全科醫(yī)生如何提高醫(yī)療質(zhì)量?

369藍(lán)田書(shū)院 2019-09-21

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原著/約翰.莫塔

翻譯/陳曦深圳市人民醫(yī)院

文/余麗琴深圳市龍華區(qū)人民醫(yī)院

指導(dǎo)/徐志杰浙江大學(xué)邵逸夫醫(yī)院

支持/深圳青年醫(yī)師俱樂(lè)部

An uninteresting problem!

一個(gè)無(wú)趣的問(wèn)題,！

I had just completed a long ‘shopping list’ consultation with one of my ‘heartsink’ patients and slipped out the back to check on the progress of an extension to the practice when the patient walked by with her husband. ‘

剛剛跟一個(gè)讓我感到“心情沉重”的病人完成了一串長(zhǎng)長(zhǎng)的“購(gòu)物清單”式的咨詢后,，我偷偷從后面溜出來(lái)，去查看延長(zhǎng)治療的進(jìn)展時(shí),，正好這個(gè)病人同她的丈夫從我旁邊走過(guò),。

I don’t think he’s interested in my problem at all’, I overheard the elderly Mrs E say.

“我覺(jué)得他對(duì)我的問(wèn)題一點(diǎn)都不感興趣”，我無(wú)意中聽(tīng)到老太太E說(shuō),。

This comment pulled me up with a shock as I took pride in being interested and caring about my patients and every problem.

這句話令我大吃一驚,，因?yàn)槲乙恢睘樽约簩?duì)待病人和他的每一個(gè)問(wèn)題都感興趣和關(guān)心而感到自豪。

When I mused over the consultation I realised that it was the last problem of unsatisfactory defecation that I had not paid much attention to.

當(dāng)我仔細(xì)回想之前的咨詢時(shí),，我意識(shí)到自己對(duì)患者最后一個(gè)排便不滿意的問(wèn)題關(guān)注太少,。

She was absolutely correct. (I’d been listening to a litany of elimination problems all morning during my hospital and nursing home rounds!)

她完全正確。(在醫(yī)院和療養(yǎng)院的整個(gè)上午,，我已經(jīng)聽(tīng)了一連串關(guān)于排泄的問(wèn)題,！)

Chastised I decided to contact her and say that I was concerned about a couple of her problems and would like to review her.

(這并不是我忽略她的問(wèn)題的理由)自責(zé)的我決定聯(lián)系E太太，并告訴她我對(duì)她的問(wèn)題非常關(guān)注因此想要回訪她,。

Mrs E was bemused but delighted.

E太太很困惑,，但很高興。

She did in fact have a rectal prolapse and she must have wondered why she received such devoted attention including surgery by a surgical colleague.

事實(shí)上,，她確實(shí)患有直腸脫垂,，她一定很好奇為什么自己能得到如此多的關(guān)注，包括外科同事的手術(shù),。

The lesson is to treat all problems as serious and perhaps it would be salutary for us to be a ‘fly on the wall’ and hear what our patients really think of the quality of their care.

這個(gè)教訓(xùn)就是要把患者所有的問(wèn)題都當(dāng)作嚴(yán)重的問(wèn)題來(lái)對(duì)待,，也許這對(duì)我們來(lái)說(shuō)是有益的，我們要做一只“墻上的蒼蠅”,，聽(tīng)聽(tīng)我們的病人對(duì)他們的醫(yī)療質(zhì)量的真實(shí)看法,。