Research On The Operation Of Medical Quality Management In Small And Medium-Sized Public Hospitals

With the development of social economy and the improvement of people’s living standards,people’s health consciousness has gradually increased,and the requirements and expectations for medical and health services have become higher as well.In a highly competitive medical market environment,the most important issue for every public hospital managers is how to improve the medical quality management system,realize the value of public medical services and maintain the superior position of public hospitals in the competition.In recent decades,with the efforts of health authorities,hospital managers and medical personnel,public hospitals in China have gradually established a PDCA cycle-based management model to comprehensively manage medical quality by introducing the "Quality of Circles(PDCA)" concept.The quality of medical care continues to improve,but there is still a gap between the effects and social expectations,and gap by comparing with developed countries.In particular,in the exploration of scientific and effective medical quality management,small and medium-sized public hospitals have exposed many serious medical quality management problems such as poor management quality and the formalization of management processes,which indeed are affected by their own survival and development difficulties,such as lack of qualified people,low medical technology and popularity.Under the supervision of the government,public hospitals provide public medical and health services,and have greater independent management and operation rights under the premise of maintaining the nature of public welfare.Therefore,the medical quality management of small and medium-sized public hospitals is more affected by their own management level.For this reason,by taking hospital Q as sample and representative of small and medium-sized public hospitals from city N in Guangxi,this paper will reveal the problems inthe operation of medical quality management,analyze the reasons and proposes the countermeasures as well by conducting case studies through the Horn-Mitt model.The results of these case studies are intended to provide research reference for other small and medium-sized public hospitals to find out their own medical quality management problems so as to improve the medical quality management system;it is also expected to provide ideas for government to continuously improve medical quality management and the supervision of public hospitals.The medical quality management of public hospitals is mainly based on the standards of medical staff’s diagnosis and treatment,so this article will focus on the "medical quality" in a narrow sense instead of the broad sense which is defined either as "medical service quality" or "hospital quality".It will be described in details in the concept definition part of this article.Based on the Horn-Mitt model analysis,this paper believes that the small and medium-sized public hospitals represented by hospital Q exist following problems: management results have not reached the expected goals,insufficient management resource allocation,management methods are not used effectively,lack of collaboration between management agencies and all departments concerned,low sense of happiness at work for administrators and satisfaction for target group.By applying the Horn-Mitt model and combining the characteristics of small and medium-sized public hospitals,six major reasons are found regarding above mentioned problems:the setting of management goals deviates from the actual situation of small and medium-sized public hospitals,difficult to increase the allocation of management and operation resources,lack of corresponding mechanisms in the management and operation mode,irrational setting of managerial hierarchy,the survival dilemma of small and medium-sized public hospitals within a system environment and low quality of the target group,and deviation of managers’ value orientation.At the same time,this article will list out thirteen suggestions in five aspects which are improving management goals and standards,integrating and optimizing management resource allocation,improving management operation mode,improving the execution of the organization,and create a good system environment,in order to provide a reference for the implementation of medical quality management in small and medium-sized public hospitals.