© 2019 CMC Today and Jian Di and Yang Shuanping

In China, the medical institutions that provide disease diagnosis and treatment services are the main component part of medical system. We have offered consulting services for over 700 medical institutions, including the People’s hospital,the Traditional Chinese Medicine Hospital, the Maternity and Child Care hospital and the basic Hospital in the medical community.

Based on our professional management consulting experience for medical institutions, we created the TSA social value model of the medical system. It is applied to illustrate the social responsibility of different types of medical institutions, that is, to quantify the social value of the medical institution by the three dimensions: Technical level, Service Quality and Area share.

1. The Technical level is the first element of the social value of medical institution
The primary duty of the medical institution is to carry out disease diagnosis and treatment activities; however, the sole criteria to measure the technology of a hospital is “rapid and accurate diagnosis and correct and timely treatment”.  In regard to rapid and accurate diagnosis, it is more reflected in the construction level of specialization of outpatient clinics, which require a team of senior doctors and matching equipment. As concerns correct and timely treatment, the medical institutions could improve the discipline construction in the standard requirement from ‘The criteria of medical service capability for the Secondary Hospital’ ‘The guidance of medical service of the Tertiary General Hospital’ and so on. On this basis, by mentoring the clinicians to follow the clinical pathway management to regulate diagnosis and treatment activities; patients could access the optimum treatment and nursing. Meanwhile; it could minimize the waste of medical resources.

For the quantification of each dimensions, we arrange the different quantification criteria based on the medical responsibilities of different medical institutions in our consulting case. Take a Secondary Medical Institution as an example, we set the basic outpatient department should include: 

  • Department of Preventative health care, 
  • Physician, 
  • Surgeon, 
  • Gynaecology and Obstetrics, 
  • Paediatrics, 
  • Ophthalmology,
  • Otorhinolaryngology,
  • Stomatology,
  • Dermatological Department,
  • Psychiatry Department,
  • Infection Department, 
  • Emergency Medical Department, 
  • Department of Rehabilitative Medicine, 
  • Department of Anaesthesiology, 
  • ICU, 
  • Medical Laboratory, 
  • Pathology Department,
  • Department of Medical Imaging, 
  • Traditional Chinese Medicine Department. 

Simultaneously, each specialist outpatient should have sub-senior or senior doctors to provide the service. As far as the accurate and timely treatment, we use the utilization rate of clinical pathway as the criteria to assess. It uses the rate which the inclusion rate obtained more than 80% and the completion rate was not less than 70% as a full mark index.

2. Service quality is a reflection of the soft power of social value of the medical institutions.
The service objects decide the medical institution has been part of high-tech service industry, thus, the social value is not only requiring the high-level medical technology, but also requiring the high-quality service. When we guide the medical institution to perform its social responsibilities, we emphasize on continuously improving medical service and focus on humanistic care; and offering a comfortable and safe medical experience for patients. As a consequence, the patients could complete feel the care from medical staff, then, it can achieve quantitative improvement of service quality through the building of ‘Patient First’ hospital culture. 

Building of a ‘Patient First’ hospital culture is quantitatively illustrated from the following five aspects: environment, service, etiquette, management and convenience, which including 32 medical treatment processes and 410 indexes. Therefore, it could evaluate the level of service quality for the medical institutions.

3. The area share is a reflection of service result of social value for a medical institution
The area share index that the proportion of the number of medical institutions serving patient (including the number of outpatient and inpatient) to the total number of medical institutions serving patient in the service region. Take a local People’s Hospital as an example, all the People’s Hospital in China is established to meet the demand of local people by the local government. 

Hence, the social responsibility of People’s Hospital is to satisfy the demand of diagnosis and treatment of diseases for the local people. In order to evaluate the People’s Hospital extent of fulfilling its social responsibility and level of its development, we describe the social value status of the its People’s Hospital in various medical institutions in this area through the proportion of outpatient and inpatient service volume. If the total number of patient of People’s Hospital occupied more than 60% of the total patients in the region, which measure from two dimension: the number of outpatient and the number of inpatient, it could tell that the area share of this medical institution is located in the gold area for it directly reflects the regional patients' recognition of this People's Hospital. Indeed, while we focus on the quantity of patient, we still pay attention to its service level (Is the level of non-pharmaceutical therapies is high enough?). We defined a medical institution with a high patient market share and a high level of non-pharmaceutical therapies (a low proportion of two expenses) as having the highest (gold) social value.

According to our extensive experience, we believe that the social value of the medical institution had been fully embodied when the three dimensions (T, S, A) all have perfect performance, otherwise, that any failure in those dimensions is a key issue that the medical institution should strive to solve in the development process.

In consultation practice, we have guided various medical institutions continuously to improve its technical level, service quality and area share through flexibility applied TSA social value model for medical system, thereby, it improves its social value which obtain the recognition and satisfaction by the residents and government of the region.