医院管理者披露医疗错误认知及态度的扎根理论研究  

Disclosure of medical error: A Grounded Theory study of hospital managers’ cognition andattitude

作　　者：罗鑫 漆加兴 李晓莉[1] 黄蓉蓉 陈贵儒 LUO Xin;QI Jiaxing;LI Xiaoli;HUANG Rongrong;CHEN Guiru(Aba Prefecture People’s Hospital,No.176,Majiang Street,Malkang,Sichuan Provincec,624000,PRC)

机构地区：[1]阿坝藏族羌族自治州人民医院,四川省624000 [2]贵州医科大学附属医院,贵州省550000

出　　处：《中国医院》2021年第9期41-45,共5页Chinese Hospitals

基　　金：四川省软科学研究计划项目资助(2020JDR0368)。

摘　　要：目的:了解医院管理者对披露医疗错误的认知、态度和决策规律。方法:采用有目的滚雪球抽样及理论抽样方法,于2020年7〜10月对符合纳入标准的12名医院管理者进行半结构式访谈,应用扎根理论分析原则进行资料分析。结果:医院管理者认为披露是指医院向患者/家属告知医疗差错、事故,解释错误的原因并取得理解和原谅,协商后续的处理办法及赔偿;推导出管理者披露医疗错误决策的流程,并识别复杂的促进及阻碍因素;构建了管理者披露医疗错误的理论框架,其中披露意向、披露前评估、披露决策是理论框架的核心。结论:提高医院管理者对披露的认识以改进披露态度是披露实施的必要条件,披露决策流程及理论框架能够为医疗机构建立披露体系提供理论参考。Objective:To understand the cognition,attitude and decision-making rules of hospital managers on the disclosure of medical errors.Methods:Using purposeful snowball sampling and theoretical sampling methods,semi-structured interviews were conducted with 12 hospital managers who met the inclusion criteria from July to October 2020,and the principles of grounded theoretical analysis were used for data analysis.Results:The hospital administrator believes that disclosure means that the hospital informs patients/family of medical errors and accidents,explains the cause of the error and obtains understanding and forgiveness,negotiates follow-up treatment methods and compensation;derives the process for the administrator to disclose medical error decisions,and Identify complex factors that promote and hinder;build a theoretical framework for managers to disclose medical errors,in which disclosure intentions,pre-disclosure assessment,and disclosure decision-making are the core of the theoretical framework.Conclusion:Improving hospital managers'awareness of disclosure and improving their attitudes towards disclosure is a necessary condition for the implementation of disclosure.The disclosure decision-making process and theoretical framework can provide a theoretical reference for medical institutions to establish a disclosure system.

关 键 词：患者安全 医疗错误 医院披露 扎根理论 

分 类 号：R197.3[医药卫生—卫生事业管理]