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已发表论文
采用整合与协同设计流程将医院管理能力建设情境化
Received 16 June 2025
Accepted for publication 27 October 2025
Published 12 November 2025 Volume 2025:17 Pages 721—736
DOI https://doi.org/10.2147/JHL.S547285
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Russell Taichman
Zhanming Liang,1 Hui Zhang2
1College of Business, Law and Governance, James Cook University, Townsville Campus, Townsville, Queensland, Australia; 2School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
Correspondence: Hui Zhang, School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Guangzhou, 510080, People’s Republic of China, Email zhanghui3@mail.sysu.edu.cn
Introduction: Context plays a critical role in shaping how interventions are designed and implemented, and must therefore be considered prior to implementation. There is consensus that the relationship between contextual factors and intervention outcomes is best understood using qualitative and quantitative methods, the process for considering and incorporating context remains unclear. Drawing on a recently completed study focusing on building hospital management capacity, this paper describes and discusses the benefits and learning from the implementation of an integrative and co-design approach.
Methods: This sequential mixed-methods study included managers and clinicians from two district hospitals in China. Focus Group Discussions [FGD] are a critical step in guiding the adaptation of several validated tools in the local hospital context. Data collected from FGDs and online surveys provides a comprehensive understanding of the current state of hospitals.
Results: This study identified a wide range of difficulties faced by mid-level managers and clinical staff in two hospitals. While managers reported hospital-specific challenges, staff across both sites consistently cited issues such as inadequate support, lack of recognition, and lack of patient trust. Survey results also revealed low levels of psychological empowerment, job satisfaction, and perceived leadership effectiveness. Self-assessment using the MCAP tool highlighted significant competency gaps among mid-level managers, particularly in operations management and leading change.
Discussion: The use of a co-design approach broadly engaging relevant key stakeholders from the design and implementation of the project and formulation of improvement strategies is key to enabling project success and maximizing and sustaining project impact.
Keywords: focus group discussions, health managers, leaders, competency, capability, hospitals
1College of Business, Law and Governance, James Cook University, Townsville Campus, Townsville, Queensland, Australia; 2School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
Correspondence: Hui Zhang, School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Guangzhou, 510080, People’s Republic of China, Email zhanghui3@mail.sysu.edu.cn
Introduction: Context plays a critical role in shaping how interventions are designed and implemented, and must therefore be considered prior to implementation. There is consensus that the relationship between contextual factors and intervention outcomes is best understood using qualitative and quantitative methods, the process for considering and incorporating context remains unclear. Drawing on a recently completed study focusing on building hospital management capacity, this paper describes and discusses the benefits and learning from the implementation of an integrative and co-design approach.
Methods: This sequential mixed-methods study included managers and clinicians from two district hospitals in China. Focus Group Discussions [FGD] are a critical step in guiding the adaptation of several validated tools in the local hospital context. Data collected from FGDs and online surveys provides a comprehensive understanding of the current state of hospitals.
Results: This study identified a wide range of difficulties faced by mid-level managers and clinical staff in two hospitals. While managers reported hospital-specific challenges, staff across both sites consistently cited issues such as inadequate support, lack of recognition, and lack of patient trust. Survey results also revealed low levels of psychological empowerment, job satisfaction, and perceived leadership effectiveness. Self-assessment using the MCAP tool highlighted significant competency gaps among mid-level managers, particularly in operations management and leading change.
Discussion: The use of a co-design approach broadly engaging relevant key stakeholders from the design and implementation of the project and formulation of improvement strategies is key to enabling project success and maximizing and sustaining project impact.
Keywords: focus group discussions, health managers, leaders, competency, capability, hospitals