摘要
目的:了解医院高风险病例特点,从医务社会工作角度探索高风险病例管理的思路与方法。方法:通过文献检索、案例研究、高风险科室座谈等方法,设计患者风险评估记录表,对高风险病例的风险点和医患沟通过程进行整理分析、追踪评价。结果:高风险病例主要分布在医院重点学科、手术科室和急诊。47例高风险病例中,30例病情评估存在不足,占63.8%;16例涉及医疗安全不良事件,占34.0%;11例受社会因素影响,占23.4%;16例涉及费用问题,占34.0%;16例医患沟通欠佳,占34.0%。结论:培养医务社会工作者,利用患者风险评估表,多部门联合参与患者知情告知,建立医院风险管理体系,有助于提升高风险病例管理水平。
Objectives:To learn the characters of high risk cases and explore the thoughts and methods of hospital management of high-risk patients from the perspective of medical social work.Methods:Through literature review,case study and discussion with high-risk department,the risk points and doctor-patient communication were analyzed and tracked by high risk patient assessment record form.Results:High risk cases mainly occurred in key departments,operation room and emergency.In total 47 high-risk cases,30 of them had incomplete clinical severity(63.8%)and 16 cases related to adverse events(34.0%).11 cases influenced by social factors(23.4%),16 cases related to medical cost(34.0%),16 lack of doctor-patient communication(34.0%).Conclusions:It is considered to training medical social worker,joint department informed consent,establish hospital risk management system and using patient risk assessment form to improve high risk cases management.
作者
张红宇
吴英锋
李晓杨
顾跃静
王全虹
ZHANG Hongyu;WU Yingfeng;LI Xiaoyang;GU Yuejing;WANG Quanhong(Xuanwu Hospital,Capital Medical University,Xicheng District,Beijing,100053,PRC)
出处
《中国医院》
2019年第2期71-73,共3页
Chinese Hospitals
关键词
医务社会工作
高风险病例
风险评估
medical social work
high-risk patients
risk assessment
