El análisis de la calidad asistencial desde la perspectiva de la satisfacción y la experiencia del pacienteuna mirada enfermera

  1. Zamora-Soler, José Ángel 1
  2. Maturana-Ibáñez, Vanesa 2
  1. 1 Servicio de Emergencias Sanitarias Alicante. Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante. Alicante, España.
  2. 2 Hospital General Universitario de Elda. Alicante, España.
Revista:
Revista Colombiana de Enfermería

ISSN: 1909-1621

Año de publicación: 2019

Título del ejemplar: Revista Colombiana de Enfermería; e009

Volumen: 18

Número: 2

Tipo: Artículo

DOI: 10.18270/RCE.V18I2.2513 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: Revista Colombiana de Enfermería

Resumen

El 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. 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.

Referencias bibliográficas

  • The Health Foundation Inspiring Improvement. N.o 18 Measuring patient experience. England, 2013.
  • Robledillo-Colmenares Alfredo; Velázquez-López Daniel. Introducción a los sistemas de gestión de la calidad total: modelo de excelencia EFQM y autoevaluación. Medicina y Seguridad del Trabajo, 2013 v. 59, n. 232, pp. 302-309.
  • Díaz Rocío. La calidad percibida en la sanidad pública. Revista de Calidad Asistencial, 2005, v. 20, n. 1, pp. 35-42.
  • Díaz Rocío. Satisfacción del paciente: principal motor y centro de los servicios sanitarios. Revista de Calidad Asistencial, 2002, v. 17, n. 1, pp. 22-29.
  • Aranaz J-M; Leutscher E; Gea M-T; Vitaller J. El aseguramiento y la acreditación sanitaria. Qué opinan sobre la acreditación los directivos sanitarios españoles. Revista de Calidad Asistencial, 2003, v. 18, n. 2, pp. 107-114.
  • The Joint Commission. Joint Commission Standards. Estados Unidos, 2019.
  • International Organization for Standardization (ISO). ISO Guides – adding value to International Standards. Ginebra, 2019.
  • European Foundation for Quality Management (EFQM). EFQM Recognition. Bruselas, 2019.
  • Belzunegui T; Busca P; López-Andújar L; Tejedor M. Quality and accreditation of emergency departments. Anales del Sistema Sanitario de Navarra, 2010, v. 33, s. 1, pp. 123-130.
  • American Nurses Credentialing Center.
  • Aiken L-H; Clarke S-P; Sloane D-M; Sochalski J; Silber M-D. Hospital nurse staffing and patient mortality, nurse burnout and job dissatisfaction. Journal of the American Medical Association, 2002, v. 288, n. 16, pp. 1987-1993.
  • Vahey Doris-C; Aiken Linda-H; Sloane Douglas-M; Clarke Sean-P; Vargas Delfino. Nurse burnout and patient satisfaction. Medical Care, 2004, v. 42, n. 2, pp. 1157-1166.
  • Aiken Linda-H; Sermeus Walter; Van-den-Heede Koen; Sloane Douglas-M; Busse Reinhard; McKee Martin; et ál. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. British Medical Journal, 2012, v. 344, p. e1717.
  • Aiken Linda-H; Sloane Douglas-M; Bruyneel Luk; Van-den-Heede Koen; Griffiths Peter; Busse Reinhard; et ál. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet, 2014, v. 383, n. 9931, pp. 1824-1830.
  • Organización Mundial de la Salud. Alianza mundial para la seguridad del paciente. La investigación en seguridad del paciente. Ginebra, 2008.
  • MacRae Rhoda; Rooney Kevin-D; Taylor Alan; Ritters Katrina; Sansoni Julita; Lillo Crespo Manuel; et ál. Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules. Nurse Education Today, 2016, v. 42, pp. 41-46.
  • University of the West of Scotland. Improvement Science Training for European Healthcare Workers (ISTEW). Escocia, 2019.
  • Yellen E; Davis G-C; Ricard R. The measurement of patient satisfaction. Journal of Nursing Care Quality, 2002, v. 16, n. 4, pp. 23-29.
  • Wilson A; Hewitt G; Matthews R; Richards S-H; Shepperd S. Development and testing of a questionnaire to measure patient satisfaction with intermediate care. Quality & Safety in Health Care, 2006, v. 15, n. 5, pp. 314-319.
  • Fitzpatrick R. Surveys of patient satisfaction: II. Designing a questionnaire and conducting a survey. British Medical Journal, 1991, v. 302, n. 6785, pp. 1129-1132.
  • Fitzpatrick R. Surveys of patient satisfaction: I. Important general considerations. Bristish Medical Journal, 1991, v. 302, n. 6781, pp. 887-889.
  • Fitzpatrick Ray; Hopkins Anthony. Problems in the conceptual framework of patient satisfaction research: An empirical exploration. Sociology of Health & Illness, 2000, v. 5, n. 3, pp. 297-311.
  • Ware J; Snyder M. Dimensions of patient attitudes regarding doctors and medical care services. Medical Care, 1975, v. 13, n. 8, pp. 669-682.
  • Mira J-J; Aranaz J. La satisfacción del paciente como una medida del resultado de la atención sanitaria. Medicina Clínica, 2002, v. 114, n. 3, pp. 26-33.
  • Meakin R; Weinman J. The Medical interview satisfaction scale’ (MISS-21) adapted for British general practice. Family Practice, 2002, v. 19, n. 3, pp. 257-263.
  • Hulka B; Zyzanski S; Cassel J; Thompson S. Scale for the measurement of attitudes toward physicians and primary medical care. Medical Care, 1970, v. 8, n. 5, pp. 429-36.
  • Ware J; Hays R. Methods for measuring patient satisfaction with specific medical encounters. Medical Care, 1988, v. 26, n. 4, pp. 393-402.
  • Feletti G; Firman D; Sanson-Fisher R. Patient satisfaction with primary-careconsultations. Journal of Behavioral Medicine, 1986, v. 9, n. 4, pp. 389-399.
  • Meterko M; Nelson E; Rubin H; Batalden P; Berwick D; Hays R. Ware patients’ judgements of hospital quality: report of a pilot study. Medical Care, 1990, v. 29, n. 9, pp. S1-S56.
  • Barry M-J; Fowler F-J; Mulley A-G; Henderson J-V; Wennberg J-E. Patient reactions to a program designed to facilite patient participation in treatment decisions for benign prostatic hyperplasia. Medical Care, 1995, v. 33, n. 8, pp. 771-782.
  • Liu G; Franssen E; Fitch M; Warner E. Patient preferences for oral versus intravenous palliative chemotherapy. Journal of Clinical Oncology, 1997, v. 15, n. 1, pp. 110-5.
  • Candlish P; Watts P; Redman S; Whyte P; Lowe J. Elderly patients with heart failure: a study of satisfaction with care anda quality of live. International Journal for Quality in Health Care, 1998, v. 10, n. 2, pp. 141-146.
  • Sixma H-J; Kersenns J; van Campen C; Peters L. Quality of care from the patients’ perspective: from theoretical concept to a new measuring instrument. Health Expect, 1998, v. 1, n. 2, pp. 82-95.
  • Loeken K; Steine S; Sandvik; Laerum E. A new instrument to measure patient satisfaction with mamography. Medical Care, 1997, v. 35, n . 7, pp. 731-741.
  • McKinley R-K; Manku-Scott T; Hastings A-M; French D-P; Baker R. Reliability and validity of a new measure of patient satisfaction with out of ours primary medical care in the United Kingdom: Development of a patient questionnaire. British Medical Journal, 1997, v. 314, n. 7075, pp. 193-198.
  • Sáinz A; Martínez B; Quintana O; Fernández A; Ferreira A; Nartín D; et ál. Consentimiento informado y satisfacción de los pacientes: resultados de una encuesta telefónica realizada a pacientes de 5 hospitales del Insalud. Revista de Calidad Asistencial, 1997, v. 12, n. 3, pp. 100-106.
  • Feldman Lya; Vivas Eleonora; Lugli Zoraide; Alviarez Vanessa; Pérez María-Gabriela; Bustamante Simonelli. La satisfacción del paciente hospitalario: una propuesta de evaluación. Revista de Calidad Asistencial, 2007, v. 22, n. 3, pp. 103-140.
  • Manary M-P; Boulding W; Staelin R; Glickman S-W. The patient experience and health outcomes. The New England Journal of Medicine, 2013, v. 368, n. 3, pp. 201-203.
  • American Nurses Credentialing Center. ANCC Magnet Recognition Program ANCC Silver Spring (MD). Estados Unidos, 2019.
  • U.S. News and World Report Health. Best hospitals rankings. Estados Unidos, 2019.
  • Chen Yao-Mei; Johantgen Mary-E. Magnet Hospital attributes in European hospitals: A multilevel model of job satisfaction. International Journal of Nursing Studies, 2010, v. 47, n. 8, pp. 1001-1012.
  • Aiken Linda-H; Poghosyan Lusine. Evaluation of “Magnet journey to nursing excellence program” in Russia and Armenia. Journal of Nursing Scholarship, 2009, v. 41, n. 2, pp. 166-174.
  • Aiken Linda-H; Buchan James; Ball Jane; Rafferty Anne-Marie. Transformative impact of Magnet designation: England case study. Journal of Clinical Nursing, 2008, v. 17, n. 24, pp. 3330-3337.
  • Gea-Caballero Vicente-Antonio. Elección de elementos esenciales de los entornos profesionales de enfermería en atención primaria, mediante el cuestionario Practice Environment Scale of the Nursing Work Index (PES-NWI), España, Repositorio Institucional de la Universidad de Alicante, 2015.
  • Armstrong K; Laschinger H; Wong C. Workplace empowerment and Magnet hospital characteristics as predictors of patient safety climate. Journal of Nursing Care Quality, 2009, v. 24, n. 1, pp. 55-62.
  • Kelly Lesly-A; McHugh Matthew-D; Aiken Linda-H. Nurse outcomes in Magnet® and non-magnet hospitals. The Journal of Nursing Administration, 2011, v. 41, n. 10, pp. 428-433.
  • Coulter Angela; Fitzpatrick Ray; Cornwell Jocelyn. The point of care. Measures of patients’ experience in hospital: purpose, methods and uses. Estados Unidos, 2009.
  • The Beryl Institute. Improving the Patient Experience. Estados Unidos, 2018.
  • Lillo-Crespo Manuel. Asesoramiento en cuidados culturalmente competentes y evaluación de la satisfacción en el paciente holandés del Plan de Choque Intereuropeo. Una investigación cualitativa y transcultural en el contexto de la práctica de Enfermería. España, Repositorio Institucional de la Universidad de Alicante, 2005.
  • Coulter Angela; Locock Louise; Ziebland Sue; Calabrese Joe. Collecting data on patient is not enough: they must be used to improve care. British Medical Journal, 2014, v. 348, g2225.
  • Scott Jason; Dawson Pamela; Jones Diana. Do older patients’ perceptions of safety highlight barriers that could make their care safer during organizational care transfers? BMJ Quality & Safety, 2012, v. 21, n. 2, pp. 112-117.
  • Young S; Wolff M; Lucey P; Maurana C-A. The Milwaukee General Assistance Medical Program: Patient perspectives on primary care in an urban safety net. Wisconsin Medical Journal, 2004, v. 103, n. 7, pp. 56-60.
  • Cox L-M; Logio L-S. Patient safety stories: A project utilizing narratives in resident training. Academic Medicine, 2011, v. 86, n. 11, pp. 1473-1478.
  • Conway James. Getting boards on board: Engaging governing boards in quality and safety. The Joint Commission Journal on Quality and Patient Safety, 2008, v. 34, n. 4, pp. 214-220.
  • Gidman Janice. Listening to stories: Valuing knowledge from patient experience. Nurse Education in Practice, 2013, v. 13, n. 3, pp. 192-196.
  • Gaal Sander; Hartman Chantal; Giesen Paul; van Weel Chris; Verstappen Wim; Wensing Michel. Complaints against family physicians submitted to disciplinary tribunals in the Netherlands: lessons for patient safety. Annals of Family Medicine, 2011, v. 9, n. 6, pp. 522-527.
  • Torres Myriam-E; Meetze Edena-G; Smithwick-Leone Julie. Latina voices in childhood obesity: A pilot study using photovoice in South Carolina. American Journal of Preventive Medicine, 2013, v. 44, n. 3, pp. 225- 231.
  • Greaves Felix; Millett Christopher. Consistently increasing numbers of online ratings of healthcare in England. Journal of Medical Internet Research, 2012, v. 14, n. 3, e94.
  • Greaves Felix; Ramirez-Cano Daniel; Millett Christopher; Darzi Ara; Donaldson Liam. Harnessing the cloud of patient experience: Using social media to detect poor quality healthcare. BMJ Quality & Safety, 2013, v. 22, n. 3, pp. 251-255.
  • Casas-Anguita Juana; Repullo-Labrador J-R; Donado-Campos J. La encuesta como técnica de investigación. Elaboración de cuestionarios y tratamiento estadístico de los datos (I). Atención Primaria, 2003, v. 31, n. 8, pp. 527-537.
  • Vocera. The Experience Innovation Network. The Evolving Role Of The Healthcare Chief Experience Officer US: Research report 2015. Estados Unidos,
  • The King´s Found. Ideas that change health care. Inglaterra, 2019.
  • Skela-Savič Brigita; Macrae Rhoda; Lillo-Crespo Manuel; M, Rooney Kevin-D. The development of a consensus definition for Healthcare Improvement Science (HIS) in seven European countries: A consensus methods approach. Slovenian Journal of Public Health, 2017, v. 56, n. 2, pp. 82-90.
  • Armstrong Lorraine; Lauder William; Shepherd Ashley. An evaluation of methods used to teach quality improvement to undergraduate healthcare students to inform curriculum development within preregistration nurse education: A protocol for systematic review and narrative synthesis. Systematic Reviews, 2015, v. 4, n. 8, pp. 1-8.
  • Tackett Sean; Grant Janet; Mmari Kristin. Designing an evaluation framework for WFME basic standards for medical education. Medical Teacher, 2016, v. 38, n. 3, pp. 291-296.
  • Reeves Scott; Clark Emma; Lawton Sally; Ream Melissa; Ross Fiona. Examining the nature of interprofessional interventions designed to promote patient safety: A narrative review. International Journal for Quality in Health Care, 2017, v. 29, n. 2, pp. 144-150.