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{"title":"业务和医疗保健交付流程的整合:波兰医疗保健绩效衡量的质量和临床有效性的案例研究","authors":"Anna Rosiek","doi":"10.4018/JHDRI.2010070103","DOIUrl":null,"url":null,"abstract":"Demand for performance improvement drives many healthcare organizations to learn as much as possible about continuous quality improvement. This case study examines the implementation of new ideas in Polish Healthcare systems, such as problem solving procedures, data collection, provision of patients satisfaction reports, employee satisfaction surveys, and management of various processes, with the use of clinical algorithms. The author examines monitoring and improvement of healthcare quality, emphasizing problem identification, development of standards, data collection, data analyses and evaluation, implementation of quality improvement in public healthcare with cost saving, and at the same time, improve the quality of patient care. Traditional forums for measuring performance have two aspects: i) Organization and ii) Patient. Organizations must measure three aspects: balance score, value-based cost management and Baldrige criteria, which lead to improvement of organizational performance and, in consequence, delivery of constantly improving value for patients—the anticipated outcome for improved healthcare quality. The method used in this article is intertwined with balance score and value based cost management in public healthcare within Poland. organizations to learn as much as possible about continuous quality improvement. They began implementing new ideas such as: problem solving procedures, data collection, providing patients with satisfying results of their treatment, employee satisfaction surveys, and management of various processes with the use of clinical algorithms. The need to measure performance in healthcare is greater than in any other public sector. The lack of high standards in healthcare DOI: 10.4018/jhdri.2010070103 International Journal of Healthcare Delivery Reform Initiatives, 2(3), 20-28, July-September 2010 21 Copyright © 2010, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. affects nearly every citizen therefore public investment in healthcare must be substantial. In the last decade Polish government started to implement reforms to improve quality of medical procedures in public healthcare. The government introduced a system, in which a certain number of points are allocated to a hospital, depending on time of patient’s hospitalization. The number of points is also dependent on whether the medical procedure, that was performed, was a traditional one, referred to as MIOM (minimal invasive operation method). Many public hospitals which do not provide highly specified procedures were degraded to a second-level healthcare institutions. That was the beginning of improvement of overall organizational performance of hospitals and their capabilities as healthcare providers. 2. LITeraTure revIew Performance measurement is one of the most important current topics discussed in healthcare institutions. Evaluation of quality improvement in healthcare (Ovretveit & Gustafson, 2002), and clear definition of the terms such as ‘healthcare performance’ and ‘healthcare measurement’, and ‘improvement of the patient outcomes’(Hickman, 2007) is fundamental to the intelligent understanding of the healthcare processes and actions. Without agreeing on basic definitions, the interpretation of measurement and marketing information leads to misunderstanding and confusion. Furthermore, because measurement is only one of many functions in business, it is important that the terms used in the business’ analysis and its measurement are in accordance with other business’ functions, such as: Logistics, Finance and Quality. Between patient satisfaction with care, and costs, Kenagy, Berwick and Shore found a strong correlation, indicating significant reduction in the cost of care when service improves (Press, 2006; Oakland & Oakland, 1998). Also Hickman cites revenue enhancement and the cost reduction in a public healthcare as a key consideration (2007). In other words, if a sustainable quality program has been developed, ultimately the return on investment will be high. This program is important as a source of information for hospital’s managers in screening for Financial and Logistic problems and developing an effective plan of action for quality improvement in healthcare organization (Levine Plume, & Nelson, 1997). The best practice for integration of business and healthcare delivery processes is learning how to connect the quality and clinical effectiveness and performance measurement in healthcare. The question is how to connect those things? Of course we should measure: performance, financial outcomes, patient satisfaction and hospital facilities in a consumerism context (Labarere & Francois, 1999; Turnbull & Hembree, 1996) and adopt this idea to the local market and country law. The literature inspired the author to investigate the application of certain management models in hospitals, including Balanced Scorecard, Excellence Model, Malcolm Aldridge Model, or TQM (Westlund, 2001) and see how these can influence public healthcare activity in patient’s assessment and help to achieve high financial results. For this purpose hospital procedure (MIOM) variable was developed. Furthermore, two other practical methods (standard vs. minimal invasive and result dependent performance measurement in healthcare system) were introduced to the study. They are used in the paper for better explanation of the role of payment for procedure, of how products’ quality, monitoring, and the improvement of all hospital’s processes can contribute to patient satisfaction, and also how business and healthcare are connected in practice. 3. researcH MeTHoDoLogy One of the disciplines in healthcare, apart from cardio-surgery and transplantology, where the quality and performance are very important 7 more pages are available in the full version of this document, which may be purchased using the \"Add to Cart\" button on the product's webpage: www.igi-global.com/article/integration-business-healthcaredelivery-processes/51682?camid=4v1 This title is available in InfoSci-Journals, InfoSci-Journal Disciplines Medicine, Healthcare, and Life Science. 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The method used in this article is intertwined with balance score and value based cost management in public healthcare within Poland. organizations to learn as much as possible about continuous quality improvement. They began implementing new ideas such as: problem solving procedures, data collection, providing patients with satisfying results of their treatment, employee satisfaction surveys, and management of various processes with the use of clinical algorithms. The need to measure performance in healthcare is greater than in any other public sector. The lack of high standards in healthcare DOI: 10.4018/jhdri.2010070103 International Journal of Healthcare Delivery Reform Initiatives, 2(3), 20-28, July-September 2010 21 Copyright © 2010, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. affects nearly every citizen therefore public investment in healthcare must be substantial. In the last decade Polish government started to implement reforms to improve quality of medical procedures in public healthcare. The government introduced a system, in which a certain number of points are allocated to a hospital, depending on time of patient’s hospitalization. The number of points is also dependent on whether the medical procedure, that was performed, was a traditional one, referred to as MIOM (minimal invasive operation method). Many public hospitals which do not provide highly specified procedures were degraded to a second-level healthcare institutions. That was the beginning of improvement of overall organizational performance of hospitals and their capabilities as healthcare providers. 2. LITeraTure revIew Performance measurement is one of the most important current topics discussed in healthcare institutions. Evaluation of quality improvement in healthcare (Ovretveit & Gustafson, 2002), and clear definition of the terms such as ‘healthcare performance’ and ‘healthcare measurement’, and ‘improvement of the patient outcomes’(Hickman, 2007) is fundamental to the intelligent understanding of the healthcare processes and actions. Without agreeing on basic definitions, the interpretation of measurement and marketing information leads to misunderstanding and confusion. Furthermore, because measurement is only one of many functions in business, it is important that the terms used in the business’ analysis and its measurement are in accordance with other business’ functions, such as: Logistics, Finance and Quality. Between patient satisfaction with care, and costs, Kenagy, Berwick and Shore found a strong correlation, indicating significant reduction in the cost of care when service improves (Press, 2006; Oakland & Oakland, 1998). Also Hickman cites revenue enhancement and the cost reduction in a public healthcare as a key consideration (2007). In other words, if a sustainable quality program has been developed, ultimately the return on investment will be high. This program is important as a source of information for hospital’s managers in screening for Financial and Logistic problems and developing an effective plan of action for quality improvement in healthcare organization (Levine Plume, & Nelson, 1997). The best practice for integration of business and healthcare delivery processes is learning how to connect the quality and clinical effectiveness and performance measurement in healthcare. The question is how to connect those things? Of course we should measure: performance, financial outcomes, patient satisfaction and hospital facilities in a consumerism context (Labarere & Francois, 1999; Turnbull & Hembree, 1996) and adopt this idea to the local market and country law. The literature inspired the author to investigate the application of certain management models in hospitals, including Balanced Scorecard, Excellence Model, Malcolm Aldridge Model, or TQM (Westlund, 2001) and see how these can influence public healthcare activity in patient’s assessment and help to achieve high financial results. For this purpose hospital procedure (MIOM) variable was developed. Furthermore, two other practical methods (standard vs. minimal invasive and result dependent performance measurement in healthcare system) were introduced to the study. They are used in the paper for better explanation of the role of payment for procedure, of how products’ quality, monitoring, and the improvement of all hospital’s processes can contribute to patient satisfaction, and also how business and healthcare are connected in practice. 3. researcH MeTHoDoLogy One of the disciplines in healthcare, apart from cardio-surgery and transplantology, where the quality and performance are very important 7 more pages are available in the full version of this document, which may be purchased using the \\\"Add to Cart\\\" button on the product's webpage: www.igi-global.com/article/integration-business-healthcaredelivery-processes/51682?camid=4v1 This title is available in InfoSci-Journals, InfoSci-Journal Disciplines Medicine, Healthcare, and Life Science. 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Integration of Business and Healthcare Delivery Processes: Case Study on Quality and Clinical Effectiveness of Performance Measurement in Polish Healthcare
Demand for performance improvement drives many healthcare organizations to learn as much as possible about continuous quality improvement. This case study examines the implementation of new ideas in Polish Healthcare systems, such as problem solving procedures, data collection, provision of patients satisfaction reports, employee satisfaction surveys, and management of various processes, with the use of clinical algorithms. The author examines monitoring and improvement of healthcare quality, emphasizing problem identification, development of standards, data collection, data analyses and evaluation, implementation of quality improvement in public healthcare with cost saving, and at the same time, improve the quality of patient care. Traditional forums for measuring performance have two aspects: i) Organization and ii) Patient. Organizations must measure three aspects: balance score, value-based cost management and Baldrige criteria, which lead to improvement of organizational performance and, in consequence, delivery of constantly improving value for patients—the anticipated outcome for improved healthcare quality. The method used in this article is intertwined with balance score and value based cost management in public healthcare within Poland. organizations to learn as much as possible about continuous quality improvement. They began implementing new ideas such as: problem solving procedures, data collection, providing patients with satisfying results of their treatment, employee satisfaction surveys, and management of various processes with the use of clinical algorithms. The need to measure performance in healthcare is greater than in any other public sector. The lack of high standards in healthcare DOI: 10.4018/jhdri.2010070103 International Journal of Healthcare Delivery Reform Initiatives, 2(3), 20-28, July-September 2010 21 Copyright © 2010, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. affects nearly every citizen therefore public investment in healthcare must be substantial. In the last decade Polish government started to implement reforms to improve quality of medical procedures in public healthcare. The government introduced a system, in which a certain number of points are allocated to a hospital, depending on time of patient’s hospitalization. The number of points is also dependent on whether the medical procedure, that was performed, was a traditional one, referred to as MIOM (minimal invasive operation method). Many public hospitals which do not provide highly specified procedures were degraded to a second-level healthcare institutions. That was the beginning of improvement of overall organizational performance of hospitals and their capabilities as healthcare providers. 2. LITeraTure revIew Performance measurement is one of the most important current topics discussed in healthcare institutions. Evaluation of quality improvement in healthcare (Ovretveit & Gustafson, 2002), and clear definition of the terms such as ‘healthcare performance’ and ‘healthcare measurement’, and ‘improvement of the patient outcomes’(Hickman, 2007) is fundamental to the intelligent understanding of the healthcare processes and actions. Without agreeing on basic definitions, the interpretation of measurement and marketing information leads to misunderstanding and confusion. Furthermore, because measurement is only one of many functions in business, it is important that the terms used in the business’ analysis and its measurement are in accordance with other business’ functions, such as: Logistics, Finance and Quality. Between patient satisfaction with care, and costs, Kenagy, Berwick and Shore found a strong correlation, indicating significant reduction in the cost of care when service improves (Press, 2006; Oakland & Oakland, 1998). Also Hickman cites revenue enhancement and the cost reduction in a public healthcare as a key consideration (2007). In other words, if a sustainable quality program has been developed, ultimately the return on investment will be high. This program is important as a source of information for hospital’s managers in screening for Financial and Logistic problems and developing an effective plan of action for quality improvement in healthcare organization (Levine Plume, & Nelson, 1997). The best practice for integration of business and healthcare delivery processes is learning how to connect the quality and clinical effectiveness and performance measurement in healthcare. The question is how to connect those things? Of course we should measure: performance, financial outcomes, patient satisfaction and hospital facilities in a consumerism context (Labarere & Francois, 1999; Turnbull & Hembree, 1996) and adopt this idea to the local market and country law. The literature inspired the author to investigate the application of certain management models in hospitals, including Balanced Scorecard, Excellence Model, Malcolm Aldridge Model, or TQM (Westlund, 2001) and see how these can influence public healthcare activity in patient’s assessment and help to achieve high financial results. For this purpose hospital procedure (MIOM) variable was developed. Furthermore, two other practical methods (standard vs. minimal invasive and result dependent performance measurement in healthcare system) were introduced to the study. They are used in the paper for better explanation of the role of payment for procedure, of how products’ quality, monitoring, and the improvement of all hospital’s processes can contribute to patient satisfaction, and also how business and healthcare are connected in practice. 3. researcH MeTHoDoLogy One of the disciplines in healthcare, apart from cardio-surgery and transplantology, where the quality and performance are very important 7 more pages are available in the full version of this document, which may be purchased using the "Add to Cart" button on the product's webpage: www.igi-global.com/article/integration-business-healthcaredelivery-processes/51682?camid=4v1 This title is available in InfoSci-Journals, InfoSci-Journal Disciplines Medicine, Healthcare, and Life Science. Recommend this product to your librarian: www.igi-global.com/e-resources/libraryrecommendation/?id=2