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Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study

机译:减少中国公立三级综合医院的等待时间并提高门诊满意度-中断时间序列研究

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Background It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. Methods We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0 . 05. Results The monthly average length of waiting time decreased 3 . 49?min ( P =?0 . 003) for consultations and 8 . 70?min ( P =?0 . 02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions ( P =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services ( r =??0 . 71, P =?0 . 004). Conclusions The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This case provides a model of carrying out continuous quality improvement and optimizing management process with the support of relevant evidence.
机译:背景技术全球公认,设计良好的医疗系统可为所有患者提供及时,便捷的医疗服务。中国公立三级医院已经采取了许多旨在减少等待时间的干预措施,以提高患者的满意度。但是,很少有文献记载,而且很少使用健壮的方法来评估效果。方法我们对华南一家公立三级医院的轮候时间进行了纵向研究,该医院开发了综合的数据收集系统。在2014年10月至2017年2月期间,平均每月约有60,000名门诊患者和70,000名指定门诊患者为研究对象。我们使用分段线性回归模型分析纵向时间序列数据,以评估住院前后的等待时间水平和趋势变化。引入减少等待时间的干预措施。进行Pearson相关分析以表明等待时间和患者满意度之间的关联强度。统计显着性水平设置为0。 05.结果每月平均等待时间减少3。 49?min(P =?0.003)进行咨询和8?min。引入相应干预措施后的相应月份中,以70?min(P =?0.02)进行开处方。填充处方的趋势从基线略有增加转变为事后显着减少(P = 0.003)。服药的等待时间与门诊对药房服务的满意度之间存在显着的负相关性(r = ?? 0。71,P =?0.004)。结论福建省立医院为减少等待时间和提高患者满意度而采取的干预措施是有效的。由于精心设计的持续努力而不是一次性的运动,并且由医院管理者授权的工作组实施了适当的激励措施,因此观察到对服药处方等待时间的持久减少效果。该案例提供了在相关证据支持下进行持续质量改进和优化管理流程的模型。

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