Sağlık Hizmet Kalitesinde Hastanın Rolü

Yıl 2019, Cilt: 2 Sayı: 1, 22 - 26, 28.06.2019

Hişam Alahdab

Öz

Bu derlemede, hastaların
sağlık hizmetlerine katılımı ve ortaklık yaklaşımı ile sağlıkta hizmet
kalitesine ve çıktılarına yansıması güncel literatür ışığında
değerlendirilmiştir. Son yıllarda, hastaların hizmetten beklentilerini
belirtmeleri incelenmiştir.  Bazı
çalışmalar, hasta ile ilişkili deneyim ölçütleri “Patient-related experience
mesaures “(PREM) ve hasta tarafından raporlanan çıktı ölçütleri
“Patient-reported outcome measures” (PROM) ile sağlık hizmet çıktıları arasında
pozitif korelasyon göstermiştir, ama hala ciddi kanıtlara ihtiyaç
duyulmaktadır. Öte yandan, hastaların katılımı arttıkça daha iyi sonuçlar ve
daha az maliyet elde edildiği gösterilmiştir. Ayrıca, hastaların ve
temsilcilerinin sağlık kalitesi iyileştirme araçlarında da rol alması konusunda
tartışmalar başlamıştır. Hasta odaklı standartlar, hasta ile ortak karar vermenin
de ötesinde organizasyonun kalite çalışmaları içerisinde hastanın da
perspektifini görmek istemektedir. Bugüne kadar yapılan çalışmalar, hastaların
aktif katılıımının hasta memnuniyetine, hizmet süreç ve sonuçlarına, maliyete
ve hatta çalışan memnuniyetine olumlu yansıdığını göstermiştir.

Anahtar Kelimeler

Hasta Katılımı, Hasta Bağlılığı, Kalite Memnuniyeti

Kaynakça

• AARP Public Policy Institute. Beyond 50.09 Chronic Care: A Call to Action for Health Reform. 2009. https://assets.aarp.org/rgcenter/health/beyond_50_hcr.pdf. (1/1/2019 da ulaşılmıştır)
• Abdullah Alkhenizan, Charles Shaw. Impact of Accre-ditation on the Quality of Healthcare Services: a Sys-tematic Review of the Literature. Ann Saudi Med 2011; 31(4): 407- 416
• Black N and Jenkinson C. Measuring patients’ expe-riences and outcomes. BMJ 2009;339:b2495.
• Black N, Varaganum M, Hutchings A. Relationship between patient reported experience (PREMs) and patient reported outcomes (PROMs) in elective surgery. BMJ Qual Saf 2014; 23: 534–42
• Committee on Quality Health Care in America, Institu-te of Medicine. Crossing The Quality Chasm: a New Health System for the 21st Century. Washington, D.C. :National Academy Press, 2001.
• Doyle C, Lennox L and Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 2013;3: e001570
• Dyas JV, Apekey TA, Tilling M, Orner R, Middleton H and Siriwardena AN. Patients’ and clinicians’ experi experiences of consultations in primary care for sleep problems and insomnia: a focus group study. British Journal of General Practice 2010;60:180–200.
• Greean CA., Perrin NA., Polen MR., et al. Development of the patient activation measure for mental health (PAM-MH). Administration and Policy in Mental He-alth and Mental Health Services Research. 37(4):327-33, July 2010.
• Hibbard JH, Cunningham PJ. How engaged are con-sumers in their health and health care, and why does it matter?. Resarch Briefs. 2008 Oct;(8):1-9.
• Hibbard J.H., Mahoney E., Stock R., Tusler M. Do increase in patient activation result in improved self-management behaviours? Health Services Research. 42(4):1443-63, Aug. 2007.
• Hibbard J.H., Stockard J., Mahoney ER., Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers, Health Serv Res 39 (4) (2004) 1005–1026.
• Ida Gremyr Hendry Raharjo, (2013),"Quality function deployment in healthcare: a literature review and case study", International Journal of Health Care Quality Assurance, Vol. 26 Iss 2 pp. 135 – 146
• Lee, CN, Hulsman, CS., Sepucha, K. “Do patients and providers agree about the most important facts and goals for breast reconstruction decisions? .” Ann Plastic Surgery (2010):563-563.
• Mosen D., Schmittdiel J., Hibbard JH., et al. Is patient activation associated with outcomes of care for adults with chronic conditions? Journal of Ambulatory Care Management. 30(1):21-9, Jan-Mar. 2007.
• Munson GW., Wallston KA., Dittus RS, et al. Activa-tion and perceived expectancies: Correlation with health outcomes among veterans with inflammatory bowel disease. Journal of Internal Medicine. 24(7):809-15 July 2009
• National Advisory Group on the Safety of Patients in England. Improving the Safety of Patients in England: a promise to learn – a commitment to act. National Advisory Group on the Safety of Patients in England: London, 2013.
• Planetree Designation Criteria, 2017. Planetree Interna-tional Organization
• Sarah E. Tevis, Ryan K. Schmocker, and Gregory D. Kennedy Can patients reliably identify safe, high qua-lity care? J Hosp Adm. 2014 October 1; 3(5): 150–160. doi:10.5430/jha.v3n5p150
• Sağlıkta Akreditasyon Standartları Hastane Seti. Has-tane Seti – v2.0/2017. Sağlık Hizmetleri Genel Müdür-lüğü, Sağlıkta Kalite ve Akreditasyon Daire Başkanlığı. 2017
• Sağlıkta Kalite Standartları / Hastane . v2.0/2017. Sağlık Hizmetleri Genel Müdürlüğü, Sağlıkta Kalite ve Akreditasyon Daire Başkanlığı. 2017
• Skolasky RL, Mackenzie EJ, Wegener ST, Riley LH 3rd. Patient activation and adherence to physical the-rapy in persons undergoing spine surgery. Spine (Phila Pa 1976). 2008 Oct 1;33(21):E784-91.
• Stepleman LM., Rutter C., Hibbard JH., et al. Validai-ton of the patient activation measure (PAM) in a a multiple sclerosis clinic sample and implication for care. Disability and Rehabilitation. 32(19):1558-67, 2010
• Susan Stone, PhD. A Retrospective Evaluation of the Impact of the Planetree Patient-Centered Model of Care on Inpatient Quality Outcomes. HERD Vol. 1, No. 4 SUMMER 2008 • Health Envıronments Rese-arch & Desıgn Journal
• Joint Commission International Accreditation Stan-dards for Hospitals, 6th Edition. Joint Commission Internaitonal 2017. ISBN: 978-1-59940-989-4. Lib-rary of Congress Control Number: 2013948698
• Thoma-Perry C1, Blocher-Smith EC1, Jacobsen L2, Saxe J3. HCAPS Score as a Surrogate for Quality Does not Correlate with TQIP Quality Measures at Level 1 Trauma Center. Surgery. 2018 Oct;164(4):810-813. doi: 10.1016/j.surg.2018.07.032. Epub 2018 Aug 24.
• Zuber Mujeeb Shaikh; Adnaan Ahmed, Dr. Awad Al Omari. The Impact of Planetree Certification on a Nationally and Internationally Accredited Healthcare Facility and its Services. RESEARCH REVIEW Inter-national Journal of Multidisciplinary Volume-03, Is-sue-08, August-2018.