门诊质量平衡计分卡

O. A. Latukha, I. M. Son, Y. Bravve, A. Kalinichenko, E. Pushkareva, K. Tolstova
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The article is devoted to identifying the specifics of quality balanced scorecard for outpatient clinic using the example of the results of preventive examination for children in the first year of life.Material and methods. The study of quality indicators of the outpatient clinic was carried out from 2019 to 2023. The base of the study was the Clinical Consultative and Diagnostic Clinic № 27 in Novosibirsk. The study of the Clinic development was carried out from 2012 to 2023. The work used data from a social and expert survey of managers (20122018), as well as comparative modeling, general logical methods and techniques.Results. The longest multi-level and complex medical service is the process of preventive examination of children in the first year of life. Therefore, using his example, a quality balanced scorecard for the outpatient clinic was developed. At the first stage, medical quality criteria were determined. Patients were interviewed and quality criteria important for the patients' parents were determined. The complexity, multi-stage nature and short time frame for providing medical services determined the criteria for the economic efficiency. At the second stage, criteria for the management effectiveness and criteria for quality monitoring were developed, which allow department heads to track key performance indicators, as well as build coordinated work between various departments. At the third stage, the quality criteria were developed, which, on the one hand, reflect the clinic work, and, on the other hand, are not redundant and can be used to assess the effectiveness of the organization as a whole.Conclusion. The study showed that to increase the sustainability of the clinic development, effective monitoring based on key performance indicators is necessary. 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引用次数: 0

摘要

各国的医疗质量审计制度以医疗服务质量、病人及其亲属的满意度以及医疗文件的质量为基础。同时,医疗机构的质量指标还包括社会和经济效益标准。通常情况下,研究人员会将这几组指标分开考虑,现有文献并未显示将不同组别的指标综合在一个过程中的平衡方法,而这正是本研究工作的基础。本文以儿童出生后第一年的预防性检查结果为例,致力于确定门诊质量平衡计分卡的具体内容。门诊质量指标研究从 2019 年开始至 2023 年结束。研究基地为新西伯利亚市№27临床咨询与诊断诊所。该诊所的发展研究始于2012年,终于2023年。研究使用了对管理人员进行的社会和专家调查(2012-2018 年)的数据,以及比较模型、一般逻辑方法和技术。最长的多层次复杂医疗服务是儿童出生后第一年的预防性检查过程。因此,以其为例为门诊制定了质量平衡计分卡。在第一阶段,确定了医疗质量标准。对患者进行访谈,并确定对患者家长重要的质量标准。提供医疗服务的复杂性、多阶段性和短时限决定了经济效益的标准。在第二阶段,制定了管理效率标准和质量监测标准,使各部门负责人能够跟踪关键绩效指标,并在各部门之间建立协调工作。在第三阶段,制定了质量标准,一方面,这些标准反映了诊所的工作,另一方面,这些标准不是多余的,可以用来评估整个组织的有效性。研究表明,要提高诊所发展的可持续性,必须根据关键绩效指标进行有效监测。确定医疗机构有效性的传统方法是基于单个流程质量标准的一般绩效指标,这种方法无法确定单个医疗和辅助流程中的违规行为,因此也无法确定解决问题的方法。它也不能说明违规的程度。在制定质量标准时采用流程和系统方法,可以针对不同组别的标准制定质量平衡计分卡,最终反映流程的整体有效性,了解因果关系,找出不稳定的根本原因。
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Quality balanced scorecard for the outpatient clinic
The quality audit system for healthcare in various countries is based on the quality of medical services, the satisfaction of the patient and his relatives, as well as the quality of medical documentation. At the same time, quality indicators of healthcare facilities include criteria of the social and economic efficiency. Often these groups of indicators are considered by researchers separately from each other, and the literature available does not show balanced approaches to combining indicators from different groups within one process, which served as the basis for this work.Aim. The article is devoted to identifying the specifics of quality balanced scorecard for outpatient clinic using the example of the results of preventive examination for children in the first year of life.Material and methods. The study of quality indicators of the outpatient clinic was carried out from 2019 to 2023. The base of the study was the Clinical Consultative and Diagnostic Clinic № 27 in Novosibirsk. The study of the Clinic development was carried out from 2012 to 2023. The work used data from a social and expert survey of managers (20122018), as well as comparative modeling, general logical methods and techniques.Results. The longest multi-level and complex medical service is the process of preventive examination of children in the first year of life. Therefore, using his example, a quality balanced scorecard for the outpatient clinic was developed. At the first stage, medical quality criteria were determined. Patients were interviewed and quality criteria important for the patients' parents were determined. The complexity, multi-stage nature and short time frame for providing medical services determined the criteria for the economic efficiency. At the second stage, criteria for the management effectiveness and criteria for quality monitoring were developed, which allow department heads to track key performance indicators, as well as build coordinated work between various departments. At the third stage, the quality criteria were developed, which, on the one hand, reflect the clinic work, and, on the other hand, are not redundant and can be used to assess the effectiveness of the organization as a whole.Conclusion. The study showed that to increase the sustainability of the clinic development, effective monitoring based on key performance indicators is necessary. The classical approach to determining the effectiveness of medical facilities is based on general performance indicators to the quality criteria of individual processes, which does not allow identifying violations in individual medical and auxiliary processes, and, accordingly, does not allow identifying ways to solve them. It also does not indicate the level of violation. The use of a process and system approach in developing quality criteria allows developing a quality balanced scorecard with respect to the criteria of various groups, which ultimately reflects the effectiveness of processes as a whole, provides an understanding of cause-and-effect relationships and identifies the root cause of destabilization.
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来源期刊
Cardiovascular Therapy and Prevention
Cardiovascular Therapy and Prevention Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.70
自引率
0.00%
发文量
155
审稿时长
6-12 weeks
期刊介绍: The most important objectives of the journal are: the generalization of scientific and practical achievements in the field of cardiology, increasing scientific and practical skills of cardiologists. The scientific concept of publication does the publication of modern achievements in the field of epidemiology, prevention and treatment of cardiovascular diseases, the results of research, national and international clinical trials. For publication in the journal are invited both domestic and foreign scientists and clinicians working in the field of cardiology, as well as doctors of other specialties. The magazine covers various issues in cardiology and related specialties. Each issue is prepared by Executive editor of the issue, a respected specialist in the field of epidemiology, prevention and treatment of cardiovascular diseases. The main focus of the publication — scientific articles on original research, the pharmacotherapy of cardiovascular disease, new diagnostic methods. All members of the group of authors should meet all four criteria of authorship set forth in the ICMJE recommendations: 1) concept and design development or data analysis and interpretation, and 2) manuscript justification or verification of critical intellectual content, and 3) final approval for publication of the manuscript, and 4) consent to be responsible for all aspects of the work, and assume that issues relating to the thoroughness and diligent execution of any part of the study submitted are duly investigated and resolved. Great importance the editors attached to the preparation of scientific papers by groups of authors at a high level, literacy, authors, and their ownership information, availability of research results not only to colleagues in Russia, but also abroad.
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