Health promoting hospitals in Lithuania: health professional support for standards

Abstract

SUMMARYThe standards for health promotion (HP) addressing five domains such as (1) management policy, (2) patient assessment, (3) patient information and intervention, (4) promoting a healthy workplace and (5) improving continuity and cooperation have been elaborated and applied within the International Networks of Health Promoting Hospitals (HPH). The awareness of HP activities by health professionals and their opinions as to the applicability of the five HP standards in three randomly selected hospitals of the Lithuanian HPH network was assessed. A questionnaire survey of physicians and nurses (including chiefs of the selected departments as managerial staff ) working in three different-sized hospitals was carried out. The overall response rate constituted 74.7%, with 280 physicians and 739 nurses completing the survey. One in four respondents stated that the first, second and fifth standards could be implemented into daily practice whereas one in three respondents held the same belief in respect to the third and fourth standards. Health professionals from the small hospital possessed better knowledge and demonstrated a more positive opinion with respect to the applicability of all five standards compared with the larger hospitals. No difference was observed between the opinions of physicians and nurses concerning the applicability of the first and second HP standards, yet a significantly larger number of nurses, compared with physicians, expressed a positive attitude towards the implementation of the remaining three standards. More physicians and nurses with managerial roles, compared with those not involved in the management of hospitals, reported that all five standards could be integrated into daily practice.

Hospitals as professional organizations: challenges for reorientation towards health promotion

“…It has been suggested that professional groups respond differently to health promotion programs and that nurses are more supportive by comparison to doctors (Johansson, Stenlund, Lundström, & Weinehall, 2010;Misevicience & Zalnieraitiene, 2013). Correspondingly, Powell and Davies (2012), as outlined above, have found that nurses were more likely to implement pain-manage-ment services.…”

“…Now, several authors have argued that the domi-nance of professionals, in particular in medicine, has decreased over the last few decades by emphasizing concepts of deprofessionalization (e.g., Elston, 2004Elston, , 1991Haug, 1988) or prole-tarianization (Mc Kinlay & Arches, 1985). However, these approaches have been criticized for being preoccupied with formal organization and tend to underplay the interactional features and micro-practices in professional organizations (Numerato, Salvatore, & Fattore, 2012) where decoupling still takes place and shields professional work from managerial control. While shifts in the relationship between the state and professionals are evident, medical domi-nance and autonomy has been transformed rather than diminished and the medical profession still is a high-status profession, which has maintained its power, at least on a micro-level in every-day practices in hospitals (Allsop, 2006;Armstrong, 2002).…”

“…Forms of decoupling between management and the operative core remain pivotal, as shown in a recent literature review by Numerato et al (2012). The authors emphasize that managerial attempts to introduce new guidelines or control measures often remain merely formal procedures, which are not readily implemented as part of the organizational behaviour i.e., in daily routines of health professionals.…”

The Impact of Setting the Standards of Health Promoting Hospitals on Hospital Indicators in Iran

“…Now with the development of an international network of health promoting hospitals in more than 40 countries, health promoting hospitals approach has been used in more than 800 hospitals [12]. However, the development of this network has been slow in developing countries and in spite of recent advances in the field of health care in these countries, the idea of health promotion has progressed slowly in their hospitals [4] and implementation of health promotion services has remained an unknown part in the transformation of the healthcare system in these countries [13].…”

“…The implementation of this approach in Iranian hospital seems to be in the very early stages [8] and there is little evidence of the effectiveness of health promotion standards on health outcomes [12]. However, the results of some studies in Iran and the world suggest that the implementation of health promotion activities in hospitals has led to the improvement of the quality of health services [14,10], improvement of the clinical outcomes after treatment and improve effectiveness of health [15], increase in patient satisfaction, decrease in the length of patient stay in hospital [13,12,3], increase in the welfare of staff and patients [16], raising the awareness and information of patients [8], increase in job satisfaction and motivation of employees [13], improvement of the effectiveness and efficiency in hospitals [9], decrease in treatment complications, repeated admissions and cost of treatment [5] decrease in mortality [3], prevention of diseases, improvement in health indicators [13] and improvement of the quality of life of patients [17]. Then, hospitals must design a specific system for improving and evaluating health promotion and therefore encourage policy-makers and health service administrators to invest resources in HPH [18].…”