Hospital case management discipline construction paper
Key disciplines construction, is a very important comprehensive hospital construction, with a strategic line of development tasks [1]. Case management discipline as a discipline team is a more special discipline, which belongs to the fringe disciplines, the development and application of medicine, many of the data are from the case information. However, most of the hospital case room (section) is not emphasized by the hospital, the quality of the talent team is low, insufficient investment and other reasons, the level of case management work is not optimistic, the development of the discipline of the case room is slow, and some hospitals have even seen the phenomenon of the atrophy of the case room. Accompanied by the progress and development of science and technology, hospital management is more scientific, medical research is also more extensive and in-depth, case information management with the development of the times, but also by the modernization, information technology, the depth of the impact and impact, whether it is the concept, technology, methodology, there are significant changes in all aspects. In the process of development, some conceptual errors lead to the management of misunderstanding, seriously hindering the normal development of the profession, affecting the hospital's investment in case information management, which adds to the discipline of the case room construction and development, but also affects the enthusiasm of the staff. How to build the case management discipline of the case room in the new situation, so that it can develop and improve the status and enthusiasm of case managers, this is a problem that managers must think y about, but also the direction of the efforts of case managers. In the face of the new situation, our hospital case room in the case management discipline construction to do exploration and pay great efforts, and achieved certain results, now provide case managers to learn from.
1 leadership attention, support from various departments, medical staff understanding and cooperation is the first condition
1.1 leadership attention and support is the prerequisite for the construction and development of the discipline
Without the attention and support of the hospital leadership to case management discipline construction and development is empty. Management discipline construction and development has become empty talk. The development of the hospital can not be separated from the accurate case information, case information can be medical, teaching, research, epidemiology, health economics, etc. to provide a large number of statistical analysis of data sources; attention to the development of the case room and case information, the case of the original information for the organization, mining, statistical analysis, can provide strong data support for the hospital's management decision-making to improve the level of management of the hospital, so that the hospital has been a full range of development. The development of the hospital in all aspects. Hospital leaders have these concepts, in order to pay attention to the construction of the discipline of the case room, to give the greatest support. At the same time, according to the requirements of case management, the case management department of the second-level hospital should be directly under the leadership of the hospital director, vice president, endowed with the discipline leader's right to make decisions and recommendations, so that the discipline can be rapidly developed. Over the years, our hospital successive leaders with pioneering spirit, advancing with the times, coupled with our multi-propaganda, the hospital leadership fully aware of the importance of case management and development of hospitals, in 2007 the case room adjustment set up for the hospital's business sector, the exercise of some of the functional functions of the department, directly under the leadership of the Vice President of the business, the director of the department of the senior title, and was approved by the Municipal Bureau of Health. Hospital leaders have increased support for the case room discipline construction, increased the case room manpower, material input, over the past few years for the development of the case room invested millions of dollars, so that my case room in the hardware and software on a higher level, to achieve a modern management.
1.2 The support of various departments is the construction and development of the discipline can not be ignored
The case room equipment is advanced, complete is the construction of the discipline of case management of the material security, in addition to the traditional case shelves, intensive case shelves and desks and chairs and other office supplies, with the application of modern technology in the management of information in the case of material security also includes a large number of electronic equipment, such as tables, chairs and other office supplies. Security also includes a large number of electronic equipment such as computers, printers, bar code machines, disks, digital tachographs, fax machines, etc., which are inseparable from the material security departments of hospitals, computer centers, the support of the Department of property; case room personnel training, training and learning, inseparable from the Department of Medical Services and the Department of Teaching support; introduction of talent and investment, inseparable from the support of the personnel department, and so on. Therefore, the support of all departments is the strength of discipline construction can not be ignored. As the director of the case room should continue to improve their level of management, innovation and coordination of all aspects of the ability; case management personnel should also improve the interpersonal relationship with various departments. Our hospital case room in the hospital leadership and the support of various departments, the department is currently equipped with computers, printers, bar code printers, packers, punching machines, scanning guns, photocopiers, intensive shelves, dehumidifiers, air conditioning, temperature and humidity meters, etc. Over the past six years, we have recruited three clinical graduate students, undergraduate graduates 5 people; sent to participate in various training exchanges at home and abroad for more than 30 times; so that the construction and development of the discipline of our department has been strengthened. The construction and development of the discipline of our department is guaranteed by material and human resources.
1.3 Understanding and cooperation of medical staff is a favorable condition for the construction and development of the discipline
To let the medical staff to recognize the importance of case management, case management personnel to do the work is not simply on the filing of medical records to organize the binding of the shelves, but according to the requirements of the management of the case of the filing of medical records for careful organization, sorting, Binding, entry, coding, checking, quality control of final quality, shelves, etc., the entire case management process is rigorous; case management is a specialty like clinical medicine; good or bad case management will affect the quality of medical care, prevention of medical disputes, scientific research management, scientific use, teaching quality, etc.. Through publicity and practical work, we strive to make medical staff understand and cooperate with the case management work, and create favorable conditions for the construction and development of the discipline of the case room. We publicize the importance of case management through various occasions, often give feedback on the quality problems in the medical records written by medical staff, and put forward corrective suggestions and recommendations to them, so as to put an end to the grade C medical records and greatly reduce the grade B medical records, and improve the grade A rate of medical cases in each department, so that clinical departments and medical staff can reduce the economic losses and other penalties, and ensure that their medical cases can pass the various inspections by the superiors. The development of the medical records office has provided the clinical medical staff with a variety of information materials, making their medical treatment, scientific research, teaching and other levels higher, and making them utilize the information materials of the medical records more quickly and conveniently; at the same time, it is supplemented by the implementation of the system of rewards and penalties for the management of the medical records, in order to improve their compliance with the management of the medical records. Through these practical work to the medical staff to bring the benefits of the system of constraints, so that the medical staff to realize the importance of case management work, so that they understand and actively cooperate with the work of the case room, the discipline of the case room construction and development to be more smooth.
2 clear discipline development planning
Discipline planning is the blueprint and basis for discipline construction. Concentrate, clear, grasp the main direction of the hospital discipline, the development of a unique ability of the advantages and characteristics of the discipline. Condensing the subject direction is the key to subject construction. Should be based on the local, to the national advanced counterparts, according to the actual unit, the development of the discipline in line with the development of the construction of the construction of the planning, planning, clear subject construction of the purpose, direction and project areas, and the development of talent cultivation, scientific research and academic echelon construction, etc.. We have formulated three-year and five-year discipline development plans and realized them gradually according to the current situation of case management in our hospital and the local city, provincial hospitals, and a number of domestic Grade 3A, and the level of development of our discipline. First of all, we analyze the current situation of our hospital, including the quality of talent, team building, working conditions, discipline management, scientific research, etc., to find the weak links, targeted measures, and continuous improvement, the achievement of the transformation from traditional management to modern management, so that our department to the province's advanced ranks.
3 The construction of the discipline must be established to form a set of efficient operation mechanism
There are no rules. The system can form a set of efficient operation mechanism, to ensure that the construction of the discipline to the established goal of development. Let the case management personnel clear work objectives, goals, duties, responsibilities, task completion standards and rewards and penalties, so that they quality and quantity, unity and cooperation to complete the work task, while mobilizing their work enthusiasm, stimulate their enthusiasm for work, so that the entire staff of the Department of the construction of the discipline of the same heart and mind. We have formulated work quality standards, designed processes, and developed implementation steps for each position, work characteristics and details of the case management process, according to the relevant provisions of the case management and the accreditation standards for tertiary general hospitals; divided the quality unit into positions and professional groups, set up the staffing of the positions according to different workloads and titles, and divided into areas of responsibility. Various systems, duties, plans and rewards and penalties have been formulated and strictly enforced. Usually self-checking, mutual checking the quality of work, the department has also set up a quality control group, the quality of each link of the monthly inspection, found that the problem is required to rectify and be punished; for the timely discovery of the problem, correcting the errors of others and by the hospital and the patient praised to give awards to mobilize the motivation of the staff to achieve the interlocking, mutual help and mutual help, layers of gatekeepers, rewards and penalties, responsibility, and constantly explore and Improvement of work, to ensure that the development of the discipline runs smoothly.
4 Discipline construction and development of talent is the key
4.1 Discipline leader is to determine the level of the discipline, characteristics and advantages of the key factors
Discipline leader must have a high degree of academic qualifications, profound level of learning, superb professional skills, good management capabilities and The main reason for this is that it is not a good idea to have a good medical practice. At the same time, the director of the case department should be able to study hard, grasp the development of health information management at home and abroad, extremely responsible for the work and career; the management of the department continue to explore, the establishment of efficient and effective case service work, good case department plan; reasonable and powerful organization; make full use of and development of human resources; correctly guiding the staff, mastery, control, and coordination of interdepartmental work. The director of the case room should be at least an associate high professional title, and dedicated to the case management work, so as to grasp the direction of the development of the discipline, a greater sense of responsibility and a sense of mission, job, power and coexistence, the construction of the discipline can be better development. Discipline leaders are different from academic leaders. Discipline leaders should be able to grasp the direction of the development of the discipline, develop discipline construction planning, to determine the discipline construction goals and major scientific research projects, to grasp the overall situation, and actively tap into the discipline construction benefits of the radiation effect of the director of the hospital case room efforts to do in accordance with the dean of the nine elements of the discipline leader to do: have a sense of commitment, sense of responsibility, dedication; have a sense of innovation and development; have a high degree of 'emotional intelligence and solidarity and cooperation spirit! The nine elements of the discipline leader are: to have a sense of enterprise, responsibility and dedication; to have a sense of innovation and development; to have a high 'emotional intelligence and the spirit of unity and cooperation; to be able to endure and be willing to suffer, and to be able to do as much as he can carry in his heart; to have the ability to drive the development of business and medical level; to have the mind of economic management; to have the quality and quantity of scientific research; to be a teacher and to teach; to have the ability of prevention and control of medical risks; and to have the power of rapid execution. The director of the case room focuses on the construction of case management culture, and constantly enhances the attraction, cohesion and infectious force of this culture, effectively improves the comprehensive quality of the case staff, and does a good job in the discipline of development of five-year plan, talent training program, the original traditional management mode of the case room is gradually transformed into a modernized management mode, so that our department has become the city's leading unit of the professional disciplines of case management and the city's quality control center of the professional quality control of the case management. The center of the dependency unit, the director of the case room to become the director of the city case management professional quality control center and the city's disease operation code expert group leader; the national secondary association of the Hercynian Medicine and Health Development Center, the director of the professional committee of the case management.
4.2 The construction and development of the discipline, inseparable from the high-quality talent team
High-quality, skilled talent team is the main force to complete the construction of the discipline. Case management involves multi-disciplinary knowledge and skills, is a professional discipline, case management personnel not only to master a certain clinical medicine, basic medical knowledge, hospital management, information technology management, but also must be proficient in the classification of diseases, surgical operation classification, computers, statistics, case management expertise and other knowledge, in particular, the development of information technology requires that case management personnel to have a high degree of The development of information technology, in particular, requires case managers to have a high level of computer application ability; talents should form a echelon in the construction of disciplines. Only through the "academic education, special training, international cooperation, conference exchanges, visits" and other ways for various types of talent to build a professional platform at different levels, in order to build into a high-quality, technically sound talent team of disciplinary construction of the main force. At present, many domestic hospitals due to the management system and historical reasons, coupled with some leaders do not pay enough attention to case management, some of the personnel retired from clinical positions to the case room, resulting in the current case room staff there is a lack of case professionals, cultural level is not reasonable, professional mismatch of talent, aging and other phenomena; at the same time, do not pay attention to the training of personnel in the case room, resulting in the development of case management professional discipline Development stagnation. Our hospital also had some problems in the past, in response to these problems, under the importance of the hospital leadership, we have established and improved the work mode of training and introducing talents.
4.2.1 The introduction of talents, cultivate the discipline leader reserve candidate selection and cultivation of discipline construction must have a good talent echelon, strengthen the discipline talent training and introduction is crucial. In response to the problem of low education, we have recruited 2 postgraduate graduates of medical clinical specialty in the quality control group and 3 undergraduates of hospital information management related specialty in the coding group over the past 5 years, in order to improve the cultural level of our department and change the phenomenon of aging personnel. Discipline construction should emphasize on strengthening the selection and training of reserve candidates for discipline leaders. Establish a reserve pool of excellent talents, implement targeted tracking and training, and cultivate a reserve army of disciplinary talents. We encourage new graduate students and undergraduates to learn, improve and perfect themselves by giving them tasks, pressing on them, and actively providing them with necessary work and study guarantees; at the same time, we cultivate their good professional ethical qualities, strong organizational and managerial skills, strong sense of responsibility and career pursuit. They have become the backbone of our discipline construction.
4.2.2 Based on the post training due to the majority of our personnel from other professional transfer, lack of systematic, standardized case management knowledge and skills. In this regard, we take pass, help, take the way, so that trained in case management knowledge and skills of the personnel on their regular or occasional training; each new personnel must be rotated in the various positions for two years, after the examination before being allowed to take up their posts; the provisions of each of the outgoing training and learning exchanges personnel, back to the department should be reported to convey; usual work, encountered problems, the department staff to discuss and communicate with the clinician The company's website has been updated with the latest information about the company's products and services, and has been updated with the latest information about the company's products and services.
4.2.3 Increase the case management personnel to go out for further study and training opportunities, and strengthen the exchange with the outside world department to develop personnel training program, combined with the needs of the discipline construction, expertise and job requirements, targeted education and training of personnel, sent to participate in the domestic and international professional training, training, learning and exchange. Junior title personnel 3 years to go out to study and exchange 1 to 2 times, intermediate titles and above go out to study and training exchanges 1 to 2 times a year. 5 years **** sent abroad to study 1 times, 2 times domestic training, to participate in the study and training exchanges for 33 times. So that the department staff broadened their horizons, acceptance of new knowledge, new information, improve the professional level of case management.
4.2.4 Strengthen the training of personnel business quality, improve the professional level of personnel over the years, my section to undertake a college in Xiamen City, health information management professional case management theory course lecturing tasks, sent more than intermediate title, professional training of personnel to teach, but also to the major, specialized colleges and universities, internships, trainees to teach; through the lectures, teaching to make personnel Through lecturing and teaching, the staff reviewed their professional knowledge and improved their teaching level. Requirements of the department personnel, especially intermediate title or above, each year must complete the publication of an academic paper above the provincial level, postgraduate students should try to have a municipal scientific research project above the subject. 5 years, the whole department **** published more than 10 provincial academic journal papers. Through writing papers, the department has cultivated the scientific research ability of the staff, and also knows the trend of the development of the discipline at home and abroad. The core of the construction of the discipline is talent, professional knowledge, teaching and research capacity is the necessary elements of the construction and development of the discipline, all-round development is the direction of efforts.
5 refinement, the use of modern management tools is the fundamental and direction of the construction and development of disciplines
The development of disciplines should not only look at the personnel, comparative advantages, business prospects, the objective conditions of the unit and the relevant policies and systems, but also to pay close attention to the situation of neighboring units, to predict the development trend of the future; therefore, the development of disciplines should be fully assessed, forward-looking, and the development of disciplines. Therefore, the development of the discipline should be fully evaluated, forward-looking and scientifically planned. With the rapid development of information technology, the case management profession is facing challenges, the traditional management mode is no longer adaptable to the needs of the new situation, and it is necessary to transform the management mode from refined and modernized management in order to move forward to the advanced level of discipline construction. Only the refinement of the management, in order to make the case management personnel industry has a fine, quality assurance, efficiency; the use of modern management tools, in order to make the work more efficient, more accurate data, the application of case information more convenient and extensive.
5.1 refinement of management
In the field of hospital management, there is a "hospital has the advantage, the section has the characteristics of the people have expertise," said, to create a disciplinary brand, the formation of strong advantages of the characteristics of the technology is the key. In order to make our discipline construction has unique characteristics, to cope with the challenges faced by the internal and external environment, to enhance the momentum of the development of the discipline, to improve the core competitiveness of the discipline, we have taken the following measures.
5.1.1 Professional refinement according to the job duties of each position, rules, quality of personnel and specialties of the different, the implementation of fixed post, set up, each person is engaged in a fixed direction of professional development, so that their professional to the specialized, refined, sharp development.
5.1.2 System, duties, processes, security measures refinement successful construction of disciplines can not be separated from the scientific mandatory system. Compulsory system construction includes the construction of organizational structure, rules and regulations and other aspects. Organizational structure is the dynamic structural system of the organization in terms of duties, responsibilities and rights, and its essence is a system of division of labor and collaboration adopted to achieve the strategic goals of the organization. For this reason, we according to the case management of each link, process, nature, from the case of the recovery, sorting, sorting, binding, coding entry, quality control, digital processing, archiving storage shelves and other processes to develop a corresponding system, responsibilities, safety management measures, each case, each process is refined, responsibility to the person, and its performance appraisal linked to the quality of the management of the case, improve the quality of the case.
5.2 Modernization of management tools
5.2.1 Adoption of commonly used management tools for management We have adopted seven management tools for quality management in each link, which are: checklists, stratification, platoons, causal diagrams, scatter diagrams, histograms, and control charts, which are used to collect and analyze the quality data in each link, analyze and identify quality problems, and control and improve the quality. and identify quality problems, control and improve the level of quality.
5.2.2 Adoption of modern technology and equipment for management adopts the bar code tracer positioning system management, according to the case number, department, date of discharge and other information, through the bar code production software to prepare bar code symbols, printed and pasted on the cover of the archived medical records; scanned with a bar code reader, the computer screen that is to display the patient's information; applied to the various links of the case management, all positions, to facilitate information query and case management, and to facilitate the use of the bar code system. Convenient information query and case location. The application of electronic medical record data realizes online application and online return of electronic medical records, and establishes various levels and permissions to facilitate access and modification by medical personnel; at the same time, it facilitates online monitoring of the quality of the end of the case and collection of statistics and reporting of the medical data required by the Ministry of Health. Adopting digital case management technology to digitize archived medical records, so that all users can combine, fuzzy custom query through the first page of the case and other contents of the case, can be extracted, analyzed and statistics in the system, the document will be exported to the application; it has a wide range of accurate, rapid retrieval, statistical performance, image records are true, **** enjoyment is good, to save a lot of user's time, the It has the advantages of occupying small space, saving storage space of medical records and low cost, which meets the needs of our hospital in medical treatment, teaching, scientific research, management and many other aspects of the utilization of medical records, and it has a certain degree of standardization, security, practicability and sophistication. Adopting the intermediate number color coding method, sticking different colors to mark the case number on the cover of the case, distinguishing the case number by color, making it easy for the case personnel to identify the case number and avoiding filing errors. The application of the above modern technology and equipment, so that the management of my department from the traditional management mode to modern management mode, improve the quality of work, work efficiency and accuracy, to achieve a comprehensive, multi-functional, all-round quality service for the hospital's scientific decision-making and prediction provides an important basis.
6 Strengthen team building, give a set of incentives to keep pace with the times
The team is a group of mutual assistance and mutual benefit, solidarity for the unity of purpose and standards and perseverance to the end of the group of people. The team not only emphasizes the individual results, but also emphasizes the overall performance of the team. The team is based on collective discussion, research and decision-making, as well as information *** enjoyment and standard strengthening, emphasizing that through the struggle of the members to get the fruits of victory, these fruits more than the sum of individual performance. We ask our section members to unite, understand and trust each other, and to pool their ideas and efforts. Under this premise, we give full play to the advantages of the team and mobilize the enthusiasm of different types of talents. Talent is constantly inspired to continue to innovate and improve, in order to maximize the excavation and play their potential to dedicate to the collective goal, the establishment of incentives to mobilize all aspects of the enthusiasm of the staff is very necessary. For the department staff incentives in addition to the implementation of the provisions of the hospital, we have also developed a series of departmental incentive mechanism, such as: the publication of papers, scientific research results, the incentives to enhance academic qualifications; according to the academic qualifications, quality of work and attitude, the development of going out to participate in academic conferences, training and further training, study visits, promotion and promotion of priority; according to the work performance and the parties commended by the award and so on; in the treatment embodies the Fair, just, open and reasonable. Mobilized the enthusiasm and initiative of our staff. After several years of exploration of discipline construction in our hospital case room, we have gained the above practical experience, which is only for the reference of our peers. We still have a lot of problems in the construction of the discipline, will continue to explore, constantly improve the work, with a view to improving the level of discipline construction, the establishment of social influence of the discipline, and strive to maintain the core competitiveness with the times in the fierce competitive environment, to win the two benefits of a double harvest.
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