Egener Barry E, Mason Diana J, McDonald Walter J, Okun Sally, Gaines Martha E, Fleming David A, Rosof Bernie M, Gullen David, Andresen May-Lynn
B.E. Egener is medical director, Foundation for Medical Excellence, Portland, Oregon. D.J. Mason is codirector, Center for Health, Media & Policy, New York, New York. W.J. McDonald is emeritus professor of medicine, Oregon Health Sciences University, Portland, Oregon, and senior vice president, QHC (Quality in Healthcare) Advisory Group, Huntington, New York. S. Okun is vice president for advocacy, policy and patient safety, PatientsLikeMe, Inc., Cambridge, Massachusetts. M.E. Gaines is distinguished clinical professor of law and director, Center for Patient Partnerships, University of Wisconsin Law School, Madison, Wisconsin. D.A. Fleming is professor and chair of medicine and codirector, Center for Health Ethics, University of Missouri School of Medicine, Columbia, Missouri. B.M. Rosof is professor of medicine, Hofstra Northwell School of Medicine, Hempstead, New York, and chief executive officer, QHC (Quality in Healthcare) Advisory Group, Huntington, New York. D. Gullen is codirector, Communication in Healthcare Program, Mayo Clinic in Arizona, Scottsdale, Arizona. M.-L. Andresen is vice president, QHC (Quality in Healthcare) Advisory Group, Huntington, New York.
Acad Med. 2017 Aug;92(8):1091-1099. doi: 10.1097/ACM.0000000000001561.
In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems.This article contains the Charter on Professionalism for Health Care Organizations, as well as the process and rationale for its development. For hospitals and hospital systems to effectively care for patients, maintain a healthy workforce, and improve the health of populations, they must attend to the four domains addressed by the Charter: patient partnerships, organizational culture, community partnerships, and operations and business practices. Impacting the social determinants of health will require collaboration among health care organizations, government, and communities.Transitioning to the model hospital described by the Charter will challenge historical roles and assumptions of both its leadership and staff. While the Charter is aspirational, it also outlines specific institutional behaviors that will benefit both patients and workers. Lastly, this article considers obstacles to implementing the Charter and explores avenues to facilitate its dissemination.
2002年,《医学职业精神宪章》发布,旨在为医生在快速变化的环境中提供决策指导。医生的反馈表明,他们无法完全践行2002年宪章中的原则,部分原因在于其受雇或附属的医疗保健机构。鉴于当前医疗服务体系的结构,一个多方利益相关者团体制定了《医疗保健组织职业精神宪章》,该宪章可能比针对个别学科的宪章提供更多指导。本文包含《医疗保健组织职业精神宪章》及其制定过程和基本原理。对于医院和医院系统而言,要有效护理患者、维持健康的员工队伍并改善人群健康状况,就必须关注宪章所涉及的四个领域:患者伙伴关系、组织文化、社区伙伴关系以及运营和商业实践。影响健康的社会决定因素需要医疗保健组织、政府和社区之间的合作。向宪章所描述的模范医院转型将挑战其领导和员工的历史角色及假设。虽然宪章具有理想性,但它也概述了将使患者和员工都受益的具体机构行为。最后,本文探讨了实施宪章的障碍,并探索促进其传播的途径。