Improve the experience of medical treatment and enhance the patient experience (Healthy China, Strive for Progress)

Recently, the National Health Commission and the State Administration of Traditional Chinese Medicine issued the Notice on Carrying out Themed Activities to Improve Medical Experience and Improve Patient Experience (hereinafter referred to as the "Notice"), which will implement themed activities to improve medical experience and enhance patient experience nationwide from 2023 to 2025, further solve the urgent and difficult problems of the people to see a doctor, improve the whole process of medical experience, enhance patient experience, and ensure that the people enjoy the high-quality development results of public hospitals.

From the perspective of patients, this theme activity puts forward a total of 6 specific measures in 20 aspects around the whole process of medical treatment, and strives to use 3 years to run "patient-centered" through all aspects of medical services, improve the comfort, intelligence and digitalization of medical services as a whole, and promote the formation of a Chinese-style modern medical service model with more scientific processes, more continuous models, more efficient services, more comfortable environments and more considerate attitudes, and further enhance the people's sense of gain, happiness and security in seeking medical treatment.

Hospitals at level 2 and above should generally establish an appointment system for diagnosis and treatment

In terms of improving the pre-diagnosis experience of patients, notification requirements are required to improve the appointment treatment system. Hospitals at level 2 and above should generally establish an appointment diagnosis and treatment system, and use artificial intelligence and other means to improve the accuracy of appointment diagnosis and treatment.

The first is to provide a variety of channels and a variety of valid certificates for appointments, implement time-based appointments, and implement a variety of appointment modes such as centralized appointments for inspection and testing. Combine professional characteristics to reasonably arrange the number source to reserve sufficient time for doctor-patient communication.

The second is to promote a variety of appointment modes such as consultation rooms, interdepartmental, follow-up, within the diagnosis and treatment team, and within the medical alliance, and secondary and tertiary hospitals open a certain proportion of number sources to primary medical institutions, giving play to the positive role of family doctors in making appointments for referrals, appointments for examinations, etc., and improving service continuity.

The third is to explore the application of artificial intelligence triage system and dock with the outpatient electronic medical record system to form an intelligent consultation-triage-appointment-medical history collection process.

The fourth is to optimize the appointment diagnosis and treatment platform, implement the real-name system for appointments, strengthen the management of number withdrawal and no-show, and severely crack down on "number traffickers".

The notice proposes that where conditions permit, medical institutions can handle "pre-hospitalization" for patients whose diagnosis is clear, their condition is relatively stable, and who are assessed to meet the indications for hospitalization and undergo elective surgery, under the premise of ensuring the quality and safety of medical treatment, and complete preoperative examination and testing before the patient is admitted to the hospital, so as to shorten the preoperative waiting time after admission.

Encourage the provision of "patient motion" MDT services

In terms of improving the patient's outpatient experience, notification requirements and reengineering the outpatient process. Further optimize the outpatient process design and shorten the patient's stay time in the outpatient clinic. The first is to compress the links of outpatient number collection, payment, and printing of reports, shortening the waiting time of patients in the outpatient clinic. The second is to strengthen guidance, clarify the reception process of patients who return the results of the examination and test on the same day, simplify the process of requiring multiple outpatient consultations and nursing, and reduce the disorderly flow. The third is to provide a variety of payment channels, and explore the implementation of "first diagnosis and treatment and later payment" and "one visit and one payment" under the premise of ensuring the safety of funds.

The notice proposes that medical institutions should use new technologies and concepts, be demand-oriented, and constantly adjust and innovate service models. The first is to establish a "one-stop" outpatient service center to provide patients with services such as guidance, consultation, examination and testing appointments, acceptance of complaints and suggestions, and rental of convenient equipment, so as to help patients familiarize themselves with the medical process.

The second is to improve the multidisciplinary diagnosis and treatment (MDT) system, encourage medical institutions to expand the specialties and diseases covered by multidisciplinary diagnosis and treatment, and medical institutions with conditions can set up outpatient MDT posts to provide MDT services that "patients do not move doctors".

The third is to encourage medical institutions to open new outpatient clinics such as anesthesia, pain, and health management to provide more abundant outpatient diagnosis and treatment services.

The fourth is to promote the outpatient integrated Chinese and Western medicine medical model, build an integrated Chinese and Western medicine team, and carry out joint diagnosis and treatment of Chinese and Western medicine. Traditional Chinese medicine medical institutions should summarize and promote the comprehensive treatment of traditional Chinese medicine and the full-chain service model integrating prevention, treatment and rehabilitation.

Fifth, encourage medical institutions with the conditions to flexibly arrange outpatient hours in combination with actual conditions to meet the needs of people such as going to work and going to school.

Sixth, family doctors are encouraged to provide appropriate services to eligible contracted groups.

Build a three-dimensional pre-hospital medical emergency system

In terms of improving patients' emergency emergency experience, notification requirements are required to improve the capacity of pre-hospital medical emergency services. Optimize the pre-hospital emergency service process, improve the accuracy of 120 call positioning, and shorten the call response time. Strengthen the construction of pre-hospital medical emergency standing and mobile forces, actively build a three-dimensional pre-hospital medical emergency system, and improve the capacity of pre-hospital medical emergency.

At the same time, strengthen the connection between the pre-hospital and the hospital. Secondary medical establishments and above shall strengthen the construction of centers for chest pain, stroke, trauma, treatment of critically ill pregnant women, and treatment of critically ill children and newborns, establish efficient processes for connecting emergency first aid, and establish real-time interactive information systems for patient data before and before the hospital to improve the efficiency of emergency emergency services.

Finally, do a good job in the treatment of critically ill patients. The first is to establish and improve the graded treatment model of emergency patients, adhere to the principle of "urgent and serious", establish a graded treatment process according to the patient's condition, and "prioritize treatment and make up procedures" for acute and critical patients.

The second is to explore the construction of a "three-way and three-link" integrated treatment model for pre-hospital emergency and critical treatment, form a process of ambulance direct access to the cath lab, operating room and intensive care unit, and connect the green channel of rescue between pre-hospital medical emergency institutions, primary medical and health institutions and hospitals. Using the emergency department as a platform, establish a multidisciplinary joint treatment mechanism for acute and critical patients.

Tertiary hospitals generally establish a day surgery management system

In terms of improving patients' hospitalization experience, notice requirements and improve the inpatient medical service system. The first is to establish and improve the day medical service system, tertiary hospitals generally establish a day surgery management system, encourage medical institutions to expand the scope of day medical services and improve relevant systems.

The second is to promote the informatization of clinical pathway management, enrich the number and connotation of clinical pathways, and build an integrated clinical pathway within the medical alliance.

The third is to comprehensively promote the exchange and sharing of inspection results and related data and materials, and strengthen the quality control and management of inspection and inspection related professions.

The fourth is to promote the application of appropriate techniques of traditional Chinese medicine, and the dominant diseases of traditional Chinese medicine in traditional Chinese medicine hospitals should be mainly treated by traditional Chinese medicine.

The notice proposes to strengthen comprehensive services for inpatients. Encourage tertiary hospitals to actively explore the establishment of a new pain management model covering the whole process of outpatient emergency and inpatient services. Promote the popularization of pain management models such as childbirth analgesia in secondary hospitals and above.

Rely on medical alliances to enhance the continuity of medical services

In terms of improving the post-diagnosis experience of patients, the notice requires that the medical alliance be relied upon to improve the continuity of medical services. With the grid layout of urban medical groups and county medical communities as the carrier, optimize the medical service process, smooth two-way referral channels, sink experts, outpatient number sources and inpatient bed resources, and provide integrated medical and health services for residents in the grid. Promote the sharing of diagnosis and treatment information within the medical alliance, and explore the establishment of a smart medical alliance.

Strengthen post-diagnosis management and follow-up. Medical institutions shall establish patient follow-up files and follow-up plans, build a multi-channel intelligent follow-up platform based on patient services as the core, provide patients with more scientific, convenient and professional out-of-hospital rehabilitation and continuous treatment, and discover potential problems in a timely manner through data analysis, provide green channels for medical treatment, and provide better guarantees for patients after diagnosis. Encourage medical institutions with the capacity to strengthen communication and interaction with patients through the follow-up platform.

Creating "warmer medical services"

The notice requires that the basic and supporting work throughout the medical service process be improved.

Enrich the connotation of high-quality nursing services. Strengthen responsibility nursing, and strictly implement the core system of graded nursing and checking and matching nursing. Do a solid job in basic nursing, standardize the implementation of nursing specialist techniques, and provide holistic physical and mental care. Encourage medical institutions to provide continuity of care services for discharged patients with nursing needs. Promote the sinking of high-quality nursing resources in large hospitals.

Strengthen the humanistic construction of medical institutions. First, hospitals at level II and above should establish a medical social worker and volunteer system, encourage medical institutions with the capacity to set up medical social work departments and posts, enrich the connotation of medical social work services, and promote the systematic, professional and standardized medical social work services. The second is to carry forward the lofty professional spirit, standardize the service language and behavior in medical institutions, enhance the awareness and ability of doctor-patient communication, build a harmonious doctor-patient relationship, and create "warmer medical services".

(People's Daily Overseas Edition, Xiong Jian)