目标管理法和关键绩效指标法在体检质量管理中的应用实践

目的:探讨目标管理法和关键绩效指标法在体检质量管理中的应用效果。方法:运用目标管理法和关键绩效指标法,确定年度体检质控工作重点,设定9项体检质控关键指标及评价标准。选取2018年一季度的体检质控结果作为对照组,以同年四季度的体检质控结果作为观察组,通过卡方检验或Fisher精确检验对比两组结果,探讨2种管理方法的的应用...     

医院后勤绩效指标建立与考核实践

随着医院后勤改革的不断深入,精细化管理的要求不断提高,后勤管理者的一项很重要的职能就是代表医院对各类服务机构进行考核。通过考核提高服务质量,节约支出。但由于历史、社会以及后勤自身的原因,医院后勤人力资源管理相对滞后,缺乏有效的监督和考核。作为医院后勤管理者,应该很清醒地认识到,后勤服务绩效如何,直接影响到医院临床一线工作的顺利进行及医疗质量。因此,如何提升服务部门的服务质量、如何挖掘资源潜力、如何加强考核力度、如何提高考核效率、如何调动一切积极因素为医务工作服务,必将成为整个后勤管理部门的重中之重!建立起有效的绩效考核机制势在必行。只有对医院后勤各科室及各社会机构进行绩效评估,从管理的角度抓问题关键,才能解决问题,从根本上提高后勤服务的整体质量。设计一套行之有效的绩效评估指标也将成为该项工作的起点和基础。     

关键绩效指标在对口支援考核中的应用

为了有效地考核和提高医院对口支援的成效,本文运用关键绩效指标(Key Performance Indicator,KPI),对对口支援专业人员工作业绩进行评价。建立对口支援专业人员考核KPI要素,细化评价指标,通过将考核结果与评先表优、津贴发放挂钩,充分调动了大家参与对口支援工作的主动性和积极性。     

DRG评价指标在医院绩效管理体系中的应用△

随着医疗体制改革进程的加快,DRG支付改革被赋予了历史重任。医院通过运用 DRG实施医保支付,可以有效地降低医院的管理难度,提高医务人员的工作满意度。DRG评价指标在医院科室绩效考核体系、医疗组绩效考核体系、核心人力资源绩效考核体系和综合医疗质量绩效考核体系中的广泛应用,将有效地提高绩效精细化管理效能,促进医院高质量发展。     

目标管理法和关键绩效指标法在职业健康体检质量管理中的应用

目的：探究目标管理法（MBO）和关键绩效指标法（KPI）在职业健康体检质量管理中的应用效果。方法：采用目标管理法和关键绩效指标法,明确职业健康体检工作质量管理的重点,共设定8项体检关键绩效指标,以2021年10月～12月的职业健康体检质控结果为对照组,2022年1月～3月的健康体检质控结果为观察组。随机抽取体检系统内1%共240份数据,利用t检验和χ2检验对比两组结果。结果：观察组的体检质控评分大于对照组,采用目标管理法和关键绩效指标法后,受检者满意度、“一企一档”建档率明显提高,差异均有统计学意义（P <0.05）。结论：MBO和KPI两种方法用于职业健康体检的质量管理有突出价值,可大力推行,确保体检工作质量持续提高。     

关键绩效指标在医院管理层应用的分析

目前国内多数医院人力资源考核都以“德、能、勤、绩”四个方面作为管理层的评价方法，但经过多年的运行实践，这种评估不够科学，也无特色可言。将企业的关键绩效指标作为医院管理层考核体系，通过关键绩效指标体系及人力资源管理体系，形成对医院管理者的约束、激励和调控，保障医院的短期、长期目标的实施，对医院管理者的管理工作起到了重要的作用，既促进了医院的战略目标得以在末端落实，又能给医院的绩效带来持续提升，使医院的发展进入良性循环。     

采用床均指标考评医院管理绩效的实践与体会

简要介绍了某部九五、十五期间在所属医院开展编制床均指标考评的主要做法。对所属医院10年来科技论文、科研成果、门诊量、收容量、对外医疗收入、医疗设备总值等6项指标床均效益统计分析。探讨床均指标在医院管理绩效考评中的意义,为新的医疗形势下医院向质量效益转型,走良性可持续发展的路子提供借鉴。     

关键绩效指标在医院管理层应用的分析

目前国内多数医院人力资源考核都以"德、能、勤、绩"四个方面作为管理层的评价方法,但经过多年的运行实践,这种评估不够科学,也无特色可言.将企业的关键绩效指标作为医院管理层考核体系,通过关键绩效指标体系及人力资源管理体系,形成对医院管理者的约束、激励和调控,保障医院的短期、长期目标的实施,对医院管理者的管理工作起到了重要的作用,既促进了医院的战略目标得以在末端落实,又能给医院的绩效带来持续提升,使医院的发展进入良性循环.     

关键绩效指标在医院管理层应用的分析

目前国内多数医院人力资源考核都以"德、能、勤、绩"四个方面作为管理层的评价方法,但经过多年的运行实践,这种评估不够科学,也无特色可言.将企业的关键绩效指标作为医院管理层考核体系,通过关键绩效指标体系及人力资源管理体系,形成对医院管理者的约束、激励和调控,保障医院的短期、长期目标的实施,对医院管理者的管理工作起到了重要的作用,既促进了医院的战略目标得以在末端落实,又能给医院的绩效带来持续提升,使医院的发展进入良性循环.     

医院个人绩效考评公益性指标的构建

本文分析建立与个人绩效有关的公益性指标的意义,对医务人员个人绩效有关的公益性指标从社会责任、质量与安全、知情与服务三个方面进行探讨;指出对个人公益性指标考核的实施,应做好动员宣传、数据搜集、流程优化三方面的工作。     

Improving performance using indicators. Recent experiences in the United States, the United Kingdom, and Australia.

This article describes recent national performance improvement initiatives in the United States, United Kingdom, and Australia. This comparison is of particular interest because each of these three countries faces similar challenges in delivering health care and improving health. Each has elevated a focus on safety and quality improvement to a national level. Marked differences in the organization and financing of health care across these three countries provide a unique opportunity to compare and contrast approaches. Drawing on the experience of the authors in each of the three countries and publicly available data sources about specific national initiatives, we describe the national context for improvement and outline recent performance improvement initiatives and emerging issues and challenges. Similarities and differences in the current evolution of national performance initiatives are described and conclusions are drawn about challenges that all three countries face, particularly in terms of developing meaningful sets of national indicators of health system performance. The challenges for future work include the importance of information infrastructure, the paucity of accurate and accessible clinical data, the need for effective performance measurement processes at a local level to capture useful data, and the tensions of balancing accountability and improvement agendas for measurement.     

Fragranced consumer products: effects on autistic adults in the United States,Australia, and United Kingdom

Fragranced consumer products, such as cleaning supplies, air fresheners, and personal care products, can have adverse effects on both air quality and health. This study investigates the effects of fragranced products on autistic individuals ages 18–65 in the United States, Australia, and United Kingdom. Nationally representative population surveys (n?=?1137; 1098; 1100) found that, across the three countries, 4.3% of adults (n?=?142) report medically diagnosed autism (2.3%), an autism spectrum disorder (2.4%), or both. Of these autistic adults, 83.7% report adverse health effects from fragranced products, including migraine headaches (42.9%), neurological problems (34.3%), respiratory problems (44.7%), and asthma attacks (35.9%). In particular, 62.9% of autistic adults report health problems from air fresheners or deodorizers, 57.5% from the scent of laundry products coming from a dryer vent, 65.9% from being in a room cleaned with scented products, and 60.5% from being near someone wearing a fragranced product. Health problems can be severe, with 74.1% of these effects considered potentially disabling under legislation in each country. Further, 59.4% of autistic adults have lost workdays or lost a job, in the past year, due to fragranced product exposure in the workplace. More than twice as many autistic as well as non-autistic individuals would prefer that workplaces, health care facilities, and health care professionals were fragrance-free rather than fragranced. Results show that vulnerable individuals, such as those with autism or autism spectrum disorders, can be profoundly, adversely, and disproportionately affected by exposure to fragranced consumer products.     

Occupational therapy students' attitudes towards inclusion education in Australia,United Kingdom,United States and Taiwan

This international, cross‐cultural study investigated the attitudes of occupational therapy students from Australia, United Kingdom, United States and Taiwan towards inclusive education for students with disabilities. The possible impact of professional education on students' attitudes was also explored. A total of 485 students from 11 entry‐level occupational therapy education programmes from Australia, the United Kingdom, the United Sates and Taiwan participated in the study. Among them, 264 were freshmen (first‐year students) and 221 were seniors (final‐year students). Data collected from a custom‐designed questionnaire were analysed both quantitatively and qualitatively. In general, the occupational therapy students reported having positive attitudes towards inclusion. Considerable differences, however, existed among the student groups from the four countries. Professional education appeared to have a significant impact on students' attitudes towards inclusion from first year to senior year. Although students were in favour of inclusion, they also cautioned that their support for inclusive practices depended on various factors such as adequate preparation, support and assistance to students with disabilities. Limitations of the study included the small, convenience sample and different degree structures of the participating programmes. Future research studies need to compare occupational therapy students' attitudes with students from other health care professions. A longitudinal study on the impact of the professional education programme on students' attitudes towards inclusive education is warranted. Copyright © 2009 John Wiley & Sons, Ltd.     

Possible Futures for Social Work with Children and Families in Australia,the United Kingdom and the United States

There has been considerable interest in recent years in comparing the operation of social work services for children and families internationally, particularly between Australia, the United Kingdom and the United States. Reviewing the respective policy environments and drawing on recent research experience in these three nations, the author speculates as to how such services may be placed to respond to a converging agenda to tackle the high social and economic costs of social exclusion. It is argued that a conspiracy of circumstances have led child and family social work away from its more general child welfare objectives of the past and have created consolidation of functions in relation to child-protection work. This has left services ill-prepared to play a central role within a new and resurgent child welfare agenda. If child-protection systems are to successfully metamorphose to encompass child welfare ideals, they will need to reconfigure to help shape their own future. This future will be concerned with the identification of, and service provision to, marginalised populations predicted to create high lifetime social and economic costs for society—the alternative being a default to the reductionist position of child-protection agencies largely concerned with the management of “child abuse”.     

A Qualitative Content Analysis of Cigarette Health Warning Labels in Australia,Canada, the United Kingdom,and the United States

The legislation of health warning labels on cigarette packaging is a major focus for tobacco control internationally and is a key component of the World Health Organization’s Framework Convention on Tobacco Control. This population-level intervention is broadly supported as a vital measure for warning people about the health consequences of smoking. However, some components of this approach warrant close critical inspection. Through a qualitative content analysis of the imagery used on health warning labels from 4 countries, we consider how this imagery depicts people that smoke. By critically analyzing this aspect of the visual culture of tobacco control, we argue that this imagery has the potential for unintended consequences, and obscures the social and embodied contexts in which smoking is experienced.Visual imagery of the health effects of smoking has a long history in the context of antitobacco campaigns. Such images featured prominently in Victorian era antismoking literature,1,2 and visual representations of the deleterious effects of smoking on the body have been a continuous thread in modern-day tobacco control and public health iconography. The first warning labels mandated on cigarette packaging were text-based only, enacted in the United States a year after the 1964 Surgeon General’s Report decisively linked smoking to cancer and other adverse health outcomes.3 In 1965, the US Federal Cigarette Labeling Act required cigarette cartons and packs to carry the warning, “Caution: cigarette smoking may be hazardous to your health.”4^(p13) The addition of pictures to warning labels on tobacco packaging is a relatively recent phenomenon, legislated first in Canada in 2000.5 Following Canada’s lead, many other countries have since followed suit, with text and picture-based warnings required in 63 countries worldwide as of 2012.6 The use of visual imagery (referred to specifically as “health warning labels”) on tobacco packaging has been driven by the World Health Organization’s Framework Convention on Tobacco Control and is based on the premise that “a picture says a thousand words.”6^(p1) Article 11 sets out clear standards for health warning labels, which are expected to cover “as much of the principal display areas as possible.”7^(p34)For tobacco control advocates, the impetus for visually based warning labels was clearly protection and empowerment against the tobacco industry’s tactics—for children and youths, who were seen as particularly susceptible to “prosmoking” media imagery, and for consumers, who had been subject to industry “fraud” and misinformation about the health risks and consequences of smoking.5^(p356) However, although the ostensible purpose of the visual imagery used on health warning labels is to educate smokers about the effects of smoking, it draws some of its impetus from the assumption that the subjective emotional response the images may provoke will force smokers into “realizing the harm done to their bodies.”8^(p358) In other words, the transition from text-based to visual warning labels reflects a growing awareness that the labels could be used not just to transmit information but to affect behavioral change. Indeed, health warning labels on cigarette packages are seen to be even more effective than traditional print and television campaigns because they “potentially reach smokers every time they purchase or consume tobacco products.”7^(p23) The underlying assumption is that, in contrast to similar messages presented in other mediums, the warnings are unavoidable. From a public health standpoint, a third goal of such labels is to facilitate tobacco denormalization by challenging the social and cultural acceptability of smoking, especially the glamorization of tobacco in media and popular visual culture.9 In this respect, the visual culture of tobacco control has been heavily influenced by the tobacco industry, and aims to use its strategies and practices against it.10Numerous studies support the view that hard-hitting graphic labels are more effective than text-based warning labels in stimulating awareness of tobacco-related health risks and increasing motivation and intentions to quit smoking.8,11,12 Plain cigarette packaging is seen to be particularly effective in reducing the appeal of smoking and focusing attention on the image and text of the health warning labels.13 Australia’s introduction of plain cigarette packaging requirements in December 2012 has generated considerable interest in such legislation. However, one limitation of the available research is that responses to cigarette packages are studied in a context in which the ordinary coordinates of smoking are absent, making effectiveness very difficult to judge.14Critical approaches to health promotion challenge the assumption of a simplistic or unidirectional relationship between public health campaigns and their intended targets, in which audiences are passive recipients of health information. Contrary to a didactic model of health education and its emphasis on individual behavioral change, critical approaches recognize the structural context of smoking and the social, historical, and political circumstances in which antismoking messages are deployed. Thus, multiple readings and responses on the part of message recipients are inevitable. In the arena of smoking cessation, this includes the potential for negative responses, ranging from context dissonance15 to defiance or resistance.16–18 This recognition challenges mainstream and top-down approaches in health promotion, which may assume that health-related behavior change is merely a matter of better education for at-risk individuals and groups (i.e., that programmers and policymakers just need to get the message right). These approaches also highlight the need for public health policies to move beyond an exclusive emphasis on questions of efficacy to consider the ethics of the strategies employed (i.e., even if they do work, at what cost?). Without careful consideration of the ethical implications and unintended consequences of such messaging, the “war against smoking” may instead become a counterproductive “war against smokers.”Our analysis of health warning labels on cigarette packaging has been informed by previous research on the visual culture of public health, which suggests that health promotion and education campaigns are constitutive of deeply embedded cultural understandings of health, illness, and social relations of power.19–21 From this standpoint, it is useful to consider how health-related imagery presented as scientific and objective privileges particular ways of seeing and defining both the bodies and identities of those who are “healthy” and pathological bodies at risk for illness.22–24 As critical public health scholars suggest, health promotion campaigns not only reinforce a normative imagery of health but can also contribute to social exclusion, stigmatization, and dehumanization when graphic and confronting images designed to provoke disgust are used.16,25 These tendencies have been explored in the context of issues such as injury prevention and disability,26,27 HIV/AIDS,22,28,29 obesity,25 and substance use, including alcohol30 and smoking.31,32 For example, analyses of antitobacco messages for pregnant women33 and campaigns directed toward adolescent girls34 suggest that the former promote the notion of the “bad mother” and neglect smoking by fathers and other men, whereas the latter reinforce the idea that what is most valuable about women is their external, physical appearance.35We analyzed the visual culture of tobacco control as represented by cigarette health warning labels in the context of 4 countries, and interpreted what this reveals about smoking as a social identity and practice. Such labels provide openings through which to see the “densely elaborated iconography”36^(p107) of tobacco control and how it conceptualizes smoking and people labeled as smokers. We contend that the currently used and proposed sets of health warning labels ground understandings of smoking and its effects in ways that obscure certain dimensions of the practice while foregrounding and prefiguring others. In particular, they frame smoking as an individual risk behavior, one entirely isolable from its social context. Our approach is critical of such framing, and cuts against both its emphasis on a biomedical imagery of the “diseased and dying” body and its diminishment of agency.9     

Doctor-manager relationships in the United States and the United Kingdom

In many developed countries, including the United States and the United Kingdom, the relationships between doctors and hospital managers are strained. The purposes of this article are to examine survey data from the United States and the United Kingdom on doctor-manager relationships and to identify the sources of strain common to both countries as well as those particular to each country's health system. The two countries exhibited many similarities. A very high proportion of respondents from both countries identified external factors-such as governmental budget cuts, pressure from third parties to increase physicians' workload, and the turbulence of the policy environment-as important barriers to improving doctor-manager relationships. Other common sources of strain were concerns over resource availability and the relative power of doctors and managers. Sources of relationship tension particular to each country were also found. Substantial divergence of opinion was expressed with respect to internal factors that affect doctor-manager relationships. Respondents from the United States were more negative than those from the United Kingdom in their ratings of teamwork and communication between doctors and managers, and they were also less likely to have confidence in the medical staff. Respondents from the United Kingdom were more likely to believe that hospital management is driven more by financial than clinical priorities. Managers can implement several strategies to improve doctor-manager relationships, including greater organizational transparency in decision making; more frequent communication between managers and doctors; and more physician involvement in decision making, especially with regard to important resource-related decisions, and in organizational governance.     

Readability of Ebola Information on Websites of Public Health Agencies,United States,United Kingdom,Canada, Australia,and Europe

Public involvement in efforts to control the current Ebola virus disease epidemic requires understandable information. We reviewed the readability of Ebola information from public health agencies in non–Ebola-affected areas. A substantial proportion of citizens would have difficulty understanding existing information, which would potentially hinder effective health-seeking behaviors.     

Food sampling practice in the United Kingdom

As an integral part of the UK food surveillance scheme, routine food sampling is undertaken by officers at local councils. One of the main purposes of the food sampling programme is to detect food contaminants before they are sold to the public. This paper investigated the current UK food sampling activity undertaken by the local Environmental Health Departments and examined the effectiveness of the food programme. A national survey was undertaken by means of a questionnaire sent to 439 UK local authorities and a response rate of 39.2% (172 LAs) was achieved. Thirty-nine per cent of replies indicated that ensuring food safety and hygiene was the most important aim of sampling. Less than half of the returns suggested that their food programmes contributed to the prevention of foodborne illness. However, over three-quarters agreed that the current food sampling system could be improved upon. This study concluded that current UK food sampling is marginalized by financial constraints. In order to design an effective routine food programme, it should be based on an overall co-ordinated approach from local to European levels. Future work towards a statistically validated approach to the design will improve the effectiveness of food sampling programme.