利益相关者视角下的临床路径认知调查研究

Cognitive Research of Clinical Pathway from the Perspective of Stakeholders

目的基于利益相关者的视角,了解各利益相关者对临床路径的认知及其意见和建议,提出相应的解决思路,为进一步深入开展临床路径工作提供参考。方法采用调查问卷、访谈和专家咨询等方法,对上海市2家三甲医院的92名医护人员、159名患者及来自不同岗位的29名专家等进行调查。结果134名(84.28%)患者不知道临床路径,经过充分讲解后,78人(49.06%)认为临床路径是个好的管理措施,有102人(64.15%)支持亲属住院选择临床路径;医护人员和行业专家认为临床路径最明显的三个优点是:规范操作,减少非必需的药品和检查医嘱,减少医疗误差和提高医疗质量;最明显的不足是增加医护工作量、减少不了非必需的药品和检查医嘱;医护人员和行业专家认为影响临床路径工作的主要问题是信息化工作和科室协调配合工作。结论需要广泛宣传,加强各方政策学习;加强培训工作;完善信息化支持并出台配套的临床管理措施。

OBJECTIVE Based on the perspective of stakeholders,to understand the cognition of clinical pathway and its opinion and the suggestion from stakeholders,put forward the corresponding solutions,provide a reference for further in-depth carrying out clinical pathway work.METHODS By adopting the method of questionnaires,interviews,expert consultation,to investigate 92 medical workers,159 patients out of the two of the top three hospitals,and 29 experts from different positions in Shanghai.RESULTS 134 patients（84.28%）donot know the clinical pathway,after fully explained,78 people（49.06%）think that clinical pathway is a good management measures,there are 102 people（64.15 %） support relatives in the hospital choosing clinical pathway;Health care workers and industry experts believe three most obvious advantages of clinical pathway： standardize operation,reduce non-essential medicines and check the doctor＇s advice,and reduce medical errors,and improve medical quality.The most obvious deficiency is to increase medical workload,reduce the nonessential drugs and check the doctor＇s advice;medical personnel and industry experts believe that the major problems affect clinical pathway work is information and department coordination.CONCLUSION It needs extensive publicity,strengthening policy study;strengthening the training work;perfecting information and more clinical management measures.