In present era, considering significant evolutions in management knowledge, the assessment structure, as one of human and physical resources management processes, gains more and more importance every day, such that today, assessment structure is today considered a tool for reaching goals of each organization (Robbins and De Cenzo, 1998).
Perhaps the major matter that makes assessment structure necessary is that operational programs and initiatives in organizations is always accompanied by a percentage of error and to eradicate these errors, provision and assessment is one of major tasks (Alvany, 2003).
Reviewing experiences of countries, shows that the countries have paid attention to process of assessment after execution and have prepared necessary legal and cultural settings for using results of assessments, have been successful and have had better situation each year after the last (Eftekhary, 2002).
Health sector is no exception to this either and requires such assessment for progress.
As the health care facilities is one of the most important units of health service providers, the weakness of supervisors performance may result delay in providing services or low quality one. This weakness may also result increase in charges and loss of financial sources and finally decrease in productivity (Hamidi, 1997).
So concerning to these problems and implementing research to be familiar with strange and weakness of supervisors performance is very important. Therefor, this study aims to assess the attitude and managerial performance of Mashhad health care facilitys supervisors.
MATERIALS AND METHODS
This study is a practical, descriptive study, which has been done in parts. The group under study includes all supervisors and staff of healthcare facilities; to perform this study, researchers have conferred healthcare facilities (1, 2, 3) and after giving necessary training and preparing cooperation settings, prepared tools of gathering data (in the form of two supervisor reviewing questionnaires. Supervisors performance from viewpoint of staff and Attitude of supervisor) and presented it to supervisors and staff of facilities and collected them after completion.
Data coded according to the information gathered on the questionnaires and after correction, entered to computer. For description of information, tables of frequency distribution were used and statistical relations with χ2-test, analysis variance and t-test was studied with 95% assurance in SPSS V11/5 software.
RESULTS AND DISCUSSION
During this sectional study 343 samples were evaluated in second 6 months of
Results made from supervisors performance: Findings regarding supervisors attitude showed to agents of planning, 13% of supervisors did not participate in this study. Thirteen percent of supervisors did not believe in determining a goal to improve their performance. Meantime 23% were not serious to determine priorities and 22% did not believe in presenting formulated schedule. Findings regarding supervisors attitude also showed to organizing, 42% of supervisors were not agree with teamwork and 33% of them were not interested in cooperation of other staff; whereas 45% of them did not pursue cooperated and regular meetings between sectional groups and 35% of them were not active in presenting clear goals to staff; but 58% of them were agree to explain duties of staff and 49% agree to do works according rules, meantime 31% of supervisors believed that the rules of facilities are disregarded.
According to the results regarding supervisors attitude toward assessment factors, 58% of supervisors were not agree to assess interferential program, 43% of them were not agree to continues assessment of staffs performance and 49% of supervisors were successful at presenting feedback to them but 48% of supervisors were not successful in registering changes in time.
Included findings of supervisors attitude shows organizing is considered
most and in reverse assessment (Table 1).
Also findings show by increase of service background, rate of consideration to planning, organizing and assessment also increase p<0.05.
Achieved results from staff viewpoints regarding the performance of supervisors: Findings regarding the viewpoint of staff about supervisor in planning topic showed 28% of staff were against doing the supervisory activities according to schedule even 10% of staff believed that the supervisors do not consider planning.
Seventy five percent of staff was in the affirmative to pursue problems by supervisor but 30% of staff believes supervisors are not studios in registering changes in time. Findings about supervisors performance indicated most consideration
of supervisors is toward organizing and least to assessment (Table
Service background of staff is one of factors affirmatively affected on their attitude regarding the duties of supervisors. Wise the opinion of staff, age and sex of supervisors does not have much influence on their performance p<0.05.
Viewpoints of staff regarding the performance of supervisors indicated between planning, organizing and supervisors assessment there is direct and meaningful correlation p<0.05.
||Approach of manager level to planning, organization and assessment
|| Performance of manager corresponding to staffs viewpoint
||Comparison of altitude supervisor's with vision of staffs
about planning, organization and assessment
||Comparison of altitude supervisor's with their performance;
By comparison of supervisors attitude and performance of them in regard
to staffs viewpoint, below results were achieved:
Between the attitude of supervisors and staffs regarding assessment, direct
and meaningful relation was observed (Fig. 1) p<0.05.
After studying the organization of supervisor; from his and staffs viewpoint
it is defined between these two groups there is a meaningful difference; as
supervisors opinions about organizing were not confirmed by staff. Comparison
of staffs opinions and supervisors regarding supervisors planning
indicated between these two ideas of groups there is a direct correlation (Fig.
This report is partial of study aims to assess the attitude and managerial performance of Mashhad health care facilitys supervisors. According to organization difference between countries and according to slighting this kind of research, attention to interpretation its results is very necessary.
Examinations indicate a kind of decision centralization in activities, such that supervisor, in executive activities, paid less attention to viewpoints of staff and informing them. Other research shows that over 50% of managers have weakened in corporation with their employee's (Asefzadeh, 2005). Nevertheless Mintzburg say that Democratic style management has more effect performance than Autocratic style management (Rizzo, 2003).
Since healthcare system in our nation is of centralized planning type, supervisors act accordingly and give less autonomy to staff and the result is less coordination of plans with needs and facilities of the area and lower motivation of staff in cooperating with plans (Tabibi, 2005).
Other results indicate supervisors, in regards to reviewing performance, are orderly individuals, law abiding and committed to their duties and they are a kind of functional style management. This indicates a complete understanding of supervisor form a goal oriented organization; however, researches show that Participative style management is more effective than task-oriented style management (Ghorashizadeh, 1998).
Reviewing viewpoints and performance of supervisor, regarding assessment indicates
that supervisor has an active role in following up of activities and overseeing
desirable outcome of the job (Nazari, 1998) Since the main factor in monitoring
process is existence of indexes and standard criteria, lack of these indexes
and attention to setting up these criteria and lack of studies relating to them
from the other hand, make the supervisor face problems when assessing level
of reaching of goals and getting proper feedback and take motivation for such
activities away from him (Mashofi, 2004).
In any case, determining of existence of problems can be a useful step in diagnosing process, since such case can transform into a focus for future analyzes.
High consideration of supervisors to planning and organizing and less considering to subclass sections of each of these two indicate that supervisors are less familiar with preparing steps of planning and organizing and meantime they often use experts and specialists available in facilities meanwhile in advancing the plans they try to use their own sovereignty and power instead. Less cooperation of staff in preparing aims and organizing process and use of rules as tools to improve their power by supervisors is a sign for this topic. These issues demonstrate having knowledge and creativity of managers can play an important role in usage of staff to improve jobs.
On the other hand lack of improvement in plans according to the schedule after considering the plan by supervisors indicates in determining aims and after that operational plan supervisors do not have adequate attention or neglect to perform job which both indicate the lack of supervisory mechanism in the system. In opinion poll took from hospital managers of all over country also indicated 46% of them have encountered the supervision on their centers weak and insufficient (Anonymous, 1995).
Comparison of supervisor's attitude with their own performance shows there is a high correlation between these two in planning and supervision topics but it is in reverse for organizing. This problem indicates that there is lack of proper and adequate relation; studies show on of the most important common problems in health care facilities is lack of attention to correct relationships as an effective tool to make relationships and managers believe that the power to make relationships is weaker than their other managerial professions (Nazari, 1998).
Base on earned results from this report main problem in health facilities are centralized design making, lack of activities monitoring, lack of familiar of supervisors with executive planning processes and without focus to implementing of executive planning; So it is advised that to be used experienced man, theory and practice, in management science for health care facilities.
I would like to acknowledge from esteem vice-chancellor of Mashhad medical sciences university and supervisors and staff of health care facilities which helped me in this study.