Milosevic Milan, Brborovic Hana, Mustajbegovic Jadranka, Montgomery Anthony
University of Zagreb, School of Medicine, Andrija Stampar School of Public Health, Zagreb, Croatia.
Br J Health Psychol. 2014 Sep;19(3):670-82. doi: 10.1111/bjhp.12062. Epub 2013 Jul 24.
To explore quality in hospitals from the patients' and health care professionals' perspective in line with Act on the Protection of Patient Rights.
A qualitative study using a focus group design and semi-structured interviews.
Three focus groups among health care professionals were conducted with 51 participants: 24 nurses and medical technicians, 15 physicians, 12 residents, followed by additional interviews (20 nurses and medical technicians, 10 physicians, and 2 residents). Twenty patients were interviewed at the time of their discharge from the hospital. Collected data were analysed using thematic analysis.
Patients identified waiting for medical treatments/procedures as the most concerning factor, followed by changes in administration procedures and admission in hospitals. From the physicians' and nurses' perspective, the main topics were inadequate resources to work with and inadequate working environment. Residents emphasized administration and lack of adequate equipment in contrast to other health care professionals. Both patients and health care professionals identified similar organizational and administrative issues impacting on service delivery.
Health care providers and patients equally recognize the factors that impact upon quality of care. This problem is beyond the health care professionals' possibility to solve, which is the main source of stress and burnout that influence the quality of care. These factors cannot be overcome, by either health care professionals or patient organizations working alone. Greater partnership between health providers and patient associations is needed.
What is already known on this subject? Healthcare providers and patients have the same goal: good quality of care and safety. Croatia has undergone significant socio-economic and political changes, which have affected the organization of the health care system. The patient experience is positively associated with clinical effectiveness and patient safety. What does this study add? From the perspective of patients and health professionals the main concern regarding quality of care is the organization of work in hospitals. Croatian patients and health professionals show considerable agreement with regard to the administrative problems in hospitals. Solutions that include only efforts on the part of the health care worker will fail.
根据《患者权利保护法》，从患者和医护人员的角度探讨医院质量。
采用焦点小组设计和半结构化访谈的定性研究。
对医护人员进行了三个焦点小组讨论，共有51名参与者：24名护士和医技人员、15名医生、12名住院医师，随后进行了额外访谈（20名护士和医技人员、10名医生和2名住院医师）。20名患者在出院时接受了访谈。使用主题分析法对收集到的数据进行分析。
患者认为等待医疗治疗/程序是最令人担忧的因素，其次是管理程序的变化和住院情况。从医生和护士的角度来看，主要问题是工作资源不足和工作环境不佳。与其他医护人员相比，住院医师强调管理和设备不足。患者和医护人员都指出了影响服务提供的类似组织和管理问题。
医疗服务提供者和患者同样认识到影响医疗质量的因素。这个问题超出了医护人员的解决能力，这是影响医疗质量的压力和职业倦怠的主要来源。这些因素无法由医护人员或患者组织单独克服。医疗服务提供者和患者协会之间需要更大的合作关系。
关于这个主题已知的是什么？医疗服务提供者和患者有相同的目标：高质量的医疗和安全。克罗地亚经历了重大的社会经济和政治变革，这影响了医疗系统的组织。患者体验与临床疗效和患者安全呈正相关。这项研究增加了什么？从患者和医护人员的角度来看，对医疗质量的主要担忧是医院的工作组织。克罗地亚患者和医护人员在医院管理问题上表现出相当大的一致性。仅靠医护人员努力的解决方案将会失败。
