医院信访工作的几点思考

医院作为与百姓群众联系最紧密的地方，其信访工作与群众的生活、生命健康密切相关。医院信访工作是指医院在医疗、教学、科研、管理等日常工作事务中处理群众来信和接待来访人员的具体工作，是医院主动接受社会群众监督的重要措施，是促进医院建设的重要环节，在提高医疗服务质量、不断满足患者就医需要、维护医院良好公众形象、积极构建和谐医患关系等方面起着举足轻重的作用，这就需要与时俱进，不断创新医院信访工作机制，优化医院信访工作方法，精细化医院信访工作管理。1注重信访工作队伍建设1．1领导重视是做好信访工作的关键医院信访是一项重要且有价值的工作，是医院主动接受社会群众监督的重要措施，只有医院主要领导重视、支持、理解信访工作，才能充分发挥信访信息在医院管理中的作用。我院党政主要领导高度重视此项工作，成立信访工作领导小组，遵循“分级负责，归口管理”的原则，责任到部门，各职能部门相互协作，齐抓共管，妥善处理每一件信访事件。同时，也要求每一位信访工作人员在熟悉主管业务的同时，要热情接待、耐心细致处理每一个来访者和来电者，认真对待每一封来信等，尽量把矛盾化解在初始阶段。     

当前医院信访工作问题探讨

随着医疗卫生体制的改革深入,医院信访工作也受到了前所未有的重视。做好当前医院信访工作,是医院一项亟待解决的重要问题。因此该文旨在对当前医院信访工作问题进行探讨,拟从制订目标、健全网络、狠抓落实等3方面提出自己的一些见解,以期能为医院信访工作提供参考。     

医院信访工作的初探与思考

目的做好医院信访工作,为促进医院建设和深化卫生改革起积极作用.方法通过回顾性总结分析医院信访工作的表现和特点,探讨其医院信访工作的重要性.结果如何提高对医院信访工作的认识,使医院信访上台阶,为医院医疗、教学、科研、管理等日常工作服好务.结论做好医院信访工作:关键是领导重视;基础是尽职尽责;重要保证是建立健全法规体系和监督约束机制;态度热情才能使信访接待工作顺利完成;做好信访工作是减少医疗纠纷的重要一环.     

医院信访案卷管理以“件”为单位的优点和作用

信访档案是信访工作的重要组成部分，是信访工作过程中最原始的记录，只有认真整理并加以保存，才能更好地为信访工作服务。近几年来，随着信访工作的发展，医院信访量不断增加，信访档案工作的整理工作也愈来越繁重。为了进一步做好信访档案管理工作，笔者认为信访部门可借鉴目前文书立卷的方法对信访档案进行整理：     

浅谈现代企业医院信访工作艺术

企业医院信访工作是一项长期的、复杂的、经常性的群众工作。它的主要任务是：一方面要做好本单位职工的信访工作。另一方面还要做好医患纠纷的协调工作。努力做好企业医院信访工作，掌握信访工作的艺术，对于调动广大职工爱岗敬业和奋发向上的积极性、发扬民主、密切同患者之间的关系、维护医院稳定、     

医院门诊信访投诉情况浅析

门诊信访工作是医院门诊医疗服务的重要组成部分,体现着医院管理规范化和法制化的进程。本文对北京协和医院近年内接待的门诊投诉情况进行了统计分析,从新时期门诊信访工作的任务、内容、产生信访投诉的原因、重要作用以及工作原则等工作进行总结与讨论,并从领导重视、健全机制、规范流程、拓宽渠道、控制源头、考核奖惩等方面,对如何做好信访工作提出思考与建议。     

简论医德医风信访工作的医学伦理支撑

医德医风信访工作是医院的一个重要窗口,其工作人员是医院与患者之间的桥梁和纽带,他们对外是接待员,对内是监督员。以医学伦理为灵魂的良好的医德,既是医学发展的内在动力,也是医院管理的根本依据。作为承担着医德建设重要的特殊使命的医德医风信访工作人员,只有具备良好的医学伦理素养,才能胜任自己的工作,才能对构建和谐的医患关系、创建社会主义和谐医院起到积极的推动作用。     

浅谈企业医院信访调研

信访调研是根据群众来信来访反映的情况和信访业务工作的实际，选择性地进行调查分析，为领导和有关部门的决策提供参考，解决实际问题的一种工作方法。特别是在改革开放和建设有中国特色的社会主义市场经济的企业医院，各种新情况、新问题层出不穷，故做好信访调研工作显得更为重要。这对于提高信访工作水平、推动信访工作健康发展、保持企业医院稳定具有十分重要的意义。     

略论医院信访领域的思想政治工作

思想政治工作，既是我党团结带领全国人民进行两个文明建设的重要法宝，也是医院信访工作和其他一切工作的生命线。我国正处在改革的攻坚和发展的关键时期，社会情况发生了复杂而深刻的变化，给思想政治工作带来大量的新情况和新问题，在信访工作领域中表现得尤为突出。如何提高认识，明确任务和夯实基础，切实加强和改进信访领域的思想政治工作，已成为一个不可忽视的重要课题。     

浅谈医院信访工作与医患关系的改善

医院信访是患者、患者家属或其单位采用各种形式，向医院提出表扬、建议、意见或投诉，要求医院给予表扬、作出合理解释、赔礼道歉或经济赔偿等。医院信访工作是医患双方沟通的桥梁，是改善医患关系的纽带。     

关于医院投诉性信访问题的伦理思考

实现医患关系和谐是医院管理工作的重要价值诉求。医院在处理群众投诉性信访问题的过程中,管理者在思想认识上高度重视,医患间相互信任,确立一套行之有效的应对投诉性信访问题的伦理机制,有利于投诉性信访问题的解决及和谐医患关系的建构。     

天津市某三甲医院处理市“8890”便民服务专线平台信访工作分析

目的探讨天津市某三甲医院信访原因及对策。方法对20162018年天津市某三甲医院处理“8890”平台的信访件进行分析,对3年信访件的问题种类进行详细汇总分析,探讨信访主要原因,总结医院为缓解“8890”信访件的实践经验。结果共接收并处理信访件398件,2016、2017、2018年分别为16、100、282件,其中反映最多的三类问题分别为门急诊就诊问题、住院医疗问题及取药问题,分别占22.4%、22.4%、13.3%。其中,门诊挂号问题是门急诊就诊的主要问题,占39.32%;质疑医生诊疗效果是住院医疗的主要问题,占40.45%;不能取到制定药品是主要的取药问题,占66.03%。结论天津市某三甲医院信访量逐年增加,经分析社会对便民服务平台的熟知度逐渐提高、患者就医需求提高及部分医生服务意识不强和沟通能力不足等是信访量逐年增加的主要原因。探索并总结出精细化归口管理,关注特殊人群就医需求,建立多渠道信访投诉机制,从源头上深抓行风建设,切实提高患者满意度的有效实践。     

分析500份病案手术及诊断性操作知情同意书填写的质量

目的了解我院手术及诊断性操作知情同意书填写状况.方法抽查我院2003年1月至6月出院内外科病案共500份进行统计.结果在抽查的500份病案中,全部符合要求的326份,占65.2%,存在问题的134份,占26.8%,有40份没有填写知情同意书.结论填写好知情同意书,提高对知情同意书重要性的认识,是减少医疗纠纷的重要途径.     

手术室护士术前访视现状及其因素分析

目的了解手术室护士术前访视现状,发现护理中的薄弱环节,为有效指导临床护理工作提供依据。方法针对临床开展术前访视现状及其可能遇到的情况自制问卷,并对我院26名手术室护士进行问卷调查。结果术前访视的重要性得到了大部分手术室护士的认同,92．3％的手术室护士认为“有必要开展术前访视”,仅65．4％的手术室护士表示“愿意进行术前访视”。但是开展术前访视工作依然存在一些困难。结论目前我院的术前访视存在着护理人员对术前访视意义及重要性认识不足、护理人员专业水平有待进一步提高等问题,应该针对这些问题找到对策,提高手术室工作质量。     

Interaction between diabetic patients, their general practitioners and a hospital diabetic clinic

OBJECTIVE: The aim of this study was to examine the sociodemographic data of diabetic patients referred to our clinic and to correlate these with characteristics of their individual general practitioners. How these factors affect the interaction between patients, general practitioners and a hospital diabetic clinic was evaluated. DESIGN: Prospective recruitment of consecutive referrals. SETTING: The diabetic clinic of a teaching hospital located in the inner city suburbs of Sydney. PATIENTS: Two hundred and forty-six patients with diabetes (10% insulin dependent), aged 20-86 years, participating in our Shared Care Project, a randomised controlled study on various methods of following up diabetic patients. INTERVENTIONS: Data for the study were gathered by interview and questionnaire during first assessment at the clinic. MAIN OUTCOME MEASURES: Clinical and sociodemographic characteristics of patients; the location of general practitioners, their diagnostic equipment and type of practice; and the level of detail recorded in referral letters from general practitioners. RESULTS: Diabetic patients of migrant background who cannot speak English are older and have less formal education. They see their doctors more often and seek out general practitioners who speak their language, even if it means travelling longer distances. Patients referred from 24 hour medical centres are younger, more educated and have less contact with their doctors both in duration and frequency of visits when compared with patients whose general practitioners operate in conventional sole or partnership practices. Many patients have more than one general practitioner, making communication with hospitals difficult. In their referral letters, general practitioners usually concentrate on hypertension, hypercholesterolaemia and metabolic aspects of diabetes, but under-emphasise diabetic complications; they make insufficient use of measurement of the glycosylated haemoglobin level to assess diabetic control while over-using glucose tolerance testing in making the diagnosis. The referral letter often does not contain enough information to help clinical decision making. CONCLUSIONS: Demography of patients and characteristics of general practitioners are important factors which can affect their interaction with public hospitals. Bearing in mind the work load of general practitioners and the diverse nature of patients, hospitals must implement systems which make it easier for general practitioners and patients to interact with them.     

广州市2015年大气PM2.5与呼吸系统疾病日门诊量的关系

目的 定量研究广州市大气细颗粒污染物(PM2.5)对呼吸系统疾病门诊量的影响.方法采用环境流行病学方法,收集2015年1月1日-12月31日大气PM2.5等污染物资料、气象资料以及广州市1家三级甲等综合性医院呼吸系统疾病日门诊量资料,采用广义相加模型研究广州市大气PM2.5与呼吸系统疾病日门诊量的关系(同时控制长期趋势、星期几效应和气象因素等混杂因素的影响).结果 2015年广州市大气PM2s平均浓度为38.6.μg/m3,Spearman相关性分析表明,呼吸系统疾病日门诊量与SO2、NO2、CO、气压均成正相关,均有统计学意义(P＜0.05).GAM模型分析结果显示,PM2.5对呼吸系统疾病日门诊量呈现出0～3 d的明显的滞后效应,均有统计学意义.PM2.5滞后1d效应最大,滞后1d时,模型结果预测ER(％)为2.847(1.310,4.408),PM2.5每增加10 μg/m3,呼吸系统疾病门诊量增加2.847％.结论 广州市大气PM2.5与呼吸系统疾病日门诊量成正相关关系,且存在滞后效应.     

山西某县2010-2013年新农合参合农民住院费用及负担的研究

目的：：了解长治市襄垣县2010—2013年新型农村合作医疗的参合率、住院率、补偿比例和负担比例等情况,发现存在的问题并提出政策建议,为新农合的可持续发展提供科学依据。方法：将2010—2013年的新农合报销的原始资料,统一汇总录入 Excel 2007数据库,运用 SPSS18.0软件,对住院人次、住院天数、住院费用、补偿比例和负担比例等指标进行描述性分析,组间比较进行Z2检验、χ2检验等。结果：襄垣县从2010—2013年,平均住院率为6.86%,住院补偿比由47.13%增加到55.12%,住院负担比由48.41%降低到45.02%;省级及以上医院住院人次下降了6.59%,乡镇医院提高了4.52%。结论：参合农民住院人次逐年提高,住院补偿比例逐步增加,负担比例逐步下降,提示新型农村合作医疗住院服务利用率稳步提高,基层医疗机构利用率正在逐步加强。但是负担比例仍很重,尤其是县外医院和恶性重大疾病补偿比例须待进一步提高。     

General practitioner and hospital letters.

Communication by letter was assessed between hospital consultants and general practitioners for outpatients and inpatients referred to the Ards Hospital during the month of January 1993. The information was assessed to be poor in several sections of 104 outpatient referral letters, and of 89 inpatient referral letters despite a high use of the standard referral letter form. Consultant physicians' or senior house officers' letters to general practitioners achieved higher scores in 72 outpatient letters, and 152 inpatient discharge summaries. The use of headings was approved by 80% of general practitioners and probably accounted for the highest scores for the headed discharge summaries. Further support and education in the use of headed letters is to be encouraged.     

Measuring the quality of referral letters about patients with upper gastrointestinal symptoms

Background: General practitioners state the reason for referring patients in referral letters. The paucity of information in these letters has been the source of criticism from specialist colleagues. Objective: To invite general practitioners to set standards for referral letters to gastroenterologists and to apply these standards to actual referral letters to one specialist gastroenterology unit. Methods: A scoring schedule was designed based on the responses to a questionnaire survey of a large sample of all general practitioners in one locality. Altogether 350 consecutive letters to a district general hospital about patients referred for an upper gastrointestinal specialist opinion were subsequently scored using the schedule. Results: 102 practitioners responded to the survey. Their responses imply that colleagues assess and record findings on 18 potential features of upper bowel disease. In practice most referral letters address fewer than six features of upper bowel disease. The mean number of positive features of upper gastrointestinal disease reported in each letter was one. Conclusions: This study reported a failure to meet "peer defined" standards for the content of referral letters set by colleagues in one locality. Referral letters serve many purposes, however, encouraging full documentation of specific clinical findings may serve to increase the pre-referral assessments performed in practice.     

When is a patient's use of primary care services unwarranted? Some answers from physicians.

To explore physicians' perceptions of what constitutes unwarranted use of their services, examples of patient-initiated encounters considered unwarranted were contributed by physicians and categorized as requests for unnecessary services, inappropriately timed encounters or inconsiderate requests. A random sample of family and general practitioners in Ontario was surveyed with a questionnaire derived from these examples. Although there was no unanimity, examples of missed appointments, requests for further, unnecessary investigations, consultations or admissions to hospital, duplication of services, visits prompted by a desire to obtain free samples of over-the-counter drugs, some out-of-hours calls, and visits of healthy workers to obtain notes regarding fitness for work were seen as unwarranted by 70% or more of the respondents.