Measures for the Administration of Complaints in Medical Institutions _ _ _ _ _
Chapter I General Provisions
Article 1 _ _ In order to strengthen the complaint management of medical institutions, standardize complaint handling procedures, improve medical services, ensure medical safety and the legitimate rights and interests of both doctors and patients, and maintain normal medical order, these Measures are formulated in accordance with the Regulations on the Prevention and Handling of Medical Disputes and the Regulations on the Administration of Medical Institutions.
Article 2 The term "complaint management" as mentioned in these Measures refers to the activities that patients report the situation to medical institutions, put forward opinions, suggestions or complaint requests, and medical institutions investigate, handle and feed back the results of the problems existing in medical service behavior, medical management and medical quality and safety.
Article 3 These Measures shall apply to the complaint management of various medical institutions at all levels.
Article 4 _ _ The National Health and Wellness Commission is responsible for supervising and guiding the complaint management of medical institutions throughout the country.
The local health authorities at or above the county level shall be responsible for the supervision and guidance of the complaint management of medical institutions within their respective administrative areas.
Article 5 The acceptance and handling of complaints by medical institutions shall implement the concept of "patient-centered" and follow the principles of legality, fairness, timeliness and convenience.
Sixth _ _ medical institutions should do a good job of information disclosure in accordance with the provisions and take the initiative to accept social supervision.
Seventh _ _ medical institutions should improve the management level, strengthen the management of medical risks, optimize the service process, improve the medical environment, improve the quality of medical services, guard against potential safety hazards, and reduce medical disputes and complaints.
Article 8 _ _ Medical institutions shall formulate emergency plans for major medical disputes, organize relevant publicity, training and drills, and ensure timely and effective resolution of contradictions and disputes according to law.
Article 9 _ _ Medical institutions shall incorporate complaint management into the patient safety management system, regularly summarize and analyze complaint information, sort out the weak links in medical management and medical quality and safety, implement rectification measures, and continuously improve the level of medical quality and safety.
Tenth _ _ medical institutions should do a good job in linking the complaint management of medical institutions with people's mediation, administrative mediation and litigation of medical disputes. _
Chapter II Organization and Personnel
Eleventh _ _ the main person in charge of medical institutions is the first person in charge of complaint management of medical institutions.
Medical institutions above the second level shall set up a doctor-patient relationship office or a designated department (hereinafter referred to as the complaint management department) to undertake the complaint management work in a unified way. Other medical institutions should be equipped with full-time (part-time) staff, and a complaint management department can be set up if conditions permit.
Twelfth _ _ medical institutions above the second level shall designate a person in charge of medical institutions to be responsible for the complaint work, and guide and manage the relevant work of the complaint management department of medical institutions.
The complaint management department shall perform the following duties:
(1) Organizing, coordinating and guiding the complaint handling work of this medical institution;
(2) Accepting complaints in a unified way, investigating and verifying the complaints, putting forward handling opinions, and responding to patients in time;
(three) to establish and improve the procedures for accepting and handling complaints;
(four) to participate in the medical quality and safety management of medical institutions;
(five) to carry out doctor-patient communication and complaint handling training, to carry out medical risk prevention education;
(six) summarize and analyze the complaint information regularly, put forward opinions or suggestions on strengthening and improving the work, and strengthen supervision and implementation. _
Only medical institutions equipped with full-time (part-time) complaint staff can undertake at least the duties listed in the preceding paragraph.
Thirteenth _ _ medical institutions complaint management personnel shall meet the following conditions:
(1) Having good professional ethics and sense of responsibility;
(2) Having certain knowledge of medicine, management, law, psychology, ethics, social work and other disciplines, and being familiar with laws and regulations related to medical treatment and complaint management and rules and regulations of medical institutions;
(three) strong social adaptability, good social interpersonal skills, good communication skills and adaptability.
Fourteenth _ _ medical institutions above the second level shall establish a three-level complaint management mechanism of medical institutions, complaint management departments and departments, and each department of medical institutions shall at least designate 1 person in charge to cooperate with the complaint management.
All departments of medical institutions should regularly assess the risks involved in complaints, sort out the hidden dangers of complaints, put forward targeted preventive measures for high-risk hidden dangers, strengthen communication with patients, and do a good job in investigating and resolving contradictions and disputes in a timely manner.
Medical institutions should encourage staff to actively collect patients' opinions and suggestions on medical services, medical quality and safety, and report them to the complaint management department or relevant functional departments through prescribed channels.
Fifteenth _ _ medical institutions above the second level should improve the linkage mechanism between the complaint management department and the clinical, nursing, medical technology and logistics, security and other departments, improve the quality of medical care, ensure medical safety and maintain normal medical order.
Sixteenth _ _ medical institutions should gradually establish and improve relevant mechanisms to encourage and attract social workers, volunteers and other people familiar with medical and legal expertise or third-party institutions to participate in the reception and handling of complaints in medical institutions.
Chapter III _ _ Doctor-patient Communication
Seventeenth _ _ medical institutions should improve the professional ethics of medical staff, enhance service awareness and legal awareness, pay attention to humanistic care, strengthen communication between doctors and patients, and strive to build a harmonious doctor-patient relationship.
Article 18 _ _ Medical personnel should abide by professional ethics, take patients as the center, do their jobs enthusiastically, patiently and meticulously, and respect, understand and care for patients in the whole process of medical service.
_ _ _ Article 19 _ _ Medical institutions shall establish and improve the communication mechanism between doctors and patients, improve the content of communication between doctors and patients, strengthen the training of communication skills between doctors and patients, and improve the communication ability between doctors and patients.
Medical staff should patiently explain and explain the suggestions, opinions and opinions put forward by patients in the process of diagnosis and treatment, and deal with them in accordance with the regulations; Questions raised by patients about diagnosis and treatment behavior should be verified and checked in time, and communicated with patients to truthfully explain the situation.
Article 20 _ _ Medical personnel shall respect patients' privacy, right to know and right to choose according to law, highlight key points according to patients' condition, different prognosis and patients' actual needs, and adopt appropriate ways to communicate.
The important contents of diagnosis and treatment in doctor-patient communication should be recorded in medical records in a timely, complete and accurate manner, and signed by patients for confirmation.
Twenty-first _ _ medical institutions may, in combination with the actual situation, formulate the system of medical risk notification and preoperative conversation, standardize the specific process, fully inform patients in a way and language that patients can understand, and obtain their written consent.
Chapter IV Acceptance and Handling of Complaints
Twenty-second _ _ medical institutions should establish a smooth and convenient complaint channel, and announce the complaint handling procedures, location, reception time and contact information in a prominent position in medical institutions.
Encourage medical institutions to strengthen public opinion monitoring, and timely grasp the demands of patients in other channels.
Twenty-third _ _ medical institutions should set up a special complaint reception place, and the reception place should provide relevant laws and regulations, complaint procedures and other information to facilitate patients' inquiries.
Medical institutions should take measures to protect the legitimate rights and interests and personal safety of complaint management staff.
Twenty-fourth _ _ medical institutions to implement the "first complaint responsibility system", patients complain to the relevant departments and departments, departments and department staff should be warmly received after receiving the complaint, to be able to coordinate on the spot, should try to coordinate and solve on the spot; For those who can't coordinate on the spot, the reception department or department should take the initiative to guide patients to the complaint management department (including full-time (part-time) staff of complaint management, the same below), and shall not prevaricate or prevaricate.
Twenty-fifth _ _ complaint reception staff should listen carefully to the opinions of patients, patiently and carefully explain the work, to avoid the intensification of contradictions; It shall verify the relevant information, truthfully record the situation reflected by patients, and keep written complaint materials in time.
Twenty-sixth patients should express their opinions and demands in a civilized manner according to law, provide true and accurate complaint information to the complaint management department of medical institutions, cooperate with the investigation and inquiry of the complaint management department of medical institutions, and must not disturb the normal medical order or commit illegal and criminal acts.
In principle, the number of individual complainants shall not exceed 5. If there are more than 5 people, representatives shall be elected to reflect their demands.
Twenty-seventh _ _ complaint reception staff found that patients have committed suicide, self-mutilation and other excessive acts, or insulted, beaten or threatened the complaint reception staff, they should take timely control and preventive measures, and report to the public security organs and local health authorities; Complaints found in the reception process that may intensify contradictions and lead to public security cases and criminal cases shall be reported to the local public security organs in a timely manner and handled according to law.
Article 28 _ _ The complaint management department of a medical institution shall, after receiving the complaints from the health authorities or the complaints assigned by them, promptly check the situation with the relevant departments, departments and relevant personnel, put forward handling opinions on the basis of finding out the facts and distinguishing the responsibilities, and give feedback to the patients.
The departments, units and relevant personnel involved in the complaint shall actively cooperate with the complaint management department to carry out the investigation, verification and handling of the complaint.
Article 29 _ _ Complaints about the same or similar problems received repeatedly shall be summarized and reported to the person in charge of the medical institution by the complaint management department of the medical institution, and the medical institution may merge the relevant complaints according to the situation, and the medical personnel who have found the link that caused the complaint or repeatedly caused the complaint shall make corresponding treatment in time according to the investigation results.
Thirtieth _ _ the complaint management department of medical institutions shall promptly handle complaints, and if it can be verified and handled on the spot, it shall promptly find out the situation; If there is any mistake, correct it immediately and inform the patient of the treatment opinions on the spot.
Involving medical quality and safety, which may endanger the health of patients, active measures should be taken immediately to avoid or reduce the damage to the health of patients and prevent the damage from expanding.
The situation is complicated and needs to be investigated and verified. Generally, the patient should be given feedback about the handling situation or handling opinions within 5 working days from the date of receiving the complaint.
Involving multiple departments, it is necessary to organize and coordinate relevant departments to carry out the same research, and feedback the handling situation or opinions to patients within 10 working days from the date of receiving the complaint.
Thirty-first _ _ complaints have been handled, and patients who have disputes about the handling opinions of medical institutions and can provide new information and evidence materials shall be re-handled according to the complaint process.
Thirty-second complaints involving medical disputes, medical institutions should inform patients in accordance with the provisions of the relevant laws and regulations on the handling of medical disputes, and actively negotiate to solve; If no settlement can be reached through consultation, the patient shall be guided to solve the problem through mediation and litigation, and the explanation and guidance shall be done well.
Thirty-third _ _ complaints involving medical institutions staff violation of law and discipline, the complaint management department shall promptly hand over to the relevant functional departments in accordance with the law and regulations.
Thirty-fourth _ _ belongs to one of the following circumstances, the complaint management department shall not handle it, but shall explain the situation to the patient and inform the relevant handling regulations:
(a) the patient has brought a lawsuit to the people's court or applied for mediation to a third party;
(2) the patient has complained to the competent health department or the petition department and has been dealt with;
(three) there is no clear object of complaint and specific facts;
(four) the contents of the complaint have involved public security cases and criminal cases;
(five) other complaints that do not belong to the scope of functions and powers of the complaint management department.
Thirty-fifth major medical disputes, medical institutions shall report to the local health authorities at or above the county level in accordance with the provisions. After receiving the report, the competent health department shall timely understand the situation and guide both doctors and patients to resolve disputes through legal channels.
Article 36 _ _ Medical institutions shall protect the privacy of patients and medical staff related to complaints, properly handle public opinions, and it is strictly forbidden to publish information that goes against or exaggerates the facts or the complaint handling process.
Thirty-seventh _ _ medical institutions shall establish and improve the complaint files and file them for future reference.
The complaint files of medical institutions shall include the following contents:
(1) Basic information of the patient;
(2) Complaints and relevant supporting materials;
(3) Investigation, handling and feedback;
(four) other materials related to the complaint.
Thirty-eighth _ _ medical personnel have the right to put forward opinions and suggestions on the management and service of medical institutions, and medical institutions and complaint management departments should pay attention to them and deal with them and give feedback in time.
Clinical frontline staff should report the problems found in the medical quality and safety protection of drugs, medical devices, water, electricity, gas, etc. to the complaint management department or relevant functional departments, and the complaint management and other relevant departments should deal with them in time and give feedback.
Chapter V Supervision and Administration
Thirty-ninth local health authorities at or above the county level shall strengthen the supervision and inspection of the complaint management of medical institutions within their respective administrative areas, and strengthen the daily management and evaluation.
Fortieth _ _ local health authorities at or above the county level shall collect, analyze and feed back the information of complaints and medical disputes of medical institutions within their respective administrative areas, guide medical institutions to improve their work and improve the quality of medical services. At present, more than 300 cities in China have basically opened the hotline 12345. The function of hotline 12345 is consultation, guidance and complaint. The hotline can handle people's livelihood issues such as government functional departments and industrial and commercial consumption disputes, and can basically solve most people's daily livelihood problems for the masses. However, there must be a systematic process for reporting the public security law, criminal cases and the efficiency of civil servants, involving many letters and visits. The reason is not clear by a phone call. It is suggested that citizens directly contact the local public security law, the civil affairs hotline 12388 and the petition departments of various cities.
Third-class hospitals don't issue sick leave notes, so you can complain to the health authorities. The complaint telephone number is 12320. If the health department determines that it is fraud, it can be transferred or you can report the case directly to the public security organ and ask for an investigation. If losses are caused, a lawsuit can be brought to the court. If you are going to sue for medical fraud, you should prepare the following evidence: First, evidence to prove the establishment of the civil legal relationship between the two parties, outpatient and inpatient medical records, medical invoices, etc. 2. Evidence to prove the fact that the damage occurred,
1, doctor's diagnosis certificate or disability certificate or death certificate;
2. Appraisal report of medical association or judicial authentication institution or relevant medical literature and opinions of medical experts. Three. Calculate the list. If there is a specific claim, a calculation list of the claim amount shall be submitted. It's better to complain when you are ready.