1、Chinas Proposed Changes in Hospital Management Education and Practice as Derived from North American Successes中國醫院管理教育與實際變革的建議-來自北美洲的勝利閱歷Howard W. Houser, Ph.D. Professor Emeritus and Former Associate DeanDepartment of Health Services AdministrationThe University of Alabama at BirminghamApril 26, 20

2、21, China霍華德豪斯博士，教授清華大學醫院管理研討院 院長高級顧問美國阿拉巴馬伯明翰大學衛生學院 原副院長,系主任,教授2021年4月26日中國北京.My Background我的背景I have 54 years of hospital management and hospital management education experience in the USA在美國，我有54年的醫院管理和醫院管理教育閱歷I have 29 years of hospital and health administration education experience in China在中國，

3、我有29年的醫院管理和衛生管理教育閱歷Hospital management education and practice in China is one of those projects 中國醫院管理教育與實際是其中之一.My USA Experience and Background我在美國的閱歷和背景Earned both Masters and Ph.D. degrees in Hospital and Health Administration擁有醫院和衛生管理的碩士和博士學位Worked in 6 different hospitals early in career在早期職業生

4、涯中曾為6所不同的醫院任務過Routine access to more than 150 hospitals in academic career在學術生涯中與150多所醫院堅持頻繁的日常聯絡Three years active duty as officer in U.S. Air Force Medical Service School preparing all levels of health workers for Air Force hospitals曾作為現役軍官在美國空軍醫療效力學校服役3年，為空軍醫院培育不同層次的管理人員。.My USA Experience and Ba

5、ckground我在美國的閱歷和背景Began full time teaching in 1970 從1970年起開場全職教書Have served as program and school developer, program director, department chair and associate dean曾擔任醫院管理系和衛生管理專業學院的開創人，工程總監，系主任和副院長Now work part time on special projects如今為一些感興趣的工程兼職任務.My China Experience and Background我在中國的閱歷和背景China

6、Ministry of Health and U.S. Project HOPE as Leader of Hospital and Health Administration Development Project May-October, 19841984年5月-10月，作為中國衛生部和美國結合工程的“HOPE基金會中“醫院和衛生管理開展工程主管人Based at Xian Medical University and extending to Medical University, Zhejiang Medical University, and Shanghai Second Medi

7、cal University當時曾主要任務于西安醫科大學，也曾參與北京醫科大學、浙江醫科大學和上海第二醫科大學的任務Focused on undergraduate and graduate hospital/health administration and continuing education主要關注醫院及衛生管理本課及研討生教育和繼續教育.The History of Hospital and Health Management Education in North America北美洲醫院和衛生管理教育的歷史Prior to 1930- Doctors, Nurses, or Bu

8、sinessmen became hospital presidents Hospitals not complicated1930年以前，醫生、護士和經商人士都可以成為醫院的院長,醫院并不復雜The 1st Generation -1933&34- Two masters programs launched at Northwestern University and University of Chicago 1933-1934-第一代：美國西北大學和芝加哥大學成立了兩個醫院管理碩士點Chicago is headquarters for both American Medical Ass

9、ociation and American Hospital Association芝加哥是美國醫療協會和美國醫院協會的總部.The History of Hospital and Health Management Education in North America北美洲醫院和衛生管理教育的歷史Led by Physician Leaders and Academic Leaders in Economics and Finance由醫生領袖和經濟與財務學科的領袖來指點Selected the Masters Degree as the terminal degree for practi

10、ce選擇碩士學位作為這個醫院管理實際學位的學位終點One year of academic work and one year of guided practice.第一年是學術課程， 第二年是有針對性的實際Other similar programs followed on the West and East coasts of U.S.另外一個類似的碩士點隨后在美國的西海岸和東海岸建立.The History of Hospital and Health Management Education in North America北美洲醫院和衛生管理教育的歷史Most educational

11、 materials prepared by practitioners and regular faculty大多數教育資料是為開業醫師和大學教員預備的Education was prescriptive in nature- How things ought to be這個教育的指點性屬性是事情應該是怎樣的The 2nd Generation, 1940s and 50s- used same model, many in public universities in the Midwest e.g. Michigan, Minnesota, Iowa1940年-1950年，第二代：運用同

12、樣的方式；大多數在中西部的公立大學，比如密歇根、明尼蘇達、愛荷華等大學Most second generation leaders were mentored by the original 1930s leaders大多數第二代管理者師從于30年代的第一批管理者.The History of Hospital and Health Management Education in North America北美洲醫院和衛生管理教育的歷史My alma mater, University of Iowa department founded in 1950 by Gerhard Hartman

13、a 1934 Graduate of the University of Chicago Department我的母校，愛荷華大學的該專業由哈特曼教授成立于1950年，他1934年畢業于芝加哥大學的衛管專業。Became clear that the education was necessary, the new model for hospital management, and it would grow and become permanent在明確了這種教育是非常有必要之后，一個新的醫院管理方式就開場開展并且成為耐久的方式Many graduates rose to top posi

14、tions in hospitals within 7-10 years很多畢業生在7-10年的時間里生長為醫院的高層管理者.The History of Hospital and Health Management Education in North America北美洲醫院和衛生管理教育的歷史The 3rd Generation- 1960s &70s- Started in areas of U.S. and Canada where there were no programs1960-1970年，第三代：在美國和加拿大的部分地域開場，這些地方之前并沒有專門的工程Example 19

15、65- University of Alabama started at Birmingham Medical Center, this School of Health Administration, now has become School of Health Professions1965年的例子-阿拉巴馬大學伯明翰醫學中心成立了衛生管理學院，就是如今的衛生管理專業學院Leaders were mostly mentored by 2nd generation program leaders這一代的指點者們多數從師于第二代的指點者.The History of Hospital and

16、 Health Management Education in North America北美洲醫院和衛生管理教育的歷史Curriculum extended to two academic years and year of guided practice課程包括2年學習和1年指點性的實際Many programs removed year of guided practice from the degree and made it totally post degree experience while many , including UAB did not由于思索學制太長很多碩士點去掉

17、了一年實際課程。 但很多碩士點沒有這樣做， UAB 選擇了后者，即保管一年的實習。Canada followed U.S. pattern加拿大仿照了美國方式.The History of Hospital and Health Management Education in North America北美洲醫院和衛生管理教育的歷史Many, even most, 4th generation programs have not yet sought or achieved accreditation大多數第4代碩士點還沒有被開掘，或者說還沒有獲得評審認證的專業Programs from al

18、l generations are housed in Schools of Public Health, Business, Graduate Schools, Schools of Medicine, and Schools of Health Professions每一代的醫院管理碩士點都建立于公共衛生學院、工商管理學院、研討生學院、醫學院或衛生專業學院。Doctoral study incorporated specific to this discipline since the 1950s1950年代，博士學位學習開場參與到這個專業.The History of Hospital

19、and Health Management Education in North America北美洲醫院和衛生管理教育的歷史Develops educators, researchers and leaders for key medical institutions為主要醫療機構培育教師、研討者和管理者 Bachelors Undergraduate evolved independently in many smaller schools with no graduate programs在一些小的學校，只需學士學位而沒有研討生學位Today many 2nd and 3rd gener

20、ation departments have bachelor, masters and doctoral programs in the same department. UAB does在今天，很多第2、3代的學院有學士、碩士和博士點。UAB也是這樣。The masters degree is still the standard of practice for top general hospital management.碩士學位依然是綜合醫院高級管理的規范配置.A Review of Hospital Management Practice in the USA美國醫院管理回想The

21、y rely instead on graduation from accredited programs and professional organizational achievement credentials而是依托評審認證的學位畢業證書和專業機構文憑This was probably a mistake because there is no law to prevent anyone from becoming a hospital president who does not have the professional degree 這能夠是一個失誤，由于沒有法律可以阻止一個沒

22、有專業學位的 人來擔任醫院的董事長Most hospitals and systems seek and staff only with professional degree holders大多數醫院和醫療系統尋覓和雇傭這些專業學位的人.What Subject Matter Do These Graduates Learn?這些研討生學什么？Health Systems Development, Organization, and Management衛生系統開展、組織和管理Hospital and other Health Organization Development, Organi

23、zation Theory, Governance, Structure, and System Relationships醫院和其他衛生組織開展、組織實際、管理、構造和系統關系Health Care Economics and Health Care Finance and Accounting衛生經濟、財務管理和會計學Hospital and Health Related Human Resources Management醫院和與衛生相關的人力資源管理.What Subject Matter Do These Graduates Learn?這些研討生學什么？Epidemiology a

24、nd Medical and Surgical Practice content流行病學、醫療和外科實際內容Statistics and Quantitative Methods for Health Administration Practice衛生統計學和計量學Health Care Marketing and Competition衛生市場和競爭Health Information Technology and Health Informatics衛生信息技術和衛生信息學.What Subject Matter Do These Graduates Learn?這些研討生學什么？Meth

25、ods of System and Organization Improvement系統和組織改善方法Quality Systems and Accountability質量體系和問責制Leadership Skills, Critical Thinking, Problem Solving, Teamwork指點力、批判性思想、問題處理和團隊協作.What Subject Matter Do These Graduates Learn?這些研討生學什么？Health Policy- What should we do and how should we do it衛生政策-我們應該做什么和應

26、該怎樣做Health Law- Federal and State Government Laws and Regulations, Contracts , Liability and Negligence 衛生法律-聯邦和州政府的法律和規定、合約、責任和過失處置Integrative course to apply all knowledge learned綜合課程保證一切知識的運用Elective courses to specialize專門化的選修課.Why Executive Models?為什么要采用高級管理人員方式Many Universities, including my o

27、wn, UAB, operate executive format masters and doctoral degrees很多大學，包括UAB，開展了針對高級管理人員的碩士和博士課程Most participants are those who hold hospital management jobs but with no formal job related education 大多數的學習者從事醫院管理但是并沒有學過相關的管理課程Large numbers of these students are doctors and other health professionals大多數學

28、生是醫生或者其他醫學專業人員They learn the same content in the same amount of time while continuing working他們用同樣的實際學習一樣的課程，同時也兼顧任務.Some Conclusions about the USA Experience美國閱歷小結The Masters degree in hospital and health care management has become the standard for hospital and medical center operations in the U.S.

29、醫管或衛管碩士學位成為美國醫院和醫療中心運營的規范There are more than 90 accredited masters programs producing more than 2000 graduates each year每年有超越90家認證的碩士工程提供2000多名畢業生Hospital and Health Care Management are very popular choices among U.S. college graduates在美國的大學和研討生院專業中，醫院和衛生管理是非常搶手 的選擇Many of the 1st, 2nd, and 3rd gene

30、ration are now deceased or retired很多第1-3代的畢業生開場逐漸退休了.Why In the 21st Century China Should Be Ready to Adopt Modern Health Management Education and Practice為什么21世紀的中國應該預備好接受現代醫院管理教育和實際The 1980s experiment we ran was too early and no one understood its importance1980年代的閱歷太早了，那時沒人明白它的重要性Today you have

31、seen your hospitals become more and more complicated to operate, technology growing exponentially and patient expectations growing more demanding他曾經可以看到今天他的醫院運營變得越來越復雜，指數性技術增長和病人越來越高的期望.Why In the 21st Century China Should Be Ready to Adopt Modern Health Management Education and Practice為什么21世紀的中國應該

32、預備好接受現代醫院管理教育和實際Health care finance becomes more complex and difficult each day衛生財務每一天都變得復雜和困難Private hospitals are growing and competing in every city in China中國每個城市，私立醫院都在生長和爭得一席之地There is a strong need for change and positive reform 變革和積極改革的劇烈需求.Why Does China Need These Types of Graduates?為什么中國需

33、求這種研討生Living in an ever expanding digital age. The delivery of health services will always be digitally dependent because of our need for medical records and research處在一個前所未有的數字膨脹時代。衛生效力的開展不斷是數據依賴，由于我們需求醫療記錄和研討Coping with endless technology progress, changes, and upgrades. Modern medicine and health

34、 care is heavily technology dependent. Our technology does not wear out, it becomes obsolete and is replaced應對無盡頭的技術提高、改革和晉級換代?，F代醫學和衛生效力嚴重地依賴于技術。我們的技術不會停頓提高，它不斷被廢棄和然后被替代。.Why Does China Need These Types of Graduates?為什么中國需求這種研討生Dealing with ever more complex systems of health care finance. Health ca

35、re finance and budgeting is among the most complex of any industry and is continually changing應對衛生財務系統的復雜性。衛生財務和預算比任何一個產業都要復雜，并且在不斷的變化。Delivering quality health services to 1.3 + billion citizens in the 21st century. We all know how to do it, but must organize, finance, and provide the health profes

36、sionals and health organizations to do it為13億多人提供醫療衛生效力。我們都知道怎樣做，但是如何組織財務、提供衛生效力的專家和衛活力構來做。.Why Does China Need These Types of Graduates?為什么中國需求這種研討生Responding to the internal and joint venture private hospital systems. They already know about the benefits of employing these people and seek them in

37、foreign countries. They will need many more native Chinese graduates應對國內的和合資的私立醫院。他們曾經懂得雇傭醫管專業的人并從國外開掘這些人才，并從中得到了益處。他們需求更多的外鄉醫管專業畢業生。Responding to the International Pursuit of Quality and Reduction of Medical Errors. Modern systems with well educated administrators establish and operate these proces

38、ses best應對國際上對醫療質量的追求和降低醫療事故。擁有這些良好專業教育背景人才的現代系統可以最正確的建立和運營。.Why Does China Need These Types of Graduates?為什么中國需求這種研討生Finally- Because it will improve overall the efficiency, effectiveness, and cost control of Chinas health delivery system最后，由于它可以促進改善整個中國醫療衛生系統的效率、效益和本錢管控。.What If They Existed Today?假設他們如今就曾經出現了呢？Every hospital president in this room could use well at least one of these graduates在這個房間里的每一個醫院院長都可以良好運用至少一個這樣的畢業生。Very large hospitals could