以危機管理建構醫療糾紛預防之模式

Applying Crisis Management to Establish a Preventive Model for Medical Dispute

鄭博文(B. Cheng) ； 賴俊裕(J. Lai) ； 邱文宏(W. Chiu)

《危機管理學刊》 1卷3期 (2004/09) Pp. 61-73

https://doi.org/10.6459/JCM.200409_1(3).0007

摘要

隨著民眾消費意識抬頭，民眾對於醫療服務品質的期望逐漸提升。一旦醫療結果與病患期望有所落差，即會產生抱怨。若是醫院忽視病患的抱怨或是處理不當，則會進一步演變為醫療糾紛。本研究透過文獻收集與專家訪談，瞭解影響醫療糾紛發生的因素，將民眾就醫過程分為五個階段，分別是「病患等候就醫」、「醫療服務提供」、「醫療服務提供結束」、「病患領藥」與「病患離開醫院」。並將醫療糾紛因素區分為徵兆與原因，用危機管理觀念設計出醫療糾紛徵兆診斷量表和醫療糾紛徵兆分佈圖，對民眾就醫過程各階段對於預防醫療糾紛徵兆區分為四個等級，分別為觀察期、潛伏期、警告期與危險期，以判斷醫院在民眾就醫過程中，對預防醫療糾紛較為不足的階段進行改善。本研究選取兩家醫院以驗證醫療糾紛診斷量表，再與醫院處理醫療糾紛人員進行訪談。結果顯示，本診斷量表分析的結果確實反應出醫院對於預防醫療糾紛準備的程度，可給予醫院在預防醫療糾紛上的參考。

關鍵字

醫療糾紛 ； 診斷量表 ； 危機管理 ； 醫療服務品質

並列摘要

Peoples' consumer conscious arise resulting in peoples' increasing expectation for medical service quality. Once the medical results were not as the patients' expectations, patients' complains arise. If hospitals did not deal well or even ignore their patients' complains, medical disputes could arise.This study reviewed literatures and interviewed experts to realize the factors causing medical disputes. Five phases of medical service are divided as: waiting for medical service, supplying medical service, finishing medical service, waiting for medicines, and leaving hospital. By summing up the factors causing the medical dispute, the concept of crisis management was applied to design diagnosis questionnaire for the sign of medical dispute (DQSMD) and a distribution chart about medical dispute system. Then, four levels of preventive sign for medical dispute are divided as: observation period, incubation period, warning period, and dangerous period. The distribution chart displays the trend of medical dispute about what phases of medical service that a hospital does not prepare enough.This study verified the DQSMD in two hospitals. The results showed that the DQSMD analysis was similar to the preventive situations for medical dispute of the hospitals after discussing with persons who handle medical dispute in the hospitals. Therefore, DQSMD of this study could be as references for hospitals to prevent medical dispute.

並列關鍵字

Medical dispute ； diagnosis questionnaire ； crisis management ； service quality of medical care

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