Janati Ali, Hasanpoor Edris, Hajebrahimi Sakineh, Sadeghi-Bazargani Homayoun
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences , Tabriz, Iran.
Department of Healthcare Management, Maragheh University of Medical Sciences , Maragheh, Iran.
Int J Health Care Qual Assur. 2018 Jun 11;31(5):436-448. doi: 10.1108/IJHCQA-08-2017-0143.
Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.
目的 医院管理者的决策会对服务成效和医院的成功产生重大影响,因此采用循证方法可改善医院管理。本文旨在识别循证管理(EBMgt)的组成部分和挑战。为此,作者提供了一个改进循证决策的框架。
设计/方法/途径 2016年共进行了45次半结构化访谈。作者还与卫生服务管理者开展了三次焦点小组讨论。数据分析遵循演绎定性分析指南。
研究结果 访谈中出现了四个基本主题,包括循证管理的证据来源(包括子主题:科学与研究证据、事实与信息、政治社会发展规划、管理者的专业知识和伦理道德证据);预测因素(子主题:利益相关者的价值观和期望、职能行为、知识、关键能力和技能、证据来源、证据水平、用途和益处以及政府项目);循证管理的障碍(子主题:管理者的个人特征、决策环境、培训与研究体系以及组织问题);以及循证医院管理流程(子主题:提问、获取、评估、汇总、应用和评估)。
原创性/价值 研究结果表明,大多数参与者对循证管理持积极态度。全面的循证医院管理者是在六步决策过程中使用所有证据来源的人。循证管理框架是管理医疗组织的良好工具。作者发现了影响医院循证管理的因素,并确定了卫生管理者可在循证决策过程中使用的六个证据来源。