Improving medical services is the orientation of people's livelihood, the requirement of medical reform and the basic duty of medical institutions. In recent years, Shanghai has always regarded improving medical services as an important livelihood project, an important measure to promote medical reform and an important part of industry management, and has made some progress. The relevant information is hereby notified as follows:
One is problem-oriented, improving the medical service process.
At the beginning of the new medical reform in 2009, the Municipal Medical Reform Office organized the relevant departments of our city to carefully analyze the medical problems reflected by people's letters and visits, listen to the opinions and suggestions of NPC deputies, CPPCC members and the people on medical services, * * * sort out the outstanding problems reflected by the masses 14, and conduct in-depth research on this basis and take targeted measures. The first is to promote the appointment of medical services. Establish an appointment service platform for medical associations, covering 38 tertiary hospitals, with an annual appointment volume of more than 65438+10 million; A two-way referral booking platform for family doctors has been established, through which patients can directly make appointments for expert clinics in higher medical institutions. At present, it has been piloted in 65 community health service centers. The second is to implement the "one-stop clinic" payment model. Covering 38 tertiary public hospitals, 27 inter-hospital clinics realized self-service stored value payment for inter-hospital and inter-bank deposits and withdrawals, and the average queue number of patients decreased by 2.8 times, and the average waiting time was shortened by 60 minutes. The third is to implement a self-service system. Self-service services such as self-service registration, self-service reservation, self-service recharge, self-service charging and self-service information inquiry were carried out. 80% of the second-class medical institutions and 98% of the third-class medical institutions in the city have carried out outpatient self-service. The fourth is to implement integrated outpatient service for special diseases. Solve the problem of patients running back and forth between specialties through multi-specialty cooperation in the hospital. At present, 24 municipal hospitals have opened 1 17 comprehensive outpatient clinics, and 229 participating departments have served 38,000 patients annually. The fifth is to carry out day surgery. Focus on process reengineering, improve and innovate the centralized management mode of day surgery, and seamlessly connect outpatient consultation, condition evaluation, admission surgery, discharge follow-up and other links. At present, it has been carried out in 28 municipal hospitals, and the number of operations has reached 82,200.
Second, pay attention to humanistic care and innovate the medical service model
The first is to carry out the theme activities of civilized service. Since 20 12, the theme activity of "caring for patients, starting with details" has been carried out. 20 13 introduced ten detailed measures such as "warm environment, warm service, warm inspection and warm reminder"; , continue to refine ten measures that focus on humanistic care, software construction and detailed service, such as "humanistic environment, psychological counseling and emotional comfort". The implementation rate of various detailed measures reached more than 90%, which improved the patient's medical experience. The second is to promote medical social workers and volunteer services. Actively explore and introduce social forces to participate in improving medical services and achieve "five firsts": setting up a medical social work department in the first medical institution; Established the first provincial medical social worker academic organization; Formulated the first government document to promote the construction of medical social workers' talent team; Compiled and printed the first practical training manual for hospital volunteers; The first sign language training manual for hospital volunteers was compiled. At present, there are 152 units in the city to carry out medical social work on a pilot basis, with more than 50,000 medical volunteers providing medical guidance, communication, visits, psychological counseling and other services to nearly 8 million patients.
Third, improve the medical service experience with the support of informatization.
The first is to promote the information sharing mechanism. Since 2006, the "medical association project" has been built. At present, four major systems, namely, hospital information system, medical imaging system, laboratory information system and clinical information system, have been built, which are connected with 38 tertiary hospitals across 8 administrative regions. Doctors can check the patient's past medical history, outpatient records, medication records and image data in networked hospitals in real time through the patient's medical card, so as to reduce repeated examinations. The second is to promote the use of new media. Hospitals use modern information network technology and new media platforms to provide various services, such as establishing a hospital micro-official website, and opening special functions such as "expert appointment", "online registration", "three-dimensional guidance", "waiting in line" and "report inquiry" on WeChat to facilitate patients to seek medical treatment.
Fourth, build a harmonious doctor-patient relationship based on patients' rights and interests.
First, vigorously promote the people's mediation system for doctor-patient disputes. Formulate the municipal government regulations "Measures for the Prevention and Mediation of Doctor-patient Disputes in Shanghai", set up people's mediation offices and people's mediation committees for doctor-patient disputes in 17 districts and counties, with 140 people's mediators, and establish 922 consulting expert databases covering medical, legal and psychological professions. * * * 3,408 disputes were accepted and 2,830 cases were successfully mediated. People's mediation has become the main channel to solve disputes between doctors and patients. The second is to actively explore the implementation of the third-party notification system for inpatients. Through the introduction of third-party personnel who do not involve both doctors and patients, we can inform relevant systems and norms such as medical services, medical insurance, medical charges, and medical rights protection. The communication platform between doctors and patients will be improved. At present, 468 cases of third-party notification have been completed, and the patients' understanding of relevant systems has reached more than 90%. The third is to establish a joint working mechanism of health insurance. Since 20 1 1, the medical insurance department of United City has set up a joint complaint office for health and medical insurance, and opened a joint complaint telephone number for health and medical insurance, focusing on accepting and solving four hot complaints, such as limiting the amount of drugs used in outpatient clinics, not distributing medical insurance drugs, limiting hospitalization days (fake discharge), and decomposing charges by CT or MRI. Up to now, more than 10000 calls have been received, and specific problems reflected by the masses have been solved 133 1 call.
Fifth, take supervision and evaluation as the starting point to promote the implementation of various measures.
First, it is included in the hospital evaluation index system. The improvement of medical services will be included in the hospital grade evaluation and comprehensive evaluation index system of public hospitals, and the evaluation results will serve as an important basis for financial investment and dean's performance evaluation. The second is to be included in the assessment category of civilized units. The implementation of humanized detailed services and measures to facilitate the people and benefit the people is an important indicator for the assessment of civilized units in the city's health system. The third is to incorporate various special inspections. Combined with medical quality, three good and one satisfaction, quality control inspection and other special inspections, urge medical institutions to implement various service measures.
Dear leaders and colleagues, although Shanghai has done some work in improving medical services, it is still far from the expectations of the masses. The National Health and Family Planning Commission's Action Plan for Further Improving Medical Services further clarified the objectives and pointed out the direction for us to promote this work. In the next step, we will conscientiously implement the spirit of this meeting in accordance with the requirements of the Action Plan, actively learn from the advanced experience of brother provinces and cities, and ensure that all measures to improve medical services are put in place.
2, to further improve the medical service action plan summary model.
According to the requirements of our hospital's Work Plan for Further Improving Medical Service Action Plan, since September, the whole hospital has entered the third stage of "Improving Medical Service Action", that is, the supervision and rectification stage, and mainly carried out the following work.
First, strengthen special inspections and further promote actions to improve medical services.
In order to further promote the action of improving medical services, our hospital has organized a "special inspection of improving medical services" since September 1. Every week, a hospital leader takes the lead, and the staff of some functional departments conduct a comprehensive inspection of the hospital's medical service quality, diagnosis and treatment process, environmental facilities, etc. through field visits, interviews with medical staff, patients and their families, etc. based on the principle of "convenient for patients and convenient for outpatient service". If it is inconvenient for patients to see a doctor and affects the work efficiency of clinical departments, they can be rectified on the spot, and the responsible departments should be clearly defined and rectified immediately. Other issues shall be submitted to the dean's office for discussion, and the rectification measures and responsible departments shall be defined, and rectification shall be made within a time limit. Inspectors are responsible for tracking and verifying the rectification, and reporting it at the dean's office meeting. The highlights found in the inspection shall be reported and praised by the whole hospital, and the sustainable and reproducible highlights shall be promoted in the whole hospital. As of September 26th, * * * has carried out four rounds of "special inspection", and found more than one key problem 10 and 30 problems 130, involving medical safety, diagnosis and treatment process, information construction, medical insurance management and logistics support. There are more than 60 on-site rectification problems, and other problems are being tracked and verified.
The second is to extend service measures to improve patients' medical experience.
1. Develop an "oral medication SMS reminder system" to guide patients in medication. The hospital information department and pharmacy department jointly developed the "SMS reminder system for oral drugs". When the outpatient doctor opens his mouth to take medicine, the information system can automatically send the medication precautions to the patient's mobile phone by SMS, which further ensures the patient's medication safety.
2. Use the "doctor-patient communication board" to "listen" to the patient's voice. In order to better understand the needs and wishes of patients with language disorders, the nursing team of rehabilitation department actively explored new communication methods and made a "doctor-patient communication board". The communication board uses simple pictures and words to show daily needs such as eating, drinking, pain, defecation and homesickness. Patients with language disorders can express their needs by pointing to relevant pictures, so that medical staff and their families can understand their voices. At present, "doctor-patient communication board" has been widely used in intensive care unit, neurology department, neurosurgery department and thrombosis department, and has been well received by patients and their families.
3. Organize community health education activities to improve people's ability to prevent and treat diseases. The Department of Thrombology of our hospital went deep into community health institutions, held five times of "Thrombosis Health Education and Community Free Clinic Activities", received more than 300 patients, distributed more than 300 publicity materials, and reached an agreement with the community to send experts to the community for free clinic at a fixed time every week. Our hospital also held a lecture on diabetes health education in autumn. Medical staff explained insulin therapy, the relationship between diabetes and fatty liver, autumn nursing and other knowledge to diabetic patients in a simple way, and deepened their understanding of diabetes by playing small videos, PPT, questions and answers and other forms. After the activity, we also measured the bone mineral density, blood sugar and blood pressure for sugar friends for free. Through a series of health education and free clinic activities, patients and their families have deepened their understanding of diseases and further enhanced their ability to prevent and treat diseases.
Third, develop rehabilitation management information system to help rehabilitation patients recover scientifically.
The information department and rehabilitation department of our hospital jointly developed the rehabilitation management information system. Through this system, the patient's condition and treatment effect can be evaluated, and the queuing of rehabilitation treatment and the statistics of treatment workload can be realized, which basically covers the whole process of rehabilitation treatment for patients. Since the system was put into use, patients can inquire about their therapists and treatment time in the ward, which shortens the waiting time, ensures the orderly progress of various rehabilitation treatments and achieves obvious results. Nursing staff in rehabilitation department also produced many health education videos according to patients' needs, including department propaganda, fire warning, bed fall prevention, limb rehabilitation exercises, turn-over training, etc., which were scrolled on the display screens of rehabilitation halls and wards, increasing the rehabilitation knowledge of patients and their families.
Fourth, serve people's health, carry out free clinic activities and send love to the countryside.
On September 18-19, our hospital organized an expert medical team of *** 17 people, led by the vice president, and went to Laochiyu, Xiangshan Qian, Huaguoyu and other villages in Pingyi County, Linyi City for free clinic. The experts of the medical team have face-to-face contact with the local people, have zero-distance communication, and carefully ask for advice, check, prescribe drugs, guide the use of drugs, and answer questions. The free clinic activity * * * received 569 patients, ECG examination 170, B-ultrasound examination 150, blood pressure and blood sugar examination for 355 times, distributed 78 medicines, distributed more than 600 health education manuals on the spot, and delivered health knowledge and medical services to people's homes, which was widely praised by local people.
Five, strengthen personnel training, improve the comprehensive ability of medical staff.
In order to further improve employees' comprehensive ability, the hospital organized a series of training activities, including medical humanities education, bedside comprehensive ability training and assessment of nurses, ECG knowledge training, core medical system training for new employees, etc., and invited psychological counselors to carry out group counseling activities for nurses' mental health with the theme of "caring for health and building a station agent". Through the above-mentioned training and psychological counseling activities, the comprehensive ability of medical staff in communication service and business technology has been improved, which has provided them with opportunities to effectively release pressure, enhanced mutual trust and enhanced team awareness. In addition to strengthening professional ability training, the hospital also plans to incorporate health education, doctor-patient communication and psychological consultation into routine work for sustainable development, and further improve the service level and ability of medical staff.
The next work arrangement of intransitive verbs
"Action to improve medical services" is a long-term systematic project. Our hospital will innovate service measures in strict accordance with the work requirements of the national and provincial health planning commission and combine the actual situation of the hospital to continuously improve medical service behavior. Do a good job in promoting the good practices and work patterns found in the work and solidify them through the system; For the problems found, we should rectify them in time as required, effectively improve the quality of hospital medical services, and create a service brand of "satisfaction lies in medical care".