上海市医疗机构投诉管理问题及对策探讨

Problems and countermeasures of complaint management in medical institutions in Shanghai

为了解上海市各级医疗机构投诉管理现状及存在的问题,以问题为导向规范医疗机构投诉管理工作,提升医疗机构投诉管理工作水平,加强医疗安全监管,并提供可行性建议,通过收集上海市2021-2022年医疗机构投诉管理监督检查数据并进行分析,形成上海市医疗机构投诉管理主要问题特征清单。得出数据:271家被监督检查的医疗机构中,47.60%位于中心城区,35.43%为未定级医疗机构,53.13%为医院;投诉管理监督检查不合格条目中,21.48%为未设置专门的投诉接待场所,19.26%为接待场所未提供有关法律、法规、投诉程序等资料供患者查询,14.81%为未建立健全医患沟通机制开展医患沟通及投诉处理培训,13.33%为未接受社会监督,10.00%为未组织宣传、培训和演练重大医疗纠纷事件应急处置预案,6.67%为未设置畅通、便捷的投诉渠道并在医疗机构显著位置公布。建议基于上海市医疗机构投诉管理在组织建设、医患沟通及投诉接待与处理方面的主要问题及特征,按照上海市地方标准《医疗机构投诉处理规范》要求,针对薄弱环节,重点关注未定级医院及基层医疗卫生机构的投诉管理工作。同时,对于二级医院应重点落实建立科室投诉管理制度和指定负责人相关规定,规范医疗机构投诉管理工作,持续加强医疗安全监管。

Objective:To understand the problems of complaint management in various medical institutions in Shanghai,and to provide feasible suggestions for standardizing complaint management in medical institutions,strengthening medical risk management,and improving the level of complaint management in medical institutions.Methods:The data of complaint management supervision and inspection of medical institutions in Shanghai from 2021 to 2022 were collected and analyzed to form a list of the main problems characteristic of complaint management in medical institutions in Shanghai.Results:Of the 271 supervised and inspected medical institutions,47.60%were located in the central city,35.43%were unclassified medical institutions and 53.13%were hospitals.Among the unqualified entries in the supervision and inspection of complaint management,21.48%were for failure to set up a special reception place for complaints,19.26%were for failure to provide information on relevant laws,regulations and complaint procedures at the reception place for patients enquiries,14.81%were for failure to establish a sound mechanism for doctor-patient communication and conduct training on doctor-patient communication and complaint handling,13.33%were for failure to accept social supervision,and 10.00%were for failure to organize publicity The percentage of medical institutions that have not set up smooth and convenient complaint channels and announced them prominently in medical institutions is 6.67%.Conclusion:Based on the main problems and characteristics of complaint management in healthcare institutions in Shanghai in terms of organizational construction,doctor-patient communication and complaint reception and handling,the focus should be on complaint management in unclassified hospitals and primary healthcare institutions in view of the weaknesses,and at the same time,secondary hospitals should focus on implementing regulations related to the establishment of departmental complaint management systems and designating responsible persons,to standardize complaint management in healthcare institutions and continuously improve the quality and safety of healthcare.