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Reducing waiting time and raising outpatient satisfaction in Chinese public tertiary hospitals: an interrupted time-series study
Poster Abstracts
Reducing waiting time and raising outpatient satisfaction in Chinese public tertiary hospitals: an interrupted time-series study Jing Sun*, Hong Li*, Qian Lin, Qiongyao Zhang, Kai Xu, Huiying Chen, Pengyu Zhao, Hongyu Fu, Cecile J Hu, Mark Stuntz, Yunali Liu
Abstract
Background It is globally agreed that a well-designed health system delivers timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few interventions were well documented, and the effects were rarely measured with robust methods. Methods We did a longitudinal study of the length of waiting times in a public tertiary hospital in southern China, which developed comprehensive data collection systems. Data were extracted from the hospital’s information systems and patient satisfaction surveys. We analysed longitudinal time-series data using a segmented linear regression model with SPSS 21·0 to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was done to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0·05. Findings The monthly average length of waiting time decreased by 3·49 min (p=0·003) for consultations and by 8·70 min (p=0·02) for filling prescriptions in the corresponding month in which respective interventions were introduced. The trend shifted from baseline from a slight increase to a significant decrease in time for filling prescriptions (p=0·003). We found a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r=–0·71; p=0·004). Interpretation The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorised by the hospital managers. This case provides a model of continuous quality improvement and optimisation of management process with the support of relevant evidence. Funding National Health and Family Planning Commission of China.
Published Online December 11, 2017 *contributed equally School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (J Sun PhD, P Zhao PhD, Hongyu Fu MSc, Prof Y Liu PhD); Nursing School, Affiliated Clinical Medical Institute of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, China (Prof H Li PhD); Patient Service Center (Q Lin MD, H Chen MSc), Center of Hospital Information (Q Zhang MD), and General Office (K Xu MSc), Fujian Provincial Hospital, Fuzhou, China; Deerfield Institute, Shanghai, China (C J Hu MPA); and Deerfield Institute, New York, NY, USA (M Stuntz MPH) Correspondence to: Prof Yuanli Liu, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China [email protected]
Contributors JS, KX, and HL contributed to the concept of the paper and study design. QL, QZ, and HC collected and analysed the data. JS, PZ, and HC took a key role in analysing the data. PZ did the statistical analysis. JS wrote the first draft of the abstract. All authors assisted in data analysis and interpretation. JS, QL, HC, HL and YL made substantial contributions to the final data analysis and interpretation and critically revised the paper. CJH and MS reviewed and edited the abstract. All authors have seen and approved the final version of the Abstract for publication. Declaration of interests We declare no competing interests.
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Reducing waiting time and raising outpatient satisfaction in Chinese public tertiary hospitals: an interrupted time-series study Jing Sun*, Hong Li*, Qian Lin, Qiongyao Zhang, Kai Xu, Huiying Chen, Pengyu Zhao, Hongyu Fu, Cecile J Hu, Mark Stuntz, Yunali Liu
Abstract
Background It is globally agreed that a well-designed health system delivers timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few interventions were well documented, and the effects were rarely measured with robust methods. Methods We did a longitudinal study of the length of waiting times in a public tertiary hospital in southern China, which developed comprehensive data collection systems. Data were extracted from the hospital’s information systems and patient satisfaction surveys. We analysed longitudinal time-series data using a segmented linear regression model with SPSS 21·0 to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was done to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0·05. Findings The monthly average length of waiting time decreased by 3·49 min (p=0·003) for consultations and by 8·70 min (p=0·02) for filling prescriptions in the corresponding month in which respective interventions were introduced. The trend shifted from baseline from a slight increase to a significant decrease in time for filling prescriptions (p=0·003). We found a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r=–0·71; p=0·004). Interpretation The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorised by the hospital managers. This case provides a model of continuous quality improvement and optimisation of management process with the support of relevant evidence. Funding National Health and Family Planning Commission of China.
Published Online December 11, 2017 *contributed equally School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (J Sun PhD, P Zhao PhD, Hongyu Fu MSc, Prof Y Liu PhD); Nursing School, Affiliated Clinical Medical Institute of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, China (Prof H Li PhD); Patient Service Center (Q Lin MD, H Chen MSc), Center of Hospital Information (Q Zhang MD), and General Office (K Xu MSc), Fujian Provincial Hospital, Fuzhou, China; Deerfield Institute, Shanghai, China (C J Hu MPA); and Deerfield Institute, New York, NY, USA (M Stuntz MPH) Correspondence to: Prof Yuanli Liu, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China [email protected]
Contributors JS, KX, and HL contributed to the concept of the paper and study design. QL, QZ, and HC collected and analysed the data. JS, PZ, and HC took a key role in analysing the data. PZ did the statistical analysis. JS wrote the first draft of the abstract. All authors assisted in data analysis and interpretation. JS, QL, HC, HL and YL made substantial contributions to the final data analysis and interpretation and critically revised the paper. CJH and MS reviewed and edited the abstract. All authors have seen and approved the final version of the Abstract for publication. Declaration of interests We declare no competing interests.
www.thelancet.com
63