A Research of Organizational Behavior and Procedure Improving in a University Hospital Obtaining JCIA by Case Study and Statistical Process Control
Date Issued
2011
Date
2011
Author(s)
Hsiao, Tzu-Yu
Abstract
The medical service system in the 21st century is facing serious transformation. The medical doctors are not the only heroes anymore. The patient safety oriented medical service teams take the place instead. The needs of patients should be fulfilled not only by well established hospital infrastructure and skillful medical doctors, but also by impressive service and compassionate treatment provided by the team work of medical staff. The quality of patient care in modern medical service emphasizes patient safety, which requires seamless cooperation of all well organized medical teams. National Taiwan University Hospital (NTUH) has a long glorious history with prestige in medical specialty performance. In the past, the organization culture of NTUH leaned to aiming at pursuing brilliant researches and cutting edge medical technology, and it put the sense of patient safety care aside. For this reason, the superintendent of NTUH decided to review the internal challenges by introducing external monitoring force, the JCIA, to initiate the organizational behavior and cultural changes via the process of hospital accreditation. Goals they achieved included transformation of the organizational behavior and culture to patient safety centered medical care and improvement of the medical care efficiency.
This research is a case study of NTUH’s changes in organizational behavior and culture before and after JCIA through reviewing the processes and records of all activities conducted in the one-year preparation period for JCIA. Five TQIP index and the completion rate of medical record within three days after patient discharge were also analyzed by using Statistical Process Control (SPC) method.
During the preparation period for JCIA, from April 2009 to March 2010, NTUH conducted many activities including delivering JCIA related information to staff at all levels through all channels, establishing and refining administration policies and procedures, establishing patient safety oriented medical operation procedures, holding core team conference every week to monitor the process in every phase, training staff in every department with appropriate and consistent content, assigning the director and the head nurse in every ward to take responsibility of patient safety, sending auditors to every department to confirm all JCIA patient safety standards are in place, and establishing a mechanism for continuous improvement.
Findings from SPC analysis of five TQIP index and the completion rate of medical record within three days after patient discharge were first, NTUH staff became more willing to report patient safety events than before. Second, the ratio of cancellation of the scheduled examination and emergent service decreased significantly. Third, the completion rate of medical record within three days after patient discharge increased remarkably.
The results of the case study showed NTUH, a public and large scale university hospital with over a hundred years history substantially changed organizational culture and procedures by obtaining JCIA.
Subjects
National Taiwan University Hospital
patient safety
organizational culture
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-100-P99748002-1.pdf
Size
23.32 KB
Format
Adobe PDF
Checksum
(MD5):ff527d9b86490432a5f05912778540ea