Dargahi Hossein, Ketabchi Khonsari Mohammad Hossein, Kooshkebaghi Mahdi
Department of Health Management, Policy, and Economics, School of Public Health, Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2025 Jan 8;39:6. doi: 10.47176/mjiri.39.6. eCollection 2025.
The successful improvement of health care system (HCS) efficiency in all countries hinges on the selection of effective leaders in the new century. Nevertheless, failing to notice the competency and meritocracy of managers still seems to be one of the major challenges drawn against Iran's HCS, mainly at hospitals, to improve global knowledge and core skills.
This scoping review was performed on the articles published on the Persian and English databases from June 2000 to September 2023, using the keywords "health care system, hospital executive manager, competency and meritocracy system." The 6-stage framework developed by Arksey and O'Malley was applied to collect and present the findings. Moreover, the quality of the desired articles was evaluated via the Mixed Methods Appraisal Tool (MMAT).
In this study, there are 7 core categories-including effective leadership, comprehensive knowledge management, evidence, managerial tasks, personality traits, management intelligence, and management skills. Using a total of 105 references-including 47 articles for entry into the review and 58 articles added as other sources alongside 95 subcategories associated with the competency and meritocracy of hospital executive managers within the Management Competency Assessment Partnership (MCAP) framework-were extracted through open and deductive coding, and ultimately confirmed. Professionalism was correspondingly supplemented to the given categories based on the MCAP framework, and the final hybrid competency-meritocracy model for the selection of hospital executive managers was proposed.
The hybrid competency-meritocracy model proposed in this scoping review can be exploited in the management of new-century hospitals. As the administration of successful hospitals cannot be fulfilled individually, this hybrid model should incorporate all levels of clinical and executive management at hospitals to achieve the desired outcomes by synergizing them with each other. It is suggested to carry out further research on how to establish a competency-meritocracy system in the selection of hospital managers at senior, middle, and operational levels.
在新世纪，各国医疗保健系统（HCS）效率的成功提升取决于有效领导者的选拔。然而，忽视管理者的能力和精英管理制似乎仍是伊朗医疗保健系统（主要是医院）面临的重大挑战之一，而这一挑战旨在提升全球知识和核心技能。
本综述对2000年6月至2023年9月在波斯语和英语数据库上发表的文章进行了研究，使用了“医疗保健系统、医院行政经理、能力与精英管理制”等关键词。采用由阿克西和奥马利开发的六阶段框架来收集和呈现研究结果。此外，通过混合方法评估工具（MMAT）对相关文章的质量进行了评估。
本研究中有7个核心类别，包括有效领导力、全面知识管理、证据、管理任务、个性特质、管理智慧和管理技能。通过开放式和演绎式编码，共提取了105篇参考文献，其中47篇文章用于纳入综述，58篇文章作为其他来源添加，同时还有95个与管理能力评估伙伴关系（MCAP）框架内医院行政经理的能力和精英管理制相关的子类别，并最终得到确认。根据MCAP框架，相应地在给定类别中补充了专业精神，并提出了用于选拔医院行政经理的最终混合能力-精英管理制模型。
本综述中提出的混合能力-精英管理制模型可用于新世纪医院的管理。由于成功医院的管理无法单独完成，这种混合模型应纳入医院临床和行政管理的各个层面，通过相互协同来实现预期成果。建议进一步研究如何在高级、中级和运营层面选拔医院经理时建立能力-精英管理制体系。
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