基于闭环管理理论改善出院患者电话回访满意度的效果研究

Effect of feedback closed-loop management system on patient satisfaction

目的 在出院电话回访中应用闭环管理理论,提高回访满意度,持续改进护理质量.方法 2015年7-12月,每月对我院出院患者电话回访结果进行分析,汇总不满意事件、分析发生原因、提出改进措施并对改进措施落实进行追踪,对电话回访问卷形成闭环式管理,促进护理质量的不断提升.将2015年7-12月的电话回访结果与2015年1-6月的电话回访结果进行比较,以观察闭环管理理论对提高患者回访满意度的效果.结果 2015年上半年患者的回访满意度为91.77%（3657/3985）,下半年为95.76%（3610/3770）,将上半年和下半年患者的电话回访满意度进行比较,差异具有统计学意义（χ2=52.22,P〈0.01）.上半年回访的问卷中存在9项不满意项,即服务态度、入院介绍、生活照顾、解答疑问、护士操作、健康宣教、对患者的尊重、环境整洁、出院指导,各项的不满意发生率分别为2.11%（84/3985）、0.23%（9/3985）、0.35%（14/3985）、0.33%（13/3985）、0.30%（12/3985）、2.99%（119/3985）、0.33%（13/3985）、0.58%（23/3985）、2.58%（103/3985）.下半年回访的问卷中,以上9项不满意发生率分别为1.09%（41/3770）、0.05%（2/3770）、0.05%（2/3770）、0.08%（3/3770）、0.21%（8/3770）、0.64%（24/3770）、0.85%（32/3770）、0.21%（8/3770）、1.25%（47/3770）.将上半年和下半年的9项不满意项得分进行比较,结果显示8项差异具有统计学意义（χ2=4.084~59.088,P〈0.01或0.05）,1项即护士操作方面差异无统计学意义（χ2=0.596,P〉0.05）.结论 通过电话回访找到影响护理工作满意度的主要因素,应用闭环式管理理论对不满意事件进行管理,使护理质量得到持续改进,护理质量管理科学性及有效性增强.

Objective To apply the feedback closed-loop management systemin the telephone follow-up service for discharged patients to increase patient satisfaction and improve the quality of nursing. Methods From January 2015,telephone return visit to discharged patients were analyzed, a summary of dissatisfaction events, analyze the causes every month. Then,the improvement measures for nursing quality were put forward and the effects were evaluated to form a closed-loop management system. Results After the application of feedback closed-loop management system,there was a significant difference in patients＇ satisfaction with nursing service between the first half （with the incidence of 91.77%,3657/3985） and the second half （with the incidence of 95.76%,3610/3770） of 2015 （χ2=52.22, P 〈 0.01）. Of the 9 items of dissatisfaction recorded in the questionnaire, significant difference was observed in 8 items, as service attitude, hospitalizing education, personal care, question answering, nurse＇s operation, health education, respect, clean environment and the discharge instructions. The incidence of each item was 2.11%（84/3985）, 0.23%（9/3985）, 0.35%（14/3985）, 0.33%（13/3985）, 0.30%（12/3985）, 2.99%（119/3985）, 0.33%（13/3985）, 0.58%（23/3985）, 2.58%（103/3985） in the first half of 2015 respectively, compared to 1.09%（41/3770）, 0.05%（2/3770）, 0.05%（2/3770）, 0.08%（3/3770）, 0.21%（8/3770）, 0.64%（24/3770）, 0.85%（32/3770）, 0.21%（8/3770）, 1.25%（47/3770） in the second half of 2015 respectively （χ2=4.084-59.088,P〈0.01 or 0.05）. However, no significant difference was observed in the nurse operational between the first half （0.30%） and the second half （0.21%） in 2015 （χ2=0.596, P〉0.05）. Conclusions Feedback closed-loop management systemic a scientific management theory. It can increase patient satisfaction with nursing service,improve the quality of nursing,and make quality management more scientific and effective .