目的 为了解决公立医院固定资产管理中存在的"管不清、管不好、用不好，重采买，轻管理"等主要问题，对公立医院固定资产管理进行探索。方法 以约束理论(theory of constraints，TOC)为核心指导思想，结合现状分析，借助问卷调查、实地调研等方式寻找公立医院固定资产管理问题的关键影响因素。结果 以问题为导向，重点从完善制度流程、系统有效使用、管理队伍建设、健全绩效考核及创新工作机制"五个关键环节"入手，构建了公立医院固定资产精益管理体系，固定资产日常规范高效管理、制度体系不断健全、管理队伍初步建成、动态管理基本实现。结论 医院探索固定资产全生命周期管理，可有效提高公立医院固定资产精细化管理水平，确保国有资产的安全完整和有效使用。
TOC theory-based lean management of fixed assets in public hospitals:taking R hospital as an example
Objective In order to address the major issues in fixed assets management for public hospitals like"unclear management boundaries,poor management,improper utilization,and placing greater emphasis on purchasing rather than manage-ment"this paper delved into the management of fixed assets in public hospitals.Methods The Theory of Constraints(TOC)was used to guide the study.In conjunction with a current situation analysis,the key factors influencing fixed assets management in public hospitals were identified using a questionnaire survey as well as field investigation.Results By adopting a problem-sol-ving approach and focusing on the"five key elements"of refining institutional processes,optimizing system utilization,develo-ping team management,establishing effective performance evaluation,and implementing innovative work mechanisms,a lean management system for fixed assets in public hospitals was developed.This system ensured the efficient and standardized daily management of fixed assets,continual enhancement of institutional frameworks,initial formation of management teams,and the fundamental establishment of dynamic management practices.Conclusion Hospitals explore comprehensive life-cycle manage-ment of fixed assets,effectively elevating the level of refined management of fixed assets and ensuring the secure integrity and effi-cient utilization of state-owned assets.
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