Article 1 In order to standardize and strengthen the management of township health centers, and to promote the healthy development of rural health undertakings, these measures are formulated in accordance with the health laws, regulations, rules and regulations, and the spirit of the "Several Opinions of the People's Government of Shaanxi Province on Strengthening the Work of Rural Health" and related documents.
Second Article This approach applies to township health centers under the jurisdiction of the county, county-level medical units with reference to the implementation.
The third township health centers must obtain a "medical practice permit", according to the Health Bureau approved the practice of diagnostic and treatment subjects, is strictly prohibited over the diagnostic and treatment subjects and scope of practice in diagnostic and treatment activities.
Township health center business work to accept the county-level medical, preventive health institutions.
Article IV of the township health center personnel, business, funding, the Health Bureau in accordance with the responsibilities of management.
Article 5 The Health Bureau to grasp the implementation of this management approach, and effectively strengthen the management of township health centers, the construction and management of township health centers within the jurisdiction of at least two times a year to supervise and inspect; every year on the county township health centers to summarize the construction and management of the situation of a briefing.
To conscientiously implement this management approach, the management of the more standardized, effective township health centers, the Health Bureau to give incentives and support to promote healthy development.
Chapter II health team construction and management
Article 6 According to the basic standards for the construction of township health centers, the Health Bureau to strengthen the establishment of township health centers and personnel management, the establishment of standardized personnel management files. Emphasis on health professionals and technicians academic level and age structure, and gradually form the echelon.
Article 7 health professionals and technicians should have the qualifications for the corresponding positions. Clinical medical service personnel must have a practicing assistant and above physician qualifications, other health technicians should have junior or above professional and technical qualifications. It is strictly prohibited to use non-health technicians to engage in diagnostic and therapeutic activities.
Physicians and nurses must be registered by the Department of Health and practice within the prescribed scope, and may not exceed the scope of practice.
The health bureau in accordance with the standards of practice of physicians regularly organize the physician's business level, work performance and professional ethics assessment.
Article VIII personnel engaged in special services, must participate in relevant training and assessment in accordance with the law, and obtain the appropriate qualifications.
Article IX in the establishment of the scope of the need to increase or adjust the personnel, in accordance with the principle of "all must be examined" by the county labor, the Office of Finance, Health and other departments in accordance with the relevant provisions and procedures, in the establishment of the scope of the need to increase the number of personnel by the employing unit to apply, reported to the Board of Health for approval and approval, and the employing unit Sign an employment contract with the employing unit, and give wages and benefits and social security in accordance with the relevant provisions. From January 1, 2007 all township health center personnel must be fully integrated into the unified management of social pensions.
Article 10 of the township health center director by the Health Bureau in accordance with the principle of openness, equality, competition, merit-based recruitment or recommended for appointment. The director of the central health center shall have a secondary school education, intermediate title or above; township health center director shall have a division title or above.
Article 11 of the dean of the comprehensive target management responsibility system. Comprehensive target management assessment of the main content for unit management, medical quality, medical service level, preventive health care, health supervision, ethical construction and economic development. The health bureau for annual assessment, and based on the assessment of rewards and punishments.
Article XII of the implementation of the dean's responsibility. The dean has the following responsibilities: first, the health bureau is responsible for the party's line and policy, the implementation of health laws and regulations and decisions of higher levels; second, to complete the medical preventive health care tasks, and correctly deal with the interests of the state, the collective, the workers; third, the survival and development of health centers and improve the business and technology is responsible for.
The director has the following powers: First, the hospital has the right to direct the work of the whole hospital; second, the right to nominate candidates for deputy director, the appointment and removal of the head of the department; third, in accordance with the provisions of the use of the hospital's economy has the right to dispose of; fourth, the right to reward and punish those who have contributed to or violated the rules and regulations.
Article XIII of the dean must participate in the county level and above the health administrative department organized by the health business management related knowledge training, and constantly improve the overall quality.
Article XIV attaches importance to the training and learning of health professionals, and actively provide the necessary conditions for in-service health professionals for further study and continuing medical education.
Establish and improve the training and learning of in-service health personnel, assessment system. Seriously implement in-service health technicians of academic education and continuing medical education.
Health technicians at least once every five years to the higher level of medical and health institutions for further training, the time shall not be less than three months. Further training content to improve clinical ability, disease prevention and control capacity and special technical level capacity.
Article 15 to strengthen the construction of medical ethics, the establishment of a mass supervision system, urging medical personnel to comply with the Ministry of Health, "Medical Ethics Code for Medical Personnel and Implementation Measures" of the Code of Professional Ethics.
Chapter III public **** health management
Article XVI to establish and improve the preventive health care work system, formulate specific work plans and quality indicators, and organize and implement.
Article 17 Strengthen the management of disease prevention and control, and do the following work in earnest:
① Establish a standardized vaccination clinic room according to the requirements of the Health Bureau.
② Do a good job of immunization, infectious disease outbreaks, food poisoning and other public **** health emergencies registration, reporting and handling.
3 actively carry out major infectious diseases, endemic diseases, epidemic prevention and control work.
④ Do a good job in food, public **** place, school, occupational and other health guidance and management.
⑤ Carry out the prevention and control of chronic non-communicable diseases.
6 formulate health education plans, targeting key groups and carrying out multi-form health education activities in conjunction with the actual situation, popularizing knowledge of health care, and promoting the formation of good health behaviors among rural residents. It also guides the development of patriotic health work.
Article 18 Strengthen the management of maternal and child health care, and seriously do the following:
①Establish a standardized maternal and child health care clinic in accordance with the requirements of the Health Bureau.
② Do a good job of maternal systematic health care and child systematic health care.
③ Carry out prevention and treatment of common diseases of women and children.
④Doing a good job of evaluating maternal deaths and infant deaths.
⑤ To do a good job of controlling neonatal tetanus.
6 Doing the work of managing and guiding the health of nurseries and kindergartens under the jurisdiction.
Article 19 Assists the township government to do a good job of publicizing, explaining and reviewing the policies of the new rural cooperative medical care and other work.
Article 20 is entrusted by the Health Bureau to undertake health supervision within the jurisdiction.
Chapter IV Medical Service Management
Article 21 According to the needs of the general public, combined with the actual situation, to develop practical business development goals. And develop specific implementation programs to implement.
Article 22 The implementation of the "Regulations on the Administration of Medical Institutions", "Regulations on the Handling of Medical Accidents" and other health laws and regulations, to take comprehensive measures to strengthen the management of medical quality, and to promote continuous improvement of the quality of medical care, and continuous improvement.
①To establish and improve the medical, nursing, medical and technical work rules and regulations centered on the job responsibility system, and strictly implement them.
②In accordance with the principle of patient first, safe and orderly, first diagnosis is responsible for, focus on strengthening the principle of patient-centered, put the quality of medical care, service quality, service attitude in the first place.
③The establishment of medical service quality monitoring and management work group (such as emergency rescue, infection control, quality management of medical records and other groups), the development of medical quality management program, quality education for all staff to establish quality and safety awareness. Regularly supervise, inspect and evaluate the quality of medical care, nursing care, medical technology, medicines and medical records, propose corrective measures, discover and correct medical defects in a timely manner, and strengthen the management of key aspects of medical quality, key departments and important posts.
④Implementation of core systems of medical quality management, such as the system of responsibility for the first visit, the physician's room system, the system for discussing difficult cases, the system for rescuing critically ill patients, the system for pre-operative discussion, the checking system, the consultation system, the system for discussing fatal cases, the system for hierarchical nursing care, the system for handing over shifts, the system for auditing the use of blood in the clinic, and other core systems of medical quality management.
⑤ Strict implementation of diagnostic and treatment routines, operating procedures, rescue routines, complete with common first aid medicines and equipment, to ensure the timely and effective operation of basic medical care and rescue work, and timely referral of critically ill and difficult patients who can not be dealt with.
6 In accordance with the "prescription management measures" and "medical record writing norms" requirements, carefully write outpatient medical records, prescriptions and hospitalization medical records.
Article 23 implements the Measures for the Management of Hospital Infections and Regulations on the Management of Medical Wastes, strictly implements the isolation and disinfection system, strengthens the construction of supply rooms, operating rooms, delivery rooms, and treatment rooms, abides by the aseptic operating procedures, and strictly manages the disinfection and cleaning; and does a good job in disposable medical supplies and the harmless treatment of sewage and filth, to prevent the cross-infections and the pollution of the environment.
Article 24 seriously implement the "Drug Administration Law", strict drug management system. The gradual implementation of centralized purchasing of drugs; drug storage to take the necessary refrigeration, anti-freezing, moisture-proof, moth-proof, anti-rodent and other measures. Drugs should be categorized in an orderly manner, and external and internal medicines are stored separately, so that a drug a label.
Article 25 focuses on strengthening the construction of obstetrics, pediatrics, and emergency and first aid, and is able to achieve the following technical levels:
①Strictly in accordance with the provincial and municipal standards for construction of obstetrics departments, strengthening the construction of obstetrics departments, and doing a good job of in-patient delivery. Township health centers have the ability to deal with smooth delivery of pregnant women, and central health centers have the ability to deal with difficult delivery of pregnant women; in accordance with the standards of baby-friendly hospitals, to create baby-friendly hospitals.
② can correctly deal with common and frequent diseases, and appropriate treatment and referral of difficult cases; mastery of common infectious diseases, endemic disease prevention and treatment techniques.
3 Medical personnel everyone mastered unarmed cardiopulmonary resuscitation and other common first aid techniques.
4 Emergency cases within the jurisdiction can be timely response (including outpatient). In-hospital patients can be immediately resuscitated; out-of-hospital patients can be seen within 10 minutes.
5 Can make preliminary diagnosis and rescue treatment of vital signs for circulatory, respiratory and renal failure, acute poisoning and shock and other general emergency patients, and organize referrals.
6 can complete surgical hemostasis, suturing, bandaging, fracture immobilization and other treatments; can carry out appendectomy, hernia repair and other common lower abdominal surgery; the conditions of the central health center should also be able to carry out part of the upper abdominal surgery.
Article 26 actively promote the application of appropriate new technologies, and constantly expand service capacity.
Article 27 Strengthen the work of traditional Chinese medicine, standardize the management of traditional Chinese medicine services, and improve the level of traditional Chinese medicine services.
Article 28 adhere to the "patient-centered", and strive to improve the service attitude, and constantly improve the quality of service.
Chapter V Administrative, Financial and Logistic Management
Article 29 The principle of "streamlining, high efficiency and low consumption" is to set up internal departments, and in principle to set up the administrative department, clinical department, nursing team, and preventive and protective station. Clinical departments set up internal pediatrics, surgery, obstetrics and gynecology, traditional Chinese medicine, medical technology room. Its specific settings by the central health centers, prevention and protection of medical-type health centers, prevention and protection of health centers according to the actual determination.
Article 30 The establishment of the hospital management committee, consisting of the head, deputy director, heads of departments, etc., to make decisions on major matters of township health center management.
Article 31 to strengthen the hospital affairs, the implementation of democratic management. Regular staff meetings are held to inform the implementation of the implementation of major decisions of the health center, day-to-day management and operation and management, and listen to the staff's suggestions for the construction and development of the health center.
Article 32 The establishment of a sound system of attendance, study, meetings and environmental health management. Manpower a work logbook.
Article 33 The establishment of material procurement, acceptance, warehousing, issuance, scrapping system to strengthen material management.
Article 34 to strengthen the equipment storage, use, maintenance, regular maintenance system to ensure that the work needs, all assets, medical equipment to establish a file.
Article 35 sound safety and security system, strengthen high-risk equipment, operating rooms, radiology rooms, delivery rooms and other special areas and highly toxic, highly numbing, psychotropic drugs management, to ensure medical safety.
Article 36 beautifies the environment of the hospital, improves indoor hygiene, and creates a neat, beautiful, quiet and comfortable medical place. Medical personnel should wear neat work clothes and hats during work, and hang up the license plate on duty.
Article 37 of the township health center of universal ownership of the staff and retired staff funding and survivors of subsidies, into the full budget of the county-level finance; collective ownership of the staff, according to the standard of 3,000 yuan per person per year by the county financial flat-rate subsidies, salary shortfalls borne by the township health centers; collective ownership of the status of the retirees, has entered the pension insurance office, by the center of unified pension insurance. Center, by the unified management of the center, not included in the pension insurance center, by the financial fixed subsidies, the subsidy standard is 500 yuan, that is, in the original 300 yuan per person per month on the basis of an additional 200 yuan.
Article 38 of the township health center financial subsidies into the full budget of the county-level finance, still to adhere to the principle of distribution according to labor and the participation of factors of production in the distribution of the combination of jobs, tasks, performance for pay, strict job tenure comprehensive target responsibility assessment, the establishment of the weight of real performance, heavy contribution to the outstanding talents and key positions tilted to the independent and flexible distribution incentive mechanism, so that income and technical level, service attitude and labor contribution. Each unit should effectively strengthen the medical cost accounting, minimize medical and pharmaceutical costs, to the benefit of the general public.
The township health centers originally contracted to lease health center contracts continue to implement the same, all on duty in the staff, whether universal, collective, employment (Health Bureau approved) personnel, the implementation of equal pay for work of equal value, collective personnel and employment of personnel wage base compared to the same position of the universal personnel wage base to determine.
After the implementation of the full budget management, each health center still has to implement the whole hospital cost accounting, each health center can only be 65% of the medical income as the allocation of the part of the full salary, 35% as the cost of medical care. Pharmaceutical income (including the difference between the two places other income) shall not be included in the distribution of wages, only as a hospital income, mainly for the repayment of outstanding debts for capital construction, the purchase of medical equipment and public **** health expenditure.
Floating wage base: medical personnel by file salary of 45% - 60% participation in floating and work performance; administrative personnel (dean, vice president, accounting), by file salary of 10% - 30% participation in the assessment; epidemic prevention, women and children's personnel by file salary of 30% participation in the assessment; medical logistics personnel by file salary of 30% - 40% participation in the assessment.
Administrative personnel's assessment of wages and the Health Bureau signed the target responsibility book is linked to the completion of the part of the variable wage shall not exceed the average value of the hospital 1.2 times; epidemic prevention, women and children's assessment of wages and the "seven vaccination rate", "two systems management" related indicators and other indicators of the hospital.
Each unit according to the actual work of their respective assessment and management methods, wage distribution program discussed and approved by the staff meeting, reported to the Health Bureau for approval before implementation.
Article 39 of the strict implementation of hospital finance, accounting and supervision and audit system. Actively explore the implementation of county-level financial centralized accounting or accounting assignment system to improve financial management. The implementation of democratic financial management, open hospital affairs, larger project expenditures should be voted by the hospital council or staff congress before implementation. Where the purchase of more than 5,000 yuan of equipment or more than 10,000 yuan of construction projects should be reported to the Health Bureau for approval before implementation.
Article 40 of the implementation of the government's medical service prices, and publicize the main drugs and diagnostic and treatment charges, and enhance the transparency of fees.
Article 41 Strengthening information management,
①The township health centers have part-time staff responsible for health information statistics. Health information must be timely and accurate.
②Strict implementation of the network of infectious diseases and other registration and reporting system and maternal mortality, infant mortality reporting system.
③To establish a relevant statistical system to do a good job in the township medical, preventive, health care, primary health care, and timely reporting of relevant statistical reports to the relevant departments at the county level.
④The township health centers shall establish a case management system and manage the cases according to the International Classification of Diseases ICD-10.
Chapter VI Management of Village and Individual Health Institutions
Article 42 Township health centers shall be entrusted by the county-level health administrative departments to manage and regularly supervise the health of village and individual health institutions within their jurisdiction according to law.
Article 43 To strengthen the village-level and individual health institutions of medical care, preventive health care and health information and other technical guidance. To strengthen the village and individual health institutions of traditional Chinese medicine management, and strive to improve the level of traditional Chinese medicine services.
Article 44 is responsible for the unified formulation of the Health Bureau of the village and individual health institutions, work systems, work norms, work duties, clinic logs, prescriptions, standardized management, and improve the various rules and regulations, so that the diagnosis and treatment of registration, prescribing medication, charging vouchers, preventive health care card registers, outbreaks of reports.
Article 45 improve the system of regular meetings of rural doctors, regularly organizing rural doctors to study the health policy, the Department of primary health care tasks in rural areas, held regular meetings no less than six times a year.
Article 46 to improve the work of the village health office and rural doctors assessment, rewards and punishments system, once a year into the assessment, evaluation, the outstanding work of the village health office, rural doctors, proposed above the county level of the health administrative department for recognition.
The violation of the management of village and individual health institutions proposed by the county-level health administrative departments to be notified of criticism or dealt with in accordance with the law
Chapter VII Supervision and Management and Rewards and Punishments
Article 47 of the Health Bureau set up a township health center supervision and management of the leading group, the organization of the relevant units of the Bureau of Health on a regular basis from time to time or the County Center for Disease Control and Prevention of the personnel to carry out supervision and inspection.
Article 48 The Health Bureau shall supervise and manage the work of township health centers in accordance with national laws and regulations, and deal with units and individuals who violate the laws and regulations in accordance with the law.
Article 49 The health bureau of the township health center business work to implement the annual target responsibility management, the completion of the target task is linked to the financial allocation. Each year from the township health center financial allocations to extract 5% as the annual target task reward fund, the advanced units to be focused on rewarding the units that fail to complete the target task shall be notified and criticized.
Article 50 of the Health Bureau of the township health centers in accordance with the law to regulate at the same time, the violation of this management approach is not enough to deal with the circumstances in accordance with the law, the implementation of internal rewards and penalties system.
① The violation of the relevant provisions of this management approach to the unit, according to the violation of each article to be punished by 50 - 300 yuan.
② accept the provincial and municipal inspections, failing to meet the work requirements of the unit to give the unit 500 --- 1000 yuan punishment; by the provincial notification of the unit criticized by the unit to give the unit 1000 yuan punishment; by the municipal notification of the unit criticized by the 500 yuan punishment; by the county notification of the unit criticized by the 300 yuan punishment.
3 in the work of the higher supervision and inspection of the problems pointed out by those who do not improve the unit 200 --- 500 yuan punishment.
④ Failure to complete the work tasks assigned by the Department of Health and the higher level business guidance department on schedule, the unit will be given a punishment of 500 - 1000 yuan.
The above penalty funds from the violation of this approach to the next month after the occurrence of time, by the Health Bureau from the financial allocations deducted by the punished unit to implement the penalty funds to the relevant responsible person to bear, the unit will not be reimbursed. Health Bureau will be penalized funds all used as incentive funds.