Renaissance Orthopaedics PC and Innovation Center and The Orthopaedic Program, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Clin Orthop Relat Res. 2012 Apr;470(4):1038-45. doi: 10.1007/s11999-011-2051-3.
The literature contains proposals for creating value by creating exceptional patient experiences rather than simply improving services. However, few articles describe replicable applications focused on the patient experience.
QUESTIONS/PURPOSES: We (1) describe the refinement and exportation of an approach that focuses on the patient and family experience; and (2) report changes in patient satisfaction, infection rates, length of stay, mortality rates, clinical indicators, staff turnover, and cost.
The Patient and Family-Centered Care Methodology and Practice (PFCC M/P) is a six-step process: (1) selecting a care experience needing improvement; (2) establishing a guiding council; (3) evaluating the current state; (4) developing a permanent working group; (5) creating a shared vision of the ideal experience; and (6) identifying improvement projects to address the gap between the current and ideal experience. We assessed patient satisfaction, changes in clinical indicators, staff turnover, and cost in three clinical programs.
In TJA, patient satisfaction is at the 99th percentile; length of stay, infection rates, and mortality rates are substantially better than the national average. In trauma, patient satisfaction increased, time in cervical collars decreased, staff turnover decreased, and the incidence of lost patient belongings was eliminated. In orthopaedic spine, patient satisfaction is higher than the national average, average time for transfer to bed decreased (%), length of stay decreased, and average discharge time decreased. Each of these would have a positive impact on cost.
PFCC M/P offers a road map for redefining value as what is important to patients and families.
文献中提出通过创造卓越的患者体验来创造价值，而不仅仅是改善服务。然而，很少有文章描述可复制的应用，侧重于患者体验。
问题/目的：我们（1）描述一种专注于患者和家属体验的方法的改进和输出；（2）报告患者满意度、感染率、住院时间、死亡率、临床指标、员工流动率和成本的变化。
患者和家庭为中心的护理方法和实践（PFCC M/P）是一个六步过程：（1）选择需要改进的护理体验；（2）建立指导委员会；（3）评估当前状态；（4）建立一个永久性的工作小组；（5）创建一个理想体验的共同愿景；（6）确定改进项目，以缩小当前体验与理想体验之间的差距。我们评估了三个临床项目中的患者满意度、临床指标变化、员工流动率和成本。
在 TJA 中，患者满意度达到第 99 百分位；住院时间、感染率和死亡率明显优于全国平均水平。在创伤中，患者满意度提高，颈托佩戴时间减少，员工流动率降低，丢失患者物品的发生率消除。在骨科脊柱中，患者满意度高于全国平均水平，转移到床上的平均时间减少（%），住院时间减少，平均出院时间减少。这些都会对成本产生积极影响。
PFCC M/P 为重新定义对患者和家属重要的价值提供了路线图。
