Knowledge, Skills, and Abilities Required of Health Care Administrators Beyond the Year 2000

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Knowledge, Skills, and Abilities Required of
Health Care Administrators Beyond the Year 2000

• Renee F. White, Ph.D. John B. White, Ph.D.
  Thomas Nicholson, Ph.D. Donna H. McCabe, Ph.D.
  Thomas Reio, Ph.D. Carolyn Rude-Parkins, Ph.D.
  and Randall Wells, Ph.D.
• For additional information, contact Dr. Renee
  White at rwhite_at_kde.state.ky.us or 502-330-9578

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PURPOSE OF STUDY

• To examine necessary knowledge, skills, and
  abilities (KSAs) required of todays health care
  administrators in the United States.
• To examine similarities and differences of KSAs
  found in Hudak et. al (1993)
• Hudak, R. P. Brooke, P. P. Finstuen, K.
  Riley, P. ((1993). Health care administration in
  the year 2000 Practitioners views of future
  issues and job requirements. Hospital Health
  Services Administration,38(2), 181-95.

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HUDAK ET. AL (1993)

• N 50 ACHE Fellows
• Stratified, random sample to represent 50 states
• Sample consisted of 21 Fellows
• Delphi iteration I identify major issues of
  greatest importance from present to 2000
• Expert panel identified 9 domains
• Delphi iteration II questionnaire developed
  from iteration I (42 response rate)
• 7-point, Likert-type scale used

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HUDAKS TOP 10 (mean in parentheses)

• Patience, listening skills, and communication
  (6.7)
• Leadership, management, and human relations (6.6)
• Strategic thinking sense of vision (6.6)
• Understand physician motives, needs, politics
  (6.5)
• Conflict management, team building, motivational
  leadership skills (6.3)
• Sensitive to staff problems, human relations
  (6.3)
• Ability to lead board and medical staff (6.3)
• Knowledge of hospital finance/cost accounting
  (6.2)
• Creative problem solving, interpersonal
  practice management skills (6.2)
• Solve long-range problems and strategic planning
  (6.2)

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STUDY SIGNIFICANCE

• Hudak et. al (1993) predicted KSAs needed for the
  year 2000 and beyond
• No follow-up study was conducted to determine if
  predictions were correct

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RESEARCH QUESTION 1

• What KSAs do health care executives regard as
  important for a position in health care
  administration?

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RESEARCH QUESTION 2

• What are the similarities and differences of KSAs
  identified by Hudak et. al (1993) and the KSAs
  identified in this study?

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VALIDITY

• Content validity
• Expert panel used
• Broke out Hudak et. als (1993) original
  questions into separate items
• Added questions

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PILOT STUDY

• ACHE Fellows (N 31)
• 51.6 response rate (n 16)
• 3 contacts with participants
• Web and paper instruments used
• 5 participants responded by web and 11 by paper
• Mean age 50.75 years, mostly white males with a
  masters degree
• Communication skills highest rated KSA

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PARTICIPANTS

• N 1,000 ACHE Fellows
• Sample (n) 555 ACHE Fellows
• Response rate 55.5
• Stratified, random sample by districts defined by
  ACHE
• Fellows in non-military facilities in United
  States
• Participants in Hudaks study were also Fellows,
  this study had larger sample size

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ADMINISTRATION OF THE INSTRUMENT

• 4 contacts with participants
• Web address given on 1st contact
• 2nd contact was reminder postcard
• 3rd contact was paper copy of questionnaire
• 4th contact was reminder letter with copy of
  questionnaire
• Follow-up phone calls
• Attempts made to contact non-responders

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INSTRUMENT

• 46 KSAs rated on 7-point, Likert-type scale
• 1 extremely unimportant, 7 extremely
  important
• 14 demographic variables
• All of Hudaks KSAs and demographic variables
  included on questionnaire. KSAs broken into
  separate items by expert panel
• 3 KSAs added by expert panel

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DATA ANALYSIS

• Descriptive statistics
• Cross-tabulations
• T-tests
• ANOVA
• Tukeys post-hoc analysis
• Correlations
• Chi-square
• Factor analysis

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FACTOR ANALYSIS

• Hudak et. al (1993) identified 9 domains through
  Delphi,reliability of domains ranged from .79 to
  .95 using Cronbachs alpha
• Factor analysis conducted to assess stability of
  instrument and to determine if same 9 domains
  identified as in Hudak
• Factor analysis revealed 2 domains
  leadership/interpersonal skills and technical
  skills

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RELIABILITY

• Cronbachs alpha used with domains identified by
  Hudak et. al (1993)
• Reliability of Hudaks domains not high 3 of 9
  domains had coefficient alpha greater than .70
• These were leadership (.93), professional staff
  (.89), and quality and risk management (.76)

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SAMPLE PARTICIPANT PROFILE

• 81 male
• 93 Caucasian
• Mean age 54 years
• Mean 30 years experience in health care
• Mean 26 years experience in health care
  management
• Mean Member of ACHE for 21 years, Fellow for 11
  years

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PROFILE, continued

• 89 held masters degree
• 48 employed in inpatient facility, 36 other
  type of facility
• 74 responded by paper
• Response from all ACHE districts

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SUMMARY OF FINDINGS RESEARCH QUESTION 1

• KSA considered important if median was 6 or 7
  (important or extremely important)
• 4 KSAs with median of 7
• 21 KSAs with median of 6
• Total of 25 KSAs identified as important to
  health care administrators

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IMPORTANT KSAs (mean, median)

• Listening skills (6.3, 7)
• Communication skills (6.43, 7)
• Leadership skills (6.42, 7)
• Sense of vision (6.14, 7)
• Management skills (5.8, 6)
• Human relation skills (5.94, 6)
• Strategic thinking skills (6.12, 6)
• Understanding physician motives (5.69, 6)
• Understanding physician needs (5.89, 6)
• Understanding physician politics (5.82, 6)
• Conflict management skills (5.75, 6)
• Team building skills (5.89, 6)
• Motivational leadership skills (5.8, 6)

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IMPORTANT KSAs (continued)

• Sensitivity to staff problems (5.49, 6)
• Sensitivity to human relations (5.56, 6)
• Ability to lead a board (5.99, 6)
• Ability to lead medical staff (5.75, 6)
• Creative problem solving skills (5.71, 6)
• Interpersonal skills (6.04, 6)
• Solve long range problems (5.61, 6)
• Strategic planning (5.8, 6)
• Speak/write/think fast on feet (5.91, 6)
• Respond to rapidly changing environment (5.91, 6)
• Compliance with federal laws (5.51, 6)
• Understand health finance payment (5.66, 6)

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SUMMARY OF FINDINGS RESEARCH QUESTION 2

• Comparison is not true comparison because
  instruments were not the same
• Nine of Hudaks top 10 were in the top 10 of the
  current study
• The same 10 KSAs appeared in the bottom 10 of
  both studies

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TOP 10 COMPARISON

• Current Study
• Communication
• Leadership
• Listening
• Sense of vision
• Strategic thinking
• Interpersonal
• Lead a board
• Human relations
• Respond to changing environment
• Speak/write/think fast on feet

• Hudak et. al (1993)
• Patience, listening, communication
• Leadership, management, human relations
• Strategic thinking sense of vision
• Understand physician motives, needs, politics
• Conflict management, team building, and
  motivational leadership
• Sensitive to staff problems, human relations
• Lead a board medical staff
• Knowledge of hospital finance
• Problem-solving, interpersonal, and practice
  management skills
• Solve long-range problems, strategic planning

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OTHER FINDINGS

• Response to web questionnaire not as good as
  response to paper questionnaire
• No significant differences found in form of
  questionnaire (web or paper)
• Some differences in KSAs by gender, ethnicity,
  age, years of experience, facility size and type,
  educational level, job title, and district

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LIMITATIONS

• Instrument is not comprehensive list of KSAs
• KSAs expressed too generally
• Reliability of domains
• Lack of non-responder data although attempts
  were made to contact non-responders, no data was
  obtained

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IMPLICATIONS

• Results could be important for current and future
  health care administrators and HCA programs
• Instrument should be used if addressing
  leadership/interpersonal skills and technical
  skills
• Further research is needed using electronic
  surveys