Strengthening the quality management of county hospitals and promoting the long-term sustainable development of hospitals

Beijing, October 20, in order to further improve the quality of hospital management and enhance the comprehensive capacity of county-level hospitals, under the guidance of the medical administration bureau of the National Health Commission, sponsored by the Hospital Management Institute of the National Health Commission and supported by Pfizer, the latest phase of “county level public hospital hospital management and clinical key specialty capacity building project” was launched Hospital management training course was held recently. < p > < p > it is understood that the “county level public hospital hospital management and clinical key specialty capacity building” project was officially launched in August 2015, aiming to strengthen hospital management, enhance the linkage between the upper and lower levels, improve the service capacity, and comprehensively improve the comprehensive capacity of county-level hospitals. < / P > < p > the training meeting was launched with the theme of hospital quality tracking method. In terms of quality management, the head of Xudong hospital said that the quality management of each hospital and its regional hospital management department should have a clear idea on the development of quality and technology. At the same time, the state will strive for more support for the development of hospitals. ” Zhang Xudong, deputy director of the Hospital Management Research Institute of the National Health Commission, pointed out that “the policy of strengthening the grassroots level” of the medical reform needs the county hospitals to carry out the major task and improve the “soft power” of the development of management talents. After five years of promotion and practice, the project has effectively improved the management capacity, technical level and service capacity of county-level medical institutions in China, and promoted the long-term sustainable development of county-level public hospitals. ” During the two-day training meeting, many experts systematically introduced the quality tracking inspection methods from the aspects of management, medical treatment, pharmaceutical affairs, nursing, hospital feeling, etc. More than 150 county-level hospital managers from 65 hospitals in 11 provinces including Hubei, Shanghai, Liaoning, Jilin, Gansu, Heilongjiang, Zhejiang, Shanxi, Guizhou, Anhui and Shandong attended the training meeting. Chen Xiaohong, director of the evaluation and Evaluation Research Department of the Hospital Management Institute of the National Health Commission, said in an interview with Xinhuanet, “in 2011, the Interim Measures for hospital evaluation proposed that” evaluation should promote reform, and evaluation should promote construction. “. To promote reform by evaluation, the hospital must first find out the problems before correcting the deficiencies. Therefore, we need to use the evaluation method to track the quality, find the potential systematic loopholes and shortcomings of hospital management, so as to make the hospital have the desire to solve problems, actively improve, and establish a closed-loop security system with interlocking links and precise operation It is understood that hospital accreditation is one of the important means of hospital management in the world, which focuses on the survival and development, safety and quality of the hospital. Chen Xiaohong pointed out that “modern hospital management must open the door, find problems and prevent them in the bud. Once the hospital has closed itself up, it can’t grow again, because you can’t accept the energy from outside people. ” How to find problems in evaluation? In the Interim Measures for hospital evaluation, it is mentioned that hospitals should be periodically evaluated through written evaluation, statistical evaluation of medical information, on-site evaluation and social evaluation. < p > < p > modern hospitals have a large amount of big data. Chen Xiaohong introduced the statistical evaluation of medical information by taking the average length of hospital stay as an example. “Average length of stay is an indicator of national performance appraisal,” she said. Reviewers will use this indicator as a starting point to track and find problems. Why is the average length of hospital stay so long? Is it management or technology? The reviewers understand the problems in the overall operation of the hospital through big data of information statistics, such as too long waiting time for examination after admission, too long waiting time for surgery, and inability to discharge due to postoperative complications. Through tracking, we can see whether the hospital is running smoothly and scientifically, and then put forward adjustment suggestions < / P > < p > What does shortening the average length of stay mean for a hospital? Chen Xiaohong introduced that if the hospital has 2000 beds and the average length of stay is shortened by half, then the utilization efficiency of hospital beds will be doubled, increasing 2000 beds than before, reducing the desire of hospital expansion, leaving more resources to be applied to improving efficiency, and the development mode will change from scale expansion to quality benefit. If the average length of stay is too low to meet the needs of patients, then we can calculate the number of beds that need to be increased. In this way, from experience management to scientific management, we can promote the “three changes and three improvements” of the hospital with practical actions. < / P > < p > in daily work, hospital quality management is not only a problem that managers have to face. Chen Xiaohong believes that only through the implementation of modern hospital quality management with full participation, can the hospital step onto the road of modern hospital management through evaluation. She summed up four points: first, the concept change: from asking me to comment; second, implementing the system: from asking me to do what I want to do; third, positive change: from passively accepting the management of departments to actively participating in management; fourth, the change of leadership style: from a small number of leaders busy meeting and commenting, to everyone taking charge of heavy burden and safety and quality management. < / P > < p > “practice has proved that the use of management tools is an effective method of hospital management, it can improve the management methods, so that all people in the hospital can participate. For example, PDCA cycles, namely plan, do, check, and action. In quality management activities, we should set up a quality continuous improvement team to solve problems. This group can not only break the administrative barriers, but also increase the number of participants. ” Chen Xiaohong gave an example. In three years, Zhejiang Provincial People’s hospital has formed more than 1200 continuous improvement groups and solved more than 1200 problems, which means that even if there are ten people in each group, tens of thousands of employees will participate in the problem solving and management of the hospital. This not only improves the technical level, but also improves the management ability to achieve the purpose of evaluation. As a trainee of this training course, Yang Huiying, vice president of Taihe people’s Hospital of Anhui Province, also introduced some practices of using PDCA cycle in Taihe County People’s Hospital in an interview with Xinhua. “Our hospital has a quality management department. In addition to the monthly performance appraisal, each functional department will also conduct a major inspection of medical quality management every quarter. In this big inspection, we will supervise and feed back the problems existing in the inspection of each functional department. In the later stage, all functional departments will focus on these problems, and then go to see the rectification of clinical departments Continue to improve, which is a PDCA cycle. ” < p > < p > for this training, Yang Huiying gained a lot. She said, “this training has brought me two inspirations: first, in addition to what we have done before, the hospital’s overall quality management can constantly find and find weaknesses and gaps through periodic self-evaluation, and then investigate the deficiencies in the implementation of the system. Second, in the future management, we should remove some stubborn diseases in the administrative management and break through the administrative barriers. For example, sometimes we may be in charge of our own affairs, which may lead to our own affairs. We need to broaden our horizons and form joint efforts with each other, so that we can work together to achieve win-win results. ” The prevention and control of nosocomial infection is an important part of hospital accreditation. Yang Huiying is not only a trainee, but also one of the lecturers of the training. She introduced the related contents of hospital management quality improvement from the perspective of hospital infection prevention and control in the training class. “Now it is autumn and winter. We should not only ensure the safety of daily diagnosis and treatment services, but also deal with the risks of influenza in autumn and winter, high incidence of respiratory diseases and rebound of epidemic situation. This requires the hospital to take the most stringent control measures to promote the quality improvement of hospital infection management Yang Huiying suggested that, first of all, at the leadership level, brainstorming method should be adopted to improve the prevention and control awareness of all hospital managers, strengthen the concept and strictly prevent and control. Let every department and every post of the hospital, especially the medical staff, strictly guard against and take the lead. < / P > < p > secondly, both the president and the functional departments should use the tracking evaluation method to continuously sort out each gate, sort out some loopholes, and check all the relevant processes of their own hospitals, so as to ensure that there is no dead end in the management and realize the whole process and seamless management. Thirdly, we should do three aspects: first, comprehensive health education. Whether outpatient patients or patients’ families, we should carry out all-round health education, using small radio or face-to-face dictation to publicize the importance of hygiene, washing hands frequently, ventilation, wearing masks, etc.; the second is the comprehensive medical guidance. The medical guidance and security personnel should play a guiding role to minimize the stay time of the personnel coming to the hospital in public places; the third is the comprehensive supervision of hospital infection prevention and control. It is required that the hospital infection personnel should walk in front of the hospital and carry out all-round supervision, so as to run through the hospital patients’ treatment from beginning to end. “In order to achieve the above three points, I think hospitals can take precautions in advance.” Yang Huiying said. < p > < p > after five years of promotion and practice, the “county in the air” project improves the comprehensive ability of the hospital, and then radiates the improvement of the county’s medical treatment ability, forming a point to area effect. Chen Xiaohong said that county hospitals are an important part of health care reform. Through the projects launched by the county, the first is to change the concept of county hospitals; the second is to guide the direction of scientific management of hospitals; the third is to train the methods of scientific management of hospitals; the fourth is to set an excellent example of county hospitals; the fifth is to promote the Presidents of county hospitals to build confidence. No matter how big or small, as long as they work hard, they will open up the road of scientific development. At the training meeting, Zhang Xudong also said, “we will continue to build a training platform. We hope that the hospital presidents and hospital managers at all levels who participate in the meeting will train a group of innovative and comprehensive management talents for county hospitals through training and learning, establish their own talent hematopoietic mechanism, and open up new ideas, methods and mechanisms for the development of county hospitals.”