ABSTRACT

Objective: Analyze management skills from employees’ perception in the Los Olivos Municipal Hospital in 2019. Methods: Quantitative, correlational, cross-sectional study. A simple random sample of 52 participants was applied. We used a questionnaire to assess perceptions regarding management skills, consisting of 27 questions and 4 dimensions, with a Cronbach’s alpha reliability value of 0.97. We used Pearson’s chi-squared test to analyze correlation between management skills variable and sociodemographic variables. Results: Management skills were considered adequate in analytic and interpersonal dimensions by 69% of participants, while emotional and motivational skills and values were considered regular by 69% and 58%, respectively. 55.8% of participants perceived their bosses’ management skills as adequate, 44.2% perceived them as regular, and none as inadequate. The only sociodemographic variable that was associated with management skills was service time. Conclusion: 55.8% of the health personnel in the Los Olivos Municipal Hospital perceived management skills as adequate.

Keywords: Clinical Governance, Health Services Administration, and Hospital Administration. (Source: MeSH NLM)

RESUMEN

Objetivo: Analizar las habilidades gerenciales desde la percepción del personal en el Hospital Municipal Los Olivos 2019. Métodos: Investigación con enfoque cuantitativo de tipo correlacional y de corte transversal, se aplicó una muestra probabilística aleatoria simple conformada por 52 participantes, se utilizó el cuestionario de percepciones respecto a las habilidades gerenciales que contiene 27 preguntas y 4 dimensiones. Tiene una confiabilidad según alfa de Cronbach de 0,97. El análisis de relación entre la variable habilidades gerenciales con las variables sociodemográficas se realizó mediante la prueba chi-cuadrado de Pearson. Resultados: Las habilidades gerenciales en las dimensiones analíticas e interpersonales fueron consideradas como adecuadas en 69%, mientras las habilidades emocionales y de motivación y valores fueron regulares en 69% y 58% respectivamente. El 55,8% de los participantes percibió que las habilidades gerenciales de sus jefes eran adecuadas, 44,2% regulares y ninguno como inadecuadas. La única variable sociodemográfica que mostró relación con las habilidades gerenciales fue el tiempo de servicio. Conclusión: Las habilidades gerenciales percibidas por el personal de salud del Hospital Municipal Los Olivos fueron consideradas como adecuadas en 55,8%.

Palabras Claves: Gestión en Salud, Gestión de Recursos de Personal en Salud, Administración Hospitalaria (Fuente: DeCS BIREME).

INTRODUCCIÓN

21st century organizations require trained managers who have skills to allow them to implement processes for decision-making with guarantees of permanent adaptation to confront different situations. In an extremely changing and competitive environment, human resources are the element which makes the competitive difference between companies⁽¹⁾.

In some health establishments, there is an absence of directors with managerial capacity and strategic thinking, this influences their functioning without adequate execution of administrative processes, which is reflected in their various organizational levels⁽²⁾. Management skills consist of identifiable actions performed by individuals in order to lead to certain results⁽³⁾. These skills, at present, have acquired greater importance and are the engine of transformation of organizations, for this reason there is a tendency to select personnel who have these skills, since their quality and profitability depend on it⁽⁴⁾.

Managers, therefore, must combine leadership, entrepreneurship and skills to meet the challenges of the changing socio-political, economic and technological scenery, as well as meet the expectations of patients and healthcare professionals. Without proper management, it is not possible to improve the efficiency, effectiveness, and response capacity in the provision of health services⁽⁵⁾.

The hospital, specifically, is an organization which includes human talent, financial and technological resources, those elements work in coordination to deliver a service for society. This is why health organizations need competent managers on charge, who plan, organize, direct and control hospital processes. In this sense, it is not enough for the manager to possess technical knowledge and higher education, but also the ability to handle various skills in the exercise of their functions, with a high level of efficiency⁽⁶⁾.

In Peru, public management professionals are scarce, either because salaries are not attractive for high-level professionals or because there is not adequate preparation to assume this kind of positions.⁽⁷⁾. Therefore, in addition to providing new study material, the present research aims to analyze management skills from the employees’ perception at Hospital Municipal Los Olivos during 2019.

METHODS

Correlational cross-sectional study. The population was made up of 249 participants from the Hospital Municipal Los Olivos, including health care personnel (nursing degree, obstetrician, nutritionist, pharmaceutical chemist, medical technologist, nursing technician, laboratory technician and pharmacy technician) and administrative personnel (civil servant and administrative technician). A simple probabilistic sample made up of 52 participants was applied. Service independent personnel were excluded. The variables studied were managerial skills and sociodemographic variables (sex, age, work condition, time of service and occupation). To measure management skills, the questionnaire designed by Moreno-Galarreta was used, adapted to be applied to health personnel and not to bosses or managers. It has a reliability of 0.97 according to Cronbach's alpha⁽⁸⁾. It is made up of 27 questions and four dimensions: motivations and values, analytical skills, interpersonal skills, and emotional skills. The answers are determined by means of alternatives on the Likert scale, with the numerical evaluation, respectively, of each one (1 to 5). The assessment scale is determined as inadequate (27-63 points), regular (64-99 points) and adequate (100-135 points).

The data were processed using R software, a free-use statistical program. The information was arranged in frequencies tables which were adapted to the variables and dimensions analyzed. Descriptive statistics were used, focusing on measures of central tendency and measures of dispersion. For the analysis of the relationship between the managerial skills variable with the sociodemographic variables, Pearson's Chi-square statistical test was applied. The study was approved and authorized by the general director of the Hospital Los Olivos Municipal. The ethical norms of the Helsinki Declaration for the rights protection of the personnel who participated in the research were taken into account.

RESULTS

From the review of the processed data, we found the participants average age is 37.3 ± 8.8 years; 84.6% of the participants are female, with a predominance of the age group between 26 and 37 years (57.7%). 88.5% had an administrative service contract as a work condition. 75% work in the hospital for less than five years. 59.6% of the participants correspond to nursing personnel (Table 1). The study sample consisted of 52 participants who met the inclusion criteria.


The responses analysis of the motivations and values dimension, allowed to identify 59.6% perceived that they always maintain the desire to achieve achievements in their work and 36.5% almost always maintain their desire to inspect and supervise the activities of their subordinates, as well as the desire for a high level of responsibility.

In analytical skills dimension, 34.6% always find and implement different solutions for different problems and 46.2% almost always evaluate information that has not been collected by the same person (Table 2).
With regard to the interpersonal skills dimension, 51.9% always express their feelings clearly and in the emotional skills dimension, 48.1% almost always face and resolve conflict situations and 42.3% almost always have the ability to take own decisions versus dependence on other people's opinions, likewise tolerance for ambiguity (Table 3).


Regarding managerial skills, the results showed 69% perceived an adequate level in the analytical skills and interpersonal skills dimensions. Meanwhile, 69% perceived a regular level in the emotional skills dimension and 58% in the motivations and values dimension (Figure 1). According to global evaluations, 55.8% perceived their bosses' managerial skills are adequate, 44.2% fair and none as inadequate. A correlation was established between service time and managerial skills (p = 0.021), according to Pearson's Chi-square test. The other sociodemographic variables did not show significant differences in relation to these skills. (Table 1).


DISCUSSION

This study results contribute to the empirical research on the management skills perceived by health personnel in a municipal hospital. Under theoretical foundations and empirical evidence, the managerial skills in health sector organizations role of has been supported. This study is according with the approaches of Griffin and Van Fleet⁽⁹⁾, stating that managers must demonstrate mastery of these skills; The combination of these in behavior, added to the effective execution of their basic managerial functions and activities, increase the success of the organization.

The perception of health personnel could be conditioned by subjective opinions and premeditated ideas about managerial skills. According to Otara⁽¹⁰⁾, in organizations, the perceptions of managers and employees shape the organizational climate and the work effectiveness, so managers must realize that staff have different perceptions, which makes it very difficult to achieve common objectives. In this sense, perception reflects the people's thinking and feelings, but it is not enough the bosses have the necessary skills for the position, but the staff perceive the same and recognize the skills required for that position⁽¹¹⁾.

On the other hand, taking responsibility for management is a complex matter. It has long been viewed simply as an administrative activity of the medical profession; in this way, today it is important to promote and improve these often-underdeveloped management skills among health professionals, which is why, in addition to professional technical skills, they must possess management skills to optimize resources⁽¹²⁾.

Due to this reason, Aini⁽¹³⁾ points out that the lack of trained managerial staff makes management systems ineffective. The hospital must be defined as an organization with a new leadership paradigm to foster the development of innovation and strive to integrate the diverse competencies of physicians and administrators in the management of patients and the health care system in general. The manager has to understand administration as a system or activity of planning, implementation, evaluation and improvement, carried out continuously to achieve a common goal and improve the quality of hospital services.

Therefore, the participants perceived in this study that their bosses have the ability to learn, the ability to continuously acquire knowledge and face reality, adapting to a rapidly changing environment. Along these lines, it should be noted that a study carried out in the United States⁽¹⁴⁾ found that the leader was more respected if he had the humility to recognize and admit he is willing to learn from others. Another study carried out in Spain⁽¹⁵⁾ refers the ability to learn of a manager is constituted in the value which helps to discover the importance of acquiring knowledge through the study and reflection of daily experiences and a deep vision of reality.

Certainly, listening is the ability to understand what is heard, and this perception encourages staff to express what they think about problems and their feelings and emotions, improving communication. For this reason, investigations carried out in other countries such as Rwanda⁽¹⁰⁾, the United States⁽¹⁴⁾, the Netherlands⁽¹⁶⁾ and Cuba⁽¹⁷⁾, found in their studies that a leader must develop good listening skills. However, Torres⁽²⁾, found that only sometimes do managers listen empathically to the staff.

Another important skill is teamwork. In this regard, in Cuba⁽¹⁷⁾ and Brazil⁽¹⁸⁾, results were shown that indicate that the most important skills specified by hospital managers are directly related to teamwork, which aims to obtain satisfactory results in the group they lead. The analysis suggests that teamwork is perceived by staff as the way to work together based on a relationship of trust to achieve common goals. Results have also been obtained in Chile⁽¹⁹⁾, which refers that a boss must influence the behavior of subordinates and possess leadership skills. Likewise, Hernández⁽²⁰⁾ highlights managers who put leadership into practice have the ability to promote and inspire their followers, influence their perspective and change it, if necessary. Therefore, it is a process by which an individual exerts influence on a group of individuals to achieve a common goal⁽²¹⁾.

It is appropriate to point out some limitations such as the size of the sample, the health care and administrative personnel with employment status were excluded service locator who constituted 70% of the population by provision of the hospital management. Another limitation was that research on managerial skills in the health sector is very scarce, which makes it difficult to compare the results obtained. A final limitation was the application of a subjective instrument, the information of which is based on the perception of the interviewees regarding their bosses and this could introduce bias in the results, due to the existence or not of retaliation at work or feelings of friendship, which was sought to control with an anonymous and voluntary survey.

CONCLUSION

Employees’ perception of management skills at Hospital Municipal Los Olivos have been considered adequate. The analytical and interpersonal skills dimensions presented better evaluations, while the regular evaluations correspond to the emotional skills and motivations and values dimensions. The workers' time of service is related to managerial skills.

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