Safran Dana Gelb, Miller William, Beckman Howard
The Health Institute, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Boston, MA 02111, USA.
J Gen Intern Med. 2006 Jan;21 Suppl 1(Suppl 1):S9-15. doi: 10.1111/j.1525-1497.2006.00303.x.
Four domains of relationship have been highlighted as the cornerstones of relationship-centered health care. Of these, clinician-patient relationships have been most thoroughly studied, with a rich empirical literature illuminating significant linkages between clinician-patient relationship quality and a wide range of outcomes. This paper explores the realm of clinician-colleague relationships, which we define to include the full array of relationships among clinicians, staff, and administrators in health care organizations. Building on a stream of relevant theories and empirical literature that have emerged over the past decade, we synthesize available evidence on the role of organizational culture and relationships in shaping outcomes, and posit a model of relationship-centered organizations. We conclude that turning attention to relationship-centered theory and practice in health care holds promise for advancing care to a new level, with breakthroughs in quality of care, quality of life for those who provide it, and organizational performance.
关系的四个领域已被视为以关系为中心的医疗保健的基石。其中,医患关系得到了最充分的研究,丰富的实证文献揭示了医患关系质量与广泛结果之间的重要联系。本文探讨临床医生与同事之间的关系领域,我们将其定义为包括医疗保健组织中临床医生、工作人员和管理人员之间的所有关系。基于过去十年中涌现的一系列相关理论和实证文献,我们综合了关于组织文化和关系在塑造结果方面作用的现有证据,并提出了一个以关系为中心的组织模型。我们得出结论,关注医疗保健中以关系为中心的理论和实践有望将医疗提升到一个新水平,在医疗质量、提供医疗服务者的生活质量和组织绩效方面取得突破。