医院用于选择绩效指标的流程的多个案例研究:它们是否与最佳实践保持一致?
Michael A Heenan1, Glen E Randall1, Jenna M Evans1
1DeGroote School of Business, McMaster University, Hamilton, Ontario L8S 4M4, Canada.
概括
医院经常难以选择相关的绩效指标,经常忽视前线经理的投入. 这可能会导致人们专注于政府授权的指标,而不是对当地运营和改进至关重要的指标.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 提高质量 提高科学 提高质量
背景情况:
- 卫生政策研究所主张减少医院绩效指标,以加强对当地环境的关注.
- 了解指标选择流程对于识别适当的指标进行消除至关重要.
- 5P指标选择过程框架为有效的指标选择提供了一个模型.
研究的目的:
- 为了分类医院指标选择流程.
- 分析这些流程与5P指标选择流程框架的一致性.
- 识别当前指标选择实践中的差距和挑战.
主要方法:
- 定性,多个案例研究设计.
- 涉及加拿大安大略省四家大型急症医院.
- 通过13次半结构面试和文档分析收集数据,然后进行主题分析.
主要成果:
- 确定了两种不同的医院指标选择过程.
- 医院通常会实施明确目标,治理,指标和战略主题等要素.
- 缺失的关键要素包括基于证据的标准,财务/人力资源指标,结构/流程/结果考虑以及广泛的最终用户参与.
- 医院面临着平衡强制性与本地指标的挑战,并且经常排除前线管理人员.
结论:
- 医院指标选择过程部分与5P框架保持一致,但存在重大差距.
- 排除前线管理人员的风险是选择与运营现实和单位级绩效需求不一致的指标.
- 改善指标选择需要更多地参与最终用户,并纳入基于证据的标准.
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