麻醉科质量改进小组绩效评估。

Fu-Lan Wang, Liz Lee, Sheu-Hua Lee, Shan Wu, Chih-Shung Wong
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引用次数: 1

摘要

在医疗卫生领域,特别是近十年来,质量改进路径一直被视为控制成本、提高效率、提升服务质量的关键指标。从理论、临床实践和研究数据来看,质量改进团队通过改进过程在适应不断变化的卫生环境和提高竞争力方面发挥了重要作用。摘要本研究旨在探讨质量改善团队干预对麻醉科成员工作满意度、士气、组织承诺和库存管理的影响。方法本研究采用准实验、纵向设计。研究对象为某综合医院45名护士麻醉师(实验组,质量改进组干预组)和50名手术室护士(对照组)。质量改进小组按照质量改进流程启动并实施了8个月。采用GEEs (Generalized estimingequations)模型检验两组员工在工作满意度、士气、组织承诺以及库存管理方面的差异。结果除年龄、婚姻状况、学历、岗位、护理经验等学历因素外,质量改进团队均存在自然增长效应。结果显示,实验组在干预后对工作满意度和组织承诺均有显著的正向影响。士气量表在两组之间没有显著差异。在库存管理方面,试验组每月的耗材库存成功减少,下降率为24.8%,而对照组在基础库存上反而增加了16.9%。结论本研究与以往的研究结果一样,也证明了质量改进团队的干预可以提高麻醉护士的工作满意度,如促进自主、组织政策和积极的成员互动。此外,它提高了工作效率,服务质量和库存的控制。
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Performance evaluation of quality improvement team in an anesthesiology department.
BACKGROUND In health care community, quality improvement pathway has always been treated as critical index to control cost, improve efficiency and promote service quality, particularly in the last decade. From theoretical standpoint, clinical practice as well as research data, quality improvement team has been demonstrated to play an important role in the adaptation to the changing health environment and enhancement of the competition through the improvement process. The purpose of this study was to explore members' job satisfaction, morale, organizational commitment and inventory management through quality improvement team intervention in a department of anesthesiology. METHODS This study was of a quasi-experimental and longitudinal design. The subjects involved 45 nurse anesthetists (the experiment group, intervention of quality improvement team) and 50 operation room nurses (control group) in a general hospital. The quality improvement team had been initiated and implemented pursuant to the quality improvement process for 8 months. GEEs (Generalized Estimating Equations) model was used to examine the differences in job satisfaction, morale, organizational commitment, and the inventory management was also examined between two groups. RESULTS After control of all variables, except education background, such as age, marital status, education, position and nursing experience, a natural growth effect was observed on quality improvement team. The results revealed that the experimental group showed significant positive effects on both job satisfaction and organizational commitment after the intervention. The morale scale did not differ significantly between two groups. In the inventory management, the experimental group successfully decreased the monthly consumable materials stock with a descending rate of 24.8%, while in the control group, the inventory was increased 16.9% in the basal stock instead. CONCLUSIONS As other previous reports did, the present study also demonstrated that intervention of the quality improvement team improves the nurse anesthetists' job satisfaction, such as promotion of autonomy, organizational policy and positive member interaction. Moreover, it improves work efficiency, service quality as well as control of the stock inventory.
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