Author: Li Zijun
Emergency grading, unified management of hospital beds... Beijing Chaoyang Hospital Affiliated to Capital Medical University (hereinafter referred to as Beijing Chaoyang Hospital) is taking a series of measures to improve the quality of medical services. On July 10, the health industry learned from Beijing Chaoyang Hospital that the hospital had recently established a large-scale centralized examination appointment center and one-stop inpatient service, bringing 30 beds under unified management.
Twenty tertiary hospitals in Beijing began to implement pre-examination and hierarchical triage in May 2019. At the media communication meeting, Mei Xue, deputy director of the emergency department of Beijing Chaoyang Hospital, revealed that currently, the emergency department of Beijing Chaoyang Hospital The proportion of critically ill patients in the hospital has exceeded 90%.
30 beds are brought under unified management
Recently, Beijing Chaoyang Hospital established a one-stop large-scale examination centralized appointment center to integrate and reorganize the various examination project processes to replace the original decentralization of various medical technology departments. reserve. At the same time, the appointment center is connected to self-service machines, APPs and other self-service equipment to realize functions such as self-service check-in for patient examinations, which not only optimizes the appointment and check-in process, but also alleviates the blindness of patients' flow in the hospital and shortens the patient's stay in the hospital. For out-of-town patients, the hospital will allocate resources and arrange the examinations for out-of-town patients to be completed on the same day, easing the difficulty of the patient's medical treatment process.
According to Li Xiaobei, deputy director of Beijing Chaoyang Hospital, the hospital has set up a one-stop inpatient service center and implemented flexible bed management. The 30 beds in the hospital have exceeded the number of beds between departments and intra-department primary care groups. Barriers, beds are centrally managed and flexibly allocated as needed to ensure the admission of difficult, urgent and critically ill patients. In addition, the patient admission process is smoothed, and patients in the surgical department can complete some preoperative examinations on the day of hospitalization, shortening the average length of stay before surgery.
90% of the patients in the emergency room and rescue observation area are critically ill patients
Starting from May 1, 2019, 20 tertiary hospitals in Beijing, including Beijing Chaoyang Hospital, There is no longer a "first come, first served" approach in the emergency department, and emergency pre-examination, triage and graded treatment (referred to as "emergency grade") are implemented uniformly.
At present, Beijing Chaoyang Hospital has fully implemented emergency pre-examination and graded treatment in accordance with the unified requirements of the Beijing Municipal Hospital Authority. Mei Xue said that when patients visit the emergency department, they first go to the emergency department triage station for pre-examination and grading. According to the severity of the condition, patients are divided into "endangered, critical, emergency and non-emergency" levels 1-4; after that, they receive diagnosis and treatment in accordance with the order of levels. Following the principle of from severe to mild, and from rapidly changing conditions to relatively stable conditions, the triage desk arranges the order of patients' treatment, giving priority to more serious patients. The level of the patient's condition determines the order of diagnosis and treatment, rather than "first come, first served". This process will minimize the subjective judgment of triage nurses, and instead nurses will classify patients based on objective data such as electrocardiogram results.
The hospital places level 1 and level 2 patients in the red zone, which represents critical conditions, gives priority to diagnosis and treatment, and sends them to the emergency room or resuscitation room for treatment. Level 3 patients fall into the yellow zone, which represents emergency patients, while level 4 patients fall into the green zone, which represents non-emergency patients. The Emergency Medicine Department of Beijing Chaoyang Hospital has established a medical consortium with Liulitun Community Hospital, Chaoyang Emergency Center Treatment Area, and the Emergency Medicine Department of Huairou Hospital. Level 4 non-emergency patients or patients who have stabilized after rescue operations will be transferred to member hospitals of the medical consortium for follow-up treatment.
"The implementation of emergency classification and triage has improved the quality of department management, achieved reasonable allocation of medical resources, and improved department operation efficiency." Mei Xue said that before the implementation of emergency classification, emergency department visits were the most common in the afternoon and evening every day. During peak hours, doctors often only have two to three minutes to treat a patient, and they don’t even have time to drink water or go to the toilet. It is difficult to achieve high standards of medical quality. Compared with two years ago, the number of consultations in the emergency department of Beijing Chaoyang Hospital has increased by 20%, but each doctor can maintain about 10 minutes of consultation time. Statistics show that the proportion of critically ill patients in the emergency room and emergency observation area of ??Beijing Chaoyang Hospital has exceeded 90%, and there are almost no extra beds. The purpose of adjusting the patient structure of tertiary hospitals has been initially achieved.
The emergency department has always been a department with a high number of patient complaints in various hospitals. Before emergency pre-examination and triage, the emergency department of Beijing Chaoyang Hospital received complaints from patients almost every day. Currently, there are only two or three complaints per month. "In the past, most of the complaints were made by family members of patients with relatively serious conditions. After the hierarchical management of patients, severely ill patients will receive priority for medical treatment. This is the reason why the number of complaints in the emergency department has dropped significantly." Mei Xue said.
This article is reproduced from other websites and does not represent the views and positions of the health industry. If you have any copyright objections to content and pictures, please contact us in time (email: guikequan@hmkx.cn)