Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

What makes a hospital manager competent at the middle and senior levels?

Zhanming Liang A B , Sandra G. Leggat A , Peter F. Howard A and Lee Koh A
+ Author Affiliations
- Author Affiliations

A School of Public Health and Human Biosciences, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3086, Australia. Email: s.leggat@latrobe.edu.au, pfh.php@bigpond.net.au, l.koh@latrobe.edu.au

B Corresponding author. Email: z.liang@latrobe.edu.au

Australian Health Review 37(5) 566-573 https://doi.org/10.1071/AH12004
Submitted: 4 April 2012  Accepted: 6 December 2012   Published: 22 April 2013

Abstract

Objective. The purpose of this paper is to confirm the core competencies required for middle to senior level managers in Victorian public hospitals in both metropolitan and regional/rural areas.

Methods. This exploratory mixed-methods study used a three-step approach which included position description content analysis, focus group discussions and online competency verification and identification survey.

Results. The study validated a number of key tasks required for senior and middle level hospital managers (levels II, III and IV) and identified and confirmed the essential competencies for completing these key tasks effectively. As a result, six core competencies have been confirmed as common to the II, III and IV management levels in both the Melbourne metropolitan and regional/rural areas.

Conclusions. Six core competencies are required for middle to senior level managers in public hospitals which provide guidance to the further development of the competency-based educational approach for training the current management workforce and preparing future health service managers. With the detailed descriptions of the six core competencies, healthcare organisations and training institutions will be able to assess the competency gaps and managerial training needs of current health service managers and develop training programs accordingly.

What is known about the topic? A competent health service management workforce is critical to the effective functioning of the healthcare system. Consequently, a competency-based educational approach has been proposed to prepare current and future health professionals including health service managers. Although the literature has suggested that core competencies exist for different management levels in different healthcare settings, there has been no study which has provided valuable data to indicate what the core competencies are for hospitals managers in Australian public hospitals.

What does this paper add? This paper identified and confirmed that six core competencies are common to middle to senior level managers (levels II-IV) in Victorian public hospitals in both Melbourne metropolitan and regional/rural areas.

What are the implications for practitioners? The findings of the study is the first step towards supporting the competency-based educational approach for training and preparing current and future health service managers for their roles. The six identified core competencies provide a very useful guide to the identification of competency gaps and managerial training needs, and the further development of the health service management training curriculum.


References

[1]  Higgins I. Benchmarking in healthcare: a review of literature. Aust Health Rev 1997; 20 60–9.
Benchmarking in healthcare: a review of literature.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3hvVCntQ%3D%3D&md5=875c8c0b9a876b83c3f0090cf2a6c265CAS | 10178132PubMed |

[2]  Sen K, editor. Restructuring health services: changing contexts and comparative perspectives. London: Zed Books; 2003.

[3]  Brown K, Waterhouse J, Flynn C. Change management practices: is a hybrid model a better alternative for public sector agencies? Int J Public Sector Management 2003; 16 230–41.
Change management practices: is a hybrid model a better alternative for public sector agencies?Crossref | GoogleScholarGoogle Scholar |

[4]  Stoelwinder J, Viney R. A tale of two states: New South Wales and Victoria. In: Bloom, AL, editor. Health reform in Australia and New Zealand. New York: Oxford University Press; 2000.

[5]  Young K, Harris A. Efficiency of hospitals in Victoria under Casemix Funding: a stochastic frontier approach. Working paper 92. Centre for Health Program Evaluation: West Heidelberg; 1999.

[6]  Dwyer J. Australian health system restructuring – what problem is being solved? Aust New Zealand Health Policy 2004; 1–6.

[7]  Dwyer J, Leggat SG. Innovation in hospital care. Aust Health Rev 2002; 25 19–31.
Innovation in hospital care.Crossref | GoogleScholarGoogle Scholar | 12474499PubMed |

[8]  Ibrahim J, Majoor J. Corruption in the health care system: the circumstantial evidence. Aust Health Rev 2002; 25 20–6.
Corruption in the health care system: the circumstantial evidence.Crossref | GoogleScholarGoogle Scholar | 12046150PubMed |

[9]  Leggat SG, Bartram T, Stanton P. Exploring the lack of progress in improving patient safety in Australian hospitals. Health Serv Manage Res 2008; 21 32–9.
Exploring the lack of progress in improving patient safety in Australian hospitals.Crossref | GoogleScholarGoogle Scholar |

[10]  Leggat SG, Dwyer J. Improving hospital performance: culture change is not the answer. Healthc Q 2005; 8 60–6.
| 15828569PubMed |

[11]  Leggat SG, Bartram T, Stanton P. Performance monitoring in the Victorian health care system: an exploratory study. Aust Health Rev 2005; 29 17–24.
Performance monitoring in the Victorian health care system: an exploratory study.Crossref | GoogleScholarGoogle Scholar | 15683351PubMed |

[12]  Young S, Bartram T, Stanton P, Leggat SG. High performance work systems and employee well-being: a two stage study of a rural Australian hospital. Journal of Health Organization and Management 2010; 24 182–199.
| 20698193PubMed |

[13]  Liang Z, Short SD, Lawrence B. Healthcare reform in New South Wales 1986–1999: using the literature to predict the impact on senior health executives. Aust Health Rev 2005; 29 285–91.
Healthcare reform in New South Wales 1986–1999: using the literature to predict the impact on senior health executives.Crossref | GoogleScholarGoogle Scholar | 16053432PubMed |

[14]  Robertson R, Cockley D. Competencies for rural health administrators J Health Adm Educ 2004; 21 329–41.
| 15379369PubMed |

[15]  National Health and Hospital Reform Commissions (NHHRC). A healthier future for all Australians: final report of the NHHRC. Canberra: Commonwealth of Australia; 2009.

[16]  Australian Bureau of Statistics. 2005 Labour Force Survey. Canberra: ABS, ; 2005.

[17]  Liang Z. Health reforms and Australian senior health executive workforce: characteristics, competencies and challenges. Saarbuecken: VDM; 2008.

[18]  Liang Z, Howard PF. Competencies required by senior Health Executives in NSW, 1990 -1999. Aust Health Rev 2010; 34 52–8.
Competencies required by senior Health Executives in NSW, 1990 -1999.Crossref | GoogleScholarGoogle Scholar | 20334758PubMed |

[19]  Australian Government Productivity Commission. Australia’s Health Workforce: productivity, research report. Canberra: ...; 2005.

[20]  Duckett SJ. The Australian Health Care System. Melbourne: Oxford University Press; 2007.

[21]  Halton J. Improving the health of rural Australians. Rural Remote Health 2005; 5 1–3.

[22]  The Australian Council on Healthcare Standards. The ACHS EQuIP5 Guide Accreditation, Standards and Guidelines. Ultimo: The Australian Council on Healthcare Standards; 2010.

[23]  Boyatzis RE. The competent manager: a model for effective performance. New York: Wiley; 1982.

[24]  Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002; 287 226–35.
Defining and assessing professional competence.Crossref | GoogleScholarGoogle Scholar | 11779266PubMed |

[25]  Garman AN, Tyler L, Darnall JS, Lerner W. Development and validation of a 360-degree instrument for healthcare administrators. J Healthc Manag 2004; 49 307–27.
| 15499805PubMed |

[26]  Calhoun JG, Dollett L, Sinioris ME, Wainio JA, et al Development of an interprofessional competency model for healthcare leadership. J Healthc Manag 2008; 53 375–91.
| 19070333PubMed |

[27]  Stefl ME. Common competencies for all healthcare managers: the healthcare leadership alliance model. J Healthc Manag 2008; 53 360–73.
| 19070332PubMed |

[28]  McCarthy G, Fitzpatrick JJ. Development of competency framework for nurse managers in Ireland. J Contin Educ Nurs 2009; 40 346–50.
Development of competency framework for nurse managers in Ireland.Crossref | GoogleScholarGoogle Scholar | 19681570PubMed |

[29]  Millar S. Rural and remote health workforce innovation and reform strategy: draft background paper. Canberra: Health Workforce Australia; 2011.

[30]  Calhoun JG, Vincent ET, Baker GR, Butler PW, Sinioris ME, Chen SL. Competency identification and modeling in healthcare leadership. J Health Adm Educ 2004; 21 419–40.
| 15495738PubMed |

[31]  Appelbaum SH, Wohl L. Transformation or change: some prescriptions for health care organizations. Manag Serv Qual 2000; 10 279–98.
Transformation or change: some prescriptions for health care organizations.Crossref | GoogleScholarGoogle Scholar |

[32]  Heifetz M, Halle S. Leading change, overcoming chaos – making change succeed in your 32 organization. Hosp Mater Manage Q 1996; 18 17–27.
| 1:STN:280:DyaK28zmsVKnsA%3D%3D&md5=d85291b1a5e39a0de2edcd2a18cf4135CAS | 10159796PubMed |

[33]  Strebel P. Why do employees resist change? Harv Bus Rev 1996; 74 86–92.

[34]  Martin V. Leading change in health and social care. London: Routledge; 2003.

[35]  Walshe K, Randall TG. Evidence-based management: from theory to practice in healthcare. Milbank Q 2001; 79 429–57.
Evidence-based management: from theory to practice in healthcare.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrhvVylsA%3D%3D&md5=48cf445695424b31fe6efb5ffc647571CAS | 11565163PubMed |

[36]  Muir Gray JA. Evidence-based and value-based healthcare. Evidence-Based Healthcare and Public Health 2005; 9 317–8.
Evidence-based and value-based healthcare.Crossref | GoogleScholarGoogle Scholar |

[37]  Howard PF, Liang Z, Fitzgerald L. The practice of evidence-based management decision making among middle level and senior healthcare managers in Victoria, Australia. Saarbuecken: VDM; 2009.

[38]  Kovner A, Rundall TG. Evidence-based management reconsidered. Front Health Serv Manage 2006; 22 3–22.
| 16604900PubMed |

[39]  Shortell SM. Promoting evidence-based management. Front Health Serv Manage 2006; 22 23–9.
| 16604901PubMed |

[40]  Liang Z, Howard PF, Rasa J. Evidence-informed managerial decision-making – what evidence counts? Asia Pacific Journal of Health Management 2011; 6 23–9.