Cumpăt Carmen Marinela, Huțu Daniela, Rusu Bogdan, Zouri Muthana, Zouri Nicoleta
Department of Medical Specialties III, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Faculty of Economics and Business Administration, Alexandru Ioan Cuza University, Carol Boulevard, nr. 11, 700506 Iasi, Romania.
Healthcare (Basel). 2024 Nov 29;12(23):2395. doi: 10.3390/healthcare12232395.
BACKGROUND/OBJECTIVES: Our study investigates the primary characteristics of managerial decision-making processes in the public hospital units in Romania, particularly in the Northeast region. This research aims to delineate the decision-making model applied by managers in these units, considering the multitude of legislative, economic, technical, ethical, and organizational changes prompted by the pandemic.
A mixed-method research approach was utilized, combining semi-structured interviews and autoethnography, to capture experiences, attitudes, perceptions, motivations, and ethical considerations of decision-makers within the healthcare system.
The findings revealed that managerial decisions in public hospitals were influenced by unique elements such as the vulnerability and support needs of patients, the absence of a clear hierarchy, the personalized nature of healthcare services, the complexity of care processes, and the use of advanced technology. External factors, notably political and economic influences, alongside internal ethical dilemmas, significantly impacted decision making.
This study identifies the reliance on evidence-based decision making and a consultative managerial style as key to addressing these challenges. This research contributes theoretically by comparing decision-making models and practically by identifying a decision-making model that includes forms, techniques, and tools that could guide managers in decision making in Romanian public hospitals.
背景/目标：我们的研究调查了罗马尼亚公立医院部门，特别是东北地区管理决策过程的主要特征。本研究旨在描绘这些部门管理者所应用的决策模型，同时考虑到疫情引发的众多立法、经济、技术、伦理和组织变革。
采用混合方法研究，结合半结构化访谈和自我民族志，以捕捉医疗系统内决策者的经验、态度、看法、动机和伦理考量。
研究结果显示，公立医院的管理决策受到诸如患者的脆弱性和支持需求、缺乏明确等级制度、医疗服务的个性化性质、护理过程的复杂性以及先进技术的使用等独特因素的影响。外部因素，尤其是政治和经济影响，以及内部伦理困境，对决策产生了重大影响。
本研究确定了依靠循证决策和协商式管理风格是应对这些挑战的关键。本研究在理论上通过比较决策模型做出贡献，在实践上通过确定一个包含可指导罗马尼亚公立医院管理者决策的形式、技术和工具的决策模型做出贡献。
