Applying Management-By-Objectives To The Hospital-Level Nursing Qualigy Control Group

Objective An indicator system of management-by-objectives (MBO) and the detailed grading rules are developed for the Hospital-Level Nursing Quality Control Group (HNQCG). The system is then applied for the management of HNQCG to incite sense of participation in management, to motivate quality management potentials, and to achieve improvement of nursing quality management of the hospital.Methods The study consists of two parts. Part one refers to the construction of the MBO indicators for HNQCG. In this part, an expert questionaire of indicator draft was developed and three cycles of consultation were followed complying with the Delphi Methods. Based on the resulted expert opinions, the draft was modified. Group discussion was then conducted to make out a detailed grading rule. The "MBO Evaluation Criteria for HNQCG" was then issued and applied to the management of HNQCG. Part two refers to the application of MBO to HNQCG. In this part of study, nine groups of HNQCG should fulfil the responsibilities and perform annual work reports according to the Indicator System, while be subject to the supervision and evaluation of the Nursing Quality and Safety Management Committee and all nursing managers of the hospital. The mean scores of nursing quality indicators and numbers of management innovation, process optimization and patients'complaints and nursing errors were compared between before and after the implement of MBO. The statistic software SPSS 17.0 was utilized to analyze the quantitative data.Results Part one:Ten experts proposed altogether 16 pieces of opinion. The index dependability of their comments was 0.83 by calculation. Expert opinion consistency analysis showed a significant difference for indicators of all levels (P?0.05). Both findings indicate high credibility of the expert opinions. By letter enquire,2 primary indicators,11 secondary indicators and 2 adding score items were determined, along with the target score for each indicator. By group discussion, the research group produced detailed grading rules which were approved by the Nursing Quality and Safety Management Committee afterwards. Then a final version of the Evaluating Criteria formed. Part two:Scores of indicators were significantly raised after implement of MBO (P?0.05). Key items, such as high quality care, emergency management and nursing skill, rose up to 98.1 ±2.2,99.6±0.6,96.1±2.1 from 93.6±2.5 (P=0.009),96.2±1.3(P= 0.000),89.3±4.5 (P=0.000), respectively. Care complaints and errors dropped sharply in inpatient wards while number of management innovation and process optimization greatly increased (?2=8.884, P?0.05).Conclusion Introduction of MBO in the hospital-level nursing quality control group does facilitate continuous improvements of care quality.