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新冠肺炎定点康复医院运行后公立康复医院管理的实践体验:一项定性研究

Experience of rehabilitation management in public hospital after it was identified as designated rehabilitation hospital for COVID-19 patients: A qualitative study.

机构信息

School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.

First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.

出版信息

Front Public Health. 2022 Jul 26;10:919730. doi: 10.3389/fpubh.2022.919730. eCollection 2022.

Abstract

OBJECTIVE

It is essential to focus on the rehabilitation of COVID-19 patients after discharge to prevent their long-term sequelae, but there is less research on healthcare organizations enhancing rehabilitation services for patients discharged from COVID-19. Therefore, this study aimed to describe how a public hospital provides better rehabilitation services for patients after being identified as a designated rehabilitation hospital for patients with COVID-19 and attempted to combine the theory of organizational change to analyze how the hospital finally successfully transformed.

METHODS

A tertiary public hospital located in the center of Xi'an was selected for the study. It was identified as a designated hospital for the rehabilitation of patients discharged from the hospital with COVID-19. Nine hospital leaders and group leaders closely related to the rehabilitation management work were invited to participate in interviews to explore the fact about the hospital's rehabilitation work. The semi-structured interview with the hospital director and the focus group interview with group leaders were used for data collection. Two researchers independently conducted a thematic analysis of these responses.

RESULTS

One hundred and seventy-eight primary codes, 22 subcategories, six main categories, and one core theme were obtained from data analysis. The main categories include organization and coordination (overall deployment, transfer patient, and external coordination), hospital infection prevention and control (process transformation, ward disinfection, hospital infection training, inspection, and supervision), staff management (staff classification, closed-loop management, and staff health screening), individual services for patients (create an individual scheme, humanistic care, organize special activities, and strengthen communication and guidance), comprehensive supporting (basic medical guarantee, daily necessities guarantee, health and nutrition guarantee, and assistance fund guarantee) and positive transformation (strategic thinking, benchmarking, strengthen cohesion, and expand influence).

CONCLUSION

The hospital had to transform its operations in the face of a complex environment during the pandemic. After deciding to transform, the hospital effectively prevented nosocomial infections and provided rehabilitation services to 583 patients through systematic management measures such as organizational coordination, staff classification, and personalized services. In the end, it has been successfully transformed and has grown rapidly. To ensure that it can continue to grow sustainably, the hospital enhanced the new ways that have emerged from this transformation.

摘要

目的

关注新冠肺炎出院患者的康复工作,以预防其长期后遗症至关重要,但针对医疗机构增强新冠肺炎出院患者康复服务的研究较少。因此,本研究旨在描述一家公立医院如何在被确定为新冠肺炎患者指定康复医院后为患者提供更好的康复服务,并尝试结合组织变革理论来分析医院最终如何成功转型。

方法

选择西安市中心的一家三级公立医院进行研究。该医院被确定为新冠肺炎出院患者康复的指定医院。邀请 9 名与康复管理工作密切相关的医院领导和小组领导参加访谈,以探讨医院康复工作的实际情况。对医院院长进行半结构式访谈,对小组领导进行焦点小组访谈,以收集数据。两名研究人员对这些回复进行了独立的主题分析。

结果

从数据分析中得出 178 个一级代码、22 个子类别、6 个主类别和 1 个核心主题。主类别包括组织和协调(全面部署、转院患者和外部协调)、医院感染防控(流程转变、病房消毒、医院感染培训、检查和监督)、员工管理(员工分类、闭环管理和员工健康筛查)、患者个体服务(制定个体方案、人文关怀、组织专项活动、加强沟通和指导)、综合支持(基本医疗保障、日常生活用品保障、健康营养保障和援助基金保障)和积极转型(战略思维、标杆学习、加强凝聚力、扩大影响力)。

结论

医院在疫情复杂的环境下必须进行运营转型。在决定转型后,医院通过组织协调、员工分类和个性化服务等系统管理措施,有效预防了医院感染,并为 583 名患者提供了康复服务。最终,医院成功转型并迅速发展。为确保其可持续增长,医院加强了从这次转型中涌现出的新途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a17/9362772/4793c67053f5/fpubh-10-919730-g0001.jpg

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