三级医院入院流程的现状调查和对策研究

Status survey and countermeasure study of admission process in tertiary hospitals

目的探讨三级医院入院流程服务效率的影响因素,为医院开展患者入院流程优化与再造工作,提高入院流程效率和入院患者满意度提出参考意见。方法采用现场调查方式,于2015年6—12月对入院患者进行调查,共发放205份调查问卷,观察医院工作人员和患者的行为情况,采用自拟满意度调查表,分层抽样和调查入院患者的满意及其期望情况。所有数据采用χ2检验、t检验、方差分析和线性回归等方法进行分析,计量资料两两比较采用LSD法,P<0.05为差异有统计学意义。结果不同年龄、文化程度、住院次数、陪护人员患者的总体满意度比较,差异均有统计学意义(均P<0.05)。58.2%(113/194)的患者能够接受5~15 min内办理完入院,34.0%(66/194)的患者希望入院流程的时间控制在5 min以下,7.7%(15/194)的患者能够接受15~30 min内办理完入院。线性回归分析显示,文化程度、住院次数和陪同人员为总满意度的影响因素。结论从门诊医患的沟通方式、医院信息管理系统的顶层设计、建筑布局和医院标识导向系统、入院患者陪同和岗位工作规范等方面强化管理,可提高患者入院的满意度和流程效率。

Objective To investigate the influential factors of tertiary hospitals admission process service efficiency, and to provide forward suggestion for carrying out the admission process optimization and reengineering work for the hospital admission, improving process efficiency and hospital patient satisfaction. Methods Hospitalized patients were investigated from June to December in 2015 by field investigation, a total of 205 questionnaires were sent out, behavior condition of hospital staff and patients was observed, self-satisfaction questionnaire was used, satisfaction and its expectation of hospitalized patients were investigated by stratified sampling. All data was analyzed by chi square test, t test, variance analysis and linear regression analysis, pairwise comparison of measurement data was used by LSD, P〈0.05 was considered statistically significant. Results The satisfactions of subjects in different age, educational level, times of hospitalization, nursing staff were statistically significant（all P〈0.05）. 58.2% （113/194） of patients received 5-15 min for admission, 34.0% （66/194） of patients hoped the time of admission process was 〈5 rain, 7.7% （15/194） of patients received 15-30 min for admission. Linear regression analysis showed that the influence factors of overall satisfaction were degree of education, hospitalized times and the accompanying person. Conclusion The managements of outpatient department of the doctor-patient communication, top-level design of hospital information management system, architectural layout and hospital sign guidance system, patients accompanied and working standard should be strengthened, then the satisfaction and process efficiency of hospital patients can be improved.