RESUMO
BackgroundThe Mongolian Government is regularly concerned on the hospital development and the improvementof hospital structure and function at the health sectors’ policy level. Therefore, there is a need ofevidence based survey that is determine possible ways in improving hospital management throughthe management function (organization, planning, decision making, leadership-motivation, monitoringand evaluation management) and management component (human resources, information,marketing, finance, foreign relationship and cooperation).ObjectiveTo outline possible approaches in improving clinical hospital management upon reviewing of itscurrent settingMaterials and MethodsThe study was conducted by qualitative method and data was collected through applying discussionsand participatory approaches. In total, 155 participants were enrolled in the study, from which 72were covered by the Focus Group Discussions, and the remained 83 were studied for OrganizationalDiagnostic Analysis.ResultsThe Clinical hospital management aspects are reasonably unsatisfactory (61.4%). As a result ofsurvey, clinical hospital structure, organization and coordination (76%), monitoring and evaluationmanagement (72.8%), planning (71.6%) encompass comparatively predominant advantageswhereas decision making management (67.5%), motivation (59.6%), human resources management(62.4%), information management (57.8%), financial management (52.9%), and hospital marketing(30%) enclose prevailing disadvantages. According to the hospital policy analysis, there were hospitalpriority issues such as inappropriate hospital structure, the weak hospital governance, monitoringand responsibility, financial system is separate and it could not the right financial lever, do not havehospital capacity planning and repairing system, private sector’s role is indefinite and coordinationis limited. There recommended 4 hospital policy approaches.Conclusion: Advantages and Disadvantages of the Clinical hospital management levels, althoughthey vary, management aspects are reasonably unsatisfactory. If to view in an isolation by eachkey role and direction of the management functions, organization, planning, monitoring andevaluation management encompass comparatively predominant advantages whereas humanresources, information, finance, motivation, and decision making management enclose prevailingdisadvantages. In terms of hospital marketing, it is extremely poor. Therefore, there are neededfor improving of hospital management and marketing through the hospital 4 policy approaches byphase.
RESUMO
Goal: To outline possible approaches in improving clinical hospital management upon reviewing of its current setting Materials and Methods: The study was conducted by qualitative method and data was collected through applying discussions and participatory approaches. In total, 155 participants were enrolled in the study, from which 72 were covered by the Focus Group Discussions, and the remained 83 were studied for Organizational Diagnostic Analysis. Conclusions: 1. Advantages and Disadvantages of the Clinical hospital management levels, although they vary, management aspects are reasonably unsatisfactory. If to view in a isolation by each key role and direction of the management functions, organization, planning, quality assurance, monitoring and evaluation management encompass comparatively predominant advantages whereas human resources, information, finance, motivation, and decision making management enclose prevailing disadvantages. In terms of marketing management, it is extremely poor. 2. Healthcare Organizations’ strategic planning is advantageous focusing on essential skills and tools needed to enhance quality and accessibility of health care as new models of care delivery. Nevertheless, it is weak in operational processes resembling of introduction of technology initiatives and improving of health care targeted to vulnerable groups of the population. 3. Human resources management surrounds in a large amount of disadvantages, particularly, career development of personnel, workforce selection and research capability are inadequate. 4. Although management decisions made are usually accepted by working groups and are enforced their implementations, issues associated with any decisions to involve representaitives of community, regular dialogue of managers with staaf and clients and provision of supervision are fairly poor. 5. By and large, leading skills of managers are quite pleasing and the orders given by managers are executed on a timely manner. Conversely, awarding, incentives and motivation of personnel is highly problematic. 6. The following actions were in good shape, e.g monitoring and evaluation is performed according to the given guidelines, and performance evaluation is recognized by employees followed by inclusion of the findings in planning design. Notably, issues linked with cooperation with other agencies, ensuring quality assurances at the all levels and transparency to inform the cases for not being accountable and for poor performamce of the commands are in low morale. 7. Application of internal information network and provision of transparency and responsiveness has considerably been improved, while predominant mono communicative management, availability of electronic health security data, proper information utilization and time management is deficient. 8. Marketing and its management for High-Performance Healthcare Organizations are underprivileged and absolutely disadvantegious. 9. Even though financial management aspect has gained an introduction of software applications compatable with the Internationally Accepted Standards and Requirements and the projected resources have well mobilized, the necessary investment required for introduction of new technology, the budget for hospital expansion, the insufficient resources for risk management, mobilization of additional assets are limited. 10. International cooperation and collaboration is subject to the legal environment, economic, financial factors, inflation and other technical dynamics. Moreover, partnership with other sectors, private entities, civil society, and the public is scarce, and even, there is no adequate mechanism to gain supports of diverse aspects and to work effectively together.