| BackgroundIn recent years, owning to the medical environment, the current situation of doctor-patient relationship got more serious, more pressure covered on the doctors. The reason to this problem contains social factors, including medical care system issues, incompletion of resolving the medical disputes, one-side reporting by the press, etc.; hospital factors, including a lack of communication between doctors and patients, excessive examination and treatment for patients, compromise under the extreme behavior of the patients, and imperfection of the medical quality management; and the patient factors, including the increased awareness of the rights of patients, over-expectations of the treatment results, and un-trust in doctors. During which, the imperfections of medical quality management is one of the most important factors, but there are still some common situations in many hospitals, and the exploration of scientific and effective medical quality management has become an important task in today’s hospitals. The walking around model which has been widely used in the enterprise’s management, as a new management approach, has been used in nursing, personnel and patients management, as well as other areas with great effect, but in the field of medical quality management use effects needs further exploration.PurposeWalking around model as a new management methods has been widely used in the enterprise, from many companies have benefited badly. Along with the changes of medical environment, the hospital medical management quality needs to be adjusted either. According to the statistics results of the application and the effect of walking around model from a certain Shanghai three-level hospital, strengths, weaknesses, improvement and suggestions were put forwards, in order to improve the standard of walking around model and the medical management quality level, finally to make it better use in hospital management.Research Methods1. Literature study:In the project designing stage, articles were retrieved and analyzed, by summarizing the references on walking around model and medical care, the research framework was established.2. Questionnaires:The questionnaires were finished under the guidance of the medical technicians, clinicians, administrators.3. Re-analysis of existing data:(1)One factor medical quality indicators from the department of surgery and internal medicine were compared from 2008-2012 in a certain three-level hospital in Shanghai. EXCEL2010 was used to establish a database with statistical charts (line graph) to described all the data, and the quality of work was analyzed through descriptive methods. All the data were analyzed by chi-square test and t test. (2) In 2008 and 2012, the patients’ satisfaction degree towards the medical technology sector and clinical departments were compared. (3) Aug.2011, the doctors’satisfaction degree towards walking around model was analyzed. (4) May 2011, the administrators’ satisfaction degree towards walking around model was analyzed.4. Quality control:(1) Investigator:Investigators was formed by experienced graduate and undergraduate students, relevant training was practiced on them, investigating methods were unified. (2) Quality control questionnaire:During the research, the medical technicians, clinicians, administrators were investigated by questionnaires. All the paper would be united, and the content and data would be reviewed, timely exchange of investigative experience could identify the problems promptly. (3) Computer data in-put and check-out:Survey the data then entered into the the computer, along with the proof-reading, in order to avoid man-made error, values missing and bias.Results and analysisThe results showed:First, the implementation of management by walking around model, to some extent, can improve the quality of medical care standards. The analysis result of the data from a certain three-level hospital in Shanghai, including unreasonable charges, medical prescriptions, secondary history, disputes, hospital infection and it’s omission, showed that, the walking around model management could make the result better, although some date might fluctuate to some extent. Second, walking around model management could enhance the satisfaction degree of different departments (P<0.0001). Walking around model management could balance the relationship between clinic and technician department, stifle the problems in the cradle, and solve them in immediately, besides, this kind of method made a bridge between the clinic and technician, increase the satisfaction degree, therefore could make better medical service for the patients. Third, the walking around model management needs more tension and support by the doctors, moreover, doctors considered it as a suitable method to meet and solve the problems. From the satisfaction degree survey, clinicians has a higher satisfaction degree (>90%) on the time arrangement of the management, evaluation content, form and the surveyors of inspection, and it’s effect; but lower on timeliness of inspection and rectification, feedback awareness, owning to lower frequency of the walking around model management, lower cover rates of feedback, and in-timeliness of rectification. The fourth, administrators had a higher degree of satisfaction. The result of this article showed, administrators had a satisfactory degree of 100 on clinical cooperation and the totally evaluation during the period of the walking around model management. As for those whom had the degree of 90, one administrator considered the evaluating system was simple and rigid, because the model was always the same, he also put forwards some suggestions that the model should be adjusted according to different departments and actual situations, another three persons said that, the management of walking around needed at least 0.5 hour earlier for work, but without compensory day-off, meanwhile, this sort of management has a conflict ion with present job in some degree, which seemed improer to some extent.Discussion and SuggestionsAlthough the walking around management method could make the medical service better, but also need to be improved in daily works. For example, this sort of management needs to increase the management frequency, to have a clear purpose, and not to stay in form, etc. |
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