Document Type : Original Article

Authors

1 Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

2 Antai College of Economics and Management/ School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China

3 Ph.D. Student, Health Education and Health Promotion, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Ph.D. Student, Health Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran

5 h.D. Candidate in Health Care Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran

6 Health Management and Economic Research Center, Iran University of medical Sciences, Tehran, Iran

Abstract

INTRODUCTION: The qualification of managers in terms of management skills is one of the most
important factors in the continuous success of each organization, and utilizing such skills can have
a positive contribution in the effectiveness of the organization while improving the performance of
the employees in line with the objectives and goals of the organization. The study's primary objective
was to examine the necessary skills of the hospital managers and their capabilities to manage the
challenges in providing health care facilities to their patients and employees.
MATERIALS AND METHODS: This study is a qualitative that deep interviews were performed with
22 managers (senior and middle managers) of educational hospitals of Kermanshah city, and the
sample size was 22 individuals. The interviews were analyzed by a MAXQDA software application
after transcription.
RESULTS: This study includes 8 themes and 23 subthemes. The strategic skill, the perceptive
skill, the human relations skill, work experience, and personal characteristics were among the skills
necessary for hospital managers. Some of the challenges facing the hospital managers included
rapid changes in the policies, the limitations of financial resources, and lack of proportion between
the educational and occupational spheres.
CONCLUSION: Because of their existential philosophy and differences with other service sectors,
managing hospitals poses a particular sensitivity. In this regard, the role of the hospital manager is very
important. Therefore, in order to meet the satisfaction of those receiving services, decision‑makers
and policy‑makers must think twice when selecting and appointing hospital managers and evaluate
and appraise this group in terms of abilities and skills necessary for managing such an important
service section.

Keywords

1. Bayrami R, Rezazadeh A, Ebrahimipour H. Challenges in
emergency departments in teaching hospitals of Mashhad
University of Medical Sciences: A qualitative study. Hospital
2017;16:63‑72.
2. Mohammed NE, Elfattah MA, Elwahab EA. Effect of training
program on unit managers’ mentoring knowledge and skills at
selected university hospital‑Egypt. Indian J Public Health Res
Dev 2019;10:1885‑9.
3. Pourrostami K, Heshmat R, Hemati Z, et al. Association of fruit and
vegetable intake with meal skipping in children and adolescents:
The CASPIAN-V study. Eat Weight Disord 2020;25:903-10.
4. Rasi V, Maleki MR, Yarmohammadian MH, Yasavoli AR,
Doosty F. Challenges of implementing pay‑for‑performance plan
in the views of nurses working in hospitals affiliated to Mashhad
University of Medical Sciences: A qualitative study. Mod Care J
2018;15:e87007.
5. Reshadat S, Zangeneh A, Saeidi S, Teimouri R, Yigitcanlar T.
Measures of spatial accessibility to health centers: Investigating
urban and rural disparities in Kermanshah, Iran. J Public Health
2019;519:27‑9.
6. Ziapour A, Kianipour N. Health‑related quality of life among
university students: The role of demographic variables. J Clin
Diagn Res 2018;12:JC01‑4.
7. Barati O, Sadeghi A, Khammarnia M, Siavashi E, Oskrochi G.
A qualitative study to identify skills and competency required
for hospital managers. Electron Physician 2016;8:2458‑65.
8. Fang CH, Chang ST, Chen GL. Competency development
among Taiwanese healthcare middle manager: A test of the AHP
approach. Afr J Bus Manage 2010;4:2845‑52.
9. Zangeneh A, Najafi F, Karimi S, Saeidi S, Izadi N. Spatial‑temporal
cluster analysis of mortality from road traffic injuries using
geographic information systems in West of Iran during 2009–2014.
J Foren legal Med 2018;55:15‑22.
10. Zangeneh A, Yoosefi Lebni J, Ebadi Azar F, Sharma M,
Kianipour N, Azizi SA. A study of the communication skills in
health care and the role of demographic variables (a case study of
the nurses at the Educational, Therapeutic and Research Center of
Imam Reza Hospital, Kermanshah, Iran in 2018). J Public Health
2019:1-7. In Press.
11. Figueroa CA, Harrison R, Chauhan A, Meyer L. Priorities and
challenges for health leadership and workforce management
globally: A rapid review. BMC Health Serv Res 2019;19:239‑48.
12. Sfantou DF, Laliotis A, Patelarou AE, Sifaki‑Pistolla D,
Matalliotakis M, Patelarou E. Importance of leadership style
towards quality of care measures in healthcare settings:
A systematic review. Healthcare 2017;5. pii: E73.
13. Hosseini SH, Rajabzadeh R, Nosrati H, Naseri F, Toroski M,
Mohaddes Hakkak H, et al. Prevalence of medicinal herbs
consumption in pregnant women referring to Bojnurd health care
centers. Iran J Obstet Gynecol Infert 2017;20:33‑40.
14. Asiabar AS, Ardestani AS. Factors affecting the leadership
effectiveness of hospital managers: A systematized review. Med
J Islamic Repub Iran 2018;32:6‑11.
15. Toygar SA, AkbulutY. Managerial skills of hospital administrators:
Case study of Turkey. J Health Manage 2013;15:579‑94.
16. Nazari B, Bakhshi S, Kaboudi M, Dehghan F, Ziapour A,
Montazeri N. A comparison of quality of life, anxiety and
depression in children with cancer and healthy children, Kermanshah-Iran. Int J Pediatr 2017;5:5305-14.
17. Hejazi S, Safari O, Arjmand R, Qorbani M, Pourrostami K,
Safari A, et al. Effect of combined versus monotherapy with
deferoxamine and deferiprone in iron overloaded thalassemia
patients: A randomized clinical trial. Int J Pediatr 2016;4:1959‑65.
18. Pillay R. The skills gap in hospital management: A comparative
analysis of hospital managers in the public and private sectors
in South Africa. Health Serv Manag Res 2010;23:30‑6.
19. Asiabar AS, Mehr MH, Arabloo J, Safari H. Leadership
effectiveness of hospital managers in Iran: A qualitative study.
Leader Health Serv 2019;33:43‑55.
20. Majid NA, Jelas ZM, Azman N, Rahman S. Communication skills
and work motivation amongst expert teachers. Proc Soc Behav
Sci 2010;7:565‑7.
21. HilalN, HarbS, JamalD, El‑JardaliF. The use of evidence in decision
making by hospital managers in Lebanon: A cross-sectional study.
Int J Health Plan Manage 2019;35:1‑6.
22. Garosi VH, Zarei MR, Farahan MA, Ziapour A, Haghani H.
A study of nurses' performance relative to the risk factors for
musculoskeletal disorders associated with patient mobility in the
teaching hospitals across Kermanshah. J Public Health 2020:1-6.
In Press.
23. Kutz MR, Ball DA, Carroll GK. Contextual intelligence behaviors
of female hospital managers in the United States. Int J Healthc
Manag 2018;11:155‑63.
24. Keshtkaran A, Heidari A, Bastani P. Study of managers’
communication skills based on the staff’s view in Shiraz
University Of Medical Sciences. J Payavard Health 2012;5:41‑8.
25. Yoosefi Lebni J, Ebadi Azar F, Sharma M, Zangeneh A,
Kianipour N, Azizi SA. Factors Affecting Occupational Hazards
among Operating Room Personnel at Hospitals Affiliatedin in
Western Iran: A Cross-Sectional Study. J Public Health 2020:1-8.
In Press.
26. Khadka DK, Gurung M, Chaulagain N. Managerial
competencies – A survey of hospital managers’ working in
Kathmandu valley, Nepal. J Hospital Admin 2014;3:62‑72.
27. Stefl ME. Common competencies for all healthcare managers:
The Healthcare Leadership Alliance model. J Healthc Manage
2008;53:360‑73.
28. Kalargyrou V, Pescosolido AT, Kalargiros EA. Leadership skills
in management education. Acad Educ Leader J 2012;16:39‑46.
29. Walsh AP, Harrington D, Hines P. Are hospital managers ready
for value‑based healthcare? Int J Organ Anal 2019;28:49‑65.
30. AbuAlRub RF, Al‑Zaru IM. Job stress, recognition, job
performance and intention to stay at work among Jordanian
hospital nurses. J Nurs Manag 2008;16:227‑36.
31. Kebede S, Mantopoulos J, Ramanadhan S, Cherlin E, Gebeyehu M,
Lawson R, et al. Educating leaders in hospital management:
A pre‑post study in Ethiopian hospitals. Glob Public Health
2012;7:164‑74.
32. Zarei E, Farzianpour F, Pouragha B, Abbasi Borogeni P,
Mohammadzadeh M. Managers’ development needs assessment:
Perspective of middle managers of public hospitals of Tehran.
J Hospital 2014;13:29‑36.
33. Rivkani F. Assessment of Required Management Information of
Hospital Managers of Ministry of Health and Medical Education
in Tehran in 2000 [Thesis]. Tehran, Iran: Tehran University of
Medical Sciences; 2001.
34. Ochonma OG, Nwatu SI. Assessing the predictors for training
in management amongst hospital managers and chief executive
officers: A cross‑sectional study of hospitals in Abuja, Nigeria.
BMC Med Educ 2018;18:138‑48.
35. Aghaye T, Jafreh M, Mirmohammadali S. Systemic thinking and
Improving staff performance. J Bus Manag 2011;3:156‑79.
36. Amini MT, Bakhtiari L, Dargahi H, Karimi O, Moammai H,
Janbozorgi M, et al. Measurement of systemic thinking among
TUMS senior managers using Goldman strategic model.
J Payavard Health 2013;7:188‑96.
37. Terzic‑Supic Z, Bjegovic‑Mikanovic V, Vukovic D,
Santric‑Milicevic M, Marinkovic J, Vasic V, et al. Training hospital
managers for strategic planning and management: A prospective
study. BMC Med Educ 2015;15:25‑32.
38. Aini Q. Motivation, commitment and leadership skill in affecting
performance hospital managers. J Soc Sci Res 2018;4:707‑10.
39. Ahmad B, Fouad FM, Elias M, Zaman S, Phillimore P, Maziak W.
Health system challenges for the management of cardiovascular
disease and diabetes: An empirical qualitative study from Syria.
Int J Public Health 2015;60:55‑62.
40. Romdhane HB, Tlili F, Skhiri A, Zaman S, Phillimore P. Health
system challenges of NCDs in Tunisia. Int J Public Health
2015;60:39‑46.
41. Khan MM, Heuvel W. Description and content analysis of the
National Health Policy of Pakistan. Asia Pac J Public Health
2005;8:1‑21.
42. Siegel K, Narayan KV, Kinra S. Finding a policy solution to India’s
diabetes epidemic. Health Affairs 2008;27:1077‑90.
43. Delgoshaie B, Tabibi J, Pahlavan P. The model of improving
human resource in Iran’s health system. Res Med J 2010;31:317‑25.
44. Ziari A, Abachizade K, Rassouli M, Mohseny M. Assessment of
barriers of implementation of clinical governance in educational
hospitals of Shahid Beheshti University of Medical sciences:
A qualitative study. J Hospital 2015;13:93‑103.
45. Mehrolhasani M, Yazdi Feyzabadi V, Barfeh Shahrbabak T.
Assessing performance of Kerman provinces hospitals using
Pabon Lasso diagram between 2008 and 2010. J Hospital
2014;12:99‑108.
46. Farzianpour F, Emami AH, Foroushani AR, Ghiasi A.
Determining the technical efficiency of hospitals in tabriz city
using data envelopment analysis for 2013‑2014. Glob J Health Sci
2016;9:42‑54