Repeated registration and queuing every day! The patient roast that he was "too bored", and he was transfused for 6 consecutive days to treat pneumonia

"Pneumonia is a disease that cannot be cured by intravenous therapy in a day. Why not prescribe multiple days of intravenous therapy at once, instead insisting that patients repeatedly register and queue up for treatment every day?"

During this period, Shencheng is in a season of high incidence of respiratory diseases such as Mycoplasma pneumonia, H1N1 and H1N1. Children are also a vulnerable group, and many children's hospitals in Shencheng are currently at a peak of seeking medical treatment. On many interactive platforms, many parents have mentioned the same distress: hospitals only provide one day's infusion volume at a time, and when children need continuous infusion treatment for multiple days, they have to re register for medical treatment every day, often facing long queues. Parents are complaining that this is time-consuming and laborious, and it also increases the burden on medical resources.

The practice of only prescribing one day of medication for intravenous infusion has been implemented in Shencheng for many years, and it is not the first time that it has been questioned due to "trouble". However, in recent years, multiple hospitals have implemented a series of measures to slow down the queuing time of infusion patients. Now there are doubts again, have those good measures failed?

I went to the hospital at noon and only hung water for dinner

Ms. Qian from Minhang District reported her experience to "12345". In late August, her child suddenly had a high fever. After diagnosis and treatment at the Affiliated Pediatric Hospital of Fudan University, she was diagnosed with Mycoplasma pneumonia, which was complicated by viral infection. She needed to use combination medication and receive continuous infusion treatment. Ms. Qian recalled that when she first visited the clinic on August 26th, she registered as a fever clinic, and had to wait for a lot of time for consultations, blood tests, and other procedures, which was unavoidable. But on that day, the doctor only prescribed the infusion volume for one day and instructed her to take the child to the outpatient clinic for follow-up the next day, and then ask the doctor to prescribe the infusion again. When she learned that the next day she would have to register again for medical treatment before she could inject liquid, Ms. Qian immediately opened her mobile phone and entered the official account of the pediatric hospital. She found that the number of the internal medicine department and respiratory department online on August 27 had already shown "full appointment", so she had to register at the hospital the next day.

The infusion department of Fudan University Affiliated Pediatric Hospital. At around noon on August 27th, Ms. Qian brought her child to the pediatric hospital for a follow-up infusion as requested by the doctor. She thought there would be fewer people in the afternoon, but unexpectedly, she hung up and realized that there were nearly 40 waiting numbers ahead. On that day, she and her child waited until 4 pm to see a doctor and receive an infusion order. Ms. Qian said that the infusion still needs to queue up, and by the time they receive it, it's already dinner time. She and her child are already exhausted.

"A total of 6 days of intravenous infusion, with repeated registration and queuing every day..." Ms. Qian said, and in the following days, she changed to watching the "night clinic" at night. Although there are fewer patients at night and less waiting time in line, she still expressed dissatisfaction, "Repeatedly queuing is a waste of time."

There are many similar complaints. Ms. Zhang's twin daughters have been infected with H1N1 fever and have encountered the dilemma of repeated registration and queuing during intravenous therapy at the Children's Medical Center. According to her, the twin sister started to have a fever on August 24th, and on the 25th, she took her sister to the children's medical center for her first visit. On the morning of August 26th, she took her child to the hospital for a second infusion. She had planned to go to the emergency department faster, but the pre examination desk arranged for them to go to the outpatient department. After registering, she realized that she had to wait for more than 480 appointments. "It's almost midnight when the water is hung up," Ms. Zhang had no choice but to spend 316 yuan to hang up a special account, saving queuing time

It's not just that children may encounter this problem during intravenous therapy. Ms. Wan, a citizen, also faced the "rule" of only requiring one day of intravenous treatment at the Baoshan Branch of Huashan Hospital due to lymphatic inflammation. She had to go to the hospital every day to repeat the process of registering for emergency treatment and queuing up for treatment. According to her, when she went to the hospital from work at 3 pm every day, she usually had to struggle until 9 pm to finish drinking water and return home. "I'm already feeling unwell, and I have to repeatedly toss and turn every day. It's too inhumane!"

"One infusion per day" has actually been implemented for a long time

In the reflection, the citizens all raised the same doubts. Ms. Qian said, "Pneumonia usually requires intravenous infusion for 5 to 10 days to cure. Why can't we prescribe an additional two days of infusion at a time?" Ms. Wan also said, "When the first treatment is given, the doctor determines that I need intravenous infusion for 3 to 4 days based on the blood routine test report. If that's the case, why can't I prescribe intravenous infusion for a full 3 days at once?" They believe that the treatment cycle for some diseases is long and multiple infusions are difficult to avoid. Hospitals can completely prescribe intravenous infusion for 3 days at a time, allowing patients to receive intravenous infusion directly based on the certificate. Isn't this greatly convenient for patients?

According to the reporter's understanding, there was indeed a practice of prescribing a three-day infusion dosage in the past, but some hospitals have changed to implementing the "one infusion per day" policy as early as 2010. Why is it limited to "one infusion per day"? The hospital provided an explanation. On the afternoon of September 4th, a nurse from the internal medicine outpatient department of the Children's Medical Center stated that the child's physical condition is weak and changes rapidly. Doctors need to take a look to determine the condition and then decide whether to continue infusion treatment. "It seems to have increased the patient's trouble, but this is for the safety of the child.". At "12345", the health administrative department also responded to citizens, stating that "one infusion per day is to enable doctors to monitor the patient's condition in real-time and consider whether to change the treatment plan based on changes." "In addition to safety considerations, it is also to avoid the abuse of antibiotics.".

But objectively speaking, during the current peak of medical visits, "one infusion per day" will indeed bring a considerable queuing burden to patients. On the afternoon of September 4th, before 5:00 pm, the reporter saw in the "Internal Medicine Outpatient Department 2" on the 2nd floor of the Children's Medical Center outpatient building that although the afternoon diagnosis and treatment was nearing its end, the waiting hall was still crowded with many people. The patient has already received a night clinic number starting with "8", and two consultation rooms are starting to receive night clinic patients. A father anxiously asked the on duty nurse for the estimated waiting time, and learned from him that the child needed to wait for the doctor to issue an order for infusion. However, the on duty nurse said there were still 17 numbers ahead, and he estimated that he would have to wait for more than an hour.

On September 4th, before 5pm, although the afternoon diagnosis and treatment was nearing its end, the waiting hall of "Internal Medicine Outpatient Department 2" on the second floor of the outpatient building of the Children's Medical Center was still crowded with many people. At around 9 a.m. on September 5th, the reporter returned to the pediatric hospital. Outside the consultation room in the internal medicine consultation area of Outpatient Building 2, there are crowds of waiting parents and children. According to the official account, only 10:30 to 11:00 am is left for the general outpatient number of internal medicine in the morning to make an appointment for registration, and the respiratory department is full all day. If you cannot "grab" an earlier time slot through your phone in advance, temporary registration will face an extremely long queue waiting time: a newly registered parent swipes their card on the check-in machine and shows that the waiting number has exceeded 50 people

At around 9:00 am on September 5th, outside the consultation room of the internal medicine consultation area in outpatient building 2 of the pediatric hospital, parents and children waiting for treatment were crowded.

A newly registered parent swiped their card on the check-in machine and found that there were 53 people waiting. "After waiting in line for one or two hours, the doctor verbally asked a few questions, such as' Has the cough improved? 'or' Has the fever subsided? 'Then she prescribed the same infusion as the previous day." Ms. Zhang believes that although it was for safety reasons, it is different from the initial diagnosis, which makes patients feel that waiting in line for a long time is not worth it.

Optimize the medical process for infusion patients

Is there a way to balance the efficiency of medical treatment for patients who require continuous infusion therapy, while ensuring safety with "one infusion per day"? Many patients have also provided suggestions, such as Ms. Zhang, a citizen, suggesting that hospitals set up a dedicated consultation room for infusion patients, specifically to verify the patient's condition and issue infusion forms, which can save the waiting time for infusion patients and alleviate the queuing burden of normal patients.

According to the reporter's understanding, some hospitals have taken some measures to address the issue of excessive time and burden of intravenous follow-up consultations reported by citizens. A hospital's pediatrics department has a duty doctor in the infusion room, who performs a second physical examination and diagnosis on the spot for the children who have completed the infusion to determine whether they need to continue infusion. If the condition does require it, they will issue a "follow-up clinic" form and ask parents to register separately at the follow-up clinic the next day. However, follow-up clinics set up in the pediatric emergency department rarely require queuing; Some hospitals have set up separate "fluid replacement clinics" to provide convenience for fluid replacement patients.

But the reporter recently inquired with the above-mentioned hospitals and confirmed that these measures have now been cancelled. It is understood that the main reason for the cancellation of these measures is the comprehensive implementation of the appointment and registration system. Hospitals believe that patients can effectively shorten waiting time by choosing a time slot for appointment and registration; On the other hand, some pediatric specialty hospitals believe that subdividing departments in recent years can effectively divert patients.

However, the reporter learned from several citizens that, taking pediatric hospitals and children's medical centers as examples, their appointment registration systems support advance appointments for multiple days, which often leads to a shortage of number sources during peak medical visits. Just like the experience of Ms. Qian, a citizen, she had to make an appointment one day in advance and had to go to the hospital to register on the same day. On the afternoon of September 5th, when the reporter attempted to make an appointment for the pediatric department at the Children's Medical Center on September 6th, the page showed that the appointment was "fully booked" in the morning and afternoon. Therefore, relying on appointment registration cannot completely solve the queuing difficulties of follow-up infusion patients.

On the afternoon of September 5th, when the reporter attempted to make an appointment for the pediatric department at the Children's Medical Center on September 6th, the page showed that the appointment was "fully booked" in the morning and afternoon. The reporter learned from multiple sources that the "pre examination grading management" approach adopted by children's hospitals is worth learning from. According to the Children's Hospital, an orderly pre diagnosis and triage system has been established in the emergency room for zoning management. With the help of 5-level triage technology and early warning scores for children, the hospital classifies the large number of emergency patients, and follow-up fluid replacement patients are individually evaluated as "D-level children" when their vital signs are stable. It is reported that patients at all levels queue up separately and have relatively fixed doctors for diagnosis and treatment, thereby further improving the efficiency and quality of emergency treatment. While ensuring medical safety, it also optimizes the allocation of medical resources, shortens the waiting time and hospital stay of patients and their families.

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