Abstract:

This study was conducted to explore the measures that can be taken to address the management challenges that relate to the organizational structure of hospital services in St. Vincent and the Grenadines. A mixed method design was employed in which both qualitative and quantitative methods were used. A semi-structured questionnaire was used to collect data from top managers assigned to four public hospitals in St. Vincent and the Grenadines. The top managers were purposively selected because of their different roles in the management of hospital services. The thematic approach was used in the analysis of data. The study was significant in that it focused on exploring measures that could be used to address management challenges that relate to the existing organizational structure of hospital services in St. Vincent and the Grenadines. The study also contributed to a strategic approach to addressing challenges that affect the delivery of hospital services. The results of the study revealed a number of measures that were highly recommended for addressing the management challenges related to the existing organizational structure of hospital services. The measures included :(i) redesigning the organizational structure to allow a single person to head the management of the organization, (ii) clearly defining the existing reporting lines, and (iii) appointing a CEO along with a board of directors to manage the hospital Services. The study informed a model framework of an organizational structure that illustrates the changes proposed.

References:

[1] Government St. Vincent and the Grenadines. (2013). National economic and social development plan 2013-2025.

[2] Gonsalves, C. (2018). Budget speech: Foundations for growth, job, and transformative sustainable development. Retrieved from http://finance.gov.vc/finance/images/PDF/budgetaddress/Budget-2019.pdf.

[3] Hartwig, K., Pashman, J., Cherlin, E., Dale, M., Callaway, M., Czaplinski, C., Wood, W. E., Abebe, Y., Dentry, T. & Bradley, E. H (2008). Hospital management in the context of health sector reform: APlanning Model in Ethiopia. International Journal of Health Planning and Management, 23(3), 203-218. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18157912.

[4] Rivers University. (2020). Hospital organizational structure. Retrieved from https://www.rivier.edu/academics/online/resources/program-resources/hospital-organizational-structure/.

[5]  Pool, J. (1991), Hospital management: Integrating the dual hierarchy? Retrieved from https://www.healthknowledge.org.uk/public-health-textbook/organisation management/5a-understanding-itd/interactions.

[6] Ditzel, E., Strach, P. &Pirozek, P. (2006). An inquiry into good hospital governance: A New Zealand-Czech comparison. Health Research Policy and Systems, 4(2), 1-10. Retrieved from https://link.springer.com/article/10.1186/1478-4505-4-2.

[7] Perryman-Starkey, M. Rivers, P.A &Munchus, G. (1999). The effects of organizational structure on hospital performance. Health Services Management Research. 12(4), 232-245. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10622802.

[8] Shukri, N. F. M & Ramli, A. (2015). Organizational structure and performance of responsible Malaysian healthcare providers: A balanced scorecard perspective. Procedia Economics and Finance, 28, 202-212. Retrieved from https://doi.org/10.1016/S2212-5671(15)0110-6.

[9] Hearld, L. R., Alexander, J. A., Fraser, I. & Jiang, J. H. Joanna. (2008). Review: How Do Hospital Organizational Structure and Processes Affect Quality of Care? A Critical Review of Research Methods. Medical Care Research and Review, 65(3), 259-299. Retrieved from https://www.researchgate.net/publication/5758625_Review_How_Do_Hospital_Organizational_Structure_and_Processes_Affect_Quality_of_Care_A_Critical_Review_of_Research_Methods.

[10] Public Health Action Support Team (2020), Understanding individuals: Interactions between managers, doctors, and others. Retrieved from https://www.healthknowledge.org.uk/public-health-textbook/organisationmanagement/5a-understanding-itd/interactions.

[11] Tsai, T. C., Jha, A. K., Arul, A., Roberts, H. S., Boo, N. & Sadun, R. (2015). Hospital board and management practices are strongly related to hospital performance on clinical quality metrics. Health Affairs, 34(8), 1304-1311. Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2014.1282.

[12] Ghiasipour, M., Mosadeghrad, A. M., Arab, M. & Jaafaripooyan, E. (2017). Leadership challenges in health care organizations: The case of Iranian hospitals. Medical Journal of the Islamic Republic of Iran (MJIRI), 560-567. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014751/.

[13] Edwards, N. & Saltman, R. B. (2017). Re-thinking barriers to organizational change in public hospitals. Israel Journal of Health Policy Research, 6(8). Retrieved from https://doi.org/10.1186/s13584-017-0133-8.

[14] Kakooza, J. B., Tusiime, I., Odoch, H. &Bagire, V. (2015). Management practices and performance of public hospitals in Uganda. International Journal or Management Science and Business Administration. 1(7), 22-29. Retrieved from Management Practices and Performance of Public hospitals in Uganda - Research leap.

[15] O’Daniel, M., & Rosenstein, A. H. Professional Communication and Team Collaboration. In: Hughes RG. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (2008). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK2637/.

[16] Barati, O., Sadeghi, A., Khammamia, M., Siavashi, E. & Oshrochi, G. (2016). A qualitative study to identify skills and competencies required for hospital managers. Electron Physician, 8(6), 2458-2465. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4965194/.

[17] Stordeur, S. & D’Hoore, W. (2006). Organizational configuration or hospitals succeeding in attracting and retaining nurses. Journal of Advanced Nursing, 57(1), 45-58. Retrieved from Organizational configuration of hospitals succeeding in attracting and retaining nurses - Stordeur - 2007 - Journal of Advanced Nursing - Wiley Online Library.

[18] Harkins, D. (2022). What are the typical organizational structures in healthcare? Retrieved from https://www.smartcapitalmind.com/what-are-the-typical-organizational-structures-in-healthcare.htm.

[19] Healthcare Management Degree Guide. What are the major responsibilities of a health care Chief Executive Officer? Retrieved from https://www.healthcare-management-degree.net/faq/what-are-the-major-responsibilities-of-a-health-care-chief-executive-officer/.

[20] West, E. (2015). Management matters: the link between hospital organization and quality of patient care. Retrieved from Management matters The_link_between_hospital_organisation_and_quality_of_patient_care.pdf.

[21] Arroliga, A. C., Huber, C., Myers, J. D., Dieckert, J. P & Wesson, D. (2014). Leadership in Health Care for the 21^st Century: Challenges and Opportunities. Retrieved from https://www.amjmed.com/article/S0002-9343(13)00971-6/pdf.

[22] Indeed, Editorial team (2022). 7 types of workplace management theories. Retrieved from https://www.indeed.com/career-advice/career-development/types-of-management-theories.