Perceived healthcare workforce needs in Lebanon: a step towards informed human resources planning and professional development.

BACKGROUND: Research in various countries has previously investigated the competencies required for effective management of health care organizations. Yet, limited information is available on the skills and knowledge areas, which are currently lacking among the healthcare workforce employed in environments with limited resources. AIMS: The aim of this study was to assess the perceived healthcare workforce needs at the management and clinical/practice levels in Lebanon. METHODS: We conducted an exploratory Delphi study involving two panels of health care professionals and a nationwide survey of hospital directors to assess the skills needed and the healthcare occupations and specialties that are limited. RESULTS: Based on the Delphi study, the top five needed skills/knowledge areas were: professionalism, ethics, quality management and improvement, strategic planning, and communication. The need for information management and technology skills was reported by more than 50% of urban hospitals, and highlighted by the two panels in the Delphi study. Healthcare professionals reported willingness to take continuing education courses. Hospitals further indicated the availability of financial support and willingness to collaborate with educational institutions for employee training and continuing education. CONCLUSIONS: Our findings set the ground for future research investigating healthcare workforce issues in Lebanon and support evidence-based planning for health human resources. They may inform the development of national and local policies in the country, which address the human resources needs of the health care system to meet regional and national demands. Universities, professional syndicates, and nongovernmental organizations may leverage these findings to develop continuing education training and diplomas incorporating the competencies critical for the healthcare workforce.

Key IT management issues in hospitals: Results of a Delphi study in Canada.

PURPOSE: To develop an authoritative list of IT management issues faced by CIOs and IT directors in public hospitals. METHODS: The ranking-type Delphi method, which elicits the opinion of a panel of experts through iterative controlled feedback, was used in this study. Data collection involved three main steps during which three panels of experts in Ontario (n=13 in rural hospitals; n=9 in community hospitals; n=8 in academic hospitals) provided their input about the key IT management issues in hospitals and their relative importance. Attrition rate was minimal; 28 out of the 30 experts who participated in the study completed all three phases of the survey. RESULTS: During the brainstorming phase, the responses from the three panels were consolidated resulting in a list of 36 IT management issues; eleven were overlapping between the three panels. In the narrowing down phase, 18 issues were retained in the rural panel; 20 issues in the community panel; and 17 issues in the academic panel. The top issues retained in this phase included: managing demand and expectations for IT services (76% of participants); having sufficient funds (69% of participants); recognizing IT as a key stakeholder in major hospital decisions (65% of participants); and implementation of an EMR (62% of participants). In the ranking phase, a moderate level of consensus was obtained for all three panels: W=0.41 (rural panel); W=0.54 (community panel); and W=0.43 (academic panel). Despite the differences in the preoccupations between the three groups, there were similarities on certain IT management issues. Besides having sufficient funds, three of the top IT management issues relate to the strategic positioning of IT within the hospital: managing demands and expectations for IT services; IT competing with other clinical priorities for scarce resources; and recognizing IT as a key stakeholder in major hospital decisions. CONCLUSIONS: This study is the first to systematically and rigorously identify and prioritize critical IT management issues in hospitals, which may be generalizable to similar environments in other industrialized countries. The prioritized lists of IT management issues may be used as a benchmark and diagnostic tool to support internal strategic decision making related to IT. The broadening of understanding of the challenges faced by IT executives in hospitals would support a more systematic evaluation of these issues over time, and allow management, educational, and research resources to be invested in the appropriate areas.