A mixed methods mapping of managerial competencies for hospital healthcare managers: implications for performance management and workforce development in a private Brazilian hospital

Abstract Background Managerial competencies shape how hospitals plan, execute and evaluate care processes, and in this study performance management is understood as the organizational cycle of planning, monitoring, evaluating and developing individual and team performance, whereas managerial competencies are treated as the individual-level attributes that enable managers to operate that cycle. In Brazilian institutional settings, however, the competencies that hospital managers require remain insufficiently characterized in empirical mixed methods studies. Objective To map the technical and behavioral competencies required for healthcare manager positions in a large private Brazilian hospital and to discuss the implications of the resulting profile for performance management practice and workforce development at the organizational level. Methods A mixed methods, exploratory, single-center design combined documentary analysis of internal hospital regulations with a structured questionnaire administered to a convenience sample of 112 healthcare professionals using a four-point Likert-type scale. Institutional documents were selected by predefined criteria and analyzed by both researchers through thematic content analysis, with themes retained by consensus and converted into competency indicators organized according to the Knowledge, Skill and Attitude (KSA) framework. Behavioral competencies were grouped by similarity through the same consensus procedure. An 85% cut-off of the highest score obtained within each KSA dimension was applied to identify core indicators. Results Documentary analysis identified ten institutional attributions of the healthcare manager position. Six core technical knowledge competencies, six core technical skill competencies and six core behavioral competencies were identified, and behavioral competencies were organized into three clusters oriented toward patient care, leadership and team management, and organizational results. Conclusions The study provides a competency profile for healthcare managers that is specific to the studied institution and is not proposed as an externally validated or generalizable measurement instrument. It supports the design of institutional training, recruitment and performance evaluation, and it offers a mapping procedure that comparable hospitals can repeat.