医患沟通管理机制和路径优化对策分析——兼论基于法定程序的医患沟通管理机制  

Analysis of management mechanism of patient-physician communication and countermeasures of path optimization-also on the management mechanism of patient-physician communication based on legal procedures

作　　者：虞凯[1] 田侃[2] 喻小勇[2] YU Kai;TIAN Kan;YU Xiaoyong(Jiangsu Provincial Hospital of Chinese Medicine,Nanjing Jiangsu 210029,China;Nanjing University of Chinese Medicine,Nanjing Jiangsu 210046,China)

机构地区：[1]江苏省中医院,江苏南京210029 [2]南京中医药大学,江苏南京210046

出　　处：《卫生软科学》2025年第2期47-52,68,共7页Soft Science of Health

基　　金：江苏省医学人文社科基金-《民法典》环境下中医医院医患沟通标准化流程研究(JSWSFX-2022-2023-001)。

摘　　要：现行的医患沟通管理机制属于一种基于医疗文书的管理机制,存在重实体轻程序的不足之处。在管理方法上以文书制作为抓手,缺少在医患沟通流程方面的实质性管控措施,是导致医疗机构医患沟通方面始终存在一定瑕疵的重要原因。基于法定程序的医患沟通管理机制将医患沟通整个流程划分为沟通主体、沟通内容、患方决策3个模块,较传统的基于医疗文书的管理机制具备一定的优势。医疗机构具备对医患沟通流程进行规范化管理的条件,为此医疗机构在医患沟通管理方面应考虑改变管理方式,从传统的文书管理提升为流程质控,从设置工作部门、合理配备工作人员、制定管理制度等方面健全医疗沟通管理体系,并通过优化身份识别、流程质控、沟通记录以及第三方见证等管理路径来加强对医患沟通的管理。The current management mechanism of patient-physician communication is a management mechanism based on medical documents,and there are shortcomings of emphasizing entity over procedure.In terms of management methods,document production is the starting point.The lack of substantive control measures in the process of patient-physician communication is an important reason for the defects in patient-physician communication in medical institutions.The management mechanism of patient-physician communication based on legal procedures divides the whole process of patient-physician communication into three modules:communicator,communication content and patients decision-making,which has certain advantages over the traditional management mechanism based on medical documents.Medical institutions have the conditions for standardized management of the patient-physician communication process.Therefore,medical institutions should change the management modes of patient-physician communication,upgrade from traditional document management to process quality control,and improve the management system of medical communication from the setting of working departments,reasonable personnel allocation,and the formulation of management systems.Management paths such as the optimization of identity identification,process quality control,communication records and third-party witness are used to strengthen the management of patient-physician communication.

关 键 词：医院管理 医患沟通 法定程序 知情同意权 

分 类 号：R197.32[医药卫生—卫生事业管理] R-05[医药卫生—公共卫生与预防医学]