Research On The Development Status Of The Organizational Structure Of The Secondary And Tertiary Public Hospitals In Xinjiang

Objective: To explore the problems of organizational structure of second-and thirdlevel hospitals in Xinjiang,analyze the factors affecting the optimization of organizational structure,find strategies for optimization,and draw the optimized organizational structure of second-and third-level hospitals,respectively.Methods: The quantitative study was conducted by convenience sampling in 30 secondary and tertiary public hospitals in the south,north and east of Xinjiang to conduct a questionnaire survey.Excel software was used to establish a database,and statistical indicators such as composition ratio and rate were used to statistically describe the hospital profile and the current situation of departmental and divisional settings;the current situation of organizational structure settings and organizational management were comprehensively evaluated using the comprehensive index method;the factors affecting hospital execution were arranged in a Pareto chart to screen key factors,important factors and general factors.Qualitative information was analyzed by coding the factors affecting the optimization of hospital organizational structure using the rooting theory,and the Pareto chart arrangement was used to screen the key factors,important factors and general factors.Results: The study involved a total of 23 secondary hospitals and 7 tertiary hospitals.(1)Quantitative results: In secondary hospitals,secondlevel departments were set up under first-level departments,administrative function departments were set up with 17 types of first-level departments,among which the highest rate of setting up second-level departments was finance department with 100%,clinical departments were set up with 21 types of first-level departments,among which the highest rate of setting up second-level departments was general surgery with 95.65%,medical technology departments were set up with 11 types of first-level departments,among which the highest rate of setting up second-level departments was ultrasound diagnosis department with 100%.In tertiary hospitals,second-level departments were set up under first-level departments,administrative function departments were set up with 17 types of first-level departments,among which the highest rate of setting up second-level departments were finance department and discipline inspection and supervision department with 100%,clinical departments were set up with 21 types of first-level departments,among which the highest rate of setting up second-level departments were gastroenterology and cardiovascular medicine,both of which were 100%,medical technology departments were set up with 11 types,among which the highest rate of setting up second-level departments were PCR room,CT room,ultrasound diagnosis department and electrocardiogram room,both of which were 100%.In a comprehensive evaluation of the current organizational structure of hospitals,17.39%,17.39%,and 65.22% of the secondary hospitals were excellent,medium,and to be optimized,respectively,and 14.29%,71.43%,and 14.29% of the tertiary hospitals were excellent,medium,and to be optimized,respectively.In the comprehensive evaluation of hospital organization and management,8.70 %,86.96 % and4.35 % of the hospitals with excellent,medium and to be optimized levels in secondary hospitals,and 14.29 %,71.43 % and 14.29 % of the hospitals with excellent,medium and to be strengthened levels in tertiary hospitals,respectively.To analyze the factors influencing the lack of execution,the lack of professional management knowledge of managers,lack of effective motivation,inadequate supervision mechanism,and lack of targeted staff training are all key factors in the secondary and tertiary hospitals,and the lack of cohesive hospital culture is also a key factor in the tertiary hospitals in addition to the above factors.(2)Qualitative results: By sorting out 86 initial concepts,13 initial categories and 7 sub-categories,hospital conditions,external environment and managerial factors were finally summarized as factors affecting the optimization of organizational structure.Conclusion: The organizational structure of the secondary and tertiary public hospitals in Xinjiang is complete,with wide coverage of departmental and divisional settings;the organizational structure of hospitals has more layers and is more administrative;the organizational management of public hospitals is good overall,but human resource management in some hospitals needs to be improved;among the factors affecting the optimization of hospital organizational structure,hospital conditions play a key role in the optimization of organizational structure,external environment is the driving force for the optimization of organizational structure,and manager factors are the subjective conditions for the optimization of hospital organizational structure.