Kaiser Permanente: a propensity for partnership
Kaiser Permanente: a propensity for partnership
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DOI：
10.1136/bmj.326.7390.654
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发表时间：
2003-03-22
影响因子：
--
通讯作者：
Crosson, FJ
中科院分区：
文献类型：
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作者：
Crosson, FJ
50年前，医生和管理者可以有效地分担卫生系统整体绩效的责任和问责的信念，使美国医疗机构对第一代永久医生感到愤怒，他们被排除在当地的医疗社会之外。然而，在第一个十年里，这种合作关系的艰苦努力几乎摧毁了Kaiser Permanente。这一结果成为Kaiser Permanente今天成功的关键，也是该组织最鲜明的特征之一：超越“医学”和“管理”之间传统冲突的组织文化。这种文化是由数百个委员会和领导委员会经过几十年的持续谈判培育起来的，这些委员会和领导委员会每天共同管理该组织。今天，医生和管理层之间的独家合作伙伴关系的相互承诺在组织中根深蒂固。这一成功可能归功于许多因素，但有三个因素最为突出。
Fifty years ago, the belief that physicians and managers could effectively share responsibility and accountability for overall performance of health systems brought the wrath of the American medical establishment down on the first generation of Permanente physicians, who were excluded from their local medical societies. Then, the hard work of making such a partnership succeed nearly destroyed Kaiser Permanente in its first decade.The outcome became the key to the success of Kaiser Permanente today, as well as one of the organisation's most distinctive characteristics: an organisational culture that transcends the traditional conflicts between “medicine” and “management.” That culture has been nurtured over decades of continuous negotiation by hundreds of committees and leadership councils that jointly manage the organisation on a daily basis. Today, the mutual commitment to an exclusive partnership between the physicians and management is deeply ingrained in the organisation. Many factors may be credited for this success, but three stand out.