Comprehensive improvement of medical quality, People's Daily: 28 measures and 5 special actions implemented over the past 3 years | Quality | Medical
The quality of medical care is directly related to public health and is an important theme for the development of the healthcare industry. The National Health Commission and the State Administration of Traditional Chinese Medicine recently jointly issued the Action Plan for Comprehensive Improvement of Medical Quality, proposing 28 specific measures and 5 special actions, including basic quality and safety management, key links and behavior management, quality management network, and other aspects. What are the key efforts to comprehensively improve medical quality? How to effectively improve the satisfaction of the public with medical services? The reporter conducted an interview on this.
Focusing on quality and safety——
Strengthen daily management of key links and areas
According to the action plan, medical institutions at or above the second level in China will carry out a comprehensive three-year action to improve medical quality.
"With the increasing demand for health among the people, the development of medical institutions has shifted from scale expansion to improving quality and efficiency, and the management and operation methods have also shifted from extensive management to refined management." Yang Yinmo, Dean of Peking University First Hospital, stated that this action plan proposes specific measures for some weak links in the field of medical quality and safety, especially strengthening daily management in key links and areas, which will further consolidate the foundation of quality and safety management.
Improve the quality of emergency care. Strengthen the seamless connection mechanism between pre hospital medical emergency and in hospital emergency, facilitate pre hospital medical emergency and in hospital emergency information, and improve the multidisciplinary collaborative treatment mechanism for critically ill patients, especially those with cardiovascular disease, multiple trauma, cardiac arrest, and other critical conditions.
Improve the quality of outpatient medical care. Strictly implement the first consultation responsibility system, strengthen the allocation of professional and technical personnel in outpatient and emergency departments, optimize the workflow of outpatient and emergency diagnosis and treatment, consult difficult outpatient cases, and provide multidisciplinary outpatient diagnosis and treatment services. Strengthen the quality and safety management of outpatient services such as surgery, chemotherapy, and infusion.
In terms of improving the quality of daytime medical care and ensuring the safety of surgical procedures, we will further improve the organizational system for daytime medical quality management, strengthen the management of daytime medical diseases and technologies, and strengthen the management of daytime medical departments and physician audits and authorizations; Comprehensively strengthen preoperative evaluation and anesthesia evaluation of surgical patients, implement preoperative discussion system, etc.
"The action plan emphasizes the strengthening of quality and safety management in emergency, outpatient, daytime, surgery, patient follow-up, and other aspects. It is executable and operable, and will further assist medical institutions in adhering to safety bottom lines and promoting high-quality development of public hospitals." Yang Yinmo said.
Patient centered——
Improve diagnostic and treatment capabilities and quality and safety levels
"The action plan embodies the patient-centered concept and ultimately aims to ensure the quality and safety of patient diagnosis and treatment." Ni Ruyang, Vice President of Beijing Elderly Hospital, said that according to the action plan, medical institutions should further break through traditional disciplinary divisions and professional barriers, explore the construction of specialized disease centers based on multidisciplinary cooperation, and provide one-stop services for major disease diagnosis and treatment for patients.
The multidisciplinary collaboration model can promote the formation of synergy among multiple departments, thereby improving clinical diagnosis and treatment efficiency. "Peking University First Hospital has established a multidisciplinary collaborative diagnosis and treatment team with multiple specialties and diseases." Yang Yin assumed that this service model is conducive to allowing patients to enjoy standardized and personalized treatment plans, avoiding insufficient and excessive treatment.
It is understood that the action plan has established five special actions: surgical quality and safety improvement action, "breaking the wall" action, medical record connotation quality improvement action, patient safety special action, and "weaving the web" action. Specific work requirements and goals have been put forward in five aspects: surgical quality and safety management, establishing a "disease chain" diagnosis and treatment model, medical record connotation quality, patient safety management, and quality control system construction.
"The five special actions will improve the connotation of medical quality and safety from different aspects." Ni Ruyang said, "This not only requires improving the refinement, scientificity, and standardization of medical quality and safety management, but also requires further optimizing the allocation of medical resources and service balance." According to the action plan, by the end of 2025, the goal is to achieve a significant decrease in the in-hospital mortality rate of surgical patients in tertiary hospitals nationwide, an increase in the national acute cerebral infarction reperfusion treatment rate to 45%, and a correct rate of the main diagnostic codes on the medical record homepage not less than 90%. ".
Strengthen quality control——
Further expand the scope of medical quality control work
The action plan proposes that the health administrative department should standardize the construction and management of the local medical quality control center, and the competent department of traditional Chinese medicine should strengthen the construction and establishment of traditional Chinese medicine quality control centers, further expand the coverage of quality control work, and extend some key professional quality control organizations to counties and districts.
"Medical quality control runs through the entire medical diagnosis and treatment process." Yang Yinmo said that with the development of information technology construction, China has the conditions to further improve the quality control system. This not only requires medical institutions to strengthen their own management, but also needs to strengthen guidance and standardization at the industry and regional levels to promote the systematic development of quality control work.
In terms of strengthening the quality control of traditional Chinese medicine, the action plan proposes that medical institutions should incorporate the application of traditional Chinese medicine medical technology and the rational use of traditional Chinese medicine into medical quality management. The competent departments of traditional Chinese medicine at all levels should strengthen the establishment and construction of quality control institutions for traditional Chinese medicine, and increase the revision and improvement of technical standards for traditional Chinese medicine diagnosis and treatment.
"In recent years, Mianyang has established a municipal medical quality control center for spleen and stomach diseases and a municipal medical quality control center for acupuncture and moxibustion and moxibustion", Zhang Ming, president of Mianyang Hospital of Traditional Chinese Medicine, said, "by strengthening training, guidance and supervision, we will further standardize the process of comprehensive treatment and diagnosis and treatment of traditional Chinese medicine, and improve the clinical efficacy of traditional Chinese medicine."
It is understood that by the end of 2025, China will establish no less than 60 national level quality control centers for specialties and no less than 10 national level quality control centers for traditional Chinese medicine specialties; No less than 1800 provincial-level quality control centers and no less than 300 provincial-level traditional Chinese medicine quality control centers; No less than 18000 prefecture level quality control centers and no less than 1800 prefecture level traditional Chinese medicine quality control centers. The quality control work will gradually cover the entire diagnosis and treatment population, including inpatients, daytime patients, and outpatient patients.
