Health management work plan 1 in order to further implement the treatment of terminal diseases with traditional Chinese medicine, according to the contents of the newly added "National Basic Public Health Service Project Specification" in the "Chinese Medicine Health Management Service Specification", the work plan of Chinese medicine health service for key population, elderly people over 65 years old and children in the jurisdiction for 20 14 years was formulated:
First, improve the system and fine management.
Improve the construction of TCM health management system, standardize the technical operation norms of TCM health management, and strengthen TCM health management.
Two, the implementation of traditional Chinese medicine health management.
Chinese medicine health management began in 20XX, focusing on adding Chinese medicine identification content to the archives of the elderly over 65 years old in the jurisdiction, and gradually developing Chinese medicine health care services for hypertension, diabetes and children, and achieving specific work indicators:
1. Grasp the current situation of the elderly population over 65 years old in the jurisdiction, and provide 1 items of TCM health management services for the elderly over 65 years old every year according to the requirements of the Regulations, including TCM physique identification and TCM health care guidance, with the management rate tentatively above 80%.
2. TCM constitution identification. Collect information according to the first 33 questions in the Record Form of Traditional Chinese Medicine Health Management Service for the Elderly, conduct physical identification according to the criteria for determining physical fitness, and inform the clients of the identification results. By the end of the year, 80% of the elderly over 65 years old in the jurisdiction will be identified by traditional Chinese medicine, and the results will be entered into the electronic file system.
3. Chinese medicine health care guidance. According to different physique, we should give corresponding TCM health care guidance and health intervention from the aspects of mood regulation, diet regulation, daily life regulation, exercise health care and acupoint health care.
4. Provide TCM health guidance such as health status identification and assessment, health intervention (including health consultation and guidance) for children aged 0-6 in the jurisdiction, including:
(1) to provide parents with guidance on children's Chinese medicine diet conditioning and daily life activities;
(2) At 6 months, 12 months, teach parents the methods of rubbing abdomen and chiropractic; 18 years old and 24 months old, teaching the methods of massaging Xiang Ying and Zusanli points; At the age of 30 and 36 months, he taught the method of massaging Sishencong points.
5. All Chinese medicine services, do a good job of data collection and input to inform the service providers, and analyze and guide the treatment of the found diseases.
Health management work plan 2 I. Work objectives
1. Establish and improve the chronic disease management system in line with the development level of our township. Through the implementation of the basic public health service management project for hypertensive patients, intervention measures were implemented for chronic diseases and related risk factors of township residents to reduce the main health risk factors and effectively prevent and control hypertension.
2. The management rate of hypertension with definite diagnosis is over 90%; The control rate of hypertension with definite diagnosis is above 60%.
Second, the main task
Management of patients with hypertension
According to the management service standard of hypertension patients, standardize the management of hypertension patients aged 35 and above in the jurisdiction.
1. Screening methods for patients with hypertension are: the blood pressure of residents aged 35 and above is measured for the first time every year; Blood pressure was measured during the diagnosis and treatment of residents; Measure blood pressure in health examination and screening of high-risk groups; Let patients take the initiative to contact township health institutions through publicity and education; Inquiries in the process of establishing residents' health records.
2. Establish health records of patients with hypertension. Establish health records of patients with hypertension, carry out physical examination, consultation, follow-up and health intervention for patients with hypertension as required, and record relevant information and activities in residents' health records for registration, so as to realize standardized management of the records. Strengthen the standardized management of registration of hypertension patients in township health institutions, realize the institutionalization of workflow and standardization of registration materials, and meet the requirements of provincial hypertension registration norms. In the process of health management of patients with hypertension, we should make good use of active health records and constantly enrich and enrich the contents of health records.
3. Management of patients with hypertension. Township medical and health institutions should provide at least 4 face-to-face follow-up visits every year for patients with hypertension diagnosed. Every time you follow up, you should ask about your illness, check and evaluate your blood pressure, and give health guidance such as medication, diet, exercise and psychology.
4. Health examination of patients with hypertension. Patients with hypertension should have a health examination at least once a year, which can be combined with follow-up. The contents include blood pressure, weight, random blood glucose (blood) measurement, general physical examination, general examination of vision, hearing and activity ability, and preliminary screening examination of cognitive function and emotional state.
Health Management Work Plan III In order to further change the service mode of health centers, better promote the sinking of technology, management and services in health centers, and improve the accessibility of basic medical services and public health services, this work plan is formulated according to the spirit of the Opinions of the Provincial Health Department on Developing Health Management Team Services in Township Health Centers (Su Wei Nong Wei [20xx] No.3) and the actual situation of our hospital.
(A) to carry out mobile medical care
1. Go to the village clinic for outpatient service regularly. Combined with the actual situation of its own technical force, considering the factors such as serving population, mass demand and geographical traffic conditions, the service area of health management team is reasonably divided to ensure that each administrative village has a team responsible. The health management team shall go to the village clinic at least twice a month, and work in the village for not less than half a day each time.
2. Carry out team services through door-to-door rounds, follow-up management, health education and village clinic inspections. For the elderly, pregnant women, children, the disabled, patients with chronic diseases, mental patients and other patients with mobility difficulties and practical needs, provide on-site diagnosis and treatment services according to the needs and diagnosis and treatment norms. Before the team enters the village to carry out services, rural doctors should inform the key management clients in advance.
3. Help rural residents to choose appropriate medical paths, assist in making appointments with higher-level hospitals, and promote the establishment of a system of primary diagnosis, graded diagnosis and treatment, and two-way referral.
4. The team makes a detailed implementation work plan according to the annual objectives and tasks assigned by the superior. The team leader determines the personnel and specific work content of each village according to the task.
5. The time and content of the fixed team entering the village should be announced on the wall of the village clinic, and the list of team members, division of responsibilities, consultation contact information and supervision telephone number should be publicized to facilitate residents' contact and accept social supervision.
(B) the implementation of health management
1. Understand the basic health status of residents in this service area and the main factors affecting health, and formulate and implement them.
Targeted intervention measures.
2. Implement basic public health services that rural doctors can't independently complete, such as health care for patients with stage III hypertension, diabetic complications, high-risk pregnant women, frail children and the elderly over 65 years old in this service area.
3. Relying on the support of information system, comprehensive utilization of health information.
(3) Standardize village clinic services.
1. Strengthen the training and guidance for village clinics and rural doctors, popularize appropriate health technologies, and help rural doctors improve their basic medical and health service capabilities.
2. Supervise the village clinics to standardize the implementation of the basic drug system, standardize the implementation of safe injection, disinfection and isolation, medical documents, antibiotics and hormone application, medical waste disposal and other medical norms and basic public health service norms, standardize the establishment of financial management systems, and standardize the provision of outpatient services for the new rural cooperative medical system.
3. Urge rural doctors to seriously complete the tasks of basic medical and public health services.
Health Management Work Plan 4 In order to strengthen the establishment and improvement of the quality of basic public health services, promote the gradual equalization of basic public health services, and improve the management system of basic public health services, the following plans are formulated in combination with the actual situation.
I. Business learning and professional training
Accept the technical guidance, training and post assessment of higher health institutions, and constantly improve the problems existing in the work. Actively participate in various business studies and professional training to improve the professional level of medical staff in children's health management services. Strengthen publicity, inform children's guardians of the service content, so that more parents of children are willing to accept the service.
Second, improve the roster of children aged 0-6.
Sort out the roster list of children under the age of 0-6 in the children's file in the early stage, and note the physical examination date of the past 1 year. Timely and effective information communication with obstetrics and gynecology, timely grasp the information collection of children, and improve the rate of neonatal treatment.
Three, the existing resident files of children aged 0-6.
1. Do a good job in filing and electronic information entry of newly added population and children who have missed construction, and update the files in time.
2. Under the leadership and coordination, the children aged 3-6 in the kindergarten were examined.
3. From March to the end of March, the children's group of public health will classify the files that need to be followed up every month by village and year. The epidemic prevention department conducts monthly telephone or face-to-face follow-up, and the public health children's group assists the epidemic prevention department to complete the paperwork, actively guides and follows up, and helps each other to complete the children's follow-up and computer entry and inspection (dynamic management).
4. Continue to screen out the number and files of vulnerable children from physical examination, such as establishing files and rosters of vulnerable children such as premature infants, low birth weight infants and moderate malnutrition, and improve the filing of vulnerable children.
5. The archives of each village are managed by village and year, classified and filed, which is convenient for consulting and finding information.
Fourth, the job requirements
1.20xx February 15 to the end of February 18, and strive to complete the filing and follow-up of 5,000 children aged 0-6, and strive to achieve 85% filing rate and follow-up rate of children aged 0-6.
2. Archive 1250 copies every quarter, 4 17 copies every month and 16 copies every day.
Children aged 3.0-6 can enjoy 13 health examination, 6, 8, 18, 30-month-old infants 1 hemoglobin test and 6, 12, 24 and 36-month-old infants 1 hearing screening free of charge.
4. Due to other particularities of public health, such as going to the countryside for physical examination and meeting inspection, other personnel * * * cooperate to complete the rest of the work.
Verb (abbreviation of verb) evaluation standard
1. neonatal mode rate = number of newborns who meet the specification requirements in the annual jurisdiction 1 time and above/number of live births in the annual jurisdiction x 100%.
2. Child health management rate = number of children aged 0-6 years who accepted 1 time and above in the jurisdiction/number of children aged 0-6 years in the jurisdiction in that year x 100%.
VI. Workload Summary and Report
Summarize and report the workload on 27th of each month, and submit the workload report and completion report to the director before 29th. Calculate the workload summary every quarter.
Health management work plan 5 With the rapid development of China's social economy, people's diet, daily life and living habits have undergone great changes. The Survey of Nutrition and Health Status of China Residents in 20XX and the National Physical Fitness Monitoring in 20XX show that chronic diseases closely related to lifestyle and their risk factors, such as unbalanced diet and insufficient physical activity, are on the rise rapidly, which has become a prominent problem threatening people's health. In order to respond to the call of the Ministry of Health and promote the equalization of public health services, Baiyu and Lu Hua started the health management project as a pilot, providing evidence and experience for the residents in the new district to provide guidance on disease prevention, self-care and injury prevention, reduce health risk factors and effectively prevent and control chronic diseases. The 20XX work plan is formulated according to the national public health service standards, and the work is carried out in strict accordance with the requirements of the plan.
I. Objectives:
1. Focus on pregnant women, children aged 0-3, the elderly, the disabled, severe mental patients, patients with chronic diseases and cancer patients, and establish unified and standardized health records for residents in the area, taking health records as the carrier to provide residents with sustained, comprehensive, appropriate and economical basic medical and health services. Health records should be updated in time to ensure that the filing rate of residents' health records reaches more than 50%, the qualified rate of health records reaches more than 70%, and the management rate of health information system reaches more than 80%.
2. Track and evaluate the patient's condition, and record the physical and chemical indexes and their changing trends; Dealing with complicated calculation of dietary nutrient intake and nutritional catering; According to the principle of exercise, diet and balance, provide patients with personalized exercise and diet analysis prescriptions to ensure that the risk factors of residents are reduced by more than 50%.
3. Strengthen publicity, education and training, strive to improve the awareness rate and compliance of health knowledge of the managed personnel, and improve the professional knowledge, business management level and attention of the doctors in charge of prevention and treatment in community health service centers, so as to improve the registration management rate of community patients.
4. Feedback the work in time, correct the problems in time, and improve the management quality.
Second, the health management implementation plan
(1) hold a symposium on 20XX work development and a symposium on 201/residents' health management in February and March of 20XX, arrange the tasks for one year, and take corresponding measures according to local conditions to improve the filing rate of health records of permanent residents;
(2) Carry out health management training in the new district in 20XX, and invite experts from the Center for Chronic Disease Prevention and Control to carry out professional and business knowledge training in March and April in 20xx;
(3) Carry out the supervision work in the second and third quarters, check the progress of the work every quarter, point out the shortcomings in the work in time, provide technical support and make corrections within a time limit;
(4) Collect the comprehensive prevention and control opinions of the health management expert group in the new district, make different publicity materials, and flexibly publicize them with the health room of the new district management committee through posters, leaflets, text messages, etc., so as to improve the awareness rate of residents' health knowledge and the formation rate of health behaviors;
(5) Carry out year-end work inspection and appraisal activities, and carry out year-end inspection of health management from 20XX 10 to 12;
(6) Carry out publicity day activities, jointly organize two general hospitals and their affiliated community health service centers in February 20XX, and conduct publicity through on-site free clinics and the use of multimedia to improve residents' awareness rate and create a good atmosphere for prevention and control;
(7) Accept the inspection and supervision of the superior leadership department and report the data.
Third, the implementation summary:
1) Based on the annual physical examination data, a unified questionnaire was designed to investigate personal living habits, behavior patterns, psychological factors and family history, and an electronic health record was established to form a unified investigation database.
2) Regular publicity to improve the formation rate of health awareness and health behavior of clients.
3) According to the classification results of health assessment, different guiding measures are taken for different groups of people.
4) Evaluate various health combinations according to the comprehensive results of the effect evaluation, find the most suitable health guidance combination, and implement it widely.