El análisis de la calidad asistencial desde la perspectiva de la satisfacción y la experiencia del paciente: una mirada enfermera / An analysis of assistance quality from the perspective of patience satisfaction and experience: A nursing view

Este artículo pretende describir dos grandes aspectos: la satisfacción y la experiencia del paciente, y cómo medirlos y analizarlos en los campos de la gestión sanitaria, la gestión clínica y los servicios sanitarios. Dichos elementos están inmersos en el abordaje en seguridad del paciente y permiten que la enfermería se relacione con temas como la calidad de los cuidados, la satisfacción del usuario, su experiencia dentro del sistema, los cambios y la implementación de mejoras así como sus formas de medición y análisis dentro del vasto campo de la gestión clínica y sanitaria. Aunque se trata de un tema ampliamente explorado y complejo, susceptible de ser abordado por métodos cuantitativos y cualitativos, en el que la encrucijada entre calidad total, calidad percibida, satisfacción y experiencia parece conformar la hoja de ruta, el artículo aporta conceptos de reciente aparición como Healthcare Improvement Science (mejora de la ciencia de la salud), centrado en la mejora de la calidad del cuidado de la salud y la reducción de daños a los usuarios de los servicios y sus familias; Magnet Hospital (hospital magnético), que relaciona la satisfacción de los profesionales con la calidad de los cuidados, y Patient Experience Officer (director de la experiencia del paciente), nuevo perfil laboral creado en Estados Unidos, centrado en la mejora continua de la calidad a partir de la experiencia del paciente. Todos estos conceptos han sido desarrollados por instituciones e investigadores reconocidos en la materia. En conclusión, en este artículo se resumen algunas de las cuestiones clave que se deben tener en cuenta a la hora de analizar la experiencia del paciente, que es un elemento importante para la mejora y el mantenimiento de la calidad en la atención sanitaria.

This article aims to describe two major aspects: patient satisfaction and experience and the way these are measured and analyzed within health management, clinical management, and health services. These elements are immersed within processes of patient safety and assume a motive for nursing of interweaving issues such as quality of care, user satisfaction, user experience within the system, change and the implementation of improvements, as well as ways of measuring and analyzing these issues within the vast field of clinical and health management. This is a widely explored and complex topic where total quality, perceived quality, satisfaction, and experience appear to make up a crossroad that needs to be taken into account and whose engagement is susceptible to qualitative and quantitative measurements. This article, however, contributes new concepts like Healthcare Impro-vement Science, centered on the improving the quality of health care and reducing harm to users of services and their families, Magnet Hospital, where the satisfaction of employed professionals is related with quality of care, and Patient Experience Officer, a new job profile created in the United States focused on the continuous improvement of patient experience quality. All these concepts were developed by recognized institutions and researchers in the field. In conclusion, this article summarizes some of the key issues that must be taken into account when analyzing the patient's experience, which is an important element for the improvement and maintenance of quality in health care.

Implementation of nursing council for magnet hospital construction / 中华护理杂志

In order to improve work environment for nurses and establish magnet hospital,nursing council was created in year of 2015,consisting of unit-based council,clinical resources council,nursing core council,nursing coordinating council and supportive system,to lead nurses to participate in nursing management and decision-making.After two years' implementation,profession nursing management index was increased from 174.13±43.90 to 170.25±38.98,and nursing management mode was transformed into shared governance,clinical nurses admitted nursing council system,and they believed it improved their awareness of responsibility and interpersonal support.Implementation of nursing council have positive effects on establishment of magnet hospital.

Implementation of nursing professional practice model in magnet hospital construction / 中华护理杂志

Objective To develop nursing professional practice model and explore its effects on magnet hospital construction.Methods The core team was established,and nursing professional practice model was developed based on standard of International Magnet Recognition Program.Nursing practices were guided by the developed model:leading clinical nurses to participate in nursing management and decision making,implementing primary holistic nursing,encouraging multidisciplinary collaboration,developing healthy work environment,promoting nursing professionalism,and fostering nursing culture.Results After two years' implementation,employment rate of interior interns was increased from 50.20％ to 72.30％(x2=22.879,P＜0.05).Nursing adverse events,nurses' job satisfaction,patient satisfaction met standard of magnet recognition.Conclusion Nursing professional practice model can increase employment rate of interior interns,decrease nursing adverse events,improve nurses' and patients' satisfaction,which has positive impacts on magnet hospital construction.

Implementation of nursing professional practice model in magnet hospital construction / 中华护理杂志

Objective To develop nursing professional practice model and explore its effects on magnet hospital construction.Methods The core team was established,and nursing professional practice model was developed based on standard of International Magnet Recognition Program.Nursing practices were guided by the developed model:leading clinical nurses to participate in nursing management and decision making,implementing primary holistic nursing,encouraging multidisciplinary collaboration,developing healthy work environment,promoting nursing professionalism,and fostering nursing culture.Results After two years' implementation,employment rate of interior interns was increased from 50.20％ to 72.30％(x2=22.879,P＜0.05).Nursing adverse events,nurses' job satisfaction,patient satisfaction met standard of magnet recognition.Conclusion Nursing professional practice model can increase employment rate of interior interns,decrease nursing adverse events,improve nurses' and patients' satisfaction,which has positive impacts on magnet hospital construction.

Research hot spot analysis on the foreign magnetic hospital nursing management based on the literature metrology / 中国实用护理杂志

Objective To investigate researches on magnet hospital and nursing management from January 1,2010 to December 31,2014 in PubMed database and provide reference information for the majority of professionals in deep research.Methods Bibliographies from research literature of magnet hospital and nursing management from January 1,2010 to December 31,2014 in PubMed database were downloaded.The publication years,journals,countries of publication,the high yielding first authors and the high frequency of main subject were counted by Bicomb 2.0 software.The affiliations were analyzed artificially.main subject appeared no less than two times were intercepted as high frequency ones and the high frequency main subject co-occurrence matrix were formed.SPSS20.0 statistical software were applied for clustering analysis with matrix,then to get the topic hotspots.Results A total of 62 literatures were screened out.The data of research trend,journals,research degree of countries were acquired.The number of high frequency main subject were 18 and among which 4 research hotspots were clustered,respectively workplace environment and job satisfaction,nursing education,nursing quality administration,creation and leadership.Conclusions Researches on magnet hospital and nursing management from January 1,2010 to December 31,2014 in PubMed database are mainly in terms of workplace environment and job satisfaction,nursing education,nursing quality administration,creation and leadership.They are the foundation of the current research situation and trend of magnet hospital nursing management,and can improve management efficiency and provide reference for scientific research topic selection project.

Hospitales magnéticos para la mejora de la calidad del cuidado / Magnet Hospitals to Improve Quality of Care

Resumen

En las instituciones de salud a nivel nacional existe escasez y una alta rotación de enfermeras, ambas situaciones se atribuyen a la insatisfacción laboral que puede ser causada por el síndrome de Burnout, poco reconocimiento entre pares y de la sociedad, percepción de falta de apoyo para la capacitación y desarrollo profesional, sobrecarga de trabajo en relación a la asignación del número de paciente/enfermera; lo anterior provoca mala calidad en la atención, aumento en los eventos adversos, altos costos en salud y por consiguiente, insatisfacción del usurario. Una estrategia para resolver esta problemática son los Hospitales Magnéticos considerados como aquellos que atraen y retienen a los profesionales de enfermería en las instituciones de salud para brindar cuidados de excelencia a través de ocho elementos magnéticos. Es por ello que en este trabajo se vinculan las ocho fuerzas magnéticas con la trilogía de evaluación de la calidad de Donabedian, destacando los beneficios para el paciente, el profesional de enfermería, la institución y la sociedad. Con ello el lector identificará áreas de oportunidad para su práctica diaria.

Summary

Nationwide there is a shortage and high turnover of nurses in health institutions, both are attributed to job dissatisfaction that can be caused by Burnout syndrome, little recognition among peers and society, perceived lack of support for training and professional development, overburden related to the number of patients per nurse; aforesaid can led to poor quality of care, increase of adverse events, high costs in health care and therefore user dissatisfaction. A strategy for solving this problem are Magnet hospitals considered as those that attract and retain nurses in health institutions to provide excellence in care through eight magnetic elements. That is why this paper links the eight magnetic forces to Donabedian’s trilogy of quality assessment, highlighting the benefits for patient, nursing professionals, the institution and society. With this the reader will identify areas of opportunity in daily practice.

Hospital Magnético, ¿qué es y cómo funciona? / Magnet hospital ¿what is and how it works?

Introducción : En el presente documento se aborda la importancia de conocer modelos de atención hospitalaria conocidos como magnéticos, en donde se logra la calidad del cuidado de enfermería y la satisfacción laboral entre otros factores, que se traduce en beneficios para los pacientes, el personal de enfermería y las instituciones. Desarrollo: Se revisan los antecedentes de los hospitales magnéticos, los elementos que se han identificado como esenciales para proporcionar cuidados de calidad de enfermería. Así como los factores que se han relacionado con este tipo de modelo de atención, que ponen de manifiesto. La importancia del rol del personal de enfermería en la atención de los pacientes y los resultados para las organizaciones. Conclusiones: Es necesario conocer estos modelos de atención en nuestro país, generando líneas de investigación que pongan de manifiesto la importancia que tiene contar con elementos necesarios para generar ambientes y entornos seguros y saludables de trabajo.

Introduction: This study highlights the importance of hospital attention models known as magnet, through which, quality of care and nurse satisfaction are achieved, generating benefits for patients, nurses, and institutions. Development: Showing the importance of nurses, high quality care identified elements and magnet attention model factors are addressed from background literature. Conclusion: It is necessary to adopt these models in our country; and therefore, it is necessary to develop research projects aimed to help generate safe and healthy working conditions for nurses.