بررسي و مقايسه عملكرد بيمارستان با استفاده از "الگوي اعتباربخشي"، "الگوي تعالي سازماني" و "الگوي زنجيره اي برنامه"

Assessment and Comparing of Hospital Performance Using “Accreditation Pattern”, “Organizational Excellence Pattern” and Program Chain Patterns

مقدمه: بررسي عملكرد بيمارستان جزء ضروري جهت ارايه بازخوردي از كارآيي و اثربخشي خدمات مي­باشد. هدف اين مطالعه ارزيابي و مقايسه عملكرد بيمارستان با استفاده از "الگوي­­ اعتباربخشي"، "الگوي تعالي سازماني" و "الگوي زنجيره­اي برنامه" مي باشد. روش كار: اين مطالعه توصيفي-مقايسه اي در سال 1398 در مراكز آموزشي درماني دانشگاه علوم پزشكي مازندران انجام شد. جامعه آماري شامل 180 تن از مديران عالي، مياني و عملياتي پنج مركز آموزشي درماني تحت پوشش اين دانشگاه بودند. نمونه­ ها به صورت تمام شماري انتخاب شدند. ابزار گردآوري داده ­ها از طريق ازپرسشنامه جمعيت شناختي، "پرسشنامه اعتباربخشي بيمارستان ايران" (Iran Hospital Accreditation Questionnaire) وزارت بهداشت، درمان و آموزش پزشكي و ابزارهاي پژوهشگر ساخته "پرسشنامه تعالي سازماني" (Organizational Excellence Questionnaire) و "پرسشنامه الگوي زنجيره­اي برنامه" (Program Chain Pattern Questionnaire) بود. روايي صوري، محتوا و سازه ابزار ها با استفاده از تحليل عامل تأييدي و پايايي آن به روش ضريب آلفاي كرونباخ و پايايي مركب انجام شد. تحليل داده­ها با استفاده از نرم افزار اس پي اس­ اس نسخه 21 انجام شد. يافته­­ها: در ارزيابي عملكرد بيمارستان با "الگوي­ اعتباربخشي"، "الگوي تعالي سازماني" و "الگوي زنجيره­اي برنامه"، به ترتيب ابعاد خدمات پاراكلينيكي (0/5±4/12) ، فرايندها (0/57±69/4) و كنترل (0/65±3/21) بيشترين نمره و ابعاد پيشگيري و بهداشت(0/75±2/62) ، نتايج جامعه(0/62±56/36) و ساختار (0/62±2/98) كمترين نمره را كسب نمودند. نتايج آزمون تحليل واريانس يك طرفه نشان داد كه تفاوت معناداري ميان ابعاد الگوهاي ارزيابي عملكرد بيمارستان وجود دارد(0/001

Introduction: Hospital performance measurement is an essential part for providing feedback on the efficacy and effectiveness of services. The purpose of this study was assessment and comparing of hospital performance using “Accreditation Pattern”, “Organizational Excellence Pattern “and Program Chain (IPOCC) Patterns. Methods: This descriptive-comparative study was conducted in 2019 in the educational and medical centers of Mazandaran University of Medical Sciences. The statistical population included 180 top, middle, and operational managers of five educational and medical centers covered by the university. Samples were selected in a census. Data collection instruments were obtained through; demographic questionnaire, " the "Iran Hospital Accreditation Questionnaire" of the Ministry of Health and Medical Education and the research instrument developed by the “Organizational Excellence Questionnaire” and the "Program Chain Pattern Questionnaire”. Face validity, content and its structure were performed using confirmatory factor analysis and its reliability by Cronbach's alpha coefficient method and composite reliability. Data was analyzed using SPSS. 21. Results: In assessment the performance of the hospital with Accreditation Pattern, Organizational Excellence Pattern and Program Chain Pattern, respectively, the dimensions of para clinical services (4.12±0.5), processes (69.4±0.57) and control (3.21±0.65) were the highest scores and the dimensions of prevention and health (2.62±0.75), society results (56.36±0.62) and outcome (2.98±0.62) were the lowest scores. The results of oneway analysis of variance showed that there was a significant difference between the dimensions of hospital performance assessment patterns (P <0.001). Conclusions: The highest score of the hospitals with the Patterns of accreditation, organizational excellence and program chain were in the dimensions of para clinical services, processes and control, respectively, and in the dimensions of results and Context, less attention was paid to the performance of the hospitals. Therefore, it is recommended to pay attention to the results of service delivery and Context standards such as teamwork and organizational culture along with process, Input and control standards to balance hospital performance assessment standards.