基于信息化的层级管理体系在住院医师规范化培训中的应用探索  

Exploration and effectiveness analysis of stratified management system combined with information technology in residency training management

作　　者：单启源 孙晓靓[2] 刘圣珺 马若琳 顾浩杰 陈迟[2] 丁敏[2] 康宝丽 徐玮[3] 徐增光[2] Shan Qiyuan;Sun Xiaoliang;Liu Shengjun;Ma Ruolin;Gu Haojie;Chen Chi;Ding Min;Kang Baoli;Xu Wei;Xu Zengguang(The School of Public Health,Guilin Medical University,Guilin 541100,Guangxi,China;Department of Post-Graduating Continuing Education,Shanghai East Hospital,Tongji University School of Medicine,Shanghai 200123,China;Department of Critical Care Medicine,Shanghai East Hospital,Tongji University School of Medicine,Shanghai 200120,China)

机构地区：[1]桂林医学院公共卫生学院,广西桂林541100 [2]同济大学附属东方医院毕业后继续教育办公室,上海200123 [3]同济大学附属东方医院重症医学科,上海200120

出　　处：《中国毕业后医学教育》2025年第2期81-85,98,共6页Chinese Journal of Graduate Medical Education

基　　金：2017年上海市卫生和计划生育委员会科研课题(201740159);2021年教育部产学合作协同育人项目(221000498102842)。

摘　　要：目的探究“信息化+层级管理”模式能否切实优化人员职责与结构、促进管理团队职能落实。方法分析同济大学附属东方医院现状,针对住院医师规范化培训(简称住培)管理框架不清晰、缺乏有效管理工具和教学管理团队职责分工不明确的问题,通过理清医院、职能科室、专业基地与轮转科室的层级管理体系、梳理并明确管理团队的职能并在住培系统中构筑相应模块、赋予相应权限。收集轮转科室主任、教学主任、教学秘书、骨干指导医师、指导医师5类人群的基本信息、登录系统次数与开展教学活动次数,对研究实施前后登录次数及开展教学活动次数进行回顾性分析,对实施后进行横截面分析。结果“信息化+层级管理”实施后,主任(Z=-3.161、P=0.002)、教学主任(Z=-2.687、P=0.007)登录次数比实施前增加,差异有统计学意义。实施后5类人员登录次数两两比较差异均有统计学意义,而教学秘书与骨干指导医师(Z=-2.948、P=0.003)、教学秘书与指导医师(Z=-6.622、P<0.001)、骨干指导医师与指导医师(Z=-6.295、P<0.001)教学活动次数差异有统计学意义。结论“信息化+层级管理”模式在住培管理中具有可行性和有效性,可有效促进管理人员和教学人员积极参与,促进其职能落实,可为进一步加强住培的精细化管理提供参考。Objective To investigate whether the"information technology+stratified management"model can effectively optimize the responsibilities and structure of staff and promote the implementation of the management team's functions.Methods It was found that such as an unclear framework,lack of effective tools and unclear division of responsibilities.The problems were solved by clarifying the stratified management system,sorting out the functions of the management team,and creating corresponding modules in the information system.The basic information,the number of system login and the number of teaching activities were collected and compared before and after the study.Results After the implementation the number of logins by the directors(Z=-3.161,P=0.002)and the teaching directors(Z=-2.687,P=0.007)both showed significant differences.In the pairwise comparisons all differences were statistically significant.Additionally,the differences in the number of teaching activities between teaching secretaries and core instructors(Z=-2.948,P=0.003),the teaching secretaries and the teaching physicians(Z=-6.622,P<0.001),and the core instructor and the teaching physicians(Z=-6.295,P<0.001)were statistically significant.Conclusion This study has verified the feasibility and effectiveness of the'information technology+stratified management'.This model effectively promoted the active participation of management personnel and teaching staff,facilitated the implementation of functions among management team members.

关 键 词：住院医师规范化培训 层级管理 信息化 

分 类 号：G40-034[文化科学—教育学原理] R4[文化科学—教育学]