ارزيابي كاركنان مراكز درمان سرپايي شهر تهران از حذف دفترچه درمان و به‌كارگيري نسخۀ الكترونيك

Evaluating the Impact of Eliminating Health Booklets and Replacing E-prescription in terms of the Staff of the SSO Out-patient Medical Centers in Tehran City.

هدف يكي از اقدامات مهم سازمان تامين اجتماعي در سال هاي اخير، حذف دفترچه بيمه از درمان مستقيم سازمان و استفاده از نسخه الكترونيك است. اين مقاله با اتكاي پژوهشي در اين زمينه، اقدام سازمان در حذف دفترچه بيمه از درمان و جايگزيني سيستم جديد HIS را از ديدگاه كاركنان مراكز درماني بررسي مي كند. روش پيامدهاي اين اقدام در دو گروه الف) بهبود كارايي و بهره وري و ب) بهبود روابط شامل ارزيابي شده است. براي اين منظور كاركنان 16 مركز درماني سرپايي شهر تهران به صورت تمام شماري در روز پرسشگري در نظر گرفته شدند كه در نهايت بعد از انتخاب حدود 600 نمونه، 423 نفر به پرسشنامه پاسخ گفتند. يافته ها: بيشتر پاسخ گويان (52/8 درصد) در ابتدا موافق حذف دفترچه و جايگزيني سيستم جديد HIS بودند. همچنين، انتظار كاركنان بر آن بود كه حذف دفترچه هاي بيمه موجب بهبود ابعاد گوناگون كار و محيط كاري (اعم از كارآيي و بهره وري و روابط بين كاركنان با بيماران و نيز با يكديگر) شود و فقط حدود 7 درصد به اثربخشي اين طرح در اين زمينه ها بدبين بودند. نسبت اين گروه از افراد در ارزيابي از عملكرد طرح حذف دفترچه در وضع فعلي به 6 درصد رسيد؛ يعني بخش اصلي انتظارات در اين زمينه برآورده شده است. با اين حال، مي توان بيان كرد كه بيشتر پاسخ گويان هم انتظار مثبتي از نقش حذف دفترچه بر فرايندهاي كاري و ارتباطي داشتند و هم وضع موجود را مثبت ارزيابي مي كردند. نتيجه در نهايت، ميانگين ارزيابي از وضع موجود، تا حدودي كمتر از ميانگين ارزيابي از انتظار و پيش بيني تاثير حذف دفترچه بر اين موارد است، اما در كل، ارزيابي مثبت و رضايت بخشي از اين طرح بين گروه هاي گوناگون كاركنان مراكز درماني وجود دارد.

Purpose: One of the important activities of theSocialSecurityOrganization inrecent years is the elimination of health booklet from the SSO direct health system and replacing the electronic prescription. This article is a report of a study that evaluates the elimination of health booklet from the SSO direct health system and the use of the new HIS system and electronic prescription from the perspective of medical staff. Method: In this regard, the outcome of implementing the new system has beenevaluated on the basis of: a) Improving efficiency and productivity including decrease of the paper consumption and medical devices; reducing errors in prescription and medicine interactions; documentation and access to medical records; speed and accuracy of services; improving work discipline; and reducing the possibility of misuse of the health booklet; b) Improving relationships including the relationships between the employees and overhead authorities (high managers); the relationships between the high managers; the potential impact on organizational sensitivities and job satisfaction. For this purpose, the staff of 16 SSO outpatient clinics in Tehran was considered as a total on the day of questioning in each clinic, of which, finally 423 people answered the questionnaire. Findings: Findings indicate that most respondents (52.8%) initially agreed toeliminate the health booklet and replace the new HIS system. Employees also anticipated that the elimination of health booklet would improve various aspects of their work and environment (including efficiency, productivity, and the relationship between employees and patients and with each other) and pessimism rate was very weak around 7% of the respondents. In other words, it can be stated that the majority of the respondents not only had a positive approach towards the impact of eliminating the health booklets on their working and communication procedures, but also evaluated the current situation positively. Conclusion: However, the average result of the assessment is somewhat lowerthan the average of the expected result, but the final outcome is the positive approach and satisfaction of the medical staff on elimination of the health booklets and replacing the e-prescription.