The Roles of Hospital Directors in Hospital Quality Improvement

Abstract

The hospital director is the highest manager of the hospital and has influenced in quality development of the  hospital. This multiple case study, qualitative research aimed to investigate the problems of quality improvement in Thai public regional and general hospitals and the role of hospital directors in hospital  quality improvement and six leader's roles support their importance for successful quality improvement of  the hospital. The unit of analysis were 4 regional and general hospitals of Permanent Secretary Department  of Ministry of Public Health of Thailand. Semi-structured, in-depth interviews of 60 key-informants, document 
and archival collection and non-participant observation were use as data-collection techniques. Data analysis using pattern matching, explanation building and cross-case synthesis. The finding of the study were, the problems of hospital quality improvement included (1) no or low commitment of the hospital directors in  hospital quality improvement (2) the discontinuity and irregularity of hospital quality improvement (3) the  hospital medical staffs are opposed to hospital quality improvement (4) inappropriate structure of hospital  quality improvement (5) personnel conflict cause by hospital quality improvement. The hospital directors had eight roles that importance for successful hospital quality improvement. They are (1) commitment to quality improvement (2) leading quality improvement (3) communicating or cascading patient safety/quality  orientation throughout the organization (4) participating in quality improvement (5) supporting quality improvement (6) problem solving in quality improvement (7) monitoring progress of quality improvement (8) providing sustainable quality improvement. The leader's six roles derived from literature review support their importance for successful quality improvement in healthcare organizations are also importance for  successful hospital quality improvement in Thai public regional and general hospital. In conclusion, the  hospital director plays an important role in hospital quality improvement and may be the problem  generating or problem solving.