Organisational Change to Health Promoting Hospitals: A Review of the Literature
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Organisational Change to Health Promoting Hospitals: A Review of the Literature Chiachi Bonnie Lee • Michael S. Chen • Michael John Powell • Cordia Ming-Yeuk Chu
Received: 17 March 2013 / Revised: 13 June 2013 / Accepted: 20 June 2013 The Author(s) 2013. This article is published with open access at Springerlink.com
Abstract The Health Promoting Hospitals (HPH) initiative, as a setting approach, was launched by the World Health Organisation in 1988, and widespread expansion and development throughout the world ensued. This paper elaborates on and clarifies the concept of HPH and highlights the development of health-promoting settings in hospitals. This review also examines the enabling and hindering roles of organisational factors in reorienting hospitals towards health-promoting settings. This paper reaffirms the significance of organisational change in building capacity for health promotion during the development of HPH and notes that hospitals require systematic organisational support to fulfil their roles in promoting population health. Nevertheless, this review suggests that many of the identified barriers are related to insufficient organisational support. In particular, the low prioritisation of health promotion in hospital missions, shortages of resources, ineffective project management, lack of communication, poor coordination and integration and inappropriate job–person matches were six major reported barriers. Organisational capacity building for health promotion must be considered if hospitals are to adopt the HPH initiative. Keywords Health Promoting Hospitals Organisational change Capacity building
C. B. Lee (&) M. S. Chen National Chung Cheng University, Chia-yi County, Taiwan, Republic of China e-mail: [email protected] M. J. Powell C. M.-Y. Chu Griffith University, Brisbane, Queensland, Australia
Introduction Many prominent international entities have called for integration of health service and health promotion in response to challenges to health systems, such as the need for a reduction in health care costs and for the effective prevention and management of non-communicable diseases [58–61]. Notably, among these entities, the World Health Organisation (WHO) launched the Health Promoting Hospitals (HPH) project in Europe in 1988, leading to widespread expansion and development throughout the world. The European Pilot Hospital Project has demonstrated the feasibility and applicability of HPH in all types and sizes of hospitals in widely diverse health systems [47]. By May 2011, HPH comprised 39 networks in 26 countries on five continents, including individual hospitals that do not belong to a national/regional network, and HPH has 841 members across 51 countries [45]. The HPH project is a form of setting-based health promotion and aims to ‘improve health gain for its stakeholders by developing structure, cultures, decisions and process’ [57], p. 6). However, there is an ‘old wine in the new bottle’ doubt in that hospitals have used the HPH project as a banner but have not bui
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