Unlike the first world (United States, Europe, etc.), where the public sector is efficient and effective, providing the best services to the population; in the third world and especially in our country, the exact opposite happens; that is to say, the public sector is accused of being deficient, uneconomic and of lack of effectiveness; all of which, in practice at the height of the situation, is accepted by the community as normal. When this happens in the administrative offices, there are no major problems, generally it does not affect health or life; However, when this refers to public health services, it is no longer just any situation, but rather one that becomes a worrying problem for those responsible for the sector and especially for the population that makes use of medical services.
The external analysis of the Health Sector Hospitals has led to the following THREATS:
- LEGAL POLICY: Obsolete administrative and legal framework and lack of intersectoral communication. ECONOMIC: Salary policy not in accordance with basic needs; Insufficient transfer of funds by the National CULTURAL level: Inadequate lifestyles of the population served by hospitals, which hinders the provision of medical services. COMPETITORS: Entry of potential competitors due to the globalization of the economy and market liberalization; Acquisition of cutting-edge technology by competitors; Presence of health entities with better service offers.
In the Internal aspect, the following WEAKNESSES have been determined:
- PERSONNEL: Human Resources deficit, mainly healthcare; Moderately trained administrative staff. FINANCE: Scarce financial resources; There is 152% of the Human Resource hired by Non-Personal Services INFRASTRUCTURE: Insufficient environments for External Consultation, Hospitalization and Emergency; which does not provide quality services. MEDICINES: Inappropriate request for medicines, which does not facilitate treatment in the best conditions.
Although it is true, the human, financial, material, technological and other resources of our national hospitals do not have the sufficiency or competence required to provide the best medical services; However, this is complicated when there is no effective direction and management to move these entities forward, all of which has repercussions against our population.
The problems identified in relation to the objectives of the Health Sector Hospitals are as follows:
It has been determined that comprehensive care is not prioritized, therefore the promotion and prevention of the most vulnerable sectors are not privileged: women and children; The infrastructure and equipment of the Health Establishments has not been implemented and maintained; The development of Human Potential in Health is not promoted nor does it consolidate an organizational culture; creative and innovative strategies are not developed to increase coverage, with emphasis on vulnerable groups; The supply of drugs is not strengthened under the criterion of rational use. All these problems lead to consider that in the Health Sector hospitals, comprehensive care of Health Services and accessibility of the entire population is not guaranteed.
It has been determined that those responsible for the Direction and management do not promote the participation of the community in the preservation of Health, they do not promote the adequate nutrition of the population through complementary feeding and nutritional surveillance; they do not promote healthy behaviors and lifestyles, nor do they prevent, control or treat communicable, non-communicable diseases and Epidemiological Control. All these shortcomings lead us to consider that there is no fostering of co-responsibility between the State and society in the promotion and prevention of Health as a means of achieving sustainable citizen development.
Those responsible for the direction and management of hospitals do not promote the shared administration of networks and establishments, nor guarantee the management of health networks in an efficient and effective way; neither do they develop an integrated health information system for decision-making. All of which means that hospitals do not have all the elements to conduct a rationalization process effectively, which has repercussions against the entity and especially against the population, which ultimately is the always loses.
The lack of an effective direction and management in the Hospitals of the Health Sector, means that these entities are not facilitators of the fulfillment of the policies and responsibilities of the State Health and the lack of fulfillment of the State of the commitments of Assistance and social welfare to favor of the population.
PROBLEM FORMULATION
How can effective leadership and management contribute to the quality, continuous improvement and competitiveness of medical services in Health Sector hospitals?
SYSTEMATIZATION OF THE PROBLEM
- How can policies facilitate patient satisfaction in Health Sector hospitals? Is it possible that the strategies help to build public confidence in Health Sector hospitals?
THEORETICAL AND CONCEPTUAL FRAMEWORK
THEORETICAL FRAMEWORK
Interpreting Martínez (2006), for the proper functioning of a hospital, everyone agrees that resources are fundamental. Therefore, it is not so much the problem, the sufficiency and competence of the same, it is more important, to have an effective direction and management,that is, they know how to use scarce resources, making the most relevant decisions, until achieving the proposed objectives. It is the application of knowledge and experience in decision making. The direction is to guide a group of individuals to achieve the goals of the hospital. Leading involves commanding, influencing, and motivating staff to perform essential tasks. Relationship and time are essential for management activities. In fact, management gets to the bottom of managers' relationships with each of the people who work with them. Managers lead by trying to convince others to join them in achieving the future that comes from the steps of planning and organizing. The direction is the approach, organization, direction and control of the transactions of a hospital,In order to achieve the objectives that it pursues and likewise, it can achieve them. It is the application of knowledge in decision-making, it includes the task of setting objectives, achieving them, determining the best way to carry out leadership and dealing with the way of planning and integrating all systems, in a whole unified. Management must know how people behave as individuals and when they are in groups and understand how different types of structure operate. This is the central and most important point of the administration, but perhaps where there are the greatest number of discrepancies, even if they are accidental. Thus, for example, some call this element performance, another execution.Terry defines performance as "having all group members aim to achieve the goal, according to plans and organization, made by the chief administrative officer." For their part, Koontz and O'Donnell adopt the term leadership, defining it as "the executive function of guiding and monitoring subordinates." Fayol defines the management indirectly by pointing out: «Once the social group has been established, it is about making it work: such is the mission of the management, which is for each boss to obtain the maximum possible results from the elements that make up his unit, in the interest of the company ”. Management is the essential and central part of the administration of a hospital, to which all other elements must be subordinated and ordered.made by the administrative head ». For their part, Koontz and O'Donnell adopt the term leadership, defining it as "the executive function of guiding and monitoring subordinates." Fayol defines the management indirectly by pointing out: «Once the social group has been established, it is about making it work: such is the mission of the management, which is for each boss to obtain the maximum possible results from the elements that make up his unit, in the interest of the company ”. Management is the essential and central part of the administration of a hospital, to which all other elements must be subordinated and ordered.made by the administrative head ». For their part, Koontz and O'Donnell adopt the term leadership, defining it as "the executive function of guiding and monitoring subordinates." Fayol defines the management indirectly by pointing out: «Once the social group has been established, it is about making it work: such is the mission of the management, which is for each boss to obtain the maximum possible results from the elements that make up his unit, in the interest of the company ”. Management is the essential and central part of the administration of a hospital, to which all other elements must be subordinated and ordered."Once the social group is established, it is about making it work: such is the mission of the management, which is for each boss to obtain the maximum possible results from the elements that make up his unit, in the interest of the company." Management is the essential and central part of the administration of a hospital, to which all other elements must be subordinated and ordered."Once the social group is established, it is about making it work: such is the mission of the management, which is for each boss to obtain the maximum possible results from the elements that make up his unit, in the interest of the company." Management is the essential and central part of the administration of a hospital, to which all other elements must be subordinated and ordered.
Analyzing Escat (2003), we determine that it refers to Forehand and Gilmer (1965), who establish that the organizational climate from the psychosocial point of view is the set of objective characteristics of the organization, lasting and easily measurable, that distinguish a another's labor entity. There are styles of leadership and management, rules and other elements that facilitate this situation.
According to Socorro (2002), we have been protagonists of multiple trends in the management area such as Total Quality, Continuous Improvement, Kaizen, Kyosei, etc. All have brought great changes after its application. All directed mainly to the process and the results.
Playing Reyes(2004), in a hospital apart from the administration of financial resources, material and technological resources, is fundamental for the direction and management, the administration of human resources. This type of administration includes the planning, organization, integration, direction, and control of personnel. To the extent that hospitals plan tactically and strategically, organize these resources structurally and functionally, integrate the different levels of functions they perform, direct These resources with adequate policies and establish instruments for supervision, oversight and control; Then you will be heading towards effectiveness in the provision of medical services. Effectiveness is a process. Obtaining a professional degree is a necessary condition,but not enough to achieve or keep a job. Today, entities demand from people, in addition to technical knowledge and skills, a series of social affective capacities that ensure effective and efficient job performance. In this sense, the leadership and management of hospitals must identify the skills of their workers to maintain, change or create good results in job performancechange or create good job performance resultschange or create good job performance results
Interpreting Stoner (2000), efficiency is an imported paradigm of economic theory, which has guided the work of organizations and their leaders for decades, from the works of classical economists, Adam Smith and David Ricardo in the mid-eighteenth century. Its essential approach taken to work is the relationship between labor costs and expenses that a hospital has to assume and the results obtained (productivity); that is, its expression is the reduction of costs, or minimum costs. It has a forceful logic, it must be produced with the lowest possible labor costs, or in other words, obtain the greatest results with the same labor costs and expenses.
Playing Yoder(2006), the direction and management of a hospital, acts internally, that is where you can work to facilitate the efficiency, economy, transparency and effectiveness of resources, until reaching quality, continuous improvement and competitiveness of medical services; However, one cannot stop looking outside, to adjust the policies, strategies, tactics and actions so that the opportunities can be seized and the threats that arise may be neutralized. Efficiency refers to the relationship between efforts and results. If more results are obtained from a given effort, efficiency will have increased. Also, if the same result can be obtained with less effort, the efficiency will have increased.In other words Efficiency consists of carrying out a job or an activity at the lowest possible cost and in the shortest time, without wasting economic, material and human resources; but at the same time it implies quality by doing well what is done. In organizations it is not enough to be efficient, modern organizations seek more than that, and that is Efficiency. When a Hospital Director reaches the goals or objectives imposed by the institution, we say that it is Effective. Then the Efficacy refers to the results in relation to the goals and fulfillment of the organizational objectives, for that reason to be Effective the tasks must be prioritized and those that contribute to achieving the objectives and goals planned must be carried out in order of precedence.but at the same time it implies quality by doing well what is done. In organizations it is not enough to be efficient, modern organizations seek more than that, and that is Efficiency. When a Hospital Director reaches the goals or objectives imposed by the institution, we say that it is Effective. Then the Efficiency refers to the results in relation to the goals and fulfillment of the organizational objectives, for that reason to be Effective the tasks must be prioritized and those that contribute to achieving the objectives and goals planned must be carried out in order of precedence.but at the same time it implies quality by doing well what is done. In organizations it is not enough to be efficient, modern organizations seek more than that, and that is Efficiency. When a Hospital Director reaches the goals or objectives imposed by the institution, we say that it is Effective. Then the Efficiency refers to the results in relation to the goals and fulfillment of the organizational objectives, for that reason to be Effective the tasks must be prioritized and those that contribute to achieving the objectives and goals planned must be carried out in order of precedence.we say it is effective. Then the Efficiency refers to the results in relation to the goals and fulfillment of the organizational objectives, for that reason to be Effective the tasks must be prioritized and those that contribute to achieving the objectives and goals planned must be carried out in order of precedence.we say it is effective. Then the Efficiency refers to the results in relation to the goals and fulfillment of the organizational objectives, for that reason to be Effective the tasks must be prioritized and those that contribute to achieving the objectives and goals planned must be carried out in order of precedence.
Drucker (2000), says, that it is not enough that the leadership and management do things well (efficiency), they have to do them correctly (effectiveness). Institutional efficiency emphasizes: the means, doing things correctly, solving problems, saving expenses, fulfilling tasks and obligations, training subordinates, applies a reactive approach. Effectiveness emphasizes results, doing the right things, achieving goals, creating more value for the user.
Analyzing Koontz & O'Donnell (2003), saying that continuous process improvement is necessary to be and remain among the most competitive is something already known and of which much has been written and talked about, the important thing is to define policies, strategies and tactics to carry it out, as well as its form of measurement.
Playing Porter(1997), the incorporation of the principles of competitiveness to the development of the functions, activities and operations of hospitals, allows to increase their level of competitiveness, now the effectiveness with which these principles are applied will determine the level of that competitiveness that the entity you are reaching, or the level you are at. The term competitiveness is widely used in business, political and socioeconomic circles in general. This is due to the broadening of the frame of reference of our economic agents who have gone from a self-protective attitude to a more open, expansive and proactive approach. Competitiveness affects the way of planning and developing any activity initiative. The comparative advantage of an entity would be in its ability, resources,knowledge and attributes, etc., that said entity has, the same that its competitors lack or that they have to a lesser extent that makes it possible to obtain higher returns than those.
According to Porter (1996), competitiveness is understood as the ability of a public or private organization, profit or not, to systematically maintain comparative advantages that allow it to reach, sustain and improve a certain position in the socioeconomic environment. Competitiveness means a sustainable benefit for the entity. Competitiveness is the result of constant quality improvement and innovation. Competitiveness is strongly related to productivity.
Hospitals in the Health Sector, despite the deficiencies they experience, can achieve high levels of productivity, to the extent that they have effective leadership and management. Without this requirement, it is impossible to yearn for quality, continuous improvement and competitiveness in services.
Interpreting Chiavenato (2004), to speak of competitiveness is to speak of quality. Even though the quality approach is usually privileged, oriented to the issues of efficiency and optimization of resources, it is necessary to consider that based on the analysis of other experiences, quality offers other alternatives to promote transparency, continuous improvement and competitiveness of the Health Sector Hospitals.
CONCEPTUAL FRAMEWORK
HOSPITALS OF THE HEALTH SECTOR
Es una entidad del Estado, donde se atiende a los enfermos, para proporcionar el diagnóstico y tratamiento que necesitan. La estructura de un hospital está especialmente diseñada para cumplir las funciones de prevención, diagnóstico y tratamiento de enfermedades. Sin embargo muchos hospitales modernos poseen la modalidad y estructura denominada Cuidados Progresivos. En este tipo de hospitales, no hay salas divididas por especialidades médicas como en los hospitales clásicos, sino que el cuidado del enfermo se logra en forma progresiva, según su gravedad y complejidad. En este tipo de hospitales suelen diferenciarse las siguientes áreas: una Área de Cuidados Críticos, otra de Cuidados Intermedios, y por último Cuidados Mínimos y Autocuidados. El paciente ingresa a una u otra área según su gravedad. Un paciente gravemente enfermo y con riesgo de perder la vida, ingresará seguramente a Cuidados Críticos, y luego al mejorar (salir de su estado crítico), se trasladará a Cuidados Intermedios, luego a Mínimos y así sucesivamente hasta dar el alta médica. Si consideramos a un hospital en su conjunto, como un sistema, éste está compuesto por varios sub-sistemas que interactúan entre sí en forma dinámica. Para nombrar los más importantes: Sistema Asistencial, Sistema Administrativo Contable, Sistema Gerencial, Sistema de Información (Informático), Sistema Técnico, Sistema de Docencia e Investigación.
HEALTH SECTOR HOSPITAL MANAGEMENT PROCESS
It consists of the good use of resources in order to obtain a better quality of medical services. In Health Sector Hospitals, resources are scarce, inefficient and sometimes incompetent; therefore, they require an excellent capacity to manage them, so that the conditions to provide medical services in the quantity and quality required by the population are obtained.
PLANNING OF HOSPITALS IN THE HEALTH SECTOR
Stage in which activities related to the definition of objectives, goals, methods, tasks, times, standards (desirable ways in which the process should take place), instruments, indicators (forms of subsequent measurement of results) are developed.
ORGANIZATION OF HOSPITALS IN THE HEALTH SECTOR
The organization is the way in which a Hospital is structured, to form the functions, activities, goals, objectives, mission and vision. The organization has several models. It is governed by principles, rules, processes and procedures. The organization model that is most related to hospitals is the so-called mixed or line-functional organization model. This model maintains the hierarchical model as its central structure, but applies greater specialization, but without exhausting the functional model, and is complemented by a set of support units or authentic specialists called STAFF that advise the different hierarchical levels. The concept of hierarchical line is characterized by an eminently executive nuance, while the staff, deprived of authority, has the mission of advising,technically support the corresponding management unit. This model allows the use of specialists who advise various departments, maintains the unity of command relationship because almost never a person depends on more than a single person. This model has the following drawbacks: Decisions are slower due to consultation with staff who have the decision; staff personnel can interfere with administrative control, introducing a confounding factor; the use of staffs increases hospital administration costs.This model has the following drawbacks: Decisions are slower due to consultation with staff who have the decision; staff personnel can interfere with administrative control, introducing a confounding factor; the use of staffs increases hospital administration costs.This model has the following drawbacks: Decisions are slower due to consultation with staff who have the decision; staff personnel can interfere with administrative control, introducing a confounding factor; the use of staffs increases hospital administration costs.
MEDICAL SERVICES
Medical service is the activity or work carried out by hospital personnel to meet the health needs of the population. Medical service is the set of related systems that work together to provide functionality.
The primary function of the medical service is to prevent and preserve the health of the population in good condition. Efficiency and effectiveness are two adjectives of a qualitative nature, both applicable to hospital services, under ordinary conditions it tends to optimization; which implies efficiency and in extraordinary conditions, the mission must be accomplished even at the expense of the media, without becoming pyrrhic victories; It is important to understand that effectiveness is not a defect, since high efficiency depends on strictly following the planning guidelines, but it is known that planning must be flexible, since there are influential variables, especially those in the environment that produce changes that not being able to act on them could lead to failure,it is in these contingencies where efficiency prevails. On the other hand, effectiveness is the quantification of the fulfillment of the goal, it does not matter if it is achieved efficiently or effectively. Efficiency: "Ability to achieve an end using the best possible means." Efficacy: "Ability to achieve the desired or expected effect, without depriving the resources or means used."
Effectiveness: «Quantification of goal achievement». Compatible use with the standard; however, it should be understood that it can be synonymous with efficacy when defined as "Ability to achieve the desired effect".
QUALITY OF MEDICAL SERVICES
Quality is a concept, a philosophy, a strategy, a model of providing medical services and is located towards the patient who uses the services of a hospital.
Quality not only refers to the service itself, but it is the permanent improvement of the organizational, managerial aspect; taking a hospital as a gigantic machine, where each worker, from the Director to the lowest level hierarchical work, is committed to institutional objectives. For quality to be fully achieved, it is necessary to rescue the basic moral values of society and it is here, where the Director plays a fundamental role, starting with the education, training, prior training and improvement of his workers to achieve a more predisposed labor population, with better capacity to assimilate quality problems, with better criteria to suggest changes in favor of quality,with better capacity for analysis and observation of the service provision process and to be able to correct errors. The use of quality has advantages, being able to cite as examples the following: Potentially achievable if there is a decision of the highest level; Improves the relationship of human resources with management; Reduce costs by increasing productivity. Reengineering together with quality can lead the hospital to electronically link with users and thus become an expanded entity. One of the most interesting structures that is being presented today is networking, which is a way of organizing a hospital and which is more than demonstrating its potential.Potentially achievable if there is a decision of the highest level; Improves the relationship of human resources with management; Reduce costs by increasing productivity. Reengineering together with quality can lead the hospital to electronically link with users and thus become an expanded entity. One of the most interesting structures that is being presented today is networking, which is a way of organizing a hospital and which is more than demonstrating its potential.Potentially achievable if there is a decision of the highest level; Improves the relationship of human resources with management; Reduce costs by increasing productivity. Reengineering together with quality can lead the hospital to electronically link with users and thus become an expanded entity. One of the most interesting structures that is being presented today is networking, which is a way of organizing a hospital and which is more than demonstrating its potential.One of the most interesting structures that is being presented today is networking, which is a way of organizing a hospital and which is more than demonstrating its potential.One of the most interesting structures that is being presented today is networking, which is a way of organizing a hospital and which is more than demonstrating its potential.
Quality is a management system that encompasses all activities and all hospital achievements, with special emphasis on the internal user and continuous improvement.
CONTINUOUS IMPROVEMENT OF MEDICAL SERVICES
For James Harrington (1993), improving a process means changing it to make it more effective, efficient and adaptable.
Fadi Kabboul (1994), defines Continuous Improvement as a conversion into the viable and accessible mechanism for companies to close the technological gap they maintain with respect to others.
Abell, D. (1994), gives as a concept of Continuous Improvement a mere historical extension of one of the principles of scientific management, established by Frederick Taylor, who affirms that every work method is capable of being improved (taken from the Course of Continuous Improvement dictated by Fadi Kbbaul).
LP Sullivan (1994) defines Continuous Improvement as an effort to apply improvements in each area of the organization to what is delivered to customers.
Eduardo Deming (1996), according to this author's point of view, total quality management requires a constant process, which will be called Continuous Improvement, where perfection is never achieved but always sought. In order to carry out Continuous Improvement both in a specific department and throughout the hospital, it must be taken into consideration that said process must be: economic, that is, it must require less effort than the benefit it provides; and cumulative, that the improvement that is made allows to open the possibilities of successive improvements while guaranteeing the full use of the new level of performance achieved. Continuous Improvement is a process that describes very well what the essence of quality is and reflects what entities need to do if they want to be competitive over time.It is something that as such is relatively new since we can show it in the dates of the concepts issued, but despite its recent birth it is currently highly developed. The importance of this managerial technique is that with its application it can contribute to improve the weaknesses and strengthen the strengths of a hospital, through which it is possible to be more productive and competitive in the market to which the organization belongs, on the other hand Organizations must analyze the processes used, so that if there are any problems they can be improved or corrected; As a result of applying this technique, organizations may grow within the market and even become leaders.but despite its recent birth it is currently highly developed. The importance of this managerial technique is that with its application it can contribute to improve the weaknesses and strengthen the strengths of a hospital, through which it is possible to be more productive and competitive in the market to which the organization belongs, on the other hand Organizations must analyze the processes used, so that if there are any problems they can be improved or corrected; As a result of applying this technique, organizations may grow within the market and even become leaders.but despite its recent birth it is currently highly developed. The importance of this managerial technique is that with its application it can contribute to improve the weaknesses and strengthen the strengths of a hospital, through which it is possible to be more productive and competitive in the market to which the organization belongs, on the other hand Organizations must analyze the processes used, so that if there are any problems they can be improved or corrected; As a result of applying this technique, organizations may grow within the market and even become leaders.The importance of this managerial technique is that with its application it can contribute to improve the weaknesses and strengthen the strengths of a hospital, through which it is possible to be more productive and competitive in the market to which the organization belongs, on the other hand Organizations must analyze the processes used, so that if there are any problems they can be improved or corrected; As a result of applying this technique, organizations may grow within the market and even become leaders.The importance of this managerial technique is that with its application it can contribute to improve the weaknesses and strengthen the strengths of a hospital, through which it is possible to be more productive and competitive in the market to which the organization belongs, on the other hand Organizations must analyze the processes used, so that if there are any problems they can be improved or corrected; As a result of applying this technique, organizations may grow within the market and even become leaders.in such a way that if there is any problem, it can be improved or corrected; As a result of applying this technique, organizations may grow within the market and even become leaders.in such a way that if there is any problem, it can be improved or corrected; As a result of applying this technique, organizations may grow within the market and even become leaders.
COMPETITIVENESS OF MEDICAL SERVICES
Competitiveness is the process by which a hospital generates added value through increases in productivity, and this growth in added value is sustained, that is, it is maintained in the medium and long term.
Probably to talk about competitiveness, as Porter says so well, one would have to go to the company, and to the sector, and identify what are the factors that determine that hospitals generate added value and that this value is sold in the market, and whether it really These factors are sustainable in the medium and long term. Being competitive today means having special characteristics that make us be chosen within a group of hospitals that are in the same market seeking to be selected. It is to differentiate ourselves by our quality, by our abilities, by our qualities, by the capacity that we have to captivate, seduce, attend and amaze our clients, whether internal or external, with our goods and services, which would translate into a wealth generator,according to what Michael Porter stated in his book «Competitive Advantages».
JUSTIFICATION AND IMPORTANCE OF WORK
JUSTIFICATION OF WORK
THEORETICAL JUSTIFICATION
If there is something that is undoubted within Health Sector hospitals, it is that they need to be directed and managed effectively. The scarcity or lack of resources forces those responsible to direct and manage them effectively, that is, to fulfill the functions, activities, goals, objectives and mission entrusted as established by Terry (1990).
The effective direction and management allow planning, organizing, directing, coordinating and controlling the human, material and financial resources for the development of medical services; as Koontz & O´Donnell (2003) hints
METHODOLOGICAL JUSTIFICATION
The research starts from the existing problems in the direction and management of Hospitals in the Health sector. On this situation he presents theoretical approaches and experiences on the subject, with the purpose of solving this problem and in that context he formulates the hypothesis; Likewise, the objectives that the work seeks to facilitate the quality, continuous improvement and competitiveness of medical services are formulated. This being the process of all research as established by Stoner (2000).
This work will describe the integral operation of hospitals; Then it will explain how effective direction and management can become a relevant factor in the quality, continuous improvement and competitiveness of the medical services provided by these entities.
PRACTICAL JUSTIFICATION
The effective direction and management will have positive consequences for the operation of the Health Sector Hospitals. Among the positive consequences, we can name efficiency, economy, transparency and effectiveness in the use of resources and the supreme goal will be the quality, continuous improvement and competitiveness of medical services for the demanding population.
IMPORTANCE OF WORK
This work is important because it allows applying the scientific method to solve institutional problems.
Also because it allows to follow the footprint of current and future paradigms such as quality, continuous improvement and competitiveness.
It is also important, because it will make it possible to capture the knowledge and experiences of leadership and management.
OBJECTIVES
OVERALL OBJECTIVE
Identify how effective direction and management can contribute to the quality, continuous improvement, and competitiveness of health services in Health Sector hospitals.
SPECIFIC OBJECTIVES
- Establish policies that facilitate patient satisfaction in Health Sector hospitals. Determine strategies that help empower citizen trust in Health Sector hospitals.
HYPOTHESIS FORMULATION
MAIN HYPOTHESIS
The effective direction and management contribute to the quality, continuous improvement and competitiveness of health services in the hospitals of the Health Sector.
SPECIFIC HYPOTHESES
-
- Policies facilitate patient satisfaction in hospitals in the Health sector. The strategies help to empower citizen trust in Health Sector hospitals.
VARIABLES AND INDICATORS
INDEPENDENT VARIABLE:
EFFECTIVE MANAGEMENT AND MANAGEMENT
INDICATORS:
X.1. POLICIES
X.2. STRATEGIES
DEPENDENT VARIABLE:
QUALITY, CONTINUOUS IMPROVEMENT AND COMPETITIVENESS OF MEDICAL SERVICES
INDICATORS:
Y.1. PATIENT SATISFACTION
Y.2. CITIZEN TRUST
INTERVINENT VARIABLE:
HOSPITALS OF THE HEALTH SECTOR
INDICATORS.
Z.1. INTEGRAL MANAGEMENT PROCESS
Z.2. INSTITUTIONAL CONTROL
METHODOLOGY
KIND OF INVESTIGATION:
This research will be of the basic or pure type, since all aspects are theorized, although its scope will be practical to the extent that they are applied by Health Sector hospitals.
INVESTIGATION LEVEL
The research to be carried out will be at the descriptive-explanatory-correlational level, since the problems experienced by the hospitals in the Health Sector will be described; It will explain how effective direction and management contributes to obtaining quality, continuous improvement and competitiveness of medical services; And, it will correlate what happens in a hospital with what is happening or can happen in the other hospitals in the health sector, because they all work on the same general policies.
INVESTIGATION METHODS
The following methods will be used in this investigation:
- Descriptive.- Because the entire theoretical framework of the Health Sector hospitals will be specified; effective leadership and management; and, the quality, competitiveness of medical services. Inductive - To infer the information of the sample in the population and determine the conclusions that the investigation merits. Information about the effective direction and management will be inferred to obtain the quality, continuous improvement and competitiveness of medical services.
DESIGN OF THE INVESTIGATION
Design is the plan or strategy that will be developed to obtain the information required in the investigation. The design to be applied will be Non-Experimental, Transectional or transversal, Descriptive, Correlational-causal.
Non-experimental design is defined as research that will be carried out without deliberately manipulating variables. In this design, phenomena are observed as they occur in their natural context, and then analyzed. The cross-sectional or cross-sectional research design to be applied consists of data collection. Its purpose is to describe the variables and analyze their incidence and interrelation at a given moment. The descriptive transactional design that will be applied in the work, aims to investigate the incidence and the values in which the research variables are manifested. The correlative-causal Transectional research design that will be applied will serve to relate between two or more categories, concepts or variables at a given moment. It will also be descriptions, but not categories,concepts, objects or individual variables, but of their relationships, whether they are purely correlational or causal relationships. Through this type of design the research elements are associated.
POPULATION OF THE INVESTIGATION
The population will be made up of personnel who work in the following hospitals:
- Puente Piedra Maternal and Child Hospital: CT 548-1799 / 548-1566 / 548-1898. Annex: 117 Direct: 548-3935. Av. Sáenz Peña s / n Km 30 Panamericana Norte, Puente Piedra. "Dos de Mayo" National Hospital. Park of the History of Medicine s / n Barrios Altos. Tel: 328-1414 / 328-1434 / 328-1421 / 328-0028
A Basic Services Hospital and an Integral Services Hospital have been considered to have complete information on the direction and management of this type of entity at all levels.
INVESTIGATION SAMPLE
To define the sample size, the probabilistic method has been used and the generally accepted formula has been applied for populations smaller than 100,000.
Where:
| n | It is the size of the sample to be taken into account for the field work. It is the variable that you want to determine. |
|
P and q |
They represent the probability of the population to be included or not in the sample. According to the doctrine, when this probability is not known from statistical studies, it is assumed that p and q have a value of 0.5 each. |
|
Z |
Represents the standard deviation units that in the normal curve define an error probability = 0.05, which is equivalent to a 95% confidence interval in the sample estimate, therefore the Z value = 1.96 |
| N | The total population. This case 135 people, considering only those who can provide valuable information for the investigation. |
| EE | Represents the standard error of the estimate, according to the doctrine, it must be 0.09 (9.00) or less. In this case 0.05 (5.00%) has been taken |
Substituting:
n = (0.5 x 0.5 x (1.96) 2 x 135) / (((0.09) 2 x 134) + (0.5 x 0.5 x (1.96) 2))
n = 100
DATA COLLECTION TECHNIQUES
The techniques that will be used in the investigation will be the following:
- Interviews.- This technique will be applied to the Directors, Deputy Directors and Heads of Units, in order to collect information on the investigation. Surveys.- It will be applied to medical personnel; nursing and related personnel; technical and medical auxiliary personnel; administrative personnel (personnel of the administrative systems of budget, treasury, supply, personnel, accounting, others), in order to gather information about the investigation. Documentary analysis.- This technique will be used to analyze the norms, bibliographic information and other aspects related to the investigation.
DATA COLLECTION INSTRUMENTS
The instruments that will be used in the investigation are the following:
- Survey questionnaire.- This instrument will be applied to carry out the survey. Documentary analysis guide.- This instrument will be useful to write down the information of standards, books, magazines, Internet and other sources.
ANALYSIS TECHNIQUES
The following techniques will be applied:
- Documentary analysis. - This technique will allow knowing, understanding, analyzing and interpreting each one of the norms, magazines, texts, books, Internet articles and other documentary sources. Inquiry.- This technique will facilitate the availability of qualitative and quantitative data of a certain level of reasonableness. Data reconciliation.- The data of some authors will be reconciled with other sources, so that they are taken into account. Tabulation of tables with quantities and percentages.- The quantitative information will be ordered in tables that indicate concepts, quantities, percentages and other useful details for the investigation. Graphics understanding.- The graphics will be used to present information and to understand the evolution of the information between periods, between elements and other aspects. Others.- the use of instruments, techniques, methods and other elements is not limiting, it is merely referential; therefore to the extent that other types were necessary.
DATA PROCESSING TECHNIQUES
The following data processing techniques will be applied:
- Ordering and classification. - This technique will be applied to treat qualitative and quantitative information in an orderly manner, in order to interpret it and make the most of it. Manual registration.- This technique will be applied to enter the information from the different sources. Computerized process with Excel.- To determine various mathematical and statistical calculations useful for research. Computerized process with SPSS.- To enter, process and analyze company data and determine average, association, differentiation, correlation, regression indicators, etc.
SCHEDULE
BUDGET
| ITEMS | QTY | UNIT |
UNIT PRICE . |
TOTAL SUB |
TOTAL
ITEM |
| I. ASSETS: | 1,720.00 | ||||
| GOODS | two | THOUSAND | 25 | 50.00 | |
| PENCILS | 5 | DOZENS | 10 | 50.00 | |
| COMPUTER INK | 10 | UNITS | 30 | 300.00 | |
| FLOPPY | 3 | DOZEN | twenty | 60.00 | |
| CD | one | DOZEN | 60 | 60.00 | |
| OTHER ASSETS | 1, 200.00 | ||||
| II. SERVICES | 4,480.00 | ||||
| SPECIALIZED ADVICE | 2,500.00 | ||||
| SECRETARIAL SUPPORT | 500.00 | ||||
| MOBILITY | 300.00 | ||||
| VIATICAL | 500.00 | ||||
| TELEPHONE | 200.00 | ||||
| IMPRESSIONS | 180.00 | ||||
| PHOTOCOPY | 100.00 | ||||
| VARIOUS | 200.00 | ||||
| TOTAL | 6,200.00 | ||||
BIBLIOGRAPHIC BACKGROUND
Thesis: " Corporate Administration for the effective management of the Universities", presented by Juan Alberto Vega Ramírez to choose the Degree of Doctor of Administration at the University of San Martín de Porres. In this work, the author describes the process of corporate administration and how it can be applied to achieve the effectiveness of the academic and administrative management of universities. Like hospitals, universities are entities that provide services, so there will be considerations that will be taken into account.
Thesis : "Strategic Management and Business Sanitation"; presented by Hugo Eduardo Jara Facundo to opt for the Doctor of Administration Degree at the Universidad Nacional Mayor de San Marcos. In this document, the author establishes that the application of the instruments of strategic management, supported by a culture of values and with effective leadership, facilitates the effective management and competitiveness of the institutions. Hospitals in the health sector need effective direction and management, for the quality, continuous improvement and competitiveness of the medical services that the population needs, therefore, in this work there are many points that are consistent with the work.
Thesis : "Organizational strategies and resource management in the Hospitals of the National Police of Peru"; presented by Juan Alberto Ramírez Gonzáles to choose the degree of Doctor of Administration at the Universidad Nacional Federico Villarreal. In this document, the author mentions the great institutional interest in trying to know, understand and apply the most appropriate organizational strategies so that the Police Hospital becomes a leader in obtaining and using efficient, effective and economic human, material resources. and financial;
Thesis: “Strategic management for the continuous improvement of the Budgetary Specifications of the Public Sector”, presented by María Aguilar Luna to choose the Degree of Doctor in Administration at the University of San Martín de Porres. In the thesis, the author presents the process of strategic management, policies, strategies and tactics to efficiently and economically manage human, material and financial resources until reaching the goals, objectives and mission of each budget specification;
Thesis: "Public Sector entities and their competitiveness"; presented by Lizeth Ramos Celis to opt for the Doctor of Administration Degree at the San Martín de Porres University. In this thesis, the diagnosis of the management of the human, material and financial resources of public sector entities is made. They are considered a set of strategic tools to achieve efficiency and competitiveness of the sector;
Thesis: Peru: " State and Society in the effective prospective of International Technical Cooperation", presented by Domingo Hernández Celis, to choose the Degree of Doctor in Economics. In this document, the author describes a set of policies, norms and strategies so that the State and Organized Civil Society can participate in the best conditions until achieving effective prospective use of resources from international technical cooperation. Hospitals in the health sector use international cooperation, therefore they must have the appropriate direction and management to make such cooperation effective in quality services for the population.
Thesis: "Benchmarking: Strategy for competitiveness"; presented by Roberto Fernández Rojas to opt for the Doctor of Administration Degree at the Autonomous University of Mexico. In this thesis, the author develops the philosophy, doctrine and methodology of benchmarking; It also develops the theoretical framework of the strategies and proposes benchmarking as a way to achieve competitive advantage in the context of business globalization.
Thesis: " Prospective: a tool to improve and compete", presented by Armando Paredes Rivera to choose the Doctor of Administration Degree at the Catholic University of Chile. In this thesis the author develops the process of the theories of foresight, continuous improvement and competitive strategy of Michael Porter and then proposes foresight as the tool of contemporary administration and finance to achieve business competitiveness.
Thesis: "Corporate Management with Benchmarking for the competitiveness of State Banking"; presented by María Felicita Peña Wong to opt for the Doctor of Administration Degree at the Federico Villarreal National University. The author carries out a detailed study of the situation of human, material and financial resources used by state banks and on that basis proposes the application of benchmarking to achieve effective and competitive corporate management.
Thesis: "Strategic management for the effectiveness of Social Food Support Programs ", presented by Maribel Grados Marcos to choose the Master's Degree in Administration at the Federico Villarreal National University. The author conducts a diagnosis of the human, material and financial resources of the government's social programs and on that basis proposes a strategic management plan that allows the fulfillment of the temporary and permanent actions, the strategic objectives and the mission of the programs, always seeking to benefit the lowest income population in our country.
Thesis: " Current and prospective conception for the effective management of human resources in hospitals in the health sector ", presented by Rosario García Delgado, to choose the Master's Degree in Administration at the National University Federico Villarreal. In this work, the author analyzes the management process, organic structure, policies, strategies and regulations of hospitals in the health sector; it also presents the current and prospective conception of human resources; Finally, it presents the ways in which the efficiency, economy, effectiveness, productivity, continuous improvement and competitiveness of human resources must be achieved, as a way of providing services to the population.
BIBLIOGRAPHIC REFERENCES
- Chiavenato Idalberto (1998) Introduction to the General Theory of Administration. Mexico. Mc Graw Hill. Chiavenato Idalberto (2004) Human Resources Administration. Mexico. Mc Graw Hill.Drucker Peter F. (2004) Management in the Future Society. Bogotá. Norma Editorial Group. Escat Cortés María (2004) How to act to improve the organizational climate. Madrid. Complutense University of Madrid.Escat Cortés María (2003) Workplace Climate. Madrid. Complutense University of Madrid.Gómez Bravo, Luis (2006) Continuous Improvement. Havana. University of Havana - Cuba.Johnson, Gerry & Scholes, Kevan (1999)Strategic Direction: Analysis of the Strategy of Organizations. Barcelona, Spain. Closas Orcoyen SLKoontz, Harold / O´Donnell, Cyril (2003) Modern Administration Course-An Analysis of Systems and Contingencies of Administrative Functions. Mexico. Lithographic Ingramex SA López Mas, Julio (2006) Work motivation and Human Resources Management in Frederick Herzberg's Theory. Mexico. Editorial LIMUSA.Martínez Luis (2006) Organizational Climate. Mexico. National Autonomous University of Mexico.Martínez de Ita María Eugenia (2006) The concept of productivity in economic analysis. Madrid. Complutense University, Palomino Mariselli. Rogger Augusto (2005) Human Resources Topics:Organizational climate. Buenos Aires. Universidad Nacional de la Plata.Pereyra Angélica (2003) Draw attention without breaking the weather. Buenos Aires. AP Consultants.Porter, Michael E. (1996) Competitive Advantage. Mexico. Compañía Editorial Continental SA. De CV.Porter, Michael E. (1996) Competitive Strategy. Mexico. Compañía Editorial Continental SA. De CV. Reyes Ponce, Agustín (2004) Personnel Administration. Mexico. Editorial LIMUSA.Stoner, Freeman Gilbert (2000) Administration. Mexico. Compañía Editorial Continental SA. From CV Terry George (1990) Principles of Management. Mexico. Compañía Editorial Continental SA. De CV.Yoder, Dale (2006) Personnel Management and Industrial Relations. Mexico. Editorial LIMUSA.Venezuela Competitiva (2004) Organizational climate. Caracas. Competitive Venezuela NGO.
_______
Data provided by the Management of the Puente Piedra Hospital.
Martínez Luis (2006) Organizational Climate. Mexico. National Autonomous University of Mexico.
Escat Cortés, María (2003) Workplace Climate. Madrid. Complutense University of Madrid
Socorro, Félix (2002) The TEA Philosophy: Improving the work environment. Barcelona- Venezuela. Gran Mariscal de Ayacucho University.
Reyes Ponce Agustín (2004) Personnel Administration. Mexico. LIMUSA Editorial.
Stoner, Freeman Gilbert (2000) Administration. Mexico. Compañía Editorial Continental SA. de CV.
Yoder, Dale (2006) Personnel Management and Industrial Relations. Mexico. LIMUSA Editorial.
Druker Peter (2000) Management in Hard Times. Mexico. Compañía Editorial Continental SA. de CV.
Koontz, Harold & O`Donnell, Cyril (2003) Modern Administration Course-An analysis of systems and contingencies of administrative functions. Mexico. Lithographic Ingramex SA.
Porter Michael E. (1997) Competitive Strategy. Mexico. Compañía Editorial Continental, SA. de CV.
Porter Michael E. (1996) competitive advantage. Mexico. Compañía editorial Continental, SA de CV.
Chiavenato Idalberto (2004) Human Resources Administration. Mexico. Mc Graw Hill.
Terry George (1990) Principles of Management. Mexico. Compañía Editorial Continental SA. From CV.
Koontz, Harold / O´Donnell, Cyril (2003) Modern Administration Course-An Analysis of Systems and Contingencies of Administrative Functions. Mexico. Lithographic Ingramex SA.
Stoner, Freeman Gilbert (2000) Administration. Mexico. Compañía Editorial Continental SA. From CV.
Download the original file
