Gero valdymo principų įgyvendinimo ir vadovavimo efektyvumo vertinimas asmens sveikatos priežiūros įstaigoje

Abstract

Aim of the work – to evaluate the implementation of good governance principles, to evaluate management effectiveness and their interrelationship in X and Y personal health care institutions. Work tasks: 1. Identify the implementation of good governance principles in X personal health care institution. 2. Evaluate management effectiveness in X personal health care institution. 3. Identify the relationship between the implementation of good governance principles and the management effectiveness X personal health care institution. Research Methodology: The study was carried out in two stages: preparation for research and the research. Literature sources and internal documents of the health care institution were analyzed in preparation for the study. During the research, a quantitative instantaneous survey was conducted using the questionnaire survey method. Later the results obtained were analyzed. The survey was conducted in October 2018 in X personal health care institution. The research methods used: analysis and synthesis of scientific literature and documents, meta-analysis, questionnaire and statistical econometric methods. Respondents were selected using the convenient selection method. 206 questionnaires were distributed, of which 2 were incomplete and 1 questionnaire was not returned from the respondent. 203 (response rate 99%) questionnaire were suitable for data analysis. Statistical data analysis was performed using SPSS 24.0 and MS Excel software packages. The study was conducted with the permission of head of X personal health care institution and LSMU Bioetics Center Permission 2018-01-18 Nr. BEC-VSV(M)-63. Results: At the X Health Care Institution the staff evaluated the implementation of principles of efficiency / effectiveness and responsiveness to the patient's needs highest, which were evaluated at 3.82 points and 3.81 points out of 5 possible. Employees of the surveyed health care institution evaluated the principles of accountability (3.66 points) and transparency (3.72 points) the lowest, although based on the evaluation scale performed by Čingienė, Laskienė and Raipa, all the principles of good governance are implemented very well, because they are higher than 3.5 points. It is also important that the principle of transparency has been evaluated higher by administrative staff and the difference was statistically significant. Administrative staff are largely related with the implementation of the transparency principle, as they are responsible for providing information and producing reports or strategic plans. Healthcare professionals who have more than 20 years of a work experience in health care and working experience in X health care institution are more likely to evaluate the implementation of the principles of good governance higher than other colleagues. Therefore, the length of service, age and occupation of healthcare professionals determines the assessment of good governance principles in institution. The management efficiency implementation in the analyzed X health care institution is evaluated very good or good by the specialists working in it. Leadership (3.59 points), Flexibility (3.71 points), Relationships (3.61 points), Execution of Tasks (3.72 points), Productivity (3.61 points), Other Education (3.70 points) and Communication (3.64) criteria implementation was considered to be very good because they exceeded 3.5 points and the personal development criterion (3.47 points) was well evaluated based on the scale used. Employees of the administration evaluate the effectiveness of management statistically significantly more often with higher scores, doctors value personal development more often with higher scores, and nurses statistically significantly more often evaluate flexibility and personal development lower. Healthcare professionals who have more than 20 years of a work experience in health care and working experience in X health care institution tend to evauate the management effectiveness higher than their colleagues with a shorter length of service. Respondents under 40 years of age evaluate the education of others higher than older colleagues, and 41-50 year olds value personal development higher. A shorter length of service in the health care facility surveyed leads to a lower evaluation of the effectiveness of management, which can be attributed to the fact that managers are less favored for newly recruited professionals. There is a direct mutual relationship between the principles of good governance and management efficiency, which means that the more effective management effectiveness criteria are implemented, the more effective the principles of good governance are implemented. And the implementation of the principles of good governance increases the manifestation of management efficiency criteria. Conclusions. 1. The implementation of all principles of good governance - participation, transparency, accountability, impartiality / justice, efficiency / effectiveness and responsiveness to the needs of patients - is very good in the investigated institution. Employees of the X Health Care Institution evaluated the implementation of efficiency / effectiveness and responsiveness to the patient's needs the highest, and the principles of accountability and transparency the lowest. Evaluation of the implementation of the principles of good governance differs depending on respondents position, age, length of service and length of service in the X health care institution. 2. Leadership effectiveness implementation is evaluated as very good in terms of leadership, flexibility, relationship, task implementation, productivity, other education and communication criteria by the X health care institution staff, and personal development criteria implementation is rated as good. Evaluation of management efficiency differ due to employee responsibilities, work experience and age and the differences are statistically significant. The administrative staff assesses the efficiency of management with statistically significant higher scores. Healthcare professionals who have been working for more than 20 years tend to evaluate the effectiveness of leadership in the institution statistically significantly higher than colleagues with a shorter length of service. 3. Analyzing the interrelations between the implementation of the principles of good governance and the interrelationship between the criteria of management effectiveness, it was found that a statistically weak positive relationship exists between the principles of accountability and impartiality / justice, the implementation of tasks and the criteria of relations, communication and personal development. In all other cases, the relationship between the principles of good governance and management effectiveness was strong and direct. Implementing the principles of impartiality / justice and efficiency / effectiveness enhances the expression of leadership, flexibility, task implementation, productivity and personal development, and a responsive response to patient needs reduces the expression of leadership.