Thorne L, Ellamushi H, Mtandari S, McEvoy A W, Powell M, Kitchen N D
Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London. UK.
Br J Neurosurg. 2002 Jun;16(3):243-55. doi: 10.1080/02688690220148833.
The objective of this study was to determine the current level of patient satisfaction with neurosurgical services from the time of initial referral to hospital discharge. The survey was camed out by a self-administered postal questionnaire survey from the National Hospital for Neurology and Neurosurgery, London, UK. The participants were 364 patients discharged from the unit within one calendar year. The main outcome measures were level of satisfaction with various aspects of care, as measured by fixed response and free text style questions. Most patients are happy with the waiting time to see a neurosurgeon and the wait for subsequent admission acceptable, but many would have preferred it to be shorter. Twenty-seven had their original admission date cancelled, but most were happy with the explanation offered. Weaknesses in the management of outpatient clinics were highlighted, 35% of patients waiting more than half an hour to be seen. The great majority were happy with various aspects of communication with the neurosurgical team. Few patients were given the opportunity to follow up their visit with literature provided or a visit to a specialist nurse (17 and 9%, respectively). However, both were considered very useful, in particular, 93% highly valued a meeting with the specialist nurse. There was a dichotomy of opinion over the course of the inpatient stay. While most aspects of care received 70-80% satisfaction, the management of discharge received the most criticism. This was thought to represent a pooling of resources around the most needy patients. The majority of patients were discharged home (76%), only a third feeling that staff did everything possible to help this process. Very few received printed information. Again, those who had seen the specialty nurse had much higher levels of satisfaction. Patient satisfaction audit gives useful data on patients' perception and satisfaction with care that may not be apparent on more traditional audit measures such as length of stay, which focus more on a unit's efficiency. This study shows generally high levels of patient satisfaction with neurosurgical practice but highlights areas needing attention and expansion, such as access to a specialist nurse and relevant literature. Dissatisfaction with various administrative arrangements are clearly shown and provide an opportunity for patient centred improvements.
本研究的目的是确定患者从首次转诊到出院期间对神经外科服务的当前满意度水平。该调查通过英国伦敦国家神经病学和神经外科医院自行发放的邮政问卷调查进行。参与者为在一个日历年内从该科室出院的364名患者。主要结果指标是通过固定回答和自由文本式问题衡量的对护理各方面的满意度水平。大多数患者对等待看神经外科医生的时间以及随后等待入院的时间表示满意，但许多人希望等待时间能更短。27人的原定入院日期被取消，但大多数人对所给出的解释感到满意。门诊管理的薄弱环节被凸显出来，35%的患者等待超过半小时才见到医生。绝大多数患者对与神经外科团队沟通的各个方面感到满意。很少有患者有机会通过提供的文献或拜访专科护士来跟进他们的就诊情况（分别为17%和9%）。然而，两者都被认为非常有用，特别是93%的患者高度重视与专科护士的会面。对于住院期间的情况存在意见分歧。虽然护理的大多数方面获得了70 - 80%的满意度，但出院管理受到的批评最多。这被认为是围绕最需要帮助的患者集中资源。大多数患者出院回家（76%），只有三分之一的患者认为工作人员尽一切可能协助这一过程。很少有人收到印刷信息。同样，见过专科护士的患者满意度水平要高得多。患者满意度审计提供了关于患者对护理的看法和满意度的有用数据，这些数据在诸如住院时间等更传统的审计指标上可能并不明显，后者更多地关注科室的效率。这项研究表明患者对神经外科实践总体满意度较高，但也突出了需要关注和改进的领域，如获得专科护士和相关文献的机会。对各种行政安排的不满也清晰显现，为以患者为中心的改进提供了机会。
