IMPROVING PERFORMANCE OF PUBLIC SECTOR HOSPITALS: IMPACTS OF QUALİTY MANAGEMENT SYSTEMS APPLICATİONS IN TURKEY

Özel sektörden kamu sektörüne adabte edilmiş yönetim metodlarından biri olan kalite yönetimi, son yirmi yılı aşkın süredir sağlık hizmeti sunan kuruluşlar tarafından da uygulanagelen bir yönetim yaklaşımıdır. Türkiye`de ise 90`lı yılların ikinci yarısından itibaren birçok kamu hastanesi kalite ve performanslarını artırmak amacıyla kalite yönetim sistemleri yaklaşımını benimsemiştir. Bu çalışma, kalite yönetim sistemleri yaklasımını benimsemiş Sağlık Bakanlığına bağlı devlet hastanelerinin kalite ve performans değişimlerini karşılastırmalı olarak incelemektedir. İlk olarak gelişmiş ülkelerin sağlık hizmeti sunan organizasyonlarında kaliteyi geliştirmeye dönük faaliyetleri üzerinde durulmuştur. Uluslararası Standardizasyon Organizasyonu (ISO)'nun kuruluş ve faliyetlerine değinildikten sonra, sağlık sektöründe kalite ve performansı arttırmaya dönük faaliyetler üzerinde durulmuştur. Çalısmamız ISO sertifikası almış ve almamış olan devlet hastaneleri arasında çok ciddi bir performans farkı olmadığını, ancak özellikle sertifika sonrası daha çok hasta ve doktorun sertifika almış olan hastaneleri tercih ettiğini ortaya koymustur. Diğer yandan, hastane kalite ve performanslarını ana boyutlarıyla ölçmemizi sağlayacak yeni indikatörlerin geliştirilmesi ve kullanılması gereği vurgulanmıştır. Son olarak, ISO belgesi almış devlet hastanelerinin kalite yönetim sistemlerini uygulamadaki tecrübe ve birikimlerinin, Sağlıkta Dönüşüm Programı`nın uygulama aşamasında diğer sağlık hizmeti sunan kuruluşlar için bir yol haritası çizilmesine büyük katkı sağlayacağının altı çizilmiştir.

Anahtar Kelimeler:

IMPROVING, PERFORMANCE, PUBLIC

IMPROVING PERFORMANCE OF PUBLIC SECTOR HOSPITALS: IMPACTS OF QUALİTY MANAGEMENT SYSTEMS APPLICATİONS IN TURKEY

One of the contemporary management methods adopted from the private sector and widely advocated in health care organizations over the past two decades is quality management approach. Many Turkish government hospitals have also implemented ISO 9001 quality management systems standards to improve their quality and performance since the second half of 1990s. This study examines the impacts of ISO 9001 certification efforts at Ministry of Health (MoH) hospitals. It begins with an examination of quality improvement experience in developed countries’ health care services, and International Organization for Standardization (ISO). Following section offers a brief discussion on recent Turkish health care reforms. Next, an analysis of the impact of ISO 9001 quality management systems certification on quality and performance of government hospitals is offered by comparing the nine ISO certified and non-certified hospitals’ performances during the pre and post certification periods. Findings of the study show that although there were no significant differences between ISO certified and non-certified MoH hospitals in terms of their performance and quality, ISO certified hospitals were able to attract more patients and doctors than non-certified hospitals during the postcertification period. In the light of these mix results, it is also discussed that there is a need for adequately designed outcome performance indicators which can be employed to measure the core quality and performance dimensions of hospitals. Finally, this study concludes that valuable lessons can be drawn from quality management systems practices of MoH hospitals in conceptualizing a road map for many other health care organizations during the implementation stage of the Transformation in Health program.

Keywords:

IMPROVING, PERFORMANCE, PUBLIC,

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