作者：张小庄 叶宁 黄水清 罗坚 张国强 罗先琼 ...激励机制增强医院不良事件主动报告作用adverseeventsincentivemechanism医疗质量相关事件qualityofcaremedicalstaffcaseanalysis数量实施事件类型医疗缺陷医疗处置事例分析技术检查
摘要：目的 探讨激励机制在增强医院不良事件主动报告中的作用.方法 在医院不良事件主动报告中实施激励机制,包括经济奖励、减轻或者取消部分医疗缺陷处罚,比较实施激励机制前后主动报告不良事件数量、类型的变化并分析典型事例.结果 激励机制实施后主动报告不良事件数量2007年1月～8月与2008年同期比较,由34例增至176例;事件类型发生明显变化,医疗相关事件明显增多,医疗处置事件2007年与2008年同期比较由5例增至10例,医学技术检查由0例升至24例,病人辨识错误由2例增至14例,并进行典型事例分析与改进.结论 激励机制使陕院不良事件主动报告数量明显增加,改变了医院不良事件报告的类型,尤其是医疗相关事件增多,强化了不良事件主动报告,提高了医疗质量. Abstract： Objective Discussion of the role/effect of an incentive mechanism in encouraging proactive reporting of adverse events in hospital.Methods Applying an incentive mechanism to encourage medical staff to report on adverse events found in their hospitals.Incentives in question include financial rewards.alleviation or cancellation of some penalties for medical defects.These measures were followed by a comparison between the number and types of proactive reporting on adverse events with those prior to such measures.in addition to typical case studies.Results Comparison of the figures during Jan.August,2007 and those during the sanqe period in 2008 after the incentive mechanism was in place found significant changes.For example,cases of proactive reporting rose from 34 to 176.Most significant changes were found in even types including medical malpractice.For medical disposal events,the number of events rose from 5 in 2007 to 10 in 2008;events in medical technical inspections from 0 to 24 cases;and that of patients identification from 2 to 14.These figures were followed by typical case analysis and improvements.Conclusion Such all incentive mechanism has si
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