Hijazi Heba H, Harvey Heather L, Alyahya Mohammad S, Alshraideh Hussam A, Al Abdi Rabah M, Parahoo Sanjai K
1 Jordan University of Science and Technology, Irbid, Jordan.
2 The Hashemite University, Zarqa, Jordan.
Inquiry. 2018 Jan-Dec;55:46958018754739. doi: 10.1177/0046958018754739.
Targeting the patient's needs and preferences has become an important contributor for improving care delivery, enhancing patient satisfaction, and achieving better clinical outcomes. This study aimed to examine the impact of applying quality management practices on patient centeredness within the context of health care accreditation and to explore the differences in the views of various health care workers regarding the attributes affecting patient-centered care. Our study followed a cross-sectional survey design wherein 4 Jordanian public hospitals were investigated several months after accreditation was obtained. Total 829 clinical/nonclinical hospital staff members consented for study participation. This sample was divided into 3 main occupational categories to represent the administrators, nurses, as well as doctors and other health professionals. Using a structural equation modeling, our results indicated that the predictors of patient-centered care for both administrators and those providing clinical care were participation in the accreditation process, leadership commitment to quality improvement, and measurement of quality improvement outcomes. In particular, perceiving the importance of the hospital's engagement in the accreditation process was shown to be relevant to the administrators (gamma = 0.96), nurses (gamma = 0.80), as well as to doctors and other health professionals (gamma = 0.71). However, the administrator staff (gamma = 0.31) was less likely to perceive the influence of measuring the quality improvement outcomes on the delivery of patient-centered care than nurses (gamma = 0.59) as well as doctors and other health care providers (gamma = 0.55). From the nurses' perspectives only, patient centeredness was found to be driven by building an institutional framework that supports quality assurance in hospital settings (gamma = 0.36). In conclusion, accreditation is a leading factor for delivering patient-centered care and should be on a hospital's agenda as a strategy for continuous quality improvement.
以患者的需求和偏好为目标已成为改善护理服务、提高患者满意度以及取得更好临床结果的重要因素。本研究旨在探讨在医疗保健认证背景下应用质量管理实践对以患者为中心的影响，并探讨不同医护人员对影响以患者为中心护理的属性的看法差异。我们的研究采用横断面调查设计，在4家约旦公立医院获得认证数月后对其进行调查。共有829名临床/非临床医院工作人员同意参与研究。该样本分为3个主要职业类别，分别代表管理人员、护士以及医生和其他卫生专业人员。通过结构方程模型，我们的结果表明，管理人员和提供临床护理人员以患者为中心护理的预测因素是参与认证过程、领导层对质量改进的承诺以及质量改进结果的衡量。特别是，认为医院参与认证过程很重要这一点与管理人员（γ = 0.96）、护士（γ = 0.80）以及医生和其他卫生专业人员（γ = 0.71）相关。然而，管理人员（γ = 0.31）比护士（γ = 0.59）以及医生和其他医疗服务提供者（γ = 0.55）更不容易察觉到衡量质量改进结果对提供以患者为中心护理的影响。仅从护士的角度来看，以患者为中心是由建立一个支持医院环境质量保证的制度框架驱动的（γ = 0.36）。总之，认证是以患者为中心护理的一个主导因素，应作为持续质量改进的战略列入医院议程。
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