探索新形势下的医疗服务模式改革——谈三位一体查房制度

PROBE INTO REFORM OF MEDICAL SERVICE MODEL IN NEW ERA:TALK ABOUT THREE IN ONE WARD ROUND SYSTEM

目的 探索新形势下的医疗服务模式,从而实现“以疾病为中心”到“以病人为中心”新的医疗服务模式的转变,满足病人求医中的各方面需求。方法 我们在日常医疗活动中调查了解现今病人在求医活动中的各种需求,不断地改变我们医疗服务中的方式方法,逐步形成了在日常查房中采用医生、护士、患者三者联合查房。共同商讨对其疾病的诊疗计划和实施,同时对比分析实施三位一体查房前后历次季度调查中病陪人对病情及治疗的知晓率、病陪人对医护工作满意度及病陪人投诉率的变化。结果 实施三位一体查房前病陪人对其疾病的病情知晓率、对医护工作的满意率及病陪人的投诉率分别为60％、85％和1～3％;实施三位一体查房后病陪人对其疾病的病情知晓率、对医护工作的满意率及病陪人的投诉率分别为90％、95％～100％和0.2～0.5％(P<0.005)。结论 医护患三位一体查房确能有效地提高病陪人对其疾病的知晓率和提高病人的满意率,有效地降低了病陪人的投诉率;从而有效地消除了医疗纠纷的隐患,降低了医患纠纷的发生率,减少或消灭医疗差错、事故的发生。

Objective To explore the transformation of the medical service mode that changed from 'make disease be the center' to 'make patient be the center' under new situation so as to meet various demands of patients. Methods The method of 'doctor, nurse, patient, three- in- one' ward round was adopted dining medical care activities to perform the diagnosis, treatment of disease. At the same time, the changes including the rate of knowing the inside story and content, the degree of patient' s satisfactory about the nursing, the rate of the occurrence of medical dispute before and after implementing this method were analyzed. Results With the implementation of the united 'doctor, nurse, patient, three-in-one' ward round the rate of patient's informed content was 90%,the satisfactory rate 95%～100%, tile rate of the occurrence of the dispute between the patients and the doctors was 0.2%～0.5%. compared with that of 60%, 85%, 1%-3% without using this method P<0.005. Conclusion Tiffs method we adopted can make the patient more knowledge about the disease they suffered from and more higher satisfactory about the nursing as well as less medical dispute.