| Sub-title | |
| Author | M K Tilney |
| Abstract | Aims and Objectives: The particular vulnerabilities of small island states have been the subject of a UN Declaration, being said to suffer from a lack of economies of scale, insularity and isolation, making development difficult. Professional isolation is noted to be a major shortcoming. However, the evidence is conflicting in that indicative human development health indicators actually revealed them to be better off. Galea (1988) describes The Healthy islands concept, which sets out to develop organizational systems that motivate and reward collaborative behaviour in the achievement of public health objectives. Small island states have their own particularities that are distinct. This study assesses the perceptions of healthcare managers and providers regarding the impact of this reality on Maltese healthcare. Methods: Qualitative study; Literature review, followed by twenty In-Depth One-To-One Interviews with key stakeholders addressing technical levels of quality of care and related issues in public and private sector. Sample included all those responsible for national development in healthcare, middle managers delivering clinical care and clinical leadership within the public and private sectors, including doctors, pharmacists and nurses. Audiotaped; consent obtained. Deductive approach. Results: Emergent themes included the following: culture, politics, historical, structural, systems, people, resources, and implications for change. small island mentality, with implications for service provision and confidentiality emerged. Implications were noted for training and maintenance of clinical competence, adequate care provision at tertiary level, quality improvement, and industrial relations. Solutions included Bilateral exchange visits overseas, for further training, and introducing external change agents into the system to encourage improvement process development. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | Volume 15 (suppl) |
| Pages | - |
| Date | |
| Link to journal | |
| Key words | perception, manager, provider, clinical quality, change agent |