摘要
如何提升医疗质量存在多种视角的解决方案,这些视角包括质量管理视角、患者视角、组织竞争视角、组织运营视角、数据技术视角以及医保控费的视角。通过对文献的阅读发现,这些多视角视域虽给出了多种解决方案,但多种方案间并没有联系和互动,尽管各有其理性逻辑,但对于医疗政策制定者和各级医院内的实践者而言,难以获得明晰的改革指向,因而提出面对多种视角,首先需要梳理识别出哪个视角是医疗质量提升的主要矛盾,便于政策制定者和实践者依照“抓大放小”、“提纲挈领”的原则持续一致地沿着一个方向和逻辑持续改进,从而避免多视角并行下思路的游移、矛盾乃至混杂。最终提出医疗质量提升的主要矛盾应该归属于“质量管理”的视角去探讨,用“质量管理”的学科逻辑去统领和整合其他多视角视域;尤其强调鲍德里奇国家质量奖的七个类目构成了一个完整框架,为解决医疗质量问题提供了一个创新性的整合视角,因而是一个具有统领意义的研究出发点。
There are many solutions to improve medical quality,including quality management perspective,patient perspective,organizational competition perspective,organizational operation perspective,data technology perspective and medical insurance cost control perspective.Through reading the literature,it is found that although these multi perspective perspectives provide a variety of solutions,there is no connection and interaction between them.Although each has its own rational logic,it is difficult for medical policy makers and practitioners at all levels of hospitals to obtain a clear direction of reform.Therefore,in the face of a variety of perspectives,it is necessary to clarify which perspective is the medical quality improvement the main contradiction of promotion.In this way,it is convenient for policy makers and practitioners to continuously improve along one direction and logic,so as to avoid the wandering,contradiction and even confusion of ideas under the multi perspective parallel.Finally,the main contradiction of medical quality improvement should be attributed to the perspective of"quality management",and the discipline logic of"quality management"should be used to guide and integrate other multi perspective perspectives;in particular,the seven categories of Baudrillard national quality award constitute a complete framework,which provides an innovative integration perspective for solving medical quality problems,so it is a priority to study the starting point.
作者
高雅虹
Gao Ya-hong(Wanping Community Health Center,Fengtai District,Beijing 100165,China)
出处
《广义虚拟经济研究》
2020年第1期86-89,共4页
Research on the Generalized Virtual Economy
关键词
医疗质量
质量管理
提升
视角
整合
medical quality
quality management
promotion
perspective
integration
