Health medical management hair [2010] No. 14 provinces, autonomous regions, municipalities directly under the Central Health Department, Xinjiang Production and Construction Corps Health Bureau:
In order to implement the deepening of the reform of the medical and health system views, to promote public hospitals in the reform and development of the strengthening of the internal management, improve the quality of service, and improve the experience of the masses to see a doctor, in summarizing the work of the local experience on the basis of the current on adhere to the "Patient-centered", the reform of public hospital service management, to facilitate the masses to see a doctor put forward the following views.
One, adhere to the promotion of appointment diagnosis and treatment services
(a) continue to promote the implementation of appointment diagnosis and treatment in public tertiary hospitals, and steadily expanding to secondary hospitals. Explore the outpatient and discharge patients follow-up the implementation of medium- and long-term appointments, with conditions of the local pilot outpatient 24-hour registration and appointment services.
(2) the development of a unified system and norms for the booking of appointments, the booking of appointments with the case management and medical insurance system effectively linked to continuously increase the proportion of patients booking appointments. Explore the establishment of city or province (districts, cities) as a unit of the reservation platform, in order to ensure information security at the same time, to achieve information interoperability, resources **** enjoy.
(3) Formulating performance evaluation and allocation policies to improve outpatient services and facilitate patients' access to medical care, and encouraging medical personnel to actively engage in evening outpatient services and holiday outpatient services.
(4) tertiary hospitals and community health service organizations and grassroots hospitals to establish a division of labor and cooperation, and to do a good job of hospitals to community health service organizations as well as inter-hospital appointment referral services.
II. Optimizing the outpatient process and increasing convenience measures
(1) Revising and improving the management system of outpatient clinics, and ensuring that medical staff attend clinics in accordance with the established arrangements. Strengthening outpatient information disclosure and counseling services, helping patients to make appointments and accurately register, and improving the effective rate of patient consultation.
(2) Exploring the reform of the medical scheduling management system, arranging medical resources properly, and deploying them in a timely manner according to the number of patients and peaks and valleys. It has done a good job of controlling and connecting the processes between outpatient clinics and auxiliary departments, and has strengthened the coordination between outpatient departments.
(3) Optimize the layout structure of outpatient clinics, rationally arrange the process of patient consultation, increase convenient measures, reduce the waiting time for medical treatment, and improve the patient's experience of medical treatment.
Three, strengthen the emergency green channel management, timely treatment of patients with acute and critical illnesses
(a) rational arrangement of emergency power, equipped with professionally trained, competent emergency medical staff, standardized configuration of emergency equipment and medicines.
(2) Implementing the system of responsibility for the first diagnosis, establishing a linkage and coordination system with 120, and establishing a system of emergency and first-aid referral services with community health service organizations and township health centers.
(3) to strengthen and improve the implementation of emergency zoning treatment, green channel into hospitalization and surgical treatment. Improve the emergency "green channel", the establishment of trauma, acute myocardial infarction, stroke and other key diseases of the emergency service process and norms, close interdepartmental collaboration, to ensure that patients receive continuous medical services.
(4) Strengthening emergency examination and diagnosis, and timely treatment of patients with acute and critical illnesses. Revision and improvement of emergency care standards, effective triage of non-acute and critical patients.
(E) for all physicians and nurses to carry out emergency technical operation procedures for full training, the implementation of regular training, qualified induction system.
Four, improve the hospitalization, referral, transfer service process, improve the level of service
(a) Revision of the patient transfer, transfer work system, revise the admission, discharge service management system and standards, improve the admission, discharge service process, and patient convenience.
(ii) Provide personalized services and assistance to patients for admission and discharge procedures. Do a good job of admission, discharge patients instructions, guidance, admission, discharge matters to implement outpatient account or bedside account. Emergency admissions patients by the Emergency Department to implement the transition of patients into the hospital or directly into the department of resuscitation and hospitalization synchronization approach.
(3) to strengthen the referral, transfer patients handover, timely delivery of patient information, to provide patients with continuous medical services. For the transfer of patients to do internal fine-tuning management.
(4) Provide appointments for transfer and inpatient treatment, and gradually realize the standardized continuity of transfer and treatment services from bedside to bedside and from community to bedside. Appointment arrangements for admission and discharge procedures and billing time are made to avoid patient waiting.
(v) Strengthening health education for discharged patients and management of follow-up appointments for important patients, improving patients' health knowledge and awareness of post-discharge medical, nursing and rehabilitation measures.
V. Reform of Medical Fee Service Management and Medical Insurance Settlement Service Management
(1) Reform of fee service management in public hospitals, reduction of patients' pre-payment of medical fees, and convenience of medical treatment for insured and enrolled patients.
(2) Collaborating with medical insurance management agencies, exploring the implementation of total prepayment, single-patient payment (fee), combining with the measures of booking consultation, identifying the patients' medical insurance status, and gradually realizing the patients' first consultation and then settlement.
(3) gradually implement real-time settlement for card-carrying medical treatment, the medical expenses incurred by patients in designated hospitals, in addition to the portion to be paid by individuals, the rest are settled directly by medical institutions and basic medical insurance, commercial insurance and various settlement systems and agencies.
Six, standardize clinical care services, the implementation of the overall care model
(a) the implementation of nursing staffing standards, improve the nursing management rules and regulations, and strict implementation of nursing technical operation norms.
(2) Provide nursing services appropriate to the patient's condition and ability to take care of themselves, and ensure that basic care and graded care measures are put in place.
(3) Focusing on humanistic care, implementing a holistic nursing model, providing patients with humanized nursing services that include physiological, psychological, social, cultural and spiritual needs, and reducing and gradually eliminating the need for patients' family members to accompany them.
(4) Carry out health education, listen carefully to the opinions of patients and their families, and continuously improve nursing care.
VII. Strengthening refined management and improving service performance
(1) Taking shortening the average hospitalization day as the entry point, optimizing the medical service system and process.
(2) Accelerating the construction of hospital information technology, rationally allocating and utilizing medical resources, solving the various bottlenecks affecting the shortening of the average hospitalization day one by one, and reducing the waiting time for patients to make appointments for examinations, in-hospital consultations, and test results.
(3) Strengthening the construction of key disciplines, process management and departmental cooperation, effectively improving the efficiency of medical services, and providing patients with convenient and satisfactory medical services.
(4) Implementing clinical pathway management, exploring the reform of single-patient quality control and single-patient payment, and promoting hospitals to improve performance.
VIII. Implementing Patient Safety Goals and Promoting Continuous Improvement of Medical Quality
(1) Strengthening the management of medical quality and safety, carrying out continuous improvement of medical quality, and supporting the China Hospital Association to carry out the annual patient safety goal activities in hospitals across the country. It implements patient safety goals and protects the safety of patients, medical staff and other visitors to hospitals.
(b) Strictly implement the checking system to improve the accuracy of patient identification by medical staff and to prevent errors in surgical patients, surgical sites and procedures.
(3) Implementing the clinical pharmacist system and prescription review system to improve drug therapy and ensure the safety of patients' medication.
(d) Improve communication among medical staff and implement medical prescriptions correctly and effectively. Implementation of hospital infection control and clinical laboratory "critical value" reporting system to prevent the occurrence of medical safety incidents.
Nine, to carry out standardized diagnosis and treatment of major diseases, and effectively reduce the burden on patients
(a) select common malignant tumors, renal failure, pediatric leukemia, coronary heart disease, and other major diseases with a high incidence rate, heavy burden of disease, and a large impact on society, drawing on the experience of developed countries in the diagnosis and treatment of tumors, based on the conditions of China, to formulate standardized diagnosis and treatment guidelines in line with the principles of basic medical care, basic medical insurance and basic medicines supply. Based on China's national conditions, it will formulate standardized diagnostic and treatment guidelines that are consistent with the principles of basic medical services, basic medical security and the supply of basic medicines, and carry out standardized diagnostic and treatment pilot projects for major diseases.
(2) Exploring payment and charging methods for single diseases based on standardized diagnosis and treatment, controlling medical costs, and effectively reducing the burden of medical costs on patients with major diseases.
(3) the use of modern electronic information technology, and gradually establish pathology remote diagnosis and consultation system, and gradually solve the problem of pathology diagnosis in county hospitals, to ensure the quality of the basis of standardized diagnosis and treatment of major diseases.
Ten, strengthen the management of complaints, and actively promote the people's mediation of medical disputes, and build a harmonious relationship between doctors and patients
(A) strengthen the communication between doctors and patients, to prevent medical disputes. The implementation of medical work "first complaint system", set up or designate a special department to accept and deal with patients and medical personnel complaints, timely processing and reply to the complainant.
(2) Based on the complaints of patients and medical staff, the hospital carries out continuous improvement of medical services.
(3) Actively promoting the work of people's mediation of medical disputes and medical liability insurance, improving the "Great Mediation", working closely with judicial, medical liability insurance and other departments, setting up people's mediation committees for medical disputes in counties (cities and districts), and training full-time people's mediators.
(4) organizing public hospitals to join the medical liability insurance, to protect the legitimate rights and interests of doctors and patients, to resolve medical disputes, and to build a harmonious doctor-patient relationship.
Health administrative departments and medical institutions at all levels to facilitate access to medical care, reduce the financial burden of the masses into the reform and development of public hospitals, as an important part of the current work, and effectively raise awareness and strengthen leadership. To improve the policy and system, the hospital's work system to clean up, do a good job of abolition, change and establishment. To educate medical staff to firmly establish the concept of "patient-centered", and strengthen the construction of medical ethics. It is necessary to strengthen the construction of informationization, improve the technical standards, build a unified platform, and lay a good foundation for doing a good job. Please report the progress of the work to the Department of Medical Services Supervision of the Ministry of Health in a timely manner.