基于医疗业务流程的知识管理研究
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摘要
目的
     医院通过实施知识管理可以整合医院的知识资源,提高医院的知识应用水平。医院中的大量知识是存在于业务流程中的,其医疗业务流程是知识密集型业务流程,且医疗业务流程中的人即医务人员本身也是知识载体,拥有丰富的隐性知识。本研究提出在医院实施知识管理要引入基于业务流程知识管理模式,探讨知识管理与医疗业务流程的结合。通过分析医疗业务流程及其知识流程,提出相应的知识管理措施,以期提高医院整体知识管理水平。
     方法
     ①文献研究法:利用中国期刊全文数据库(CJFD)、维普数据库、OVID数据库、Elsevier Science(SDOS)等全文数据库以及Google、Baidu等搜索引擎,系统查阅国内知识管理、医院知识管理、基于业务流程知识管理研究方面的相关文献,整理归纳前人研究取得的成果,总结提炼已有研究中的相关理论和概念介绍,作为本课题研究开展的基础。
     ②业务流程分析法:分析医疗业务流程是研究流程知识管理的前提。在查阅、汇总、分析医院医疗业务方面资料的基础上,绘制医疗业务流程图,直观、清晰地描述流程中的业务活动,进而使知识管理研究围绕业务活动所需及产生的知识进行。
     ③类比推理法:搜集有关医院知识管理策略、流程知识管理策略方面的资料,在对资料进行整理、分析的基础上,通过类比推理,提出实施医疗业务流程知识管理的策略。
     结果
     ⑴选取了医院的临床诊断流程,检验、检查流程及临床用药流程为典型研究对象,针对流程中业务活动需要或产生的知识,提出的相对应的知识管理措施如下:①临床诊断流程中的知识管理:利用临床信息系统辅助知识传存;建立医学知识库;建立典型病例库;构建知识地图。②检验流程的知识管理:建设功能完善的LIS系统;建立样本采集指导知识库;建设电子病历系统;将统计方法引入LIS系统。③检查流程的知识管理:建设功能完善的RIS系统;建立医学影像学知识库;建立常见检查情况描述知识库。④临床用药流程的知识管理:建设药事管理系统与医嘱管理系统;建设合理用药监测系统。
     ⑵结合对四个医疗业务流程知识管理问题的研究,依据医院知识管理及流程导向知识管理的策略进行类比推理,提出实施医疗业务流程知识管理的总体策略:确定医疗业务流程知识管理目标;构建面向医疗业务流程的知识管理系统;建立面向流程的医院组织结构;营造良好的医院文化环境;开展业务流程知识管理审计。
     结论
     以文献研究得到的知识管理相关理论及医疗业务流程知识定义等为基础,选取了医院的临床诊断流程,检验、检查流程及临床用药流程为典型研究对象,通过汇总、分析有关医院医疗业务方面的资料,绘制出相应的业务流程图,直观体现了各个业务流程包含的业务活动及其涉及的知识,针对流程中业务活动需要或产生的知识,提出了相对应的知识管理方法。以医院知识管理策略及流程导向知识管理策略为基础,提出基于医疗业务流程的知识管理策略。将基于业务流程的知识管理模式引入医院知识管理,会有效提高医院整体知识管理水平。
Objective
     The implementation of knowledge management of hospital will contribute to integration of knowledge resources of hospital, improvement of application of hospital knowledge. A great deal of knowledge exists in bussiness process in hospital, and its medical bussiness process is knowledge-intensive bussiness process, the person of medical bussiness process, viz medical staff itself riches in tacit knowledge, is knowledge carriers. The study proposes the implementation of knowledge management in the hospital should introduce knowledge-based business process management models, discusses the combination of knowledge management and medical business processes. By analyzing medical business processes and knowledge in process, this article proposes the corresponding knowledge management measures to improve the overall level of hospital knowledge management.
     Methods
     ①Literature Research: Making use of the full-text databases, such as China Journal Full-text Database (CJFD), VIP Database, OVID database, Elsevier Science (SDOS), as well as other search engines like Google, Baidu and so on, systematically accessing to the related literature of domestic and international knowledge management, hospital knowledge management and business process-based knowledge management research, summarizing the fruit of previous studies, summarizing and refining the relevant theories and concepts introduced previously as the promoting basis of this research.
     ②Business Process Analysis: Analysis of medical business process is the premise of knowledge management process. On the basis of inspection, summary, analysis of information on hospital medical business, drafting Medical business flow chart and describing operational activities of process intuitively and clearly, so as to make knowledge management research focus on business knowledge what operational activities need.
     ③Analogical Reasoning Method: Collecting information on hospital knowledge management strategy and hospital process knowledge management strategy, on the basis of listing the information systematically and analyzing, proposing the strategy for implementing knowledge management of medical business process through analogical reasoning method.
     Results
     ⑴The research selected process of clinical diagnosis, clinical laboratory process, actinoscopy process and medication process as the typical study, projected the following corresponding knowledge management measures for the knowledge needed or produced in the medical business activities.①Knowledge management in process of clinical diagnosis: supporting knowledge communication and saving with the help of clinical information system; setting up medical knowledge base; setting up typical case base; structuring Knowledge Map.②Knowledge management in clinical laboratory process: structuring LIS with perfect funtions; setting up knowledge base for sampling guidance; structuring Electronic Medical Record; introducing statistical methods into LIS.③Knowledge management in actinoscopy process: structuring RIS with perfect funtions; setting up medical imaging knowledge base; setting up knowledge base discribing conmmon inspection.④Knowledge management in medication process: constructing Pharmacy Administration System and Medical Order System; setting up Prescription Automatic Screening System.
     ⑵Combining research of knowledge management in the four medical business process, basing on hospital knowledge management strategy and process-oriented knowledge management strategy, the research projected overall strategy for implementing knowledge management in medical business process through analogical reasoning by analogical reasoning: setting the goal of knowledge management in medical business process; constructing knowledge management system orienting medical business process; structuring process-oriented organizational structure of hospital; creating favorable hospital cultural environment; carrying out business process knowledge management audit.
     Conclusion
     Basing on the knowledge management theory form literature research and the knowledge definition of medical business process, The study selected process of clinical diagnosis, clinical laboratory process, actinoscopy process and medication process as the typical study, through the summary, analysis of the medical business information, drew the corresponding operational flow chart which intuitively reflected the operational activities and related knowledge contained in the various business processes, projected corresponding knowledge management methods for the knowledge needed or produced in the medical business activities. Basing on hospital knowledge management strategy and process-oriented knowledge management strategy, the study proposed strategy for knowledge management based on medical business processes. Introducing knowledge-based business process management models into hospital knowledge management will effectively improve the overall level of hospital knowledge management.
引文
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