Optimize service process and implement service measures (health focus)
With the widespread application of information technologies such as the Internet, big data, and artificial intelligence in medical institutions, it has become more and more convenient for patients to seek medical treatment.
However, some elderly people encounter inconvenience in the process of seeking medical treatment because they cannot access the Internet or use smart phones.
In June of this year, the National Health Commission issued the "Notice on Further Optimizing the Process of Medical Services to Facilitate the Elderly's Seeing Doctors", requiring medical institutions to establish rapid pre-inspection channels for the elderly, and actively promote "one-stop" services for admission and discharge, and build suitable medical services for aging. Environment, etc.
A few days ago, the reporter conducted an interview on this.
Optimize hospital services and improve medical experience
While advancing the construction of smart hospitals, fully consider the special needs of elderly patients, and adhere to the parallel between traditional diagnosis and treatment services and intelligent services
"The machine says that there are two films, why only one is spit out?" "Look, what was output is one film and one diagnosis result sheet, but there is no shortage." In the outpatient hall of Xiangya Hospital of Central South University At window 13, two volunteers in red vests are providing consultation services for an elderly patient who comes to pick up the film.
Yu Weiwei, director of the outpatient department of Xiangya Hospital, said that although various signs and green passages in the outpatient hall have been improved, there are still some elderly patients who "cannot figure out the process and can't find a place."
To this end, the hospital recruited volunteers to help elderly patients facilitate medical treatment.
In addition to the recruited volunteers, retired employees of Xiangya Hospital also put on red vests and became volunteers.
Li Xueying, a retired employee, shuttled back and forth in the outpatient hall to help elderly patients who do not use self-service machines register, and assist elderly patients with mobility impairments to go to the bathroom and clinic.
She can not only guide the diagnosis, but also assist in the triage based on her own experience and patient symptoms, which effectively saves the time of doctors and patients.
"These volunteers used to be the backbone of various departments. After retirement, they used the residual heat to improve the satisfaction of elderly patients." said Liao Weifeng, director of the Patient Service Center (Medical Social Work Center) of Xiangya Hospital.
Elderly patients do not use health codes, how do they enter the hospital?
Ruijin Hospital Affiliated to Shanghai Jiaotong University arranged special volunteers to help the elderly operate their mobile phones and show their health codes at the entrance of the outpatient building.
Considering that some elderly patients do not have smart phones, the hospital has set up channels without health codes and installed ID and medical insurance card code checkers.
As long as the elderly patients show their ID card or medical insurance card, they can quickly find the health code on the code checker.
The percentage of outpatients over 60 years old in Beijing Friendship Hospital affiliated to Capital Medical University is 35%.
In order to reduce the queuing of elderly patients, the hospital has formulated the "Guiding System for Elderly Medical Patients". Specialized elderly service windows are set up in the outpatient hall and each ward, and priority is given to patients with elderly certificates, and the registration, payment, and medicine collection are shortened. Wait for the queue time.
Patients who are 80 years old and above can go to the triage table to issue an ID card, and the triage table will arrange priority treatment to reduce the waiting time in line.
The Second Affiliated Hospital of Zhejiang University School of Medicine provides various forms of "one-stop" services to reduce the rush of elderly patients in the hospital.
Set up a comprehensive service center in the outpatient hall, and implement a unified implementation of "one window for all services" that was originally dispersed in the outpatient office, financial department, medical insurance office, examination appointment and other departments; the pre-hospital preparation center provides uniform admission registration and payment , Pre-hospital inspection, admission education, anesthesia assessment, nursing assessment, and doctor assessment services have realized the “one-stop” treatment of admission; all discharge procedures, such as settlement, medicine withdrawal, and various certificates and stamps, can be handled in the ward. The processing time for patient discharge procedures has been shortened from the original 2 to 3 hours to about 20 minutes.
While promoting the construction of smart hospitals, medical institutions in various regions fully consider the special needs of elderly patients and insist on paralleling traditional diagnosis and treatment services with intelligent services.
The National Health Commission will guide all localities and medical institutions to implement service measures to facilitate the treatment of the elderly, and continuously improve the experience of the elderly.
Renovate hardware facilities to facilitate medical treatment for the elderly
Adhere to the patient-oriented approach, while advancing the transformation to adapt to aging, provide supporting and high-quality services
"Elderly patients in wheelchairs, please use barrier-free passages." There is such a striking sign at the entrance of the outpatient building of Beijing Friendship Hospital, which is crowded with people.
On the north side of the gate, a barrier-free gentle slope was built, and brand-new handrails were installed on both sides, so that patients in wheelchairs can easily enter the outpatient building along the gentle slope.
If elderly patients drive to the hospital, they can park their car in the dedicated parking space for the elderly in the underground parking lot of the outpatient building.
Compared with the general parking space, the dedicated parking space for the elderly is 1/3 wider, which is convenient for the elderly to park and get on and off the car.
Walking into the bathroom of the outpatient hall, the reporter saw 3 clean and tidy sinks, one of which is equipped with handrails on both sides; 3 urinals, one of which is equipped with anti-fall handrails; 4 toilets, one of which is equipped with a toilet. Handrails are installed on both sides.
The bathroom floor is dry and non-slip, so it is safe to walk on it.
"We will clean the ground regularly to prevent accumulation of water." The cleaner who is cleaning said.
Elderly patients with leg inconvenience can also borrow wheelchairs for free.
A shared wheelchair area is set up on one side of the outpatient hall, and some wheelchairs are parked.
The patient uses the mobile phone to scan the QR code on the wheelchair, pay a deposit, and then unlock the wheelchair and use it for free for 24 hours.
"There are usually more than 30 wheelchairs parked in the shared wheelchair area. If the elderly cannot use the mobile phone to scan the code to unlock, you can ask the doctor for help." The hospital staff introduced.
According to Zhang Zhongtao, deputy dean of Beijing Friendship Hospital, in the past five years, the hospital has invested hundreds of thousands of yuan in aging-adaptive transformation, including multiple projects such as ground signs of the outpatient building, toilet equipment transformation, elderly supplies configuration, and environmental transformation.
In the future, the hospital will increase the number of self-service kiosks for the elderly, improve the guidelines for the elderly, and further facilitate the elderly to come to the hospital for medical treatment.
Some hospitals have also carried out age-appropriate renovations to inpatient wards.
In the Hernia and Abdominal Surgery Ward in the 9th Ward of Xiangya Hospital of Central South University, electric lights, nursing beds, chairs, pagers, and toilets are all optimized for the needs of the elderly.
"From a nursing point of view, whether the lighting in the ward affects the rest of the elderly, and whether the toilets and surrounding chairs are suitable for the elderly need to be remodeled to suit the standards of aging. In addition, there are also dedicated wards for the elderly in the 9th ward. Patients over the age of 65 can be admitted first." Yue Liqing, director of the nursing department of Xiangya Hospital, said that in the next step, the hospital plans to gradually apply new technologies such as voice control, sensors, and robots to pilot wards to further facilitate elderly inpatients.
"The aging-adaptive transformation of the ward is to focus on the high-frequency matters involved in the hospitalization of elderly patients, starting from the four aspects of friendly culture, management, service and environment for the elderly. We first pilot the transformation in individual wards, and then gradually expand the scope of the pilot." Xiang Said Liu Longfei, vice president of Ya Hospital.
Zhang Zhongtao said that my country has entered an aging society with more and more elderly patients.
It is normal for them to go to the hospital alone or accompanied by their wives, and there is an increasingly urgent need for hospitals to adapt to aging.
The hospital will adhere to the patient-oriented approach, and provide high-quality supporting services while advancing reforms to adapt to aging.
Provide continuous care and improve the quality of care
Some hospitals open wound stoma clinics and provide on-site services, which greatly facilitates elderly patients
"The stoma doesn't leak anymore, it doesn't hurt anymore, and I feel better!" Grandpa Li, who lives in Guo'ao Village, Chaoyang District, Beijing, recently received continued nursing services from Beijing Friendship Hospital, and his physical condition has improved significantly.
In May of this year, 89-year-old Grandpa Li underwent rectal cancer resection at Beijing Friendship Hospital. He had a stoma in his abdomen.
After being discharged from the hospital, he went home to recuperate and was taken care of by his 80-year-old wife and nanny.
Before long, Grandpa Li’s stoma leaked fluid, and the surrounding skin became inflamed and painful.
Grandpa Li has been in bed and is weak and unable to go to the hospital for care.
After learning about Grandpa Li's situation, the Wound Stoma Clinic of Beijing Friendship Hospital sent a nursing team to provide continued care for the elderly.
Zhao Lihong, the head nurse of the general surgery ward of the hospital, is one of the team members.
Zhao Lihong and his colleagues rushed to Grandpa Li's home with stoma care products, and while enlightening Grandpa Li, they took care of his stoma and dermatitis.
On-site teaching the nanny how to properly handle stoma leakage and prevent skin inflammation.
In addition, the nanny also explained the matters needing attention in diet and nutrition.
When Zhao Lihong came to provide him with nursing services again, Grandpa Li had already gone to the ground to move around, and sometimes went to the garden of the community to look at the flowers and plants.
Since 2011, Beijing Friendship Hospital has provided extended care services for elderly patients with inconvenient travel within 10 kilometers from the hospital. Authorized and certified specialist nurses provide free online and offline specialist nursing follow-up and guidance, involving wound stoma and peritoneal dialysis. In 5 majors, the average annual household follow-up is nearly 200 people.
For elderly patients from other places, the nursing team will establish a WeChat group. Patients with stoma care and other issues can ask on WeChat, and nurses will provide long-term online guidance.
Recently, Qin Man, a specialist nurse from Xiangya Hospital, came to Grandma Tian’s home in Kaifu District, Changsha City, Hunan Province to maintain her indwelling catheter.
Before departure, Qin Man checked out the on-site nursing service information reserved by Grandma Tian through the mobile phone applet "Xiangya e Jian Angel", and then consulted Grandma Tian's health status via telephone.
At the same time, she preliminarily assessed the basic situation of the catheter through the catheter pictures in the "Xiangya eHealth Angel" and the information in the maintenance manual, and prepared the supplies needed for the home care.
According to Qin Man, "Xiangya e Jian Angel" is a mobile app based on WeChat applet.
Elderly patients or their family members purchase the hospital's door-to-door care services online through a small program at home. After receiving the user's order, the hospital will evaluate the patient's current physical condition by phone or questionnaire, and assign a nurse to door-to-door service based on the actual situation of the patient.
After arriving at Grandma Tian's home, Qin Man and colleagues once again learned about the condition in detail and conducted an assessment.
Subsequently, they performed indwelling catheter maintenance for Grandma Tian and registered maintenance information.
In addition, they provided guidance on daily care and precautions for indwelling catheters for Grandma Tian and her family.
"I used to go to the hospital to maintain catheters, but now it is very convenient to have on-site service!" Grandma Tian couldn't help but praise Qin Man and her colleagues.
"Elderly patients will have a stoma after a major operation, which is very difficult to care for and requires professional nursing guidance. The continued nursing service provided by the hospital is conducive to improving the quality of self-care at home for patients and improving the quality of life of elderly patients." Zhao Lihong said, stoma Will follow the elderly for a lifetime, if the care is not standardized, complications are prone to occur.
Nowadays, some hospitals open wound stoma clinics and provide on-site services, which greatly facilitates elderly patients.
Our reporter Shen Shaotie Sun Chao
Our reporter Shen Shaotie Sun Chao