I. What is the background of the document? According to data released by the National Health Commission, with the sharp increase in the number of clinics across the country, the average number of clinics per province has more than 7,000, the average number of practicing physicians per clinic is 1.4, the number of nurses 1.2, clinics play an increasingly important role in primary health care, but at the same time, clinic human resources, medical services, such as the main problems of the industry regulatory difficulties are also tight are becoming more and more prominent. Compared with other provinces and cities, the city has a large number of clinics, and it is particularly important to comprehensively improve their standardization and standardization level to ensure medical quality and safety.In 2019, the National Health and Health Commission and other five departments jointly issued the "Opinions on the Pilot Project for Promoting the Development of Clinics" (National Health and Medical Development 〔2019〕 No. 39), and Chengdu was identified as one of the 10 pilot cities. In order to promote the development of this pilot work in a scientific and standardized manner, deepen the medical field "put in place" reform, improve the medical service system, attract high-quality medical resources sinking, the city has developed this implementation plan. Second, what are the main contents of the document? The implementation of the program **** is divided into five parts: (a) Part I: General requirements. Clearly promote the development of the guiding ideology and objectives of the work of the clinic, the pilot arrangements and the scope of application. (ii) Part II: work measures. 1. Optimize the clinic practice permit policy. Simplify the clinic access procedures, cancel the planning restrictions on the establishment of clinics, clinics from the practice permit to the filing system management; implementation of the basic standards of the pilot area clinic, from the focus of the audit equipment and facilities, such as hardware adjusted to the qualifications of the physician and the ability to audit; Encouragement of medical institutions in the practice of 5 years, to obtain intermediate and above the title qualification of the physician, full-time or part-time to open a specialty clinic. 2. Improve the quality of medical services in clinics. Encourage the clinic into the construction of the medical consortium; support the clinic scale, group development, the formation of normative, standardized management and service model; encourage the government to purchase services in the form of eligible clinics into the family doctor can provide contracted services within the scope of the medical institutions; encourage the clinic to provide basic medical and health care services, clinics providing basic medical and health care services, talent training and other aspects of the implementation of the government-run primary health care institutions with the same subsidies. Government-run primary medical and health care institutions, the same subsidy policy, the conditions of the district (city) county to provide basic medical and health services to the basic construction and equipment purchases and other development and construction expenditures, you can give appropriate support; clinic full-time physicians to provide a good environment for professional development, and further improve the development of clinics in favor of the price of medical insurance and other related policies. 3. Strengthen the supervision of the industry. Innovative means of regulation, in particular, the clinic information construction and supervision of clear requirements; clinics are required to establish an electronic medical record system, standardize the writing and management of medical documents, to protect the clinic medical quality and medical safety; emphasize the strengthening of the clinic physician practice management, to encourage the clinic (especially the medical clinic) or medical staff to purchase medical liability insurance. (C) the third part: to ensure the organization and implementation. Clear division of labor, from strengthening the organization and leadership, do a good job of assessment and summary of the two aspects of the requirements for the solid promotion of the pilot work to provide support and protection. Third, the document what innovative reform initiatives?
One is simplified access procedures. Cancellation of the medical institutions set up planning restrictions on clinics, clinic set up for approval into the filing system management, organized clinics, reported in the district (city) county clinic approval department for the record, issued "medical institutions license", you can carry out practice activities. Cross-administrative region operating chain, group clinics by the Municipal Health Commission for the record.
The second
adjusts the setting standards. It is emphasized that the function of the clinic is to provide residents with diagnosis and treatment services for common and frequent diseases and contracted services of family doctors, and to ensure the service capacity and quality and safety of the clinic is the basis and premise of the clinic setup. Therefore, the audit of the clinic will be set up, from the previous focus on the audit of equipment and facilities and other hardware adjusted to focus on the audit of the qualifications and capabilities of the physician, the requirement of the clinic (excluding Chinese medicine clinics) must be qualified to obtain the title of the physician intermediate and above.
Three stimulate the vitality of the stock. Encourage qualified physicians, full-time or part-time specialist or general practice clinics; encourage social forces to organize chained, group clinics; clinics are encouraged to be included in the medical consortium, and the members of the medical consortium, independent medical testing centers, medical imaging centers, disinfection and supply centers, pathology centers and other institutions to establish a collaborative relationship to achieve the health care resources **** enjoyment.
Fourth is innovative means of supervision. Clearly require the clinic to establish an information system to record information on diagnosis and treatment, access to the medical service supervision information system, reporting and uploading information on diagnosis and treatment; multi-departmental joint promotion of clinic malpractice points management, to achieve the information *** enjoyment, joint disciplinary action; strengthen the clinic service credit system, the establishment of a health integrity file, the establishment of a long-term mechanism of joint disciplinary action.