目的研究预警分级管理对于防范医院手术科室医疗纠纷和医疗不安全事件的作用。方法以医院2012年未实施预警分级管理的手术科室医疗安全状况为对照组,对比分析实施策略后的2013年(预警组)手术科室医疗纠纷发生率、医疗不安全事件发生率、平均赔款额及医疗安全系数。结果实施策略后,预警组医疗纠纷和医疗不安全事件发生率显著低于对照组(P〈0.05),医疗赔款额也有显著下降(P〈0.05),而医疗安全系数从0.50±0.26提高到0.79±0.28(P〈0.05)。结论预警分级管理可显著降低手术科室医疗纠纷和医疗不安全事件发生率,提高医疗安全系数,降低平均赔款额,可成为医院医疗安全管理的一个重要部分。
Objective: To study the effects of early warning and hierarchical management in preventing medical disputes and unsafe events in surgical departments. Method: The authors took the medical safety in surgical departments in which early warning and hierarchical management was not implemented in 2012 as the control group,compared and analyzed the incidences of medical disputes and unsafe medical events,the average amount of compensation and medical safety coefficient( of the early warning group) after policy implementation in 2013. Result: After policy implementation,the incidences of medical disputes and unsafe medical events of the early warning group are lower significantly than those of the control group( P〈 0. 05),the amount of compensation is strikingly reduced( P 0. 05),while medical safety coefficient increases from 0. 50 ± 0. 26 to 0. 79 ± 0. 28. Conclusion: The early warning and hierarchical management can greatly reduce medical disputes and of unsafe medical events,upgrade medical safety coefficient,decrease the amount of compensation in surgical departments and it can be the significant part of the management of medical safety in hospitals.