Challenges faced by a hospital administrator

Abstract

A hospital is a very complex organization because it works on all days, at all hours uninterruptedly. The people visiting a hospital are in pain, and the people working in a hospital are diverse ranging from highly skilled medical, paramedical, and technical staff to unskilled employees working as runners, female attendants, and house-keeping staff making it a unique place to be or work in. Hence, a hospital administrator who is at the helm of affairs needs to be mature and tactful in dealing with the staff. A hospital administrator is a professional who oversees the daily operations of a hospital by planning, directing, and coordinating health services. In view of the peculiar nature of the hospital as an organization, the hospital administrator needs to have a multidisciplinary approach applying the principles of public administration, behavioral science, and management skills. He needs to have a balanced approach and find a middle path for multiple issues which are likely to crop up almost daily while working in a hospital. Hospital managers need to possess expertise in the form of strategic skills, perceptive skills, human relation skills, work experience, and personal characteristics in the form of motivation, self-confidence, and courage of decision-making. Hospital administrators should be capable to solve any number of problems quickly and efficiently and must know the best ways to approach a conflict so as not to escalate the situation. The primary focus of hospital administrator is on ensuring high-quality patient care and efficient hospital services and use their administrative skills to manage budgets, funding, and resources.

Introduction

The word hospital has been derived from a Latin word hospes which means a guest. Hospitals were established as a result of sympathy for the sick and suffering. It is an institution where the sick are treated, the physician practices, and the medical and nursing students are imparted medical education. A hospital is a very complex organization because it works on all days, at all hours uninterruptedly. The patient and his relatives are at the peak of their emotions when they visit a hospital, and a small little issue may trigger an event which may blow out of proportion. The diversity of staff working in a hospital ranges from highly skilled physicians, nurses, technicians, and administration to unskilled staff in the form of female attendants, house-keeping staff, and security staff. Hospital walls see more tears and hear more prayers than those of a temple. Hence, a hospital administrator who is at the helm of affairs needs to be mature and tactful in dealing with the staff. He needs to rise to the level of a reputed, talented, and dedicated physician while interacting with him and suddenly shift gears to come down to the level of a housekeeper who comes up with his problem.

The demand for healthcare services is increasing, accompanied by rising costs. However, there is an uneven distribution of trained healthcare professionals, leading to shortages. The changing healthcare delivery requirement needs a novel managerial approach to tackle the transition [1].

A hospital administrator is a professional who oversees the daily operations of a hospital by planning, directing, and coordinating health services. The requirements of being a good hospital administrator are so complex and so different from a general administrator that bachelor’s and master’s degree in hospital administration and healthcare management has been made available in most countries [2]. Liang in his study demonstrated that knowledge, skills, and attitudes to perform the managerial tasks and fulfil their managerial responsibilities are the core competencies required to be possessed by hospital administrators [3].

Peculiarities of a hospital

The essence of a hospital lies in providing healthcare services, which defy quantification. Healthcare delivery is a collaborative effort involving a diverse team of medical, paramedical, technical, and nontechnical professionals, tailored to each patient’s unique needs. Standardization is impossible due to varying ailments and treatment protocols. Healthcare management often involves crisis response, as emergencies arise. Balancing the spectrum of skilled professionals with less formally educated staff requires a nuanced psychosocial approach. Dual control—professional and executive authority—can lead to management conflicts.

Administrator

Mary Parker Follett has defined management as the art of getting things done through the efforts of others. Hospital administrator needs to have special skills in addition to that required in general administration. The primary functions of management include planning, organizing, staffing, directing, and controlling. There are three types of skills required for effective management: technical, human, and conceptual skills. Technical skill is the ability to work with resources in a particular area of expertise. Human skill is the ability to work effectively as a team member. Conceptual skill enables the administrator to see the organization as a whole. As the leader climbs up the ladder of hierarchy, technical skills become less important, but human and conceptual skills become most important.

Hospital administrator

Given the unique nature of hospitals, administrators must adopt a multidisciplinary approach, drawing from principles in public administration, behavioral science, and management. They must navigate interactions with superspecialists without bruising egos while also empathizing with patients and understanding the challenges faced by both medical and nonmedical staff. Striking a balanced approach to address daily issues is essential.

Hospital managers have ethical and legal responsibilities and have a major role in supervising and directing human resources, as well as ensuring the quality of the care and the security of hospitals [4]. The majority of efforts for increasing the capacities of the health-care system have focused on increasing general medical and health-care skills, and there has been less attention to the development of hospital managers despite their major role in improving the performance and the quality of the health-care system [5].

Hospital managers need to possess expertise in the form of strategic skills, perceptive skills, human relation skills, work experience, and personal characteristics in the form of motivation, self-confidence, and courage of decision-making. A study by Pillay shows that managing individuals and human skills is the most important skill for health-care managers [6]. The results of a national survey in the USA show that the most important skill needed for nursing managers was effective and influential human relations [7]. Khadka et al. in his study emphasizes the importance of communicative skills for hospital managers [8]. Kebede et al. in his study found that training hospital managers based on improving their managerial skills results in a significant improvement in the performance of health-care systems [9].

Possessing strategic and long-term vision as a skill is of prime importance for hospital managers, and a systemic mindset is a conceptual framework for solving problems, which occurs through focusing on problems during execution. Terzic-Supic et al. realized that teaching strategic planning and management plays an effective role in the optimal decision-making of hospital managers [10]. Motivation is the main pillar of management, and an unmotivated individual cannot be a successful manager [11].

Hospital administrators are bombarded with information from physicians, nurses, patients, and insurance companies. They need to know how to absorb, process, and utilize this information. Patient hearing and seeing each situation from a broader perspective are crucial for a hospital administrator. Hospital environment is constantly changing, and administrators need to always be looking for ways to better their organization. It is important for them to be proactive and not reactive. Hospital administrators won’t always have all of the manpower, equipment, drugs, surgical consumables, and capital they need, but resourceful hospital administrators know how to properly utilize what they do have. A lack of certainty is also commonly faced by hospital administrators, but they must be adaptable and confident in decision-making even if they may not have all the information and are facing a deadline. Hospital administrators should be capable to solve any number of problems quickly and efficiently. They must know the best ways to approach a conflict so as not to escalate the situation.

The prerequisites of being a good hospital administrator and the qualities which contribute to efficient functioning of healthcare facilities and ultimately impact patient outcomes are critical thinking, relationship building, ethical judgment, adaptability, leadership, and healthcare compliance.

Conclusion

It may take 4 to 6 years to become an effective and efficient hospital administrator whilst the nuances of general administration can be learnt in 1 to 2 years. The most important skills for a general administrator are customer service, data entry, and troubleshoot, while a hospital administrator needs to be proficient in patient care, has to be empathetic, and should efficiently manage patient flow, optimize resource allocation, and enhance patient care coordination. The primary focus of hospital administrator is on ensuring high-quality patient care and efficient hospital services and use their administrative skills to manage budgets, funding, and resources.