Summary of Hospital Clinical Pathway Work 1 In order to implement the opinions of Central the State Council on deepening the reform of medical and health system and some opinions of the State Council on supporting and promoting the development of traditional Chinese medicine, according to the Notice of state administration of traditional chinese medicine on Printing and Distributing the Implementation Plan of Clinical Pathway Management of Traditional Chinese Medicine (State Administration of Traditional Chinese Medicine [xx] No.8) and the spirit of the kick-off meeting of clinical pathway management of traditional Chinese medicine in state administration of traditional chinese medicine, our hospital started the pilot work of clinical pathway management of traditional Chinese medicine in XX. Over the years, under the correct leadership of the higher authorities, we have made great efforts to explore and deepen clinical pathway management, and some achievements have been made, but there are also some problems, which are summarized as follows.
First, the main practices
(A) to strengthen organizational management
The hospital has set up an organizational network system, such as clinical pathway management pilot work leading group, guidance and evaluation group and department implementation group.
(1) The leading group is headed by the president, with the vice president of business as the deputy head. Its members are the heads of medical department, nursing department, pharmacy department, hospital infection department, information department, finance department and pilot department. The leading group is responsible for organizing the formulation of specific pilot work objectives and implementation plans in our hospital, studying and formulating management systems related to the pilot work, determining the diseases to be implemented by clinical pathway in our hospital, reviewing clinical pathway documents, reviewing the evaluation results and improvement measures of clinical pathway, coordinating the problems encountered in the formulation and implementation of clinical pathway, and reporting the relevant situation of the pilot work to the superior on a regular basis.
(2) The guidance and evaluation team is headed by the vice president of business, and the heads of relevant functional departments and experts in related disciplines are members. Responsible for guiding the formulation and implementation of clinical pathway and pilot work in our hospital, organizing the training of medical staff in clinical pathway pilot departments, organizing the formulation and implementation of evaluation indicators and methods, analyzing and evaluating regularly, putting forward improvement opinions and measures, and feeding back to the leading group and pilot departments in time.
(3) The director of the department is responsible for the implementation team of the department, and senior medical personnel of the department participate.
As a member, I am specifically responsible for the implementation of clinical pathway of diseases related to my major and the collection and collation of data related to clinical pathway, regularly evaluate and analyze the implementation effect of clinical pathway in our department, and make reasonable adjustments to medical resources in our department according to the actual needs of clinical pathway management pilot work.
(2) Selection of professional diseases
In xx years, according to the clinical pathway of 1 12 diseases issued by the Ministry of Health, combined with the actual situation of our hospital, five specialties and six diseases were selected to implement the pilot work of clinical pathway management. After gaining some experience, our hospital continued to explore deeply. In xx years, the scope of clinical pathway management diseases was expanded, and hemorrhoids and turbid diseases were increased in surgical specialties. The major of orthopedics and traumatology increases femoral neck fracture; Internal medicine majors increase stroke; Acupuncture specialty increases the disease of partial arthralgia; Hysteria increases in obstetrics and gynecology. With the development of business and the change of diseases, in xx, our hospital carried out in-depth clinical pathway management of traditional Chinese medicine, and adjusted the diseases managed by clinical pathway on the original basis. At present, there are 4 specialties 15 diseases that implement TCM clinical pathway management.
(C) pay attention to training and guidance
1. Actively publicize through hospital journals, briefings, intranet, etc. Unify thinking, raise awareness, and stimulate the enthusiasm and subjective initiative of professional departments and medical staff for clinical pathway pilot work.
2, through intensive training, let each department personnel understand the concept and content of clinical pathway, master the undergraduate course room clinical pathway management goals, requirements, steps, links and measures.
3, guide the evaluation team to strengthen the technical guidance in the process of clinical pathway management in each department, and solve the difficulties and problems in the implementation process in time.
(4) Establish and improve the evaluation mechanism.
1. Incorporate clinical pathway management into medical quality assessment, formulate corresponding assessment standards and scoring rules, and the medical department and quality control room are responsible for supervision and inspection at ordinary times, and conduct floor-to-floor assessment once every six months. The assessment results are first linked to the evaluation of various departments.
2, the implementation of individual assessment. In xx years, the hospital issued a single assessment index notice, requiring all clinical departments to carry out clinical pathway management in depth, and the quality control room was responsible for the assessment, and strictly implemented the rewards and punishments regulations according to the completion of each department.
Second, the effectiveness of the work.
Through continuous exploration and in-depth promotion, clinical pathway management in our hospital has achieved certain results.
First, it promotes the further standardization and process of medical behavior, and improves the accuracy of disease diagnosis and treatment and the evaluability of prognosis;
Second, it reduces the average length of stay of inpatients; The third is to reduce medical expenses; Fourth, the relationship between doctors and patients has been improved, and patient satisfaction has been improved. Taking xx years as an example, the topic of ideological report is compared as follows:
Third, there are problems.
1. There are still some limitations in the existing professional diseases that implement clinical pathway management, which cannot fully highlight the characteristics of specialties.
2. It is difficult for some patients to do relevant examinations according to the time specified in the path, and there are misunderstandings. They don't want to go to the hospital for examination and only ask for medical treatment; Patients' habits or working conditions make some patients unable to follow the path requirements, resulting in variation and retreat.
3. Some departments and medical staff have some misunderstandings about the purpose and significance of clinical pathway implementation. They think that clinical pathway may not achieve the purpose of improving medical quality, controlling medical expenses and improving patients' satisfaction, and it wastes paper and increases the workload of medical staff and the cost of hospitals, so it lacks initiative. There is some resistance in the development of clinical pathway management in hospitals, which affects the promotion of clinical pathway management to some extent.
4. Supervision needs to be strengthened. The records of clinical pathway implementation in some departments, the filling of clinical pathway evaluation form and the withdrawal of patients from clinical pathway are incomplete, which is not conducive to summing up and accumulating experience.
Fourth, the rectification measures
1, it is necessary to further expand the categories of professional diseases in clinical pathway, do a good job of investigation and study according to the admission situation of diseases, adjust diseases in time, continuously optimize the pathway, and give full play to the characteristics and advantages of traditional Chinese medicine.
2. Pay attention to publicity and create an atmosphere. Strengthen the publicity and interpretation of policies related to clinical pathway management to improve patients' acceptance and recognition of clinical pathway management; It is necessary to correctly guide public opinion, publicize positive information, and strive for the understanding, support and cooperation of all sectors of society.
3. Strengthen study and raise awareness. Medical staff in the whole hospital should attach great importance to clinical pathway management, strengthen the training and education at the hospital and department levels, change the traditional concept of medical staff, do everything possible to mobilize their subjective initiative and actively carry out clinical pathway management.
4. Constantly sum up and be brave in innovation. It is necessary to strengthen the supervision and inspection of clinical pathway management in the whole hospital, strictly implement reward and punishment measures, do a good job in data collection, archiving and summary, be good at discovering good experiences and practices in the implementation process, and steadily promote them.
Summary of Hospital Clinical Pathway Work 2 Our hospital began to carry out clinical pathway management in the second half of 20xx. By carrying out the clinical pathway work, our hospital further optimized the medical process, standardized the medical behavior of medical staff, improved the overall medical quality, reduced unreasonable examination, treatment and medication, reduced the overall treatment cost and shortened the average hospitalization days. Compared with those who did not enter the pathway, the total disease cost and hospitalization days were reduced, and the work efficiency was improved. The communication between doctors and patients has been further enhanced, and the communication ability of medical staff in departments has been significantly improved, which has strengthened the doctor-patient relationship and reduced medical complaints and disputes.
Up to now, the hospital has *** 1 1 departments to carry out clinical pathways, and there are ***28 diseases, namely orthopedics, general surgery, cardiology, respiratory department, digestive department, obstetrics, pediatrics, otolaryngology, geriatrics, oncology department and Kunji branch, among which only three diseases have entered the single-disease payment. Or because of mutation, 46 cases entered the clinical pathway in 20xx, including 2 cases of nasal bone fracture, 2 cases of community-acquired pneumonia 10, 2 cases of distal ulna and radius, 5 cases of acute simple appendix, 2 cases of inguinal hernia, 3 cases of Grawes disease, 1 case of lumbar disc herniation 1 case, 3 cases of rotavirus diarrhea, 4 cases of hand-foot-mouth disease and 65 cases of ectopic pregnancy.
Although the clinical pathway has been developed in our hospital for 1 years, it is still in the initial exploration stage, with certain limitations and shortcomings. The analysis is as follows:
1, medical staff have insufficient understanding of the significance of clinical pathway implementation.
Clinical pathway is to establish a set of standardized treatment models and processes for a certain disease, and it is a comprehensive model related to clinical treatment. The ultimate goal is to make doctors reduce unnecessary medical treatment, avoid the waste of medical resources, reduce the variation caused by various reasons when patients are hospitalized, reduce the medical expenses of patients, help patients know more about their diseases, enhance their awareness and ability of self-protection, enable patients and their families to actively participate in treatment, and improve patient satisfaction. However, some medical staff still don't understand the ultimate goal, how to choose the target, how to enter, what is the retreat, what is the variation, and what is the significance to both doctors and patients, thus reducing the access rate, and even some diseases are not connected to patients.
2. Effective communication between doctors and patients needs to be strengthened
Entering the clinical pathway is not a matter for medical staff themselves, but also a process of communication with patients and their families. It is necessary for patients and their families to know what the clinical pathway is and what practical significance it has for themselves, and to carry out health education for patients after entering the pathway, so as to enhance their understanding of their own diseases, enhance their confidence in healing and raise their awareness of self-protection.
3. Lack of standardization and information platform management.
The lack of information management platform makes the data collection into the clinical pathway incomplete, and it is impossible to analyze and summarize intuitively. The workload of manual statistical data collation and analysis is heavy, which is not conducive to the collection and utilization of relevant data in the pilot work.
In view of the shortage of clinical pathway work in our hospital, in order to help the development of clinical pathway, our department has also formulated corresponding plans:
1 and 20xx, we continued to carry out clinical pathway work, strengthened the induction training of new medical staff and conducted all-staff training, so that everyone fully realized the true significance of developing clinical pathway;
2. Under the condition of imperfect information platform, try to collect all the data of clinical pathway;
3. Actively communicate with departments to discuss the feasibility of clinical pathways of various diseases, and update diseases in time, so as to facilitate clinical departments to carry out clinical pathways.
Summary 3 of Hospital Clinical Pathway Work is to further standardize the clinical diagnosis and treatment process, improve medical quality, ensure medical safety, provide patients with safe, effective, convenient and cheap medical services and make greater contributions to people's health. Combined with the actual situation in our hospital, the Department of Cardiology has carried out the clinical pathway work, and achieved certain achievements and experience through the practice of clinical pathway of palpitation. The summary report is as follows:
I. Work progress and results
1. Establish an evaluation team and improve the working system. The department set up a clinical pathway implementation team, with the director and head nurse as the team leader and medical staff as the team members, and defined the responsibilities of all kinds of personnel at all levels. The department shall set up a clinical pathway administrator, who shall be responsible for the clinical pathway implementation of related diseases in this major and the filling, collection and collation of relevant materials, and participate in the evaluation and analysis of the effect of clinical pathway implementation.
2. Strengthen study and establish an effective work coordination mechanism: Clinical Pathway Management Committee organizes medical staff in departments to study relevant documents and get familiar with the pilot scheme and related requirements.
3. Establish a reasonable and effective incentive mechanism, link clinical pathway work with performance appraisal, and encourage and promote the development of clinical pathway work in departments through performance appraisal.
4. Evaluation and analysis of the implementation effect: The Clinical Pathway Office collects and sorts out the relevant indicators of the pilot diseases of the clinical pathway, establishes the pilot files and related material files, organizes case discussions on cases that quit the pathway halfway, and analyzes the reasons and existing problems. For successful cases, the department evaluates the implementation effect by analyzing the treatment process, hospitalization days, overall cost comparison, patient satisfaction and recognition. All departments collect, collate, evaluate, analyze and improve data.
In 20xx, 96 cases entered the pathway, and 32 cases exited the pathway due to mutation. Through the development of the clinical pathway of palpitation, the medical behavior of medical staff is standardized, the overall medical quality is improved, unreasonable examination, treatment and medication are reduced, and the overall treatment cost is reduced, 3000 yuan/person, and the average hospitalization days are shortened, 18 days/time.
Second, the existing problems and continuous improvement measures
At first, the pilot departments were unfamiliar with the clinical pathway, so it was difficult to carry it out. The number of cases implemented is very small, and there are defects in the operation process:
1, all kinds of data and information are incomplete.
2. Individual doctors did not prescribe the doctor's advice strictly according to the path.
3. Individual nurses are not responsible enough, and there are omissions when recording the nursing clinical path table.
According to the above problems, the clinical pathway evaluation team has organized the head nurses of relevant departments to communicate and make rectification. In the future, we should strengthen inspection, improve relevant management systems, and strive to meet the requirements of clinical pathway specification.