Identification and Prioritization of Required Managerial Competencies for Healthcare Management Graduates in Iran Health System

Extended Abstract
Background
Leadership, human resource management, equipment and finance, organization, planning and decision-making, supervision, and control are the most important tasks of any manager in any organization. Being supported by science, each of these principles can play an important role in the success of the organization. The existence of different stakeholders, limited resources, and increasing costs have led to an increased focus on the role of healthcare managers who can facilitate progress and solve many problems with their knowledge. The field of health services management was created with the aim of training efficient managers in the field of health. Considering the role of this group in furthering the objectives of the health system, their training should be based on scientific principles and focused on environmental needs and conditions. Therefore, the identification of the key competencies required by health services management graduates can form the basis for training efficient managers in this system.
Methods
This study was conducted in three steps using the method of content analysis, Delphi, and factor analysis. The study aimed to determine the key competencies needed by health service management graduates. In the first step, a semi-structured and interactive in-depth interview was used to determine the skills required for managerial jobs in the health system, and the data were analyzed based on the content analysis method. The study included expert managers who had a managerial position in the health system or had at least three years of work experience in this field as well as management professors, researchers, and health care service management graduates at various educational levels including bachelor’s, master’s, and Ph.D. programs. Data collection continued until the researcher reached the same concepts and answers, no new concepts were revealed and the data began to repeat. The study included 14 interviews with relevant experts. The data collection tool at this stage was a semi-structured and interactive (face-to-face) in-depth interview. Conceptualization and code extraction were systematically used to examine the content of the interviews. The analysis of the interview data was based on the content analysis method with the MAXQDA software. In the second step of the study, a Delphi study was conducted to create a consensus on the skills, and extracted capabilities from the first step. The participants in this stage were 14 experts who were the participants in the previous step. For data collection, a questionnaire was designed based on the content analysis of the interviews of the first step and was provided to the experts for the survey. The participants scored 44 skills extracted from the interviews through a three-point Likert scale from disagree to agree (from 1 to 3). To analyze the data from the second step of Delphi questionnaires, descriptive statistics were used in the SPSS software environment. In the third step, a factor analysis was carried out to reduce variables to a limited number of factors and to categorize the skills required by managers and graduates in the field of health services management in the health system in terms of several components.

Results
Among 14 study participants, 7 were male (50%) and 7 were female (50%). The participants included 5 hospital managers, 4 professors, and 5 health services management graduates. Overall, 44 key skills and competencies required by managers and health services management graduates in the health system were identified in the form of 10 components. Most agreements with 100% are related to communication and human skills, the root analysis of problems, the skill of managing and integrating diverse perspectives, teamwork, responsibility, time management, and creativity and innovation. Social skills, systemic thinking, history of presence in the environment and in the real arena, decision-making skills, participatory skills, critical skills, resolution of conflicts and tensions, familiarity with the laws and regulations upstream of the country, crisis management skills, problem-solving skills, expertise in the areas of counseling and guidance, change management, and human resource management were ranked second with an agreement of 92.9%. The skills and competencies required by health system managers were categorized in the form of ten components including, mastery of management tasks (with a variance percentage of 29.69), human skills (with a variance percentage of 22.92), mastery of the concepts of finance and economics (with a variance percentage of 11.34), organizational and group behavior (with a variance percentage of 7.46), awareness of the current issues of the health system problem (with a variance percentage of 6.48), and problem-solving skills (with a variance percentage of 4.60); these skills determine over 83% of skills needed by health managers. Nine of the skills were identified under managerial tasks, ten under the set of human skills, four under financial and economic skills, two under organizational behavior, three under daily health system problems, four under problem-solving subset, two under experience and work experience subsets, four under systems and process thinking subsets, one under quality improvement subset, and three under optimization and mathematics subsets.
Conclusion
The results of this study indicated that the key competencies that health management graduates need as future health system managers are communication and human skills, the ability to analyze the root of problems, management and integration skills, different visions, teamwork skills, responsibility, time management skills, creativity, and innovation. In any organization, managers and their perspectives, skills, and abilities are the main pillars to guide and lead the organization. In the field of health, due to dealing with human life, this basic pillar and their competencies become doubly important, therefore, the allocated cost and resources for training these forces in the field of health and treatment management in the country should be based on such needs for employment and workspace, and important skills should be included in training health services management graduates.