基层医院规避医疗风险减少医疗纠纷的治本之策

医疗风险、医疗事故和医疗纠纷长期困扰医院管理者和医务人员。加强制度落实、促进管理到位、做到沟通有效,切实处理好医患关系,是基层医院规避医疗风险、防范医疗事故和减少医疗纠纷的治本之策。     

导致当前医患关系紧张的"五位一体"模式

医患关系紧张是当前医疗界面临的重要问题，经综合分析，这一问题主要由医院、医务人员、患者、医学院以及社会5大方面因素导致产生，并且各因素之间相互影响，相互制约，笔者称之为形成医患关系紧张的“五位一体”模式。     

构建和谐医患关系的对策研究——全国十城市典型调查

针对全国十城市医患关系现状典型调查结果及影响医患关系和谐的因素分析研究，本文从政府责任、医疗保障、法律、医方、心理学、伦理学及医学教育等七个方面对构建和谐医患关系的对策进行多维的跨学科研究。     

信息化管理流程再造对社区患者及社区医护人员的影响

目的探讨信息化管理流程再造在社区健康服务领域的应用,研究信息化管理流程再造对社区患者及社区医护人员的影响。方法根据社区患者需求,改变既往社区医疗服务流程,引入信息化管理流程。选择2010年1月～2011年9月在本社区健康服务站就医的患者100例,随机分成2组。其中对照组按照本社区健康服务站原有医疗服务流程进行医疗服务;观察组按照信息化管理流程进行医疗服务。医疗服务结束后分别对两组患者进行对社区健康服务的满意度调查,并对社区患者的医生及护士进行对信息化流程管理的满意度调查。对2组调查结果进行统计分析。结果对照组患者满意度为(86.05±1.86),其医生对信息化管理流程的满意度为(87.52±1.88),其护士对信息化管理流程的满意度为(85.33±1.72);观察组患者满意度为(94.22±1.39),其医生对信息化管理流程的满意度为(94.52±1.24),其护士对信息化管理流程的满意度为(95.33±1.65)。差异具有统计学意义(p值均<0.05)。结论信息化管理流程可以为患者提供更优质的服务,提高患者对社区健康服务的满意度;信息化管理流程可以提高医生及护士的工作效率;信息化管理流程可以改善医患关系。     

医务人员对医疗纠纷认知分析

目的：了解医务人员对医疗纠纷的认知情况．客观评价和把握医务人员对医疗纠纷的认知程度．采取干预措施的认知程度。从医务人员的角度论证对医疗纠纷进行有效干预是否具有可行性。方法：采取自拟调查表的形式．利用横断面调查方法．对5所医院医务人员进行随机抽查。结果：医务人员对国家相关法律有所了解．认为并且承认医疗纠纷形成是有早期表现的．并对早期表现有所了解．接受医疗纠纷干预主动权在医患双方。结论：从医务人员角度论证了对医疗纠纷进行早期有效干预是可行的。     

问题提示列表应用于医患沟通的研究进展

介绍问题提示列表的概念、研制过程及在医患沟通中的应用进展,分析其优势与不足之处,旨在为采取新措施帮助病人主动参与医患沟通、增进医患关系提供参考。     

Problematic resident-patient relationships

OBJECTIVES: The objectives of the study were to identify the characteristics of a problematic doctor-patient relationship from the perspective of primary care patients who are cared for by medical residents and to determine whether patients' perception of the relationship is a function of their demographic, clinical, or social attributes. DESIGN: Cross-sectional survey. SETTING: An adult primary care practice in an academic medical center. PATIENTS: One hundred fifty-one patients whose primary care physicians were senior internal medicine residents. MEASUREMENTS AND MAIN RESULTS: Patients completed a questionnaire addressing several aspects of their doctor-patient relationship, the general health perception item on the SF-12, and items on social support from the Duke Social Support and Stress Scale. By design of the study, approximately half of the patients had been identified by their physicians as being in problematic relationships (n = 74) and half as being in satisfying relationships (n = 77). Among patients in relationships described as satisfying by their resident, 10% viewed the relationship as problematic. Of the patients involved in relationships described as problematic by the resident, 23% viewed their relationship as problematic (P = .03). Patients who rated the relationship as problematic were much more likely to also report low social support compared to patients involved in relationships described as satisfying (76% vs 16%; P < .001). Compared to residents involved in relationships described as satisfying by their patients, residents in problematic relationships were more likely to be described as being less accessible and less capable of handling medical complaints (P < . 001). CONCLUSIONS: Patients were more likely to describe the doctor-patient relationship as problematic if they felt that the resident was less accessible or less capable of handling medical complaints, or if they had low self-perceived social support.     

急诊护患纠纷发生原因分析及对策

通过对一所二级甲等综合性医院急诊常见护患纠纷原因的分析 ,提出护理人员必须转变护理观念 ,一切以病人为中心 ,改善服务态度 ;启发护理人员的角色意识 ,主动为患者提供优质服务 ;加强护患交流沟通 ,建立良好护患关系 ;通过护士礼仪、形体、语言学习 ,规范服务行为 ;加强护理管理 ,健全完善管理机制等防范对策。减少护患纠纷 ,提高病人满意率 ,为病人提供温馨、便捷、优质服务 ,需要每一位护士做出积极、有效的努力     

新时期新型医患关系现状的多维思考

本文针对新时期新型医患关系的现状、成因及所给启示，依据社会学和心理学的理论，从社会政治、经济、文化、心理、法律多维层面进行了思考。认为医患关系恶化的现状是令人担忧的；其形成原因是多元的：其改善途径应是全方位的；努力应是社会的；历程是漫长的；人性化的医疗服务是必要的。     

防范医疗纠纷 提高病案基础质量

防范医疗纠纷 ,必须提高病案基础质量和医疗工作者意识 ,认清病案基础质量存在的主要问题 ;对存在问题进行改进 ;保证病案基础质量 ,维护自己和医院合法权益。