12 января 2016г.
Summary
We present data from a pilot research about ways to perfect a control system for public health service. In research took part 600 leaders of medical establishments at different levels. Respondents indicated that necessary to develop concepts and a complex of measures that optimize professional training of managers that may include knowledge from foreign colleagues.
Key words: perfection, management, public health
ПУТИ СОВЕРШЕНСТВОВАНИЯ МЕНЕДЖМЕНТА В СИСТЕМЕ ЗДРАВООХРАНЕНИЯ
Сухарева И.А., Третьякова О.С., Павлюк В.Г., Василенко С.А.
Аннотация
В статье представлены данные пилотного исследования о путях совершенствования системы управления в здравоо хранении, в котором участвовало 600 руководителей лечебно-профилактических учреждений разного уровня Республики Крым. Отмечено, что необходима разработка концепции и комплекса мероприятий по оптимизации профессиональной подготовки менеджеров с учетом опыта зарубежных коллег.
As the health care sector moves into the period of rapid metamorphosis, the quality of leadership and management provided within the health care system will be pivotal over its success [1]. Hence we carried out our research to analyze the quality of current and future managers with the hope of re-organizing the management system where necessary [2].
Material and method
Our research was carried out by sociological questionnaires. The questionnaires consisted of 19 questions. The object of our research were targeted to the heads of medical - prophylactic establishments and future potential administrative staff in health care system had the aim of revealing their understanding of the need for knowledge in modern time management.
Results and its discussion
600 doctors took part, 49(8.2%) were heads of hospitals, 43(7.2%) were deputy heads of hospitals, 167(27.8%) were head of departments and 341(56.8%) were practicing doctors. 32 % of respondents were males. Average age was 47± 0.5 years and 20.8% from the total number were of pensioner age. 44.2 % were aged 45 and below. 96.7 % were government staffs. During the period of research, 15.6% were serving in the rural public health services while 84.4% - served in city and republican establishments.
86.3 % of respondents had more than 10 years experience in general medical work, and 43.8 % of respondents have specified that the general e xpe rience in them is 30 and more years. 49 % of them have been working as heads for the last 10 years, while 3.7% have over 30 years of similar e xpe rience. 2.7 % of respondents have specified that they hold a scientific degree of the candidate in medical sciences, and 2 persons possess academic status of senior lecturer.
Analyzing categories of respondents, only one third had been assessed, from which 27.8% achieved second category of management – 53.6 %, and high category – 18.6 %. Every other doctor has received a category on management during the last 5-7 years 61 % achieved the basic specialty category. 39 % had not achieved any general category due to insufficient preparation of a personnel reserve and insufficient motivation to improve their professional skill and gain higher certification.
Analyzing improvement of professional skill in branch of management, 25.5 % of heads have passed higher qualifications, and in last 5 years, 6 % for the first time. The basis on preparing administrative reserve for our region is CSMU where have passed improvement of professional skill of 71 % of heads. So, the majority of respondents passed their last improvement of professional skill in CSMU. For last 5 years 79 %. 21 % of respondents passed higher qualifications at other universities.
To estimate the understanding of the need for preparation concerning management in public health services, we asked the respondents to give points ranging from 1 to 5 for several questions.
43.7 % specified that theoretical bases of management are necessary (4-5 points). 27.3 %, moderately necessary (3 points) and 29 % not necessary (1-2 points). Knowledge on the organizations of administrative work, 45.3 %, specified that it’s necessary, 29.8 % moderately necessary, and not necessary - 25 %. Respondents indicate that correct skill to supervise the staff (legal and psychological aspects) 53.6 %, as necessary, 25.4 % as moderately necessary and 21 % not necessary.
The need for knowledge concerning marketing and financings, 49.7 % as necessary, 21.3 % as moderately necessary and 29 % not necessary.
Supply with information management, 48.5 % as necessary, 25.7 % - moderately necessary and 25.8 %, –not necessary. On necessity of knowledge on evidence-based medicine 55.7 % as necessary, 22.2 % moderately necessary and 22.1 % as not necessary.
Knowledge on the organizations of management system of medical aid to the population, 55.5 % as necessary, 23.3 % as moderately necessary and 21.2 % not necessary.
Knowledge on maintenance of quality of public health services, 54.6 % as necessary, 22.2% as moderately necessary and 23.2 % not necessary.
Thus, by analyzing the above data, it is possible to conclude that the most necessary in the medical practice are knowledge on the following aspects, personnel administration-79 %, organization of the management system of medical aid -78.8 %, evidence-based medicine – 77.9% and maintenance of quality of public health services -76.8 %. Regarding knowledge on theoretical bases of management and management of the finance and marketing, almost one third of respondents think it is not necessary in their future practical work, and one fou rth thinks it is not necessary to have knowledge on the organization of administrative work and to supply with information of management [3].
Respondents have specified that, while solving management questions, they more often rely on standards or official recommendations (60.8 %), their own expe rience (45.5 %), and advice of colleagues or other specialists (32.5 %), and only 13.8 % search for similar models in the decision of a situation that testifies an insufficiency of knowledge on theoretical aspects of management.
96 % of respondents agree on the necessity of theory and practice in managements during study in a higher educational institution, and only 4 % have disagreed. 18.7 % gave special importance to necessity of reception of this knowledge for each doctor irrespective of professions and posts, while 70.4 % think that this knowledge is necessary and
10.9 % think that usual doctors can do without this information.
While estimating the importance of such knowledge for the doctors holding a supervising post, 75.2 % specified it as very important, 24.2 % as important and only near 1 % as not important. As for the heads of public health services of the highest ranks, 86.7 % specified it as very important, 12.1 % as important and only 1.2 % as not importan t. This shows that the majority of respondents understand the importance of application and perfection of the professional level in questions of management.
Respondents were also asked to estimate forms of study that can be implemented during improvement o f professional skill. Overwhelmingly, a vast majority of 69 % preferred lectures, 65.5 % choose practical classes (on reception of skills of drawing up of official papers, calculation of parameters of activity) and only every second respondent choose seminar, business games or psychological trainings. A mere 5.5 % of respondents chosen use of e xperience of other countries during learning, USA and France in particular. This testifies to the lack of awareness of management system in other countries and that the use of knowledge of foreign colleagues is necessary for modern manager [4].
Conclusions
We can conclude that formation and development of potential, both the operating managerial personnel, and personnel reserve, in modern conditions of reforming of public health services, is not possible without development of concepts and a complex of actions on their optimization vocational training, and also the account of experience of foreign colleagues. Future leaders need to be provided with an intensive integrated management education in quantitative and analytical skills, leadership processes, the transformative nature of technology and the special skills of entrepreneurship. This education needs to be a vibrant combination of classroom teaching and real-life e xperiences in the realities of the health sector in order to meet the requirements of a modern management system.
References
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