Characterizing Managerial Decision Making in Public Hospitals: A Case Study from Romania.

Abstract

Background/objectives: Our study investigates the primary characteristics of managerial decision-making processes in the public hospital units in Romania, particularly in the Northeast region. This research aims to delineate the decision-making model applied by managers in these units, considering the multitude of legislative, economic, technical, ethical, and organizational changes prompted by the pandemic.

Methods: A mixed-method research approach was utilized, combining semi-structured interviews and autoethnography, to capture experiences, attitudes, perceptions, motivations, and ethical considerations of decision-makers within the healthcare system.

Results: The findings revealed that managerial decisions in public hospitals were influenced by unique elements such as the vulnerability and support needs of patients, the absence of a clear hierarchy, the personalized nature of healthcare services, the complexity of care processes, and the use of advanced technology. External factors, notably political and economic influences, alongside internal ethical dilemmas, significantly impacted decision making.

Conclusions: This study identifies the reliance on evidence-based decision making and a consultative managerial style as key to addressing these challenges. This research contributes theoretically by comparing decision-making models and practically by identifying a decision-making model that includes forms, techniques, and tools that could guide managers in decision making in Romanian public hospitals.