A Study On Nurse Manager Competency Model Of Tertiary General Hospitals

After human beings step into the 21 st century, an era witnessing the dramatic growth of knowledge and economy, the similar changes have taken place in the medical and health field- the medical science is experiencing a rapid development, the medical model is remodeling and the medical reform is deepening while the health needs of humans are diversified along with the living betterment. This innovative age brings both opportunities and challenges to hospitals. Nurses are indispensable for hospitals to practice medical treatment and care, but they demonstrate the uncomfortableness to cope with new circumstances in terms of their number and competence. Responsible for the management of nurses on the primary level and serving as the nursing implementers in wards and nursing units, nurse managers play a crucial role to promote the development of nurse teams in hospitals. Then the question is what qualities and abilities are required for nurse managers to be competent with their job posts so that they can show satisfactory working performance and help with the improvement of nurses’ abilities.Selection is an important method for hospitals to take in talents. However, what has been mostly concerned about the nurse manager selection in hospitals currently are the explicit features such as knowledge, skills and diplomas, while the implicit competencies which define nurse managers’ potentials such as motivation, organizational commitment and responsibility have long been overlooked. This results in the ineffectiveness in nurse manager selection from a scientific and systematic perspective. The selected nurse mangers, in some cases, are not quite able to fulfill their jobs in their posts, which causes the inefficiency in time, manpower and material resources. There are fairly-researched competency frameworks and models of nurse managers in other countries, but they do not conform to our national and hospital situation compeletely. Majority of domestic researches still stay on the theoretical level followed with general suggestions, which are hardly applicable in reality. Therefore, how to establish a nation-oriented, scientific and practical competency model of nurse managers, through which the competent nurse managers can be selected is longing for futher studies. A research on the nurse manager competency model may not only identify the competencies demanded by the posts of nurse managers, but also promote the nurse manager selection in hospitals, thus it is of an great significance to hospitals.The paper aims to establish a nurse manager competency model of tertiary general hospitals, and then apply the model to the selection of nurse managers after its empirical validation. It is expected to provide a scientific foundation for nurse management selection and the nursing human resources management in tertiary general hospitals.Research contents: The research starts to obtain nurse managers’ competencies in four ways, which are literature review, behavioral event interview, job analysis and the organizational environment analysis of nursing-related legal and regulative documents, and then integrates all obtained competencies to be preliminary ones for further screening to establish the model. The Delphi is conducted twice and the ration of full scores, mean, coefficient of variation and critical value method are adopted to define the number, names and definitions of competencies; then the questionnaires containing these competencies are distributed to nurse managers from tertiary general hospitals for further competency screen by the virtue of ration of full scores, mean, coefficient of variation and critical value method. An analysis is also done to manifest relations between 7 demographic characteristics and competency importance recognition. The factor analysis is employed to delineate the dimensions of the competencies, and the competency system is subsequentially tested by Cronbach’s α and structural equation model. The competency classification and the classification standards are implemented with literature review and expert panel discussions; an analytic hierarchy process is consequently utilized for the weights of each dimension and competency. The nurse manager competency model containing 22 competencies subject to 4 dimensions are eventually constructed through above procedures.In order to validate that the established model can reflect the working performance of nurse managers, the research selects an exemplary tertiary general hospital which enjoys the recognization of its performance evaluation in China as a benchmark. The fuzzy synthetic evaluation is used on all primary nurse managers in the hospital for their competency evaluation, and the evaluation outcomes are compared with those of the performance evaluation given by the hospital. The model is then deployed on a effort to select nurse managers in a tertiary general hospital with fuzzy synthetic evaluation while the present nurse manager selection is carried out simultaneously. The two selection outcomes are compared and the strengths of the competency-model-based selection are summarized, and the suggestions are raised afterwards. It is hoped that this competency model as well as the selection trial may provide a scientific, objective and pragmatic ground for the nurse manager selection and improve the human resource management in tertiary general hospitals.Research outcomes: Overall 31 competencies are obtained from four methods and 27 are selected out through Delphi consultation. The number of competencies is decreased to 23 by the questionnaire screening and 1 competency is further deleted in the reliability test, hence 22 competencies are finally wrapped up for the model. 4 dimensions are reached with the factor analysis and the competency system shows fair reliability and validity through Cronbach’s α and structural equation model. 5 categories are classified based on literature review and expert panel discussions and the category standards of each competency are stated. Weights of the dimensions and competencies are allocated with AHP. The nurse manager model of tertiary general hospitals that contains 22 5-category competencies subject to 4 dimensions is built up, and it entails the names, explanations, weights and classification standards of all 22 competencies. The dimensions and competencies are detailed as followed:D1 Leadership and management: leadership, interpersonal communication, self-control, learning ability, analytical thinking, conceptual thinking, group decision making. The weight of the dimension is 0.357, and those of the competencies are 0.075、0.056、0.052、0.051、0.046、0.041、0.035;D2 Occupational qualities: concern for quality and safety, responsibility, initiative, teamwork and cooperation, patient service orientation and developing others. The weight of the dimension is 0.247, and those of the competencies are 0.066、0.048、0.036、0.035、0.034、0.028;D3 Professional capacities: clinical nursing skills, professional knowledge and teaching ability. The weight of the dimension is 0.204, and those of the competencies are 0.073、0.069、0.062;D4 Personal traits: organizational commitment, attention to details, self-confidence, physical health, flexibility and self-evaluation. The weight of the dimension is 0.192, and those of the competencies are 0.042、0.032、0.031、0.031、0.030、0.027.In the empirical validation, the model-based competence evaluation outcomes of nurse managers are compared with those of the performance evaluation made by the hospital, and it is found that the 98% outcomes agree with each other. Because the exemplary hospital is a universally recognized hospital both in nursing management and in performance evaluation in China, the comparison indicates that the model-based competence evaluation is congruent with the working performance of the assessed nurse managers regarding their performance, which further proves that the good working-performance nurse mangers can be identified in use of this model and the established model is able to echo and predict the working performance of nurse managers fairly well. As a reslut, it lays a scientific foundation for the model to find good-performance nurse manager candidates for nurse manager selection in tertiary general hospitals. Empirically validated, the model is applied to a nurse manager selection trial in a tertiary general hospital through fuzzy synthetic evaluation. The same nurse manger candidates from 5 offices are selected by model-based selection and the traditional selection, but the scores for several candidates from certain medical offices show smaller gaps in model-based selection, and scores for a couple of candidates are even opposite in two selections. These distinctions are related to different selection factors, their weights and scoring scope in two selection ways.Research conclusions: Through the all-around considertaion and scientific screening of nurse manager competencies, the established nurse manger competency model of tertiary general hospitals passes the statistic tests of reliability and validity as well as the performance-reflected empirical validation. When it is tried in nurse manager selection in a tertiary general hospital, it demonstrates strengths over the selection manner the hospital currently adopts, so the model is of scientific, applicable and feasible value for nurse manager selection in tertiary general hospitals. It is suggested that the tertiary general hospitals may start such a selection trial in one office, and gradually expand it to other offices upon the continuous enhancement so as to promote the person-job fit in the management of nurse mangers and upgrade human resources management in hospitals.