Study On Process Status And Process Reengineering Of Outpatient Services In The Tertiary Hospital

Outpatient hospital service is the first window as well as one of the most importantlinks in medical work. With the development of medical and health services, as well asthe improvement of patient demand for medical services, drawbacks of the traditionalmodel outpatient started to become apparent and gradually expanded. Outpatientprocess optimization and reengineering is both the difficulty and focus of the modernhospital management, but also catches more and more attention of hospitaladministrators. Change the mode of service, to seek “patient-centered, in order toimprove the quality of medical services for the purpose of out-patient process”, andconsider arranging for the treatment process from the patient s ’ point of view, todevelop appropriate strategies. It has become necessary to optimize the recyclingoutpatient process to improve patient medical care satisfaction.Objective:1. Understand the business processes of a large general hospital out-patient statusand found problems there.2. Put forward more scientific mode of out-patient services based on the status quo,to optimize the recycling of out-patient service processes, and improve patient medicalcare satisfaction.Methods:1. Through literature search, query the full-text database of Chinese science andtechnology journals, full-text database of Chinese academic journals and Medlinedatabase, to collect domestic and foreign public about hospital outpatient processreengineering. The Chinese search terms were “hospital outpatient process "and"process reengineering ". Search Medline database of keywords for hospital outpatientprocess, the subheadings of the process reengineering. Analyzed the related journalarticles found. 2. According to the data stored in the hospital HIS system, collect2010outpatientregistration fees, dispensary patients of the window.Track and measure the time ofoutpatient treatment. Acquire finishing fees examination, treatment, outpatient surgeryor debridement of the charges details, subtotals by different execution sections and consultthe relevant medical staff of each examination, treatment, surgery, the average time.3. Use the self questionnaire survey, though the current situation, to obtain patient’ssatisfaction of the current hospital outpatient service as well as the patient and hospitalstaff’s views on the out-patient end of the charging mode. Database with Excel toestablish statistical, software spss13.0statistical description of data, the chi-square test,nonparametric rank sum test, correlation analysis and multivariate regression analysisand other statistical methods.Results:1. Hospital HIS system data analysis:(1)Combination of the number of registered people in2010as a whole, the averageper registered person needs to and from the pay window of3.4times; per outpatienttreatment link for7.589.(2) The outpatient time was90.45minutes in2010; the average time of effectivediagnosis and treatment was17.62-31.97minutes, accounting for19.48%-35.35%;the total service (communication) time was20.34-34.69minutes, accounting for22.49%-38.35%. Without considering the time it takes to lose fluid or hemodialysistreatment programs, outpatient hospital time65%-80%for the invalid waiting, queuing,and back and forth in.2. Opinion poll results for the current out-patient service processes:(1) The overall satisfaction of the patients’ quality of hospital outpatient serviceswas82.1%.(2) The main problems of the patients’ medical care service processes, according tothe seriousness of the degree of recognition from more to less, registration fees queuingtime is too long (51.2%), waiting time is too long (45.8percent), medical treatmentaspects of too much (34.1%), waiting for long time (32.4%), waiting for the report toolong (23.3%), labeling is not clear (15.0%).3. The end of charging analysis results:(1) Implementation of the technical means on the end of charging four kinds of feature analysis and trade-offs, lock-the positive impact of activation are better thanthe other three ways.(2) Implementation of the choice of technical means to the end of charging,whether patients or hospital workers, choose to lock-the largest number of activation.(3) Outpatient and emergency services to the end of charging, regardless of thepatient or hospital staff, the overall view in favor than against. By Fisher’s exact test(P=0.001), the patient than the hospital staff more willing to accept the end of charging.(4) Logistic regression method to study the impact of respondents intention ofoutpatient endpoint type charging a variety of personal socio-economic factors, theresults show that the administrative duties more than administrative duties tend tochoose "agree"(P <0.05).(5) A Survey of the necessity of legislation on the end of charging, the Fisher’sexact probabilities test, medical staff compared with patients with more urgent hope thatthe relevant competent departments of the government to pass legislation to effectivelyguarantee the smooth implementation of the (P <0.05).Conclusion:1. The main problems of existing out-patient service processes: patient visits manylinks and toll links occupy half; patients effective treatment less time; disorder medicaltreatment, highlight the hidden dangers of doctor-patient contradiction.2. The charging mode of the endpoint type is the direction of the reform of hospitalout-patient process: Lock-activate the most fully embodies the concept ofpatient-centered, scientific and rational the end of charging mode technology, a highdegree of reality of the promotion and practical application of significance;implementation of the end of charging a need for legislation to protect both doctors andpatientslegitimate rights and interests, the Government has put more attention andexecution.