Journal of Health Promotion Management
فصلنامه مدیریت ارتقای سلامت
JHPM
Medical Sciences
http://jhpm.ir
1
admin
2251-8614
2251-9947
10.22034/jhpm
2251-8614
fa
jalali
1399
7
1
gregorian
2020
10
1
9
5
online
1
fulltext
fa
بررسی و مقایسه عملکرد بیمارستان با استفاده از "الگوی اعتباربخشی"، "الگوی تعالی سازمانی" و "الگوی زنجیره ای برنامه"
Assessment and Comparing of Hospital Performance Using “Accreditation Pattern”, “Organizational Excellence Pattern” and Program Chain Patterns
مدیریت خدمات بهداشتی درمانی
health services management
پژوهشي
Research
<strong><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">مقدمه</span></span></strong><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">: بررسی</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">عملکرد</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">بیمارستان</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">جزء</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">ضروری</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">جهت</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">ارایه</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">بازخوردی</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">از</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">کارآیی و اثربخشی</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">خدمات</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">می­باشد. هدف این مطالعه ارزیابی و مقایسه عملکرد بیمارستان با استفاده از "الگوی</span></span><span dir="LTR"><span style="font-size:14.0pt;">­</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">­ اعتباربخشی"، "الگوی تعالی سازمانی</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;"> و </span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">الگوی زنجیره­ای برنامه</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;"> می باشد.</span></span><span dir="LTR"><span style="font-size:14.0pt;"></span></span><br>
<strong><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">روش کار:</span></span></strong> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">این</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">مطالعه</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">توصیفی-مقایسه ای</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">در</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">سال</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">1398 در مراکز آموزشی درمانی دانشگاه علوم پزشکی مازندران انجام شد. جامعه آماری شامل 180 تن از</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">مدیران</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">عالی، میانی</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">وعملیاتی پنج مرکز آموزشی درمانی تحت پوشش این دانشگاه بودند. نمونه­</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">ها به</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">صورت تمام شماری انتخاب شدند.</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">ابزار گردآوری داده­ها از طریق</span></span><span style="font-family:B Nazanin;"><span style="font-size:14.0pt;"> ازپرسشنامه جمعیت شناختی،</span></span> <span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">پرسشنامه اعتباربخشی بیمارستان ایران" (</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Iran Hospital Accreditation Questionnaire</span></span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">) وزارت بهداشت،</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">درمان و آموزش پزشکی</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">و ابزارهای پژوهشگر ساخته "پرسشنامه تعالی سازمانی"</span></span> <span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">(</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Organizational Excellence Questionnaire</span></span></span><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">) </span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">و "پرسشنامه الگوی زنجیره­ای برنامه"</span></span> <span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">(</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Program Chain Pattern Questionnaire</span></span></span><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">)</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">بود. روایی صوری، محتوا</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">و</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">سازه ابزار ها با</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">استفاده</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">از</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">تحلیل</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">عامل</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">تأییدی و پایایی آن</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">به</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">روش</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">ضریب</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">آلفای</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">کرونباخ</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">و</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">پایایی</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">مرکب</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">انجام</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">شد. تحلیل داده­ها با استفاده از</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">نرم افزار اس پی اس­ اس نسخه 21 انجام شد. <span style="color:red;"></span></span></span><br>
<strong><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">یافته­­ها:</span></span></strong><span style="font-family:B Mitra;"><span style="font-size:14.0pt;"> در ارزیابی عملکرد بیمارستان با </span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">الگوی­ اعتباربخشی</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">، </span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">الگوی تعالی سازمانی</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;"> و </span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">الگوی زنجیره­ای برنامه</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">، به ترتیب ابعاد خدمات پاراکلینیکی (5/0</span></span><span style="font-family:Cambria,serif;"><span style="font-size:14.0pt;">±</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">12/4) ، فرایندها (57/0</span></span><span style="font-family:Cambria,serif;"><span style="font-size:14.0pt;">±</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">4/69) و کنترل (65/0</span></span><span style="font-family:Cambria,serif;"><span style="font-size:14.0pt;">±</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">21/3) بیشترین نمره و ابعاد پیشگیری و بهداشت(75/0</span></span><span style="font-family:Cambria,serif;"><span style="font-size:14.0pt;">±</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">62/2) ، نتایج جامعه(62/0</span></span><span style="font-family:Cambria,serif;"><span style="font-size:14.0pt;">±</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">36/56) و ساختار (62/0</span></span><span style="font-family:Cambria,serif;"><span style="font-size:14.0pt;">±</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">98/2) کمترین نمره را کسب نمودند. نتایج آزمون تحلیل واریانس یک طرفه نشان داد که تفاوت معناداری میان ابعاد الگوهای ارزیابی عملکرد بیمارستان وجود دارد(001/0</span></span><span dir="LTR"><span style="font-size:14.0pt;">P<</span></span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">). </span></span><br>
<strong><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">نتیجه­­گیری:</span></span></strong> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">بیشترین نمره بیمارستان­ها با </span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">الگوی­ اعتباربخشی</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">، </span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">الگوی تعالی سازمانی</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;"> و </span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">الگوی زنجیره­ای برنامه</span></span><span style="font-size:14.0pt;">"</span><span style="font-family:B Mitra;"><span style="font-size:14.0pt;">، به ترتیب در ابعاد خدمات پاراکلینیکی، فرایندها و کنترل بود و در ابعاد نتایج و زمینه­ای کمتر عملکرد بیمارستان­ها را مورد توجه قرار می­دادند. از این رو توجه به نتایج ارائه خدمت و استانداردهای زمینه­ای نظیر کار گروهی و فرهنگ سازمانی در کنار استانداردهای فرایندی، ورودی و کنترل جهت متوازن کردن استانداردهای ارزیابی</span></span> <span style="font-family:B Mitra;"><span style="font-size:14.0pt;">عملکرد بیمارستان پیشنهاد می­شود.<strong><span style="color:red;"></span></strong></span></span><br>
<strong><u>Introduction:</u></strong> <u>Hospital performance measurement is an essential part for providing feedback on the efficacy and effectiveness of services<span dir="RTL">.</span></u> <u>The purpose of this study was </u><u>assessment and comparing of hospital performance using “Accreditation Pattern”, “</u><u>Organizational Excellence</u> <u>Pattern</u> <u>“and Program Chain (IPOCC) Patterns.</u><br>
<strong><u>Methods: </u></strong><u>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</u><u>. Samples were selected in a census. Data collection instruments were obtained through;</u> <u>demographic questionnaire, "</u><u> 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 <span dir="RTL">"</span>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.</u><span dir="RTL"></span><br>
<strong><u>Results</u></strong><u>:</u> <u>In assessment the performance of the hospital with Accreditation Pattern, </u><u>Organizational Excellence </u><u>Pattern</u> <u>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 one-way analysis of variance showed that there was a significant difference between the dimensions of hospital performance assessment patterns (P <0.001).</u><br>
<strong><u>Conclusions</u></strong><u>: 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<span dir="RTL">.</span> </u><br>
<span dir="RTL"></span>
ارزیابی عملکرد, اعتباربخشی, تعالی سازمانی, زنجیره ای برنامه
Assessment, Accreditation, Organizational Excellence, Program Chain Pattern.
48
58
http://jhpm.ir/browse.php?a_code=A-10-1334-2&slc_lang=fa&sid=1
Roya
Malekzadeh
رویا
ملک زاده
roya.malekzadeh30@yahoo.com
100319475328460010731
100319475328460010731
No
Mazandaran Medical Sciences University
دانشگاه علوم پزشکی مازندران
Ghahraman
Mahmoodi
قهرمان
محمودی
ghahraman.mahmoodi@gmail.com
100319475328460010732
100319475328460010732
No
Islamic Azad University, Sari
دانشگاه آزاد اسلامی، ساری،
Ghasem
Abedi
قاسم
عابدی
iq134589@yahoo.com
100319475328460010733
100319475328460010733
Yes
Mazandaran Medical Sciences University
دانشگاه علوم پزشکی مازندران