肿瘤专科医院如何开展多学科诊疗

多学科诊疗是肿瘤治疗主流趋势。通过对肿瘤MDT开展过程进行总结,从团队组建、流程优化、管理举措及监督考核等方面,探讨了具有肿瘤专科医院诊疗特色的肿瘤MDT模式。并立足于当前实际,提出解决思路和肿瘤MDT未来发展方向,包括顶层设计、资源整合、成本核算、智慧管理等     

基于社区患者满意度调查的分级诊疗政策分析

目的 本文通过就患者对社区卫生服务满意度等相关问题进行研究,分析北京石景山区分级诊疗的实施情况,并基于结果提出相关建议措施。方法 采用统计学描述方法,通过分析社区居民对“签约服务、社区用药、慢性病管理与服务”的满意度来分析分级诊疗的实施效果。结果 只有17.80%的被访者表示“签约了家庭医生服务”,签约中91.70%的患者表示会续约。对转诊预约服务的认知度达到了67.30%。在“对药品齐全状况的满意度”方面,24.8%的被访者认为“不太满意或很不满意”。“对药品价格的满意度”方面,1.10%的被访者认为“不太满意”,没有“很不满意”。“对健康档案的”认知度和使用度分别为71.40%和52.50%,“对高血压和糖尿病患者慢性病管理”使用度只有36.09%。结论 社区卫生服务中心/站点位置设置相对合理,便于患者就医。患者对“签约服务”的认知度和满意度较高,但有效签约率可能不足,有必要加强签约宣传力度,提高医疗保险对签约服务的约束及激励,加大差异化报销力度,提高实际的家庭医生签约率。社区用药方面对“药品价格”满意度高于对“药品齐全状况”的满意度,北京分级诊疗的实施有待于进一步扩大基层的用药报销范围。慢性病管理与服务认知度较高,但利用度偏低。在社区应加大慢性病管理与服务力度,通过持续跟进慢性病随访全程监管慢性病进展,及时帮助患者利用社区慢性病管理服务提高慢性病管理水平。     

医院专家门诊预约诊疗服务对患者满意度的影响

目的探讨基层医院专家门诊预约服务对患者满意度的影响。方法对医院实施专家门诊预约诊疗服务前后患者满意度问卷调查结果进行对比、分析。结果实施专家门诊预约诊疗服务后患者的满意度明显提高(X2=4.145,p<0.05);影响患者满意度的相关因素依次为:预约次数、就诊次数、路途时间、就诊科室、知晓程度、就医距离、职业和年龄等。结论基层医院实施专家门诊预约诊疗服务,可有效减少候诊时间,方便患者就医,提高了患者的满意度。     

基于IPA分析的患者满意度影响因素研究

在肿瘤专科型医院患者满意度测评体系的基础上,选取某一肿瘤专科医院患者进行满意度问卷调查,运用IPA分析方法研究肿瘤专科医院患者的满意度影响因素,帮助医院识别患者满意度不高的因子,分析医院管理实践中存在的不合理因素,为后期的管理工作提供指导意见。     

肿瘤专科医院传染病的调查分析及控制

肿瘤病人合并传染病的治疗控制近几年已逐步引起医务人员的高度重视。自2003年SARS的发生及2004年修订的《中华人民共和国传染病防治法》的出台，肿瘤专科医院传染病的预防控制再次引起医务人员的高度重视。福建省肿瘤医院感染管理科针对以往肿瘤专科医院在预防控制传染病方面存在的薄弱环节，进行全面系统的管理，有效地控制传染病的流行暴发及医院感染的发生。     

肿瘤专科医院恶性肿瘤病人的随访特点

随诊工作是病案管理不可缺少的重要组成部分 ,是病人经过治疗后的信息反馈 ,对该信息进行不断加工处理的过程 ,即是医疗、科研不断发展的过程。由此可见没有随诊资料的病案是不完整的病案 ,尤其对某些价值较高的病例 ,如恶性肿瘤的远期疗效观察。但是 ,肿瘤专科医院与一般综合性医院相比 ,在接待、治疗病人方面有他的局限性及特殊性。恶性肿瘤病人不同于一般的疾病 ,它恶性程度高 ,生存期限短 ,生活质量差 ,死亡率高。虽然在住院期间进行了手术、化疗、放射的综合性治疗 ,病情相对得到了控制及好转 ,但是恶性肿瘤的特征是具有局部侵犯及远处…     

县医院护士工作满意度调查与分析

目的 探讨基层医院护士工作满意度情况及其影响因素.方法 对某县二级医院工作1 年以上有护士执照的护士进行问卷调查.结果 基层医院护士工作满意度不尽如人意,尤其是低年资护士和合同制护士的工作满意度低.结论 医院管理者应充分调动护士的积极性,从人文关怀、素质培养、薪资福利等方面着手,关注高年资护士晋升及身心健康,培养聘用护士的组织归宿感、认同感,改善工作环境,提高护士工作满意度.     

医院满意度调查

目前在中国，患者对医院服务的需求仍处于初期标准化阶段，医院对员工的要求是落实服务规范．所以，基于“服务落实度调查”的HCAHPS满意度测评方法更适合中国医院。     

肿瘤专科医院连续3年医院感染现患率调查分析

目的回顾性分析某肿瘤专科医院医院感染现患率及变化趋势,为制定区域性肿瘤专科医院预防控制医院感染措施提供理论依据。方法分别于2012年11月14日、2013年11月27日、2014年11月26日对所有住院患者进行医院感染横断面调查,采用床旁调查与病历调查相结合的方式。结果 2012、2013、2014年全院医院感染现患率分别为2.55%、1.70%、2.46%,例次感染率分别为2.55%、1.70%、2.60%;医院感染部位以上呼吸道感染为主,占37.08%;医院感染病原菌以革兰阴性菌为主,占48.3%;抗菌药物使用率连续3年分别为15.83%、15.71%、14.58%。结论该院连续3年医院感染现患率无显著变化;放疗科头颈部肿瘤患者医院感染率2014年呈上升趋势,应加强放疗科头颈部肿瘤患者上呼吸道感染目标性监测。     

住院患者对医院满意度的评价研究

[目的]通过分析住院患者对医院满意度评价的影响因素,为医院管理者提高医院服务质量提供科学依据。[方法]对某二甲医院307名住院患者进行问卷调查,并进行统计分析与比较研究。[结果]不同科室间住院患者的性别、年龄、婚姻、职业等对医院满意度评价得分没有差别,而不同文化程度、家庭收入、医疗费用支付方式等对医院满意度评价得分有差别。[结论]医院管理者应重视住院患者对医院满意度的评价,将患者满意度作为改进工作的重要标准之一。     

医院类型对门诊患者满意度影响分析

目的分析医院类型对门诊患者满意度的影响,对医院提升服务质量提出建议。方法于2016年12月采用偶遇抽样法对山东省2家专科医院及3家综合医院的1 000例门诊患者进行满意度问卷调查,并对调查结果进行描述性分析、χ2检验、两独立样本t检验、因子分析、多分类logistic回归分析。结果专科医院和综合医院门诊患者在性别、年龄、受教育程度、职业类别、医保类型、家庭年收入、患者来源方面差异均有统计学意义(P<0.05);专科医院和综合医院的"就诊流程"得分分别为(2.61±0.99)、(3.04±1.46)分,"就诊环境"得分分别为(4.19±0.95)、(3.94±1.05)分,差异均有统计学意义(均P<0.01);两类型医院门诊患者对就诊流程、就诊环境的满意度评价具有群体倾向性。结论专科医院与综合医院应根据自身定位与医院特色,以患者为中心,改善硬件环境,优化流程设计,把不断提升患者满意度作为医院工作的终极目标。     

苏州市区参保住院人员对定点医院满意度影响因素研究

目的了解苏州市区参保住院人员对定点医院的满意度,为医疗保险管理部门以及医院制定相应的管理政策提供科学依据。方法采用现场问卷调查的方法,运用因子分析、回归分析和方差分析对影响满意度的因素进行研究。结果苏州市区参保住院人员对定点医院的满意度处于较高水平,对满意度影响最大的因素是医、护服务质量。不同年龄段以及不同医疗保险类型住院参保人员的满意度有统计学差异。结论医疗保险部门应将参保人员的满意度调查作为一项长期存在的满意度监督制度坚持贯彻实施。     

患者满意度分析与医院管理对策研究

简述了国外利用病人满意度信息改进医疗服务的发展历程,介绍了患者满意度的测评方法,分析了产生差异的原因,指出了现有研究工作的局限性,并从不同的角度指出今后患者满意度在医院管理方面的重要性。     

The progress of reforms: job satisfaction in a typical hospital in Estonia.

OBJECTIVE: To evaluate the level of job satisfaction among the staff at an Estonian hospital and to describe factors related to their job satisfaction. DESIGN: Questionnaire survey. SETTING: P?rnu County Hospital in Estonia. STUDY PARTICIPANTS: All staff members of the P?rnu County Hospital (n = 673), except 56 staff members who were away from work during the study. RESULTS: Respondents (n = 473) indicated an average job satisfaction level of 3.86 +/- 0.81 on a 5-point scale. The efficiency of hospital management as measured by planning, relationships with supervisors, knowledge and communication regarding hospital goals, plans, quality of services, budgetary situation, and staffing problems was positively correlated with job satisfaction. Stress and unrealistic expectations were negatively correlated with job satisfaction. The feeling of being part of the organization was also correlated with job satisfaction. Recognition from supervisors and discussions with colleagues were found to be weakly correlated with job satisfaction. There were differences between occupational categories. CONCLUSION: The management of P?rnu County Hospital has been able to create good supervisory relationships with staff by providing sufficient information about the goals of the hospital, the quality of services, the budgetary situation, and staffing problems that arise. Stress levels reported are not excessive and staff are loyal to their hospital.     

基于患者满意度的管理对医院管理质量的影响

[目的]探讨基于患者满意度的管理对医院管理质量的影响。[方法]选取2017年1-12月住院患者300例作为A组,选取2018年1-12月住院患者300例作为B组。A组给予传统管理,B组在此基础上给予基于患者满意度的管理。采用自制《住院患者满意度问卷》评估患者满意度,记录住院时间、医疗投诉及纠纷情况,计数资料采用χ2检验,计量资料采用T检验,比较两组满意度、住院时间、医疗投诉及纠纷情况。[结果]B组医疗效果、心理指导、医疗操作、服务态度、环境卫生等满意度评分明显高于A组,B组满意率(98.00%)明显高于A组(97.00%),差异有统计学意义(P<0.05);B组住院时间[(6.58±0.71)d]明显低于A组[(7.26±0.78)d],差异有统计学意义(P<0.05);B组医疗投诉率(0.67%)、纠纷发生率(1.33%)明显低于A组(3.33%、4.67%),差异有统计学意义(P<0.05)。[结论]基于患者满意度的管理可有效提高医院管理质量,有利于提高诊疗服务水平,值得临床推广。     

Influence of length of stay on patient satisfaction with hospital care in Japan.

OBJECTIVE: The objective of this study was to identify specific patient satisfaction items related to overall satisfaction by different length of stay (LOS) for patients in Japanese hospital settings. METHODS: This cross-sectional study involved a participant sample, drawn from 77 voluntarily participating hospitals throughout Japan, of in-patients discharged to the community. Older patients and psychiatric, pediatric, obstetric and gynecologic patients were excluded. The 1050 respondents analyzed (response rate > or = 5l.1%) were divided into three groups based on their LOS: group 1, LOS < or = 1 week; group 2, LOS < or = 1 month; and group 3, LOS > 1 month. Using stepwise multiple regression analysis, we explored for each LOS group the relationship between overall patient satisfaction and satisfaction with 33 individual items, including three regarding perceived reputation of the hospital in question. RESULTS: Some unique satisfaction items for each group (e.g. 'skill of nursing care' in group 1, 'Recovery of physical health', 'skill of nursing care', and 'respect for patients opinions and feelings' in group 2, and 'relief from pain' and 'respect for patients' opinions and feelings' in group 3) were significantly associated with overall satisfaction. In all three groups, common items (e.g. 'recovery from distress and anxiety' and 'doctor's clinical competence') also related significantly to overall satisfaction. Two items pertaining to the hospital reputation dimension (e.g. 'family member's evaluation of the hospital' and 'hospital reputation among other patients') were also significant predictors of overall satisfaction in all three groups. CONCLUSION: The findings show that according to LOS, unique items could determine significantly the achievement of overall satisfaction, while some common predictors across all three LOS groupings also seemed to be indispensable for inpatient's assessment of hospital care. It was also confirmed in this study that a positive perception of hospital reputation might have an important role in patient satisfaction in Japan.     

医院医生对护理人员工作满意度调查分析

目的了解医生对医院护理工作的满意度及其影响因素,为制定护理管理对策提供依据。方法问卷分别调查一、二、三级医院临床医生,采用匿名方式由医生自行填写调查问卷。调查内容包括医生一般情况,对病房环境、护理人员服务态度、技术操作、依表着装、护士职业道德满意度等。结果医生对护理工作总体满意度较高。对病房环境、护理人员仪表和着装、护理人员使用文明用语满意度低于对护理人员服务态度、护理技术水平和医护配合的满意度。医生年龄和学历是影响满意度评价的因素。结论加强护理质量控制,改善病房环境;尊重病人权利,加强人文关怀是提高护理工作质量和顾客满意度的主要措施。     

Cataract surgery in a community hospital outreach clinic: patients’ costs and satisfaction

A cataract day surgery service for the population of central Norfolk, UK, was provided by the main ophthalmic department in a district general hospital and in an outreach clinic in a community hospital 40 km distant. The outreach clinic aimed to extend the accessibility of this particular service in a rural area where many patients faced long journeys to the main hospital. Samples of 201 patients attending the main hospital for day cataract surgery and 198 patients attending the outreach clinic for the same procedure were identified. Patients were interviewed and given questionnaire forms to establish their general health before the operation, their arrangements to get to hospital and their satisfaction with the clinic and the care they had received. The sample of patients attending the outreach clinic was slightly older, less affluent and in slightly poorer general health than the patients attending the main hospital. The two samples were similar in terms of visual acuity after the operation, complication rates, satisfaction with the outcome of the operation and subsequent use of health services. The journey to hospital was quicker, more convenient and less costly for the outreach clinic patients than the main hospital patients. The net benefit to patients of the outreach clinic was estimated as £39,000 per annum. Satisfaction with administrative matters, facilities at the two clinics and the care received was high in both samples, but patients were significantly more satisfied with arrangements at the smaller outreach clinic. This evidence suggests that an outreach clinic in a small community hospital can provide cataract day surgery under local anaesthesia as effectively as a district centre, at a reduced social cost and with positive social benefits. Further study of heath service costs is vital, but political pressure to acknowledge patient preferences for more local services is growing.