| ObjectiveThe out-patient doctors in a comprehensive hospital in Dalian were observed,and the outpatients in this hospital were investigated by a questionnaire.We comprehensively analyzed the frequency and distribution of interruptions at the time of diagnosis,the major events that led to the interruption,and the duration of the interruption,and to understand patients’ psychological and behavioral responses to interruptions during diagnosis and treatment,and put forward countermeasures and suggestions accordingly,so as to provide references for hospitals to improve medical service quality and work efficiency,improve medical service satisfaction and reduce conflicts between doctors and patients.MethodsUsing qualitative and quantitative research methods,and consulting literature,field investigation and other ways to understand the current situation and existing problems of doctor s ’ diagnosis and treatment workflow interruptions.The database was established by using Excel2003,and the statistical analysis software of SPSS 21 and the corresponding statistical methods were used to carry out data statistics and analysis.The outpatient clinic treatment workflow observation data and outpatient questionnaire survey data related to the statistical description and analysis,and thus put forward the implementation of measures to deal with interruption of treatment and methods.Results1.The object of this study was 25 outpatient doctors.During the observation period,a total of 2877 visits were made,with an average of 4.58 minutes per visit.In the observation,it was found that there were 2103 workflow interruptions,and the average interruption was 9.59 times per hour.The total interruption time was 1622.02 minutes,and the average time for each interruption is 0.77 minutes.2.Distribution of workflow interruptions in the department,the internal medicine workflow interruptions averaged 11.51 times per hour,the surgery was 8.64 times,and the pediatric was 8.58 times.The average physician hourly workflow interruption washigher than surgery and pediatrics,the difference was statistically significant(χ2 =23.589,p <0.05).In gender,male doctors averaged 8.12 interruptions per hour,10.64 times for female doctors.The average hourly workflow interruption of female doctors was higher than that of male doctors,and the difference was statistically significant(χ2=31.155,p<0.05).On the job title,the average doctor had 9.57 interruptions per hour and the associate chief physicians were 9.89 and the resident physicians were 8.08.The average hourly workflow interruption of the deputy chief physician was higher than that of the chief physician and the chief physician.The results of the significance test were not statistically significant(χ2=4.834,p>0.05),it could not be considered that the average number of interruptions per hour of the deputy chief physician was higher than that of the chief physician and attending physician.3.There was a difference between the time of diagnosis and treatment of interruption and the time of diagnosis and treatment without interruption.In the total treatment time,the average diagnosis and treatment time without interruption was 3.67 minutes,and the interruption was 5.31 minutes.The time of diagnosis and treatment of interruption was 1.64 minutes more than the average time of diagnosis and treatment without interruption.In the effective treatment time,the average time of diagnosis and treatment for no interruption was 3.67 minutes,and the interruption was 4.29 minutes.An average of 0.62 minutes per visit was given for interrupted visits compared to uninterrupted visits.4.The workflow interruption caused by patients was the most,529 times,accounting for 25.15%,followed by other round trip patients,420 times,accounting for10.75%,equipment or technology failure was the least,13 times,accounting for 0.62%.5.Among the 811 outpatients surveyed,274(33.79%)patients were interrupted in the recent outpatient service,a total of 328 times.The number of workflow interruptions accounted for 40.44% of visits,with an average of 0.40 times a visit occurred forced disruption.6.At age,The patient’s dissatisfaction with the interruption decreased with age,the difference was statistically significant(χ2 = 9.087,p <0.05).In gender,the male dissatisfaction rate was higher than female patients,the difference was statistically(χ2 =4.412,p <0.05).In the education level,the higher the level of education,the higher the dissatisfaction rate of interruption,the difference was statistically significant(χ2 =13.402,p <0.05).7.Among the 811 outpatients surveyed,77.31% were dissatisfied with interruption at the time of their visit,and only 22.69% of patients were indifferent.The discontent of the patient was aggravated with the prolonged duration of the interruption.The tolerable time limit was 3.09 minutes,and the intolerable time limit was 6.38 minutes.Although patients were dissatisfied or intolerant of interruption,67.30% of patients would not take any actions to prevent interruption or complain to doctors.8.The top three patients were the most disliked diagnosis and treatment interruption were the doctors left temporarily(29.22%)during the visit,the doctors answered the phone(19.85%)and the rest(17.63%)caused by other medical staff.ConclusionHospital outpatient department doctors in the treatment of patients withinterruption were quite frequent,showing a high incidence of interruption of the treatment environment.Interruption events would prolong the doctors ’ treatment time,reduce the doctors’ work efficiency,and increase the doctors’ workload,negative effect in the evaluation of patients’ satisfaction with the medical service.Workflow interruption was not conducive to providing better and more efficient medical services for doctors in a short period of outpatient service.Patients’ dissatisfaction with interruption aggravated with the extension of interruption time.After interruption,doctors should explain or apologize to patients,and at the same time,shorten the duration of interruption as much as possible.Hospitals and medical staff should pay attention to outpatient service interruptions,actively control and avoid the occurrence of medical interruption,so as to further improve the quality of medical service and patient satisfaction. |
PDF Full Text Request