Borchers Uwe, Evans Michaela
ZIG - Zentrum für Innovation in der Gesundheitswirtschaft OWL, Bielefeld.
Z Evid Fortbild Qual Gesundhwes. 2011;105(8):616-23. doi: 10.1016/j.zefq.2011.07.019. Epub 2011 Aug 4.
Hardly any other part of the healthcare sector is under such a pressure to change as the hospital sector. Hospitals are high-performers in coping with complex changes in modernising patient care, process design, quality, cost-effectiveness and service orientation. But, what really makes value to the patient? Currently, this question is raised with new seriousness. Those hospitals which consequently align their portfolio to value based and 'patient driven' healthcare delivery will succeed by both quality and cost-effectiveness. We receive such messages from the USA. In Germany there are on-going and admonishing pleas since the end of the 1990s not to lose sight of the patients' needs while designing new concepts for healthcare delivery. Future challenges imply not only the renaissance of patient centred care, but also demand for a comprehensive user orientation as a key factor to successful hospital modernisation. This is particularly true of concepts of structured, integrated and regional healthcare delivery. But a consequent alignment of healthcare with value for patients clearly exceeds the focus on integrating hospital and outpatient care. In designing new services of coordinated regional healthcare, hospitals gain strategic options for a single-source healthcare delivery. In terms of business development, user orientation does not only yield important impulses for stronger patient centred care, but also opens up chances for better quality and competitive advantages. Nevertheless, it requires a new understanding of innovation processes which considers value for patients and quality of results and outcome as a relevant scale for measuring effects of change management. Finally, the methods of the assessment of user oriented healthcare delivery are an essential challenge for the evaluation of cooperative healthcare services.
医疗保健领域几乎没有哪个部分像医院部门那样面临如此大的变革压力。医院在应对现代化患者护理、流程设计、质量、成本效益和服务导向等复杂变化方面表现出色。但是，真正对患者有价值的是什么呢？目前，这个问题被重新严肃地提了出来。那些因此将其业务组合与基于价值和“患者驱动”的医疗服务提供方式保持一致的医院，将在质量和成本效益方面取得成功。我们从美国收到了这样的信息。自20世纪90年代末以来，德国一直在发出告诫，即在设计新的医疗服务提供概念时不要忽视患者的需求。未来的挑战不仅意味着以患者为中心的护理的复兴，还要求将全面的用户导向作为医院成功现代化的关键因素。对于结构化、综合化和区域化医疗服务提供的概念尤其如此。但是，医疗保健与患者价值的紧密结合显然超出了整合医院和门诊护理的范畴。在设计新的区域协调医疗服务时，医院获得了单一来源医疗服务提供的战略选择。在业务发展方面，用户导向不仅为更强的以患者为中心的护理带来重要推动，还为提高质量和竞争优势创造了机会。然而，这需要对创新过程有新的理解，将患者价值和结果质量视为衡量变革管理效果的相关尺度。最后，以用户为导向的医疗服务提供的评估方法是合作医疗服务评估的一项基本挑战。
