Leadership, Management and Governance (LMG) Practices in Ethiopian Public Hospitals: 2018–and 2019

AbstractBackground: Optimal Leadership, Management and Governance (LMG) practices are essential to ensure effective, efficient, and high-quality health service that contributes to good health conditions of the population. The aim of this study was to determine the level of LMG practices and identify factors associated with it at public hospitals in the years 2018 and 2019. A total of 250 hospitals (Tertiary hospitals, General hospitals, and Primary hospitals) were included in the study.Methods: The study used hospital self-assessment reports which were reported in Districts Health Information System II (DHIS2) using quantitative national tools developed by the Ministry of Health. The data was collected by officers that have experience of working in hospitals (that means, those who were familiar with DHIS2) and whom we trained in how to use the data collection tools. The data was cleaned and analyzed using SPSS software. Descriptive statistics was used to measure level of LMG practices and cross-tabulation to identify factors associated with LMG practices.Results: - The national mean score of LMG practices by hospital standard was 67% in 2018 and 65% in 2019. Overall mean scores were 52.6% and 52.1 for Tertiary hospitals. 72.8% and 69.3% for General hospitals and 65.2%, 67.2% for Primary hospitals, in 2018 and 2019, respectively. Out of the 250 public hospitals, studied, 49% had a well-functioning Health Development Army (HDA) is teams within the department/unit of a hospital. Only 50% of the public hospitals had evaluated the LMG practices of their Chief Executive Officers (CEOs) against the minimum standards set in EHSTG.Conclusion: the entire variable in the assessment tools was a minimum standard to be fully complied with in all the public hospitals. The results of this study revealed that the LMG practices were below the minimum standard. Well-functioning health development army was missing in many of the hospitals, and this suggests that there remains a lot to improve in health service s delivery in public hospitals. Not evaluating hospital performance against annual plan was found to be a cause of misunderstanding the challenges and not targeting them in future direction to meet requirement. [Ethiop. J. Health Dev. 2021; 35(2):97-104]Keywords: Leadership, Management and Governance practices; public hospitals; health service quality, Ethiopi

Operational Plan for HMIS Rollout to be Read in Conjunction with the MoH&SW Document of October 2007

The MoH&SW, with a consortium of partners, in October 2007, developed a Proposal to Strengthen the HMIS in Tanzania. This document builds on that proposal to develop a budgeted 6‐month plan to kick‐start implementation of the Revised MTUHA in one region and at national level, to develop a replicable model that can be scaled up to other regions as additional funds become available. The overall HMIS revision process will ensure that, within a period of five years the HMIS will be functional in all 21 regions of the country, in a phased manner Six months intensive systems and database development in Mtwara region Eighteen months implementation in one region in each of the six zones Within 5 years, National rollout to every region The initial six months implementation process, described in depth in this document, will use action research and participatory development methodology that will integrate the six work packages in the HMIS document, in line with the HSSP III proposals for strengthening M&E. A number of dedicated teams will roll out the HMIS, develop a toolkit for implementation in other regions and produce a modern web based data warehouse. The project logframe aims to provide quality routine data for monitoring MDGs and the NHSSPIII by producing five outputs – HMIS revision, HMIS implementation, Capacity development, the DHIS software and action research. Terms of reference are developed for each of the HMIS teams, based on the activities in the logframe – Indicator and dataset revision, HMIS design, Database development and training team. An action‐based budget of US$15 million is provided for three years that envisages The model region will cost$1,25 million for the first year, including the rollout activities, the development of training material, adaptation of software etc. The other six regions will cost 1,05million for first year; all regions will reduce to $500,000 for the second year and$300,000 in the third year. National level costs will reduce from $700,000 to 500,000 a year as local consultants replace international technical assistance and Ministry takes over running expenses. Rollout for the other 14 regions will need a separate budgeting process after the six regions, but should be in the range of 1,8 million a year (or less if costs can be reduced). The activities in the model initiation region will cost$1,2 million for the first year, including the rollout activities, the development of training material, adaptation of software et

The Promise of Health Information Technology: Ensuring that Florida's Children Benefit

Substantial policy interest in supporting the adoption of Health Information Technology (HIT) by the public and private sectors over the last 5 -- 7 years, was spurred in particular by the release of multiple Institute of Medicine reports documenting the widespread occurrence of medical errors and poor quality of care (Institute of Medicine, 1999 & 2001). However, efforts to focus on issues unique to children's health have been left out of many of initiatives. The purpose of this report is to identify strategies that can be taken by public and private entities to promote the use of HIT among providers who serve children in Florida

Acceptance model of electronic medical record

This paper discusses acceptance issues of Electronic Medical Record System (EMR), particularly in Malaysia. A detailed overview of EMR and its benefits are firstly discussed. A number of acceptance models are scrutinized. Then factors affecting EMR acceptance are put forward. Finally, before proposing an EMR acceptance model, an instrument formed by adapting and then finding its factors loading is presented

The New York City Health and Hospitals Corporation: Transforming a Public Safety Net Delivery System to Achieve Higher Performance

Describes the results of the public benefit corporation's improvement initiatives -- a common clinical information system for continuity, coordination on chronic disease management, teamwork and continuous innovation, and access to appropriate care

Identifying common problems in the acquisition and deployment of large-scale software projects in the US and UK healthcare systems

Public and private organizations are investing increasing amounts into the development of healthcare information technology. These applications are perceived to offer numerous benefits. Software systems can improve the exchange of information between healthcare facilities. They support standardised procedures that can help to increase consistency between different service providers. Electronic patient records ensure minimum standards across the trajectory of care when patients move between different specializations. Healthcare information systems also offer economic benefits through efficiency savings; for example by providing the data that helps to identify potential bottlenecks in the provision and administration of care. However, a number of high-profile failures reveal the problems that arise when staff must cope with the loss of these applications. In particular, teams have to retrieve paper based records that often lack the detail on electronic systems. Individuals who have only used electronic information systems face particular problems in learning how to apply paper-based fallbacks. The following pages compare two different failures of Healthcare Information Systems in the UK and North America. The intention is to ensure that future initiatives to extend the integration of electronic patient records will build on the ‘lessons learned’ from previous systems

Developing Health System Surge Capacity: Community Efforts in Jeopardy

Examines six communities' efforts to build surge healthcare capacities to respond to terrorist attacks, epidemics, and natural and manmade disasters; the needed components and funding; and the effects of the restrictions and decline in federal funds