Singh Suprit C, Sheth Raj D, Burrows James F, Rosen Paul
University of Central Florida, College of Medicine, Orlando, Florida.
Nemours Clinic Specialty Care, Jacksonville, Florida.
Pediatr Neurol. 2016 Jul;60:37-41. doi: 10.1016/j.pediatrneurol.2016.04.002. Epub 2016 Apr 12.
Hospitals have begun to shift toward patient-centered care because of the pay-for-performance system that was established by the Patient Protection and Affordable Care Act. In pediatrics, the needs of both the caregiver and the pediatric patient have to be taken into account. Pediatric practices have been shifting toward a family-centered approach, although the primary drivers have not been well defined. Identifying the key patient experiences that lead to higher patient satisfaction would enable a more meaningful clinical encounter. To better understand patient experience, we examined waiting time and the elements of the physician-patient interaction in pediatric neurology. We predict that the determining factor in patient satisfaction is the physician-patient interaction.
Patient satisfaction surveys were sent to families via mail or e-mail after their ambulatory pediatric neurology visit. The visits took place between January 1, 2012, and December 31, 2014, at one of multiple locations in a children's health system spanning four states. A Likert scale was used for these surveys, and a top-box method (measuring percent of survey questions were rated 5 out of 5) was used to filter data from this database. Statistical analysis using a Pearson correlation was used for data analysis, with likelihood to recommend practice as the dependent variable.
The five survey questions that correlated most with overall likelihood to recommend the practice were cheerfulness of practice (r = 0.79); staff working together (r = 0.76); cleanliness of practice (r = 0.70); wait time at clinic, from entering to leaving (r = 0.66); and likelihood of recommending care provider (r = 0.65).
Pediatric neurologists striving to enhance overall patient satisfaction in their practices should work toward providing an atmosphere that supports office staff cheerfulness, teamwork, and visit efficiency provided in a clean and friendly environment.
由于《患者保护与平价医疗法案》建立的绩效付费系统，医院已开始向以患者为中心的护理模式转变。在儿科领域，必须同时考虑照顾者和儿科患者的需求。儿科医疗实践已逐渐转向以家庭为中心的模式，尽管其主要驱动因素尚未明确界定。确定能带来更高患者满意度的关键患者体验，将使临床诊疗更具意义。为了更好地理解患者体验，我们研究了儿科神经科的候诊时间以及医患互动的要素。我们预测，患者满意度的决定因素是医患互动。
在儿科神经科门诊就诊后，通过邮件或电子邮件向家庭发送患者满意度调查问卷。就诊时间为2012年1月1日至2014年12月31日，地点为一个覆盖四个州的儿童健康系统的多个地点之一。这些调查采用李克特量表，并用顶格法（测量调查问卷中评为5分的问题百分比）从该数据库中筛选数据。数据分析采用Pearson相关性统计分析，将推荐该医疗机构的可能性作为因变量。
与推荐该医疗机构的总体可能性相关性最高的五个调查问题分别是：医疗机构的愉悦氛围（r = 0.79）；工作人员协作（r = 0.76）；医疗机构的清洁程度（r = 0.70）；从进入到离开诊所的候诊时间（r = 0.66）；以及推荐护理提供者的可能性（r = 0.65）。
努力提高儿科神经科患者总体满意度的儿科神经科医生，应致力于营造一种氛围，在干净友好的环境中，支持办公室工作人员保持愉悦心情、团队协作并提高就诊效率。
