Young D W, Barrett D
Healthcare Management Program, Boston University School of Management, MA 02115, USA.
Hosp Health Serv Adm. 1997 Summer;42(2):255-79.
An integrated delivery system (IDS) in healthcare must coordinate patient care across multiple functions, activities, and operating units. To achieve this clinical integration, senior management confronts many challenges. This paper uses a cross-functional-process (CFP) framework to discuss these challenges. There are ten CFPs that fall into three categories: planning processes (strategy formulation, program adaptation, budget formulation), organizational processes (authority and influence, client management, conflict resolution, motivation, and cultural maintenance), and measurement and reporting processes (financial and programmatic). Each process typically spans several functional units. Senior management must consider how to improve both the functioning of each CFP, as well as its "fit" with the other nine. The result can be greater clinical integration, improved cost management, and more coordinated care for enrollees.
医疗保健领域的综合服务体系（IDS）必须跨多个职能、活动和运营单位协调患者护理。为实现这种临床整合，高级管理层面临诸多挑战。本文运用跨职能流程（CFP）框架来探讨这些挑战。有十个CFP，分为三类：规划流程（战略制定、项目调整、预算制定）、组织流程（权力与影响力、客户管理、冲突解决、激励和文化维系）以及衡量与报告流程（财务和项目方面）。每个流程通常跨越多个职能单位。高级管理层必须考虑如何改善每个CFP的运作，以及它与其他九个CFP的“契合度”。结果可能是实现更大程度的临床整合、改善成本管理以及为参保人提供更协调的护理。
