医院实施千分制综合管理量化考核的效果分析

赖登祥，石朝凯，张先祥，陈尚蓉，钟小勤，张建明，周余重庆三峡中心医院，重庆　404000

医院实施千分制综合管理量化考核的效果分析

赖登祥，石朝凯，张先祥，陈尚蓉，钟小勤，张建明，周余
重庆三峡中心医院，重庆404000

为探索有效的医院质量缺陷量化考核办法，该院按照国家法律法规的要求，参照三级医院评审标准，结合医院工作实际情况和各学科专业特点，在医疗质量缺陷管理的工作基础上，探索千分制综合管理考核办法，将各类质量缺陷进行分级量化，按照不同科室进行分值权重分配，由多部门每月进行考核，由质控部进行汇总分析并全院公示，同时配合绩效考核。运行近一年时间，千分制综合量化考核的办法被各职能部门广泛认可，被医务人员普遍接受，自觉规范诊疗行为，减少了医疗质量缺陷和医疗纠纷的发生，提高了医疗质量及患者安全。

质量缺陷；量化考核；效果

［Abstract］In order to explore the effective hospital quality defect quantitative evaluation method，our hospital explores the general management evaluation method and hierarchically quantifies various quality defects and gives score weight distribution in different departments on the basis of medical quality defect management work according to requirements of national laws and regulations，referring to tertiary hospital evaluation criteria and combined with practical conditions of hospital work and characteristics of various disciplines，which is evaluated by multiple departments per month，summarized and analyzed by the quality control department and showed publicly in the whole hospital and evaluated cooperating with performance. Since the millesimal system general quantitative evaluation method ran for about 1 year，it has been widely recognized by various functional departments and generally accepted by the medical staff，and it consciously standardizes the diagnosis and treatment behavior，reduces the occurrence of medical quality defect and medical dispute and improves the medical quality and safety of patients.

［Key words］Quality defect；Quantitative evaluation；Effect

医院质量缺陷管理是医院质量管理的重要内容，各级医院也非常重视。通过文献［1-3］分析发现，医院质量缺陷管理存在以下几个特点：一是制度、规定很多，缺少对违反制度及规定的量化管理；二是不同职能科室之间对质量考核的量化评分不一致，处理尺度不统一；三是质量缺陷管理呈条块分割，缺乏整合及系统性，不利于对科室进行总体评价；四是对缺陷处理的方式简单，单纯与绩效挂钩，缺失教育及对管理者的问责；五是部分医院对质量缺陷管理呈运动式，未体现常态化，未体现PDCA循环持续改进。……