Values of medical leaders in perspective of value-oriented approach

BACKGROUND: Modern healthcare is based on a value approach and focuses on improving results that are important to patients. The successful implementation of pilot projects at hospitals depends on the motivation of medical stuff and endorse values of the entire team, their readiness to implement management innovations. Team management skills is an important competence of a leader and should be based unique values.

AIMS: to investigate doctors’ understanding of the value-based approach and their attitude to the concept for the subsequent development of educational programs and methodological approaches to the management of employees in order to implement value-oriented healthcare programs.

MATERIALS AND METHODS: A content analysis of publications of the understanding of the term “value” was carried out and key ideas were identified. The author’s questionnaire contained twenty closed questions with simple and ordered nominal scales. The survey included managers with more than 5 years of experience, involved in managerial and clinical practice. 69 specialists from Moscow and the Moscow region, working in public or private hospitals took part in the study.

RESULTS. There is a need to develop additional professional education programs on the topic of value-based healthcare — 84% (n=58) of doctors need it. According to medical managers, the main values for the patient are the availability of medical care, its quality and the responsible attitude of medical personnel to their duties. 95.6% (n=66) of doctors consider important to create values (decent pay for the work, respect for patients, the possibility of professional self-improvement) not only for patients, but also for medical personnel. The values of a clinician and a doctor-manager may not coincide. The problem of the discrepancy between the effectiveness and quality of treatment is felt by 84% (n=58) of respondents. The patient’s subjective assessment should not serve as the only guideline for creating the value of his treatment. It is important to train doctors in the formation of patients’ adherence to treatment and the factors that determine it — joint discussion of treatment options, medical technologies convenient for the patient.

CONCLUSION. The new and important aspects of the doctors’s values and their attitude to the value-oriented approach were identified as well as their attitide to the problems of effectiveness and quality of treatment, patient experience indicators, the role of independent assessment of the quality of medical services, ways and means of achieving patient adherence to treatment, barriers to the implementation of this approach in practical healthcare. In order to identify the profile of potential project leaders, a semantic differential describing key personality parameters is proposed. Orientation to the values of the patient is impossible without taking into account the value system of other participants. Understanding the system of values and expectations of a doctors, their attitude to new ideas, is important in the implementation of a new value-oriented approach and avoids value conflicts.