Helbig Matthias, Helbig Silke, Kahla-Witzsch Heike A, May Angelika
Department of Otolaryngology, Head and Neck Surgery, University Hospital of Frankfurt/Main, Theodor Stern Kai 7, 60590 Frankfurt/Main, Germany.
BMC Health Serv Res. 2009 Jan 31;9:21. doi: 10.1186/1472-6963-9-21.
Public health systems are confronted with constantly rising costs. Furthermore, diagnostic as well as treatment services become more and more specialized. These are the reasons for an interdisciplinary project on the one hand aiming at simplification of planning and scheduling patient appointments, on the other hand at fulfilling all requirements of efficiency and treatment quality.
As to understanding procedure and problem solving activities, the responsible project group strictly proceeded with four methodical steps: actual state analysis, analysis of causes, correcting measures, and examination of effectiveness. Various methods of quality management, as for instance opinion polls, data collections, and several procedures of problem identification as well as of solution proposals were applied. All activities were realized according to the requirements of the clinic's ISO 9001:2000 certified quality management system. The development of this project is described step by step from planning phase to inauguration into the daily routine of the clinic and subsequent control of effectiveness.
Five significant problem fields could be identified. After an analysis of causes the major remedial measures were: installation of a patient telephone hotline, standardization of appointment arrangements for all patients, modification of the appointments book considering the reason for coming in planning defined working periods for certain symptoms and treatments, improvement of telephonic counselling, and transition to flexible time planning by daily updates of the appointments book. After implementation of these changes into the clinic's routine success could be demonstrated by significantly reduced waiting times and resulting increased patient satisfaction.
Systematic scrutiny of the existing organizational structures of the outpatients' department of our clinic by means of actual state analysis and analysis of causes revealed the necessity of improvement. According to rules of quality management correcting measures and subsequent examination of effectiveness were performed. These changes resulted in higher satisfaction of patients, referring colleagues and clinic staff the like. Additionally the clinic is able to cope with an increasing demand for appointments in outpatients' departments, and the clinic's human resources are employed more effectively.
公共卫生系统面临着成本不断上升的问题。此外，诊断和治疗服务变得越来越专业化。这些是开展一个跨学科项目的原因，该项目一方面旨在简化患者预约的计划和安排，另一方面要满足效率和治疗质量的所有要求。
为了理解流程和解决问题的活动，负责的项目组严格按照四个方法步骤进行：现状分析、原因分析、纠正措施和效果检验。应用了各种质量管理方法，如民意调查、数据收集以及几种问题识别和解决方案建议的程序。所有活动均按照该诊所获得ISO 9001:2000认证的质量管理体系的要求进行。从规划阶段到在诊所日常工作中启用该项目以及随后的效果控制，逐步描述了该项目的发展过程。
可以确定五个重要的问题领域。在进行原因分析后，主要的补救措施包括：设立患者电话热线、为所有患者的预约安排标准化、考虑就诊原因修改预约簿，为特定症状和治疗规划规定的工作时间、改善电话咨询服务，以及通过每日更新预约簿转向灵活的时间规划。将这些变更应用于诊所日常工作后，等待时间显著缩短，患者满意度提高，从而证明了项目的成功。
通过现状分析和原因分析对我们诊所门诊部现有的组织结构进行系统审查，发现有必要进行改进。根据质量管理规则实施了纠正措施并随后检验了效果。这些变更提高了患者、转诊同事和诊所工作人员等的满意度。此外，诊所能够应对门诊部预约需求的增加，并且诊所的人力资源得到了更有效的利用。
