重庆市市级医院医疗设备维修外包模式构建的研究
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摘要
医疗设备是医院固定资产的重要组成部分,其在医疗临床诊断、治疗和医学科研、教学工作中发挥着重要的作用,医疗设备使用的安全性和有效性是保障患者利益的重要基础。近年来医疗设备发展迅速,高新科技应用于医疗设备上的程度仅次于航天技术。医疗设备在为医院创造较大的社会和经济效益的同时,其维护保养过程也暴露出越来越多的问题。医院传统维修保养模式与日益发展的医疗设备技术之间的矛盾越来越突出,其中医疗设备维护计划性不强、维护保养人力资源配置不合理、维护保养效率较低、维修费用较高等问题已越来越制约医院的发展.这些引起了国内越来越多的医院管理者的重视,并开始探讨医疗设备维护保养的社会化模式。
进入20世纪以来,随着知识经济的到来,企业为提高核心竞争力,纷纷引入“流程再造”(BPR)的思想[1][2]。而业务外包作为一种新型的流程再造模式,已逐渐涉及到人力资源、物流和售后服务等各项企业的职能中,作为售后服务外包的扩展,设备维修服务外包也得到广泛运用.有资料显示,美国医疗设备维修实行外包模式已达80%。近年来随着医疗卫生体制改革的深入,医疗设备市场的不断发展壮大,高技术含量的国产医疗设备和进口医疗设备在医疗卫生单位得到普遍应用,并在临床和科研教学工作中发挥着重要技术支撑作用.而第三方医疗设备维修机构的兴起,为医疗设备维修工作外包创造了必要的条件和外部环境。近年来,国内一些大型的医院已经开始作医疗设备维修外包的尝试,并已成为设备维修发展的一个必然方向。
本课题结合重庆市几所市级医院设备维护管理的实际情况,针对市级医院设备维修计划性不强、设备维修资金占用较大、维修的时效性不强以及设备维修人员结构不合理等问题,对医院设备维修“外包”模式的构建进行研究。课题采用文献研究、现况调查、问卷调查等方法对重庆市几所市级医院的医疗设备管理现状进行了总结和分析,得到了模式构建的基础条件,并在此基础上构建了重庆市市级医院医疗设备维修“外包”管理模式。同时应用德尔菲法对构建的模式作了预测性研究;使用问卷调查法对该模式在重庆市市级医院、医疗设备维修公司以及有关的卫生主管部门的认可程度和需求程度进行了解;最后运用专家访谈法对该模式的可行性及在运用过程中可能遇到的问题作了深入探讨。
1.通过专家访谈,收集专家对现行模式及存在弊端的分析,并对医疗设备维修模式的发展方向进行探讨。
2.对医院设备维修现状进行调查,分析医院在医疗设备管理方面存在的问题,得出模式构建的需求性。
3.医院医疗设备维修模式构建的具体步骤:医院根据实际情况,对需进行维修“外包”的设备进行范围划分;设备管理委员会采取公开招标或邀标的方式选择设备维修外包商;医院方确定好“外包”服务商与之签定合同,确定外包的年限及价格并明确一些具体维修保养条款;医院按照已制定好的服务评价体系定期对维修服务商进行考核,发现问题及时进行修正或中止合同,以便为今后“外包”服务提供参考意见。
4.由于国内社会化维修机构尚处于发展阶段,受外部条件的限制,该模式仅能选取部分设备进行维修“外包”,且医院要选择需外包的医疗设备时有一定困难。
Medical equipment is the key component in fixed assets of the hospital,it played a very important role in clinical diagnosis, treatment,medical research and teaching. The safety and effectiveness of the medical equipment usage is the important foundation for keeping patients` interest. Following the rapid development of medical equipment in recent years, the application of high-tech for medical equipment is just less to the astronautics technology. Following the great social and economic benefit created by the medical equipment, more and more maintenance problems exposed. The Contradiction Between traditional repair and maintenance pattern with the increasing development medical equipment and technique become more and more outstanding, The lacking of medical equipment maintenance in scheme and consecution, the unreason of human resources of repair and maintenance department, the maintenance inefficient and high maintenance cost became the important key restriction factors to the development of hospital increasingly, more and more hospital managers paying great attention to it, and study on socialized pattern of medical equipment repairing and maintenance now.
In 20st century, with the coming of Knowledge economy, in order to improve the core competence, enterprise import the thought of“Business Process Reengineering(BPR)”. The outsourcing, as the new Business Process Reengineering style, have involved many department such as human resources, logistics and after service in enterprise. As the extended of after service outsourcing, equipment maintain outsourcing has been widely accepted in enterprise. Data showed, 80% medical equipment repairing in America was taken to outsourcing. With the health system reform and medical equipment manufacture market development and strengthen in recently, the high-tech and imported medical equipment are generally applied in medical and health units, and it`s an important technical support to clinic work, research and teaching, the rising of the third party medical equipment maintenance institutions has created necessary condition and situation for medical equipment maintenance outsourcing. In recent years, many domestic large hospital have tried the medical equipment maintenance outsourcing, and which would be the inevitable direction.
In the study, the reality of equipment maintenance management in several municipal hospital was taken into account, aiming directly at problems such as lacking of plan, overspend, weakness of time-effectivity and unreasonable personnel on equipment maintenance, etc. to study the construction of outsourcing. The methods include document research, investigation and questionnaire, to analysis and summarized the medical equipment management status in several ChongQing municipal hospital, so as to obtain basic conditions for medical equipment maintain outsourcing, based on which, the medical equipment maintain outsourcing was fabricated for municipal hospital in ChongQing.
meanwhile, Delphi method was used to predictably investigate the fabricated medical equipment maintain outsourcing in hospital, questionnaire was practiced to learn about the degree of recognition, ratification and requirements of such management mode in municipal hospital, medical equipment maintain company and health institutions, The feasibility and the possible problems during operation were further discussed by consulting relating experts. The conclusions are as follows:
1. At first, collecting the Analysis of the current models of medical equipment maintain and disadvantage in present as well as the development direction of models of the experts through consulting with them.
2. Investigate the current medical equipment maintenance situation in hospital, analyze the problems in the medical equipment maintain course, and the requirements for the Mode Construction was obtained.
3. The mode construction step is: the hospital select the scope of outsource equipment through actual situation; the equipment management committee select equipment maintain company; and sign a contract with the definitive company, make sure of the fixed number of years and price, and practical item in the process. evaluate the outsourcing company services by the evaluation system been made, so the hospital could find problem and modify or suspension contract to provide some useful opinion for outsourcing services in future.
4. Be restricted by the condition for the developing stage in domestic socialized maintain institutions, only some equipments could be selected for outsourcing, moreover, the selection of medical equipment was difficult relatively.
进入20世纪以来,随着知识经济的到来,企业为提高核心竞争力,纷纷引入“流程再造”(BPR)的思想[1][2]。而业务外包作为一种新型的流程再造模式,已逐渐涉及到人力资源、物流和售后服务等各项企业的职能中,作为售后服务外包的扩展,设备维修服务外包也得到广泛运用.有资料显示,美国医疗设备维修实行外包模式已达80%。近年来随着医疗卫生体制改革的深入,医疗设备市场的不断发展壮大,高技术含量的国产医疗设备和进口医疗设备在医疗卫生单位得到普遍应用,并在临床和科研教学工作中发挥着重要技术支撑作用.而第三方医疗设备维修机构的兴起,为医疗设备维修工作外包创造了必要的条件和外部环境。近年来,国内一些大型的医院已经开始作医疗设备维修外包的尝试,并已成为设备维修发展的一个必然方向。
本课题结合重庆市几所市级医院设备维护管理的实际情况,针对市级医院设备维修计划性不强、设备维修资金占用较大、维修的时效性不强以及设备维修人员结构不合理等问题,对医院设备维修“外包”模式的构建进行研究。课题采用文献研究、现况调查、问卷调查等方法对重庆市几所市级医院的医疗设备管理现状进行了总结和分析,得到了模式构建的基础条件,并在此基础上构建了重庆市市级医院医疗设备维修“外包”管理模式。同时应用德尔菲法对构建的模式作了预测性研究;使用问卷调查法对该模式在重庆市市级医院、医疗设备维修公司以及有关的卫生主管部门的认可程度和需求程度进行了解;最后运用专家访谈法对该模式的可行性及在运用过程中可能遇到的问题作了深入探讨。
1.通过专家访谈,收集专家对现行模式及存在弊端的分析,并对医疗设备维修模式的发展方向进行探讨。
2.对医院设备维修现状进行调查,分析医院在医疗设备管理方面存在的问题,得出模式构建的需求性。
3.医院医疗设备维修模式构建的具体步骤:医院根据实际情况,对需进行维修“外包”的设备进行范围划分;设备管理委员会采取公开招标或邀标的方式选择设备维修外包商;医院方确定好“外包”服务商与之签定合同,确定外包的年限及价格并明确一些具体维修保养条款;医院按照已制定好的服务评价体系定期对维修服务商进行考核,发现问题及时进行修正或中止合同,以便为今后“外包”服务提供参考意见。
4.由于国内社会化维修机构尚处于发展阶段,受外部条件的限制,该模式仅能选取部分设备进行维修“外包”,且医院要选择需外包的医疗设备时有一定困难。
Medical equipment is the key component in fixed assets of the hospital,it played a very important role in clinical diagnosis, treatment,medical research and teaching. The safety and effectiveness of the medical equipment usage is the important foundation for keeping patients` interest. Following the rapid development of medical equipment in recent years, the application of high-tech for medical equipment is just less to the astronautics technology. Following the great social and economic benefit created by the medical equipment, more and more maintenance problems exposed. The Contradiction Between traditional repair and maintenance pattern with the increasing development medical equipment and technique become more and more outstanding, The lacking of medical equipment maintenance in scheme and consecution, the unreason of human resources of repair and maintenance department, the maintenance inefficient and high maintenance cost became the important key restriction factors to the development of hospital increasingly, more and more hospital managers paying great attention to it, and study on socialized pattern of medical equipment repairing and maintenance now.
In 20st century, with the coming of Knowledge economy, in order to improve the core competence, enterprise import the thought of“Business Process Reengineering(BPR)”. The outsourcing, as the new Business Process Reengineering style, have involved many department such as human resources, logistics and after service in enterprise. As the extended of after service outsourcing, equipment maintain outsourcing has been widely accepted in enterprise. Data showed, 80% medical equipment repairing in America was taken to outsourcing. With the health system reform and medical equipment manufacture market development and strengthen in recently, the high-tech and imported medical equipment are generally applied in medical and health units, and it`s an important technical support to clinic work, research and teaching, the rising of the third party medical equipment maintenance institutions has created necessary condition and situation for medical equipment maintenance outsourcing. In recent years, many domestic large hospital have tried the medical equipment maintenance outsourcing, and which would be the inevitable direction.
In the study, the reality of equipment maintenance management in several municipal hospital was taken into account, aiming directly at problems such as lacking of plan, overspend, weakness of time-effectivity and unreasonable personnel on equipment maintenance, etc. to study the construction of outsourcing. The methods include document research, investigation and questionnaire, to analysis and summarized the medical equipment management status in several ChongQing municipal hospital, so as to obtain basic conditions for medical equipment maintain outsourcing, based on which, the medical equipment maintain outsourcing was fabricated for municipal hospital in ChongQing.
meanwhile, Delphi method was used to predictably investigate the fabricated medical equipment maintain outsourcing in hospital, questionnaire was practiced to learn about the degree of recognition, ratification and requirements of such management mode in municipal hospital, medical equipment maintain company and health institutions, The feasibility and the possible problems during operation were further discussed by consulting relating experts. The conclusions are as follows:
1. At first, collecting the Analysis of the current models of medical equipment maintain and disadvantage in present as well as the development direction of models of the experts through consulting with them.
2. Investigate the current medical equipment maintenance situation in hospital, analyze the problems in the medical equipment maintain course, and the requirements for the Mode Construction was obtained.
3. The mode construction step is: the hospital select the scope of outsource equipment through actual situation; the equipment management committee select equipment maintain company; and sign a contract with the definitive company, make sure of the fixed number of years and price, and practical item in the process. evaluate the outsourcing company services by the evaluation system been made, so the hospital could find problem and modify or suspension contract to provide some useful opinion for outsourcing services in future.
4. Be restricted by the condition for the developing stage in domestic socialized maintain institutions, only some equipments could be selected for outsourcing, moreover, the selection of medical equipment was difficult relatively.
引文
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1.赵杰宇.关于加强医院医学工程科学科建设的思考医疗卫生装备, 2006,27(9):76-78
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4.陈康.改革医学工程人才培养模式之探讨医疗卫生装备, 2006,27(5):61-62
5.马滨.医疗设备维修管理的现状及对策医药产业资讯, 2006,11(3):95-96
6.王芳茹.医疗设备维修工程人员现状与加强队伍建设的建议医疗设备信息,2006,21(2):47-48
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8. Prahalad , C. K. and Gary Hamel, The core competence of the corporation, Harvard Business Review ,1990,86:79-90.0017-8012.
2. Michael Hammer, James Champy. Reengineeringthe Corporation A manifesto for business revolutaion. Harper Collins Publishers Inc, 1993:30-51.
3.赵杰宇.关于加强医院医学工程科学科建设的思考医疗卫生装备, 2006,27(9):76-78.
4. Prahalad , C. K. and Gary Hamel, The core competence of the corporation, Harvard Business Review ,1990,86:79-90.0017-8012.
5. Heywood J.B.The outsourcing dilemma[M].Pearson Education Limited, 2001.
6. Gottfredson M. and Puryear R., Phillips S., Strategic sourcing: from periphery to the core[J].Harvard Business Review, 2005,83(2):132-139.
7.马士华,林勇,陈志祥.供应链管理[M]北京:机械工业出版社2000.
8.陈菊红,汪应洛,孙林岩.虚拟企业—跨世纪企业的崭新组织形式[J].管理工程学报,2000(2).
9.王立明,刘丽文.外包的起源、发展及研究现状综述.科学学与科学技术管理,2007(03):151-156.
10.刘丽文.供应链管理思想及其理论和方法的发展过程[J].管理科学学报, 2003, 6(2):81- 88.
11.文荗平半导体业资讯委外决策模式-台湾晶圆代工厂之个案研究.国立交通大学2000.
12. David P.Lepak & Scott A.Snell. Virtual HR: strategic human resource management in t he 21st century [J]. Human Resource Management Review, 1998, 8 (3): 215 -234.
13. Aidan vining,Steven Globeman.A conceptual framework for understanding the outsourcing decision[J].European Management Journal,1999,(6):645-654.
14. Arnold Ulli. New dimensions of outsourcing:A combination of transaction cost economics and the core competencies concept[J]. European Journal of Purchasing & Supply Management,2000,6:23-29.
15.杨成刚:外包:让财富联动,经济日报出版社,2002年.
16. http://www.wjmj.yy.gov.cn/art/2008/5/13/art_11692_89338.html.
17. Morgan Chambers. Outsourcing in the FTSE100 : The Definitive Study[DB]. http://www.cw360ms.com/outsourcing/index.asp.
18. Lacity M C, Willcocks L P, Kern T. Risk mitigation in IT Outsourcing Strategy Recisited:Longitudinal Case Research at LISA[J]. Strategic Information system, 200,1(13).
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