A Practical Study On Crisis Management In Coping With Medical Disputes

Objectives:This study,based on the perspective of crisis management,hospital medical dispute disposal in nearly five years of sample case study,by Robert heath 4 r crisis management model for the analysis framework,combing the medical disputes event,the events of the development of the prevention,treatment,recovery,reduce the stages such as evaluation,aiming at the existing problem of each link improvement countermeasure and the suggestion is put forward,to perfect the hospital medical dispute crisis management system,improve the level of hospital management and service ability,and provide theoretical reference for other hospitals at the same level.Methods:This study choose a 3 armour hospital in yunnan province as the research site,adopt the method of combination of qualitative and quantitative analysis,through the sample hospitals in 2014-2018,287 cases of medical dispute cases were analyzed,refer to related files,knowledge management system,relevant samples hospital according to the medical disputes occurred reasons,department,solution to classification statistics,each year the number of cases and the compensation amount.Using self-designed questionnaire,based on the perspective of crisis management,in yunnan province some 3 armour hospital medical,nursing,and 386 people adopting purposive and stratified random sampling method to carry out the investigation,using EpiData 3.1 software for data entry,and apply statistical knowledge of health and SPSS23.0 software for statistical analysis,classification information use cases and the percentage of n,(%)was described,combined with interviews,literature,policy information,such as the statistical results are described.Results:1.The number of patients,the number of discharges and the rate of medical disputes in the sample hospitals increased year by year from 2014 to 2018;Most of the causes were medical disputes,accounting for 64.11%.Second,disputes over non-medical negligence account for 31.71%.Medical negligence disputes accounted for only 4.18%.2.From 2014 to 2018,234 cases of medical disputes occurred in the surgical system,accounting for 81.53%.The number of medical disputes was 27,accounting for 9.41%.The number of medical disputes was 26,accounting for 9.06%.The proportion of third-level and fourth-level surgeries in the surgical departments is also increasing year by year.The first six departments were provincial key specialties of the sample hospital,namely thoracic surgery,gynecology,breast surgery,head and neck surgery,and orthopedics.3.Medical dispute settlement:From 2014 to 2018,22 medical disputes have been settled through litigation,accounting for 7.67%of the total number of medical disputes,and 81.18%through negotiation in the sample hospitals.Non-litigation is the way to settle medical disputes.4.The rate of medical disputes was 0.42� in 2014 and 1.67� in 2018,showing an increasing trend year by year.However,the number of compensations for medical disputes decreased year by year,from 50%in 2014 to 3.73%in 2018.5.The median result of the four dimensions of medical dispute management,namely prevention stage,treatment stage,recovery stage and reduction stage,is between 3-4 points,which is between doing well and doing well.In comparison,the treatment stage and recovery stage are slightly better than the prevention stage and the establishment of long-term effect stage.Conclusions:1.The sample hospital is the only provincial-level grade-? first-class tumor hospital in Yunnan Province.In the past five years,the number of patients and the number of discharges has been increasing constantly,and the incidence of medical disputes is highly concentrated in surgery.2.The proportion of medical disputes caused by diversified and non-technical reasons is on the rise;According to the distribution of medical disputes,there is a high incidence of surgery.3.The way to handle medical disputes in sample hospitals is gradually standardized,and non-litigation negotiation is the main way to handle medical disputes.The compensation for medical disputes is mainly without compensation,and the ratio of compensation is decreasing year by year.4.The sample hospitals paid insufficient attention to the risk assessment and crisis prevention before the outbreak of medical dispute crisis.Despite the establishment of a specialized medical complaint management office with staff and equipment,the sample hospitals still lack a professional crisis management team.In addition,the relevant crisis response exercises on how to fine operation and crisis management of hospital managers have hardly been carried out.Suggestions:1.Optimize internal management in the prevention stage:strengthen medical quality management;The gateways shall be moved forward,and emergency treatment plans and early warning mechanisms shall be formulated.2.Actively respond to and strengthen multi-party cooperation in the processing stage:strengthen the awareness of medical risk disclosure and reduce the incidence of non-technical medical disputes;We will implement the doctor-patient communication system.3.Pay more attention to and control in the recovery stage:process optimization and reengineering,and pay more attention to after-action summary;We will implement the hospital complaint supervision system and the reward and punishment system for those involved.4.Establishment of long-term mechanism stage:establishment of professional management team with distinct responsibilities;Strengthen the hospital staff crisis management awareness.