某医院医疗纠纷案例分析及管理启示

A Hospital’s Case Analysis and Management Enlightenment of Medical Disputes

目的通过对所经历328个过失性纠纷案例的梳理分析,希望从中获得一些医务管理上的启示。方法收集某三甲综合医院2005—2016年的医疗纠纷档案,共获得过失性医疗纠纷资料328例。主要采取案例分析方法,对每一纠纷案例的发生科室、纠纷发生时的患者状态、医疗缺陷和过错进行梳理。并对医疗纠纷的续存状况进行梳理。结果医疗纠纷多发于手术操作型科室,纠纷发生时患者多处于不良状态,纠纷案例中包含了16种缺陷、过错项目,纠纷构成呈“多因态”,主要的缺陷、过错呈“常在性”分布形态。结论医疗纠纷的形成具有规律性,纠纷形成的要素是行为过错和沟通缺陷,而医疗过错的续存状态与科室医疗管理和医院医务管理双相关。由此,临床科室和管理部门必须加强行为过错的检测,及时提出临床警示性管理要点,并采取措施实行宏观管理。

Objective Sorting out and analyzing up to 328 hospital’s precious negligent dispute cases,the purpose to draw some medical management enlightenment from it are hopping to be fulfilled.Methods In collection of the medical dispute files of a third-class general hospital from 2005 to 2016,so far the total number of negligent medical disputes cases we are holding are 328.implementing case analysis as the principal method,we categorize the involved hospital departments,the status of the patients,the medical defects and faults in every single case,meanwhile,sorting out the annual distribution of medical disputes and that of medical defects or faults.Results High incidence of medical disputes can be found in surgical operation departments,in most of which patients were in a negative condition.The disputes cases embrace defect and fault up to 16.The disputes feature in multiple factors and the primary defects and fault characterize in regularity-type distribution.Conclusion Medical disputes happen regularly and the reasons for medical disputes mainly are behavioral faults and communication defects.Moreover,the long-existed medical faults is related to both departmental medical management and hospital medical management.Therefore,clinical departments and management departments must strengthen the detection of behavioral faults,timely put forward key points of clinical warning management,and take necessary measures to implement macro-management.