Lee Vivian S, Miller Thomas, Daniels Chrissy, Paine Marilynn, Gresh Brian, Betz A Lorris
V.S. Lee is A. Lorris Betz Senior Vice President for Health Sciences, dean, School of Medicine, and CEO, University Health Care, University of Utah, Salt Lake City, Utah. T. Miller is chief medical officer, University Hospitals and Clinics, University of Utah, Salt Lake City, Utah. C. Daniels is director of strategic initiatives, University Hospitals and Clinics, University of Utah, Salt Lake City, Utah. M. Paine is assistant vice president for strategic initiatives, University of Utah Health Care, University of Utah, Salt Lake City, Utah. B. Gresh was senior director of interactive marketing and Web, University Health Care, University of Utah, Salt Lake City, Utah, at the time this work was completed. He is executive director of multichannel content marketing, Cleveland Clinic, Cleveland, Ohio, now. A.L. Betz is senior vice president for health sciences emeritus, University of Utah, Salt Lake City, Utah, and immediate past chair, Board of Directors, Association of American Medical Colleges, Washington, DC.
Acad Med. 2016 Mar;91(3):338-44. doi: 10.1097/ACM.0000000000001007.
Whether patient satisfaction scores can act as a catalyst for improving health care is highly debated. Some argue that pursuing patient satisfaction is overemphasized and potentially at odds with providing good care because it leads providers to overtest and overtreat patients and to bend to unreasonable patient demands, all to improve their ratings. Others cite studies showing that high patient satisfaction scores correlate with improved health outcomes. Ideally, assessing patient satisfaction metrics will encourage empathy, communication, trust, and shared decision making in the health care delivery process. From the patient's perspective, sharing such metrics motivates physicians to provide patient-centered care and meets their need for easily accessible information about their providers. In this article, the authors describe a seven-year initiative, which began in 2008, to change the culture of the University of Utah Health Care system to deliver a consistently exceptional patient experience. Five factors affected the health system's ability to provide such care: (1) a lack of good decision-making processes, (2) a lack of accountability, (3) the wrong attitude, (4) a lack of patient focus, and (5) mission conflict. Working groups designed initiatives at all levels of the health system to address these issues. What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams.
患者满意度评分能否成为改善医疗保健的催化剂,这一问题备受争议。一些人认为,追求患者满意度被过度强调,而且可能与提供优质医疗服务相矛盾,因为这会导致医疗服务提供者对患者进行过度检查和过度治疗,并屈从于不合理的患者要求,而这些都是为了提高他们的评分。另一些人则引用研究表明,高患者满意度评分与改善健康结果相关。理想情况下,评估患者满意度指标将鼓励在医疗服务提供过程中的同理心、沟通、信任和共同决策。从患者的角度来看,分享这些指标会促使医生提供以患者为中心的护理,并满足他们对轻松获取医疗服务提供者信息的需求。在本文中,作者描述了一项始于2008年的为期七年的倡议,旨在改变犹他大学医疗保健系统的文化,以提供始终卓越的患者体验。五个因素影响了医疗系统提供此类护理的能力:(1)缺乏良好的决策过程,(2)缺乏问责制,(3)态度错误,(4)缺乏以患者为中心,(5)使命冲突。工作组在医疗系统的各个层面设计了倡议来解决这些问题。最初作为患者满意度倡议开始的活动,逐渐演变成一种医生参与、基于价值观的就业实践、增强专业性和沟通、减少绩效差异以及改善医院和教师团体实践团队的使命与愿景一致性的模式。