On further standard community health service management and improve service quality of guidance

The 2015-11-25 national health and population and family planning commission of the People's Republic of China

The guard hair [2015] no. 93 at the grass-roots level

Provinces, autonomous regions and municipalities directly under the central government health and family planning commission, the administration of traditional Chinese medicine, the xinjiang production and construction corps health bureau:

For the implementation of the central committee of the communist party of China the opinions of the state council on deepening the reform of medical health system \", \"the state council on promoting the development of health services in several opinions (guo fa [2013] no. 40), the state council on accelerating the development of pension services of several opinions (guo fa [2013] no. 35), the state council on further promote the reform of household registration system of opinion\" (guo fa [2014] no. 25), the general office of the state council on promoting the construction of the grading system of guidance \"(countries do hair [2015] no. 70) and other documents spirit, regarding further standardize community health service management, improve community health service quality and the ability to put forward the following opinions:

A, standard community health service institutions and management

(a) improve the community health service network. Considering regional health planning, service resources, service radius, an aging population and urbanization, population migration and other factors, formulate scientific and rational program of the establishment of community health service institutions, according to the planning and gradually improve the community health service network. In the process of urban renewal in city residential area or new, to be in accordance with relevant requirements synchronized planning and construction of community health service institutions, encourage and area endowment institutions joint construction. Populated areas, the floating population should be based on the population quantity and radius of the service, etc., appropriate additional community health service institutions. To the larger population in the county and city government at the county level, shall, according to the need to set up community health service institutions or the structure and function of existing health resources in the transformation, the development of community health services. In the process of promoting the construction of rural communities, should adjust measures to local conditions to synchronous perfect rural community health service institutions. Around in the process of urbanization, the village committee after the change of residents' committees, according to the actual situation, according to the relevant standards to transform the original village clinics for community health service station or revocation of village clinics.

(2) give full play to social forces to run medical positive role. The main body of urban community health service network is the community health service centers and community health centers, clinics, outpatient department, medical and other grassroots health institutions responsible for primary diagnosis and treatment is an important part of community health service network. Around shall actively create conditions to encourage grassroots medical institutions run by social forces, meet the demand of residents a variety of health services. Encourage all actively explore, by means of government purchase services for basic medical and health institutions run by social forces to provide basic medical and health services subsidised.

(3) the specification gp practice registration. In community health service institutions engaged in the work of the general medical (TCM) clinical physicians, through standardizing the general practitioner training or obtain professional technical position qualifications in general medicine, registered as a professional in general medicine; Through the family planning administrative department of public health at the provincial level and approved by the administrative departments of general practitioner of Chinese medicine job-transfer training and on-the-job training, the scope of registration as a general practice, at the same time can infuse relevant categories of other professional. To finish before the end of June in 2016 around the existing registration change of qualified personnel work, and specific measures for registration by the family planning administrative department of public health at the provincial level, the administrative department of traditional Chinese medicine.

(4) improve the community health service environment. Community health service institutions to visit for the service object to create a good environment, standardize the department layout, a clear functional partition, ensure that the service environment and facilities clean, tidy, comfortable, warm, embody humanistic care. Vaccination, child care, health education and service area should highlight the characteristics of traditional Chinese medicine, create a suitable service atmosphere; Registered, triage, pharmacies and other service area to open the window. Encourage the use of self-help registration, electronic station to station, test results self-help print self-test, health and other facilities, improve residents' clinic experience. Specification use of community health service institutions logo, unified community health service institutions visual identification system, unified work clothing, nameplate, visits, etc., internal agency all kinds of logo must be easy to identify clearly. To protect the patients privacy, conditional shall be a medical clinic. Improve the barrier-free facilities, to create a smoke-free environment, do a complete ban on smoking in community health service institutions.

Second, to strengthen the construction of basic medical and public health community service ability

(5) improving the capacity of community health service. Community health service institutions should focus on strengthening the construction of general medicine and Chinese medicine department, improve the ability of diagnosis and treatment of common disease, frequently-occurring disease and chronic diseases. According to the demand, the development of rehabilitation, oral cavity, women (care) of department of gynaecology, paediatrics, child care, mental (psychological) and other professional departments. Considering service demand, the aging process, two-way referral to basic condition and institutional factors, such as overall planning community health service institutions in municipal districts bed size, reasonable setting each community health service organization &personnel, increasing the service efficiency of beds. Community health service institutions give priority to with care, rehabilitation beds, conditional can be set up the hospice care, elderly care beds. Transformation for community health service centers in towns and townships, the hospital beds and internal departments can be adjusted according to actual needs to be maintained or. According to hierarchical diagnosis and treatment work need, in accordance with the relevant regulations and requirements for drug varieties, with satisfy the demand for treating patients.

(6) to strengthen public hospitals and linkage. Support community health service institutions and fixed collaborative relationship between public hospital, explore promote the construction of medical association. Collaboration hospital should reserve a percentage of the outpatient service for community health service institutions, the source, open referral to the green channel, give priority to arrange referral patients see a doctor. Encourage public hospital doctors to community health service institutions more practice, through the visit, a variety of ways, such as teaching, improving the capacity of community health service. In diseases such as hypertension, diabetes, tuberculosis as the breakthrough point, to build gp contact public hospital of specialized subject doctor communication platform, strengthen the collaboration, upper and lower linkage, explore community first option and two-way referral system. Tracking service system, and gradually establish a public hospital discharged patients turn for the patients with continuity of service. Pushing forward the construction of the telemedicine remote consultation, medical imaging, remote medical service such as ecg diagnosis. Make full use of resources, such as public hospital development focus inspection, inspection mutual recognition, reduce duplication of seeing a doctor.

(7) to carry out the community public health service. Make full use of the residents' health records, health statistics data, information, such as special investigation on a regular basis to carry out community health diagnosis, clear jurisdiction residents basic health problems, formulate the crowd health intervention program. Well implement the national basic public health services, and constantly expand coverage for beneficiaries. Strictly carry out the public health service specifications and technical specifications, in accordance with the relevant service process for certain people to provide basic public health services, improve the residents of the acquisition. Strengthening community health service institutions and professional collaboration of public health institutions, setting up reasonable public health service jobs, further integration of basic medical and public health service, promote prevention and control. Steadily increase the number of public health services at the same time, pay attention to strengthen the monitoring and management of public health service quality, focus on the effect of health management.

(8) to develop the traditional Chinese medicine services. In the basic medical and public health services and rehabilitation of chronic diseases, make full use of traditional Chinese medicine resources, play to the advantages of traditional Chinese medicine and role. Conditional set comprehensive service of traditional Chinese medicine community health service center. Enhance the propaganda and training, reasonable application of proprietary Chinese medicine acupuncture and moxibustion, massage, cupping therapy, Chinese medicine fumigation and other appropriate technologies. Actively carry out the traditional Chinese medicine \"cure not ill\" service, provide the community with the traditional Chinese medicine health consultation, health status identification assessment and intervention services, promoting universal health concept and knowledge of traditional Chinese medicine.

(9) to strengthen the construction of community health personnel. Rational allocation of community health service institutions personnel structure, strengthen, with emphasis on the general practitioners, community nurses, community health personnel team construction. Continue to enhance the support to the standardized training of general practitioners, take active measures, encourage medical graduates to participate in the standardized training of general practitioners. Vigorously promote gp job-transfer training, enrich the gp team. In order to improve the practical ability as the key point, strengthen community health personnel training and continuing medical education, community health technical personnel every 5 years to attend technical training time is not less than 3 months. Regularly carry out community health service institutions from management personnel training, training a batch of understand the business, management, and public satisfaction of management personnel.

Third, change service pattern, vigorously promote the contract signing

To strengthen the construction of signing the doctor team (10). Signing team by the second class above hospital physicians with basic medical and health institutions of medical personnel. According to districts service radius and the population, reasonable division team responsibility area, the grid management. Signing the doctor team should grasp the jurisdiction residents major health problems, carrying out health education and health promotion, risk factor intervention and disease prevention and control, to achieve comprehensive, continuous and effective health management services. By 2020, strive to achieve let every family has a sign for a qualified doctor, each resident has an electronic health records.

(11) push forward the basic contract services. Forward contract signed with residents or family doctor team service agreement, set up by contract service relationship. In signing service starting phase, should take the elderly, severe chronic diseases and mental disorders, maternal and children, disabled people long-term use of community health service as the key point, gradually extended to the general population. In advancing the process of signing service, should pay attention to sign the service effect, a clear sign the service content and the conditions of contract, determine the two sides should bear the responsibility, rights, obligations and other such matters to let residents through signing service can get more convenient medical and health services, guide the residents take the initiative to sign up. To explore the difference service sign, classification, paid signing contract service in the form, meet the demand of residents multi-level services. Signing contract incentive constraint mechanism, service fee is mainly composed of medical insurance fund, signing residents pay channel such as basic public health services and funds is solved.

For the convenience of services (12). Community health service institutions should reasonable arrangement of time, there are conditions of community health service institutions shall be appropriately extended time and weekends, holidays begin, traffic service, meet the demand of work the crowd to see a doctor. Encourage around to chronic disease management, vaccination, child care, maternal health care and related service object as the key point, gradually develop time-phased reservation medical services. To focus groups to carry out regular follow-up, to come to visit to patients in need. To develop community nursing, to encourage home care services.

(13) for community health services of the floating population. Around to migrant workers and their trailing families into the scope of community health service institutions, according to the actual service population of rational allocation of health technical personnel, convenient floating population get to the nearest medical and health services. According to the relevant provisions of the floating population and residence population of equally enjoy free basic public health services. Should go deep among the floating population concentrated area, adopt to preach, posters, and issuing of materials, new media, and other forms to carry out propaganda, make them understand the national basic public health services of the service object, content, process, etc. According to the characteristics of the floating population, should focus on strengthening health education, immunization, maternal health, disease control and prevention and public health services.

(14) extending community health service function. According to the basic medical and health community people demand, and constantly improve the community health service contents, service forms, rich development services. Encourage community health service institutions and pension service agencies to carry out various forms of cooperation, strengthen cooperate with related departments, medical a collaborative advancement service mode. Encourage community health service institutions in areas of service-oriented organizations, schools, office buildings, and other functions, the community people to carry out targeted to basic medical and health services. Guide the community residents to participate in community health service, by conducting a club or a chronic disease care support groups, training family such as form, improve the residents' awareness of self health management.

Four, strengthen the management of community health service security and supervision

(15) to improve the quality of medical security. Strictly implement relevant laws and regulations of medical quality management norms, rules and regulations, and diagnosis and treatment, strengthen medical quality control. Strengthen the disposable medical supplies, disinfectants, disinfecting apparatus, etc. Show me and validation work. For dental therapeutic, disinfection supply room, dressing room and debridement room key sectors such as medical equipment and the environment to strictly carry out cleaning, disinfection and sterilization. To strengthen the hospital infection control, strict disinfection sterilization operation standard, handling medical waste, according to the requirement shall practise a system of registration and management, ensure medical safety. Strictly abide by the principle of the use of antibacterial drugs, hormones and combined use of antibacterial drugs indications. The reasonable choice method, control the use of antibacterial drugs, hormones, intravenous drug use ratio, ensure that the drugs and diagnosis. Improve the medical risk sharing mechanism, and encourage community health service institutions to participate in the medical liability insurance.

(16) to strengthen the information technology support. Promote residents use \"all-in-one-card\", go to a doctor with good use electronic health records. In provinces (autonomous regions and municipalities) as the unit, the construction of community health service information management system as a whole, the further integration of maternal and child health care, family planning, vaccination, the infectious disease report, severe mental disorder and so on various related business system, to avoid repeated input data. To promote community health information platform and community public service comprehensive information platform for effective docking, promote community health services and other community public service, the convenience and benefit, voluntary and mutual assistance service organic integration and system integration. Perfecting community health service information management system function, gradually realize reservation, registration, diagnosis and treatment, referral, public health services and fees, insurance settlement, inspection and application functions such as drug management, strengthen organization internal information sharing, step by step through the information system to realize the dynamic regulation of quantity and quality of service. To strengthen the construction of regional health information platform, promote community health service institutions and regional information connectivity between other medical and health institutions, the resources sharing. Make full use of the mobile Internet, smart client, instant messaging and other modern information technology, strengthen the doctor-patient interaction, improve residents' feeling, increase the efficiency of the service.

(17) to strengthen the policy support and performance appraisal. The family planning administrative department of public health, management of traditional Chinese medicine departments at all levels to promote the implementation of community health service agencies, financial aid, personnel distribution and other related security policy, fully arouse the enthusiasm of community health workers. To further strengthen the supervision and management of community health service institutions, to establish and perfect the management system, strengthening the construction of community health service organization culture and ethics. Around to constantly improve the system of performance evaluation, will improve the service quality related content into the important content of community health service institutions examination, to promote community health service institutions continue to improve service, improve the residents' trust and utilization.

The national health and family planning commission of the state administration of traditional Chinese medicine

On November 17, 2015