基于患者流量探索门诊护士固定岗与动态岗管理模式的应用效果

Exploring the effectiveness of outpatient nurses′fixed post and dynamic post management model based on patient flow

目的通过分析门诊患者流量,探索门诊护士固定岗与动态岗联合管理模式的应用效果。方法调取HIS系统2017年3月至2018年2月期间聊城市第二人民医院门诊各护理科室在每月、每天不同时段的患者流量数据,分析其变化规律。打破原有的排班模式,门诊所有护理科室岗位优效组合、搭配排班,固定岗与动态岗相结合的模式:各科室根据工作特点选出部分人员组成门诊动态岗,轮转排班;同时根据门诊流量比例改革绩效。比较排班模式改变前后人力资源利用情况、高峰时段患者等候时间、投诉及护理差错发生次数、护患满意度。结果排班模式改变后,节约护士约1.60人;抽血室、输液室高峰时段患者等候时间分别从(16.40±6.36)min缩短至(7.31±2.31)min、从(26.26±7.08)min缩短至(12.44±3.88)min,差异有统计学意义(P<0.01);投诉及护理差错发生次数由13降到1例;患者满意度从86.56%上升到98.43%,护士自我评价满意度从66.67%上升到97.91%,差异有统计学意义(P<0.01)。结论门诊各护理科室固定岗与动态岗相结合排班模式是一项合理利用人力资源的有效措施,在持续推动门诊优质护理服务中发挥了积极的促进作用。

Objective To explore the application effect of the joint management model of fixed and dynamic posts of outpatient nurses by analyzing the outpatient flow.Methods To retrieve the patient flow data of each nursing department in the outpatient clinic of this hospital from March 2017 to February 2018 in different time periods of each month and day,and analyze its change pattern.The original scheduling model was broken,and all nursing department positions in the outpatient clinic were combined in an optimal and efficient way,with a combination of fixed and dynamic posts:each department selected some personnel to form dynamic posts in the outpatient clinic according to their work characteristics and rotated their shifts;at the same time,the performance was reformed according to the proportion of outpatient flow.Compare the utilization of human resources,waiting time of patients during peak hours,number of complaints and nursing errors,and satisfaction of nurses and patients before and after the change of scheduling mode.Results After the change of scheduling pattern,about 1.6 nurses were saved;the waiting time of patients during peak hours in the phlebotomy and infusion rooms was shortened from(16.40±6.36)min to(7.31±2.31)min,and from(26.26±7.08)min to(12.44±3.88)min,respectively,with statistically significant differences(P<0.01);the number of complaints and nursing errors decreased from 13 to 1 case;patient satisfaction increased from 86.56%to 98.43%,and nurse self-evaluation satisfaction increased from 66.67%to 97.91%,the difference was statistically significant(P<0.01).Conclusion The combination of fixed post and dynamic post scheduling model in each nursing department of outpatient clinic is an effective measure to rationalize the use of human resources,and has played a positive role in promoting quality nursing service in outpatient clinic.