我国医护人员对改善医疗服务行动计划的认知与参与情况调查

Survey of providers＇ awareness and implementation of the National Healthcare Improvement Initiative in China

目的了解医护人员对《进一步改善医疗服务行动计划》（以下简称＂行动计划＂ ）的认知与执行情况，探讨医疗服务质量改进的相关因素。方法通过对＂行动计划＂的知晓程度、流程和环境、以患者为中心、工作效率4个维度进行问卷设计，选取全国31个省、自治区、直辖市和新疆生产建设兵团的136所三级医院，按照职称比例对各样本医院抽取一定数量的医生和护士，运用描述性和非参数检验等方法，了解医护人员对＂行动计划＂的认知和执行情况。结果85.4%的医护人员知道本院正在开展＂行动计划＂ ；超过97%的医护人员称自己能够做到以患者为中心，具体体现在诊疗前严格执行查对制度、严格执行洗手制度、保护患者隐私、安慰患者。66.4%的医护人员认为有足够时间与患者沟通，33.4%的医生与患者沟通时间为10-20分钟，28.9%超过20分钟。结论＂行动计划＂得到医疗机构及医护人员的广泛认同，＂以患者为中心＂的医疗服务得以贯彻实施，但与患者的沟通时间等方面仍需改进。

Objective To gauge into provider＇ s knowledge of and participation in the （Shma Healthcare Improvement Initiative （the Initiative）and into factors for improvement quality of care. Methods The questionnaire was designed based on such dimensions as awareness of the Initiative, procedures and environment, patient centering and work efficiency. Doctors and nurses were randomly sampled from 136 tertiary hospitals in China＇s 31 provinces, and were surveyed with their awareness and implementation of the Initiative by means of descriptive and non-parameter test methods. Results 85.4% of the doctors and nurses surveyed knew about the Initiative being launched at their hospital. Over 97% of the subjects said they provided patient-centered care, as evidenced in strict observation of the checkup regulations and the hand-washing regulations before medical service; protection of patient＇s privacy, and patient＇s comforting. 66.4% of them said to spend sufficient time in communicating with patients, as evidenced in 33.4% of the doctors communicating 10--20 minutes and 28. 9% over 20 minutes for an average clinical encounter. Conclusions The Initiative is warmly embraced by medical institutions and providers at large, and ＂patient-centered＂ service is well implemented, yet further improvement is needed in such aspects as effective communication with patients.