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迈向医院韧性:在印度尼西亚的混乱时代识别医院冲击的定性研究。

Toward hospital resilience: a qualitative study on the identification of hospital shocks during disruption era in Indonesia.

机构信息

Hospital Management Department, Public Health Faculty, Hasanuddin University, Makassar, Indonesia.

Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK.

出版信息

BMC Health Serv Res. 2024 Oct 4;24(1):1185. doi: 10.1186/s12913-024-11385-2.

Abstract

BACKGROUND

Hospital resilience has been well recognized among healthcare managers and providers as disruption of hospital services that threatens their business environment. However, the shocks identified in the recent hospital resilience concept are mainly related to disaster situations. This study aims to identify potential shocks that hospitals face during disruptions in Indonesia.

METHOD

This qualitative study was conducted in Makassar, Indonesia in August-November 2022. Data was collected through semi-structured interviews with hospital managers and resilience experts using a semi-structured interview guide. 20 key informants were interviewed and data were analyzed by thematic analysis.

RESULTS

The study identified seven shocks to hospitals during the disruption era: policy, politics, economics, hospital management shifting paradigms, market and consumer behavior changes, disasters, and conflicts. It also identified barriers to making hospitals resilient, such as inappropriate organizational culture, weak cooperation across sectors, the traditional approach of hospital management, inadequate managerial and leadership skills, human resources inadequacies, a lack of business mindset and resistance to change.

CONCLUSION

This study provides a comprehensive understanding of hospital shocks during disruptions. This may serve as a guide to redesigning the instruments and capabilities needed for a resilient hospital.

摘要

背景

医院弹性在医疗保健管理人员和提供者中得到了广泛认可,因为医院服务的中断会威胁到他们的商业环境。然而,最近医院弹性概念中确定的冲击主要与灾害情况有关。本研究旨在确定印度尼西亚医院在中断期间面临的潜在冲击。

方法

本定性研究于 2022 年 8 月至 11 月在印度尼西亚的望加锡进行。通过半结构化访谈,从医院管理人员和弹性专家那里收集数据,使用半结构化访谈指南。采访了 20 名关键知情人,并通过主题分析对数据进行了分析。

结果

该研究确定了医院在中断时代面临的七种冲击:政策、政治、经济、医院管理范式转变、市场和消费者行为变化、灾害和冲突。它还确定了使医院具有弹性的障碍,例如不适当的组织文化、各部门之间合作薄弱、医院管理的传统方法、管理和领导技能不足、人力资源不足、缺乏商业思维和对变革的抵制。

结论

本研究全面了解了医院在中断期间面临的冲击。这可以作为重新设计弹性医院所需工具和能力的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8d/11453058/ec06b3cb8f8b/12913_2024_11385_Fig1_HTML.jpg

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