Management Practices in U.S. Hospitals

美国医院的管理实践

• 批准号: 8111681
• 负责人: Kenneth John McConnell
• 金额: $ 22.41万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8111681
• 关键词: Management; Practices; U.S.; Hospitals

DESCRIPTION (provided by the applicant): Why is the quality of care in some hospitals better than others? It is well documented that the U.S. health care system is marked by problems of inefficiency, poor coordination, and highly variable quality of care. The research literature has focused on a number of factors that could affect quality, but relatively little is known about the ways in which hospitals are internally managed. This application seeks funding to conduct a survey that will produce an entirely new set of data on management practices in a large sample of U.S. hospitals. By management practices, we mean the policies, systems, and standards that are used to guide hospital operations, performance measurement, clinical relationships, and employee incentives. Measuring these practices is not easily accomplished through traditional surveys or reliance on administrative data. We will use an innovative survey methodology that represents a significant breakthrough in its ability to elicit true information on organizational practices and to minimize the gaming of responses toward favorable scores. The overall goal of this application is to measure management practices in U.S. hospitals and their association with patient outcomes. The specific hypothesis behind the proposed research is that there are managerial techniques that are associated with better patient outcomes, but not widely adopted or disseminated within the hospital sector. The survey, and its linkage with existing data on hospitals, patient outcomes, and quality indicators, will address an important gap in the knowledge about the policies and practices that define how a hospital operates. The proposed study would be the first to open the .black box of U.S. hospital management, and to assess its importance in patient outcomes. This proposal has three specific aims: Aim 1. Survey and measure management practices in 800 U.S. hospitals. Aim 2. Explain why management practices vary across hospitals. Aim 3. Assess the relationship between management practice scores and the quality of patient care. This research aims to improve the understanding of these tools, their frequency of use as well as their apparent effectiveness, so that good tools can be promoted and more quickly adopted by hospitals, with the ultimate goal of improving patient outcomes.

描述（由申请人提供）：为什么有些医院的护理质量比其他医院好？有据可查的是，美国医疗保健系统存在效率低下、协调不力和医疗质量参差不齐的问题。研究文献重点关注了许多可能影响质量的因素，但对医院内部管理的方式知之甚少。该申请寻求资金进行一项调查，该调查将产生一组关于美国医院大样本管理实践的全新数据。我们所说的管理实践是指用于指导医院运营、绩效衡量、临床关系和员工激励的政策、系统和标准。通过传统调查或依赖行政数据很难衡量这些做法。我们将使用一种创新的调查方法，该方法在获取有关组织实践的真实信息并最大限度地减少对有利分数的反应的游戏能力方面取得了重大突破。该应用程序的总体目标是衡量美国医院的管理实践及其与患者治疗结果的关系。拟议研究背后的具体假设是，存在一些与更好的患者治疗结果相关的管理技术，但并未在医院部门内广泛采用或传播。该调查及其与医院、患者结果和质量指标的现有数据的联系，将弥补有关定义医院运作方式的政策和实践的知识中的一个重要差距。拟议的研究将是第一个打开美国医院管理黑匣子的研究，并评估其对患者治疗结果的重要性。该提案具有三个具体目标： 目标 1. 调查和衡量 800 家美国医院的管理实践。 目标 2. 解释为什么不同医院的管理实践有所不同。 目标 3. 评估管理实践得分与患者护理质量之间的关系。本研究旨在提高对这些工具的理解、使用频率及其明显有效性，以便好的工具能够被医院推广并更快地采用，最终目标是改善患者的治疗效果。