适度绩效薪酬激励对住院医师出院小结听写时间的影响。
Effect of modest pay-for-performance financial incentive on time-to-discharge summary dictation among medical residents.
作者信息
Wolk Adam, Wang Erwin, Horak Bernard, Cloonan Patricia, Adams Michael, Moore Eileen, Jaipaul Chitra Komal, Brown Gabrielle, Dasgupta Dabanjan, Deluca Danielle, Grossman Mila
机构信息
Department of Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia (Drs Wolk, Adams, Moore, and Jaipaul); Georgetown University School of Medicine, Washington, District of Columbia (Mr Wang); School of Nursing and Health Studies, Georgetown University, Washington, District of Columbia (Drs Horak and Cloonan and Ms Brown, Deluca, and Grossman); and University of Virginia, Charlottesville (Mr Dasgupta).
出版信息
Qual Manag Health Care. 2013 Oct-Dec;22(4):272-5. doi: 10.1097/QMH.0000000000000008.
OBJECTIVE
Evaluate the effect of a modest financial incentive on time-to-discharge summary dictation among medicine residents.
BACKGROUND
Pay-for-performance incentives are used in a number of health care settings. Studies are lacking on their use with medical residents and other trainees. Timely completion of discharge summaries is necessary for effective follow-up after hospitalization, and residents perform the majority of discharge summary dictations in academic medical centers.
METHODS
Medicine residents with the lowest average discharge-to-dictation time during their 1-month inpatient medicine ward rotation were rewarded with a $50 gift card. Discharge data were captured using an autopopulating electronic database.
RESULTS
The average discharge-to-dictation time was reduced from 7.44 to 1.84 days, representing a 75.3% decrease. Almost 90% of discharge summary dictations were performed on the day of discharge.
CONCLUSION
A modest financial incentive resulted in a marked improvement in the time-to-discharge summary dictation by medicine residents. Pay-for-performance programs may be an effective strategy for improving the quality and efficiency of patient care in academic medical centers.
目的
评估适度经济激励对内科住院医师完成出院小结听写时间的影响。
背景
绩效薪酬激励措施在许多医疗环境中都有应用。但关于其在住院医师及其他实习生中的应用研究较少。及时完成出院小结对于住院后的有效随访至关重要，而在学术医疗中心，大部分出院小结听写工作由住院医师完成。
方法
对在内科住院病房轮转1个月期间平均出院到听写时间最短的内科住院医师给予一张50美元的礼品卡作为奖励。出院数据通过自动填充的电子数据库收集。
结果
平均出院到听写时间从7.44天降至1.84天，降幅达75.3%。近90%的出院小结听写在出院当天完成。
结论
适度的经济激励使内科住院医师完成出院小结听写的时间有显著改善。绩效薪酬计划可能是提高学术医疗中心患者护理质量和效率的有效策略。
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