[Influence of leadership style on knowledge management and hospital efficiency]. / Influencia del liderazgo en gestión del conocimiento y eficiencia hospitalaria.

OBJECTIVE: To analyse the effect of leadership style on knowledge management in hospitals and hospital efficiency based on the opinion of experts in hospital management, applying fuzzy cognitive maps (FCM). METHOD: FCM are relational models that can be used to graphically represent expert opinion and knowledge to infer cause-effect relationships between different concepts. The use of FCM as a simulation tool allows the evaluation of possible scenarios based on different leadership styles in hospitals. RESULTS: In the resulting augmented matrix, standardized effects range from 0.02 to 0.84, with the highest value representing the strongest relationship between knowledge exploitation and hospital efficiency. From the viewpoint of experts, knowledge creation within the hospital also influences hospital efficiency. Regarding variables reflecting leadership characteristics, positive effects have been identified, though with varying intensities, between authority, benevolence, and charisma, both in terms of knowledge creation and exploitation, as well as hospital efficiency. The transformational leadership style is associated with coefficients having higher values for knowledge management and hospital efficiency. CONCLUSIONS: Experts suggest that hospitals with authoritarian leadership styles would exhibit lower levels of knowledge creation and management, as well as lower hospital efficiency. On the other hand, they associate hospitals managed with a paternalistic leadership style with better values in both knowledge creation and exploitation, as well as hospital efficiency, compared to the authoritarian leadership style. Finally, they attribute the highest levels in aspects related to knowledge management and hospital efficiency to the transformational leadership style.

Influencia del liderazgo en gestión del conocimiento y eficiencia hospitalaria / Influence of leadership style on knowledge management and hospital efficiency

Objetivo: Analizar el efecto del estilo de liderazgo sobre la gestión del conocimiento y la eficiencia hospitalaria aplicando para ello mapas cognitivos difusos (MCD). Método: Los MCD son modelos relacionales que se pueden utilizar para representar gráficamente la opinión y el conocimiento de un grupo de personas expertas e inferir las relaciones causa-efecto que hay entre distintos conceptos. La utilización de MCD como herramienta de simulación permite evaluar posibles escenarios basados en distintos estilos de liderazgo en los hospitales. Resultados: En la matriz aumentada resultante, los efectos estandarizados varían de 0,02 a 0,84, representando el valor más alto la relación entre explotación del conocimiento y eficiencia hospitalaria. Para las personas expertas, la creación de conocimiento en el hospital también influye en la eficiencia hospitalaria. Se han identificado efectos positivos, aunque con distinta intensidad, de la autoridad, la benevolencia y el carisma del líder en la creación y la explotación del conocimiento y en la eficiencia hospitalaria. El liderazgo transformacional se asocia a los valores más altos de gestión de conocimiento y eficiencia hospitalaria. Conclusiones: El estilo de liderazgo autoritario parece ofrecer niveles más bajos de creación y gestión de conocimiento, así como una menor eficiencia hospitalaria. Se asocian al estilo de liderazgo paternalista mejores valores tanto en la creación y la explotación de conocimiento como en la eficiencia hospitalaria, en comparación con el estilo de liderazgo autoritario. Por último, se atribuyen al liderazgo transformacional las mayores cotas en los aspectos relacionados con gestión del conocimiento y eficiencia hospitalaria.(AU)

Objective: To analyse the effect of leadership style on knowledge management in hospitals and hospital efficiency based on the opinion of experts in hospital management, applying fuzzy cognitive maps (FCM). Method: FCM are relational models that can be used to graphically represent expert opinion and knowledge to infer cause–effect relationships between different concepts. The use of FCM as a simulation tool allows the evaluation of possible scenarios based on different leadership styles in hospitals. Results: In the resulting augmented matrix, standardized effects range from 0.02 to 0.84, with the highest value representing the strongest relationship between knowledge exploitation and hospital efficiency. From the viewpoint of experts, knowledge creation within the hospital also influences hospital efficiency. Regarding variables reflecting leadership characteristics, positive effects have been identified, though with varying intensities, between authority, benevolence, and charisma, both in terms of knowledge creation and exploitation, as well as hospital efficiency. The transformational leadership style is associated with coefficients having higher values for knowledge management and hospital efficiency. Conclusions: Experts suggest that hospitals with authoritarian leadership styles would exhibit lower levels of knowledge creation and management, as well as lower hospital efficiency. On the other hand, they associate hospitals managed with a paternalistic leadership style with better values in both knowledge creation and exploitation, as well as hospital efficiency, compared to the authoritarian leadership style. Finally, they attribute the highest levels in aspects related to knowledge management and hospital efficiency to the transformational leadership style.(AU)

Integration of healthcare and financial information: Evaluation in a public hospital using a comprehensive approach.

Public healthcare organisations are moving towards the use of new technologies to automate and improve their internal processes in order to increase the effectiveness and efficiency of their use of resources. The aim of this research is to tackle the systematic evaluation of an experience of integrating information in a healthcare organisation, paying attention to the implications that this entails. The results show that the integration of the information in the hospital results in higher levels of quality. This study contributes a vision of interrelated work, in which tasks are shared and aims are jointly established.

The roles of users personal characteristics and organisational support in the attitude towards using ERP systems in a Spanish public hospital.

Enterprise resources planning (ERP) systems enable central and integrative control over all processes throughout an organisation by ensuring one data entry point and the use of a common database. T his paper analyses the attitude of healthcare personnel towards the use of an ERP system in a Spanish public hospital, identifying influencing factors. This research is based on a regression analysis of latent variables using the optimisation technique of partial least squares. We propose a research model including possible relationships among different constructs using the technology acceptance model. Our results show that the personal characteristics of potential users are key factors in explaining attitude towards using ERP systems.

Modeling nurses' attitude toward using automated unit-based medication storage and distribution systems: an extension of the technology acceptance model.

This article analyzes the attitude of nurses toward the use of automated unit-based medication storage and distribution systems and identifies influencing factors. Understanding these factors provides an opportunity to explore actions that might be taken to boost adoption by potential users. The theoretical grounding for this research is the Technology Acceptance Model. The Technology Acceptance Model specifies the causal relationships between perceived usefulness, perceived ease of use, attitude toward using, and actual usage behavior. The research model has six constructs, and nine hypotheses were generated from connections between these six constructs. These constructs include perceived risks, experience level, and training. The findings indicate that these three external variables are related to the perceived ease of use and perceived usefulness of automated unit-based medication storage and distribution systems, and therefore, they have a significant influence on attitude toward the use of these systems.

Deploying information technology and continuous control monitoring systems in hospitals to prevent medication errors.

The serious repercussions of healthcare errors on patient safety have led hospitals to deploy information technology and continuous control monitoring systems to prevent them. Hospitals are moving away from traditional paper-based systems and focusing on designing new systems that prevent errors, using information technologies to catalyse the process re-engineering. This paper presents a case study that analyses the effect of computerised physician order entry and automated unit-based medication storage and distribution systems on the drug ordering and delivery process. It is concluded that information technology and continuous control monitoring systems have led to significant process re-engineering in the sequential stages of the drug ordering and delivery system. The new systems have also provided the opportunity to improve information available. This is an exploratory case study and the conclusions drawn from it offer possible routes for future research in this field.

Implantación de sistemas integrados para una gestión eficiente de los recursos en el ámbito hospitalario / Implementation of integrated systems for efficient resource planning in hospitals

Objetivo: evaluar el impacto de la implantación de Sistemas de Información Integrados para la planificación de recursos empresariales en hospitales, mediante el análisis de su diseño y utilización, con especial atención a la satisfacción de los usuarios. Métodos: investigación cualitativa basada en un estudio de caso longitudinal. Para la recogida de la información se utilizaron las técnicas de observación no participante, análisis de documentación interna, entrevistas individuales y en grupo y conversaciones informales. La unidad de análisis fue una Fundación Hospitalaria de la Comunidad Autónoma de Madrid seleccionada de manera intencional por su adecuación al objetivo del trabajo y por la facilidad de acceso a la información. Resultados: las expectativas previas de los responsables del hospital se cumplieron razonablemente. Se consiguió un sistema único con distintos módulos en el que la información está integrada. Los usuarios están satisfechos con el funcionamiento del sistema, especialmente el personal clínico. Gracias a la implicación de la dirección y de los mandos intermedios, se minimizaron las dificultades derivadas de los roces entre la cultura clínica y la administrativa durante el proceso de implantación y en la utilización posterior del sistema. Conclusiones: la aplicación de Sistemas de Información Integrados en los hospitales no solo es posible, sino que resulta muy conveniente. Para la Fundación Hospitalaria supone una mejora de la eficacia en la gestión clínico asistencial y un aumento de la eficiencia en la gestión económico financiera. La implantación generalizada de estos sistemas permitiría establecer comparaciones entre distintos hospitales y avanzar hacia la gestión integral del sistema sanitario.

Objective: to evaluate the impact of the setting up of the enterprise resource planning in hospitals, by analysing their design and implementation, paying special attention to the user satisfaction. Methods: qualitative research study based on a longitudinal case study in which the techniques of internal documentation analysis, non-participant observation, individual and group interviews and informal talks were used to collect data. The analysis unit was selected because of its suitability for the objective of the paper and easy access to the necessary information. Specifically, the study has been conducted in "Fundación Hospitalaria de la Comunidad de Madrid (FHM)". Results: the hospital management's prior expectations of the system were fulfilled to a reasonable degree. A single system, with different modules in which the information is integrated, has been achieved. The users, especially the clinical staff, are satisfied with the operation of the system. Thanks to the involvement of the senior and middle managers, it has been possible to minimise the difficulties arising from confrontation between the clinical and the administrative cultures during the process of the setting-up and subsequent utilisation of the system. Conclusions: the implementation of enterprise resource planning in hospitals is not only possible but also very advantageous. For the Fundación Hospitalaria de Madrid, it represents not only improved effectiveness in clinical assistance management but also higher efficiency in economic and financial resources management. If these systems were established generally, it would be possible to make constructive comparisons between different hospitals, and to progress towards the integral management of the health-care system.