Assessing the predictors for training in management amongst hospital managers and chief executive officers: a cross-sectional study of hospitals in Abuja, Nigeria.

BACKGROUND: There is a compelling need for management training amongst hospital managers in Nigeria mostly because management was never a part of the curricula in medical schools and this has resulted in their deficiencies in effective policymaking, planning and bottom line management. There has been no study to the best of our knowledge on the need and likely factors that may influence the acquisition of such training by hospital managers and this in effect was the reason for this study. METHODS: Data for this study came from a cross-sectional survey distributed amongst management staff in twenty five (25) hospitals that were purposively selected. One hundred and twenty five (125) questionnaires were distributed, out of which one hundred and four (104) were answered and returned giving a response rate of 83.2%. Descriptive and Inferential statistics were used to summarize the results. Decisions were made at 5% level of significance. A binary logistic regression was performed on the data to predict the logit of being formally and informally trained in health management. These statistical techniques were done using the IBM SPSS version 20. RESULTS: The result revealed a high level of formal and informal trainings amongst the respondent managers. In formal management training, only few had no training (27.9%) while in informal management training, all had obtained a form of training of which in-service training predominates (84.6%). Most of the administrators/managers also had the intention of attending healthcare management programme within the next five years (62.5%). Socio-demographically, age (p = .032) and academic qualification (p < .001) had significant influence on training. Number of hospital beds (p < .001) and number of staff (p < .001) including managers' current designation (p < .001) also had significant influence on training. CONCLUSION: Our work did establish the critical need for both formal and informal trainings in health management for health care managers. Emphasis on training should be directed at younger managers who are the least likely to acquire such trainings, the smaller and private hospitals who are less likely to encourage such trainings amongst their staff and the least educated amongst health managers.

Cues-to-Action in Initiating Lesbian, Gay, Bisexual, and Transgender-Related Policies Among Magnet Hospital Chief Nursing Officers: A Demographic Assessment.

This study explored Magnet Chief Nursing Officers' cues-to-action initiating lesbian, gay, bisexual, or transgender (LGBT)-specific policies. Homonegativity has a negative effect on employee recruitment and retention and patient satisfaction. Little has been known about what cues-to-action might initiate LGBT inclusive training. Surveys were mailed to 343 Chief Nursing Officers. Cues-to-action survey was used to assess what inspires initiation of LGBT training. Demographic surveys were used to assess what impact variables might have on cues-to-action. Age, sex, religiosity, location, and region had significant effect on cues-to-action. Developing demographically informed training and policies for LGBT equality in health care is suggestive of greater employee and patient satisfaction.

Health System Chief Nursing Officers: Is an MBA the Degree of Choice?

This thought-provoking column is submitted by a senior executive at Witt/Kieffer based on recent recruiting experience of system chief nursing executive candidates.

Chief executive officers in US hospitals: a reexamination of workforce demographics and educational issues.

The US Bureau of Labor Statistics reports the "employment of medical and health services managers is expected to grow by 22% from 2010 to 2020" (http://www.bls.gov.ooh/management/medical-and-health-services-managers.htm#tab-6). The US Bureau of Labor Statistics notes this is substantially faster than the national average for other occupations. Information from this report finds its way into popular media, news shows, and other information outlets, which increases the number of prospective applicants to college and university health care management programs. (For the purposes of this article, no differentiation is made between various programs geared toward preparing health care managers; this includes, but is not limited to, degrees in hospital administration, hospital services administration, health care management, etc.) In 2007, the authors conducted a survey of chief executive officers in US hospitals that sought to identify educational and demographic information of individuals holding top management positions in US health care institutions. The survey was repeated in 2012, at the 5-year interval, to determine if chief executive officer information had changed.

Predictors of hospital CEO affiliation with a professional association.

Based on a 2008 cross-sectional survey of 582 hospital CEOs in the United States, this study reports the findings of two logistic regression models designed to identify CEO and hospital characteristics associated with Member and Fellow status in the American College of Healthcare Executives (ACHE). The purpose of the study was to understand the personal and organizational characteristics of those CEOs who choose to be Members and Fellows of a professional association such as ACHE. The results showed that most (74 percent) of the respondents considered ACHE to be their primary professional association. The results also revealed that a master's degree in health administration [beta = .88, t(427) = 5.35, p < .0001], male gender [beta = .59, t(427) = 3.01, p = .002], and financial incentives provided by the parent hospital [beta = .25, t(427) = 2.73, p = .006] were statistically positively linked with Member status in ACHE. A master's degree in health administration [beta = .81, t(424) = 5.79, p < .0001], male gender [beta = .39, t(424) = 2.25, p = .02], and age [beta = .02, t(424) 2.32, p = .02] were also statistically positively associated with Fellow status in ACHE. Notably, organizational factors such as size, geographic location, for-profit status, and financial strength of the hospital do not seem to play an important role in the CEOs' decision to become a Member or Fellow of ACHE. The implication of these findings is that membership and fellowship at a professional association are influenced by characteristics of the individual, and incentives provided by employers can encourage employees to get involved with their professional associations.

Educating leaders in hospital management: a pre-post study in Ethiopian hospitals.

Despite recent focus on health systems strengthening, few studies report large-scale efforts to improve hospital management capacity in low-income countries, a central component of improving health care delivery. We sought to assess the contributions of a systems-based approach, the Ethiopian Hospital Management Initiative (EHMI), which established hospital chief executive officers (CEOs) trained through a Masters of Healthcare and Hospital Administration (MHA) degree programme in Ethiopia. We conducted a pre-post study of 24 hospitals that are managed by CEOs in the MHA programme. We measured changes in hospital functioning based on adherence to a set of 86 hospital performance standards across 12 management domains published in the Standards for Hospital Management in Ethiopia. We found that adherence to hospital performance standards increased significantly during the one-year follow-up (27% compared with 51% of standards met at baseline and follow-up, respectively; P-value < 0.001); overall improvement was driven by improvement in seven of the 12 management domains. The EHMI is an example of health systems strengthening with focus on building hospital management capacity. Early evidence suggests that the establishment of hospital CEOs and MHA training to equip them with management skills may promote scalable improvements in health facility functioning.

Chief nursing officer executive development: a crisis or a challenge?

The roles and responsibilities of nurses are expanding, as they become more involved in administration and leadership within their field. Nurses are taking on executive positions, which have become a crucial part of hospital organizations. With this expansion, an executive development program is necessary to provide nurses with the knowledge and competencies that these executive positions require. Their focus must evolve from singular bedside practice to the greater scope of health care administration. Leadership skills are extremely important, in addition to interpersonal, management, mentoring, and interprofessional skills. A number of nursing associations have worked to develop a set of curricula for nurse executive education, but a consistent and specific set of academic requirements has yet to be agreed upon. With the importance of the chief nursing officer's (CNO) role in the function of a hospital and the requirement of the knowledge of the changing health care system in the United States, it is essential that nurses are provided with proper education and training that will help them become successful nurse executives. Some suggestions include a dual MSN/MBA degree, a PhD in nursing, continuing education institutes, and mentoring programs. However, research must be done to clarify the best way to prepare CNOs for their roles.

Factors affecting the continuing education of hospital CEOs and their senior managers.

This article examines the influences on executives' continuing education in hospitals. It uses data from a national survey on professional development conducted in 2009 by the American College of Healthcare Executives (ACHE) to explore how organizational and individual characteristics are related to the amount of continuing education (CE) taken by chief executive officers (CEOs) and the commitment to CE by their senior managers. Our findings suggest that the organizational characteristics of ownership, size, and region and the individual characteristics of gender, professional affiliation, and the focus of CE may influence how much CE CEOs take. CEOs from for-profit, larger hospitals and ACHE members tend to take less CE. Likewise, senior managers' commitment to CE is influenced by region, gender, the CEO's personal CE hours, and the focus of the CE. Surprisingly, ACHE membership is associated with lower amounts of personal CEO CE. Also, female CEOs appear to engender greater commitment to CE in their senior managers. Finally, CE focused on change increases the senior managers' commitment, while a focus on new technology lessens it. For those organizations seeking to meet current and future challenges by creating a learning organization, CE is essential. Understanding factors that influence the amount of and commitment to CE is important. We hope our research adds to this understanding and that leaders will seek to improve the dedication and value of CE in their organizations.

Hospital chief executive officer perspective on professional development activities.

A study was undertaken to develop understanding of hospital chief executive officers' (CEOs') perspectives concerning importance and impact of professional development activities in US hospitals. It was also intended to reveal CEO preferences for various modalities of professional development including membership in professional societies, attainment of credentials, and coaching by mentors. A mail survey of 582 hospital CEOs made use of a pilot-tested questionnaire with 30 close ended multipart questions. Results showed that most CEOs assigned a high level of importance to professional development and favored conferences, seminars, and networking opportunities, but low priority assigned to online activities such as webinars. They reported lending support to senior managers for participation in these activities by providing financial resources and by allowing time off to engage in these activities. The respondents indicated that the importance of various modalities of professional development has either increased or remained high over the recent 5 years. Conclusions suggest that verifiable quantitative data are needed for understanding of the frequency of participation and resource commitment of health care organizations toward the professional development of CEOs and senior managers. The results of this perceptual study reveal a high level of importance accorded to various forms of professional development activities by the participating CEOs.

Are your docs management ready?

Hospital chief executives are tapping physicians for upper management roles beyond the traditional chief medical officer and other primarily clinical positions. But often, these highly educated, entrepreneurial and strong-willed individuals need help acquiring the business and people skills to successfully make the transition.

Most wired. CMIOs steadily on the rise.

These tech-savvy physicians will play a big role as meaningful use requirements put more emphasis on integrating IT and quality. Just asking doctors to volunteer some time to serve on a committee "just doesn't fly anymore".

Who'll run your IT?

Hospitals already face a shortage of qualified health IT workers, a shortage that will only intensify with new HIPAA rules, the transition to ICD-10 coding and, most importantly, government pressure to ramp up EHRs. Many initiatives are under way to ease the potential crisis, but hospitals will have to be creative in cultivating talent and deploying limited staff and financial resources to generate the greatest return.