Healthcare Organization Research Report
In today's society, the need to use the report is more and more, the content of different reports is equally different. Before you write it, you can refer to the sample, the following is my research report on healthcare organizations.
Medical institutions research report 1
The supervision of medicines in rural medical institutions is an important part of our daily supervision, is to protect the majority of farmers with drug safety an important link. However, in the practice of drug supervision, rural medical institutions of drug management is very weak, drug sampling test failure rate is significantly higher than the county drug business enterprises, but also the prevalence of fake and shoddy drugs, due to violations of the law were investigated and dealt with the case also remains high, which is not only the focus of our work in drug supervision, but also the hot issue of drug management research. According to the author of several years of drug
supervision work practice, the difficulties of rural medical institutions and countermeasures to regulate drugs to talk about some of the views and experience.
First, the current situation of rural medical institutions and the analysis of pharmaceutical management
I County, the existing townships 23 health centers, village health clinics and individual clinics 316. Distributed in the rural 16 townships and 187 natural villages. Due to the impact of the local economy, these township health centers, village clinics and individual clinics of the economic base is relatively weak, some even employees can not open the salary, and the hardware facilities are extremely scarce, in the maintenance of the status quo. Under such circumstances, the pharmacological management of rural medical institutions is difficult to meet the requirements of the government and the people, and also brings great difficulties to our drug supervision work. First of all, the function of pharmacy management in rural medical institutions fails to meet the requirements. Due to the limitations of rural medical institutions in terms of scale and personnel, there is a lack of pharmacy personnel in pharmacy management, some of them are not qualified enough to engage in pharmacy management, and some of them have low qualification ability, and their knowledge of drug maintenance, evaluation, preparation and distribution as well as the management of special medicines is not up to the prescribed requirements, which results in the incomplete function of pharmacy management, and they can only maintain the simple pharmacy management duties. Secondly, non-pharmacy professionals account for a certain proportion of pharmacy technicians, with generally low academic qualifications and low business quality, and some pharmacy personnel are engaged in several duties. This situation is especially prominent in rural medical institutions. Thirdly, the pharmaceutical management system is not sound. Pharmaceutical management depends on the effective implementation of a scientific and sound management system. Most of the rural medical institutions in the construction of the drug management system is not on the agenda, individual primary medical institutions in fact, the drug management system is in a dispensable state, both the lack of external pressure, but also the lack of internal incentives for motivation, even the "Drug Administration Law" clearly stipulates that the "purchase inspection and acceptance system", "drug storage system", "drug storage system", "drug storage system", "drug storage system", "drug storage system", "drug storage system", "drug storage system". Even the "Drug Administration Law" clearly stipulates the "purchase inspection and acceptance system", "drug storage system" and so on due to the lack of corresponding legal responsibility, in a considerable portion of rural medical institutions can not be implemented, to the safe use of medicines has brought about hidden dangers. Fourth, the level of pharmaceutical management is low. In daily supervision, the level of drug management in rural medical institutions is obviously lower than that in large comprehensive medical institutions and drug enterprises. The technical standard, legal awareness and quality consciousness of drug-related personnel in rural medical institutions are generally low. Hospitals often only pay attention to the number of drugs in and out of the management, focus on the economic benefits of drugs, ignoring the quality of drug management, and the pharmacy, drugstore and facilities investment is relatively small, many rural medical institutions of the pharmacy, drugstore hardware is not as good as an ordinary pharmacy, the system and the software construction is at a low level, can not be adapted to ensure that the clinical use of drugs is safe and effective in the basic requirements. Fifth, the poor condition of drug maintenance and storage facilities, rural medical institutions of drug storage facilities can be described as "simple". First, the poor conditions of the pharmacy pharmacy, neither heat insulation devices, indoor air conditioning, curtains, exhaust fans, and rodent-proof devices and other facilities, drugs in direct contact with the ground or walls, in the humid and rainy season is very easy to absorb moisture mold. Some medical institutions, especially village health centers and individual clinics, all kinds of drugs are randomly placed, not classified according to the requirements, very easy to confuse; Second, the lack of cool storage. 80% of the county's medical institutions are not set up cool storage, cool storage of its area and the scale of medication does not match, the air conditioning is closed for a long time, can not play a due role. Thirdly, the cold storage equipment is not complete, only the medical institutions above the township are equipped with refrigerators, 95% of the village-level medical institutions do not have refrigerators, and the ones that do have refrigerators are also mixed with families. Some medicines that need refrigeration, such as placenta injection, are also stored at room temperature. Above the township medical institutions refrigerator is either not in use or not enough, the refrigerator does not play a due role; Fourth, the Chinese medicine storage equipment is simple. With cardboard boxes, bamboo baskets, sacks filled with Chinese medicine phenomenon is common, resulting in the occurrence of Chinese medicine tablets absorb moisture mold; Fifth, the thermometer is not fully equipped, most medical institutions are not equipped with thermometers, some equipped with thermometers, but also no record of the temperature and humidity exceeds the prescribed range, but also do not take any measures, temperature and humidity control has become an empty word; Sixth, the lack of drying in some medical institutions, fumigation and other Chinese medicine conservation facilities; Seventh, the drugs out of the warehouse does not According to the principle of first-in-first-out operation, arbitrariness, resulting in the operation of the discovery of expired and invalid drugs. Sixthly, drug procurement channels are irregular, and the quality of hidden dangers are great. Due to the lack of institutional constraints, coupled with the drive of economic interests, some medical units are willing to risk being investigated and punished for purchasing drugs from unlicensed operators, especially individual clinics in rural areas, where the drug procurement channels are relatively chaotic. The source of drugs provided by unlicensed operators is complex, coupled with poor storage and maintenance conditions and the absence of appropriate quality assurance measures for drugs, making it difficult to guarantee the quality of drugs and posing a major safety hazard. And because of the purchase of drugs without quality acceptance system does not carry out acceptance, once the drug quality problems, it is difficult to trace the root cause.
Second, the root cause of the status quo
Caused by the relative chaos of the rural medical institutions drug management for a number of reasons, summarized in the following aspects
1, the laws and regulations are not perfect. Drug Administration Law" and "Drug Administration Law Implementation Regulations" clearly stipulates that the drug manufacturer, drug business enterprises are not in accordance with the provisions of the implementation of gsp, give a warning, and ordered to make corrections; the circumstances are serious, the revocation of the "drug business license". And when the medical institutions to obtain the qualification of drugs and drug companies with different conditions of access, medical institutions to use (in essence, is the operation of) drugs as long as the administrative department of health license, issued by the "medical institutions license" can be used, and a wide range of medicines, and can be combined with the three types of medical devices. Although the "Regulations on the Management of Medical Institutions" on the application for registration of medical institutions to practice relevant facilities, equipment, professional and technical personnel and rules and regulations have corresponding requirements, but there is no specific ` detailed provisions, so the health administrative department
In the issuance of the "license to practice in the medical institutions" before the organization of the site acceptance of very few organizations, and run a drugstore, the requirements of the legal representative of the high school diploma or higher, and at the same time there are also two Pharmacist above the title of technical personnel, and must pass the gsp certification. In addition, the general retail pharmacy to obtain the operating qualification of Class III medical devices, there must be 2 competent pharmacist above the title of pharmacy technicians. As a result, there are few people applying for pharmacies in rural areas, while there are many people applying for individual clinics. In addition, the laws and regulations on the scope of medicines used in medical institutions
The regulations are unclear. Article 27 of the "Supervision and Administration of the Circulation of Medicines" (Interim) states that "Individual medical practitioners and individual clinics in cities and towns are not allowed to set up pharmacies or engage in the purchase and sale of medicines. In reality, individual medical practitioners and individual clinics in cities and towns generally set up pharmacies. Although the relevant interpretation of the distinction between urban and rural areas, but the pharmacy and medicine cabinet how to distinguish between the laws and regulations are not clearly specified, and thus the violation of Article 27 how to penalize the reality of difficult to operate.
2, do not pay attention to drug management, facilities and equipment investment is not enough. Rural medical institutions have always focused only on the upgrading of medical equipment and medical technology to improve the management of drugs only to cope with the attitude. On the one hand, some medical institutions believe that the level of medical care and reputation enhancement depends entirely on the upgrading of medical equipment and medical staff to improve medical technology, and the management of drugs has no obvious direct impact on this. Especially the township-level health centers are already short of funds, and the investment in drug management is not as fast as the economic benefits of investing in medical equipment. When a township health center buys an air conditioner, the electricity cost is several thousand dollars a year, and the value of the medicines kept is only a few hundred dollars, which is economically uneconomical. Village health centers need to be kept in the cool and refrigerated conditions of the price of some drugs only a few dollars, even if the drug supervision department seized, the amount of punishment is also much less than the investment required; on the other hand, some people regard the pharmacy department as an auxiliary department, in the capital and technology to invest in the obvious insufficient; furthermore, from the reality, the use of medicines in health care institutions (even if the use of fake and shoddy medicines) led to disputes is far fewer than the other medical malpractice The above is the direct cause of the disputes over medicines in medical institutions. The above are the main factors that directly lead to the lack of attention to the management of medicines in medical institutions and the insufficient investment in facilities and equipment. In addition, rural medical institutions do not pay much attention to the training of drug practitioners. Each year, in addition to the drug supervision department of the pharmacy staff to carry out a limited one or two training, rarely organized for the pharmacy staff to carry out training in pharmacy knowledge and laws and regulations, which led to a lack of professional knowledge and drug management knowledge of the pharmacy staff, the overall quality of the low, some of the pharmacy technicians lack of dedication and the necessary professional moral cultivation.
3, we also have the problem of supervision is not enough. Due to the drug supervision and management department was established in a short period of time, fewer personnel, insufficient funds, backward law enforcement equipment, thus affecting the regulatory coverage. xx County, the existing township 23 health centers, village clinics 187, individual clinics 316, the distribution of the more decentralized, the frequency of supervision and inspection of less than two times a year, which is also caused by the supervision of the in place of an objective reason.
Three, to strengthen the rural medical institutions drug management countermeasures and recommendations
1, the rural medical institutions drug management into the legal track. Above talked about the various problems of rural medical institutions drug management, to govern well must rely on a sound legal system. As we all know, drugs are special commodities that directly affect people's health, but also one of the commodities subject to the strict management of laws and regulations. The current "Drug Administration Law" on the production and operation of drugs to implement a strict market access system, must meet the legal conditions in order to get the legal "license", due to China's medical institutions, the market attributes of the delay in the legal level has not been recognized, still belongs to the "using The nature of the "unit", so the medical institutions of the "use of drugs" do not need to obtain "permission", certification norms and drug business enterprises gsp certification norms, bear more than 80% of the end consumption of drugs at all levels of various types of medical institutions So far there is no set of corresponding scientific management system to standardize, this is China's pharmaceutical management of the "chain defect". It should be said that large general hospitals over the years in the construction of the drug management system has formed a lot of effective and successful experience and practice, however, a large number of rural medical institutions drug management starting point is low, the implementation of the system is almost unwritten, and there is no way to talk about the system of implementation and safeguards, directly leading to the rural medical institutions, drug management, random, passive, weakened, resulting in the rural health care institutions, drug management has always been at a low level or even a negative cycle. In the regulatory practice, some rural medical institutions have been found to be in a low level or even a negative cycle. In regulatory practice, some rural medical institutions, drug quality lack of controllable measures to ensure that violations of the law repeatedly prohibited, one of the main reasons is that the pharmaceutical management is not standardized, the lack of necessary institutional safeguards. The author believes that, at this stage, the rural medical drug management system should not be delayed, on the one hand, we must resolutely implement the drug laws and regulations, clearly stipulated in the relevant systems, such as medical institutions purchasing drug inspection and acceptance system, purchase and sale record system, drug storage system, etc.; on the other hand, we must start from the practical point of view, mobilize the rural health care institutions of their own enthusiasm, with reference to the gsp certification standards for drug business enterprises, the development of a set of suitable for the characteristics of the medical institutions in this jurisdiction, the use of medicines. The jurisdiction of the medical institutions with the characteristics of the management system, such as procurement approval system, prescription allocation system, drug split management system, drug quality post system, drug quality accountability system.
In the current stage of the legal system of drug management in medical institutions is still not sound and perfect, to strengthen and promote the drug management of rural medical institutions on the stage, on the level, we must rely on the strength of various aspects, we must take effective measures to mobilize the enthusiasm and initiative of various aspects, in particular, we must coordinate action with the government and the health administrative departments, the use of the legal system, policy, self-discipline, economic means, and to strengthen the drug management of primary medical institutions, make it possible to achieve the goal of the medical system, to make the drug management of primary medical institutions, to make it possible to achieve the goal of the medical system. Pharmaceutical management of primary health care institutions, so that it is gradually moving towards legalization, standardization, scientific track, for the majority of farmers with safe and effective medication, and promote local economic development to create a good environment.
Medical institutions research report 2How to effectively do a good job of supervision of the new rural cooperative medical institutions, is related to the people's immediate interests, the relationship between the new rural cooperative medical institutions whether to get the healthy development of the problem. Heilongjiang Province, health supervision in line with the form of the development of the establishment of medical administration of the four sections, is a newly established section. The section in order to do a good job of the province's new rural medical institutions, continue to explore, research, in March 22, 20xx to 31 organizations to Hailun City, Suiling County, Lanxi County, three counties and three townships to conduct research. The research group has penetrated into the county health bureau agricultural cooperation office, the county people's hospital, township health centers to visit, understand the situation. The research is reported as follows,
First, the basic situation of the new rural cooperative medical
Helen City, Suileng County, Lanxi County, after several years of exploration, the initial establishment of a set of effective management system and operational mechanisms, compensation policies gradually improved, compensation levels gradually increased, the reimbursement process gradually simplified, regulatory capacity The compensation policy has been gradually improved, the compensation level has been gradually increased, the reimbursement procedure has been gradually simplified, the supervisory capacity has been gradually strengthened, the use of funds has been reasonable and safe, the trust of farmers has been significantly improved, and the enthusiasm of farmers to participate in the program has been increasing.
1. The basic situation of Hailun City.
Under the careful guidance of the Provincial Department of Health and Suihua Municipal Bureau of Health, the municipal government of Hailun City attaches great importance to the city's new rural cooperative medical care work has achieved remarkable results by increasing contributions, strengthening regulatory measures, and strict underwriting procedures. There are 28 designated cooperative medical institutions, including 23 townships. 20xx, the number of participants reached 400,618 people, the participation rate of 98%; collection of farmers to participate in the fund 12.01 million yuan, the total funds for cooperative medical care amounted to 60.09 million yuan, **** for 46,130 participants in the write-off of the medical expenses of 59.95 million yuan, of which, hospitalization write-off of 58.36 million yuan, outpatient write-off of 1.59 million yuan, the actual proportion of hospitalization of 45%, the provincial level, and the outpatient write-off of 1.59 million yuan. The actual hospitalization rate of 45% at the provincial level, 55% at the municipal level, 65% at the township level, 20xx, the city's enrollment is still 400,618 people, the enrollment rate of 98% of the total
Funds of 60.09 million yuan, as of now, has been written off the total funds of 13 million yuan.
2, Suileng County, the basic situation.
In 20xx, the county has a registered agricultural population of 177,337 people, the resident farmer population of 140,565 people, there are 146,638 people to participate in the New Farmers' Cooperative, according to the resident population of the participation rate of 104. 32%. In order to complete the provincial and municipal governments put forward in 20xx the participation rate of more than 98% of the work target, the county government and the county governor in charge of the main leaders personally convened the township chiefs of the new rural cooperative work conference, the implementation of the new rural cooperative work tasks. The Health Bureau, the county co-management office personally in-depth village Tuen Mun on the new rural co-operation policy and farmers face-to-face to answer questions and solve puzzles. County's participation rate has achieved promising results. In order to make the participating farmers to get the party's policy, in accordance with the provincial and municipal requirements for the work of the new rural co-operation, scientific and reasonable development of the county's compensation program, to ensure that the use of the new rural co-operation funds and the management of a more standardized and safe.
3, Lanxi County, the basic situation of the Starfire Township.
Xinghuo Township area **** 5 administrative villages, 32 natural tunnels; more than 3,300 villagers, resident population of about 15,000 people; **** there are 5 village health center, 18 village doctors. The participation rate of farmers in the whole township has reached 100%. The lobby of the township health center has a public notice board for the New Farmers' Cooperative Program and a consultation telephone number for the Farmers' Cooperative Office, but there is no public notice of the basic situation of specific underwriting patients. All participants hold NAC medical certificates, and all the bills at the time of reimbursement are machine-printed receipts. The files of the participating and reimbursing farmers are basically complete.
Second, there are problems
Through the research, in the achievements, there are also management problems.
1, this survey found that some municipalities have not been given to the participating farmers for the cooperative medical card, in lieu of collection receipts, some for the, but there is no photographs and other information, to the real identity of the participating farmers to identify the inconvenience, the formation of a number of fixed-point institutions only on the basis of the verbalization of the participating farmers, the phenomenon of impersonation can not be put an end to.
2, the problem of the management body, the composition of the County Agricultural Cooperation Office there is a certain technical structure is unreasonable, due to the lack of talent in some areas, resulting in the supervision of fixed-point medical technology problems, such as the review of cases, what kind of patients should be hospitalized and discharged from the hospital standards. The new rural cooperative office due to the lack of independent office funds, its daily supervision of medical institutions there are more distant sentinel medical institutions supervision is not in place.
3, the problems of the sentinel medical institutions, sentinel medical institutions, the existence of case writing is not standardized, signage and procedures are not publicized, the price of essential medicines are not open. There is also the existence of the existence of the phenomenon of hanging beds, such as the prescription of favors, large prescriptions, as well as ultra-standard discharges with medication, and so on. There are also some hospitals "small disease," "short disease," and other phenomena are more prominent.
4, the personal problems of participating farmers, some use the loopholes in the management of hospitals to make false medical records to fraudulent insurance, there are false medical bills sold directly to the farmers to facilitate the reimbursement of their hometown. There is also the phenomenon of doctor-patient collusion fraudulent fraudulent cooperative medical fund is also relatively serious, such as patients admitted to the hospital procedures are not standardized, procedures are not complete, the identity is difficult to approve, coupled with some of the village leaders to prove that is not realistic, resulting in the nature of the trauma patient is difficult to determine, to the New Farmers' Cooperative Fund to cause unnecessary losses.
5, the national implementation of the "government-led, province-based centralized purchasing of medicines on the Internet", due to the distribution system to build, distribution costs, supervision and other aspects of the reason, some township health centers reflect the basic medicines can not meet the needs of some patients have to go to the county health centers, coupled with the cost of transportation, food and lodging costs, so that the burden of some farmers increased.
6, the new rural cooperative network information transmission platform, some counties have not yet established.
7, the townships of the sentinel medical institutions management personnel lack of training.
Three, to solve the countermeasures and recommendations
First of all, we must clarify the management of the content of the management body, the sentinel medical institutions and patients of the tripartite supervision, fund management and standardization of the behavior of the sentinel medical institutions to carry out the key issues, such as legal supervision, audit supervision, democratic supervision, social supervision and special supervision, and a variety of forms of supervision.
1. Strengthen the supervision of management organizations. Enrich the regulatory power and improve regulatory capacity. The province should increase training efforts, so that some supervisory departments of the supervisory staff of the policy mastery, to prevent violations of discipline problems. The key to the safe, standardized and effective use of the New Agricultural Cooperative Fund lies in the standardized management and strict auditing and checking of the relevant departments and agencies at the local level, especially in counties and townships. With the full coverage of the new rural cooperative and the increase in the level of funding, we must strengthen the new rural cooperative fund supervision as a long-term period of huge tasks to grasp, increase the management and use of the fund supervision and inspection efforts, comprehensively strengthen the fund-raising, storage, disbursement of all aspects of the supervision, to ensure that the fund management and safety, operation norms to ensure that the fund is all used in the farmers, and effectively improve the level of medical protection of farmers.
2, strengthen the supervision of designated medical institutions. Strictly implement the provisions of the "Heilongjiang Province, the new rural cooperative medical management approach" to strengthen the supervision of the designated medical institutions at all levels, increase the control of medical costs, improve the management of single-sickness limit charges, strictly approved by the designated medical institutions of the number of hospitalizations and the average cost of hospitalization, strict control of medical costs, reduce the burden on farmers, reduce the New Rural Cooperative Fund unnecessary expenditures, improve the efficiency of fund use. In addition, to improve the evaluation system of medical records and prescriptions, regular sampling of medical records and prescriptions of the designated medical institutions, by the new rural cooperative expert committee to focus on its evaluation, to further standardize the behavior of medical services.
3, the management of participating farmers. First of all, the designated medical institutions to hold the identification of participating farmers; secondly, the Agricultural Cooperative Office of the strict audit of foreign personnel. Thirdly, the province should be unified for the participants to handle the card, in order to confirm the identity of the real and the fake identity.
4, strengthen the supervision team construction. It is recommended that the relevant departments of the state should formulate as soon as possible the provincial, municipal and county levels of the new rural cooperative management organization personnel, the establishment of regulations to strengthen the handling and management capacity
Construction.
5. Strengthen the supervisory staff and the business training of the staff of the organization to improve the level of service.
6, increase the construction of the new rural cooperative network information platform, and gradually realize the provincial, municipal and county new rural cooperative funds online audit, online monitoring, online information summary, timely early warning report, better supervision of the use of funds. The establishment of the new rural cooperative reimbursement and civil affairs departments of the medical assistance funds one-stop synchronization settlement platform.
7, as soon as possible the introduction of the new rural cooperative management regulations, so that the new rural cooperative management work can be based on the law, there are rules to follow, and increase the supervision.
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