death rates and therefore the project basis hopes to get positive feedback and support from the key and concerned stakeholders (Thompson, 2016). Upon understanding the main aims of the project and identifying the key aspects to be communicated to stakeholders, passing of the information will be done mainly in writing where the key issues will be addressed, desired approach to problem-solving and the expected outcomes.
References
U.S Department of Veterans Affairs. (2017). Partners and Stakeholders. Retrieved 02 28, 2018, from Office of Health Equity: https://www.va.gov/HEALTHEQUITY/Partners_Stakeholders.asp
Thompson, R. (2016). Stakeholder Analysis. Retrieved 02 28, 2018, from MindTools.com: https://www.mindtools.com/pages/article/newPPM_07.htm#Interactive
please look at the Mind Tool I posted in the Main Forum. That was what you were supposed to use for this assignment per the Business Plan paper. Be sure to complete it for your final business plan.
Part 3: Stakeholder Analysis and Communication Plan
Complete a stakeholder analysis to identify and prioritize the various stakeholders. Refer to the "Stakeholder Analysis - Winning Support for Your Projects," resource (located on the Mind Tools website) and complete all steps.
(https://www.mindtools.com/pages/article/newPPM_07.htm#Interactive
Include a communication plan for disseminating your action plan for all of the stakeholders. Which strategies do you plan to utilize and why? Your plan should demonstrate how you plan to use various types of communication channels to implement the plan.
In addition, explain how the communication plan addresses what you are hoping to achieve with your strategic goal.
While APA format is not required for the body of this assignment, solid academic writing is expe ...
Project OverviewThe course project is designed to provide studen.docxbriancrawford30935
Project Overview
The course project is designed to provide students with an opportunity to write a risk management plan specific to the banking industry. The project provides students with the opportunity to investigate the different aspects of business risk and risk management. It is also designed to help students assess their ability to analyze different aspects of financial decision making.
Due Date
Your final project is due in Module 06. There will be individual assignments along the way. The module they are due is noted in the time line below.
Time Line
Module
Assignment
01
Bank Risk Types and Trends
02
Identify Banking Risks
03
Mitigating Bank Risks
04
Bank Credit Risks
05
Bank Lending Practices
06
Risk Capital at a Bank and FINAL Project Submission
Requirements
Your final risk management plan must be 12 - 15 pages long. Your plan should have an introduction with a thesis statement. The body of your plan should be divided into at least 6 subject headings corresponding to your assignments in Modules 1 - 6. Your plan should have a conclusion that summarizes the main points and leaves the reader with a final thought. Your plan should be supported by research from at least 15 different sources. Include both in text citations and a References page in APA format.
Evaluation
Each assignment leading up to the final assignment is evaluated and graded independently. Your instructor will provide specific grading criteria for each step of the project prior to its due date
Running head: COMMUNICATION PLAN 1
COMMUNICATION PLAN 2
Communication Plan
Tiffiany Cooper
Grand Canyon University: LDR-620 Leading as a Manager
August 15, 2016
Communication plan
A communication plan refers to a set of strategies that are employed to give a vivid description of how one intends to communicate the results that they have obtained from a certain kind of an evaluation conducted. One of the strategies that I plan to utilize in my action plan is the formal communication channels to implement the plan. This refers to a channel of communication where the message is passed through means that are predefined (Sehgal, & Khetarpal, 2006). Although this channel of communication is slow, it has a high level of formality, and it is also very reliable in the passing of the message. In the implementation of the action plan, I will make use of the formal communication channel to pass the message to the doctors on the importance of ensuring that the patients who have been given the discharge orders have been discharged within the specified time frame.
The other strategy that I will employ in the implementation of my action plan is the informal communication. This refers to a channel of verbal communication whereby the interchange of the information does not make use of any specific channel. .
Clinical Assignment Quality Improvement Final Project GoalWilheminaRossi174
Clinical Assignment: Quality Improvement Final Project
Goal:
· Combine your Quality Improvement Project Part 1 through Part 3 and finalize the Quality Improvement Project.
· Compose a conclusion for your Quality Improvement Project.
Content Requirements:
1. A description of the clinical issue to be addressed in the project.
2. An assessment of clinical issue that is the focus of the quality improvement project.
3. A SWOT (strengths, weaknesses, opportunities, threats) analysis for the project. Analysis of the strengths, weaknesses, opportunities, and threats related to the quality improvement process.
4. An outline of the action plan for the project.
5. Discuss stakeholders and decision makers who need to be involved in the quality improvement project.
6. Discuss resources including budget, personnel and time needed for the quality improvement project.
7. Discuss potential strategies for implementation and evaluation.
8. Conclusion
Submission Instructions:
· Refine your Quality Improvement Project Part 1, Part 2, and Part 3 based on your instructor's feedback.
· The paper is to be clear and concise, and students will lose points for improper grammar, punctuation and misspelling.
· The final project is to be 8 - 12 pages in length and formatted per current APA, excluding the title, abstract and references page.
· Incorporate a minimum of 12 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
· Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
Running Head: QUALITY IMPROVEMENT PROJECT 3
QUALITY IMPROVEMENT PROJECT
Part 3
June 20, 2021
Quality Improvement Project
Action Plan
Outline
-Defining the scope of the recruitment work plan, nursing residency enhancement, and career development projects.
-Allocation of responsibilities to stakeholders of the project departments.
-Estimate and create workable timelines and activities for each team.
-Note down the budget for the project.
The project involves an action plan to ensure quality improvement in the nursing profession. It is based on the fact that there is a significant shortage of nursing practitioners, which directly affects their quality of service. The action plan itself involves defining the nature of the recruitment work plan, which will be in connection to the newly graduated nurses with no experience and using their feedback on the job to determine if they will retain them. The work plan will involve questionnaire interviews, group sessions, and one-on-one interviews about the state of the job as the nurse continues.
The action plan will also include research on the state of nursing residency facilities at different medical institutions and later crafting proposals to the medical center and the government department involved in their nursing residency facilities with recommendations. Th ...
Measuring What Counts in HIS - Balanced ScorecardsSudhendu Bali
This study aimed to develop a balanced scorecard (BSC) for a tertiary care private university hospital in Pakistan using a modified Delphi technique. An expert panel of clinicians and hospital managers identified and rated potential performance indicators according to importance, scientific soundness, relevance to strategy, feasibility, and modifiability. Of an initial 50 indicators, the panel selected 20 indicators across the four BSC domains of financial, customer, internal processes, and learning/growth. The resulting scorecard will be implemented to monitor performance, address measurement issues, and enable benchmarking with other settings. This represents one of the first attempts to implement BSC in a low-income country hospital setting.
Introduction
Planning
Definitions
Components
Types of health planning
Steps in planning process
Introduction
Planning
Definitions
Components
Types of health planning
Steps in planning process
Evaluation
Definitions..
Types
Steps in evaluation
Frame work for evaluation of public health program.
Conclusion.
References.
Discussion 1 Leadership Theories in Practice.docxbkbk37
1) The document discusses leadership theories and their effectiveness when applied in practice. It provides resources on transformational leadership and examines how well formal theories are implemented.
2) The author reflects on leadership behaviors from selected resources and examples of leaders effectively using skills like emotional intelligence and transformational leadership.
3) The effectiveness of applying these theories in impacting organizations is considered, with examples of both successes and limitations in real-world implementation.
A Process-Centered Approach to the Description of Clinical Pathways Forms and...Lisa Graves
This document summarizes a study that examined the forms of presentation of clinical pathways that physicians require in hospital information systems and electronic medical records. The study found that physicians need the presentation of clinical pathways to change depending on the phase of diagnosis and treatment. It identified some of the main factors that determine the choice of clinical pathway presentation. While not conclusive, the study provides initial directions for further research on optimal interface design in systems that support dynamic management of clinical pathways.
A Process-Centered Approach to the Description of Clinical Pathways Forms and...Jessica Navarro
This document summarizes a study that examined the forms of presentation of clinical pathways that physicians require in hospital information systems and electronic medical records. The study found that physicians need the presentation of clinical pathways to change depending on the phase of diagnosis and treatment. It identified some of the main factors that determine the choice of clinical pathway presentation. While not conclusive, the study provides initial directions for further research on optimal interface design in systems that support dynamic management of clinical pathways.
Evaluation of egypt population project eppkehassan
This document provides an independent evaluation of Parts A and B of the Egypt Population Project (EPP). It finds that the EPP achieved several objectives including breaking down social barriers to family planning, improving service provision, increasing contraceptive prevalence and vaccinations. It analyzes the effectiveness of project components like social change agents and microloans. Challenges included sustainability after phasing out funds. Lessons learned included the importance of partnerships and decentralized management. Further interventions were still needed in some communities.
Developing comprehensive health promotion - MedCrave Online PublishingMedCrave
As the global prevalence of obesity and chronic diseases continues to rise, the need for effective health promotion programs is imperative. Whilst research into effectiveness of health promotion programs is needed to improve population health outcomes, translation of these research findings into policy and practice is crucial. Translation requires not only efficacy data around what to implement, but also information on how to implement it.
http://medcraveonline.com/MOJPH/MOJPH-02-00007.pdf
The document discusses key concepts in health planning including:
1. The importance of health planning and different types and levels of planning.
2. The planning process which involves situation analysis, priority setting, option appraisal, programming, implementation, monitoring and evaluation.
3. Effective plans involve participation, are comprehensive, flexible, updated, realistic and time-phased. Planning helps balance views and formalize decisions.
The document discusses exploring clinical service lines of hospitals as business models for organizational and societal flourishing. It outlines a research process used to redesign the adult mental health outpatient services at a hospital using a Flourishing Business Canvas workshop. The workshop helped identify challenges with the current model and informed the creation of a new patient journey map to improve experiences.
Running head: QUALITY IMPROVEMENT
Quality improvement 1
Introduction
Health care system consists of various areas that have different functions, and these areas need improvement from time to time to improve the quality of services offered. One of these areas is health care literacy of patients especially the least served; it is defined as the ability of people to access, process and understand basic health information (Lie et al., 2012). An elaborate quality improvement is needed to ensure the provision of quality services. Therefore in a quality improvement plan, each and everyone has a role to play. From the board of directors, middle to department staff in data collection and reporting, reporting implementation progress, orientation and education of staff about the plan and finally evaluation of the plan. Comment by Earl: ok
Roles
Board of directors need to review the quality improvement plan, once approved oversee its implementation by CEO, directors, managers and the staff. Executive leadership oversees the implementation of the plan by the staff. The quality improvement committee analyzes the performance data, evaluates the data and determines the effectiveness of the plan, and makes recommendations on the progress. Medical staffs implement the quality improvement plan. Middle management manages staff and ensures implementation of the plan and is answerable to the executive leadership. The departmental staff handles ensuring that they play their specific role required of them in the implementation of the plan that involves their department (Barrera Jr et al., 2013). Comment by Earl: Discuss roles specific to your project in depth – this is too generic
Data collection and data reporting
Quality improvement committee handles data collection and reporting. The committee should collect data, evaluate and analyzes it and make the necessary recommendations. If the plan is adopted, they determine the functionality of the plan and what changes need to be made to ensure its effectiveness. Comment by Earl: Be specific; explore in more depth
The board of management responsible for reviewing the recommendations and decides whether to adopt them or not. Once they approve they give a go-ahead for its implementation. The management team will take the responsibility of overseeing its implementation.
Changes implemented
There are various changes that need to be implemented to improve health literacy among patients, especially in the underserved population. Firstly is to promote universal access to health information. There needs to be readily accessible health either through their Internet or read materials such as brochures to every patient and should be presented in the simplest manner for the patients to understand..
Co-located or embedded case management is a critical component of value-based care. The role of case managers has changed significantly over the past 25 years as the healthcare system has shifted from fee-for-service to value-based. Case managers are now seen as integral members of care teams in primary care offices, hospitals, and other settings. Having case managers embedded directly in these settings, rather than just co-located, has been shown to lead to more successful programs and better patient outcomes. As value-based programs and medical home models have expanded, the need for embedded case managers has grown substantially.
This document discusses the relationship between research evidence and decision making in the context of health system reform. It makes three key points:
1) While decisions are influenced by many factors besides evidence, good research can guide decision makers towards better policies by highlighting issues and limiting discretion. However, evidence must also be seen as an empowering tool.
2) Health system reform is currently widespread as countries address both old and new health challenges. Reform processes need research to illuminate unknowns, and a research agenda should be integral to every reform initiative.
3) Essential National Health Research (ENHR) has an important role by ensuring research priorities are participatory and address national problems. ENHR can contribute to reform at
The document discusses the role of DNP-prepared healthcare leaders and their positive impact on healthcare systems through improved patient outcomes, innovation, and influence. It also discusses strategies for implementing evidence-based guidelines in clinical practice, including identifying issues, searching for evidence, applying evidence, and evaluating impacts. Barriers to implementation include lack of training, unclear roles, and lack of buy-in from stakeholders. Overcoming barriers requires effective communication, collaboration, and addressing resistance to change by emphasizing benefits to patients and staff. Additional resources like meeting spaces and educational materials may be needed.
This standardized position description is for an Army Nurse (Clinical/Case Management) at grade GS-12. The nurse serves as a case manager on a multidisciplinary team, providing assessment, planning, implementation, coordination, evaluation and monitoring of patient care. Key responsibilities include developing plans of care for beneficiaries, facilitating communication between healthcare providers, and empowering patients to make informed healthcare decisions. The nurse also oversees nursing practice, develops clinical guidelines, and identifies strategies to improve access, quality and cost-effectiveness of care.
Similar to Results-Oriented Hospital Administration Barriers and Perspectives.pdf (20)
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
IT Risk Factors: Identify and mitigate risks related to your IT infrastructure.
Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
Clarity on Compliance: Clear up misconceptions and understand the reality of HIPAA regulations.
Ensure your compliance strategy is up-to-date and effective. Enroll now and be prepared for the 2024 HIPAA audits.
Enroll Now to secure your spot in this crucial training session and ensure your HIPAA compliance is robust and audit-ready.
https://conferencepanel.com/conference/hipaa-training-for-the-compliance-officer-2024-updates
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
COPD Treatment in Ghatkopar,Mumbai. Dr Kumar DoshiDr Kumar Doshi
Are you or a loved one affected by Chronic Obstructive Pulmonary Disease (COPD)? Discover comprehensive and advanced treatment options with Dr. Kumar Doshi, a preeminent COPD specialist based in Ghatkopar, Mumbai.
Dr. Kumar Doshi is dedicated to delivering the highest standard of care for COPD patients. Whether you are seeking a diagnosis, a second opinion, or exploring new treatment avenues, this presentation will guide you through the exceptional services available at his practice in Ghatkopar, Mumbai.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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Gemma Wean- Nutritional solution for Artemiasmuskaan0008
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
By offering a variety of massage services, our Ajman Spa Massage Center can tackle physical, mental, and emotional illnesses. In addition, efficient identification of specific health conditions and designing treatment plans accordingly can significantly enhance the quality of massaging.
At Malayali Kerala Spa Ajman, we firmly believe that everyone should have the option to experience top-quality massage services regularly. To achieve that goal we offer cheap massage services in Ajman.
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We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
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The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
MYASTHENIA GRAVIS POWER POINT PRESENTATIONblessyjannu21
Myasthenia gravis is a neurological disease. It affects the grave muscles in our body. Myasthenia gravis affects how the nerves communicate with the muscles. Drooping eyelids and/or double vision are often the first noticeable sign. It is involving the muscles controlling the eyes movement, facial expression, chewing and swallowing. It also effects the muscles neck and lip movement and respiration.
It is a neuromuscular disease characterized by abnormal weakness of voluntary muscles that improved with rest and the administration of anti-cholinesterase drugs.
The person may find difficult to stand, lift objects and speak or swallow. Medications and surgery can help the patient to relieve the symptoms of this lifelong illness.
Results-Oriented Hospital Administration Barriers and Perspectives.pdf
1. ORIGINAL ARTICLE
P J M H S Vol. 14, NO. 2, APR – JUN 2020 846
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
Norbert Wiener Private University
Correspondence to César Antonio Bonilla Asalde, Email: cesar.bonilla@uwiener.edu.pe; Mobile phone +51 958975406).
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.
INTRODUCTION
Results-oriented management is a public management
strategy that involves making decisions on the effects that
government action has on society1.2
and it is, at the same
time, a model of resources administration focused on the
fulfillment of actions defined for a specific period and with
certain resources3.4
.
Public hospitals require conditions that allow them to
perform their functions efficiently and effectively. Therefore,
it is important that they implement management models
that contribute to the impact of their interventions5.6
.
Similarly, various changes that have occurred in recent
decades (geopolitical, demographic and economic,
epidemiological transition, among others) represent new
challenges and encourage administrators to seek new and
better forms of administration7
.
In Peru, the search for solutions regarding these
challenges has led managers to the adoption of new
results-based models of public administration in various
sectors of the country, including health institutions. They
are part of a fragmented health system, which operates
under traditional bureaucratic schemes. Thus, hospitals try
to modernize their administration applying new models
established by the country’s authorities, with components
such as: strategic and operational planning, budgeting for
results, management by process, meritocratic civil service
and knowledge management8
.
However, even though there is evidence that shows
the advantages of results-based management9,10
, the
traditional management approach continues to be the
predominant paradigm, whose failure has precisely
motivated the search for improvement11
. In this regard, it is
necessary to know what difficulties the institutions are
experiencing and the factors that would facilitate the
change. Therefore, the objective of this study is to
determine the barriers and synergy perspectives regarding
the implementation of results-oriented hospital
administration in a public hospital in Peru through the
exploration of the perspectives of decision makers.
METHODOLOGY
This study used a mixed approach: quantitative and
qualitative. For the quantitative part, an observational and
cross-sectional descriptive design was used, applying a
survey to anintentional non-probability sample composed of
97 administrative and care area managers at the Daniel
Alcides Carrión National Hospital (DACNH) in Callao, Peru.
A structured questionnaire with a Likert-type response
format was used, considering five major dimensions:
strategic and operational planning, budgeting for results,
management by process, meritocratic civil service and
knowledge management. The instrument was validated by
five experts and with primary sources. Thus, the reliability
was determined by the Cronbach's Alpha coefficient, with a
value equal to 0.785. The SPSS V25.0 program was used
for analysis and for obtaining central tendency and
dispersion measures.
In the qualitative approach, we worked with 20
officials selected incidentally (10 from the care area and 10
from the administrative area), with whom we conducted five
in-depth individual interviews and two focus groups, which
were recorded on audio and then transcribed. The analysis
was done using the program Atlas.ti V7 by following
Grounded Theory procedures12
. A total of 532 coded
2. Barriers and Perspectives of Synergies
847 P J M H S Vol. 14, NO. 2, APR – JUN 2020
citations were obtained, which were used for descriptive
and comparative analysis of the data, and for the
elaboration of syntheses.
Finally, in the triangulation process, we proceeded to
the contrast and comparison between the quantitative and
qualitative data, to identify coincidences and differences.
The study was approved by the DACNH’s Institutional
Research Ethics Committee. The study participants gave
their informed consent and their identity was protected.
RESULTS
General characteristics: Table 1 shows some
characteristics of the survey respondents. As we can see,
there were slightly more men than women, most of them
with a permanent appointment in the labor system, and
more than half had previous experience in management
positions. The most common education level was complete
undergraduate studies, followed by a specialty. Very few
officials reported having graduate studies.
Strategic and operational planning: The 64.9% of
officials reported having an indifferent opinion on this
dimension, followed by 25.8% who were in favor and 9.3%
who were against. Table 2 shows that most of the sample
believed that the institutional plan should be updated; few
of them agreed with the current plan or its vision and
mission, and a large proportion of the sample felt that the
hospital's weaknesses outweighed its strengths. Positions
were more nuanced regarding funding as a difficulty in
fulfilling the plan.
In the qualitative exploration, the officials identified
weaknesses in the development of the strategic plans and
in the bodies responsible for their formulation. They
mentioned that, particularly, there was a lack of connection
between those bodies and the operational areas, and a
lack of understanding of the reality in which the plans
should be implemented.
The plan. was formulated by the management team,
but no one from the operational team has been involved...
These documents are not shared or discussed with those
who are going to do the operational part, in the end... they
do not usually materialize (Focus Group 1).
Other problems mentioned were the scarcity of
reliable information to develop the plans, the need for
planning specialists, tensions between the Hospital and the
Regional Government of Callao, and the "lack of
knowledge" of the plans among the staff. The officials
recognized that the hospital's own internal organization
imposed barriers to coordination, both in planning and in
day-to-day work.
On the other hand, the officials made
recommendations to overcome planning problems. Among
them we have: to seek "technical competence" (planning
specialists); introduce an approach that takes into account
the Hospital’s problems and needs; and adopt a
participatory and deliberative approach, involving more
actors in the planning process. One consensus position
was to introduce effective training, communication and
dissemination measures regarding the plans. And, along
with these recommendations, it was mentioned that it was
necessary to encourage the staff to have greater
"commitment" and "motivation".
Budgeting for results (BfR): The 63.9% of staff reported
having an indifferent opinion regarding the budgeting for
results dimension, followed by 34% with a favorable
opinion, and only 2.1% with an unfavorable opinion. Table
3 shows that slightly less than half considered that activities
at the Hospital should be funded under the BfR scheme.
There are divided positions regarding knowledge of BfR-
funded activities; and something similar occurs with the
perception of alignment between the institutional strategic
objectives and the funding of their activities, although, at
this point, the neutral and disagreement position
predominated.
In the qualitative approach, some participants
associated the "budget" topic only with the lack of
resources they experienced. Others knew and valued the
BfR methodology positively, but highlighted that it was not
adequately applied in the institution and perceived a
"disorder" in resource management.
[BfR] is not being respected.It is believed that this money
has to be spent in a disorganized, untimely way and not
really respecting what they were created for, right?, based
on goals and production, public policy guidelines (Interview
1).
The respondents also mentioned that there was a
disconnection between BfR and the reality in which it is
applied, which would create problems in budget execution
and accountability. In addition, there is a lack of knowledge
of BfR management, and an inadequate use of resources
due to rushing and deadlines.
People who take responsibility for a certain amount of
money don't often know they have that amount and... the
reality does not help them either to respond about the
execution of that amount. And when they are told "hey,
look, the year is going to end and you have this money
left", they rush and time is not enough and they start
distributing expenditures wherever (GF1).
The use of resources from a specific budget line to
address other items was repeatedly mentioned, in addition
to a lack of coordination and even conflicts in the BfR
management. Some participants attributed these
"disorders" to deficiencies in planning.
It was also mentioned that there were ineffective
control mechanisms for budget management, both in the
Hospital and in the Ministry of Health, including ineffective
ways to monitor, measure and evaluate progress.
Indeed, one of the main recommendations regarding BfR
was to strengthen control systems at different levels. Also,
it was proposed to improve budget programming from the
planning stage with greater openness to the participation of
those who are most familiar with the distribution and use of
resources.
Management by process: The 60.8% of officers
expressed an indifferent opinion on this dimension in
general, followed by 24.7% with an unfavorable opinion
and only 14.4% with a favorable opinion. As we can see in
table 4, the respondents considered that the hospital
workers scarcely knew the goals that would lead to the
achievement of the institutional objectives, and even only a
third of them thought that the managers knew such goals, a
similar figure was found in the consultation on knowledge
of the institutional quality principles. Moreover, less than
the half of the respondents estimated that workers knew
3. César Antonio Bonilla-Asalde, Elizabeth Adrianzen, José Jáuregui et al
P J M H S Vol. 14, NO. 2, APR – JUN 2020 848
the objectives and functions of their units, almost the same
proportion as those who believed that managers knew the
performance indicators.
The qualitative analysis showed that several staff
members approved the idea of process-based
management and handled its schemes and concepts.
However, most of them recognized deficiencies in this
area, stating that it simply did not apply in the hospital, or
that it would be applied ineffectively: "I would say that there
is no process design... [and] if there are some processes
that are made, they need to be redesigned" (GF1). Failed
attempts to introduce the strategy were mentioned as well:
The hospital does not work with processes. On many
occasions, in many years of management, attempts have
been made to work on the basis of processes (GF1).
The idea of "disorder" was again expressed under this
item. Several officials saidthat the entities where
management instruments are formulated were the origin of
the problems, and also that there was an apparent conflict
between overlapping regulations and the absence of
control.
Since there is not an audit of the processes that we
have and that we have, in many cases, [to] redesign, and...
they are not formalized, because... all those management
documents that need to be approved are not
operationalized in a timely manner... Unfortunately, as they
are Region [Regional Government] they had to validate it
with a technical team that had no national or public idea.
And they gave us norms that are still in force; many of them
also contradict each other (GF1).
However, another position was also expressed that places
the barriers in the organizational culture itself, with various
areas of the institution operating more as "fiefdoms" than
as interrelated parts of a system.
With regard to the goals and indicators, the predominant
perception was that they are known only by those who
prepare the management documents, something that was
repeated when discussing the principles of institutional
quality. The participants agreed that the "majority" of
workers are unaware of the goals, indicators and principles,
a situation that several attributed to poor communication:
"Nobody knows that. There is no dissemination. If they
don't exist or if the managers and the staff are not prepared
, it doesn't work" (E5). For others, however, this lack of
knowledge is due to the "lack of motivation" and the poor
worker "commitment" which come from problems in labor
relations (such as salaries and incentives). In addition,
there is a lack of effective mechanisms for monitoring
indicators and evaluating goals achievement.
Thus, the proposed solutions focused on improving
communication channels, changing the organizational
culture, optimizing planning and process design, and the
effective functioning of monitoring and evaluation
mechanisms.
Meritocratic Civil Service: Regarding this dimension,
58.8% of the officials expressed an indifferent opinion,
while the favorable and unfavorable positions were
presented in equal proportion, 20.6%. Table 5 shows that
most of them approve the promotion and incentives
processes, but there is a predominance of disagreement
with how profiles are established to fill positions in the
hospital.
The participants in the qualitative component said,
almost unanimously, that meritocracy is not applied in the
institution. For many, "cronyism" (GF1) predominates, or
appointment to positions and functions according to
"favoritism", political ties or simple transactions, which
would lead to management actions being more aligned with
particular purposes and interests, rather than with
institutional goals.
In the narratives, the lack of meritocracy in the
Hospital appeared to be linked to a perceived absence of
effective regulations for the recruitment and management
of staff. However, for the officers the problem was not only
the Hospital: "Meritocracy is ideal but it is not fulfilled. Not
only here, but I believe in all public institutions, there is the
political factor, the political favors" (GF1). And, in
connection with this problem, there would be a
postponement of those who enter the public service
through competitions and formal channels.
There were few recommendations on this point,
because the lack of meritocracy was perceived mainly as a
problem conditioned from higher political entities. Despite
this, some participants indicated that the Hospital could
contribute to the development of a meritocratic scheme, for
example by improving staff profile designs.
Knowledge Management: For this dimension, 57.7% of
the officials expressed an indifferent opinion, followed by
33% with an unfavorable opinion and only 9.3% with a
favorable opinion. As can be seen in table 6, the majority of
them considered that the Hospital’s personnel development
plan (PDP) does not include sufficient resources for
management improvement, and a high percentage of them
expressed their disagreement with the way in which it is
elaborated and with the definition of activities
The qualitative data support the situation presented in the
table. A broad understanding of the PDP was found, but
the idea that its application is deficient predominated. The
most common perception was that the training activities did
not meet institutional requirements, either because of a
shortage of resources or because they would be redirected
to other purposes.
When the training plan is made, everyone is very
enthusiastic about it... But the reality is different, because,
in the end, the budget gets reduced so much that they take
away the money for training. (GF1).
In response to these problems, the first proposal was
to introduce a comprehensive and cross-cutting approach
to human resources management and training, based on
institutional needs and in line with strategic planning
guidelines. In this
.
4. Barriers and Perspectives of Synergies
849 P J M H S Vol. 14, NO. 2, APR – JUN 2020
Table 1. Distribution of officers according to general characteristics
General characteristics Frequency Percentage
Gender
Male 51 52,6%
Female 46 47,5%
Employment situation
Permanent appointment 85 87,6%
Temporary appointment 5 5,2%
Temporary transfer 7 7,2%
Management experience
Yes 54 55,7%
No 43 44,3%
Degree level
Doctor 5 5,2%
Master 6 6,2%
Specialty 25 25,8%
Undergraduate 61 62,8%
Source: Own elaboration.
Table 2: Distribution of officials’ responses regarding the strategic planning dimension
Items Categories N %
Q1. The hospital's strategic plan
should be updated
Strongly disagree 1 1,0%
Disagree 8 8,2%
Neither agree or disagree 1 1,0%
Agree 49 50,5%
Strongly agree 38 39,2%
Q2. I sympathize with the institutional
strategic plan
Strongly disagree 19 19,6%
Disagree 37 38,1%
Neither agree or disagree 30 30,9%
Agree 8 8,2%
Strongly agree 3 3,1%
Q3. The vision and mission express
the institution’s point of view on what
the institution has been developing
Strongly disagree 8 8,2%
Disagree 48 49,5%
Neither agree or disagree 25 25,8%
Agree 13 13,4%
Strongly agree 3 3,1%
Q4. I think the hospital's weaknesses
outweigh its strengths.
Strongly disagree 9 9,3%
Disagree 3 3,1%
Neither agree or disagree 4 4,1%
Agree 40 41,2%
Strongly agree 41 42,3%
Q5. The greatest difficulty in fulfilling
the operational plan is its funding.
Strongly disagree 10 10,3%
Disagree 9 9,3%
Neither agree or disagree 21 21,6%
Agree 43 44,3%
Strongly agree 14 14,4%
Source: Own elaboration.
Table 3: Distribution of staff responses for the budgeting for results dimension
Items Categories N %
Q6. Funding for hospital activities
should be based on BfR*.
Strongly disagree 2 2,1%
Disagree 25 25,8%
Neither agree or disagree 24 24,7%
Agree 29 29,9%
Strongly agree 17 17,5%
Q7. Most of the hospital’s managers
do not know what activities are
funded with BfR
Strongly disagree 1 1,0%
Disagree 20 20,6%
Neither agree or disagree 37 38,1%
Agree 29 29,9%
Strongly agree 10 10,3%
Q8. There is an alignment between
the strategic objectives and the
financing of the activities
Strongly disagree 6 6,2%
Disagree 28 28,9%
Neither agree or disagree 36 37,1%
Agree 22 22,7%
Strongly agree 5 5,2%
* BfR: budgetingfor results. Source: Own elaboration.
5. César Antonio Bonilla-Asalde, Elizabeth Adrianzen, José Jáuregui et al
P J M H S Vol. 14, NO. 2, APR – JUN 2020 850
Table 4: Distribution of the officials’ answers regarding the management by process dimension
Items Categories N %
Q9. The hospital workers know the
most important goalsto achievethe
institutional objectives.
Strongly disagree 24 24,7%
Disagree 36 37,1%
Neither agree or disagree 25 25,8%
Agree 11 11,3%
Strongly agree 1 1,0%
Q10. The hospital administrators
know the most important goals to
achieve institutional objectives
Strongly disagree 17 17,5%
Disagree 16 16,5%
Neither agree or disagree 32 33,0%
Agree 31 32,0%
Strongly agree 1 1,0%
Q11. The workers know the functions
and objectives of the unit where they
work
Strongly disagree 13 13,4%
Disagree 16 16,5%
Neither agree or disagree 24 24,7%
Agree 43 44,3%
Strongly agree 1 1,0%
Q12. The administrators know the
performance indicators they have to
meet to achieve the objectives.
Strongly disagree 6 6,2%
Disagree 14 14,4%
Neither agree or disagree 34 35,1%
Agree 39 40,2%
Strongly agree 4 4,1%
Q13. The Hospital workers clearly
understandthe definitions of the
institutional quality principles.
Strongly disagree 16 16,5%
Disagree 24 24,7%
Neither agree or disagree 47 48,5%
Agree 9 9,3%
Strongly agree 1 1,0%
Q14. The hospital managers clearly
understand the definitions of the
institutional quality principles.
Strongly disagree 10 10,3%
Disagree 12 12,4%
Neither agree or disagree 45 46,4%
Agree 28 28,9%
Strongly agree 2 2,1%
Source: Own elaboration.
Table 5. Distribution of officials’ responses regarding the meritocratic civil service dimension
Items Categories N %
Q15. I agree with the promotion
processes for the hospital workers
Strongly disagree 14 14,4%
Disagree 12 12,4%
Neither agree or disagree 12 12,4%
Agree 44 45,4%
Strongly agree 15 15,5%
Q16. I agree with the incentives for
the hospital workers.
Strongly disagree 16 16,5%
Disagree 11 11,3%
Neither agree or disagree 12 12,4%
Agree 39 40,2%
Strongly agree 19 19,6%
Q17. I agree with the job profile used
in the hospital to fill the positions in
the units
Strongly disagree 39 40.2%
Disagree 39 40.2%
Neither agree or disagree 12 12.4%
Agree 5 5.2%
Strongly agree 2 2.1%
Source: Own elaboration
Table 6. Distribution of officials’ responses regarding the knowledge management dimension
Items Categories N %
Q18. The institutional personnel’s
development plan (PDP) provides
resources to improve the
management system
Strongly disagree 20 20,6%
Disagree 47 48,5%
Neither agree or disagree 18 18,6%
Agree 11 11,3%
Strongly agree 1 1,0%
Q19. The PDP identifies
stakeholders and expectations of
hospital professionals and
Strongly disagree 23 23,7%
Disagree 48 49,5%
Neither agree or disagree 16 16,5%
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851 P J M H S Vol. 14, NO. 2, APR – JUN 2020
technicians for its elaboration Agree 9 9,3%
Strongly agree 1 1,0%
Q20. I agree with the policies to
define the activities in the PDP
Strongly disagree 8 8,2%
Disagree 23 23,7%
Neither agree or disagree 53 54,6%
Agree 10 10,3%
Strongly agree 3 3,1%
Source: Own elaboration.
DISCUSSION
This study, which involved officials from a public hospital in
Peru, shows that the implementation of results-oriented
hospital administration faces barriers in all the areas of
exploration, highlighting inadequate forms of planning,
budgeting, personnel management and control. In addition,
participants identified obstacles in the organizational
culture itself and in the political environment. Nevertheless,
a critical view of the problems and a favorable attitude
towards change prevailed, which is expressed in the
proposals the officers made to overcome those barriers,
with emphasis on improving technical skills for strategic
and budgetary planning, adopting a participatory approach,
facilitating information flows and establishing effective
monitoring and control systems.
Numerous papers have examined these issues in
hospital settings, focusing either on the introduction and
effectiveness of administrative improvements (5,17,18), or
on barriers to adoption of change (13-15). Also, many
studies in Peru and other countries address specific
aspects of management, such as planning, budgeting,
operational processes, among others, with quantitative or
qualitative approaches, or through documentary analysis
(1,5,13,17). This study contributes to the literature on
hospital management by showing not only the difficulties
that arise in a specific case due to the modernization of
management, but also some alternatives to overcome
them, based on the actors’ perspectives most directly
involved, trying out a multidimensional view that integrates
five components of a state model of public management
(8), and also combining quantitative and qualitative
approaches.
The study shows that, in this hospital context, or in others
with similar characteristics, efforts to implement results-
oriented management need to anticipate and address the
structural and circumstantial problems of the institutions.
Among these issues, deficiencies in the technical
capacities of planning and budget design, barriers in the
organizational culture, dysfunctions in the administration of
resources, obstacles in the communication flows, the
functionality of the monitoring and control systems, and the
political context need special attention. In this sense, the
findings support those other studies that emphasize one or
more of these points (14, 17, 19), including those that
influence the participatory and convening nature of
management change processes as an indispensable
condition for success (9, 18, 20).
This work has some limitations. The officers’ responses
and perceptions may contain biases (desirable responses,
recalling, self-defense, among others), and workers, users,
or authorities from other organizations have not been
included, nor has an analysis been made regarding
management documents, situational diagnoses or records
on the Hospital operation and its units, all of which could
contribute to a better understanding of the problem.
However, the main virtue of the work is that it offers a first-
hand image of the vicissitudes experienced by civil
servants, who are key actors in the process of improving
hospital administration. In these processes, results-based
orientation in plans and budgets should always consider
the quality of services, the correspondence between
institutional objectives and national and sectoral health
policies, and institutional and local contexts and realities,
and especially the human factor, which involves aspects as
varied as the development of administrative and health
staff skills, knowledge management, organizational culture
and user satisfaction.
Statement on conflicts of interest: The authors state that
no interests or values other than those usually present in
research have been involved during the execution of the
study or the drafting of the manuscript.
Funded by Norbert Wiener University's Research Fund
REFERENCES
1. Méndez C, Miranda C, Torres M, Márquez C. Política de
autogestión hospitalaria en Chile: percepciones de los
tomadores de decisiones. Rev Panam Salud Pública.
2013;33(10):47–53.
2. Huang L. Exploring factors affecting top management
support of IT implementation: a stakeholder perspective in
hospital. J Inf Syst Technol Manag. 2015; 26(1):31–45.
3. Aguilar V, Garrido P. Gestión Lean en logística de
hospitales: estudio de un caso. Rev Calid Asist. 2013;28(1):
42–49.
4. UNICEF. Manual sobre la gestión basada en resultados: la
labor conjunta en favor de la niñez. Nueva York: UNICEF;
2017.
5. Martín MA, Zaragoza G, Martínez C, Gobbo M, García-
Vicuña R. Barreras y facilitadores en la implantación de
estándares de calidad en las unidades de hospital de día
reumatológicas: análisis cualitativo del proyecto VALORA.
Reumatol Clin. 2018; 14(4):196-201.
6. Nariño AH, León AM. Inserción de la gestión por procesos
en instituciones hospitalarias: concepción metodológica y
práctica. Rev Administração. 2013;48(4): 739–756.
7. Cabello P, Hidalgo A. Análisis de la eficiencia hospitalaria
por Comunidad Autónoma en el ámbito del Sistema
Nacional de Salud. Invest Regionales. 2014;28:147-158.
8. Perú. Presidencia del Consejo de Ministros. Política
Nacional de Modernización de la Gestión Pública. Decreto
Supremo N° 004-2013-PCM. El Peruano, Normas Legales.
2013 9 de enero.
9. OCDE. Buenas prácticas recientemente identificadas de
gestión para resultados de desarrollo. París: OCDE; 2006.
10. Rodríguez J, Dackiewicz N, Toer D. La gestión hospitalaria
centrada en el paciente. Arch Argent Pediatr.
2014;112(1):55–58.
7. César Antonio Bonilla-Asalde, Elizabeth Adrianzen, José Jáuregui et al
P J M H S Vol. 14, NO. 2, APR – JUN 2020 852
11. Shack N, Rivera R. Seis años de la gestión para resultados
en el Perú (2007-2013). Huancayo: Universidad Continental;
2017.
12. Glaser BG, Strauss AL. The discovery of grounded theory:
strategies for qualitative research. Oxon, London:
Routledge; 2017.
13. Yactayo E. La ejecución presupuestal de ESSALUD del
Perú como un instrumento de gestión. Pensam Crítico.
2019;24(1):103-120.
14. Alcázar L, Andrade R. Transparencia y rendición de cuentas
en hospitales públicos: el caso peruano. Lima: BID; 1999.
15. Vargas I, Mogollón-Pérez A, De Paepe P, da Silva M, Unger
JP, Vázquez ML. Barriers to healthcare coordination in
market-based and decentralized public health systems: a
qualitative study in healthcare networks of Colombia and
Brazil. Health Pol Plann. 2016;31(6):736–748.
16. Herrero L, Martín J, Del Puerto M. Eficiencia técnica de los
hospitales públicos y de las empresas públicas hospitalarias
de Andalucía. Gac Sanit. 2015;29(4):274–281.
17. Cruz O. Diseño de un sistema de control interno para
contrataciones del Estado en el Hospital “La Caleta” de
Chimbote, Perú. Rev Ciencia Tecnol. 2013;9(1):69-86.
18. López P, Díaz Z, Segredo A, Pomares Y. Evaluación de la
gestión del talento humano en entorno hospitalario cubano.
Rev Cub Salud Pública. 2017;43(1):3-15.
19. García F, Llanos A. Características de la demanda de
capacitación en personal administrativo en hospitales
nacionales de Lima y Callao. Rev Med Hered.
2006;17(1):42-47.
20. Méndez CA. Reflexión sobre la planificación de los recursos
humanos y la autonomía de gestión en los hospitales de
Chile. Rev Esp Salud Pública. 2009;83(3):371-378.