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在台湾长庚医院工作20年后,他总结出3个医院发展因素!

2018-05-20 子不语 医学界智库

长庚纪念医院成立之初,台湾的医疗市场格局与今天的中国大陆一样,也以公立医院为主,而占市场份额30%的民营医院也都规模不大,以提供高端医疗服务为主,被台湾人民称之为“贵院”:收费很贵的医院。傅天明于1978年加入长庚医院,他参与并见证了长庚医院的崛起和台湾医疗市场的巨变。在长庚医院工作的20年间,傅天明从事过很多岗位,用他的话说,“除了没做过医生,其它岗位基本都做过。”这段工作经历让他对医院的

长庚纪念医院成立之初,台湾的医疗市场格局与今天的中国大陆一样,也以公立医院为主,而占市场份额30%的民营医院也都规模不大,以提供高端医疗服务为主,被台湾人民称之为“贵院”:收费很贵的医院。

傅天明于1978年加入长庚医院,他参与并见证了长庚医院的崛起和台湾医疗市场的巨变。在长庚医院工作的20年间,傅天明从事过很多岗位,用他的话说,“除了没做过医生,其它岗位基本都做过。”这段工作经历让他对医院的运营管理谙熟于心,也为他后来到大陆专业从事医院运营管理工作提供了良好知识背景和经验。

5月25日—26日,医学界传媒联合北京大学国际医院、清华大学医院管理研究所共同推出的“2018现代医院运营管理实战研修班”将在北京举行。如今已在中国大陆工作了10余年,担任惠宏医疗管理集团首席顾问兼副董事长的傅天明将以讲师身份在这次研修班授课,分享对医院绩效和运营管理的经验。

长庚医院的成功之道

在傅天明看来,有三个因素促成了台湾长庚医院的传奇。

第一个因素是勤劳朴实。在当年民营医院纷纷走高端路线的医疗市场环境下,长庚医院却定位在了平民医院:平民化经营、平民化消费,医院从建设到装修走的也是俭省路线;所有采购的物资虽然使用的材料都很廉价,但质量并不打折。

第二是追根究底。林口长庚医院开业的前三年里,基本上每个星期日董事长王永庆都会亲自主持会议,讨论医院运营管理问题及患者抱怨事项,会中针对问题提出解决方案,解决方案确定后还要试行三个月,再对试行结果进行讨论,如果不满意继续改善,长庚医院的制度和流程就是在这种反复讨论纠错中建立的。

第三个因素是求新求变。作为一所新建立的医院并不墨守成规,通过反复发现问题寻找答案,并不断改变完善,从而创新制度和流程。傅天明表示,这三点在台湾长庚医院发展过程中至关重要。

长庚医院不仅从创院起就实施主诊医师负责制,同时是台湾第一个实施医师费制度的医院,目的是将医疗权责具体考核到最小服务单元,然而今天中国大陆医院,也仅有为数不多的几家医院实施主诊医师负责制。此外,长庚医院也是第一个引进专科经营助理的医院,让专业的人做专业的事情,医生做好医疗的事情,专科经理做好科室主任幕僚的角色,针对科室经营分析、质量改善、作业流程、成本控制、市场营销等事务,提出具体建议,供科室主任决策。同时协助科室主任将医院与科室规划事项落实执行。在长庚医院,医院所有部门都围绕着病人和医生这两个核心服务对象做事情,以病人为中心,以医生为中心。

长庚医院的成功,可以说是胜在管理和运营,并且最终改变了台湾医疗格局,开创了台湾民营医院蓬勃发展逐渐占据市场主流的局面,现状台湾民营医院在床位数和服务量上都占到了70%以上的份额,而且在医疗水平、就医满意度、教学科研等方面也都赶超了公立医院。

如今长庚医院也已经开到了中国大陆,大陆的非公医疗也正在蓬勃发展,但在服务量上公立医院依然占据着绝对主导地位,在这医疗市场演变过程中,正是医院管理者发力之时,傅天明也决心把自己多年的医院管理经验帮助更多的医院实现突破性发展。

帮助大陆医院做好运营管理

上世纪90年代初,在上海的两次就医经历让傅天明看到了中国大陆医院管理水平的落后,也开始萌生了来大陆寻找机会的想法。

一次是他朋友的女朋友,去上海一家很有名的医院看急诊,医生说是盲肠炎,要准备手术,而在手术前妇产科医生来了,说是宫外孕。“当时吓一跳啊,如果不是妇产科医生来了会是什么结果?”

另一次则是傅天明自己的就医经历,看的特需门诊,但整个就医的过程让他感觉很差:服务不好、人满为患、等候时间长等。这让他意识到大陆虽然经济飞速发展过程中,医疗管理水平却亟待提高。

2004年,傅天明实现了他来大陆做医院管理的夙愿。第一站就是四川大学华西医院这家大型公立三甲医院,为该院培训管理人才队伍。华西医院能成为中国大陆现代医院管理体系的代表医院,与当初傅天明两年的理论培训和实战训练分不开。2017年中日友好医院开始实行主诊医师负责制,所学习的对象就是华西医院。

“华西能成为现代医院的样板不是我们的功劳,是医院院长的功劳。”傅天明说,“作为顾问,我们只能把我们认为对的事情介绍给医院,同时辅导他们如何规划,如何执行。至于能否最终落实并持续推行,则有赖于医院领导层的决心与毅力。”

傅天明举了邵逸夫医院的例子,如今的邵逸夫医院实现了中美医院管理模式的完美对接,形成了“邵医模式”,但在开业之初,至该院工作的诸多人员,总认为美国的做法不适合中国国情,而要求修改。“幸好当初他们能够坚持了下来,今天的邵逸夫医院才会与众不同,所以制度设定后,运营过程中一定要坚持,用制度改变人的观念,而不是让人的观念改变制度。”

此后,傅天明还还主导了山东千佛山医院和烟台山医院的绩效管理项目,其中,千佛山医院的管理模式还受到了当时温家宝总理的认可。另外傅天明教授发现国内有些新医院建成后,由于布局及流程的不合理,不仅浪费空间,也给病人带来很多不便,更增加了运营成本。他团队也开始为新医院筹建做规划,同时也帮助一些医院做开院前制度设定、人员训练及开业后的辅导。

对于国内非公医疗的发展,傅天明比较担心的是这些非公医院如能不能掌握技术和人才这两样核心资源,最终沦为公立医院的附庸,这会更制约非公医院的发展。他说:“国内成功的民营医院都有自己的核心专家团队,并且都经过了5年以上的发展积淀才步入成功,如果长期依赖外来的专家资源,而无法形成自身的技术团队,就等于核心价值握在别人手上,医院长远发展就很危险。”

今天,国家大力鼓励社会办医,出台了一系列的扶持政策,这对非公医院正是个机会,问题是他们能否把握机会规范制度、培养人才、加强服务、提升效率。为社会会办医走出一条示范道路。在此同时,国家也同时出台了一系列医疗改革政策。这些改革,在国外及境外都是历经多年,且逐项实施而达到今天的成果,而现在中国大陆却期望在短短几年完成。政府的配套政策、基层医疗人才培养、公立医院现有职工的心态、民众对各级医院信任等,这些是否已经做好了准备则是他比较担心的。

因此傅天明预测:如果在未来的五年中,公立医院无法顺利改革,而国家又未能感受到社会办医为社会、民众带来的效益;届时恐怕医改的方向会再度改变。

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    2018-05-21 lyh994

    厉害.各项全能!

    0

  3. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon May 21 01:33:23 CST 2018, time=2018-05-21, status=1, ipAttribution=)]
    2018-05-21 龙胆草

    学习谢谢分享

    0

  4. 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    2018-05-21 wzb521zf

    一起学习学习

    0

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    2018-05-21 神功盖世

    0

  6. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon May 21 01:33:23 CST 2018, time=2018-05-21, status=1, ipAttribution=)]
    2018-05-21 深海的鱼

    解决之道就是

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon May 21 01:33:23 CST 2018, time=2018-05-21, status=1, ipAttribution=)]
    2018-05-21 大爰

    学习了谢谢分享!!

    0

  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon May 21 01:33:23 CST 2018, time=2018-05-21, status=1, ipAttribution=)]
    2018-05-21 yjs木玉

    学习学习再学习

    0

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    2018-05-21 哈哈869

    学了

    0

  10. 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    2018-05-21 天地飞扬

    了解一下.谢谢分享!

    0

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