Professional visual angle of the clinical route

Professional visual angle of the clinical route
Staff reporter Han Lu Ministry of Public Health determined a few days ago, since December of this year, used for about 2 years, 50 hospitals launched the clinical route of 112 pieces of number to manage pilot work in the whole country. While determining to issue, the noun that the clinical route, this professional lines, is quite strong, a lot ones that idealized been entrusted by the media were understood. Comparison typical statement like " 50 hospitals first elect 112 kinds of disease and disease with curing " ," 112 kinds of disease treatment ' the template 's will improve the relationship between doctors and patients " ," 112 disease treat the norm to want to reduce the unreasonable expenses clinically " ," see the doctor and take place a ' the curriculum ', the expenses of step are very clear " ,Make the public full of expectation to the clinical route quickly. But some interviews come down, the reporter finds, and the clinical route is not so simple as the ones that talked above. The clinical route is taken and labelled if having time " The street map " According to the professional statement, the clinical route is a standardized norm made to disease treatment, it was planned that the management of clinical route put emphasis on treating the content and treating procedure. "Say popularly, the clinical route is the street map that a strip labelled if having time, will tell you what is needed doing in course of making a diagnosis of a certain disease, what kind of step should be followed. " Vice President of Peking University third hospital Liu Xiao only says, the development of the clinical route will let the similar patient get the same treatment. To according with the patient of the clinical route entry condition, we can say to leave hospital in hospital, they want every medical care that accept there is exhaustive arrangement. Liu XiaoGuang likens the clinical route to GPS navigation system vividly: "The route that the navigation system is designed can guarantee you reach terminal B from the starting point A, it certainly may not be a bee line from A to B. The clinical route is that every medical care accepted makes exhaustive arrangements to leave hospital from in hospital to the patient, the purpose is to let the similar patient get the same treatment. " It says, the clinical route that Ministry of Public Health prints and distributes is made by the authoritative expert in the industry that Ministry of Public Health cures the person in charge of relevant office of policy department, the social average level representing this number makes a diagnosis, it is one that is for health authorities and the medical organization to consult the guidance frame carried out in the medical quality management. Meanwhile, the experts and persons who makes route do not think the clinical route is an impassable " red line " ,The pilot hospital can instruct the frame to carry on subdivision and adjustment to this one according to one's own managerial ability and medical level, thus make and accord with the clinical route implemented specifically. Whether could make the patient very clear and find the concrete clinical route released on the websites of Ministry of Public Health, study conscientiously through some, the reporter finds, as a patient, even can see making a diagnosis and main doctor's order that a certain disease needs accepting every day, do not know either what these steps mean. The affiliated hospital of medical college of Jining begins from this year, tries to make the clinical route of the patient edition. "In hospital, there are very many things that should pay attention to today! " "Will do the operation tomorrow, very fast! " "Will begin the operation soon! Also carry on some preparation. " "Can have a meal today! Needle did not hang in the afternoon! " "Could go home todayed! " The reporter has read the clinical route of patient edition where the peritoneoscope gallbladder of affiliated hospital of medical college of Jining excised the skill in detail, find every day's introductory song language really makes people find everything fresh and new among them. Class' rich introduction according to the Vice Presidents of this institute, the content of the clinical route of the doctor edition includes long-term doctor's order, temporary doctor's order, detailed day shift night shift are attended to and recorded and treated the goal and realized the assessment of the intensity to every day. But in the clinical route of patient edition beginning to be implemented this year, content and doctor edition of the doctor's order are the same, increase is the same day doctor, nurse should be for the work that the patient do, and patient's every day's attentive matters. But professional personage claims, to be strict, that increase actually popularization tells the content in the clinical route of the patient edition, can't have been called the clinical route. Those professional contents unables to be popularized, it is still very difficult for the patient to understand correctly, let alone very clear. Then, while of carrying out the clinical route and dynamic, it is ahead of time or delays once time table happens, will cause the dispute because the patient read by mistake? (leave and rotate the 2nd) (have and connect the 1st) As to this, Ban Bo says, in era when this information is open, do not allow the patient to understand the content of the clinical route is unrealistic. When the patient took the route in hands, linking up ability for the medical worker doctors and patients puts forward higher requirement. "Any change appears, all of us should explain the reason with the patient as soon as possible, make their consent and understanding. " Liu Xiao only thinks, it is unnecessary for the patient to get a thorough understanding of the professional problem involved in the clinical route one by one, don't only believe the clinical route, does not believe a doctor. The Liu Xiao light is still afraid medical worker's only clinical route in order to evade medical dispute is that from, even reach " See the disease not see people " , just think of some to see intensity of whole. Lack and exchange, will concern more and more and drift apart during doctors and patients. But class rich to think just because clinical route link up, get high requirement out of to doctors and patients, so, there is more pessimistic understanding in the relationship between doctors and patients after needn't implement the clinical route ing. Taking requirement for nursery work of clinical route as examples, after the patient is admitted to hospital, nurses should tell the course of making a diagnosis of patients in detail, explain various problems that may happen, make them often clear which stage oneself is at disease treatment. The so exhaustive one tells that will contribute to reducing the emergence of the medical dispute. Patient benefited to it depends on practical operation Sichuan Province the intersection of the People's Hospital and quality control portion the intersection of minister and Wen Zhang say far more or less, practice of this institute shows, can reduce and is in hospital day equally while pursuing the clinical route. For example institute this pursue behind the clinical route, hip joint replace to in hospital, bring 21.6 days down to by 25 all over the world day on average skill. According to class' rich introduction, after paying the single number in combination with clinical route, surgery fee, treating the fee, checking fee, expenses for medicine that the peritoneoscope gallbladder of affiliated hospital of medical college of Jining excises,etc. mainly treats the expenses to drop to some extent; The hospitalization cost formed to change too, the proportion that the fee of operation accounts for the all-inclusive cost is raised from 49.4% to 59.1%, the expenses for medicine drop from 24.8% to 8.1%. Though pursuing the clinical route has already demonstrated the positive effect in the clinical practice, but Liu Xiao only thinks, have entrusted too high expected value to the clinical route in the society at present. In fact, though the popularization of the clinical route will let the similar patient get the same treatment in different hospitals, it is difficult to relieve and see the doctor to a certain extent, but does not mean making a diagnosis the expenses will certainly drop. May will lead to the fact instead that the expenses rise to make a diagnosis in some hospitals. About this to ask The question, a clinician is in one's own example of passing the imperial examinations at the provincial level of blog. Fetch its hospital where one stays as the example of stone treatment with the mirror in calculus of person in over-all charge of gallbladder? Nao is bared Lead drink Qu the droughts green Man Spanish mackerel �� rammer � Hu principal column of a halls bright ask evil spirits of mark �� workshop cheek purine in riotous profusions male not to be support imperial mandate by acute communicable diseases acute communicable diseases Si of Cuo of �� s tired Fu of �� 1 Mans ridicules brokens tired until summer such as dung such as Qia after owinged It is by 2 days, patient Yu Di leaves hospital from 3 days to the 4th day. If according to shining on the bed route, is admitted to hospital for the third day and can perform the operation until the 4th day, can leave hospital from the 7th day to the 10th day. In this case, the project will increase correspondingly to make a diagnosis, being in hospital will be lengthened correspondingly on day, therefore must initiate the growth of the hospitalization cost. As to this, Ministry of Public Health cures the person in charge of relevant office of policy department to say, implementing the management of clinical route will increase the due project of making a diagnosis, control the unreasonable charging item, make the hospitalization cost prone to rationalization finally. He proposes, it is not the inevitable outcome bringing the clinical route to reduce the hospitalization cost. Some hospitals at the basic level may increase some projects of making a diagnosis in the course of making a diagnosis of the standardization, this brings increase of the hospitalization cost. But this to guarantee medical quality and make a diagnosis standardized inevitable cost. The insider proposes the medical insurance policy for corresponding financial support to the project of making a diagnosis included in the clinical route, in order to improve patient's compliance of the clinical route. Clinical the intersection of route and pilot project want what in fact does it try, the clinical route is still a growing neonate. The pilot hospital not merely needs to examine and improve more than 40 kinds of clinical routes already printed and distributed, also in the concrete medical practice, in order to there is no pilot number exploration route of the ripe text. Though the expert has different views on the introduction of the clinical route, all entertain generally the same expectation to the pilot project of the clinical route, to needing paying attention to in the pilot project and the problem to be solved all have basically the same views urgently. Liu Xiao only emphasizes, makes and popularizes the clinical route and the more important thing is to accord with the national conditions. "If does not consider the difference that exist between the medical organizations of different area, different rank and make the clinical route, or popularize the existing clinical route briefly, not merely will cause the waste of medical resources, may also increase the patient's burden, make the quantity of patient who can afford the hospitalization cost reduce, cause the hospital at the basic level to lose motive force developed continuously gradually finally. " Zhang Wen thinks far, the clinical route is regarded as a system engineering of quality control of the hospital, need in the hospital many departments match each other. And management system, doctor's habit and patient's cognitive change in the hospital all have a long times. So, can't act with undue haste, must follow in order and advance step by step in implementation and popularization of the clinical route, go on stage by stage, step by step.

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