Study On Evaluation Index System Of Hospital Internal Discipline Construction Based On The Core Competence

BackgroundThe introduction of a series of policies have brought opportunities for the construction and development of the medical service system,and the discipline construction of public hospitals has become an important topic.Discipline evaluation is the premise of discipline construction,but there is a lack of unified hospital discipline evaluation criteria at present.The existing evaluation systems are mostly organized by the official or the third party organizations to compare and select the clinical specialty in each hospital,and only for part of the clinical departments.In addition,the published evaluation criteria and indicators mostly emphasize medical quality and scientific research,and less involve some other important contents of discipline construction such as operation,culture and information management.Therefore,how to make the horizontal comparison of all disciplines within a hospital,and find out the development shortcomings of the whole hospital and all disciplines,so as to realize fine management,and make reasonable use of limited resources,which has become the key issue of discipline construction in Q Hospital and other tertiary general hospitals in Shandong Province.ObjectiveBased on the theory of core competitiveness and by referring to the existing discipline evaluation systems,this research constructs the hospital’s internal discipline evaluation index system and model,and applies it in practice.According to the evaluation results,the index system is modified and improved,and relevant suggestions on discipline construction of the hospital are put forward.At the same time,it provides a scientific basis for the discipline evaluation of hospitals in Shandong Province,and also provides reference for other tertiary general hospitals.ContentThe research content of this study is mainly divided into three parts.Firstly,based on the theory of core competence,the study referred to the current domestic and foreign hospital discipline evaluation indicators,gathered and classified these indicators,and established the hospital internal discipline evaluation index system.Secondly,27 clinical disciplines of Q Hospital in Shandong Province were selected as the evaluation objects.The discipline evaluation index system was used to evaluate the departments,and the departments were classified and analyzed according to their core competence.At the same time,the evaluation results were compared with the actual situation of the departments through expert interviews to prove the validity of the model.Thirdly,according to the evaluation dimensions and evaluation results of the disciplines,the paper found the shortcomings in the discipline construction of Q Hospitals,and proposed targeted suggestions to improve the discipline level of Q Hospital and expanded the influence of the hospital.MethodsBased on the theory of core competence,the study constructed the theoretical framework of core competence of disciplines from five aspects:human resources,technology and innovation,operation and management,cultural cohesion,and brand appeal.In the process of data collection,the literature research method was used to understand the current situation of hospital discipline evaluation at home and abroad.Based on the results,the evaluation index database was established and the indexes were classified according to the theoretical framework.In the Delphi method,30 experts were selected from universities,health administrative departments and 4 tertiary general hospitals for two rounds of consultation according to the screening criteria to choose the indexes.At the same time,10 experts were selected for two interviews to collect their opinions on the index system and evaluation results.In the process of data analysis,the critical value method was used to set the criteria of screening indicators and to screen all levels of indicators.The analytic hierarchy process(AHP)was used to construct the judgment matrix,and the entropy weight method was used to sort out and analyze the data,and the index weights of each level were determined preliminarily.Then the combination weight method was used to construct the internal discipline evaluation index system of the hospital.In the empirical study,the data of 27 departments in Q Hospital were collected according to the requirements of indicators,and the departments were evaluated and ranked.The weighted rank sum ratio was used to classify the discipline core competitiveness of the 27 departments,so as to verify the validity of the evaluation system.Based on the five dimensions of assessment,the study carried out one-way ANOVA to find out the main factors that lead to the difference of subject ability.Results(1)The research has established an evaluation index system of the core competence of hospital internal discipline construction through literature research method,Delphi method,analytic hierarchy process(AHP)and entropy weight method.There are 5 first-level indicators,13 second-level indicators and 28 third-level indicators in the index system.The positive coefficient of experts is 90%,the authority coefficient is 0.87,the coordination coefficients of the first,second,and third levels are 0.172,0.165,and 0.113 respectively,and the P values after inspection are all≤0.001.The Cronbach α coefficient of the entire index system is 0.899,the KMO value is 0.807,and the Bartlett sphere test value is 25.255(P=0.005<0.05).The above proves that the indicator system has good reliability and validity and can be used for empirical research.(2)Taking the comprehensive score of core competitiveness(Zi)as the dependent variable,the quality and ability of human resources(A1),technological innovation ability(A2),business management ability(A3),cultural cohesion(A4)and brand appeal(A5)as the independent variables,the research uses the combination weighting method to establish the hospital’s internal discipline core competence evaluation equation Zi=0.3230A1+0.2724A2+0.2499A3+0.1011A4+ 0.0535A5.(3)In the empirical study which evaluated 27 departments,the top three comprehensive scores are General Surgery,Cardiovascular Medicine,Nephrology,and the least score is Rehabilitation Medicine.(4)The paper uses the weighted rank-sum ratio method to classify the department capability.The departments with strong core are General Surgery,Cardiovascular Medicine,Nephrology,Gastroenterology and Ophthalmology.The departments with weaker core are Infectious Diseases,Rehabilitation medicine,Stomatology,Rheumatism immunology,and the remaining 18 departments are all of medium level in evaluation.(5)By comparing the capabilities of each department from the five evaluation dimensions,it is found that there are statistical differences in the three evaluation dimensions,the quality and ability of human resources,the ability of discipline management,and discipline culture cohesion.Conclusion and suggestionsThe index system of hospital’s internal discipline core competence has clear hierarchy and reasonable weight.The evaluation model established by this method can be used for empirical research,which can reflect the real situation of the department,and has good validity and feasibility.The evaluation effect is obvious,and it is easy to find the shortcoming of the discipline,so as to provide reference for the hospital and other related institutions.In response to the results of this research,the following suggestions are put forward.Using the discipline evaluation indicators and models,the hospital should regularly conduct internal discipline evaluations,strengthen feedback and dynamic management of evaluation results,create an environment of active competition,improve the discipline structure,and create discipline characteristics.The hospital can continuously improve the evaluation model of the core competence of the discipline.At the same time,according to the follow-up policy,the needs of the hospital,changes,etc.,indicators can be added in time to make the indicator system more perfect.Regarding the discipline development and construction of various departments,the quality and ability of human resources,discipline management and management capabilities,and discipline culture cohesion are the three main factors that cause the difference in discipline scores.Therefore,the following three suggestions are put forward:(1)The hospital should vigorously introduce senior talents and young talents,train the discipline reserve army,stimulate the discipline potential,and optimize the age structure and title structure;and abandon the "seniority theory",special promotion should be made for those who have made significant contributions,and more opportunities and development platforms should be provided for talents.(2)The hospital can formulate specific reward and punishment measures to further standardize the diagnosis and treatment behavior and make the income and expenditure structure more reasonable;and as for the clinical pathway,on the basis of developing the existing diseases,the hospital should gradually increase the specialties and diseases and strengthen the quality control.(3)The department can set up billboards,brochures,etc.,increase cultural input,regular group construction;employees are required to understand their own professional characteristics and the development direction of the hospital,learn the spirit of The Times,fully integrate the two,and keep learning,pioneering and innovative with a positive spirit.