Seyed Mahmoudi Mohsen, Akbari Sari Ali, Dargahi Hossein
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Management and Economics, School of Public Health, Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2024 Aug 21;38:96. doi: 10.47176/mjiri.38.96. eCollection 2024.
Managerialism and leaderism were introduced in response to the challenges in public service management, aiming to improve the management of public service organizations. These ap-proaches both have their own strengths and challenges. The purpose of this study was to examine the current and desired state of the Iranian health system and to find whether these approaches can be integrated to leverage their strengths and address some of the management and leadership challenges of the country's health system.
In this qualitative study, semi-structured interviews were conducted with 43 senior managers of the health system, employees of three medical universities in Tehran, and experts in public management. The participants were selected using purposive sampling, and the snowball technique was used to increase the number of interviewees. The data were analyzed using the framework method in MAXQDA 18.
Structural changes, realization of managerialism, establishment of evidence-based in-formation systems, readiness of managers and employees, creating a climate of trust, identifica-tion, and recruitment of competent individuals, specialized training, delegation of sufficient au-thority to managers, building a culture conducive to an integrated approach, communication and cooperation, and benchmarking were identified as the prerequisites for complementing Manageri-alism Ideology with Leaderism Discourse.
Complementing managerialism ideology with leaderism discourse can help solve some of the management and leadership challenges faced by the country's health system. But more important are the prerequisites that need to be satisfied in order to prepare the ground for integrating these approaches and capitalizing on their advantages.
管理主义和领导主义是为应对公共服务管理中的挑战而引入的，旨在改善公共服务组织的管理。这些方法都有其自身的优势和挑战。本研究的目的是考察伊朗卫生系统的现状和理想状态，并探究这些方法是否可以整合，以发挥其优势并应对该国卫生系统的一些管理和领导挑战。
在这项定性研究中，对43位卫生系统高级管理人员、德黑兰三所医科大学的员工以及公共管理专家进行了半结构化访谈。采用目的抽样法选取参与者，并使用滚雪球技术增加受访者数量。使用MAXQDA 18中的框架法对数据进行分析。
结构变革、管理主义的实现、基于证据的信息系统的建立、管理人员和员工的准备情况、营造信任氛围、识别和招募有能力的个体、专业培训、向管理人员充分授权、营造有利于综合方法的文化、沟通与合作以及标杆管理被确定为用领导主义话语补充管理主义意识形态的先决条件。
用领导主义话语补充管理主义意识形态有助于解决该国卫生系统面临的一些管理和领导挑战。但更重要的是需要满足一些先决条件，以便为整合这些方法并利用其优势奠定基础。
