以医院文化建设提升医院竞争力

先进的医院文化建设是医院发展和进步的体现,可直接推进医院各方面工作的发展。本文结合所在单位加强医院文化建设的实践,从医院文化与政治思想工作的关系,突出＂以人为本＂的基本医院文化理念,以及改善医疗服务等几方面,进行了深入浅出的阐述,说明医院文化是提升医院竞争力的核心。     

Pilot test of an organizational culture model in a medical setting

The authors conducted a pilot test of the organizational culture model in a health care setting. The study was based on a questionnaire with mixed quantitative and qualitative analysis. Quantitative analysis confirmed the expected distribution of responses among the subcultures for all three questions, with significant differences in two of the three. Qualitative analysis further strengthened these results. The authors believe the organizational culture model may be a useful tool for making subcultural differences explicit, showing opportunities for better information exchange and opening dialogue between groups. These data should be confirmed with larger studies using psychometrically sound outcome instruments.     

Rethinking the globalisation of problem-based learning: how culture challenges self-directed learning

Medical Education 2012: 46: 738–747 Context  Medical schools worldwide are increasingly switching to student‐centred methods such as problem‐based learning (PBL) to foster lifelong self‐directed learning (SDL). The cross‐cultural applicability of these methods has been questioned because of their Western origins and because education contexts and learning approaches differ across cultures. Objectives  This study evaluated PBL’s cross‐cultural applicability by investigating how it is applied in three medical schools in regions with different cultures in, respectively, East Asia, the Middle East and Western Europe. Specifically, it investigated how students’ cultural backgrounds impact on SDL in PBL and how this impact affects students. Methods  A qualitative, cross‐cultural, comparative case study was conducted in three medical schools. Data were collected through 88 semi‐structured, in‐depth interviews with Year 1 and 3 students, tutors and key persons involved in PBL, 32 observations of Year 1 and 3 PBL tutorials, document analysis, and contextual information. The data were thematically analysed using the template analysis method. Comparisons were made among the three medical schools and between Year 1 and 3 students across and within the schools. Results  The cultural factors of uncertainty and tradition posed a challenge to Middle Eastern students’ SDL. Hierarchy posed a challenge to Asian students and achievement impacted on both sets of non‐Western students. These factors were less applicable to European students, although the latter did experience some challenges. Several contextual factors inhibited or enhanced SDL across the cases. As students grew used to PBL, SDL skills increased across the cases, albeit to different degrees. Conclusions  Although cultural factors can pose a challenge to the application of PBL in non‐Western settings, it appears that PBL can be applied in different cultural contexts. However, its globalisation does not postulate uniform processes and outcomes, and culturally sensitive alternatives might be developed.     

The importance of monitoring legionellosis in hospital setting: the case of a Sicilian Hospital

Hospital-acquired legionellosis is a major problem. In Italy this issue is still underestimated because the reported figures are lower than the actual cases. This is probably due to a lack of diagnosis and monitoring. In Sicily, no cases of hospital-acquired legionellosis were reported in the last few years. In the year 2001, a reference laboratory was set up to help health authorities monitor and prevent hospital-acquired legionellosis. The authors report the data concerning a measure of environmental monitoring and water treatment carried out in a hospital where no legionellosis was ever detected before.     

The effects of organizational structure on hospital performance.

The relationship between organizational structure and organizational performance would seem at first to be straightforward and obvious. The more complex organizational structures will result in positive organizational performance (i.e. greater effectiveness or profitability). The premise is that the ability of an organization to achieve its mission successfully should be a result of the organizational structure. It is generally accepted that certain structural configurations are able to achieve certain goals better than others (i.e. a diversified structure as opposed to a simple structure). The research to date indicates that this is not necessarily true. The specific issue examined in this paper will be the effect of structural diversification on performance in industry and healthcare.     

Developing a collaborative culture in a hospital setting. Interview by Donald E.L. Johnson

Moving an organization from "me"to "we" can be a frightening proposition for any organization. Tim Harrington, chief executive officer of Victory Hospital, Waukegan, IL, offers his perspectives to Health Care Strategic Management publisher, Donald E. L. Johnson. Harrington found that a collaborative environment within Victory hospital and Baxter enabled the introduction of total quality management and continuous quality improvement concepts to be freely introduced into the system. He also provides guidance for establishing and fostering collaboration among hospital departments, especially amid middle-management personnel.     

Effective dashboards. What to measure and how to show it

Today, hospitals must measure not only financial health, but also operational efficiency and quality of care. Redesigned dashboards make the data more accessible.     

Making culture a forethought. What to do when strategy meets organizational culture

Organizational culture is a key ingredient in successfully managing monumental strategic change initiatives. Those who are successful in managing change are actively integrating organizational culture into their total planning process. Organizational cultures should be a forethought in the management of the change process. Managers should give the same care and thoroughness to culture that they allot to the other major aspects of a plan. The culture of any organization in the midst of rapid change will not tolerate an information vacuum. People affected by change want to be able to ask questions and be heard. Communication should be interactive. Create opportunities that allow people at all levels of the organization to close the past. Without closure, some of the best people may feel that the organization has betrayed them. Creating a process that allows people to work through the change and motivating people to reinvent their approach and role in the new ways of doing things is what healthcare leadership in the 1990s is all about. It is part of the critical skill set that is necessary to lead Catholic-sponsored health services into the future.     

The ethical leadership challenge: creating a culture of patient- and family-centered care in the hospital setting

The growing number of medical errors and resulting preventable deaths in hospitals presents an ethical dilemma that must be addressed by health care leaders and managers. These medical errors and deaths raise questions about safety and quality issues resulting in rising public mistrust and patient dissatisfaction. Many of these medical errors and deaths could have been avoided by including the patient and family in the care. The ethical challenge for leadership is creating a culture of patient- and family-centered care as a means to improve quality, safety, patient satisfaction, and public trust. This article addresses ways to improve safety, quality, patient satisfaction, and cost and thereby reduce medical errors and deaths by implementing a patient- and family-centered care culture. The first critical step for improvement is for hospital leaders and managers to answer the ethical call to create a culture centered on patient- and family-centered care in the hospital setting.     

The healthy-years equivalents: how to measure them using the standard gamble approach

The healthy-years equivalent (HYE) is a measure of outcome of health care programs that combines two outcomes of interest: quality of life and quantity of life. Unlike QALYs (quality-adjusted life years) HYEs fully represent patients' (or other individuals') preferences, as a result of the way they are calculated from each individual's utility function. The authors suggest an algorithm to measure the HYE of any given lifetime health profile. The algorithm is based on the classic standard gamble method to measure individuals' preferences under uncertainty, and consists of two lottery questions. Algorithms for the general case (any given lifetime health profile) and a simpler case--the chronic health state case--are provided, as is a modification of the algorithm aimed at shortening the length of the interview when an individual is faced with many possible lifetime health profiles. In addition, two questions are addressed. The first is theoretical and deals with the existence of HYE: do all lifetime health profiles, which are preferred to death, have hypothetical equivalents that can be measured in healthy years? The second is empirical and deals with the reproducibility of the measures obtained by using the measurement technique suggested. This is needed because the technique employs a combination of lottery questions that had not previously been used together. The results of an experiment performed to test the reproducibility of the measures were satisfactory.     

医院文化在医院整合中的作用

现代医院的竞争，归根到底是文化的竞争。医院文化是构成核心竞争力的灵魂因素。 只有培育形成独具特色的优势医院文化，才能形成医院的核心竞争力，引导医院走向成功。因此， 在医院整合过程中继承与发扬优秀的医院文化是整合成功的关键。