Training needs assessment of hospital CEOs in a developing country: the example of Iran.

BACKGROUND: It is essential to identify the necessary competencies of hospital CEOs in order to improve the quality and efficiency of services they provide. Expert leadership skills and competencies can have a significant impact on the success of an organization, benefiting both patients and staff. This study aimed to assess the competencies and training needs of hospital CEOs in Iran public hospitals. METHODS: We conducted this cross-sectional analytical study through a self-assessment questionnaire, which was a web-based platform developed by the WHO country office in Iran, between July 2018 and September 2018. The questionnaire was completed by 180 hospital CEOs and included a core set of 81 items based on Assessing the Competency of Hospital CEO. These items were categorized into five superordinate categories: leadership, personality and quality of individual behavior, knowledge and business skills, social responsibility, and healthcare environment. In addition, we conducted focus groups with 30 hospital CEOs, supervisor assessments with 10 hospital managers, and interviews with 10 supervisors. RESULTS: Of the 180 questionnaires distributed, 78% were returned, and most respondents were medical specialists. The need for leadership competencies such as individual behavior skills and change management received the highest priority. Most respondents required training in management skills, including financial management, governance, strategic thinking, quality improvement, and disaster management. CONCLUSION: Providing needs-based education is crucial, especially in developing countries. In this study, leadership and strategic thinking were found to be the most needed competencies among hospital CEOs in Iran. These findings serve as reference points for developing countries with similar backgrounds and healthcare environments as Iran.

Dimensions of Health Care Management Professionalization: A Scoping Review.

Background: Within the public sector, health managers occupy positions that are typically filled by individuals with a medical, clinical, or nursing experience who are entrusted with assuming an additional role. The primary objective of this study was to employ a scoping review methodology to ascertain a cluster of prevalent subjects encompassing the development of a proficient health care manager. Methods: The purpose of this scoping review study was to identify critical components in the field of management professionalization, as described by Arksey and O'Malley. A total of 13 studies, characterized by predefined keywords, were meticulously culled from Scopus, Web of Science, PubMed, and Embase, Magiran, and SID databases. The inclusion and exclusion criteria considered factors such as language, temporal relevance, redundancy, thematic alignment with the professionalization domain, and congruence with the overarching objectives and methodologies of the present investigation. Subsequently, the contents of the selected studies were subjected to rigorous thematic analysis and judicious categorization using a framework analysis approach. Results: From a total of 10,117 articles, a rigorous selection process yielded 13 articles to be included in this study. The identified dimensions are classified and elucidated across 6 overarching domains; namely, the science of management, educational trajectory, and curriculum, cultural infrastructure and ideologies, standards, professional institutions and associations, and licenses and certifications. Conclusion: To enhance the efficacy of health management, policymakers and planners ought to adeptly incorporate these dimensions within the framework of the country's health system.

Response Time and Causes of Delay in Prehospital Emergency Missions in Mashhad, 2015.

Background: The response time is considered as one of the most important criteria for the quality of given care to the injured. This research aimed to investigate the frequency and causes of prehospital emergency delays in the 115 emergency center, in city of Mashhad, in 2015. Methods: In this cross-sectional study, 21,142 missions performed in 2015 were investigated, from among which 640 missions with delays in systematic sampling were recognized. For data analysis purposes, descriptive statistics (frequency, mean and SD) in Excel 2013 software was implemented. Results: Nearly 60% of the injured were men, 23% women, and the gender of 17% was not recorded in their profiles. The mean age of the injured was 29.8+15.9 years and 30% of the injured were in the age group of 16 to 25. The mean response time was 9:01+2:46. The most prevalent causes related to missions out of the operational zone (29.3%) and the second cause has been related to traffic groups (24.2%). Conclusion: Establishing new bases and completing the number of ambulances and human recourses, intervention in traffic causing factors, and training the public about emergency cases can be effective in reducing the number of missions and the pace and quality of services provided to the injured.

Innovation in the use of motor ambulance for prehospital emergency care.

BACKGROUND: Prehospital emergency care system is one of the important parts of the health system. Heavy traffic, increasing urban population, and growing demands for prehospital emergency services are challenges faced by this section of the health system. One of the approaches to deal with this issue is using motor ambulances. AIMS: This study aims to investigate the missions of motor ambulances, ambulances, and the effects of motor ambulance services on response time and ambulance missions. MATERIALS AND METHODS: This applied research has been designed as a descriptive and cross-sectional study. Overall, 267,836 missions carried out by ambulances and motor ambulances of Tehran emergency medical service (EMS) Center in the years 2014 and 2015 were investigated. The data were gathered personally by visiting Tehran EMS Center. The data were analyzed by Excel (2013) software. RESULTS: The average response time for ambulances and motor ambulances were 16 min and 14 min and 13 s, respectively. Most of the ambulance and motor ambulance missions were reportedly due to weakness (20%) and heart problems (16%). In 57% of ambulance missions and 71.5% of motor ambulance missions, the patients refused to being transferred to the hospital. Most of the transport missions to hospital (24%) were caused by traffic accidents. CONCLUSIONS: According to the results, the response time was higher than the national standards. Locating motor ambulances on the streets and outside emergency stations during peak traffic times decreased the response time by 2 min and by providing the necessary services in the scene and transferring fewer patients to the hospital, it is possible to provide further services by assigning ambulances to more urgent missions. Thus, it is recommended to employ more seasoned staff, multiply motor ambulances, and locate motor ambulances precisely to decrease response time and also at a lower cost more citizens are provided with prehospital care.