“特殊”病人追踪管理降低医疗纠纷的研究

Research on Reducing Medical Disputes of Special Patients Tracking Management

对笔者所在医院2015年1月至2017年12月168例诊疗效果不佳、住院时间超长、发生手术并发症、非计划再次手术的特殊病人实施追踪管理,分析发现我院近三年医疗纠纷发生率逐年下降,医疗纠纷的发生率在二次手术或严重术后并发症、疑难危重并治疗效果不佳及住院日超30天病人中差异有统计学意义(P<0.05);追踪对象主要集中在疑难危重并治疗效果不佳、二次手术或术后合并严重并发症及住院日超过30天,最多的是外科、ICU及内科特殊病人;追踪方法包括组织院内多学科会诊、医务部参与医患沟通及调阅病历。实施特殊病人持续追踪管理可有效降低医疗纠纷的发生。

168 special patients with poor clinical effect,long-time hospitalization,complications and unplanned reoperation were followed up and managed from January 2015 to December 2017 in The First Affiliated Hospital of Dali University.It was found that the incidence of medical disputes in this hospital decreased in the past three years.There were significant differences in the incidence of medical disputes among the patients whose complications after the secondary surgery,dates of hospitalization exceed 30 days(P<0.05).The subjects of follow-up mainly focused on patients with difficult and critical conditions,poor therapeutic effect,severe complications after operation include the secondary operation,and hospitalization for more than 30 days.Those special patients were mainly from surgery,ICU and internal medicine departments.Tracking methods include organizing multidisciplinary consultation in hospital,participating in doctor-patient communication by Department of Medical Administration and checking medical records.A conclusion was drawn that the implementation of continuous follow-up management of special patients can effectively reduce the occurrence of medical disputes.