Medical Staff’s Experience In Practicing Medical Services And Practicing Environment

Objective:Through the satisfaction survey of the medical service and the practicing environment of the medical staff of the three provincial-level hospitals in Nanchang,we will grasp the changes in satisfaction in 2016 and 2017,and scientifically analyze the experience of medical staff in the practice of medical services and the practice environment,and understand the medical care.Personnel practice status and physical and mental feelings,and propose suggestions for improvement,provide decision-making information and reference basis for improving the working environment and treatment of medical staff,and provide theoretical support for further improvement of medical services.Methods:Using the stratified equidistant sampling method,qualified clinicians and nurses were selected from three hospitals,and they were surveyed twice in 2016 and 2017respectively.The questionnaire survey method was used to provide medical practitioners with medical services and practice.The environmental experience and related factors were investigated by questionnaires,and the satisfaction of medical staff on workload and physical and mental health,practicing environment and professional identity,hospital management,welfare treatment and job satisfaction were obtained.χ~2 test,t test,Non-parametric test,multiple linear regression analysis and other methods were used to statistically analyze the collected data.Results:(1)The constructed medical staff and practice environment questionnaires were divided into 23 items in 4 dimensions.The Cronbach’s Alpha values of the four evaluation dimensions were all between 0.703 and 0.893,and the overall Cronbach’s Alpha value was 0.944.The KMO value of the questionnaire was 0.812 and passed the Bartelett spherical test(P<0.001).The cumulative contribution rate of the total variance of the four common factors extracted was 70.345%.(2)The overall satisfaction in 2016 and 2017 was 3.23±0.686 and 3.22±0.638,respectively,and there was no difference between the two years(t=0.499,P>0.05).Among the 4 dimensions,(1)Dimension I:physical and mental health and workload scores were 2.99±0.676,2.92±0.655,respectively,in 2016,the score was significantly higher than 2017(t=2.148,P<0.05);(2)Dimension II:two years The practice environment and professional identity were 3.24±0.754,3.28±0.678,and the score decreased by 0.04 points,the difference was not obvious(t=1.163,P>0.05).(3)Dimension III:The hospital management in the two years was 3.44±0.916,3.41±0.868,and the score decreased by 0.03,the difference was not obvious(t=0.664,P>0.05).(4)Dimension IV:The satisfaction of welfare and treatment for two years was 3.27±0.813,3.26±0.738,and the score decreased by 0.01,the difference was not obvious(t=0.172,P>0.05).(3)The items with significant increase in satisfaction of 23 items in the two years included:(1)the workload satisfaction score increased by 0.3 points(P<0.001),(2)the medical staff value increased by 0.2 points(P<0.001),(3)social identification and respect increased by 0.13 points(P<0.05),(4)medical work achievement increased by 0.16 points(P<0.05),(5)overall medical practice increased by 0.19points(P<0.001).The items with significant decline in satisfaction included:(1)physical health satisfaction score decreased by 0.3 points(P<0.001),(2)mental health satisfaction score decreased by 0.22 points(P<0.001),(3)satisfaction with patient communication time decreased by 0.1 points(P<0.05).(4)satisfaction with the praise or complaint mechanism decreased by 0.11 points(P<0.05),(5)satisfaction with the income distribution plan decreased by 0.15 points(P<0.05),(6)satisfaction with the cooperation and trust of colleagues decreased by 0.14 points(P<0.005).There was no difference in the remaining 12 entries(P>0.05).(4)Multiple linear regression found that male satisfaction was lower than female(?=0.075,P<0.05),overall doctor satisfaction was lower than nurses(?=0.270,P<0.001),and those with lower professional titles were higher than those with higher professional titles(?=-0.066,P<0.001),obstetrics and gynaecology staff is higher than other hospital departments(such as ENT,ophthalmology,dermatology,etc.)(?=0.171,P<0.001),other small departments were higher than the average level of 4large departments including internal medicine/surgery/obstetrics and gynecology/pediatrics(?=0.177,P<0.001).Conclusion:(1)The questionnaire has good reliability and validity.The questionnaire for the medical staff and the practice environment questionnaire constructed by this time is divided into 23 items in 4 dimensions.The reliability and validity of the questionnaire are ideal.(2)The overall change in the satisfaction of medical staff on the medical service and the practicing environment is not obvious.Among the four dimensions,the satisfaction of the physical and mental health and workload dimensions increased significantly,and the satisfaction of the other three dimensions did not change significantly.(3)The satisfaction of 23 items in two years was mixed.There were 5 items with significantly higher satisfaction,6 items with significantly lower satisfaction,and the remaining 12 items with no difference.It is suggested that from the perspective of medical staff,the focus of improving medical services should be:to improve the health and health of medical staff,increase communication time with patients,improve the mechanism of praise or complaints,rationally optimize income distribution programs,increase cooperation and trust among colleagues,and build well.(4)There is a significant difference in the overall satisfaction of medical staff with different natures in the practice of medical services and the practice environment.The overall satisfaction of doctors,men,high-ranking titles,internal/external/pediatric medical staff is low,and these people should be focused on and effective measures should be taken to improve the satisfaction of key populations.