1, the concept of contracted service for rural doctors:
Taking basic public health services as the main content and covering basic medical services, rural doctors take the initiative to sign service agreements with family representatives, so that rural doctors can form contractual services with the masses.
2, the purpose of developing rural doctors contract service:
(1), promote basic public health services and basic medical services in the form of contracts.
(2) Let rural doctors and the masses know their respective rights and obligations.
(3) Let the work of rural doctors be supervised by the masses.
(4) Promote the implementation of basic public health services.
3. Responsibilities and tasks of township hospitals in rural doctors' contract service:
(1), under the unified arrangement and deployment of the health administrative department at a higher level, formulate the work plan for the contracted service of rural doctors in this township.
⑵ Responsible for the unified printing of paper materials required for contract signing service, such as contract signing agreement, convenience contact card, work log, contract signing service network diagram, etc.
(3) Be responsible for the configuration of necessary inspection equipment for providing health services when signing the contract, such as visiting box, sphygmomanometer, stethoscope, etc.
(4), responsible for the area of rural doctors to carry out contract service business training.
5. Set up a service team to provide business guidance for rural doctors' contract service and supervise the progress and quality of contract service.
[6], rural doctors contract service work inspection and acceptance.
4. How to organize and implement rural doctors' contract service in township hospitals;
(1), actively communicate with the party committee and the government, and strive for financial and policy support from the party committee and the government.
(2) On the basis of establishing the service team, the responsibilities of the service team and rural doctors should be implemented, and measures such as responsibility for all-in-one responsibility and responsibility to the people should be implemented.
(3), formulate feasible accountability, supervision and inspection system.
(4) In order to encourage and improve work enthusiasm, it is necessary to link with performance appraisal and formulate rewards and punishments and incentive measures.
Second, how is the rural doctor signing service carried out?
1, working basis
(1) Through the implementation of the national medical reform policy, township hospitals have increased their development vitality, business premises, medical equipment and business departments have been continuously improved, the number of medical visits has increased substantially, business income has also increased year by year, and people's satisfaction has been greatly improved.
(2) Since 2009, with the deepening of medical reform, the funds for infrastructure construction of village clinics have been continuously invested, and the subsidies for basic public health, essential drugs and rural doctors have increased year by year. Especially since 20 12, the county has implemented integrated rural management, and the satisfaction of village clinics has been significantly improved.
(3) Since the implementation of the national basic public health service in 2009, the county has taken various measures to carry out this work. At present, the filing rate of health records has reached more than 90%.
The standardized management rate of the elderly and chronic diseases has also reached more than 80%, and public health work such as immunization planning and maternal and child health care management is at the forefront of the city.
Step 2 carry out the work
(1) Taking the opportunity of the county-wide on-site kick-off meeting, in accordance with the unified deployment of the county health bureau, actively communicate with the local party committee and government to win support, quickly set up a leading group and service group for rural doctors to sign contracts, formulate specific work implementation plans, hold a mobilization meeting in the jurisdiction, conduct business training for members of the service group and rural doctors, and take measures such as taking responsibility to their posts, and the public health office is responsible for organizing and implementing specific work.
(2) Main contents of business training: signing process, matters needing attention in signing, arrangement of signing documents, and health services provided during signing.
(3) health education brochures, letters to the masses, agreements, signing records, convenience contact cards, etc. Is uniformly printed.
(4) Rural doctors' contract service work permit shall be made uniformly, with visiting box, stethoscope, sphygmomanometer, blood glucose meter and work log.
5], equipped with a unified file box, the contract service documents will be bound into a book and filed in time.
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(6) Large-scale publicity activities have been carried out by using publicity measures such as posting and broadcasting. (7) There are two ways to sign contracts, one is that rural doctors come to the clinic to sign contracts, and the other is that the masses take the initiative to sign contracts with rural doctors.
(8) Service teams or rural doctors need to bring stethoscopes, sphygmomanometers, blood glucose meters and other necessary inspection equipment to send health and contract services to their homes, and make health examination registration in time.
(9) It is necessary for the masses to take the initiative to sign contracts with rural doctors in clinics to carry out a health examination and health guidance service.
⑽. When signing the contract, the rural doctors will report the problems and difficulties found to the service team in time, and the service team will assist the rural doctors to solve them together. For families with special patients, service team members and rural doctors provide contract services together.
Third, supervision and incentive measures.
1, a set of feasible supervision and incentive measures has been established to ensure the solid development of rural doctors' contract service.
Incorporating rural doctors' contract service into the performance evaluation of basic public health services, its contract rate and mass satisfaction directly affect the allocation of funds for basic public health services.
2. In order to avoid the perfunctory work of rural doctors, a steering group headed by the dean was set up to supervise and inspect the contracted services of each rural doctor at any time. In the supervision, random door-to-door inquiry and random telephone survey were adopted to check, which dispelled the lucky psychology of rural doctors and played a good role in promoting them.
3. After the signing service is completed, send someone to pay a telephone call back to the people registered in the signing record reported by the rural doctors to verify the authenticity of the signing and the satisfaction of the people. If the signing rate and mass satisfaction are below 90%, rural doctors will be ordered to make rectification within a time limit, and points will be deducted according to a certain proportion in the performance appraisal of basic public health services.
4, in order to encourage and improve the enthusiasm of rural doctors, under the premise of ensuring the signing rate and the satisfaction of the masses above 90%, the implementation of performance management.
Fourthly, the expected effect of rural doctors' contract service.
1, the masses know the services and rights they should enjoy, and rural doctors have made clear their responsibilities and obligations.
2. Publicize basic public health service projects in the form of signing contracts, and the masses have played a supervisory role in the basic public health work of rural doctors.
3. Through the development of rural doctors' contract service, the work of rural doctors will change from passive service to active service.
Through this work, the relationship between medical institutions and the masses has been brought closer.
5. Better promote the implementation of national basic public health service projects.
Verb (abbreviation of verb) Problems and difficulties in contract service.
1, some rural doctors can't change their ideas in time. They think that the duty of rural doctors is to wait for the people, and they don't pay enough attention to basic public health services and signing contracts with rural doctors, which leads to poor work.
2. Some people don't understand the contract service work, and think that rural doctors are a kind of profit-making propaganda to fight for the source of the disease, which leads to the embarrassing situation that the door is difficult to enter and the face is ugly.
3. The enthusiasm of rural doctors to receive professional training and new knowledge is not high enough, which leads to low professional level and can not meet the development of health undertakings and the needs of the masses.
4. The cooperation mechanism between village clinics and superior medical institutions is not in place, and two-way referral is difficult to implement.
5. Due to high threshold, high risk, low income and other factors, the rural doctor industry gradually lost its appeal, and the phenomenon of personnel structure fault appeared. The serious shortage of rural doctors' talent resources is another major problem we are facing under the new situation.
Part II: Overview of family doctor contract service.
In order to give full play to the role of family doctors as the "gatekeeper" of residents' health, combined with the actual work of basic public health services, the contract service of family doctors was fully implemented. Our work is summarized as follows.
(A) attach great importance to and actively deploy
According to the work arrangement of the regional bureau and the situation of our jurisdiction, the implementation plan of family doctor contract service in Suixi Central Health Center was formulated, and a work leading group headed by the president was established, with members from hospital team, public health department, rural doctor management department and other relevant functional departments. Up to 65438+ in February this year, 1, * * * held two special conferences; Promotion meeting 1 meeting; Set up 8 teams with 63 members; Two training sessions, 15 1 person-time.
(B) extensive publicity, in-depth mobilization
In order to ensure the smooth and orderly service, since late September, our hospital has carried out publicity through four channels:
1. Use the LED electronic display screen, health education bulletin board and medical insurance bulletin board of our hospital to publicize the visiting residents.
2. Public health departments and rural doctors' management departments publicize by distributing "a letter to the public".
3 through the street offices, actively coordinate with the village party secretary, and ask him to use various channels to publicize the relevant contents of the family doctor contract service.
4. The family doctor service team publicizes through home visits.
(C) clear principles, hierarchical management
1. Dividing services and clarifying responsibilities According to the characteristics of population distribution and village clinics distribution in Suixi Street Office, each administrative area is divided into corresponding village clinics in a "gridded" way, taking 28 village clinics and 3 neighborhood committees in the jurisdiction as units, so as to ensure that all residents in Suixi Street can be covered by the community health service system. Hospitals and village clinics have formed a "family doctor-style contract service team" with "a doctor, a nurse, a public health worker and a village doctor" as the core to provide family doctor-style services. Clarify the distribution of the villages under its jurisdiction, and set up a "family doctor-style contract service team" publicity board in each village department to publicize the team service personnel, service scope, service time, service content, contact information and other information.
2. Graded services and clear objectives
Each service team divides residents into three grades according to their actual needs for health services and their acceptance of family doctor services. The first level is residents who are temporarily unwilling to receive family doctor services; Second-class residents are only willing to accept family doctor-style services when needed; The third level is residents who are willing to receive family doctor services. Provide different health management services according to different levels of residents.
At the first level, focus on observation, strengthen publicity, and conduct regular and irregular telephone follow-up to understand the changes in their service needs.
The second level focuses on publicity, promoting health management services, and issuing contact cards to family doctors so that they can contact team members at any time when needed.
The third level is mainly active service, which is classified according to health status and health needs, and provides targeted family doctor-style contracting services for different categories of special people.
3. Classified services and clear standards
Third-level residents who are willing to receive family doctor services are divided into three categories according to their health status and health needs: the first category is healthy ordinary people, the second category is people who need attention, the third category is patients with chronic diseases, and the fourth category is special people such as high-risk patients or patients with serious complications, patients with severe mental illness, disabled people, dependents and empty nesters. According to the categories of residents, the service content and standards are defined, and targeted contract services are provided to ensure service quality and sustainability.
In order to further standardize the implementation of basic public health service projects and promote the implementation of basic public health service tasks, according to the requirements of the Health Bureau, it is determined to implement the contracted service for rural doctors within the jurisdiction. In order to ensure the solid and effective work, the Implementation Plan for contracted service for rural doctors in * * * Health Center is formulated.
In order to ensure the solid and effective work, our hospital hired the chief of the public health department of the Health Bureau to come to our hospital to train all the staff of the public health department and all the rural doctors. Let all medical staff fully understand the work, and at the same time, through radio, publicity column, door-to-door service and other forms, make it a household name, so that more rural residents can consciously accept the contract service. First of all, focus on the elderly, infants, pregnant women and patients with chronic diseases within their jurisdiction. Priority coverage, priority contract signing, priority service, clear service content combined with their own service capabilities, enrich the service connotation of rural doctors when signing contracts, and effectively meet the health requirements of rural residents. Our hospital has set up a leading group for rural doctors' contract service, and set up three teams to implement the responsibility system of ensuring the village, and the responsibility lies with the people. Based on residents' health records, we will focus on the elderly over 65, children aged 0-6, pregnant women, patients with chronic diseases and patients with severe mental illness. It also measures blood pressure and blood sugar for customers, provides intervention guidance for healthy living behavior and guidance for diagnosis and treatment path, and provides telephone consultation, home visit nursing, home sickbed and home rehabilitation guidance services for contracted customers with mobility difficulties. For chronic diseases, severe mental patients to provide annual
Not less than * times of health consultation and classified guidance services, and timely discover the existing health risk factors, health-threatening behaviors and other health problems. On the premise that both parties fully understand the connotation of rural doctors' contract service, farmers voluntarily choose doctors, sign relevant service agreements on a household basis and enjoy the contract service. In principle, each rural doctor is controlled at about * households, and the service population does not exceed *. In the contract system, all medical staff strengthen their sense of responsibility and implement the weekly report system. The remuneration of rural doctors is closely combined with the workload and quality of work to ensure the solid and effective work. Informed criticism will be awarded to the clinics where rural doctors have irregular contracts and ineffective work measures, and the clinics with good work, remarkable achievements, high public satisfaction and awareness will be commended and rewarded.