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多视角探讨全科医疗中对患者投诉的理解及其对患者安全改善的潜力。

A multi-perspective exploration of the understanding of patient complaints and their potential for patient safety improvement in general practice.

机构信息

Discipline of General Practice, National University of Ireland Galway, Galway, Ireland.

School of Medicine, National University of Ireland Galway, Galway, Ireland.

出版信息

Eur J Gen Pract. 2021 Dec;27(1):35-44. doi: 10.1080/13814788.2021.1900109.

Abstract

BACKGROUND

Healthcare complaints are an under utilised source of information for safety improvement, particularly in general practice settings. Within general practice in Ireland, complaints management is dependent on individual practice policies, with little standardisation nationally, impeding their use for safety improvement. There is a need to understand factors that contribute to unlocking the potential of complaints for safety improvement in general practice in Ireland and internationally.

OBJECTIVES

To explore perceptions of healthcare complaints of general practitioners, practice nurses and managers, medico-legal professionals, and policymakers.

METHODS

Participants were recruited using convenience sampling. Interviews were conducted from November 2019-May 2020, based on a semi-structured interview guide. Data were then transcribed and analysed using content analysis. An iterative process was applied to identify emerging themes from the interviews.

RESULTS

A total of 29 participants (19 female, 10 male) were interviewed. Three themes emerged from the analysis, 'why patients submit complaints', 'management of complaints', and 'impact of complaints'. Subthemes included 'barriers and facilitators to complaining', 'practice processes' for complaints management, and 'impacts on staff' of complaints, among others.

CONCLUSION

There is a lot to be learned about how individuals experience complaints, however, this study adds to existing knowledge. The findings from this study can be used to tackle challenges facing complaints management in general practice, including the barriers to complaining for patients and the negative impacts of complaints on the staff, and can also help to build on positive aspects of complaints such as the desire for systemic change among interested parties.

摘要

背景

医疗投诉是一种未被充分利用的信息来源,可用于改善安全性,尤其是在全科医疗环境中。在爱尔兰的全科医疗中,投诉管理依赖于个体实践政策,全国范围内几乎没有标准化,这阻碍了它们在安全性改进方面的应用。需要了解哪些因素有助于挖掘投诉在爱尔兰和国际全科医疗安全性改进方面的潜力。

目的

探索全科医生、执业护士和管理人员、医疗法律专业人员和政策制定者对医疗投诉的看法。

方法

采用便利抽样法招募参与者。访谈于 2019 年 11 月至 2020 年 5 月进行,基于半结构化访谈指南。然后对数据进行转录和内容分析。应用迭代过程从访谈中识别出新兴主题。

结果

共对 29 名参与者(19 名女性,10 名男性)进行了访谈。分析得出了三个主题,分别是“患者提出投诉的原因”、“投诉管理”和“投诉的影响”。其中包括“投诉的障碍和促进因素”、“投诉管理的实践流程”以及“投诉对员工的影响”等子主题。

结论

虽然还有很多关于个人对投诉的体验的知识需要学习,但本研究增加了现有知识。本研究的结果可用于解决全科医疗中投诉管理面临的挑战,包括患者投诉的障碍和投诉对员工的负面影响,同时也可以帮助建立对投诉的积极方面,例如利益相关方对系统变革的渴望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5998/8081321/c39677a46525/IGEN_A_1900109_F0001_B.jpg

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