China News Service, Beijing, March 4th. In January 2017, the "13th Five-Year Plan" medical reform plan, which is closely related to the core interests of ordinary people to see a doctor, was issued, marking that medical reform has entered a new stage.
Member of the Expert Advisory Committee of the State Council Medical Reform Leading Group and Director of Shanghai Shenkang Hospital Development Center pointed out that "establishing a scientific and effective modern hospital management system" is one of the five important tasks for deepening medical reform during the 13th Five-Year Plan period, and has been given deeper connotation and higher expectations, and is regarded as the "hub" for deepening public hospital reform .
Chen Jianping said that from the 11-year reform practice of Shanghai municipal public hospitals, it can be seen that establishing a modern hospital management system mainly involves two tasks: management system and operation mechanism. The core of the modern hospital management system is "separate management and office, separate government and affairs" and "separate two powers and clear rights and responsibilities."
From his understanding, this means that the government's exercise of the management of the entire medical and health industry is separated from investing in the establishment of public hospitals and performing the functions of state-owned assets investors in public hospitals. The government's exercise of administrative management function is separated from the operation and management functions of public hospitals; the medical entity (the representative of the investor) exercises the ownership of state-owned assets and is moderately separated from the operation and management autonomy of the legal person in public hospitals, each taking its own position and performing its duties.
He said that this is based on a comprehensive analysis of the problems and basic characteristics of the current problems and basic characteristics of public hospitals facing our country, and he has drawn the core of the public hospital management system based on a comprehensive analysis of the current problems and basic characteristics of public hospitals in my country.
Data picture: A male nurse is working in a public hospital in Guangxi. Photo by Zhu Liurong
Chen Jianping believes that the structure of the modern hospital management system should be a professional, refined and standardized closed management loop supported by strategic planning management, comprehensive budget management, performance management as the starting point, asset supervision and audit supervision as the guarantee, and informatization and big data as the support.
Specifically, strategic planning management guides public hospitals to scientifically answer the two questions of "what kind of hospital should be run" and "what kind of hospital should be done" and bring hospital development into the strategic planning management track, so that hospitals have a clear idea of development. At the same time, the hospital development plan is closely combined with the president's term goals, so that it will not only become the common goal of all the hospital staff, but also the president's term responsibility.
Comprehensive budget management guides public hospitals to improve the level of economic operation management, incorporate all income and expenditure into the track of comprehensive budget management, strengthen economic operation analysis , and let hospitals "have a clear idea of spending money." While implementing comprehensive budget management, the investor will appoint chief accountants to the public hospitals, be responsible to the investor, assist the president in strengthening the hospital's financial management, economic analysis and risk prevention, and continuously optimize the professional structure of the economic management of public hospitals.
performance management has established an effective incentive and constraint mechanism, guide public hospitals to implement the government's purpose of running medical services, and focus on the performance orientation of "improving services, improving quality, controlling costs, and benefiting the people", and encourage all employees, including the presidents of public hospitals, to "have their responsibilities in their hearts of performing their duties." Among them, the design of the indicator system for the performance appraisal of the president insists on public welfare as the core and takes into account operation performance, highlighting the positive guidance for the operation of public hospitals; the assessment results are "implemented" and are linked to the president's annual performance rewards and punishments, selection and appointment, evaluation and evaluation of the hospital, and the approval of the total salary budget of the hospital.
The reform of the internal performance appraisal and distribution system of hospitals is aimed at "two cuts, one transformation" and "eight elements", that is, cut off the direct link between the economic income indicators of clinical departments and the income distribution of medical personnel, cut off the direct link between the income of medical personnel and the income of prescriptions, examinations, consumables, etc., and change the model of department revenue reduction and surplus commission distribution, and carry out the assessment and distribution of medical personnel around core elements such as "job workload, medical quality, disease type and surgical difficulty, patient satisfaction, cost control, medical expense control, clinical research and teaching, medical ethics and medical style", and explore the establishment of a performance compensation system that conforms to the characteristics of the medical industry.
On January 27, 2017, a doctor in the intensive care unit of the Emergency Department of Binzhou Medical College Affiliated Hospital was examining the patient.Photo by Qiu Yu, China News Service,
Asset supervision and audit supervision guide hospitals to establish an internal control system for , standardize economic operation behavior, ensure the safe preservation and effective use of state-owned assets, and allow hospitals to "have a warning in their operation." The efficient use and standardized management of state-owned assets will help strengthen the public welfare attributes of public hospitals and improve the ability and efficiency of state-owned assets of public hospitals to serve the development of health and serve the health of the general public; the establishment and improvement of internal control systems will support the standardized operation of public hospitals, effectively control costs and expenses, and make hospitals more efficient in operation and benefit more from the people's medical treatment.
Informatization and big data support the transformation of service models and innovation of management models in public hospitals, allowing hospitals to "serve the people in their hearts" and "management knows". Relying on the rapid development of information technology, we will promote the informatization construction of public hospitals and realize real-time sharing of clinical information in patients. "There is no need to repeat the cross-hospital inspection and examination, and the cost of medical treatment has been reduced"; the medical treatment process is smooth and convenient, "there is no need to go to the hospital to check it at home," and "The long queue at the payment window is gone, and the registration and payment has been completed by self-service"; the intelligent level of clinical diagnosis and treatment is effectively improved, "the past medical history and medication status are clear at a glance, there are taboos in the compatibility, repeated medications and intelligent reminders." That is, through systematic collection, real-time monitoring, and fully tapping the medical big data of public hospitals, we will guide and support the professional, refined and standardized management at the micro, meso and macro levels.
Chen Jianping pointed out that the reform of public hospitals is a systematic project. At the critical stage of deepening the comprehensive reform of public hospitals entering the "deep water zone" and "tough period", we should follow the "Plan for Deepening the Reform of the Medical and Health System in the 13th Five-Year Plan", adhere to the original intention of reform, grasp the core of reform, actively explore and strive to innovate, and continuously improve the professional, refined and standardized management capabilities and levels of public hospitals. We hope that the closed loop of modern hospital management system can become the wheel of public hospital reform, promote the healthy and sustainable development of public hospitals, better provide health care services to the people, and contribute to the construction of a healthy China. (End)
