The Investigation On Knowledge,Attitudes,practices Of Quality Management Tools Of Public Hospitals In Henan Province

ObjectiveInvestigation status of public hospital in Henan province quality management tools application,and understand the medical workers in Henan province cognitive evaluation of quality management tools,application support and training needs and demand,promote quality management tool for the public health administrative department of Henan province,to carry out all kinds of training to provide the reference data,policy advice,quality management tool for medical institutions to promote the use and the improvement of management level is put forward relevant suggestions.MethodA certain number of secondary and tertiary hospitals in Henan province were selected by multi-stage and stratified random sampling method.Medical staff in the hospital were randomly selected in a cluster based on departments.The self-designed questionnaire was used as a survey tool to conduct a questionnaire survey on public hospitals and medical staff.EpiData3.1 was used to establish the database and double check the input data.SPSS21.0 software was used for descriptive analysis and statistical difference test analysis of the survey data,2 test and Fisher’s exact probability method were used for the count data,t test and one-way variance were used for the measurement data,and the significance test level was = 0.05.Result1.Basic conditionThere are 20 hospitals in this survey,including 9 tertiary hospitals and 11 secondary hospitals.A total of 765 questionnaires were issued,and 719 questionnaires were collected.A total of 685 valid questionnaires were issued,and 379 and 306 questionnaires were sent to secondary and tertiary hospitals respectively.The respondents were mainly female(88.9%),543 nurses(79.3%);there were 569 people(83.1%)with bachelor’s degree.The number of junior and intermediate titles was 562,accounting for 82.0% of the total.Working years < 10 years was 546,accounting for 79.7% of the total.2.Cognition conditionThe quality management tool with the highest cognitive score of medical staff is quality management circle(3.83±1.03),and the one with the lowest cognitive score is six sigma management(2.01±0.84).Medical staff understand quality management tools through relevant academic conferences or lectures(62.0%),participation in or watching various competitions(49.2%)and other channels.3.Promote conditionAn independent quality management office was set up in 80.0% of the hospitals,and the "quality control department" was responsible for the promotion and application of modern management tools in 55.0% of the hospitals,and the "department without special responsibility" was set up in 15.0% of the hospitals.50.0% of the hospitals "included the application of modern management tools in performance appraisal",and 45.0% of the hospitals gave "material and spiritual rewards".The average score of medical staff’s importance evaluation of modern management tools is > 4 points(full score is 5 points).62.0% of medical staff applied modern management tools and expected to obtain "both material and spiritual rewards".Without incentives,13.7% of medical staff would not apply modern management tools.4.Application conditionAmong the 20 hospitals surveyed,the average number of quality management tools applied in each hospital was 2.65,and the three quality management tools with the highest development rate were clinical pathway(80.0%),quality control circle(60.0%),and PDCA cycle(45.0%).The overall application rate of quality management tools for medical staff in tertiary hospitals(89.2%)was significantly higher than that in secondary hospitals(79.9%),and the difference was statistically significant(P<0.05).The three quality management tools with the highest application rate for medical staff were clinical pathway(59.7%),quality control circle(55.9%)and PDCA cycle(27.7%).5.Training conditionThe main forms of quality management tool training carried out by 20 hospitals are: "inviting experts outside the hospital to give lectures and guidance","attending professional competitions to observe and learn",and "attending professional academic conferences",all accounting for 70.0%.The proportion of medical staff in tertiary hospitals receiving quality management tool training(77.5%)was significantly higher than that in secondary hospitals(57.0%),and the difference was statistically significant(P<0.05).The first three quality management tools that medical staff expect to receive training are: quality control circle(65.1%),PDCA cycle(58.0%),and total quality management(47.3%).Conclusion1.The application of most quality management tools lacks the advocacy and support of health administrative departments,hospital functional departments and other relevant organizations,with small promotion force,low overall application rate and concentrated application in the field of nursing.2.Medical staff lack the training of quality management tools,and their overall cognitive level of quality management tools is low.They have insufficient theoretical knowledge and are not familiar with operating methods,and they are not very motivated to apply quality management tools.3.Medical staff have a high demand for quality management tool training and a strong willingness to train.It is suggested that health administrative departments should strengthen the publicity and promotion of quality management tools,organize and carry out various levels of training,give corresponding financial support,promote the implementation of quality management tools in medical institutions,and realize scientific,standardized and refined hospital management.