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目的探讨心理契约理论对病案管理质量的影响。方法分析某医院临床医护人员在实施心理契约管理前后一年职业倦怠感及病案质量数据变化。结果在实施心理契约管理后,职业倦怠感方面,情绪衰竭人数较前有明显下降。成就感低落和情绪衰竭两维度,较前均明显减轻。病案三天回收率较前提高17个百分点。病案质量也有所好转,病案甲级率方面,较前提高了5个百分点,返修率下降了13个百分点(P<0.001)。结论医院管理者宜对医护人员进行全程动态心理契约管理,减轻职业倦怠感,以提升病案三天回收率和甲级率,降低返修率,从而提高病案管理质量。
Objective To explore the impact of psychological contract theory on the quality of medical record management. Methods Analyze the changes of occupational burnout and medical record quality data of a hospital clinic staff before and after the implementation of psychological contract management. Results In the implementation of psychological contract management, job burnout, the number of emotional decline significantly decreased compared with the previous. Achievement depression and emotional exhaustion two dimensions, significantly reduced compared with the previous. Three days recovery rate of cases increased by 17 percentage points. The quality of the medical records also improved. The medical record rate was 5 percentage points higher than before and the rework rate dropped by 13 percentage points (P <0.001). Conclusion Hospital managers should manage the entire dynamic psychological contract for medical staff and reduce the sense of job burnout so as to enhance the three-day recovery rate and Grade A rate of medical record, reduce the rate of rework, and improve the quality of medical record management.