Capacity of middle management in health-care organizations for working with people—the case of Slovenian hospitals

Abstract

BackgroundEffective human resources management plays a vital role in the success of health-care sector reform. Leaders are selected for their clinical expertise and not their management skills, which is often the case at the middle-management level. The purpose of this study was to examine the situation in some fields that involve working with people in health-care organizations at middle-management level.MethodsThe study included eight state-owned hospitals in Slovenia. A cross-sectional study included 119 middle managers and 778 employees. Quota sampling was used for the subgroups. Structured survey questionnaires were administered to leaders and employees, each consisting of 24 statements in four content sets evaluated on a 5-point Likert-type scale. Respondents were also asked about the type and number of training or education programmes they had participated in over the last three years. Descriptive statistics, two-way analysis of variance, Pearson’s correlation coefficient and multiple linear regression were used. The study was conducted from March to December 2008.ResultsStatistically significant differences were established between leaders and employees in all content sets; no significant differences were found when comparing health-care providers and health-administration workers. Employment position was found to be a significant predictor for employee development (β = 0.273, P < 0.001), the leader–employee relationship (β = 0.291, P < 0.001) and organizational motivation (β = 0.258, P < 0.001). Area of work (β = 0.113, P = 0.010) and employment position (β = 0.389, P < 0.001) were significant predictors for personal involvement. Level of education correlated negatively with total scores for organizational motivation: respondents with a higher level of education were rated with a lower score (β = -0.117, P = 0.024). Health-care providers participate in management programmes less frequently than do health-administration workers.ConclusionEmployee participation in change-implementation processes was low, as was awareness of the importance of employee development. Education of employees in Slovenian hospitals for leadership roles is still not perceived as a necessary investment for improving work processes. Hospitals are state owned and a national strategy should be developed on how to improve leadership and management in Slovenian hospitals.

10.5937/sjas11-6957 = Differences in motivation of health care professionals in public and private health care centers

“…Perceived lack of positive feedback in communication and respect for one's opinion could be understood as a de cit in mutual professional communication with supervisors. ese results are in contrast with high satis ed sociability needs and self-actualization needs, but they coincide with the results from health care professionals surveyed in Slovenia andCroatia (Skela Savič andPagon, 2008, Skela Savič andRobida, 2013). Vertical communication is in uenced by professionals' values and the existence of appropriate institutional coordination mechanisms (Martinez et al, 2009).…”

“…Research conducted in China and Tanzania showed that the most important factors for performance improvement of health care professionals are the opportunities for professional development, opportunities for training and skill improvement, working environment, raises, working conditions and salaries (Hung et al, 2013;Manongi et al, 2006). Health professionals in Slovenia and Croatia have stated that their suggestions and eagerness for professional development are not taken into consideration when implementing changes in health care centers (Skela Savič and Pagon, 2008;Skela Savič and Robida, 2013). Almost two-thirds of medical sta in Australia has thought about leaving the public sector (Dalton, 2010).…”

Evidence‐based practice among nurses in Slovenian Hospitals: a national survey

“…Thus, nursing managers now face the challenge of introducing continuous professional development in EBP to nurses. Research evidence to date has shown that management workers in Slovenian hospitals are not active in encouraging employee development and do not have enough competences in this field (Lorber & Skela-Savi c 2012;Skela-Savi c & Kiger 2015;Skela-Savi c & Robida 2013), which leads to subpar results in research and EBP implementation (Skela-Savi c 2009Strojan et al 2012). The results also testify to a limited availability of resources for improving EBP implementation.…”

Work-Related stress factors in nurses at Slovenian hospitals – A cross-sectional study

“…Unfulfilled needs in the process of acquiring new knowledge are also of great importance as well as experiencing feelings of injustice, uncertainty around expectations at work, and inadequate rewards (11). Employees often consider difficulties in balancing between work and private life as the most common stressors, conflicts among peers and vague values in an organization (2), poorly addressed daily work issues as well as the establishment of conditions for a safety culture by managers (12, 13). …”