Hetherington R W
Health Serv Res. 1982 Summer;17(2):185-201.
The purpose of this paper is to explore some aspects of a general theoretical model within which research on the organizational impacts of quality assurance programs in hospitals may be examined. Quality assurance is conceptualized as an organizational control mechanism, operating primarily through increased formalization of structures and specification of procedures. Organizational effectiveness is discussed from the perspective of the problem-solving theory of organizations, wherein effective organizations are those which maintain at least average performance in all four system problem areas simultaneously (goal-attainment, integration, adaptation and pattern-maintenance). It is proposed that through the realization of mutual benefits for both professionals and the bureaucracy, quality assurance programs can maximize such effective performance in hospitals.
本文的目的是探讨一个通用理论模型的某些方面，在这个模型中，可以对医院质量保证计划的组织影响进行研究。质量保证被概念化为一种组织控制机制，主要通过加强结构的形式化和程序的规范化来运作。从组织的问题解决理论的角度讨论了组织有效性，其中有效的组织是那些在所有四个系统问题领域（目标达成、整合、适应和模式维持）同时保持至少平均绩效的组织。有人提出，通过实现专业人员和官僚机构的互利，质量保证计划可以使医院的这种有效绩效最大化。
