The Construction Of Performance Evaluation Index System Of Tertiary Public Hospitals Based On Lean Management

BackgroundWith the deepening of the new round of medical and health system reform,the state has put forward new requirements for the comprehensive reform of public hospitals.At the same time,the market access of non-public medical institutions has been weakened,the number of private hospitals has increased significantly,the competition in the medical market is increasingly fierce,and public hospitals are facing challenges both inside and outside.In this context,performance evaluation,as the core of hospital management,plays an important role in enhancing the core competitiveness of hospitals and promoting their sustainable development.As the vanguard of public hospitals,tertiary public hospitals have more practical significance to this study.ObjectiveThis study integrates lean management and hospital performance evaluation index system,aiming to build a set of scientific and comprehensive hospital performance evaluation index system,so as to meet the requirements of the new national medical reform and promote the improvement of hospital internal operation efficiency.MethodsLiterature research method was adopted to review the domestic and foreign research situation,construct the index item pool,select the index items around the five core concepts of lean management,and build the initial index database.Delphi expert consultation method was used to optimize and adjust the index system.The reliability of expert consultation was tested by positive coefficient,authority degree and coordination degree,and indexes were selected according to the mean,standard deviation and coefficient of variation of each index.After two rounds of Delphi expert consultation,the final performance evaluation index system was formed.Based on the index importance score of the second round of expert consultation,the expert scoring method was used to calculate the index weight.In order to verify the reliability of the index system in practice,the qualitative interview data of a hospital was obtained and compared with the empirical research results by using the key insider interview method.ResultsThe initial index database included 5 first-level indexes,15 second-level indexes and60 third-level indexes.After two rounds of Delphi expert consultation,the index system finally formed consists of 5 first-level indicators,15 second-level indicators and 48third-level indicators.The results of expert consultation show that the positive coefficients of the two rounds of expert consultation are 88.00% and 90.91% respectively,indicating that the experts have a high degree of care,support and participation in this study.The authority coefficient is 0.85,indicating that the scores and suggestions given by experts are reliable.The test results of the two rounds of expert consultation were statistically significant（P<0.001）,indicating a certain correlation between expert scores and a good degree of coordination.The calculation of index weight shows that the weight of first-level index is between 0.1912-0.2048;The weight of the secondary index is between0.0587-0.0696;The third-level index weights are between 0.0133-0.0358.ConclusionsThe performance evaluation index system of tertiary public hospitals based on lean management has high reliability,innovation and applicability,and the evaluation results of the hospital basically conform to the objective status quo.Therefore,it is considered that this index system is scientific and reasonable,and can provide New evaluation tools for the objective and comprehensive evaluation of the performance level of tertiary public hospitals.