China News Service, March 27 (Xinhua) According to the website of the National Health Commission, the General Office of the National Health Commission recently issued a notice on strengthening the management of midwifery services (hereinafter referred to as the "Notice"). The notice mentioned that midwifery institutions must compare with standards, strengthen facility renovation, equipment configuration and staffing, and establish and improve internal management rules and regulations. Implement the "Medical Quality Management Measures", establish an obstetrical medical quality management working group, and carry out no less than 2 medical quality and safety case warning educations every year. For common critical illnesses such as postpartum hemorrhage and neonatal asphyxia, special skills training and rapid response team first aid drills are carried out at least once every quarter. The time from decision-making surgery to fetal delivery (DDI) for emergency cesarean section is strived to be controlled within 30 minutes and gradually shorten.
The full text of the notice is as follows:
Notice from the General Office of the National Health Commission on strengthening the management of midwifery services
National Health Office Maternal and Child Development [2024] No. 7
Health Commissions of all provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps:
Midwifery services are basic medical services, related to the safety and health of mothers and babies, and the happiness of thousands of families. In order to ensure the accessibility of midwifery services, improve the quality of midwifery services, and effectively ensure the safety of mothers and infants, the relevant work is hereby notified as follows:
1. Strengthen the planning and layout of midwifery services
Health administrative departments at all levels should combine the preparation of regional medical and health service system plans and medical institution establishment plans to plan and layout midwifery service resources within their respective administrative regions to ensure the supply of midwifery services and effectively meet the needs of pregnant women. Promote provincial and municipal maternal and child health care institutions to meet the standards of third-level maternal and child health care hospitals. In principle, counties (cities, districts) with a population of more than 300,000 will have at least two public medical institutions that can provide midwifery services. Counties with a population of less than 300,000 ( In principle, at least one public medical institution in a city or district can provide midwifery services. Areas with vast areas, sparse population, and inconvenient transportation must ensure that relevant primary medical and health institutions have the ability to provide midwifery services.
2. Proactively publish the list of midwifery institutions
After the county-level health administrative department makes an administrative licensing decision on midwifery technology, it shall, in accordance with the provisions of the Administrative Licensing Law and the Government Information Disclosure Regulations, proactively disclose it to the public within 20 working days and promptly update it within the administrative region upon approval. List of medical institutions providing midwifery technical services (hereinafter referred to as midwifery institutions), practice addresses and other relevant information. Provincial and prefecture-level health administrative departments should publish the list and practice addresses of midwifery institutions in their respective administrative regions in the previous year before January 31 of each year, actively accept social supervision, and facilitate the public's orderly medical treatment.
3. Strengthen quality management of midwifery services
Midwifery institutions must follow standards, strengthen facility renovation, equipment configuration and staffing, and establish and improve internal management rules and regulations. Implement the "Medical Quality Management Measures", establish an obstetrical medical quality management working group, and carry out no less than 2 medical quality and safety case warning educations every year. For common critical illnesses such as postpartum hemorrhage and neonatal asphyxia, special skills training and rapid response team first aid drills are carried out at least once every quarter. The time from decision-making surgery to fetal delivery (DDI) for emergency cesarean section is strived to be controlled within 30 minutes and gradually shorten. Strictly abide by the core system of medical quality and safety, focus on strengthening the three-level ward round system, preoperative discussion system, emergency and critical patient rescue system, etc., and encourage multi-disciplinary team treatment. Strictly abide by the professional obstetric diagnosis and treatment guidelines and technical operating specifications, carry out monthly self-assessment and analysis around key links and weak links in key departments such as operating rooms and delivery rooms, and continue to implement quality improvement measures. Comprehensively carry out delivery safety inspections in the delivery room, fill out the verification form in a standardized manner, and incorporate it into medical record management as medical documents to reduce the incidence of medical errors and adverse safety events in the delivery room. Implement the maternal identification system, equip necessary facilities and equipment, encourage those with conditions to equip ID card readers, biometric systems (such as fingerprints, facial images), etc., and strengthen the establishment of maternal records, hospital delivery, and issuance of birth medical certificates, etc. Identity verification at key points.
4. Carry out the construction of fertility-friendly hospitals
Midwifery institutions should strengthen the construction of birth-friendly hospitals, fully equip medical staff and facilities and equipment, rationally set up outpatient waiting areas, optimize the layout and service processes of obstetric clinics, and create a warm and comfortable environment for delivery and hospitalization. It is necessary to focus on the prominent medical treatment and delivery problems reported by pregnant women, optimize health care services during pregnancy and delivery, promote comprehensive appointment diagnosis and treatment, promote appointment hospital delivery, provide maternal-centered humanized delivery services, and actively carry out analgesic delivery services, where conditions permit. Medical institutions can provide family members to accompany children during delivery to promote safe and comfortable delivery. Encourage qualified midwifery institutions to strengthen the establishment of high-quality, universal obstetric beds, adjust and optimize hospital resources, increase the number of single and double rooms in obstetric wards, effectively improve obstetric hospitalization conditions, and enhance the sense of gain and happiness of pregnant women. and a sense of security.
5. Standardize the adjustment of midwifery service resources
In principle, maternal and child health care institutions at all levels, public general hospitals at level 2 and above, public medical institutions tasked with the task of treating critically ill pregnant women, and public primary medical and health institutions in sparsely populated areas should ensure continuous obstetric services, and the local health administrative department shall coordinate Except for adjustments to medical resources. If other public medical institutions plan to close their obstetrics departments, they must extensively solicit the opinions of registered pregnant women and seek written opinions from local street offices (township governments) and county-level health administrative departments to effectively protect the people's rights to medical treatment. When the obstetrics department of a medical institution is closed, it must be approved by the registration authority in accordance with regulations, formulate a business adjustment plan, properly provide maternal check-up and hospital delivery continuity services, reasonably arrange the positions of medical personnel, and standardize the transfer of birth medical certificates and other materials.
6. Improve policy guarantee mechanisms
Health administrative departments at all levels should actively coordinate with relevant departments to build a policy guarantee mechanism to promote the high-quality development of obstetrics. Public hospitals at all levels must conscientiously implement the "Guiding Opinions on Deepening the Reform of the Salary System of Public Hospitals", strengthen the public welfare attribute, improve the internal allocation system, mobilize the enthusiasm of obstetrics medical staff, and strive to ensure that the salary level of obstetricians in general hospitals is not lower than that of hospital doctors Regarding the average level of salary, it is strictly prohibited to issue income-generating targets to obstetrics and obstetrics medical staff. The salary of obstetrics and gynecology medical staff must not be linked to business income from drugs, health materials, examinations, tests, etc.
General Office of National Health Commission
March 16, 2024