van der Ham Annelies, Boersma Henri, van Raak Arno, Ruwaard Dirk, van Merode Frits
CAPHRI School for Public Health and Primary Care, Maastricht University Maastricht, Netherlands.
Health Serv Manage Res. 2019 Aug;32(3):158-165. doi: 10.1177/0951484818813488. Epub 2018 Nov 21.
In order to improve the quality and efficiency of hospitals, they can be viewed as a logistical system in which integration is a critical factor for performance. This paper describes the results of a scoping study that identifies the logistical parameters mentioned in international research on hospitals and indicates whether literature reflects system integration. When subsystems collaborate in order to accomplish the task of the entire organization, there is integration. A total number of 106 logistical parameters are identified in our study. In addition, the flow type – patients, materials and staff – and hospital subsystems were registered. The results presented in international literature show that logistics is highly fragmented in hospitals. Studies also show integration, although this takes place mainly within the subsystems of hospitals. A multi-agent perspective on hospitals is proposed, following the view that both integration and differentiation are essential for effective organizational performance. Given the widely recognised importance of controlling hospital costs and the potential of logistics to help in this process, it is important to gain more knowledge of hospitals as network organizations, as well as knowledge regarding the degree of integration and the logistical parameters that are required for better hospital performance.
为提高医院的质量和效率,医院可被视为一个后勤系统,其中整合是影响绩效的关键因素。本文描述了一项范围界定研究的结果,该研究确定了国际医院研究中提及的后勤参数,并指出文献是否反映了系统整合。当子系统为完成整个组织的任务而协作时,就存在整合。我们的研究共确定了106个后勤参数。此外,还记录了流程类型(患者、物资和人员)以及医院子系统。国际文献中的结果表明,医院后勤高度分散。研究也显示了整合,不过这主要发生在医院的子系统内部。基于整合和分化对有效的组织绩效都至关重要这一观点,提出了关于医院的多智能体视角。鉴于控制医院成本的重要性已得到广泛认可,且后勤在这一过程中具有帮助作用,了解医院作为网络组织的更多情况,以及了解更好的医院绩效所需的整合程度和后勤参数非常重要。