Scher Eric, Whitehouse Sarah, Van Harn Meredith, Bollinger John, Stevens Bret, Macki Kathy, Saoud Deborah, Baker-Genaw Kimberly
Department of Medical Education, Henry Ford Health System, Detroit, MI, USA.
Department of Medicine, Henry Ford Medical Group, Detroit, USA.
J Healthc Leadersh. 2019 Jun 12;11:75-80. doi: 10.2147/JHL.S201060. eCollection 2019.
This study examined whether change in physician engagement affected outpatient or resident physician satisfaction using common US measures. Surveys were administered by Advisory Board Survey Solutions for staff physician engagement, Press Ganey for Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) for outpatient satisfaction, and Accreditation Council for Graduate Medical Education (ACGME) for the ACGME Resident/Fellow Survey. Survey sample sizes were 685, 697, and 763 for physician engagement and 621, 625, and 618 for resident satisfaction in 2014-2016, respectively; only respondents were available for CGCAHPS (24,302, 34,328, and 43,100 for 2014-2016, respectively). Two groups were analyzed across 3 years: (1) percentage of "engaged" staff physicians versus percentage of outpatient top box scores for physician communication, and (2) percentage of "engaged" staff physicians versus percentage of residents "positive" on program evaluation. For resident evaluation of faculty, the number of programs that met/exceeded ACGME national compliance scores were compared. Univariate chi-squared tests compared data between 2014, 2015, and 2016. For 2014-2016, "engaged" physicians increased from 34% (169/497) to 44% (227/515) to 48% (260/542) (<0.001) whereas CGCAHPS top box scores for physician communication remained unchanged at 90.9% (22,091/24,302), 90.8% (31,088/34,328), and 90.9% (39,178/43,100) (=0.869). For the second group, "engaged" physicians increased from 33% (204/617) to 46% (318/692) to 50% (351/701) (<0.001) and residents "positive" on program evaluation increased from 86% (534/618) in 2014 to 89% (556/624) in 2015 and 89% (550/615) in 2016 (=0.174). The number of specialties that met/exceeded national compliance for all five faculty evaluation items grew from 44% (11/25) in 2014 to 68% (17/25) in 2015 and 64% (16/25) in 2016 (=0.182). For our medical group, improvement in physician engagement across time did not coincide with meaningful change in the outpatient experience with physician communication or resident satisfaction with program and faculty.
本研究使用美国常用指标，考察医生参与度的变化是否会影响门诊患者或住院医生的满意度。由咨询委员会调查解决方案公司进行员工医生参与度调查，Press Ganey公司进行门诊患者满意度调查（临床医生及医疗服务提供者和系统团体消费者评估，即CGCAHPS），研究生医学教育认证委员会（ACGME）进行ACGME住院医生/研究员调查。2014 - 2016年，医生参与度调查的样本量分别为685、697和763，住院医生满意度调查的样本量分别为621、625和618；CGCAHPS调查中仅提供了受访者数据（2014 - 2016年分别为24302、34328和43100）。在3年期间对两组进行了分析：（1）“积极参与”的员工医生百分比与门诊患者对医生沟通的最高评分箱百分比，以及（2）“积极参与”的员工医生百分比与住院医生对项目评估“积极”的百分比。对于住院医生对教员的评估，比较了达到/超过ACGME全国合规分数的项目数量。使用单变量卡方检验比较2014年、2015年和2016年的数据。2014 - 2016年，“积极参与”的医生从34%（169/497）增至44%（227/515），再增至48%（260/542）（<0.001），而CGCAHPS中医生沟通的最高评分箱分数保持不变，分别为90.9%（22091/24302）、90.8%（31088/34328）和90.9%（39178/43100）（=0.869）。对于第二组，“积极参与”的医生从33%（204/617）增至46%（318/692），再增至50%（351/701）（<0.001），住院医生对项目评估“积极”的比例从2014年的86%（534/618）增至2015年的89%（556/624），2016年为89%（550/615）（=0.174）。在所有五项教员评估项目中达到/超过全国合规标准的专业数量从2014年的44%（11/25）增至2015年的68%（17/25），2016年为64%（16/25）（=0.182）。对于我们的医疗集团而言，随着时间推移医生参与度的提高，与门诊患者对医生沟通的体验或住院医生对项目及教员的满意度的显著变化并不一致。
