引导医院由结局质量监管向结构和过程质控转移——析我区"医院管理年"活动

把医疗质量贯穿于"结构、过程、结局"的思路,体现了把医疗质量融入医疗机构组织战略框架的思想。而长期以来卫生行政部门关注的是医疗服务结局的质量。为了防止在评价中过多地强调质量的结局所造成的评价偏倚,在开展"医院管理年"活动的评价工作中,从考评指标的设计到考评办法的应用,都突出了对组织结构和过程质量的管理测评,引导医院由结局的质量监管向结构和过程质控转移,并取得了预期的效果。笔者认为就"结构、过程、结局"的质量管理而言,前两者应为先。

Guide Hospital from Outcome Quality Management to Quality Control of Structure and Process

The thinking of running medical quality through"structure,process and outcome"reflects the theory of medical quality and organizational strategic framework.However,health and the executive branch has always been concerned on the quali- ty of the outcome of medical services.To prevent biased evaluation led by too much stress on the outcome quality during the evalu- ation procedure,the test and evaluation on the quality of the management structure and procedure has been highhghted in the eval- uation work when conducting the"hospital management year"from the design of test indicators to the application of test methods. More over,health and the executive branch has guided the hospital quality management to the structure and process quality con- trol,and achieved the expected results.The author believes that in terms of the quality management of"structures,processes and outcomes",the former two should always come first.