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为何工业方法在医疗保健中不奏效:一种分析方法。

Why industrial methods do not work in healthcare: an analytical approach.

机构信息

Department of Cardiology, Gelre Hospital, Apeldoorn, The Netherlands.

Department of Medicine, University College London Hospitals NHS Foundation Trust, London, UK.

出版信息

Intern Med J. 2020 Feb;50(2):250-253. doi: 10.1111/imj.14730.

Abstract

Healthcare professionals and managers in hospitals are frequently suggested to learn from industry and business to improve quality and efficiency. However, evidence that the implementation of industrial techniques and business methods has a meaningful effect on patient outcomes is often lacking. An explanation for this phenomenon is thought to be the complexity of the hospital organisation and the diversity of patients. In this article, we use the practice approach to discuss the application of industrial techniques and business methods in healthcare. We employ a practice model that offers three perspectives to understand professional practices: Identity and intrinsic values, Interests of stakeholders, and Ideals and basic beliefs (Triple I). This model demonstrates that the nature of healthcare practices differs strongly from the nature of industrial and business practices. Healthcare has a moral nature that does not let itself be easily organised along technological or business categories. This may provide a fundamental explanation of why industrial techniques and business methods in general will be less successful in healthcare. At the same time, this model invites hospitals to develop innovative approaches that do justice to the identity and intrinsic values of healthcare. In this process, insights from industry and business cannot be copied but have to be used as sources of inspiration.

摘要

医院的医疗保健专业人员和管理人员经常被建议借鉴工业和商业领域的经验,以提高质量和效率。然而,实施工业技术和商业方法对患者结果有意义影响的证据往往缺乏。人们认为,造成这种现象的原因是医院组织的复杂性和患者的多样性。在本文中,我们使用实践方法来讨论工业技术和商业方法在医疗保健中的应用。我们采用了一个实践模型,该模型提供了三个视角来理解专业实践:身份和内在价值观、利益相关者的利益以及理想和基本信念(三重 I)。该模型表明,医疗保健实践的性质与工业和商业实践的性质有很大的不同。医疗保健具有道德性质,不容易按照技术或商业类别进行组织。这也许可以从根本上解释为什么工业技术和商业方法在医疗保健领域总体上不太成功。同时,该模型邀请医院开发创新方法,这些方法应尊重医疗保健的身份和内在价值观。在这个过程中,不能照搬工业和商业的见解,而必须将其用作灵感的来源。

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