基于AMO模型的三级公立医院职能部门管理效能影响因素研究

Influencing factors of management efficiency of functional departments in tertiary public hospitals:an analysis based on AMO model

目的评价公立医院职能部门管理效能,分析其影响因素,为改进公立医院职能部门绩效管理和提高医院整体运营效率、效益提供依据。方法基于人力资源管理的AMO模型构建管理效能测评体系并设计问卷,结合医疗机构管理情境,将三级公立医院职能部门划分为党务群团、综合行政、业务管理、科研教学、经济运营、技术支持、后勤保障7个类别,针对其管理效能开展分层随机抽样调查和关键知情人访谈。采用多重线性回归分析组织环境、工作动机、能力素质3个维度的8个项目对职能部门管理效能的影响。结果医院职能部门管理效能、履职程度、履职时效百分制评分分别为85.96、87.53、88.43,8个评价项目均存在不同程度的问题。经济运营、技术支持、后勤保障3类职能部门的工作绩效评分低于其他4类职能部门。部门职责、规章制度、敬业精神、创新思维4个评价项目存在问题的严重程度等级与职能部门管理效能综合评分呈负相关。结论职能部门人力资源规划应注重前瞻性,不同类别职能部门管理效能存在差异,提升管理效能应重点加强绩效管理,同时需要建设多维激励机制和高绩效团队,公立医院也应适时考虑引入广泛应用于企业的AMO模型,以完善职能部门绩效管理体系。

Objective To evaluate the management efficiency of functional departments in public hospitals,analyze their influencing factors,and provide evidence for improving the performance management of functional departments of public hospitals and the overall operational efficiency and revenue of hospitals.Methods Based on the Ability,Motivation,and Opportunity(AMO)model of human resource management,a management performance evaluation system was constructed,and a relevant questionnaire was designed.According to the context of medical institution management,the functional departments in tertiary public hospitals were divided into seven categories:Party affair offices and mass groups,general administration,business management,scientific research and teaching,economic operation,technical support,and logistics.Stratified random sampling surveys and key informant interviews were carried out for their management performance.Multiple linear regression method was used to analyze the impact of 8items in three dimensions(including organizational environment,work motivation,and competency)on the management performance of functional departments.Results The scores of management efficiency,performance of duties,and performance timeliness in the functional departments were 85.96,87.53,and 88.43,respectively,and problems of varying degrees were ldentified in all the eight items.The performance scores of three functional departments including economic operation,technical support,and logistics were lower than those of the other four functional departments.The severity grade of the problems in four items including department duties/responsibilities,rules/regulations,professionalism,and innovative thinking was negatively correlated with the comprehensive score of management efficiency in functional departments.Conclusions Human resources planning for functional departments should be farsighted.The management efficiency differs among different types of functional departments.Performance management should be enhanced to improve the management efficiency,and at the same time multi-dimensional incentive mechanism and high-performance teams are also required.Public hospitals should also consider introducing AMO models,which are widely used in enterprises,to improve the performance management system of functional departments.