军队大型三甲综合性医院医疗质量考评体系的构建与应用体会

The construction and application experience of medical quality evaluation system in large military third-grade class-A general hospital

目的在医改和军队医院转型重塑阶段,根据医院高质量建设发展要求,探讨运用关键绩效指标法(KPI),构建适用于军队大型三甲综合性医院医疗质量考评体系。方法分析军地大型三甲综合性医院医疗质量考评体系重构的必要性,确定构建质量考评体系的原则和指标遴选依据,按照临床科室、门诊、急诊、麻醉、医技科室和机关职能科室6大类目,通过Delphi法分别建立了4~5个一级指标、近30个二级指标和160余个三级指标的质量考评指标体系。结果新建的质量考评体系采用质量、服务、卫勤及单项分模块考评,结合新开发的质量考评信息管理模块,由不同的考核部门针对各自职能范畴对全院各科室进行在线考核,每月质量考评时间从原来的半个月缩短到5 d,促进了质量管理和运行效率大幅度提高。结论在军队医院转型重塑和高质量发展导向下,优化构建军队医院质量考评体系,能在一定程度上调动医护人员积极性,更好发挥军队医院为兵服务和卫勤保障职能。

Objective In the stage of medical reform and the transformation and reshaping of military hospitals,according to the requirements of high-quality construction and development of hospitals,key performance indicators(KPIs)are discussed to establish a medical quality evaluation system suitable for large third grade class-A general hospitals in the military.Methods Analyze the necessity of reconstructing the medical quality evaluation system of the large third-grade class-A general hospitals in the military and local areas,and determine the principle of constructing the quality evaluation system and the selection basis of the indicators,according to the six categories of clinical departments,outpatient department,emergency department,anesthesia department,medical technology department and organ functional department.The quality evaluation index system of 4-5 first-level indexes,nearly 30 second-level indexes and more than 160 third-level indexes have been established by Delphi method.Results The new quality evaluation system adopts the evaluation of quality,service,medical service and individual sub-modules.Combined with the newly developed quality evaluation information management module,different assessment departments carry out online assessment for all departments of the hospital according to their respective functional categories.The monthly quality evaluation time is shortened from half a month to 5 days,which greatly improves the quality management and operation efficiency.Conclusion Under the guidance of the transformation and reconstruction of military hospitals and high-quality development,the optimization and construction of the quality evaluation system of military hospitals can mobilize the enthusiasm of medical staff to a certain extent,and better play the functions of military hospitals to serve soldiers and provide medical service.