Managing the pilot project in the clinical route has reaped something

Managing the pilot project in the clinical route has reaped something
At the end of last year, Ministry of Public Health starts the clinical route to manage the pilot project. Up till now, the clinical route of use is paid and made a diagnosis the behavior is managed and tried in 110 of third grade and second hospital in the whole country. The hospital that has been already launching a pilot project, what does the medical worker think of this management style? What questions has pilot project met while running? Need how to solve? On the professional clinical route training class of internal medicine department of Ministry of Public Health that finished a few days ago, over 260 pilot subject chiefs of the office and head nurses coming from 72 pilot hospitals have discussed this warmly. There is much medical quality control " The mandatory tool " Clicking to enter the information-based system can find, the clinical route must select while dividing the doctor's order project into HeKe select. Entering the impatient of the clinical route to every one, the doctor must confirm that attend to the rank, diet type and check the project etc. on the first day. Must select doctor's order carry out, must fill in reason is otherwise unable to order, turn on next step. If doctor choose, can select doctor's order or newly-increased doctor's order of Zhong, the doctor's order is postponed or the operation is postponed, also need to fill in the reason At training class, Peking University the People's Hospital breathe and critical disease high utilize multimedia in medical the intersection of department and chief physician, have demonstrated the clinical route administrative systems of electronization of this institute. In fact, it is the standardized management done on a certain disease or a certain treatment means that the clinical route is managed, have described the medical activity that should be carried on exhaustively during every concrete time slot, can regard as one and is presumed the good one in advance " The patient looks after the plan " . The clinical route is all right " Mandatory " Procedure of demanding to make a diagnosis in doctor's norm of ground. The first hospital heart head of the department of internal medicine Huo Yong in Peking University points out, under the traditional medical mode, the doctor makes a diagnosis behaviorally randomly and oldly, how much a certain a certain therapeutic ways of disease have the patient's cure rate on earth, which link such therapeutic way high endangers links, all unable to find out how to avoid accidents,etc. better. The management of clinical route can solve these problems effectively. He thinks, in accepting a large number of hospitals at the basic level of common multiple disease case and low age and service seniority doctor lacking experience for medical treatment, the management of clinical route has a larger medical quality control meaning. We can say, the clinical route makes the medical safety management have a " mandatory tool " . " make a variation " Promote it manage to various change will take place during not carrying out actually in route after making a diagnosis to what hand design well in advance after pushing away by route, this is receiving much concern in management of clinical route " Make a variation " . Because misdiagnose, leak, examine and make a diagnosis and give treatment in the course taking place the intersection of condition and change, the intersection of treatment and result and clinical pre- result of route of patient produce enormous to offset, so that can't continue making a diagnosis and giving treatment according to the route, must return the outlet foot-path. Until pilot project assess, variation rate and person who withdraw of route become receiving much concern two index, certainly become primary topic that the training class discusses warmly too. The central hospital clinical director of route office Dai BingBing of Dalian thinks, it is very normal that the clinical route makes a variation. For example, doctors can't avoid a patient who is admitted to hospital because of pneumonia in the stomach appears to ache suddenly during this time in hospital. So, the rate of making a variation so long as control is normal among 20%-40%. What's more it is positively charged that some make a variation. For example, a patient needs to carry on the gallbladder and excise the skill treatment, presumes according to the route, the time of operation is the third day after being admitted to hospital of patient, but the patient has already finished all necessary checking in the clinic, perform the operation and can advance according to the circumstances. "In addition, the variation situation that every hospital more generally appear to some number, have made ' the sub route ' for the clinical route of every number. This should be regarded as a push of management of clinical route. " Dai BingBing says, quite a lot of patients of senile cataract have basic diseases such as diabetes or hypertension,etc. for example. So the ophthalmology department of central hospital of Dalian is while making the clinical route of senile cataract, right away make senile cataract of the simple eye ' Basic disease is hypertension and diabetes) , eyes senile cataract ( Basic disease is hypertension and diabetes) Wait for " sub route " . In this way, can reduce the making a variation rate, gave the doctor more choice spaces at the same time. Director of people in Peking University Wang Shan says, the mutant quantity should not be the focus that the administrator pay close attention to, the more important thing is not to analyze disease treatment with the variation rate at stage, especially as the route presented shouldering variation, the hospital should deal with, record, analyze and make a variation the reason to appear and improve in time. If make a variation the reason to appear is relatively centralized, should scrutinize and improve route. This kind of " examining type by oneself " Self-promotion,in fact it can have interpreted ased to clinical for route for the getting more strong pushes of the managements. The informationization is essential " Assistant " "Pursue in our hospital in the first 4 months of the clinical route, it is all done by hand that the doctor's clinical route form, doctor's order are dealt with etc., the hospital also needs to specially take manpower out in the department of clinical route of all pilot projects, responsible for the save of the clinical route of the paper edition, the inspection of the implementation, mutant collection, statistics, analysis and appraisal and modification of route. The work load is enormous. " Dai BingBing says. The question which the central hospital of Dalian meets, have certain universality while the clinical route pursues. This question lets some medical personnel produce resentment, pursue the bottleneck in the course as the route for a time. At the training meeting, expert point out informationalized clinical the intersection of route and system can make a report on work, freeing, coming out the intersection of first line and person from strenuous document, favorable to the supervision of the route. "The whole institute's popularization since July of this year of information-based system of the central hospital of Dalian, the situation is makeovered. " The situation that Dai BingBing introduced has offered the evidence for expert opinion. Sail Liu, assistant of director, people of Peking University, say clinical informationization of route information-based the intersection of hospital and a portion of management. The hospital imbeds the information system of the hospital, the assigning, checking, carrying out, printing of doctor's order of the form of the clinical route, the project can be finished in the system to make a diagnosis in the writing etc. of case history, obviously raise the doctor's working efficiency. This system can also count and analyze the patient information who enters the route automatically, finish the management of the route in time. "Use the clinical route form that the word processor edits, prints simply, should not be interpreted as the clinical route of the informationization. " Ministry of Public Health clinical the intersection of route and technology check Committee of Experts the intersection of peak and associate professor Jin remind some administrators at the same time.

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