陈麒麟　封秀萍　郑彦　魏萱　李振香　冯玉婕

[关键词] 门诊;质量管理;指标体系;德尔菲法

[中图分类号] R197.323          [文献标识码] C          [文章编号] 1673-9701（2021）17-0147-04

Construction of outpatient quality management system of tertiary hospitals in Shandong province

CHEN Qilin   FENG Xiuping   ZHENG Yan   WEI Xuan   LI Zhenxiang   FENG Yujie

Outpatient Department， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Ji′nan   250021， China

[Abstract] Objective To construct the outpatient quality management system of tertiary hospitals in Shandong Province， and to provide a reliable basis for improving the quality of outpatient management in the province and promoting homogenized services. Methods A preliminary questionnaire for outpatient quality management standards in Shandong Province was drafted through research on national medical and health policies and group discussions. The Delphi method was used to organize two rounds of expert consultation. The experts evaluated the importance level， familiarity， and judgment basis of the items， and put forward suggestions for additions and deletions. The expert opinions were summarized. The arithmetic mean of importance grade scores， full score ratio， coefficient of variation， and coordination coefficient were calculated， and the enthusiasm and authority of experts were evaluated. Results The positive coefficient of the two rounds of expert consultation was 100%. The coordination coefficient （W） was 0.306， 0.311， χ2=425.603， 441.977， P=0.00， 0.00. The authority coefficient of the expert was 0.902. The result is an outpatient quality management system with eight dimensions and 40 specific items. Eventually， an outpatient quality management system including 8 dimensions and 40 specific items was formed. Conclusion This study has established the outpatient quality management system of tertiary hospitals in Shandong Province， which is highly scientific and authoritative， and provides an important basis for outpatient quality management in our province.

[Key words] Outpatient; Quality management; Index system; Delphi method

門诊是患者到医院就诊最早接触的场所，是医院面向社会、为患者提供医疗服务的重要窗口，门诊作为医院工作的重要环节，其工作的优劣、质量的高低是医院整体技术水平的直接反映，是衡量医院管理水平的重要指标之一[1-4]。有学者指出，医疗服务质量是医院发展的生命线和医院管理的核心内容[5-8]，直接决定了医疗机构的竞争力[9]。评价医疗质量离不开评价指标[9]，一个好的评价指标体系可以真实、客观、公正的反映医疗质量的实际水平，从而促进医院进一步提高医疗质量、改善医疗服务[10]。

尽管《进一步改善医疗服务行动计划（2018-2020年）》、《国务院办公厅关于加强三级公立医院绩效考核工作的意见》、国家等级医院评审标准等均对门诊质量管理及其评价指标提出了要求，但国内相关研究主要集中在住院部，对门诊重视程度不够[11]，专门针对门诊质量管理体系的研究相对缺乏，在门诊服务质量、门诊医疗质量管理方面尚未建立规范的质量控制标准[12]。

鉴于此，本研究以山东省门诊管理质量控制中心为依托，结合我省医疗机构门诊管理实际情况和工作经验，由山东省门诊管理质量控制中心挂靠单位山東第一医科大学附属省立医院作为牵头单位，联合质控中心内国家卫健委委属委管三级医疗机构2家、山东省卫健……