精益管理在优化围生期医疗和护理服务质量中的应用

Application of lean management in optimizing the quality of perinatal medical care and nursing services

目的分析精益管理的模式在围生期门诊管理的应用与效果。方法对2015年1月-2016年12月完成产检的孕妇进行满意度和就诊体验调查。对照组为实施精益管理前,2015年1-4月期间,按孕产妇保健手册单号随机抽取的产检孕妇2914例,实验组为实施精益管理后,2015年5月-2016年6月期间,按孕产妇保健手册单号随机调查的产检孕妇2363例。采用例数和率对分类资料进行统计,采用卡方检验分析实验组与对照组满意度的差异。结果实施精益管理后调查对象对护士技术与服务态度、对医务人员沟通服务的满意度、对医务人员诊疗技术的满意度、对医疗全过程的满意度分别为85.6%、83.7%、88.5%和88.5%,均高于实施精益管理前对照组的满意度,且差异有统计学意义(P<0.001)。实施精益管理后有84.6%的患者可以根据病情选择医生,按预约时间准时看诊的比例明显增高,实施前后差异有统计学意义(P<0.001)。结论将精益管理的理念与方法运用到围生期诊疗和护理服务中,可以显著提高服务质量和效率,提高就诊患者满意度。

Objective To analyze the application and effect of lean management mode in perinatal outpatient management.Method Satisfaction and the patient experience survey were conducted during January 2015 to December 2016.In the control group,2,914 pregnant women who underwent antenatal examination in our hospital were randomly selected according to the order number of maternal health manual from January 2015 to April 2015 before the implementation of lean management.After the implementation of lean management,2,363 pregnant women who underwent antenatal examination in our hospital were randomly investigated according to the order number of maternal health manual from May 2015 to June 2016 were selected in the experimental group.The number and rate of pregnant women were used to count the classified data.Chi-square test was used to analyze the difference of satisfaction between the experimental group and the control group.Result After the implementation of lean management,the respondents’satisfactions with nurses’technology and service attitude,medical staff communication service,medical staff diagnosis and treatment technology and the whole medical process were 85.6%,83.7%,88.5%and 88.5%,respectively.These satisfactions were higher than those of the control group,and the difference was statistically significant(P<0.001).After the implementation of lean management,84.6%of the patients could choose a doctor according to their health conditions,and the proportion of the patients who went to see the doctor on time by appointment was significantly increased,and the difference was statistically significant(P<0.001).Conclusion Lean management can significantly improve the quality and efficiency of perinatal medical care and nursing service,and also helps improve the satisfaction of patients.