对影响患者安全行为的医院内部追责机制探讨
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摘要
患者安全是未来医学发展的方向。对影响患者安全行为进行医院内部追责是保障患者安全、提高医疗服务质量的重要环节。通过分析美国法律体系中医疗责任承担方式的演进规律,结合对我国医事法律责任的梳理,明确依据主诊医师负责制对影响患者安全行为进行内部追责具有可行性,且能够兼顾医疗不良事件报告"不惩罚原则",起到保障患者安全、提高医疗服务质量的作用。但应注意,国内医疗机构引入主诊医师负责制的同时,不应削弱我国传统质控制度对患者安全的积极作用。
Patient safety is the future direction of medical development. The internal accountability of hospitals about behavior which affects patient safety is an important part of ensuring patient safety and improving the quality of medical services. By reviewing the evolution of medical liability in the American legal system and the medical legal liability in China, it is feasible to make internal accountability mechanism of behaviors affecting patient safety based on the attending-in-charge. Attending-in-charge can take into account the principle of no-punishment of adverse event reporting system and protect the patient safety, improve the quality of medical services. However, it should be noted that the introduction of attending-in-charge should not weaken the positive role of traditional quality control on patient safety.
Patient safety is the future direction of medical development. The internal accountability of hospitals about behavior which affects patient safety is an important part of ensuring patient safety and improving the quality of medical services. By reviewing the evolution of medical liability in the American legal system and the medical legal liability in China, it is feasible to make internal accountability mechanism of behaviors affecting patient safety based on the attending-in-charge. Attending-in-charge can take into account the principle of no-punishment of adverse event reporting system and protect the patient safety, improve the quality of medical services. However, it should be noted that the introduction of attending-in-charge should not weaken the positive role of traditional quality control on patient safety.
引文
[1] 王启辉,王洪忠.我国实施医疗安全风险金制度的实践与思考[J].中国医疗管理科学,2016,6(5):50-53.
[2] 蓝昕.浅谈我国医师执业责任保险之必要性及制度构建[J].医学与法学,2018,10(4):19-23.
[3] 张华.医政视角下的医患纠纷管理研究[D].南京:南京农业大学,2015.
[4] 中国医院协会患者安全目标:2017版[J].中国医院,2017,21(1):81.
[5] GENE A B.The Doctrine of Corporate Liability[J].AANA J,2005,73(4):253-257.
[6] GENE A B.Another Article on the Surgeon's Liability for Anesthesia Negligence[J].AANA J,2007,75(2):89-93.
[7] ELLEN K M."Captain of the Ship" Doctrine Continues to Take on Water[J].AORN J,2001,74(4):525-528.
[8] 顾旻轶.主诊本质在于责任落实访美国新罕布尔什州Elliot卫生医疗集团高级副总裁李小言[J].中国医院院长,2012(14):48-49.
[9] JONATHAN D K.Conflict and Its Resolution in the Operating Room[J].J Clin Anesth,2007(19):152-158.
[10] 王岳.医事法[M].北京:对外经济贸易出版社,2013:115.
[11] 周昀,程永忠,李为民.四川大学华西医院主诊医师负责制的探索与实践[J].中国卫生事业管理,2018,35(11):816-818.
[12] 周运翱,吴国安,杨志云,等.北京市某医院主诊医师负责制实施效果评价[J].医学与社会,2016,29(12):23-26.
[13] 何安南,鲁胜锟,邬姜海.主诊医师负责制的矩阵组织管理模式提升医疗质量[J].世界最新医学信息文摘,2017,17(A3):12-13.
[14] 黄颖,张雪梅,袁欣,等.医疗不良事件发生与上报情况差异性分析[J].中国卫生事业管理,2016,33(8):575-577.
[15] 龙敏.组织医疗行为中过失责任的分配问题[J].河北法学,2015,33(2):69-77.
[16] AUDREY S W,DANIEL B E.Surgical Complications:Disclosing Adverse Events and Medical Errors[J].J Am Acad Dermatol,2012,68(1):144-146.
[17] 刘文生.主诊医师制:旧制度与大变革[J].中国医院院长,2018(10):44-50.
[2] 蓝昕.浅谈我国医师执业责任保险之必要性及制度构建[J].医学与法学,2018,10(4):19-23.
[3] 张华.医政视角下的医患纠纷管理研究[D].南京:南京农业大学,2015.
[4] 中国医院协会患者安全目标:2017版[J].中国医院,2017,21(1):81.
[5] GENE A B.The Doctrine of Corporate Liability[J].AANA J,2005,73(4):253-257.
[6] GENE A B.Another Article on the Surgeon's Liability for Anesthesia Negligence[J].AANA J,2007,75(2):89-93.
[7] ELLEN K M."Captain of the Ship" Doctrine Continues to Take on Water[J].AORN J,2001,74(4):525-528.
[8] 顾旻轶.主诊本质在于责任落实访美国新罕布尔什州Elliot卫生医疗集团高级副总裁李小言[J].中国医院院长,2012(14):48-49.
[9] JONATHAN D K.Conflict and Its Resolution in the Operating Room[J].J Clin Anesth,2007(19):152-158.
[10] 王岳.医事法[M].北京:对外经济贸易出版社,2013:115.
[11] 周昀,程永忠,李为民.四川大学华西医院主诊医师负责制的探索与实践[J].中国卫生事业管理,2018,35(11):816-818.
[12] 周运翱,吴国安,杨志云,等.北京市某医院主诊医师负责制实施效果评价[J].医学与社会,2016,29(12):23-26.
[13] 何安南,鲁胜锟,邬姜海.主诊医师负责制的矩阵组织管理模式提升医疗质量[J].世界最新医学信息文摘,2017,17(A3):12-13.
[14] 黄颖,张雪梅,袁欣,等.医疗不良事件发生与上报情况差异性分析[J].中国卫生事业管理,2016,33(8):575-577.
[15] 龙敏.组织医疗行为中过失责任的分配问题[J].河北法学,2015,33(2):69-77.
[16] AUDREY S W,DANIEL B E.Surgical Complications:Disclosing Adverse Events and Medical Errors[J].J Am Acad Dermatol,2012,68(1):144-146.
[17] 刘文生.主诊医师制:旧制度与大变革[J].中国医院院长,2018(10):44-50.