医疗纠纷危机管理情况评估分析——基于“危机管理”理论框架

Assessment and Analysis of Medical Dispute Crisis Management——Based on the Theoretical Framework of “Crisis Management”

目的通过危机管理理论模式来评估医院医疗纠纷危机管理情况,以期能为医院医疗纠纷危机管理逐步走向日常化、规范化和系统化提供理论参考。方法基于危机管理的视角,采用自制问卷,对云南省某三甲专科医院医、护、管386人采用随机抽样方法开展调查。结果该三甲专科医院近一半的工作人员认为近几年未发生医疗纠纷,绝大多数认为发生了1~3起;医务人员认为患者素质一般的占71. 15%,认为其素质较高和素质较低均为10%左右;对于医患关系的评价认为很紧张和比较紧张的分别占14. 79%、50. 51%,认为很融洽的仅占1. 63%;医疗纠纷危机管理各阶段多重线性回归分析结果显示,对四阶段总评分的影响因素是工作满意情况评价、对患者评价、纠纷发生数量、年龄。结论医疗纠纷危机管理预防阶段满意度评分依次低于处理阶段、建立长效机制阶段和恢复阶段,医务人员工作满意情况评价和对患者评价越高对医疗纠纷危机管理效果有较积极的促进作用,而医务人员年龄越大和医疗纠纷发生数量越多是降低医疗纠纷危机管理效果的因素。

Objective To evaluate the hospital medical dispute crisis management situation through the theoretical model of crisis management in order to provide a theoretical reference for the gradual routinization,standardization,and systemization of the hospital medical dispute crisis management. Methods From the perspective of crisis management,a self-made questionnaire was designed to investigate 386 staff from medical,nursing and management departments of a specialized Class A tertiary hospital in Yunnan province by random sampling. Results Nearly half of the staff in the hospital believe that no medical disputes have occurred in recent years,and the vast majority believe that 1-3 cases of medical disputes have occurred. 71. 15% of the medical staff described the patients’ integrity as normal,compared with 10% who view it as high or low. For doctor-patient relationship,those who regard it as very tense and relatively tense account for 14. 79% and 50. 51%respectively,and those who view it as very harmonious only account for 1. 63%. The Results of multiple linear regression analysis of each stage of medical dispute crisis management show that the factors influencing the total score of the four stages are job satisfaction evaluation,patient evaluation,number of disputes and age. Conclusion The satisfaction score for the prevention stage of medical dispute crisis management is lower than the processing stage,the stage to establish a long-term mechanism and recovery stage;the higher the medical staff job satisfaction evaluation and the evaluation of the patients are,the bigger the role the effect of medical dispute crisis management plays is;and the older age of medical staff and greater number of medical disputes is a factor that reduces the effect of medical dispute crisis management.