Ege Üniversitesi Acil Servise yapılmış şikayet başvurularının geriye dönük incelenmesi
Küçük Resim Yok
Tarih
2012
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Hasta memnuniyeti ?hastanın değer ve beklentilerinin ne düzeyde karşılandığı konusunda bilgi veren ve bakımın kalitesini gösteren temel ölçüt? olarak tanımlanmaktadır. Acil Tıp literatüründe hasta memnuniyeti son yıllarda giderek önem kazanmaktadır. Kaliteli bir acil tıp hizmeti için fiziki şartları iyi bina, tıbbi donanım, kalifiye insan gücü yanında, o bölgede acil servise başvuran hasta özelliklerinin de iyi biliniyor olması gerekir. Birçok şikâyet gelişim için fırsattır. Servis hizmeti kalitesi hakkında olumsuz görüş bildiren hastalar ve hasta yakınları, aslında problemlerin çözümü için olanak sağlarlar. Bu çalışmanın amacı, 11 yıllık dönemi kapsayan sürede Ege Üniversitesi Tıp Fakültesi Hastanesi acil servisine yönelik yapılmış olan, hasta veya hasta yakınlarına, kurumlara ait şikâyet başvurularının incelenmesi, şikâyet nedenlerin belirlenerek uygun çözüm önerileri sunabilmektir.Araç ve Yöntem: 2001-2011 tarihleri arasında EÜTF Hastanesi Halkla İlişkiler birimi, Disiplin ve Ceza İşleri birimi ve Hastane Yönetimi tarafından ön inceleme için acil servise gönderilmiş şahıs veya kurumlara ait şikâyet dilekçeleri olmak üzere toplam 474 şikayet başvurusu incelendi. Elde edilen veriler SPSS For Windows 16. 0 istatistik programına aktarılarak değerlendirildi. Gruplar arası bağıntı analizlerinde Spearman korelasyon testi kullanıldı. Frekans analizleri ile kategorik değişkenler arasındaki farklılıklar parametrik ki-kare testi ile analiz edildi.Bulgular: Bu çalışmada 733 başvuru formu incelendi. 259 adet başvuru çalışmaya alınmadı. Çalışmaya alınmayan başvuruların; %5' i mükerrer başvurular, %8' i bilgi edinme amaçlı gönderilen dilekçeler, %4. 6' sı hasta ve hasta yakınlarına ait memnuniyet dilekçeleri olduğundan, % 5' i ise hasta veya hasta yakınlarına ait şikâyet formlarında şikâyet eden veya edilene ait kimlik bilgileri verilmediği, şikâyetin hangi kliniğe ait olduğu net belirtilmediği için inceleme yapılamaması, bilgilere ulaşılamaması, 92' si (%12.6) farklı kliniklere ait şikâyetler olması nedeniyle çalışmaya alınmadı.Acil servise yıllara göre başvuran hasta sayısı ve bu yıllara göre şikayet oranları incelendiğinde, aralarında kuvvetli korelasyon olduğu saptandı (r:0.979, p:0.009). Acil servise başvuran hasta sayısı arttıkça şikâyet sayılarının da arttığı tespit edildi. Tüm yılların acil servise başvuran hasta sayısına göre şikâyet oranına bakıldığında bu oranın 2010 yılında en fazla olduğu saptandı.651 şikayet konusu incelendiğinde; işleyişle ilgili şikayet başvurularının %72. 8 (n=474), medikal hata iddiası ile ilgili başvuruların %20. 9 (n=136), fiziksel yapı ile ilgili şikayet başvurularının ise %6. 3 (n=41) oranında olduğu saptandı. Hakkında şikâyette bulunulan hekimlerin %33. 8' nin acil tıp hekimi, diğerlerinin ise acil tıp dışından hekimler olduğu saptandı. Yıllar içerisinde acil servise yönelik şikâyetlerin genel olarak arttığı fakat bu şikâyetler içerisindeki medikal hata iddialarının, genel şikâyetler içerisindeki oranının 2006 yılından itibaren azaldığı tespit edildi. Medikal hata iddialarının; en sık konsültan hekimlere (%10. 5), ikinci sıklıkta da rotasyoner hekimlere (%9) yapılmış olduğu tespit edildi.İşleyişle ilgili şikâyetler incelendiğinde; en fazla şikayet edilen konunun ?personelin davranışlarındaki olumsuzluk? ve ikinci sıklıkta ise ?bekleme süresinin uzun olması? ile ilgili olduğu görüldü. ?Bekleme süresinin uzun olması? ile ilgili şikâyetler incelendiğinde ise; %40. 4 oranında ?acilde herhangi bir kliniğe yatış için bekleme?, %25. 5 oranında ise ?triajda bekletilme? olduğu saptandı. ?Bekleme süresinin uzun olması? ile ilgili şikâyetlerin ?triajda bekletilme? ile ilgili bölümünün acil servisle ilgili olduğu, diğer bekletilme nedenlerinin acil servis dışı hastane organizasyonundaki sıkıntılardan kaynaklandığı saptandı.Tüm şikâyetlerin sonuçlanma durumuna bakıldığında; %95. 9' nun (n=624) sonuçlarına ulaşıldı ve yalnızca %16. 3' nün (n=106) ileri soruşturulmasına gerek görüldüğü tespit edildi.Sonuç: Türkiye' de son yıllarda sağlıkta dönüşüm programı kapsamında her geçen gün değişen konsept nedeniyle, hastaların hastanelerden beklentileri de farklılaşmaktadır. Acil servislerin hastanelerdeki rolü oldukça önemlidir ve acil servis işleyişi diğer kliniklerden farklıdır.Acil servislerde; acil hizmetler, bu konuda uzman tabip sorumluluğunda, acil sağlık hizmetleri konusunda eğitim görmüş, tecrübeli ve yeterli sayıda tabibin, hemşirenin ve diğer personelin de katılımı ile bir bütün olarak yürütülecek şekilde organize edilmesi gerekir.Acil servis hizmetleri, hastane içerisinde multidisipliner olarak yürütülmektedir. Acil servise yönelik şikâyetlerin büyük bir kısmı acil servisle ilgili olmayıp hastanenin diğer kliniklerin işleyişiyle ilgili olduğu görülmektedir. Bu konuda daha fazla veri toplayarak, düzenlemelere gidilmesi, ne yapılacağı konusunda daha sağlıklı tartışma ortamı sağlanabilmesi için, daha çok şikâyet başvurusunu içeren, prospektif tasarlanmış çalışmalara ihtiyaç vardır
Introduction: Patient satisfaction with information on the patient's values and expectations of the level and quality of care that met the basic criteria is defined as. Patient satisfaction in emergency medicine literature is becoming increasingly important in recent years. Emergency medical service, good physical conditions for a quality building, medical equipment, skilled manpower, as well as characteristics of patients admitted to emergency service in that area must be well known. Opportunity for the development of many complaints. Stating a negative opinion about the quality of service to patients and relatives of the patient, in fact, allow us to solve problems. The purpose of this study, covering the period 11years period made for the emergency department of Ege University Medical Faculty Hospital, patients or their relatives complained of the examination of applications and to provide appropriate solutions.Methods: Ege University Hospital between 2001-2011 Public Relations unit, discipline and for preliminary review by the Director of Criminal Affairs unit and the hospital sent to the emergency department complaining of persons or institutions for a total of 474 petitions were two applicants. The data obtained were transferred to SPSS for Windows 16.0 statistical program. Spearman rank correlation test was used for correlation analysis between the groups. Frequency differences between the parametric analyzes, chi-square test for categorical variables were analyzed.Findings: This study examined 733 pieces of the application form complaint-satisfaction. 259 (35. 3%) application are not taken in the study. Applications are not taken in the study; 37 (5%) repeated references, 59 (8%) for the acquisition of information sent to the petitions, 34 (4.6%) of patients and their relatives are pleased petitions, 37 (5%) complaints by patients or relatives of patients who complain of the forms of credentials belonging to or granted to that complaint, which clearly stated to belong to the clinic for the investigation of making, the information can not be reached, 92 (12.6%) were excluded because of complaints by the different clinics.The number of patients presenting to the emergency department over the years and these rates were complaints over the years, among them there was a strong correlation (r = 0.979, p = 0.009). As the number of patients admitted to the emergency department was found to increase the number of complaints. All years of complaints by the number of patients admitted to the emergency department in 2010, this ratio is taken into consideration, there was a maximum.651 subject of the complaint is examined, 72.8% working arrangements applications for complaints (n = 474), 20.9% of applications related to medical malpractice claims (n = 136), complaining about the physical structure 6.3% (n = 41) were found to be the rate. About 33.8% of physicians complained of emergency medicine physicians, emergency medicine, while others were from outside physicians. Over the years, as a general increase in complaints to the emergency department medical malpractice claims, but in these complaints, general complaints were reduced in the ratio since 2006. Medical malpractice claims, the most frequent consultant physicians (10.5%), the second most common rotationer assistants (9%) were found to have been made.Complaints about working arrangements examined, the more complaints the subject "negative behavior of the staff" and the second most common "is a long waiting time" was about. "Waiting time is long" is examined complaints about, the rate of 40.4% "in the emergency department waiting for any admission to a clinic," 25.5% percent, while "holding triaj" was established. "Waiting longer duration" of complaints about "holding triaj" is related to the service related to the emergency department, other non-hospital emergency service organization of the causes of the detention was due to hardship.In the examination of all complaints to result, %95. 9 's (n = 624) the results achieved, and only % 16. 3 `s (n = 106) were deemed necessary by further investigation.Results: In Turkey within the scope of the health transformation program in recent years due to the ever-changing concept, patients in hospitals differs from expectations. Emergency services are very important role in the functioning of hospitals, and emergency services are different from other clinics.In the emergency departments, emergency fascilities, the responsibility of the medical experts in this area, have been trained in emergency medical services, and a sufficient number of experienced surgeon, with the participation of nurses and other staff must be organized so as to perform as a whole.Emergency services, carried out by a multidisciplinary team within the hospital. The majority of complaints to the emergency department with the operation of the hospital's emergency service that are not related. Collecting more data on this subject, arrangements in, a healthy debate about what to do in order to ensure the reference contains more than complain, prospectively designed studies are needed.
Introduction: Patient satisfaction with information on the patient's values and expectations of the level and quality of care that met the basic criteria is defined as. Patient satisfaction in emergency medicine literature is becoming increasingly important in recent years. Emergency medical service, good physical conditions for a quality building, medical equipment, skilled manpower, as well as characteristics of patients admitted to emergency service in that area must be well known. Opportunity for the development of many complaints. Stating a negative opinion about the quality of service to patients and relatives of the patient, in fact, allow us to solve problems. The purpose of this study, covering the period 11years period made for the emergency department of Ege University Medical Faculty Hospital, patients or their relatives complained of the examination of applications and to provide appropriate solutions.Methods: Ege University Hospital between 2001-2011 Public Relations unit, discipline and for preliminary review by the Director of Criminal Affairs unit and the hospital sent to the emergency department complaining of persons or institutions for a total of 474 petitions were two applicants. The data obtained were transferred to SPSS for Windows 16.0 statistical program. Spearman rank correlation test was used for correlation analysis between the groups. Frequency differences between the parametric analyzes, chi-square test for categorical variables were analyzed.Findings: This study examined 733 pieces of the application form complaint-satisfaction. 259 (35. 3%) application are not taken in the study. Applications are not taken in the study; 37 (5%) repeated references, 59 (8%) for the acquisition of information sent to the petitions, 34 (4.6%) of patients and their relatives are pleased petitions, 37 (5%) complaints by patients or relatives of patients who complain of the forms of credentials belonging to or granted to that complaint, which clearly stated to belong to the clinic for the investigation of making, the information can not be reached, 92 (12.6%) were excluded because of complaints by the different clinics.The number of patients presenting to the emergency department over the years and these rates were complaints over the years, among them there was a strong correlation (r = 0.979, p = 0.009). As the number of patients admitted to the emergency department was found to increase the number of complaints. All years of complaints by the number of patients admitted to the emergency department in 2010, this ratio is taken into consideration, there was a maximum.651 subject of the complaint is examined, 72.8% working arrangements applications for complaints (n = 474), 20.9% of applications related to medical malpractice claims (n = 136), complaining about the physical structure 6.3% (n = 41) were found to be the rate. About 33.8% of physicians complained of emergency medicine physicians, emergency medicine, while others were from outside physicians. Over the years, as a general increase in complaints to the emergency department medical malpractice claims, but in these complaints, general complaints were reduced in the ratio since 2006. Medical malpractice claims, the most frequent consultant physicians (10.5%), the second most common rotationer assistants (9%) were found to have been made.Complaints about working arrangements examined, the more complaints the subject "negative behavior of the staff" and the second most common "is a long waiting time" was about. "Waiting time is long" is examined complaints about, the rate of 40.4% "in the emergency department waiting for any admission to a clinic," 25.5% percent, while "holding triaj" was established. "Waiting longer duration" of complaints about "holding triaj" is related to the service related to the emergency department, other non-hospital emergency service organization of the causes of the detention was due to hardship.In the examination of all complaints to result, %95. 9 's (n = 624) the results achieved, and only % 16. 3 `s (n = 106) were deemed necessary by further investigation.Results: In Turkey within the scope of the health transformation program in recent years due to the ever-changing concept, patients in hospitals differs from expectations. Emergency services are very important role in the functioning of hospitals, and emergency services are different from other clinics.In the emergency departments, emergency fascilities, the responsibility of the medical experts in this area, have been trained in emergency medical services, and a sufficient number of experienced surgeon, with the participation of nurses and other staff must be organized so as to perform as a whole.Emergency services, carried out by a multidisciplinary team within the hospital. The majority of complaints to the emergency department with the operation of the hospital's emergency service that are not related. Collecting more data on this subject, arrangements in, a healthy debate about what to do in order to ensure the reference contains more than complain, prospectively designed studies are needed.
Açıklama
Anahtar Kelimeler
İlk ve Acil Yardım, Emergency and First Aid, Acil servis-hastane, Emergency service-hospital, Acil tıp, Emergency medicine, Acil tıp servisleri, Emergency medical services, Hasta memnuniyeti, Patient satisfaction, Hastane hasta ilişkileri, Hospital patient relations, Yanlış teşhis ve tedavi, Malpractice, Şikayet, Complaint
