【作者】 王建国；

【导师】 陈志军；

【作者基本信息】 山东大学 ， MBA（专业学位）， 2020， 硕士

【摘要】 健康是人类赖以生存和发展的基础,一个国家或地区的居民健康状况反映了区域的经济和社会发展水平。医疗卫生事业发展水平直接决定着居民获得健康服务的便利程度。随着我国深化医药卫生体制改革政策的进一步落实,我国医疗卫生事业得到蓬勃发展。医疗卫生服务机构发展进入新时代,公立医疗卫生机构公益性作用发挥愈发明显,私立医疗机构数量不断增加,医疗服务更加多样化,医疗机构之间竞争效应越发明显,对医院管理提出新的考验。医疗风险事关医院发展全局,医疗风险管理是医院科学规范管理的头等大事。山东省鲁南眼科医院处于区域专科医疗核心地位,近年来发展规模不断壮大,社会影响逐渐扩大,但医疗纠纷与投诉也呈现逐年增长状态。2018年数据显示,医院共发生医疗安全(不良)事件213起,处理各类投诉175起,给医院造成一定经济损失的同时,更是给医院的社会形象造成了较大的负面影响。因此讨论如何加强山东省鲁南眼科医院全面医疗风险管理具有重要意义。根据COSO全面风险管理框架,山东省鲁南眼科医院医疗风险管理存在的主要问题为风险管理分散,未形成科学、系统的医疗风险管理体系。医院缺少专门的医疗风险管理组织和医疗风险管理专门人才、未能形成良好的医疗风险管理文化、医疗风险责任划分不明确、缺乏合理的医疗风险指标体系和责任追究制度,同时内部缺少沟通交流和风险预警机制。利用专家访谈和问卷调查,结合风险矩阵,共计梳理出包括护理管理、医疗质量、后勤保障、服务质量、发展规划5个方面在内的39项医疗风险,并从这些医疗风险中总结出10项关键风险:发错药、手术部位标识错误、血液标本采集量不足、术前准备不充分、交接班不到位、病情评估不到位、高危物品管理不到位、医疗仪器校正不及时、人员替代不及时、信息泄露,同时针对关键风险提出对应的改进措施。针对山东省鲁南眼科医院医疗风险管理过程中存在的突出问题,提出包括优化风险管理目标、完善医疗风险管理组织体系、培育全员参与的风险管理文化、培养风险管理专业人才、建立风险管理信息系统、完善医疗风险管理报告制度、完善医疗风险内控与监督机制7个方面的具体措施,从制度、机制、体系上为山东省鲁南眼科医院全面建成医疗风险管理体系提供保障。更多还原

【Abstract】 Health is the basis for human survival and development.The health status of residents in a country or region reflects the level of economic and social development in the region.The level of development of medical and health services directly determines the convenience of residents in obtaining health services.With the further implementation of China’s policy to deepen the reform of the medical and health system,China’s medical and health undertakings have developed vigorously.The development of medical and health service institutions has entered a new era.The public welfare role of public medical and health institutions has become more and more obvious.The number of private medical institutions has continued to increase,medical services have become more diversified,and the competitive effects between medical institutions have become more apparent.test.Medical risk is related to the overall development of the hospital.Medical risk management is a top priority for scientific and standardized management of hospitals.Lunan Eye Hospital is at the core of regional specialty medical care.In recent years,the scale of development has been growing and the social impact has gradually expanded.However,medical disputes and complaints have also increased year by year.According to data from 2018,213 medical safety(adverse)incidents occurred in the hospital,and 175 complaints of various types were handled,which caused certain economic losses to the hospital and caused a greater negative impact on the hospital’s social image.Therefore,it is of great significance to discuss how to strengthen the comprehensive medical risk management of Lunan Eye Hospital.According to the COSO comprehensive risk management framework,the main problem of medical risk management in Lunan Eye Hospital in Shandong Province is decentralized risk management,and a scientific and systematic medical risk management system has not been formed.Hospitals lack specialized medical risk management organizations and medical risk management expertise,failed to form a good medical risk management culture,medical risk is not clear division of responsibilities,lack of reasonable medical risk index system and accountability system,while a lack of internal communication and risk early warning mechanism.Using expert interviews and questionnaires,combined with the risk matrix,a total of 39 medical risks including nursing management,medical quality,logistics support,service quality,and development planning were sorted out,and 10 medical risks were summarized from these medical risks.Key risks:wrong medicines issued,incorrect identification of the surgical site,insufficient blood specimen collection,insufficient pre-operative preparation,inadequate handover shifts,inadequate disease assessment,inadequate management of high-risk items,and inadequate medical instrument calibration Timely,untimely replacement of personnel,information leakage.At the same time,corresponding solutions are proposed for ten key medical risks.Finally,according to the prominent problems in the medical risk management process of Lunan Eye Hospital,specific countermeasures are proposed from the three aspects of internal environmental protection,perfect information and communication,and internal control and supervision,including improving the medical risk management organization system and cultivating all employees.Optimize risk management goals,participated risk management culture,training of risk management professionals,establishment of a risk management information system,improvement of the medical risk management reporting system,and improvement of the medical risk internal control and supervision mechanism.These measures include Lunan Ophthalmology in terms of system,mechanism,and system.The hospital has built a comprehensive medical risk management system to provide protection..更多还原