Debehnke Daniel, Decker M Chris
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Am J Emerg Med. 2002 Jul;20(4):267-70. doi: 10.1053/ajem.2002.34199.
The objectives were to investigate the effects of a RN/MD patient care team operational change on ED patient satisfaction. In period 1, RNs had standard room assignments and MDs evaluated patients based upon physician availability and perceived patient load. In period 2, RNs and MDs were organized into 2 patient care "teams" and patients were assigned to teams on an alternating basis. Patient satisfaction was rated using the standard ED Press, Ganey survey instrument. A total of 508 surveys were returned in period 1 and 454 in period 2. From period 1 to 2, overall ED patient satisfaction improved from 78.2 +/- 20.4% to 82.2 +/- 17.2% (improvement from 23rd to 59th percentile, P <or=.01). Patient satisfaction with waiting time to treatment area improved from the 33rd to 52nd percentile (73.6 +/- 30.0% v 77.4 +/- 27.0%, P <or=.05). Satisfaction with waiting time to see the physician also improved from the 25th to the 62nd percentile (67.6 +/- 32.2% v 73.4 +/- 28.5%, P <or=.01). Patients feelings that staff cared about them as a person improved from the 20th to the 65th percentile (77.3 +/- 28.3% v 83.0 +/- 22.4%, P <or=.01) Patients were more likely to recommend the ED following the operational change, improving from the 26th to 69th percentile (75.8 +/- 32.7% v 82.83 +/- 25.3%, P <or=.01). ED patient care using a RN/MD patient care team improved patients' overall waiting time and length of stay satisfaction and improved the patients' satisfaction with staff and their likelihood of recommending the ED to others.
研究目的是调查注册护士/医生患者护理团队运营变革对急诊科患者满意度的影响。在第1阶段，注册护士有标准的病房分配，医生根据自身可利用时间和感知到的患者负荷来评估患者。在第2阶段，注册护士和医生被组织成2个患者护理“团队”，患者交替分配到各个团队。使用标准的急诊科Press、Ganey调查问卷工具对患者满意度进行评分。第1阶段共收回508份调查问卷，第2阶段收回454份。从第1阶段到第2阶段，急诊科患者总体满意度从78.2±20.4%提高到82.2±17.2%（从第23百分位提高到第59百分位，P≤0.01）。患者对等待进入治疗区域时间的满意度从第33百分位提高到第52百分位（73.6±30.0%对77.4±27.0%，P≤0.05）。对等待看医生时间的满意度也从第25百分位提高到第62百分位（67.6±32.2%对73.4±28.5%，P≤0.01）。患者感觉工作人员关心他们个人的情况从第20百分位提高到第65百分位（77.3±28.3%对83.0±22.4%，P≤0.01）。运营变革后患者更有可能推荐该急诊科，从第26百分位提高到第69百分位（75.8±32.7%对82.83±25.3%，P≤0.01）。采用注册护士/医生患者护理团队的急诊科患者护理提高了患者总体等待时间和住院时间满意度，改善了患者对工作人员的满意度以及他们向他人推荐该急诊科的可能性。
