Nowadays, the hospital managers are facing increasing financial difficulties, because of the global budget policy from the national health institute. Patient-oriented services, good manner of the care providers, and the rapid response of the hospital to the medical environment are among the important factors for hospital survival. Therefore, many medical care providers had designed the clinical pathway for standardized medical treatment to control the medical costs, but they also allowed some extra-services for attracting and recruiting more patients. In this study, by way of participating management and job enrichment, we try to improve the quality and the patient satisfaction of the pelvic sonography provided by Obs/Gyn department. The study was proceeded in 2 ways. First, we designed a standardized obstetrical and gynecological sonography service pathway, which include a standard flow chart, customer encounter, and a checklist. Second, we measured the total service time duration, including those of pre-service consultation, actual sonography performing, and the post-service consultation. The measurements were performed before and after the application of the standardized sonography pathway. The measurement results were used to analyze and evaluate the validity and efficiency of the originally designed pathway. The study results demonstrate that after application of the sonography pathway, the total service time duration is reduced in Gyn sonography, but increased in Obs sonography. For Gyn sonography, the duration of pre-service consultation and post-service consultation were significantly reduced after application of standardized pathway. Further analysis revealed that thorough pre-service consultation not only made our patients more comfortable, but also reduced the post-service consultation time. However, the actual sonography performing time was increased, because of the adding of the standardized conversation. For obstetrical sonography, the duration of the actual sonography performing time was decreased, possibly due to the adding of standardized conversation, which answered most of the questions that the pregnant patients want to know about. In conclusion, by way of establishment and repeated reassessment/correction of the standardized sonography pathway, the quality of the sonography services can be greatly improved, and the patient¡¦s satisfaction can be even greater. The same experience can be applied to other fields. The quality of medical care can be more stable by the application of standardized clinical pathway. Besides, through the efforts of quality control, the medical cost can be limited, and the financial burden of the hospital and medical care providers can be reduced, making a double-win medical environment. Key Word: service pathways,total service, Obs/Gyn sonography

My diploma work is about philosophy of CRM which is connecting tools for good quality customer care, insists on propriety and process efficiency, quality of staff and usage of IT technologies for recording all important facts which can have impact on relationship. Because of this is implementation of CRM suitable for health care as well. In my work deal with rules of process funciton CRM to activity of private gynecologist clinic. My aim is improve relation between company and consumer.

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Background Up to 34% of perinatal individuals experience childbirth as traumatic. These individuals are at increased risk for developing depression, anxiety, and posttraumatic stress disorder (PTSD) after the traumatic event. The objective of this study was to elicit the perspectives of individuals with a traumatic birth experience on barriers and facilitators to receiving mental health support in the postpartum period after a traumatic delivery. Methods Individuals who delivered within the last three years and perceived their birth experience to be traumatic (n=32) completed an hour-long semi-structured phone interview. The interview included screening for PTSD, depression, and anxiety with validated instruments including the Posttraumatic Stress Disorder Checklist for DSM-V (PCL-5), the Patient Health Questionnaire depression scale (PHQ-8), and the Generalized Anxiety Disorder scale (GAD-7), respectively. Qualitative data was analyzed using a modified grounded theory characterizing participants’ barriers and recommendations for mental health support after traumatic births. Results Among participants, 34.4% screened positive for PTSD, 18.8% screened positive for major depressive disorder, and 34.4% screened positive for anxiety. Qualitative themes revealed multi-level barriers involving lack of communication, education, and resources which prevented obstetric professionals from recognizing and supporting patients’ mental health needs after a traumatic birth. Recommendations from participants included that 1) obstetric professionals should acknowledge trauma experienced by any individual after childbirth, 2) providers of multiple disciplines need to be integrated into postpartum care, and 3) mental health support is needed before the ambulatory postpartum visit. Conclusions There are multi-level barriers toward detecting and responding to individuals’ mental health needs after a traumatic birth. Obstetric professionals need to use a trauma-informed approach and proactively follow-up and assess mental health care in the postpartum period.