我国医疗机构多年来推行为人民服务的宗旨和“以患者为中心”的服务理念， 但是目前医患矛盾凸显，纠纷不断，医患关系仍然紧张，患者满意度仍 有待提升； 另一方面随着时代发展和新医改的不断深入，医院改善医疗服务面临新形势，深化 医改对医疗服务提出新要求，人民群众对医疗服务提出新需求，医院在服务水平提 升与服务管理等问题上面临前所未有的机遇和挑战。因此，缓解紧张的医患关系在 当前新医改方案实施、共建和谐社会背景下显得尤其重要；如何创新医疗质量持续 改进方法， 提升医疗质量管理水平，成为医疗机构在市场竞争中取胜的关键。本文 在文献分析和现场调研基础上，结合石家庄市M医院的实际情况，首先以 SERVQUAL模型为设计基础，站在患 者满意度的角度，构建基于患者满意度的医疗 服务质量指标体系；在问卷调查的基础上，构建一个较为客观的、适用于石家庄市 M医院的医疗服务质量综合评价体系，利用综合评 分法确定权重，设计患者满意度 调查方案；然后针对调查结果进行分析，以此找出该医院在服务质量上存在的问题 和薄弱环节，结合国家“进一步改善医疗服务行动计划”中的 要求，深入分析总结 原因；最后针对性的提出对策建议，通过有效的提升医疗服务质量的手段，满足患 者多层次的医疗保健服务需求，改善患者看病就医感受，提高社会满意度 ，努力构 建和谐医患关系，帮助该医院更好更有效的进行医疗服务质量管理，赢得市场竞争， 在新形势下抓住机遇，在竞争中取得优势，实现医院可持续发展。 关键词 医院服 务质量；医疗质量；医疗服务质量管理；评价指标体系； 患者满意度 III Abstract Medical service is related to people's vital interests and livelihood, and also effects the reformation of medical and health system. Over the years, Chinese medical institutions have implemented the concept of "patient- centered" service and the purpose of serving the people, but patients’ satisfaction still needs to be improved, contradictions between doctor-patient are highlighted, disputes continues, relationship of them is still tense; on the other hand, with the development of the time and the deepening of the new medical reformation, hospitals are facing a new situation of improving medical services and deepening the medical reformation to put forward new ideas for medical services. Requirements of the customers increase new demands for medical services. Hospitals are facing unprecedented opportunities and challenges of improving the quality of service. Only by continuously improving the quality of medical services, hospital will gain advantages in competition and achieve benign circle. Therefore, how to improve the quality of medical services and alleviate the tense doctor-patient relationship is particularly important in the context of the implementation of the current new medical reformation program and the build of a harmonious society. On the basis of literature analysis and on-site investigation, combined with the actual situation of Shijiazhuang M Hospital, this paper first takes SERVQUAL model as the design basis, and from the perspective of patient satisfaction, constructs a patient satisfaction index system based on medical service quality. On the basis of questionnaire survey, a scientific and objective comprehensive evaluation of medical service quality suitable for Shijiazhuang M Hospital is made. The system uses the comprehensive scoring method to determine the weight and design the survey plan of patient satisfaction; secondly, according to the analysis of the survey results, to find out the problems and weaknesses in the quality of service in the hospital, combined with the requirements of the National Action Plan for Further Improvement of Medical Services, analysis and summary of the reasons; finally, targeted countermeasures and suggestions are put forward, through effective proposals. The means to improve the quality of medical service are to meet the needs of patients with multi-level medical and health care services, improve patients' medical experience, improve social satisfaction, strive to build a harmonious doctor-patient relationship, help the hospital to better and more effectively manage the IV quality of medical service, win market competition, seize opportunities in the new situation, gain advantages in competition, and achieve sustainable development of the hospital. Key words Hospital service quality; Medical quality; Evaluation index system; Quality management of medical service; Satisfaction survey V 目 录 摘要 ········ I Abstract ····· III 第1章 绪 论 ············· 1 1.1 研究背景 ············ 1 1.2 选题意义 ············ 1 1.3 国内外文献综述 ··· 2 1.3.1 国外文献综述 · 2 1.3.2 国内文献综述 · 3 1.4 研究思路和主要研究内容 ······· ·· 4 1.5 研究方法 ············ 4 第2章 相关理论与研究方法 ············· 7 2.1 相关理论 ············ 7 2.1.1 患者满意度 相关理论 ·········· 7 2.1.2 医疗服务质量评价相关理论 · 7 2.1.3 SERVQUAL模型理论 ········ 7 2.2 研究方法 ············ 8 2.2.1 综合评价方法 · 8 2.2.2 满意度调查方法 ················ 9 2.3 本章小结 ··········· 10 第3章 指标体系构建及评价 ········· ··· 11 3.1 石家庄市M医院基本情况 ······· 11 3.2 石家庄市M医院服务质量评价指标体系构建 · 12 3.2.1 石家庄市M医院服务质量评价模型维度构建 ····· ········· 12 3.2.2 石家庄市M医院服务质量评价指标权重确定 ·············· 13 3.2.3 石家庄市M医院服务质量评价指标体系指标 ······· ······· 14 3.3 医疗服务质量综合评价模型的构建 ·············· 16 3.4 评价结果 ··········· 17 3.4.1 综合评分法评价结果 ···· ····· 17 3.4.2 评价结果分析 18 3.5 本章小结 ··········· 18 第4章 石家庄市M医院患者满意度调查及结果分析 ················· 19 VI 4.1 患者满意度调查方案 ·············· 19 4.1.1 调查对象 ······ 19 4.1.2 调查内容 ······ 19 4.1.3 问卷回收统计 20 4.1.4 统计学方 法 ··· 20 4.2 石家庄市M医院满意度调查结果分析 ·········· 20 4.2.1 患者满意度评价调查结果 ··· 20 4.2.2 患者满意度评价调查分析 ··· 21 4.2.3 意见建议分析 23 4.3 本章小结 ··········· 24 第5章 石家庄市M医院服务质量管理中存在问题分析 ·············· 25 5.1 石家庄市M医院服务质 量管理中存在问题分析 ················ 25 5.1.1 为民服务主动性差，服务理念急需改变 ··· 25 5.1.2 基础医疗质量、医疗技术水平有待提高 ··· 25 5.1.3 医德医风建设有待加强 ······ 25 5.1.4 基础就医环境不够完善 ······ 25 5.1.5 服务收费不明确 ··············· 26 5.2 石家庄市M 医院服务质量现存问题原因分析 · 26 5.2.1 基础设施建设滞后 ············ 26 5.2.2 医护人员医疗技术水平有待提高 ············ 26 5.2.3 互 联网技术应用程度低 ······ 27 5.2.4 服务态度仍需改善 ············ 27 5.3 本章小结 ··········· 27 第6章 提升石家庄市M医院医疗服务 质量实施方案 ················· 29 6.1 行动目标 ··········· 29 6.2 重点工作 ··········· 29 6.2.1 医疗质量管理 29 6.2.2 服务流程管理 30 6.2.3 医疗收费服务管理 ············ 31 6.2.4 医疗纠纷投诉管理 ············ 31 6.2.5 医德医风建设 32 6.2.6 就诊环境管 理 33 6.2.7 服务态度管理 33 6.3 本章小结 ··········· 33 VII 结 论 ······ 35 附 录 ······ 37 附录A 37 附录B 38 附录C 39。。。。。。以下 内容略