医患沟通和人文关怀.ppt

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level,*,现实中我们有很多抱怨，但没有自问我们自身有没有问题。,为什么在相同的环境和条件下，有人成功，也有人失败？有人发展，有人停滞不前？,现今医院面临着社会变化加快、竞争加剧、患者对医院的要求越来越高的挑战。面临新形势，许多新的矛盾和问题摆到了我们的面前。这些问题，靠老办法、老经验、老思路，是不可能得到解决的。如果不具备现代医院的经营、管理、领导新思维，就会对医院发展中出现的问题产生没完没了的困惑，就会对医院的改革发展失去信心，更不可能带领员工使医院得以发展壮大。,未来医院的竞争从根本上讲是思想的竞争，而非单纯医疗技术和服务的竞争，更不是医疗设备的竞争,思维决定意识，意识决定思路，思路决定出路,只有思想才能驾驭财富，只有思想才能使医院走出困境,成功医院的三大价值理念,经营上树立有患者导向的价值理念,管理上树立有员工导向的价值理念,领导上树立有追求卓越领导力导向的价值理念,疾病才是我们真正的对手,-,医患沟通和人文关怀,内容,医疗行业现状,换位思考,满足患者基本需求,满足患者希望需求,内容,医疗行业现状,换位思考,满足患者基本需求,满足患者希望需求,医院窗口服务的特征,1.,时间上的短暂性,2.,对象的不可选择性,3.,受尊重程度,4.,矛盾的随机性,5.,矛盾的影响力,医疗服务的变化特征,1.,生理服务,知识服务,2.,单向服务,互动服务,3.,粗放服务,精细服务,4.,基本服务,分层服务,5.,职业服务,社会服务,案例：外科术前谈话,开也是死,不开也是死,护士有没有开小差,护士有没有与患者家属沟通,案例：输液护士被打,医务工作者的价值,救死扶伤,医疗环境的现状,有,73.33,的医院出现过病人及其家属用暴力殴打、威胁、辱骂医务人员的情况,有,76.67,的医院发生过患者及其家属在诊疗结束后拒绝出院，且不交相关住院费用的情形,有,61.48,的医院发生过病人去世后，病人家属在医院内摆设花圈、烧纸、设置灵堂等行为,顺口溜,医院医生依旧在，只是面孔改。问君能有几多愁?恰似羊儿见着狼群抖。,要想富，做手术，做完手术告大夫，一夜变成暴发户。,病人权利,1973,年,由美国医院联合会,病人权利典章,1974,年法国公布,病人权利宪章,1979,年欧共体医院委员会通过,患者宪章,1981,年世界医学会第三十四届全体大会提出,里斯本病人权利宣言,1997,年中华医学会医学伦理学分会制定了,病人的权利与义务,美国医疗纠纷处理方式,医疗纠纷解决委员会,(Commission on Health Care Dispute Resolution),美国仲裁协会,(AAA),美国律师协会,(ABA),美国医学会,(AMA),作为中立的第三方参与协助解决纠纷的一种医疗纠纷解决机制,目前的医患关系,信任缺失,1.,改变不了别人，请改变自己,坐飞机安检,2.,医方正在改变,内容,医疗行业现状,换位思考,满足患者基本需求,满足患者希望需求,病人的背景,素质参差不齐,医患关系中的观念,不能改变别人，就改变自己。,以病人为中心,以病人为中心,为何要以病人为中心？,医院要求？,考评？,工资奖金挂钩？,还是自己内心这样想的？,医患沟通的精髓,换位思考,-,我是病人我会怎么想？,病人 你,病人的状况,素质参差不齐,没有学过专业知识,来看病，精神差,焦虑不安,你的状况,高素质,多年的专业学习,在工作，身体良好,工作压力,内容,医疗行业现状,换位思考,满足患者基本需求,满足患者希望需求,病人的需求,基本的需求,快速,准确,希望的需求,友善,耐心,满足病人需求,想病人所想急病人所急,=,以病人为中心,不满足病人需求,病人吵闹,病人投诉,医院声誉受损,更严重的是病人流失,“,快速”为何难做到,病人多,病人多是好事还是坏事？,患者投诉,排队三小时，看病三分钟,话没说完，药已经开好了,整个看病期间，都没有正眼看过我,现实与期望存在差距,期望,现实,疾病接受程度,计划行动,结果的认知程度,病史,就医经历,疾病认知程度,两个关键问题,其他医生怎么说？,你最担心什么事？,准确性,不遵医嘱,对医生的满意程度和信任程度,对医嘱内容的理解和记忆程度,对医嘱有恐惧感和惧怕副作用,无法改变原来的生活习惯,怕麻烦,认为疗法不可靠,病人经济拮据,提供准确的信息,基本的要求,难在沟通,沟通障碍之一（专业不对称）,举例：,p.o.,代表什么？,t.i.d,代表什么？,沟通的流程,噪 音,噪 音,传送者,编 码,通 道,解 码,接收者,反 馈,信息,信息,内容,医疗行业现状,换位思考,满足患者基本需求,满足患者希望需求,提高病人满意度的方法,友善的态度,耐心的指导,中国医患关系调查研究,对医生不满意的有：,服务态度不好,不认真、诊疗时间短,开大处方、不必要检查,医术不高、诊疗结果不好,病历书写潦草,不尊重患者隐私,对护士不满意的有：,服务态度不好,护理技术差,不敬业,其他,不尊重患者隐私,有效沟通,-,表达的艺术,友善的态度,多用肢体语言,身体,手,微笑,眼神交流,友善的态度,望,眼神交流，微笑,闻,聆听，支持,问,获取反馈,切,肢体接触,耐心的指导,沟通的方式,口述,笔述,辅助的宣传资料,宣传画报,等等,医患沟通用图文,总而言之,我们中医院的发展,还需要大家共同努力,中医院的明天会更好,!,谢谢聆听,!,