基于质量功能展开改进急诊医疗服务质量

目的准确识别急诊患者关键需求，针对性提出医疗服务质量改进措施，提升患者满意度。方法对某院50位急诊患者针对服务需求进行问卷调查,以质量功能展开（QFD）为基础,借鉴SERVQUAL服务质量五维度并利用亲和图（KJ）法将患者需求层次化,采用0-1度对比表确定患者需求重要度，创建急诊医疗服务质量屋,构建患者质量需求与服务质量改进要素的二维关系矩阵。结果急诊医疗服务质量改进要素重要度前6位依次为:（1）完善重点病种服务流程与规范；（2）加强医德医风建设；（3）急诊医务人员经过专业培训掌握急诊相关理论与技能；（4）落实首诊负责制；（5）加强急诊预检分诊，有效分流患者；（6）建立院前急救、院内急诊与住院或转诊的连贯性医疗服务流程。对此，提出并实施相应改进措施。改进后，急诊患者平均滞留时间较前明显缩短，满意度较前明显提升（P均<0.05）。结论运用QFD能确定影响急诊医疗服务质量的关键因素, 为医院管理提供依据和改进方向, 从而提升医疗服务质量。

Improvement of the Quality of Emergency Medical Service Based on Quality Function Deployment

ObjectiveTo accurately identify emergency patients' critical needs, and put forward purposeful measures to promote the quality of medical service to improve patients' satisfaction.MethodsA questionnaire survey was carried out on 50 emergency patients in a hospital. Based on Quality Function Deployment (QFD), the five dimensions of service quality of SERVQUAL were used for reference and the affinity diagram (KJ) method was used to classify patients' needs. The 0-1 degree comparison table was used to determine the importance of patients' needs. The house of quality of emergency medical service was established, and the two-dimensional relational matrix of patients' quality demands and service quality improvement factors was constructed.ResultsThe top six important factors of improving the quality of emergency medical service were listed as follows: (1) to refine the service process and specification aiming at main diseases; (2) to strengthen the construction of medical ethics and moral; (3) to help medical staff in emergency department grasp emergency-related theories and skills through professional training; (4) to implement the first diagnosis responsibility system; (5) to enhance the pre-examination and triage procedure in emergency department, in order to efficiently distribute patients; (6) to establish the coherent medical service flow among pre-hospital first aid, in-hospital emergency and transfer treatment.In this regard, corresponding improvement measures were proposed and implemented. After implementation, the average stay time of emergency patients was significantly shorter than before, and satisfaction was significantly improved ( P<0.05).Conclusion The application of QFD can determine the key factors affecting the quality of emergency medical services, and provide basis and improvement direction for hospital management, so as to provide better medical services.