There are two sentences like this, the first sentence, the masses are voting for the service with their feet, the service is done well, the masses trust, and the trust is willing to come; the second sentence, the advantages in transportation are often the disadvantages of health services, the service is not good, and it is empty talk to want to retain patients. As a township health director, my colleagues and I have a particularly deep understanding of these two sentences.
In recent years, we have firmly grasped the two main lines of service capacity improvement and medical community construction, and have achieved certain results by taking multiple strategies at the same time, letting service capabilities speak, and leaving patients at the grass-roots level. According to statistics, from 2017 to 2021, two-thirds of the patients in the town will no longer go to the large hospital outside the region and stay in the Cijian Health Center for treatment, so that the people can "afford to see the disease and cure the disease" at the doorstep of their homes, and on the road of ensuring the health of residents and helping rural revitalization, they have won the trust and praise of the masses.
First, hardware and software are grasped at both hands, and the service capacity is greatly improved
In order to improve the service capacity of the grass-roots level and improve the quality of service, according to the requirements of the county health commission, the health center has solidly carried out the activity of "improving the service capacity of the township health center" from the two aspects of hardware improvement and software improvement.
In terms of hardware upgrading, 1, the outpatient clinic, medical technology complex building and ward building hall, corridor, medical office, treatment room, bathroom decoration and transformation, operating room according to the standard planning and upgrading, outpatient department and ward standardized decoration, replacement of curtains, new beds, bedding, installation of TELEVISION, free WIFI, etc. 2. Strive for the support of the superiors to equip the health center with 32 rows of spiral CT, DR, color ultrasound, C-arm machine, 800-speed automatic biochemistry and gastroscope, which are equipped to provide a higher level of medical examination services for the people in the town. 3. Set up a centralized oxygen supply center, install a 500KV transformer, and replace all the power grid lines in the hospital to ensure the normal operation of various medical equipment.
Software improvement: 1, mainly to the training of characteristic specialist talents, strengthen the intensity of talent training, send business backbones to provincial and municipal hospitals for further study every year, introduce talents, and lay a solid foundation for the level of hospital diagnosis and treatment and long-term development. 2. Implement 6S fine management, require employees to start from small things, cohesion, so that "everyone picks a thousand pounds of heavy burdens, and everyone has indicators on their shoulders", requires the department to sort out and rectify the environment, standardize the placement of goods, cultivate everyone's good habits, and continuously improve their quality; requires the staff of the hospital to ensure work safety, equipment safety and personal safety. So as to create a civilized, clean, orderly, efficient and safe working environment and humanistic environment, to create a clean, tidy, safe and comfortable medical environment for patients.
Second, with the help of high-quality service grassroots activities, promote the standardized development of health centers
In the "quality service grassroots line" activity carried out by the National Health Commission, we carefully organized, around the grade review clauses and standards, compared to find their own "short boards", through the improvement of service capabilities, built a new type of grass-roots medical institutions service system of "sufficient supply, environmental beauty, excellent service, up-down connection, information communication, medical prevention and integration". In 2020, it has been reviewed by the consistency evaluation of experts in provinces, cities and counties, and has reached the recommended standards.
Third, guide the masses to seek medical treatment reasonably, and solidly promote the construction of the medical community
In October 2019, since becoming a member unit of the medical community of Xin'an County People's Hospital, we have strictly implemented the work issued by the superiors, formulated and improved the feasible measures applicable to the health center to promote the work of the medical community, incorporated the work of the medical community in the performance appraisal of the department and individual, and taken a variety of effective measures to guide the masses to seek medical treatment reasonably, providing a strong guarantee for the smooth development of the work of the medical community.
1. Conscientiously implement the first diagnosis at the grass-roots level and increase the medical treatment rate within the county. First, pay attention to statistical analysis of data. The health center arranged special personnel to conduct statistical analysis of the outpatients, inpatients, inpatients in the county and outside the county through 10 aspects of the town residents in the month, so as to provide reliable information support for the control of external transfer, so as to achieve targeted treatment, more accurate, and more effective measures. The second is the people-centered service concept that runs through the work. The health center adopts the service mode of leading the package, the backbone of the hospital business, the village and the package household, enters the village every month, visits all inpatients or their families, measures blood pressure and blood sugar for them free of charge, publicizes the knowledge of chronic disease prevention and treatment, promotes knee talks, closes the distance, gains trust, and finally reaches the jurisdiction of the masses as long as there is a medical need, they will get in touch with the bao village personnel, help solve problems, provide convenient services, and firmly grasp this part of the resources in the hands of the staff of our hospital, and precipitate to them for a long time. Let the masses gradually change their medical habits, seek medical treatment in an orderly manner, and implement hierarchical diagnosis and treatment. The third is to do a solid job in follow-up work. In hospitalized patients in health centers, the competent doctors established WeChat groups to follow up, guide medication, carry out health knowledge education and other services, and from January 2017 to December 2021, 17413 discharged patients were returned, with a return visit rate of 99.2%. For patients hospitalized in other hospitals from January 2020 to December 2021, follow up by telephone to understand the reasons for their hospitalization outside the county, find out the shortcomings in the work, catch up, and do a good job of health intervention to improve the satisfaction of the masses. Fourth, effectively reduce the burden of medical treatment on the masses, so that the masses can really get benefits. At present, the proportion of drugs in the hospital is 23.5%, which is 10.5% lower than that in 2017; the proportion of national essential drug varieties is 66.53%, the average hospital stay is 6.8 days, and the average medical insurance reimbursement ratio of insured patients receiving treatment is 85.58%.
2. Implement policies related to two-way referral and acute and slow treatment. The health center conscientiously implements the relevant policies issued by the county medical community, actively publicizes the service capacity of the 18 business centers of the medical community, and guides the county to seek medical treatment. In the past two years, a total of 176 patients have been transferred to the county hospital through the health center, and 27 patients have been transferred from the county hospital; in 2019, the medical treatment rate in the county has reached 63.3%, and in 2021, the county treatment rate has reached 77.8%, which can be seen that the two-way referral and graded diagnosis and treatment policy has achieved remarkable results; to a large extent, the phenomenon of patients pouring into the municipal hospital has been reduced, ensuring the rational use of medical resources, and shortening the time limit for acute and critical patients, so that they can get the most effective treatment in the shortest time. At the same time, the health center has set up 6 lower transfer wards to provide high-quality primary medical services for patients who have been transferred down.
3. Give full play to the role of informatization. Relying on the talent and technical advantages of Xin'an County-level Hospital, we will actively integrate various businesses into the 18 major centers of county medical donors, make full use of newly purchased medical equipment to carry out new inspection projects, and upload relevant image data to the Xin'an County Medical Community Heart Movie Diagnosis Center. As of the end of December 2021, 6,027 CT examinations, more than 10,000 DR examinations, and more than 10,000 ECG examinations have been examined, and the diagnostic results have been uniformly issued by the center to achieve unified diagnosis and mutual recognition of inspection results, which has solved the limited level of medical technology in grass-roots health centers, reduced the misdiagnosis rate and missed diagnosis rate of grass-roots hospitals, and shortened the time for patients to confirm their diseases.
(The author is the president of The Health Center of Cijian Town, Xin'an County; the text is arranged by Liu Yongsheng and Guo Huandu)