护理管理中绩效考核的应用价值探讨

目的:观察探讨绩效考核在护理管理当中的应用价值。方法:就我院外科科室的18名护理人员进行分析,观察绩效考核制度引入前后的护理人员的从业素质、护理质量、教学指标和患者满意度进行观察。结果:我院在引入绩效管理进入之后,护理人员的从业素质、护理质量、教学指标和患者满意度得到了明显地提高。结论:绩效考核制度能够切实有效地提高医院护理管理的水平,帮助护理人员自身素质、护理专业技能和知识的提高,可以督促护理人员不断学习,而且可以提高患者的满意度,减少医患纠纷的发生。     

正确对待医患关系,携手构建和谐社会

医患关系是重要的人际关系之一,医患关系也是社会和谐建设不可或缺的部分,如何构筑和谐的医患关系正成为医学进步、医院发展过程中举足轻重的问题。现代医院建设中,患者满意度是医院管理的重要指标,而医生满意度并未得到关注,这一现象正成为导致医患关系不和谐的重要原因之一。正确看待医患关系,协调处理医患矛盾,营造医患之间的和谐氛围。     

持续质量改进用于护理质量控制的实践

持续质量改进是新时期医院质量管理发展的重点。我院将持续质量改进应用于护理质量管理,通过三级质量控制方式,保证了护理质量的有效控制和不断提高,提高了病人的满意度。     

护理管理在小儿康复病房中的作用分析

目的:探讨护理管理在小儿康复病房中的作用并进行分析。方法:调查我院2010年3月起开展系统护理管理以来160例小儿康复患者的满意程度。结果:通过对系统管理的实施,发现在这160例患者当中,不曾出现一例纠纷问题,同时在患者出院后,病患家属的满意程度也达到93.75%,满意人数达150例。结论:系统护理的实施具备很大的优势,同时还让护理病房得到了全面的、系统的,以及详细的管理方法,从而将护理人员的工作热情和护理技术提高了上去,降低风险几率。     

浅析如何提高基层医院住院病人膳食满意度

通过对住院病人膳食供应的各个环节、人员、物资等的全面管理,同时考虑到基层医院住院病人的特点,实行以人为本的人性化管理。并进行严格的成本控制,为病人提供优质适价、满足病人个体差异的膳食,从而提高了住院病人的膳食满意度。     

医护信息移动平台的规划与设计

我院以实施通过国际医院评审JCI认证为契机,规划并设计了以移动护理工作站、移动医师工作站、PDA手术患者交接系统等为核心的医护移动信息工作平台。保障患者医疗安全的同时提高了工作效率,降低了医疗差错,提升了医院形象和患者满意度。     

基于客户满意度的医院门诊业务流程优化研究

运用A医院门诊业务流程的客户满意度指标体系,针对A医院进行评测,并运用四象限法对结果进行分析,提取门诊业务流程存在的关键问题,最后遵循"重视顾客需求和市场发展趋势,兼顾顾客满意与成本"的原则,提出了A医院门诊业务流程的改进方案。     

医院门诊业务流程病人满意度研究

提供了一套构建医院门诊业务流程病人满意度指标体系的方法。首先对一所二级甲等医院门诊病人进行了两次问卷调查;在数据分析的基础上,提取指标并确定权重。最后,构建了一套评价医院门诊业务流程病人满意度的指标体系。     

Materiel management: a clinical experience.

It is easy to understand why unit managers are eager to embrace a comprehensive approach to materiel management. The system allows for the professionals from the purchasing, supply, and distribution areas to meet and work with the managers of individual departments and units. Recognizable outcomes of this system are improved staff satisfaction because of standardized products; improved nursing competency secondary to product familiarization, and improved quality of patient care because area managers have more time to devote to their individual unit functions. The serendipitous benefit is that areas and personnel within a hospital that were once diverse in goals and functions may now develop positive working relationships around the hospital's prime goal of quality patient care, a marketable commodity.     

Interaction of organizational commitment and job satisfaction of nurses and medical secretaries in Turkey

The main aims of this study is to explain the relationship between job satisfaction and organizational commitment and to investigate the effects of gender, education level, age, monthly income, ownership type of the employed hospital, length of employment in the hospital, job and marital status on organizational commitment and job satisfaction. The research was carried out in three hospitals in Turkey. The research population includes 872 people: 677 nurses and 195 medical secretaries. All the questions on the research instruments were answered by 55.4% of the population. A significant and positive relationship was found between job satisfaction and organizational commitment.     

Analysis of different public policies through simulation to increase total social utility in a healthcare system

Public and private hospitals are seen to co-exist in several countries and they have different levels of service, waiting times and prices. Public hospitals, in general, are cheaper, but more crowded and offer lower quality service than private ones while private ones are underutilized because of the higher payments required for their services. These differences among hospitals affect patients’ choices in hospital selection and result in different levels of satisfaction in the community. Appropriate subsidy mechanisms can be developed to balance the capacity utilization of both sectors and to improve overall access to healthcare. The objective of this study is to develop an estimate of the magnitude of this improvement and differential effectiveness of various policies in achieving this improvement. For this purpose, we develop a simulation model that includes all the emergency departments of main public and private hospitals in a certain region of Turkey. We analyze the effects of different public policies on patients’ preferences regarding hospital choices and the results of these choices on social utility and public healthcare spending. Different capacity decisions, contracting and subsidy mechanisms are proposed and the optimal system parameters are determined under these mechanisms over this simulation model. After the validation and verification of the simulation model, several scenarios are designed and executed to increase social utility, decrease government expenses, improve patient satisfaction level and decrease waiting times. We compare the proposed scenarios based on multiple objective functions and present numerical results for different scenarios in this system.     

组织创新气候、员工工作满意度与员工创新绩效关系的实证研究

医院的任何创新都必须经由医院的员工完成,员工的个人创新绩效将对医院的整体创新产生重大影响,因此研究医疗行业中影响员工创新绩效的因素具有现实意义。通过实证检验发现:员工的工作满意度将正向影响员工的创新绩效;员工的工作满意度将正向影响组织的创新气候;组织创新气候将在员工工作满意度对员工创新绩效的作用中起到部分中介作用。     

What aspects of the job have most effect on nurses?

The study reported here compared the influences of psychological constructs (job demands and scheduling control) and objective work characteristics (shiftwork, night‐work and hospital department type) on job satisfaction, organisational commitment, burnout and withdrawal intentions. Our hypothesis was that psychological constructs have a higher influence on work‐related attitudes than objective characteristics of work schedules. In addition to the main effects, we proposed an interactive hypothesis: poor attitudes would result from high demands and low control rather than from other combinations of both psychological variables. Using a sample of 153 hospital nurses in Israel, the hypotheses were generally supported. As night‐work, shiftwork and working in intensive care units are unavoidable characteristics of the modern medical environment, these findings are meaningful for improving the personal adjustment of hospital nurses.     

浅谈医院门诊排队叫号系统的建设实施

针对我院皮肤科门诊患者流量大,存在排队管理中无序,医生诊室纷乱,病人的心理焦虑有压力,医生看病环境差,医护人员工作强度大等问题,医院上线了门诊排队叫号系统,实行病人挂号直接到医生,病人在候诊大厅等待语音广播叫号等,很好地解决病人在看病时拥挤和等候现象。改善了医院门诊就医环境,减小了病人因环境造成烦燥情绪和医生因环境恶劣造成的工作压力,实现了医院管理的人性化,提高了医院数字化,从而提高了医院的经济效益和社会效益。     

A mutually beneficial supply partnership at Columbia Hospital for Women Medical Center

Columbia Hospital's variation of the JIT system to support its repetitive-type surgical procedures performed by the L&D and OR departments has proven to be the right system for this specialty care hospital to ensure that the right product at the right price is available at the right place and time. This system established by the cooperative efforts of the three partners involved (the hospital, manufacturer, and distributor) has been a win-win system for all. The manufacturer and distributor receive a profitable return for their products and services, and the hospital receives reimbursement for the products it utilizes to provide quality care to its ultimate customer, the patient. Columbia's supply flow system, as described herein, is a creative example of the many variations of the stockless or JIT supply systems being established in the world of hospital materiel management today.     

Effects of healthcare quality and reimbursement rate in a hospital association

Tackling the mismatch between the supply of and demand for care service is an especially important issue among many healthcare providers and regulators. To entice patient demand distribution to become more equilibrated among different regions, some countries' governments have proposed to establish a hospital association with different levels of hospitals to implement patient mobility. However, the sustainable operation and management of the hospital association have not been formally analyzed. In this paper, we develop a Salop model to analyze the strategic behavior of patient welfare and hospital utility maximizations in a hospital association comprised of three hospitals in different income regions. For the former objective, we find that the higher quality provisions may harm patient welfare, and especially there are unique quality thresholds of the hospitals such that the higher quality provisions lead to higher patient welfare only when the quality provisions exceed the thresholds. For the latter objective, we capture the optimal equilibrium quality provisions of the overall hospital association. We consider both the case when the taxation rates are regulated (TRR) and exogenous to the hospitals and the case when taxation rates are adjusted (TRA) and constrained by hospital reimbursement rates. Under the TRA case, we find that a higher reimbursement rate of the local hospital causes a higher and lower quality threshold of the hospital in the local and neighboring regions, respectively; and we also show that with the utility maximization objective, the reimbursement rate's impact depends on regulator's altruism towards patient welfare. For a relatively low altruistic behavior, a TRA could improve the quality provision but lower the number of outflowing patients in the case of a high (and low) hospital's reimbursement rate in the local (and neighboring) region. When the regulator cares more about patient welfare, the findings in the quality provision and patient mobility are just contrary. Our analytical results lead to some important policy implications for facilitating the further deployment of hospital association delivery in the hospitals' quality provision associated with patient mobility.     

医院绩效管理的探索和实践

目的:探索以提高神经外科护理质量、满足患者需求为目的的护理绩效管理模式及效果。方法:通过将护理质量考核、效率考核和绩效管理相结合,制定神经外科护理绩效的考核标准、细则,考核结果作为奖金分配依据。结果:护理质量、患者满意度及护士对工作、奖金分配满意度均有所提高。结论:在神经外科护理管理中应用有效的绩效考核,不仅充分调动了护理人员工作中的主动性与积极性,转变了护理服务的理念,提升了工作效率,更能提高护理质量与患者的满意度。     

中国医疗卫生事业效益分析之系列研究——2005-2009年全国妇产(科)医院效益分析

2005-2009年三大女性恶性肿瘤以年均188%的速度增长。研究全国妇科(科)医院若干投入、产出效益指标并分析,找出影响医院发展因此提出对策。妇产(科)医院投入与产出均呈高速发展,但应改善就医环境,提供良好工作环境,保护病人隐私,更大程度发挥妇产(科)医院的公益性和社会职能。     

The effects of environmental characteristics on the structure of hospital clusters

The population ecology view that variation in sets or clusters of organizations should be isomorphic with variation in cluster environment was used here to explain structural variation among hospital clusters. The structural characteristics studied were range of services offered within the cluster, average size of hospitals in the cluster, and cluster differentiation. In the causal model that was developed and evaluated, variation in the patient environment and variation in the supplier environment were compared. Four lagged panels of data on a national sample of fifteen hospital clusters demonstrated the relative superiority of supplier variables over patient variables. Supplier group preferences were more powerful than patient needs in determining the range of services offered by the cluster. Furthermore, increasing the range of services in the cluster had a positive, significant effect on average hospital size, whereas size apparently exerted no effect on range of cluster facilities. Cluster differentiation seems to be causally affected by range of services, average hospital size, and by the periodic closing of hospitals over time.     

Implementation of an automated medication/supply distribution system

In the summer of 1992, Carraway Methodist Medical Center implemented a computerized medication and supply distribution system from the pharmacy and central supply to the patient care units. Improved efficiency was achieved in the form of automatic billing, inventory control, decreased worked hours per patient day, and improved documentation. Regulatory requirements relating to narcotic distribution were simplified through technology eliminating manual counting, handwritten signatures, and manual record keeping. The impact from this change was cost effective, allowed more time at the bedside, provided easier access to pharmacy and central supply items, facilitated inventory control, and increased nursing productivity as well as increasing nursing satisfaction.