临床路径实施满意度对医疗服务质量的影响分析

Analysis of the impact of clinical pathway implementation satisfaction on medical ser vice quality

目的:从医方视角探讨临床路径实施满意度对医疗服务质量的影响机制,为医院质量管理实践提供理论参考。方法:采用临床路径实施满意度量表、工作投入量表、工作绩效量表、医务人员医疗服务质量量表,对四川7家三级公立医院1 557名医护人员进行问卷调查,应用SPSS 19.0进行统计分析。结果:医护人员临床路径实施满意度与工作投入(r=0.625,P<0.01)、工作绩效(r=0.615,P<0.01)及医疗服务质量(r=0.872,P<0.01)均显著正相关;医护人员临床路径实施满意度能够直接正向预测医疗服务质量(效应值=0.738),同时存在“临床路径实施满意度→工作绩效→医疗服务质量”(效应值=0.033)与“临床路径实施满意度→工作投入→工作绩效→医疗服务质量”(效应值=0.043)两条中介路径。结论:医护人员临床路径实施满意度在直接作用医疗服务质量的同时,还通过中介变量工作投入与工作绩效对医疗服务质量产生间接影响,提升医护人员临床路径实施满意度可以有效提升医疗服务质量。

Objective: To explore the influence mechanism of clinical pathway implementation satisfaction on medical service quality from the perspective of medical, and to provide theoretical reference for hospital quality management practice. Methods: A questionnaire survey was conducted on 1 557 medical staff in seven Grade III public hospitals in Sichuan by the clinical pathway implementation satisfaction scale, job engagement scale, job performance scale, and medical staff medical service quality scale, and SPSS 19.0 was used for statistics analyze.Results: The clinical pathway implementation satisfaction of medical staff was significantly positively correlated with job engagement(r =0.625, P <0.01), job performance(r =0.615, P <0.01) and medical service quality(r =0.872,P <0.01). Medical staff ?s clinical pathway implementation satisfaction can directly and positively predict the quality of medical services(effect size = 0.738), and there are "clinical pathway implementation satisfaction → job performance → medical service quality"(effect value = 0.033) and "clinical pathway implementation satisfaction →job engagement→job performance→medical service quality"(effect size=0.043) two mediating paths. Conclusion:The satisfaction of medical staff?s clinical pathway implementation not only directly affects the quality of medical services, but also indirectly affects the quality of medical services through intermediary variables job engagement and job performance. Improving the clinical pathway implementation satisfaction of medical staff can effectively improve the quality of medical services.