Results-Oriented Hospital Administration: Barriers and Perspectives of Synergies in a Public Hospital in Peru

Aim. To determine the barriers and synergy perspectives in the implementation of results-oriented hospital administration in a public hospital in Peru. Methods: Mixed study, with a descriptive and cross-sectional designed survey administered to 97 staff members of a public hospital in Callao, Peru, five in-depth interviews and two focus groups. The studied dimensions were: strategic planning, budgeting for results, management by process, meritocratic civil service and knowledge management. We undertook an exploratory analysis and obtained central tendency and dispersion measures with the quantitative data. The qualitative analysis was conducted following the Grounded Theory procedures. Results: A critical view of the hospital's management and a favorable attitude towards change prevailed among the staff. Barriers in all areas of exploration were identified, the most important were: inadequate forms of planning and budget management, deficiencies in personnel management and control mechanisms, and dysfunctions in organizational culture and political context. Conclusions: The introduction of results-oriented hospital administration implies anticipating and addressing structural and circumstantial problems of the institutions, with emphasis on improving technical competences for strategic and budgetary planning, adopting a participatory approach, facilitating information flow, establishing effective monitoring and control systems, and transforming the organizational culture.