——熊瑶 邹伏英

【摘要】主诊医师负责制是提升医疗质量和推进医院精细化管理的重要手段。以促进亚专业建设发展为目标，通过明确科主任责权、遴选诊疗组长、细化考核指标、强化信息化支撑等措施，推行主诊医师负责制下的诊疗小组工作模式。实践后，相比2019年4月—10月，2021年4月—10月医院门急诊工作量增加40.9％，出院人次数增长17.9％，平均住院日由9.08 d缩短至8.67 d，学科综合实力不断增强，心血管内科CMI值由1.12上升至1.17，DRG组数由184个增加至223个。推行主诊医师负责制应重点关注信息化建设、责权分配、绩效考核等问题，以实现精细化管理，提升医疗质量管理水平。

【关键词】医院；主诊医师负责制；疾病诊断相关组；精细化管理；医疗质量

中图分类号：R197.323文献标识码：B

Improving Medical Quality Management Through Attending Physician Responsibility System/XIONG Yao,ZOU Fuying.//Chinese Health Quality Management，2022,29(8):25-27,32

Abstract The attending physician responsibility system is an important means to improve the medical quality and promote the hospital fine management. Aiming at promoting the construction and development of sub-specialties, the working mode of diagnosis and treatment group under the responsibility of the leading physician was implemented by clarifying the responsibilities and powers of the department director, selecting the leader of the diagnosis and treatment group, refining the assessment indicators and strengthening the information support. After practice, from April to October 2021, compared with April to October 2019, the workload of outpatient and emergency services increased by 40.9%, the number of discharged patients increased by 17.9%, the average length of stay was shortened from 9.08 days to 8.67 days, and the comprehensive strength of the discipline was constantly enhanced. The CMI value of Cardiovascular Department increased from 1.12 to 1.17. The number of DRG groups increased from 184 to 223. In order to realize fine management and improve medical quality, the system should focus on information construction, responsibility and power distribution and performance assessment.

Key words Hospital; Attending Physician Responsibility System; DRG；Fine Management; Medical Quality

First-author's address Jiangxi Provincial People's Hospital,Nanchang,Jiangxi,330006,China

主诊医师负责制又称医疗组长负责制，即由主诊组全面负责并开展医疗、教学、科研等工作的一种新型医疗管理模式［1］。医院科室管理由科主任负责制逐步转变为主诊医师负责制［2］。主诊组一般由1名主诊医师、1名主管医师、1名或多名经管医师组成。主诊医师查房制度在增加查房频率、明确医疗责任主体、规范病历书写等方面能够有效地弥补三级查房制度的缺陷［3］。主诊医师负责制是优化医院服务流程和保障医疗安全的有效措施，但在责任权利、绩效考核、竞争协作等方面还存在问题［4］。本研究结合样本医院实际，提出以主诊医师负责制为主导的诊疗小组工作模式，取得较好的管理效果。

原文链接：文章标题