Minvielle Etienne, Sicotte Claude, Champagne François, Contandriopoulos André-Pierre, Jeantet Marine, Préaubert Nathalie, Bourdil Annie, Richard Christian
Centre for Medical Research, Medicine, Health and Society, 94276 Le Kremlin-Bicêtre cedex, France.
Health Policy. 2008 Jul;87(1):8-19. doi: 10.1016/j.healthpol.2007.09.017. Epub 2007 Nov 26.
To find out which are the emerging views on hospital performance and to analyze how these views vary among hospital stakeholders.
Three hospital stakeholder groups (physicians, caregivers, and administrative staff) in a large Paris teaching hospital.
A case study combining a qualitative (interviews of 80 key hospital stakeholders and a survey of hospital staff), and a quantitative analysis (a questionnaire composed of 4 theoretical dimensions, 13 sub-dimensions, 66 items) with triangulation of the results.
Hospital stakeholders assign greatest importance to the human relations dimension, i.e., organizational climate (professional and public service values) and quality of work life. These values attract a high degree of consensus among stakeholders (no statistical difference between physicians, caregivers and administrative staff).
Our findings challenge the mainstream view that competing values underlie hospital performance. Currently, views are to some extent shared among different stakeholder groups. A reason for this could be the need to form a more united front in the face of recent reforms. This common emphasis on professional and public service values could be the basis for formulating management priorities in teaching hospitals in order to improve performance.
了解关于医院绩效的新观点，并分析这些观点在医院利益相关者之间如何不同。
巴黎一家大型教学医院的三个医院利益相关者群体（医生、护理人员和行政人员）。
一项案例研究，结合定性研究（对80名医院关键利益相关者进行访谈以及对医院工作人员进行调查）和定量分析（一份由4个理论维度、13个子维度、66个项目组成的问卷），并对结果进行三角验证。
医院利益相关者最重视人际关系维度，即组织氛围（专业和公共服务价值观）以及工作生活质量。这些价值观在利益相关者之间达成了高度共识（医生、护理人员和行政人员之间无统计学差异）。
我们的研究结果挑战了主流观点，即相互竞争的价值观是医院绩效的基础。目前，不同利益相关者群体在一定程度上持有相同观点。一个原因可能是面对近期的改革需要形成更统一的阵线。这种对专业和公共服务价值观的共同强调可为制定教学医院的管理重点以提高绩效奠定基础。
