社区儿童健康综合服务体组织架构与管理模式的质量改进研究  

Study on quality improvement in organisational structure and management model of integrated community child health services

作　　者：张遥远 戴益莉 王天宇 沈真原 宦红梅 沈福来[2] 冯雨 刘姣钰 Zhang Yaoyuan;Dai Yili;Wang Tianyu;Shen Zhenyuan;Huan Hongmei;Shen Fulai;Feng Yu;Liu Jiaoyu(Gumei Community Health Service Centre,Minhang District,Shanghai201102,China;Healthy Foundation Research Centre,Healthy Yangtze River Delta Research Institute,Shanghai Jiaotong University,Shanghai200021,China;High Quality Development Project Team of Paediatrics,Gumei Community Health Service Center,Minhang District,Shanghai201102,China)

机构地区：[1]上海市闵行区古美社区卫生服务中心,上海201102 [2]上海交通大学健康长三角研究院健康强基研究中心,上海200021 [3]上海市闵行区古美社区卫生服务中心儿科高质量发展项目组,上海201102

出　　处：《中华全科医师杂志》2024年第12期1270-1275,共6页Chinese Journal of General Practitioners

基　　金：上海市医院协会医院管理研究基金项目(X2023177);上海市中西医结合学会科研基金项目(2023SQ31)。

摘　　要：目的:探索社区儿童健康综合服务体团队组织架构及管理模式的质量改进。方法:该研究为质性研究,分为两个研究阶段:原因分析阶段和服务改进阶段。在原因分析阶段,首先采用数据挖掘法识别上海市闵行区古美社区卫生服务中心儿童健康综合服务体中有价值的模式和关联;进而于2023年12月,对中心12名儿童健康综合服务体相关科室负责人及员工进行半结构化访谈,深入探讨问题存在的根本原因。服务改进阶段,通过焦点小组会议汇集意见,针对发现的问题制定具体的改进措施。结果:通过数据挖掘与半结构化访谈,明确了古美社区卫生服务中心儿童健康综合服务体多部门信息孤立以及协作机制缺乏等关键问题,构建了基于“三定”原则的组织架构和管理模式。综合服务体团队组织架构元素包括儿科家庭医生团队、儿科、妇保科、儿保科、计划免疫科、儿童康复科及全科医生管理团队。管理模式包括建立跨科室的资源与信息共享机制、推行儿科家庭医生模式、物理空间的优化整合和加强儿童健康综合服务体宣传活动。结论:该研究通过分析古美社区儿童健康服务存在问题,优化了社区儿童健康综合服务体团队组织的组织架构和管理模式。Objective To explore the quality improvement in the organization structure and management model of the integrated community child health services.Methods This was a qualitative study,including two parts:cause analysis and service improvement suggestions.In the analysis part the data mining was conducted to identify valuable patterns and relationships in the comprehensive child health services.Semi-structured interviews were conducted with 12 relevant department heads and health workers of the comprehensive child health service team at Gumei Community Health Service Center in December 2023,and the causes of the key problems were explored.In the service improvement part,focus group discussions were held to propose suggestions,then improvement measures were formulated to address the identified problems.ResultsThrough data mining and semi-structured interviews,the key problems were identified:information isolation among multiple departments and lack of coordination mechanism in the comprehensive child health service team.A team organizational structure based on the"three definite"principle was established.The organizational structure should include the pediatric family doctor team,general practitioner management team and departments of pediatrics,maternal and child health care,immunization and child rehabilitation;the management model should include a cross-department resource and information sharing mechanism,the pediatric family doctor model,optimization and integration of physical space,and enhancement of publicity activities for the comprehensive child health services.Conclusion Based on the analysis in Gumei health service center,this study identified key problems in community integrated child health services,and proposes the quality improvement measure in the organizational structure and management model of the service team.

关 键 词：社区卫生中心 儿童健康综合服务体 组织架构 管理模式 质量改进 

分 类 号：R179[医药卫生—妇幼卫生保健]