Effects of high-quality neurosurgical nursing care on improving clinical nursing quality

BACKGROUND With continuous advancements in medical technology,neurosurgical nursing is constantly developing and improving to provide higher-quality nursing services.AIM To explore the effects of different types of high-quality nursing care on clinical nursing quality and patient satisfaction in neurosurgical nursing.METHODS Eighty patients who received neurosurgical treatment in the Affiliated Hospital of Southwest Medical University from June to December 2020 were selected as study participants and categorised into study and control groups.The study group comprised 40 patients who received 4 different types of high-quality nursing care,whereas the control group comprised 40 patients who received conventional nursing care.After a specific period,nursing satisfaction levels and adverse event and complication rates were compared between the two groups.RESULTS Satisfaction with high-quality care was higher than that with conventional care,and high-quality health services and regional services showed the highest satisfaction levels,with an average score of 12 on the Glasgow scale.The satisfaction levels of the study and control groups were 75%and 57%,respectively,with a statistically significant difference(t=7.314,P<0.05).During the nursing period,the adverse event and complication rates were the highest in patients with level III pathology grade and those who underwent neurosurgery(40.02%and 85.93%,respectively),and the difference was statistically significant.CONCLUSION In neurosurgical nursing,employing appropriate high-quality nursing methods can effectively reduce adverse event and complication rates in patients,thereby improving the quality of nursing care and increasing clinical nursing value.

The impact of a computerized care records service (CRS) on doctors’ work patterns in urological outpatient clinics

Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.

Trends in outpatient breast cancer surgery among Medicare fee-for-service patients in the United States from 1993 to 2002

The practice of outpatient breast cancer surgery has been controversial in the United States. This study aimed to update time trends and geographic variation in outpatient breast cancer surgery among elderly Medicare fee-for-service women in the United States. Using the 1993-2002 linked Surveillance, Epidemiology and End Results (SEER)-Medicare claims data and the Area Resource Files, we identified 2 study samples, including the women whose breast cancers were the first-ever-diagnosed cancer at age 65 years or older from 9 regions continuously covered by the SEER registries since 1993. The first sample included the women receiving unilateral mastectomy for stage 0-IV cancer; the second included the women receiving the breast-conserving surgery with lymph node dissection (BCS/LND) for stage 0-II cancer. The proportions of patients receiving outpatient surgery increased from 3.2% to 19.4% for mastectomy and from 48.9% to 77.8% for BCS/LND from 1993 to 2002. We observed substantial geographic variation in the average proportion of the patients receiving outpatient surgery in the studied areas across the 10-year period, ranging from 3.9% in Connecticut to 27.2% in Utah for mastectomy and from 54.7% in Hawaii to 78.1% in Seattle, Washington, for BCS/LND. As the popularity of outpatient breast cancer surgery continues to grow, more evidence-based analyses related to quality and outcomes of outpatient breast cancer surgery among various populations are needed in order to facilitate the public debates about state and federal mandated health benefit legislations.

Outpatient telephonic transitional care after hospital discharge improves survival in cirrhotic patients

BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our center, CP are now offered outpatient telephonic transitional care (OTTC) by a care coordinator for 30 d after hospital discharge. AIM To determine the effect of OTTC on survival in CP. METHODS In this cohort study from a tertiary center, CP who received OTTC formed the intervention group. They were compared with a control group discharged during the same period. Mortality and RR were compared between the groups. RESULTS After OTTC introduction, 194 CP were discharged. After applying exclusion criteria, 169 CP (51% male, mean age 58 years ± 12 years) were included. OTTC group comprised 76 patients and was compared with 93 controls. Baseline disease and index admission related characteristics were not significantly different between the groups. The intervention group showed significantly higher 6 mo survival compared to controls (84.2% vs 68.8%;P = 0.03), while RR at 1, 3, and 6 mo were comparable. On multivariable analysis, the intervention group showed lower odds for mortality compared to the controls (hazard ratio: 0.4;95% confidence interval: 0.2-0.82;P = 0.012), while higher model for endstage liver disease scores were associated with higher mortality (hazard ratio: 1.05;95% confidence interval: 1.01-1.1;P = 0.024).CONCLUSION CP provided OTTC had higher 6 mo survival compared to controls without a difference in RR. Use of RR to gauge quality of care provided during hospitalization or subsequent transitional care programs should be revisited.

Impact of Pharmaceutical Care on Self-Administration of Outpatient Low-Molecular-Weight Heparin Therapy

Outpatient subcutaneous (s.c.) therapies are becoming more and more common in the treatment of different diseases. The effectiveness of community-pharmacy-based interventions in preventing problems that arise during s.c. self-injections of low-molecular-weight heparins (LMWH) is unknown. Our objective was to provide a standard operating procedure (SOP) for community pharmacists and to compare pharmaceutical vs. standard care in both clinical and daily life settings. We hypothesized that: pharmaceutical care results in improved adherence, safety, and satisfaction, and in fewer complications;the interventions used are feasible in daily life;and the results achieved in clinical and daily life settings are comparable. In the clinical setting (randomized controlled trial), patients were recruited sequentially in hospital wards;in the daily life setting (quasi-experimental design with a comparison group), recruitment took place in community pharmacies by pharmacists and trained master students during their internship. Interventions were offered according to patient needs. Data were collected by means of a monitored self-injection at home and structured questionnaire-based telephone interviews at the beginning and the end of the LMWH treatment. The main outcome measures were: scores to assess patient’s skills;syringe count to assess adherence;and frequency, effectiveness, and patient’s assessment of received interventions. The results show a median age of the 139 patients of 54 years. Interventions resulted in improved application quality (p p = 0.03). Oral instructions were pivotal for improving patients’ application quality. We found no significant score differences between the intervention groups in the clinical and daily life settings. Patients’ baseline skills were high, with the lowest score being 0.86 (score range ?2.00 to +2.00). Adherence rate was high (95.8%). In conclusion, our SOP for pharmacist interventions was of good quality, adequate, appreciated, and feasible in daily life. Patients are capable of managing s.c. injection therapies if adequate assistance is provided.

The Introduction of Pharmaceutical Care in Psychiatric Outpatients in Community Pharmacy of the Northeast Region of Argentina

The purpose of this paper is to implement a pharmaceutical care program in psychiatric outpatients in a community pharmacy. Outpatients （536） with psychiatric treatment requiring the dispensing of medication prescribed by a psychiatrist were followed up in a community pharmacy, where different medicines were prescribed as PS （pharmaceutical specialties）, PC （pharmaceutical compounding） or both PS and PC. Each prescription was registered with details on a patient level. Also, three reporting sheets were designed： patients profile, patients monitoring and patients counseling. The total study population in the community pharmacy consisted of 536 outpatients： 357 （66.6%） females and 179 （33.4%） males. Most of the outpatients （78.5%） have health insurance, 50% correspond to public and 28.5% to private institution. The other patients （21.5%） do not have medical insurance. We also observed that the education level of these patients was： primary school 19.1%; high school 45.9%; college 15.3% and university 20.7%. Many patients had more than one psychiatric diagnosis, to whom were prescribed different medicines. All the medication studies on the charts were screened for prescriptions with antidepressants and other psychotropic drugs, starting on the date of first diagnosis made by a psychiatrist. The counseling to the patients was also registered. The possibility of the follow-up of these outpatients in the community pharmacy promoted the development of the psychiatric pharmacy and all advances in care for patients with mental health needs, working in closer collaboration with psychiatrists.

Outpatient Experience of Human Caring Scale （OEHC-Scale）： Improvement by Delphi Method

Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the scale by Delphi method. Sixteen experts in medical management, human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the DeLphi consultation questionnaires twice in the consulting round. In the first round, the recovery rate showing the experts＇ positivity was 80%; the coefficient of reliability （Cr） ascertaining the authority of the evaluation was 0.92; the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25%-93.75% respectively; the coefficients of variation （CV） and the Kendall＇s W determining the concordance of the evaluation were 5.06%-52.15% and 0.21-0.24 respectively. In the second round, the recovery rate was 93.75%; the Cr was 0.93; the mean was 3.93-4.93; the full mark ratios were 26.67%-93.33%; the Kendall＇s W was 0.14- 0.31, the CV was 5.25%-23.61%. Via the two-round Delphi study, the scale that included 10 dimensions and 61 items has been improved. Ten dimensions are pre-hospital medical service, guidance, registration, waiting, diagnosis ＆ treatment, paying, inspection ＆ assay, medicine receiving, therapy/injection/transfusion and global evaluation. It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience. The experts have given high agreements about the dimensions which were established with Chinese outpatient process. The dimensions are different from the similar researches about outpatient experience study. In the future, it is necessary to survey the outpatients to test the construct validity, internal consistency reliability and others of the scale to improve the scale.

The patients’ opinion on the use of information technologies at the Seskine Outpatient Clinic and “Centro poliklinika” Outpatient Clinic of the city of Vilnius according to the age of patients

Objectives: The objective of this study is to assess patients’ opinion of the information technologies (IT) electronic registration systems at the “Centro poliklinika” and Seskine outpatient clinics in Vilnius City. Material and Methods: The survey was conducted in May-June, 2012. In the course of the primary survey, one questionnaire was handed out to one in tenth of the newly arrived patients. Total number of 650 questionnaires was distributed. 563 respondents participated in the survey (feedback rate—86.6%). Statistical analysis of data was performed by means of personal computer using SPSS software package. Results: 54.7% of respondents state that they make use of the possibility of online registration with the family doctor. 85.05% of respondents indicate that a doctor, when making the next appointment or referring to the medical specialist, registers a patient on site by means of computer. Upon arrival of a respondent to the reception desk of the medical establishment, 90.3% of respondents are registered by means of computer. 72.4% of respondents say that they have a choice to telephone and inquire about the time of visit if they have forgotten the visit time or lost the appointment sheet. Majority of respondents using the online registration option belong to the age group between 21 and 40 years—35.3%. Conclusions: Answers by the respondents and the breakdown between “Centro poliklinika” and Seskine outpatient clinics are very similar and no essential differences have been determined.

Study on the Effect of High-quality Nursing Combined with Breathing Exercises on Patients with Chronic Obstructive Pulmonary Disease

Objective:To study the effect of high-quality nursing combined with breathing exercises on patients with COPD.Methods:Using the random number table method of medical experiments,60 patients with COPD received in our hospital from March 2020 to March 2021 were used as research samples.According to the differences in treatment measures,they were equally divided into control group and intervention group.Symptomatic support treatment and nursing routine,high-quality nursing combined with respiratory function exercise treatment and nursing were given respectively,and the application effects of the two groups were compared and analyzed.Results:The controllable rate of disease between the intervention group and the control group was 93.33%(28/30)and 66.67%(20/30)respectively,which was statistically significant(P<0.05).The comparison between the intervention group and the control group on the pulmonary function indexes of VT,TPTEF/Te,VEF/Te/,Ti/Te was statistically significant(P<0.05).The results of the intervention group on exercise pulse and 6-minute walking distance were significantly higher than those of the control group(P<0.05).Conclusions:The combination of high-quality nursing care and breathing exercises has outstanding disease controllable rate in patients with COPD,especially in improving the lung function of the patients and the level of treatment and care.It can be used as a feasible measure in the subsequent clinical treatment and nursing practice of patients.It is worthy of clinical promotion and implementation.

Effect of High-Quality Nursing on Patients with Hemorrhagic Fever with Renal Syndrome

Objective:To explore and analyze the effect of high-quality nursing on patients with epidemic hemorrhagic fever with renal syndrome.Methods:Ninety patients with epidemic hemorrhagic fever with renal syndrome treated in Huyi District People’s Hospital from October 2021 to January 2022 were randomly divided into an experimental group and a control group,with 45 cases in each group.The control group received routine nursing and the experimental group received high-quality nursing.The effect of routine nursing and high-quality nursing were compared and analyzed based on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),the degree of satisfaction with nursing care,and the patients’quality of life.Results:Before nursing,there was no significant difference in the patients’psychological state between the two groups(P>0.05);after nursing,there was significant difference in the patients’psychological state between the two groups(P<0.05);the degree of satisfaction with nursing care of the experimental group was significantly higher than that of the control group(P<0.05);comparing the quality of life of the two groups,the quality-of-life score of the control group was significantly lower than that of the experimental group(P<0.05).Conclusion:For patients with epidemic hemorrhagic fever with renal syndrome,high-quality nursing can significantly and effectively improve their psychological state,level of satisfaction with nursing care,and quality of life.

Importance of labelling and patient knowledge to ensure proper care during drug dispensing: A case study from a tertiary hospital in Ethiopia

Correct drug labelling is central for ensuring proper drug dispensing and thus for patient safety. Labelling errors may result in adverse health outcomes. The objective of this study was, therefore, to assess the effect of labelling on the quality of drug dispensing and patient knowledge about dispensed drugs in Jimma University model and specialized hospital outpatient Pharmacies. Individual packages with prescribed drugs were examined using pretested questionnaire and observational check lists during the dispensing process. Patients’ knowledge about drugs dispensed to them was assessed at the exit interview using a pretested questionnaire. Out of 743 prescribed drugs, 682 (91.8%) were dispensed to 426 patients. The average labelling score (range from 0 to 6) of dispensed drugs in Model and Outpatient pharmacy was 2.00 (95% CI 1.97 to 2.04) and 1.73 (95% CI 1.6 to 1.8) respectively, with overall average labelling score of 1.90 (95% CI 1.84 to 1.91). The average patient knowledge score (range from 0 t0 5) was 3.45 (95% CI 3.31 to 3.59) and 3.5 (95% CI 3.35 to 3.64) for model and outpatient pharmacy, respectively, while the overall average knowledge score was 3.46 (95% CI 3.37 to 3.57). Major labelling problems were absence of patient’s name and dose followed by frequency of administration, duration of treatment, and the reason for prescription. Literacy status of patients had a significant effect on their knowledge (p 0.05). We recommend that corrective measures targeting both, labelling and patients’ knowledge should be implemented to improve the patients’ safety and drug therapy adherence.

Heart Failure: Organization of Care after Hospitalization at the Abidjan Cardiology Institute

Introduction: The care pathway for heart failure (HF) patients is poorly documented in sub-Saharan Africa. A multidisciplinary management reduces hospitalizations and mortality. In our context of frequent rehospitalization of heart failure patients, the objective of this study was to analyse the post-hospital follow-up health care. Methods: We conducted a prospective study in the medical department of a Heart Institute from January 1st to December 31, 2015. Patients over 18 years of age, hospitalized for heart failure, consenting and followed up on an outpatient basis for 2 years were included. Results: We collected 396 patients hospitalized for HF. The mean age was 57.4 ± 16 years with a male predominance (59.3%). Retired and unemployed people represented 27% and 16.2% respectively. During the post-hospitalization follow-up, patients who were regularly followed up represented 10.8% of the cases. 74.1% of the cases were regular patients. Patients were not followed up by the usual practitioner (58.2%). Only 94 patients had undergone a cardiovascular rehabilitation programme, of which 21.3% for exercise rehabilitation and 78.7% for therapeutic education. Patients who had attended titration sessions (n = 59) had reached optimal doses of ACE inhibitors, ARB II and beta blockers in 67.8%, 7.3% and 38.5% respectively. The rates of decompensation (73.3%) and rehospitalization (49.5%) were higher. The paraclinic check-up (ECG, X-ray, Cardiac Doppler ultrasonography, Biology) was rarely requested. The probability of survival was higher in patients regularly monitored than in those irregularly monitored. Conclusion: The organisation of care and coordination between professionals should be structured or planned. Therapeutic strategies need to be intensified in order to optimise their long-term benefits.

基于专家咨询法的公立医院门诊药学服务评价体系构建研究

目的:构建门诊药学服务的三级评价指标体系,并确定各级指标的权重。方法:通过文献回顾、运用结构-过程-结果(SPO)模型、德尔菲专家咨询法,研究公立医院门诊药学服务评价指标。结果:最终入选的15名咨询对象均为各自领域的专家,两轮专家咨询结果趋于一致,咨询专家意见集中,结果可信度高,专家积极程度达93.33%(14名专家提出各自的修改意见),权威系数为0.880,指标重要性赋值均数均>3.5分,而变异系数则<0.25。结论:经过两轮专家咨询,建立了公立医院门诊药学服务三级评价指标体系,其中,一级指标3个,二级指标10个,三级指标39个,并赋予各指标权重。

门诊、日间和住院3种不同模式宫腔镜手术的比较

目的探讨门诊、日间和住院3种不同模式的宫腔镜手术的安全性和宫腔镜的管理模式。方法通过查阅复旦大学附属妇产科医院电子信息化系统和宫腔镜中心每个月的质控报表,回顾性分析2019年1月至2021年12月本中心门诊、日间和住院宫腔镜的手术量、Ⅳ级手术占比、手术种类分析、并发症、计划外二次手术等数据。结果2019—2021年共纳入门诊宫腔镜患者5162例、日间宫腔镜患者15331例、住院宫腔镜患者5942例。住院宫腔镜患者年龄大于门诊、日间患者,差异有统计学意义(P<0.001)。日间宫腔镜的比例逐渐升高,住院宫腔镜比例逐渐下降(P均<0.001)。Ⅳ级宫腔镜手术占比12.9%,其中住院高于日间、日间高于门诊(P均<0.001)。宫腔镜术中并发症和意外发生率为0.117%(31/26435),包括子宫穿孔17例、宫腔镜失败7例、术中大出血3例、液体超负荷2例、肠道损伤1例、麻醉意外1例。其中门诊、日间、住院宫腔镜发生率分别为0.020%(1/5162)、0.137%(21/15331)、0.151%(9/5942)。结论门诊、日间和住院3种不同模式宫腔镜手术均安全可靠。门诊、日间宫腔镜可提高医疗服务效能,逐渐成为趋势。

门诊患者人文关怀管理规范质量评价量表的构建及信效度检验

目的构建门诊患者人文关怀管理规范质量评价量表并检验信效度。方法参考中国生命关怀协会发布的团体标准《门诊患者人文关怀管理规范》,以及相关指南及文献,形成门诊患者人文关怀管理规范质量评价量表条目池,并经专家函询和专家论证构建门诊患者人文关怀管理规范质量评价量表。于2024年1月—2月选取郑州市5家医院的243名医院管理者作为调查对象,对量表进行项目分析和信效度检验。结果分别进行2轮专家函询和2轮专家论证,问卷回收率分别为92.00%和100.00%,专家权威系数均为0.952。第2轮专家函询量表一级指标的重要性均分为4.80~5.00分,满分比为88.00%~100.00%,变异系数为0.04~0.17,肯德尔和谐系数为0.857(P<0.001);二级指标的重要性均分为4.60~5.00分,满分比为80.00%~100.00%,变异系数为0.00~0.21,肯德尔和谐系数为0.775(P<0.001);三级指标的重要性均分为4.60~5.00分,满分比为76.00%~100.00%,变异系数为0.00~0.21,肯德尔和谐系数为0.830(P<0.001)。最终形成包括5个一级指标、25个二级指标、58个三级指标的门诊患者人文关怀管理规范质量评价量表。探索性因子分析产生5个公因子,累计方差贡献率为74.628%。5个因子得分之间的Pearson相关系数为0.648~0.798,各因子得分与量表总分之间的相关系数为0.784~0.938。量表平均内容效度指数(S-CVI)为0.945,条目内容效度指数(I-CVI)为0.725~1.000,总量表的Cronbach’sα系数为0.973,重测信度系数为0.934。结论构建的门诊患者人文关怀管理规范质量评价量表具有较好的科学性和可靠性,可作为门诊患者人文关怀管理规范质量评价的测评工具。

三级综合医院门诊护士人文关怀现状、影响因素及其与情绪智力、职业认同的相关性

目的 探讨综合医院门诊护士人文关怀现状,并分析其影响因素。方法 采用方便抽样的方法,选取2021年2—3月某三所三级综合医院门诊护士226例为研究对象。应用一般资料调查表、护士人文关怀量表、情绪智力量表及护士职业认同量表对其进行调查并分析其影响因素。结果 226例综合医院门诊护士人文关怀得分(113.23±15.14)分,情绪智力得分(117.97±11.79)分,职业认同得分(106.49±21.65)分;综合医院门诊护士人文关怀总分及各维度评分均与情绪智力、职业认同总分及各维度评分呈正相关(P<0.01);情绪智力、职业认同及职称是人文关怀的主要影响因素(P<0.01),共解释总变异的40.3%。结论 综合医院门诊护士人文关怀现状总体处于中等水平,而情绪智力、职业认同及职称是影响综合医院门诊护士人文关怀水平的主要因素。护理管理者应关注门诊护士人文关怀水平,制定针对性培训计划,以提高门诊护士群体的人文关怀水平。

基于行为诱导法的个性化心理护理结合家属赋权干预对学龄期毛细支气管炎门诊雾化吸入治疗患儿医疗恐惧及配合度的影响

目的探讨基于行为诱导法的个性化心理护理结合家属赋权干预在学龄期毛细支气管炎门诊雾化吸入治疗患儿中的应用效果。方法选取2020年9月至2022年3月我院收治的90例学龄期毛细支气管炎门诊雾化吸入治疗患儿为研究对象,以随机数字表法将其分为对照组和观察组,各45例。对照组采用常规护理,观察组采用基于行为诱导法的个性化心理护理结合家属赋权干预。比较两组的干预效果。结果干预后,观察组的医疗恐惧调查量表(CMFS)各维度评分均低于对照组(P<0.05)。观察组的配合度优良率高于对照组(P<0.05)。干预后,观察组的呼吸频率(RR)、功能残气量(FRC)低于对照组,潮气量(TV)高于对照组(P<0.05)。结论基于行为诱导法的个性化心理护理结合家属赋权干预可减轻学龄期毛细支气管炎门诊雾化吸入治疗患儿的医疗恐惧感,提高其配合度,也能促进患儿肺功能改善,值得临床推广应用。

门诊患者膝关节腔注射治疗中应用专科护理小组多学科合作模式的效果分析

目的:分析在门诊患者膝关节腔注射治疗中应用专科护理小组多学科合作模式的效果。方法:选取2020年6月—2021年3月于苏北人民医院门诊注射室行膝关节腔注射治疗的260例患者作为研究对象,将2020年6—10月的130例患者设为对照组,2020年11月—2021年3月的130例患者设为观察组。对照组实施常规护理,观察组建立专科护理小组并实施多学科合作模式。比较两组护理效果。结果:观察组穿刺失败、穿刺部位感染、疼痛加剧、残肢血运障碍及并发症总发生率高于对照组,差异有统计学意义(P<0.05)。观察组满意率高于对照组,差异有统计学意义(P=0.043)。结论:门诊患者膝关节腔注射治疗中建立专科护理小组的效果显著,能够降低并发症发生率,提高患者满意度,值得临床应用并予以推广。

三级公立医院绩效考核背景下门诊医疗服务质量提升的实践效果研究

目的通过对内蒙古医科大学第二附属医院三级公立医院绩效考核实施前后门诊医疗服务质量进行对比,分析三级公立医院绩效考核对医院门诊医疗服务质量的影响,并提出改进措施。方法筛选三级公立医院绩效考核实施后2022年1月1日至12月31日及三级公立医院绩效考核实施前2018年1月1日至12月31日的门诊医疗服务质量的门诊运营、门诊预约管理、患者等候时间、门诊医疗安全和患者评价指标,分析三级公立医院绩效考核实施前后门诊医疗服务质量的差异。结果三级公立医院绩效考核实施后门诊总量同比增加11.8%,专家门诊量同比增加63.7%,普通门诊量同比下降45.7%,差异有统计学意义(P<0.05);线上预约挂号数同比增加46.4%,分时段就诊数同比增加41.0%,按时就诊数同比增加43.0%,退号数同比下降95.3%,差异有统计学意义(P<0.05);患者等候时间也都有所降低,差异有统计学意义(P<0.05);门诊医疗安全比较,差异无统计学意义(P>0.05),但是门诊医疗安全管理在逐步完善;门诊患者满意度也有显著提高。结论三级公立医院绩效考核是将各项服务质量进行量化管理,对提升医院门诊服务质量有显著效果。

基于移动互联网的门诊医疗管理与服务创新研究

目的分析基于移动互联网的门诊医疗管理的应用价值及服务创新。方法选取2019年1月—2022年12月四川大学华西医院门诊20名医务人员为研究对象,按照管理模式不同将医务人员分为对照组(n=10,传统管理模式)和研究组(n=10,移动互联网门诊医疗管理模式),并选取同一时期入院诊疗的100例患者为观察主体,两组各50例。比较两组患者管理前后缴费时间、住院预约时间、退换号率、投诉率、门诊各科室医务人员满意度。结果研究组住院缴费时间、住院预约时间短于对照组,差异有统计学意义(P均<0.05);研究组退换号率与投诉率低于对照组;研究组医务人员满意度为90.00%(9/10),高于对照组的80.00%(8/10),差异有统计学意义(P=0.048)。结论基于移动互联网的门诊医疗管理与服务创新模式的构建可缩短缴费时间与住院预约时间,提高医务人员满意度。