Outpatient clinics have to receive a large number of patients from all aspects of society and different classes every day. According to the Ministry of Health in 1987, "China's health statistics summary" reported that China's outpatient visits and admissions ratio of about 100:1.9 ~ 2.0, of which hospitals above the county level for 100:2.19 ~ 2.23. In particular, some of the technical equipment, better conditions, the transportation is more convenient to the city hospitals are more concentrated in the outpatient clinic, the general provincial-level hospitals are more than 2,000 outpatient visits daily, and some even more than 4,000 people. In general, the daily outpatient volume of provincial general hospitals exceeds 2,000, and some even exceed 4,000. For this phenomenon of outpatient concentration, hospitals should strive to ensure that patients get timely, effective, high-quality diagnostic and treatment services, to overcome the contradiction between the number of outpatient clinics and the quality of the request for hospital leadership attaches great importance to the management of outpatient clinic work and support, rationalize the arrangement of outpatient clinic staff, to improve outpatient clinic working conditions, in particular, we must do a good job of outpatient clinic peak diversion work, to ensure that a good diagnostic and treatment order.
(B) diagnosis and treatment links
The outpatient clinic is a diagnosis and treatment of the function of the system as a whole, from the patient registration, waiting, consultation, to the hospital to provide diagnosis and triage, diagnosis, testing, radiology, injections, treatment, medication, etc. is a series of processes composed of a number of links in the process, in the process of obstruction of any of the links can be caused by serious congestion of the outpatient clinic, to the patient brings Inconvenience. And the above links also involves the payment procedures, so the outpatient clinic diagnosis and treatment of the characteristics of the link, requires hospital leaders to apply systems management theory and methodology, analysis of outpatient clinic diagnosis and treatment of the process of the link, time and characteristics, to prevent and overcome the phenomenon of "three long and one short" phenomenon (i.e., long time to register, wait for a long time to diagnosis, check the disposal of medication for a long time, (i.e., long registration time, long waiting time, long time for examination and disposal of medicines, short time for diagnosis and examination), to do a good job of outpatient medical services, simplify the procedures for consultation, and at the same time, rationalize the layout of outpatient departments, add a variety of auxiliary equipment and services for the people, especially for patients with mobility problems to provide assistance, which is to improve the satisfaction of the hospital and quality of care can not be ignored as an important aspect.
(C) the crowd is mixed, many kinds of diseases
The crowd is mixed, many kinds of diseases is the focus of outpatient work characteristics. The so-called crowd refers to patients from all walks of life, and accompanied by a variety of complex social phenomena may occur in the outpatient clinic; the patient population has the elderly and infirm, infants and young children and patients with low resistance, the mix between patients and healthy people; the patient population in general acute and chronic diseases, infectious diseases, there may be infectious diseases or even virulent infectious diseases mixed together, it is easy to cause cross-infection between the patient and the healthy people. It is easy to cause cross-infection between patients and healthy people, and can also cause patients to be re-infected. Therefore, hospital leaders are required to fully comply with this feature, seriously do a good job in outpatient medical safety, good outpatient infection management, especially the prevention of cross-infection and environmental health management is an important task of outpatient management.
(D) emergency changes
In general, the number of outpatient clinics, the type of disease, the degree of urgency and slowness is difficult to predict, in a passive situation. For example, an epidemic of infectious diseases will focus on a large number of infectious patients, the hot season will be more heat stroke patients, winter freezing slippery season will be more fractures, bruises, car accidents patients, especially once a major industrial accident, fire and flooding, earthquakes, traffic accidents will be a steep increase in outpatient, so the hospital outpatient clinic must be ready for emergency preparedness and temporary scheduling of the potential and ability to emergency outpatient changes.
(5)
(E) doctors change more
Doctors change more frequently is an important feature of outpatient work, although the hospital strives to make outpatient doctors relatively stable, but the flow of outpatient doctors change is unavoidable, the patient re-examination of the requirements of the initial doctor's diagnosis and treatment is often more difficult, which sometimes affects the patient's careful analysis of the observation, and sometimes even in the process of handover of the doctor prone to medical defects or medical malpractice hidden danger, easy to be able to change the outpatient clinic. Sometimes even in the process of handover of doctors are prone to medical defects or medical accidents, easy to cause misdiagnosis and omission of diagnosis and varying degrees of impact on the quality of medical care. The development of modern hospitals often requires good collaboration of medical staff to complete high-quality, high-level outpatient work, for outpatient doctors change more characteristics, especially require medical staff to have a good moral quality, good sense of responsibility and good medical skills, require hospitals to establish and strictly implement outpatient system (including outpatient diagnosis, outpatient consultation rate, outpatient medical record writing system, outpatient cases) (including outpatient confirmation rate, outpatient consultation rate, outpatient medical record writing system, outpatient case discussion system, referral and transfer system, etc.) in order to adapt to the requirements of improving outpatient quality. For provincial hospitals and teaching hospitals, it is important to strengthen the management of the teaching of the trainee doctors and interns, to ensure the proportion of the doctors in the hospital, to ensure the proportion of the attending doctors and above, to ensure the number, frequency and proportion of the chief doctors, professors and other specialists attending outpatient clinics on a regular basis, to ensure that the doctors of each department working in the outpatient clinics should be relatively stable, and in principle, should be working for more than half a year and then rotated, which is essential for the outpatient clinics to be well quality. The first is to ensure that the number and proportion of doctors working in the outpatient clinics are relatively stable.
(F) short consultation time
Outpatient clinic patients with the demand for treatment, treatment of disease, a strong desire to come to the hospital outpatient clinic, but the outpatient doctors every day to receive a large number of patients, although the outpatient clinic clinic of the various disciplines of the patient's time to make principled requirements in order to prevent the emergence of the phenomenon of sloppiness and hasty, but the actual status quo is sometimes difficult to properly solve the contradiction between the number of quality, especially in the peak moment of the number of outpatient clinic patients. In particular, the contradiction is more prominent at the peak time or peak season of the number of outpatients. Moreover, it is difficult to ensure that doctors can make correct diagnostic and therapeutic thinking and observation for each patient when some patients with complicated conditions or precursor symptoms are not typical. That is to say, outpatient doctors on these difficult patients if the time spent more, even more than the time spent on multiple patients, but for the purpose of making correct and timely diagnostic and therapeutic measures, the time is still short. To solve this "short time" contradiction, the key is to strengthen scientific management, and the characteristics of outpatient work to manage the focus on improving the quality of implementation, which is the current outpatient management of the management of the most urgent consideration to solve the problem.
The outpatient work of the above "five less a short" characteristics, is the outpatient work of the disadvantages and weaknesses, so the hospital management must be through a variety of management measures, through the development of hospital development planning, through the development of regional health planning and reasonable macro-control, through the development of "civilized hospital", "civilized hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital", "hospital" and "hospital". Hospital", "100 best hospitals" and other activities to strengthen the construction of outpatient window, through efforts to improve the quality of medical staff and improve the outpatient environment, through the whole society *** with concern, support and supervision, especially the government's macro-control function, and gradually change the large number of large urban hospitals. Outpatients seeking treatment for common diseases, and vigorously reduce the ratio of outpatient visits to hospital admissions. In this regard, the experience of Western hospitals is worth learning from.