Source: [Dahe Health News]
htmlOn June 6, the National Health Commission issued the "Interim Regulations on Outpatient Quality Management of Medical Institutions", requiring medical institutions at second-level and above to include outpatient quality management in the work system of the Medical Quality Management Committee, strengthen outpatient quality management of medical institutions, improve the quality of outpatient medical services, and ensure medical safety. The "Regulations" apply to level 2 and above medical institutions, excluding emergency clinics, fever clinics, intestinal clinics, and Internet clinics. will come into effect on June 6, 2022.The "Regulations" clearly state that outpatient clinic refers to the behavior of medical personnel in medical institutions that provide medical services such as disease consultation, prevention, diagnosis, treatment, nursing, rehabilitation, etc. based on the patient's valid registration certificate. Outpatient quality management is a process of managing and controlling outpatient service elements, processes and results in accordance with relevant requirements and regulations, in order to achieve continuous improvement of outpatient quality, mainly including medical personnel visit management system, source management system, pre-examination and triage system, outpatient medical document management system, multidisciplinary (MDT) outpatient system, special outpatient system, outpatient referral system, outpatient surgery management system, and outpatient emergency response system.
The "Regulations" point out that medical institutions should strengthen the management of medical personnel's visits, dynamically adjust the number of medical units and the number of unit receptions, reasonably allocate outpatient human resources; dynamically adjust the number of registration channels and number sources, strengthen the management of withdrawal and cancellation, and establish a candidate mechanism for withdrawal; implements time-divided appointments to improve the rate of patients' visits within 30 minutes after they arrive at the hospital; clarify the effective time of registration, establish a guarantee mechanism for patients to continue visiting due to test and examination results, and reasonably arrange the order of patients' follow-up visits . Medical institutions should improve the work efficiency of medical and technical departments, shorten the appointment waiting time for examinations, endoscopy, ultrasound, CT, magnetic nuclear magnetic field, etc., and issue inspection and inspection reports within the prescribed time limit to promote mutual recognition and sharing of inspection and inspection results; equip the number of outpatient doctors or intelligent guidance equipment at a rate of no less than 0.2% of the average daily outpatient volume, and provide medical assistance services for patients with mobility difficulties.
The "Regulations" propose that medical institutions should actively promote multidisciplinary (MDT) clinics and consolidate the visitor and time, and the content of diagnosis and treatment records should be comprehensive and specific. Strengthen the management of outpatient difficult cases, establish an outpatient difficult case consultation system, and provide outpatient difficult case consultation services; strengthen the ability of pharmacy services, implement outpatient prescription review and comment system, and provide outpatient drug consultation and medication guidance services for patients; strengthen outpatient intravenous infusion treatment management, strictly grasp the indications of intravenous infusion treatment, control the use rate of outpatient infusion treatment, monitor and promptly handle adverse reactions; strengthen the management of outpatient medical records and other medical documents, and promote the use of outpatient electronic medical records.
The "Regulations" require that medical institutions should strengthen the management of outpatient clinical critical value, formulate outpatient critical value reports and processing procedures, report promptly and accurately and notify patients to seek medical treatment in a timely manner; formulate catalogs of outpatient surgery and invasive diagnosis and treatment, implement core systems for medical quality and safety, strictly grasp the indications, formulate specific preoperative discussions, surgical safety verification, surgical site identification and other systems and processes; strengthen outpatient infectious diseases pre-examination, triage, disinfection, isolation and occupational protection; strengthen outpatient emergency management, establish emergency plan , equip rescue equipment and drugs, organize training and drills regularly, and strengthen inspections.
It is understood that in recent years, with the development of medical and health care, the outpatient diagnosis and treatment services in my country's medical institutions have increased day by day, the service scope has gradually expanded, and the service connotation has become richer. In 2021, the number of outpatient diagnosis and treatments in medical institutions above the second level in the country exceeded 3 billion, and new service forms such as appointment diagnosis and treatment, multidisciplinary (MDT) clinics, and special needs clinics have increased day by day, and the demand for strengthening outpatient quality management is getting higher and higher. However, the national requirements for outpatient quality management of medical institutions are spread in multiple documents, which is not conducive to medical institutions' continuous improvement of outpatient quality management and outpatient quality. The implementation of the "Regulations" will help ensure medical quality and safety, and guide medical institutions to carry out outpatient quality management systematically and standardize.
full text is as follows:
Interim Regulations on Outpatient Quality Management of Medical Institutions
Article 1 In order to strengthen the outpatient quality management of medical institutions and ensure medical safety, these regulations are formulated in accordance with the provisions of " Physician Law of the People's Republic of China ", " Infectious Disease Prevention and Control Law of the People's Republic of China ", " Medical Institution Management Regulations ", " Medical Quality Management Measures " and other relevant laws and regulations.
Article 2 This regulation applies to the quality management of outpatient clinics of secondary and above medical institutions (excluding emergency clinics, fever clinics, intestinal clinics, and Internet clinics).
Article 3 Outpatient clinic refers to the act of medical staff in which medical personnel provide medical services such as disease consultation, prevention, diagnosis, treatment, nursing, rehabilitation, etc. based on the patient's valid registration certificate.
Article 4 Medical institutions shall strictly practice in accordance with the law and provide relevant outpatient services within the scope of their practice.
Article 5 Outpatient quality management refers to the process of using modern scientific management methods to manage and control outpatient service elements, processes and results in accordance with the laws and relevant laws and regulations formed by outpatient quality and the requirements of relevant laws and regulations to achieve continuous improvement of outpatient quality.
Article 6 Outpatient quality management is an important part of quality management of medical institutions. Second-level and above medical institutions should include outpatient quality management in the work system of the Medical Quality Management Committee, clarify the departments responsible for daily outpatient management, establish outpatient quality management systems, continuously improve the outpatient quality management system in accordance with the two-level responsibility system of hospital and department, strengthen daily supervision and inspection, regularly collect, analyze and feedback outpatient quality data, and promote continuous improvement of outpatient quality.
Article 7 The outpatient quality management system refers to a system formulated by medical institutions in accordance with relevant national laws, regulations and management requirements, and that medical institutions and their medical personnel should strictly abide by in outpatient diagnosis and treatment activities. It mainly includes medical personnel visit management system, source management system, pre-examination and triage system, outpatient medical document management system, multidisciplinary (MDT) outpatient system, special outpatient system, outpatient referral system, outpatient surgery management system, and outpatient emergency response system.
Article 8 Medical institutions shall strengthen the management of medical personnel's visits, reasonably arrange medical doctors of different seniority in each major in accordance with the classification and characteristics of outpatient patients' disease types; and dynamically adjust the number of visiting units and the number of unit receptions based on the regional and seasonal characteristics, combined with the use of the number source, and reasonably allocate outpatient human resources.
Article 9 Medical institutions shall implement patients’ real-name medical treatment. The unique identity management of patients is implemented in all aspects such as registration, registration, diagnosis and treatment.
Article 10 Medical institutions shall dynamically adjust the number source delivery volume of each registration channel according to changes in the number of medical treatments, strengthen the management of withdrawal and cancellation of appointments, establish a candidate mechanism for withdrawal, and improve the efficiency of the use of the number source. Strengthen appointment registration management and provide a variety of appointment registration methods such as network, self-service machines, clinics, and manual windows.
Article 11 Medical institutions should actively promote time-divided appointments for diagnosis and treatment, increase the rate of patients seeking medical treatment within 30 minutes after they arrive at the hospital, guide patients to seek medical treatment in an orderly manner, reduce waiting time in the hospital, and reduce gatherings of people.
Article 12 Medical institutions shall strictly implement the outpatient first-patient responsibility system. Before the end of this medical treatment process or before other doctors receive the patient, the first-patient doctor shall be responsible for the patient's examination, diagnosis, treatment, rescue and transfer of departments.
Article 13 The outpatient diagnosis and treatment process and disposal measures shall follow diagnostic and treatment standards, clinical guidelines, etc., and diagnostic, prevention and treatment measures shall follow the principles of safety, standardization, effectiveness and economical.
Article 14 Medical institutions shall actively promote multidisciplinary (MDT) clinics, and MDT clinics shall be provided at a fixed time and place by a relatively fixed team of experts. The content of the MDT outpatient diagnosis and treatment records should include the visit time, the department, the name and professional and technical positions of the participants, the main complaint, the current medical history, past history, physical examination, auxiliary examination results, the comprehensive diagnosis and treatment opinions of the MDT outpatient team and the signatures of all physicians participating in the discussion.
Article 15 Medical institutions shall strengthen the management of outpatient difficult cases, establish an outpatient difficult case consultation system, provide outpatient difficult case consultation services, and ensure that patients are treated in a timely manner.
Article 16 Medical institutions shall clarify the valid registration time, establish a guarantee mechanism for patients to continue visiting medical treatment due to the return of test and examination results, and reasonably arrange the order of patients' follow-up visits.
Article 17 Medical institutions shall improve the work efficiency of medical and technical departments, shorten the waiting time for appointments for examinations, endoscopy, ultrasound, CT, magnetic and other examinations, and encourage the provision of various forms of appointment services such as centralized appointments for outpatient examinations, self-service appointments, and clinic appointments. If conditions permit, one-stop examination appointment services can be provided.
Article 18 Medical institutions shall issue inspection and inspection reports within the prescribed time limit in accordance with relevant regulations, and conduct statistics and analysis on the issuance time of various outpatient inspection and inspection reports, and gradually reduce the time of issuance of reports according to actual conditions. Medical institutions should promote mutual recognition and sharing of inspection and inspection results, improve the efficiency of medical resource utilization, and improve the medical experience of the people.
Article 19 Medical institutions shall strengthen the management of outpatient clinical critical value, formulate outpatient critical value reports and processing procedures, report promptly and accurately, and notify patients to seek medical treatment in a timely manner to ensure the medical safety of patients.
Article 20 Medical institutions shall formulate a catalog of outpatient surgery and invasive diagnosis and treatment, conscientiously implement the core systems for medical quality and safety, strictly grasp the indications, and formulate specific preoperative discussions, surgical safety verification, surgical site identification and other systems and processes based on the patient's condition, surgical level, anesthesia methods, etc., to ensure the safety of outpatient invasive diagnosis and treatment and surgery. The outpatient surgery records should include the operation time, the name of the operation, the level of the operation, the preoperative diagnosis, the postoperative diagnosis, the name of the operator and assistant, the anesthesia method, the operation process, the destination of the specimen, etc.
Article 21 Medical institutions shall strengthen their pharmaceutical service capabilities, implement outpatient prescription review and comment system, and provide patients with outpatient drug consultation and medication guidance services.
Article 22 Medical institutions shall strengthen the management of outpatient intravenous infusion treatment, strictly grasp the indications of outpatient intravenous infusion treatment, control the utilization rate of outpatient intravenous infusion treatment, closely monitor and promptly deal with adverse reactions of outpatient intravenous infusion treatment.
Article 23 Medical institutions shall strengthen the management of medical documents such as outpatient medical records, associate outpatient medical records with the patient's unique identity label, carry out outpatient medical records review and quality control work, and ensure that the content of outpatient medical records is objective, true, accurate, timely, complete and standardized. Outpatient diagnosis should distinguish between main diagnosis and other diagnosis.
Article 24 Medical institutions shall promote the use of outpatient electronic medical records. If an outpatient electronic medical record is used, the unified disease diagnosis and surgical operation code library of the health and health administrative department shall be adopted to establish, record, modify, use, save and manage outpatient electronic medical record information in accordance with the relevant provisions of the "Electronic Medical Record Application Management Standards (Trial)" to ensure that the patient's diagnosis and treatment information is complete, continuous and traceable.
Article 25 Medical institutions shall strengthen the pre-examination, triage, disinfection, isolation and occupational protection of outpatient infectious diseases, and implement standard preventive measures such as hand hygiene and environmental cleaning and disinfection. High-risk infection departments in hospitals such as endoscopic centers (rooms), hemodialysis centers (rooms), outpatient operating rooms, and dentistry shall formulate and implement relevant systems for infection prevention and control in medical institutions.
Article 26 Medical institutions shall strengthen the management of outpatient medical treatment order and equip appropriate security forces in accordance with relevant national regulations to ensure the safety of patients and medical personnel. At the same time, improve the medical quality (safety) rate of adverse events and reduce and avoid accidental injuries to patients and medical staff during diagnosis and treatment.
Article 27 Medical institutions shall strengthen the management of outpatient emergencies, establish emergency plans, equip rescue equipment and medicines according to standards, organize training and drills regularly, strengthen inspections, and promptly and properly handle outpatient emergencies.
Article 28 Medical institutions shall, in accordance with the provisions of the "Regulations on the Disclosure of Information of Medical and Health Institutions", adhere to the principles of legality, compliance, truthfulness, accuracy, convenience and practicality, timely and proactiveness, and disclose relevant information such as outpatient medical service items, processes, common medicines and major medical consumables; strengthen the maintenance of websites, mini programs, public accounts, etc. to ensure that information is released in a timely and accurate manner.
Article 29 Medical institutions shall carry out various forms of health education in outpatient clinics such as text, audio, and video. Medical institutions with conditions may carry out special health education courses to convey scientific, accurate and practical medical and health information.
Article 30 Medical institutions shall create a safe, comfortable, warm and clean medical environment. The outpatient clinic has a scientific and reasonable layout, safe facilities and equipment, and has barrier-free facilities. The medical signs are clear and the warnings are eye-catching.
Article 31 Medical institutions shall equip outpatient medical guides or intelligent guidance devices at a rate of no less than 0.2% of the daily outpatient volume, and provide medical assistance services for patients with reduced mobility. Medical institutions are encouraged to provide social worker and volunteer services in outpatient clinics.
Article 32 Medical institutions shall establish satisfaction surveys, analysis, feedback and improvement mechanisms, conduct outpatient satisfaction surveys regularly, and improve patients' medical experience.
Article 33 Medical institutions shall strengthen outpatient complaint management, disclose complaints and medical dispute handling methods, and provide good reception, analysis, feedback and continuous improvement of complaints.
Article 34 The management of fever clinics, intestinal clinics, and Internet clinics in medical institutions shall be implemented in accordance with relevant regulations of the health administrative department.
Article 35 The medical treatment unit in these regulations refers to the half working day when a medical staff is in the clinic at one time.
Article 36 These provisions shall come into force on June 6, 2022.
Source: National Health Commission, Health News
This article comes from [Dahe Health News] and only represents the author's views. National Party Media Information Public Platform provides information release and dissemination services.
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