会诊双向评价在会诊管理中的应用

Application of Two-way Consultation Evaluation in Consultation Management

目的 了解会诊质量及影响因素,为加强会诊管理,落实会诊制度提供科学依据。方法 通过HIS系统电子会诊功能采集2020年1月1日至2021年6月30日对邀请会诊方评价表31551份及对受邀方双向评价表18891份,采用秩和检验对满意度、意见实用性、及时性、指征把握等评价指标进行分析。结果 对会诊医师总体满意度95%以上,患者对其他科会诊医师满意度高于对内科会诊医师的满意度,具有显著性差异(p<0.001);总体会诊及时率90.98%,内科会诊及时率低于外科、儿科、及其他科,差异有统计学意义(p<0.001);会诊意见实用性均在95%以上,其他科会诊意见实用性评价高于内科,有统计学差异(p<0.001);申请会诊指征符合率高于95%,外科、儿科、其他科的会诊申请指征高于内科,妇产科会诊指征把握情况低于内科,有统计学差异(p<0.013);紧急会诊指征符合率96.96%,妇产科及其他科申请紧急会诊指征符合率低于内科差异有统计学意义(p<0.001)。结论 双向评价可以反映不同科室在会诊满意度、意见实用性、及时性、指征把握的差异性,可以帮助医疗质控管理部门分析、发现不同科室在会诊过程中所存在的问题。

Objectives To understand the quality and influencing factors of the consultation, and provide a scientific basis for strengthening the consultation management and implementing the consultation system. Methods The electronic consultation function of HIS system was used to collect 31,551 evaluation forms for invited consultants and 18,891 two-way evaluation forms for invited consultants from January 1st, 2020 to June 30th, 2021. Rank sum test was used to analyze the evaluation indexes of satisfaction, practicality, timeliness and indication grasp. Results Overall satisfaction with consultants was more than 95%, and patients’ satisfaction with consultants in other departments was higher than that of consultants in internal medicine, with a significant difference(P<0.001).The overall consultation timeliness rate was 90.98%,The consultation timeliness rate of internal medicine was lower than that of surgery,pediatrics and other departments, and the difference was statistically significant(P<0.001). The practicality of consultation opinions was above 95%, and the practicality evaluation of consultation opinions in other departments was higher than that in internal medicine, with statistical difference(P<0.001). The consultation application indication coincidence rate was higher than 95%, the consultation application indication of surgery, pediatrics and other departments was higher than that of internal medicine, and the consultation indication grasp of obstetrics and gynecology was lower than that of internal medicine, with statistical difference(P<0.013). The conformity rate of emergency consultation indication was 96.96%, the conformity rate of obstetrics and gynecology and other departments was lower than that of internal medicine, and the difference was statistically significant(P<0.001). Conclusions Two-way evaluation could reflect the differences in consultation satisfaction, practicality, timeliness and indication of different departments, and could help the medical quality management departments to analyze and find the problems existing in different departments in the consultation process.