Development and validation of methodology of multi-axial evaluation of management quality of health care organizations

制定并验证了医疗机构管理质量多轴评价方法：1：作为对医院管理进行综合评价的框架，对医院认可方法、管理质量奖评价标准、ISO和BS管理体系要求进行了比较和考察。以下因素是有效管理的共同重要因素，需要加以改进。在大多数医疗保健组织中：与政策部署、目标管理和临床治理集成的领导；以流程为导向的部门内部和部门之间的合作，流程的标准化，个人护理层面和组织层面的系统规划，投诉和事件的管理系统，以及改进和纠正措施的彻底跟踪，绩效衡量和反馈，客户满意度。分析了顾客满意度、员工满意度与组织改进活动的分布、相关关系和相互关系。在医院之间发现了很大的差异，并且发现满意度取决于患者的身体和精神状态以及期望。工作满意度与质量改进活动的子量表之间存在维度特异性的相互关系。对100多家医院缺血性心脏病、子宫肌瘤、股骨颈骨折、夹持手术病例的过程和结果等临床指标进行了测量。在不同的医疗机构中存在差异，并且这些差异在风险调整后变得更大。除收入外，还通过使用作者开发的患者级成本框架来衡量成本。对示范医院各级卫生保健的收入、成本和利润进行了测量和分析，并对使用这些数据进行组织管理的方法进行了审查。

The methodology of multi-axial evaluation of management quality of health care organizations was developed and validated as follows :1 : As frameworks to evaluate hospital management comprehensively, the hospital accreditation method, management quality award assessment criteria, and ISO and BS management system requirements were compared and examined. The following elements are the commonly important for the effective management and they need to be improved. in most of healthcare organizations : Leadership integrated with policy deployment, management by objective, and clinical governance ; process-oriented intra-and inter-departmental collaboration, standardization of process, systematic planning at individual care level and at the organizational level, the system of management of complaints and incidents and thorough follow-up of improvement and corrective actions, performance measurement and feedback, customer satisfaction. The distribution, correlates and inter-relationship were analyzed on customer satisfaction, staff satisfaction and organizational improvement activities. Substantial variation among hospitals were found and satisfaction was found to be dependent upon the patient physical and mental status and also on expectation. Dimension specific interrelation was found among the subscales of job satisfaction and quality improvement activities.Clinical indicators including process and outcome aspects were measured among more than 100 hospitals in cases of ischemic heart diseases, myoma uterus, femoral neck fracture, clipping surgery. They varied among healthcare organizations, and these variation got widened after the risk adjustment. Besides income, costs were measured by use if the patient-level costing framework which was developed by the author. revenue, cost and profit were measured and analyzed at various levels of health care at model hospitals, and the methods too use these data for the organizational management were examined.