社区卫生服务机构岗位工作内容的非参与观察研究

Work Content of Key Posts in Community Health Services:A Non-participant Observation

目的真实反映社区卫生服务机构主要岗位的工作特征。方法采用目的抽样原则,选取A、B、C 3个区县,在每个区县内再分别选取2家社区卫生服务机构进行非参与观察,主要观察全科医生、社区护士、预防保健人员不同岗位每天开展的工作任务内容、每项工作时间及每天的累计工作量等。结果在非参与观察中发现,社区卫生服务机构不同岗位人员的职责多没有明确界定,工作内容存在一定的交叉,工作中互相推诿的现象较为常见。社区卫生服务机构全科医生岗位的工作内容多以社区门诊诊疗为主,虽开展慢性病管理,但很不规范,服务缺乏合理的操作流程;预防保健人员提供公共卫生服务的积极性和主动性不高,健康教育服务过多地注重形式而忽视内容,很难得到居民的认同,无法实现预期的效果。结论非参与观察可以为社区卫生服务机构的岗位绩效考核提供较为客观的参考依据。

Objective To investigate the content of key job positions in community health service institutions. Methods Two community health service institutions were selected from each of the three districts using purposive sampling method.Routine work content,work hour allocation,and daily workload of general practitioners,nurses,and preventive health care workers in these six community health care centers were observed. Results The lack of the clear definition of job responsibilities resulted in overlapping work content and buckpassing.General practitioners in community health services were mainly responsible for community outpatient consultation;however,they also carried out chronic disease management,but in a relatively non-standardized way.Preventive health care workers had relatively less enthusiasm and motivation when providing public health services,and there health education was hardly accepted by the community residents due to the poorly designed content. Conclusion The non-participant observation of the key job positions may provide useful information for performance appraisal in community health service institutions.