Organization Structure Design of Maternal and Child Hospital 
Under the Big-health Service Model

Jian Di and Zhang Shujun
    
 

Since the founding of the People's Republic of China in 1949, China's maternal and child health has gone through an extraordinary journey. The health of women and children has been improved continuously, while remarkable progresses have been achieved in different development stages. By 2018, China had 3,080 maternal and child health care institutions, 807 O&G hospitals and 129 children's hospitals. By employing nearly 640,000 people, they provided 400 million outpatient visits service, and 13.79 million inpatient visits service, with 338,000 beds. The number of obstetrics, gynecology and pediatric beds in various medical institutions continues to increase. China's maternal and child health has entered a new era, with every woman, every child in every place could have access to quality medical and health care services. The principal contradiction in maternal and child health has been transformed into a contradiction between the growing health needs of women and children and the unbalanced and inadequate development of medical care services. Faced with new opportunities and challenges, women and children's workers all over the country have made great efforts to promote the all-round development of women and children health, promote the construction of a healthy China, and build a moderately prosperous society in all respects. Through decades of management consulting experience in over 700 medical institutions, as well as in the establishment and promotion practices, we first put forward the big-health service model of the maternal and child hospital (M&C hospital).

In order to further improve the management system of M&C hospital, strengthen party building, and accelerate the construction of a modern hospital management system with clear rights and responsibilities, scientific management, sound governance, efficient operation and strong supervision, it is necessary to establish an organizational structure matching it. The organizational structure of the hospital is not only characterized by diversity, but also dynamic adaptability. The strategic positioning of M&C hospital institutions determines the design and selection of organizational structure model. In turn, the implementation process and effect of M&C hospital strategy are restricted by the organizational structure.

To adhere to the work policy for M&C hospital, define the functional orientation of M&C hospital, and establish a new mechanism for the operation of big-health service model, it is essential to restructure the business units of M&C hospital, and to redefine the functions and tasks of each department. Otherwise, it is difficult to adapt to the development requirements of maternal and child health institutions in the new situation under the circumstances of unclear rights and responsibilities, ineffective implementation and unclear rewards and punishments. In addition to breaking the long-term separation between clinical practice and health care, the construction of the big-health service model of M&C hospital also reflects the change of thinking mode of development: from the highly integrated development mode of clinical practice and health care to a development model that regards full life cycle, tertiary prevention as social development responsibility. The change of development thinking mode determines the readjust of organizational structure. If the organizational structure is not readjusted in time, it will restrict the implementation of the strategic focus of maternal and child health service institutions.

1. Proposal and implementation of big-health service model in M&C hospital

This paper describes the combination of subjects through three latitudes: clinical, health care, and health, under the big-health service model and points out the direction for the development of M&C hospital.

Under the guidance of the big-health model of the M&C hospital, a functional positioning evaluation model was established. In line with the concept of full life cycle and tertiary prevention, focusing on primary and secondary prevention, we provide active, continuous physical and psychological services and management for women and children from birth to old age. Focusing on the health needs of women and children in different special periods, the quantitative evaluation system for improving maternal and child health services is supported by clinical diagnosis and treatment technology.

   
 


That is, through the definition of maternal and child health institutions throughout the life cycle of primary prevention, secondary prevention, tertiary prevention should be implemented specific work. To evaluate the implementation of functional positioning and the fulfillment of social responsibilities of maternal and child health care institutions through specific index scores. The functions of group screening, high-risk management, critical care management, rehabilitation management and defect control were highlighted through index weight. A reasonable organizational structure of maternal and child health institutions is the basis of fulfilling the tasks of maternal and child health.

2. The business department setting frame of maternal and child health service institution
In the past, health care department and clinical department were set to manage the business department, resulting in the health care and clinical separation of the internal management system, not only difficult to achieve the real combination of prevention and treatment, but also easy to appear heavy medical and light prevention

phenomenon. There are serious contradictions and conflicts between the old internal department setting and management system and the functional orientation of M&C hospital.

Detailed guidance is provided for the establishment of business departments and construction of specialty departments for M&C hospitals. in Guidelines on establishment of business departments of maternal and child health service institutions at all levels (no. 59 [2015] of the national health office for women and children), and Guidelines for the construction and management of maternal and child health care specialties (trial) (no. 113[2016] of notice of national health women's and children's health). 

3. Organization chart of MC hospital 
Maternal and child health service institutions vary in size and stage of development, which requires each maternal and child health service institution to 

dynamically adjust its organizational structure according to the little targets setting to achieve the strategic goal.


Introduction of Jian Di

Mr. Jian Di the chairman of JYWJ, is a certified management consultant in China. He is also the man of the year 2016 for management consulting and training, and the professional advisory committee member of Chinese women’s foundation. He has published 3 monographs based on the theory innovation of JYWJ, which are On Relations Between New Medical Reform Policies and Expand Domestic Demand, Destruction and Reconstruction of Hospital Culture, and Evaluation and Construction of Hospital Culture.
In 2017, Mr. Jian Di made speeches in both the ICMCI global meeting and Asia-Pacific meeting, as the representative of China.

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