Future competencies for hospital management in developing countries: Systematic review.

Background: This was a systematic review presenting the future competencies for hospital managers. Methods: Participants, interventions, comparisons and outcomes (PICO) strategy with MeSH terms were used for searching. Databases used were Web of Science, PsycINFO and Medline, EBSCO, ScienceDirect, Emerald, ProQuest, Social Sciences Research Network, Embase, and some Iranian database such as IRANDOC and SID. All publications were accepted if they had been published in English or Persian language and fulltexts were accessible. The study was carried out using a systematic literature search published between January 1995 and December 2018. The Endnote v.17 software was used to facilitate reference management. Quality assessment of publications were carried out independently by two reviewers using the Critical Appraisal Skills Programme (CASP) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A descriptive summary with data tables produced to summarize the literature. Data extraction was conducted by two researchers. Results: Forty seven studies were analyzed to identify the future competencies required for hospital managers. In all, 3190 publications were retrieved. 1934 citations were excluded because of irrelevant (n=2600), duplicates (n=316), and unavailable full text (n=18). After studying the 256 remaining publications, 33 citations were extracted and presented. After extracting the future competencies of hospital managers, competencies were classified into four main categories based on the qualitative meta-synthesis process. Conclusion: The most important competencies in the future are global knowledge, Key Eligibility Criteria, wide attitude and core skills that must be addressed in the face of ambiguity.

Factors affecting sentinel events in hospital emergency department: a qualitative study.

Purpose A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological injury or the risk thereof. The purpose of this paper is to investigate the influencing factors of sentinel events in the emergency department of a military hospital in Tehran to find out some of the effective solutions. Design/methodology/approach In this qualitative study with content analysis approach, 20 hospital healthcare personnel participated as participants from the fields of medicine and nursing. Purposive random sampling and semi-structured interviews were used for data collection. Atlas.ti software version 5.2 was used for data analysis. Findings Four themes and 32 subthemes were identified by numerous revisions and combining the codes. The four main themes of sentinel events were: causes, incidence barriers, cause prevention solutions, and barriers' improvement solutions. Moreover, these main factors were related to these issues: staff and patients' education, communication, assessment, patients and their companions, employee rights, leadership, care continuum, human factors, physical environment, information management and medication use. Some solutions were also suggested according to these factors and a policy was recommended. Practical implications Hospital managers and authorities should try to find the main causes of sentinel events by periodical analysis to find ways to prevent them in the future, using logical and reasonable solutions. Originality/value This study confirms that strategies to reduce the sentinel events in emergency departments should focus on empowerment of all staff.

Training needs assessment of nursing managers for achieving university health coverage.

BACKGROUND: University health coverage gives everyone accesses to health services focused on the most important causes of illness and death and ensures that the quality of services is high enough to improve the health of those receiving services. Nurses as the largest group of staff in the health system play an important role in achieving UHC. This study aimed to determine the training needs of nursing managers in universities of medical sciences of Iran in achieving UHC. MATERIALS AND METHODS: This study was a qualitative study conducted in 2019 using the framework method. There were 15 experts in nursing management, health management, and nursing authorities at the national level using the purposive random sampling. Data were collected from the expert panel. We used the Atlas.ti software version 7.2 and using the framework method for the analysis of qualitative data. A set of codes organized into categories that were jointly developed by the researchers involved in the analysis. The UHC framework used to summarize data in a way that could support answering research questions. RESULTS: This study showed that three educational modules leadership and strategic thinking, management, and decision-making, achieving excellence in nursing management to capacity building of nursing managers in the country. CONCLUSION: Training leadership skills and strategic thinking in the nursing empowerment modules illuminate global and national health roadmaps and policies and change attitudes to the model of nursing service delivery. Since nurses are the largest group of professionals in the health system, it facilitated by changes in the role and functions of the hospital and nurses to reach UHC.

Macroeconomic policies and increasing social-health inequality in Iran.

BACKGROUND: Health is a complex phenomenon that can be studied from different approaches. Despite a growing research in the areas of Social Determinants of Health (SDH) and health equity, effects of macroeconomic policies on the social aspect of health are unknown in developing countries. This study aimed to determine the effect of macroeconomic policies on increasing of the social-health inequality in Iran. METHODS: This study was a mixed method research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect the data along with a multiple attribute decision-making method for the quantitative phase of the research in which the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was employed for prioritization. The NVivo and MATLAB softwares were used for data analysis. RESULTS: Seven main themes for the effect of macroeconomic policies on increasing the social-health inequality were identified. The result of TOPSIS approved that the inflation and economic instability exert the greatest impact on social-health inequality, with an index of 0.710 and the government policy in paying the subsidies with a 0.291 index has the lowest impact on social-health inequality in the country. DISCUSSION: It is required to invest on the social determinants of health as a priority to reduce health inequality. Also, evaluating the extent to which the future macroeconomic policies impact the health of population is necessary.

Early Warning System for Disasters within Health Organizations: A Mandatory System for Developing Countries.

BACKGROUND: Disaster identification and alert systems can be processed in dif-ferent ways. An early warning system is designed to detect impending danger and send appropriate and clear signals to at risk communities and organizations at the right time and in an unambiguous way. This study aimed to determine early warning system for disaster within health organization in Iran. METHODS: This article presents the findings of a mixed-methods study of early warning systems for disaster management within the health organizations in Iran. During the years 2011 to 2012, a sample of 230 health managers was surveyed using a questionnaire and 65 semi-structured interviews were conducted with public health and therapeutic affairs managers who were responsible for disaster management. RESULTS: A range of problems were identified. Although there is a multi-agency alert system within the health organizations, other indicators of early warning system are not satisfactory. Furthermore, standard messages which are used to alert organizations are not used under the current system. CONCLUSION: Some activities such as memorandum of understanding among different stakeholders of disaster response and education of staff and communities could improve the response to disasters within the health organizations.