Abstract:
BACKGROUND:Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. METHODS:We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). RESULTS:The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p < .001). CONCLUSIONS:It is possible to meaningfully assess hospital management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Funk LM,Conley DM,Berry WR,Gawande AAdoi
10.1007/s00268-013-2172-9subject
Has Abstractpub_date
2013-11-01 00:00:00pages
2520-8issue
11eissn
0364-2313issn
1432-2323journal_volume
37pub_type
杂志文章,多中心研究abstract::Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654771
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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pub_type: 杂志文章,随机对照试验
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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journal_title:World journal of surgery
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2004-06-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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journal_title:World journal of surgery
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