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    Home > Medical News > Medical World News > Hospital assessor: our work is very similar to "Chinese captain"

    Hospital assessor: our work is very similar to "Chinese captain"

    • Last Update: 2019-10-29
    • Source: Internet
    • Author: User
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    After five years of training, Li Jinsong finally got the certificate of hospital assessor There are only a hundred people in China who have obtained this certificate This is the first batch of reviewer certificates issued after the hospital review was restarted in 2011 Every time when he went to the hospitals for evaluation, others called him "Mr Li", and his job was Deputy Secretary of the Party committee of Xinhua Hospital Affiliated to Shanghai Jiaotong University Recently, he often flashed in his mind the scene of the newly released movie "captain of China": when the crew is on a flight mission, the captain, the purser and the stewardess often form a temporary team and don't know each other, but they can cooperate with each other to complete a flight Because the units have been strictly homogenized It's very similar to our own hospital evaluation work Six people are organized at a time to perform their respective duties "In my mind, there are only standards and standards You may not know them, but they are all well-trained It's like the captain doing the captain's work and the purser doing the purser's work Each of them checks several things over and over again." Homogenization assessor is the key of hospital evaluation, and it is also the common practice of hospital quality and safety service certification in the world This "homogenization" team of judges began in 2012 The Ministry of Health established the National Hospital Evaluation Project Office (hereinafter referred to as the Evaluation Office) in the previous year, following the restart of hospital evaluation and the release of the 2011 version of the Interim Measures for hospital evaluation Chen Xiaohong, who just retired from Beijing 301 Hospital, was responsible for the establishment of the evaluation office and participated in the whole process of the new round of hospital evaluation She looks forward to this new evaluation system, which will change the traditional evaluation method of "one hammer sale" and evaluation for evaluation She believes that modern hospital management must follow the "standard" and not change dramatically due to the change of the president Looking back, China's hospital accreditation has experienced three decades of twists and turns: it started in 1989, went through ten years of rapid progress, and was once stopped in 1998 because of the will of the chief above the system, resulting in "pompous, falsifications, formalism"; since then, until 2011, the Accreditation was restarted In the middle 12 years, China's hospitals coincided with the "golden age" of rapid expansion, which is in urgent need Authoritative evaluation system, in the fierce market competition for its "proof" To fill the market gap is the international JCI standard, which once became the certification system for Chinese hospitals Since the restart of a new round of hospital evaluation in 2011, the medical market has undergone tremendous changes The previous evaluation standards focusing on technology and scale, as well as the evaluation implementation work full of human factors and great differences, have turned to be more scientific, more homogeneous and more international A new quality management evaluation system Why is this evaluation system that makes presidents "love and hate"? What efforts have been made in the new round of hospital accreditation, and can problems in the past be avoided? It is not too late to start hospital evaluation in China The prototype first appeared in the 1970s, and hospitals around the country spontaneously carried out "civilized hospital" evaluation In the 1980s, under the chairmanship of Chen minzhang, the former Minister of health, this matter was put on the agenda Yu Zonghe, a doctor, has gone through the whole process of preparation He has been the director, deputy director and director of the Department of medical administration of the Ministry of health since the 1980s Before assuming the post of medical administration department, Yu Zonghe was a doctor of Union Medical College Hospital and a colleague of Chen minzhang They met some grassroots patients in clinical practice, who should not be sent to Xiehe, so they came up with the idea that different hospitals should have evaluation criteria matching their functional tasks, and had exchanges I didn't think that these ideas were used in the later work Shortly after taking up the post of medical administration department, Yu Zonghe and others went to Australia, New Zealand, the United States and other countries for investigation with the support of Chen minzhang They got in touch with the experience of hospital accreditation in various countries and broadened their horizons The United States is the first country in the world to carry out hospital evaluation, and the most authoritative is the Joint Commission (JC) established in 1914 As we all know, JCI is the abbreviation of the international version of evaluation standards formulated by the JCI After consulting the experience of other countries and brewing for two years, the Ministry of Health issued the measures for the hierarchical management of general hospitals (Trial draft) in November 1989, which was piloted in Shenyang, Dalian, Beijing and other cities China has become the seventh country in the world to carry out hospital accreditation Chen minzhang once talked about the outstanding feature of this work, that is, the combination of hierarchical management and evaluation, that is, the hospital is divided into three levels, within the same level, a, B, C rating, to encourage the competition and promotion of hospital management He also explicitly instructed that hospital evaluation standards should be combined with the goals of medical reform In that era, hospital hardware was generally backward Like ordinary people's dream of new appliances, the desire to improve hospital hardware was natural, and technical ability was considered as the top priority in the evaluation standard "At that time, it was impossible to change management first and then technology," Yu said Management and finance should guarantee the realization of technology, otherwise they will not keep up with it " At that time, the government strictly controlled the charging standard of the hospital, and the registration fee was only a dime Through the Zhejiang pilot project, Yu Zonghe pushed the charging distance of the third level hospitals in the evaluation standard to be widened, with 15% difference between the three levels In 1993, this pilot project was launched from Zhejiang to 23 provinces in China He believed that the hospital patient shunt must have the economic lever, through the classification standard setting, has realized the breakthrough in the hospital charge standard difference In February 1994, the State Council promulgated the regulations on the administration of hospital institutions, which clearly stipulated that "the State implements the hospital evaluation system", which means that the hospital evaluation in China has been brought into the orbit of legalization Since then, hospital reviews have been widely carried out Statistics show that the total number of hospitals reviewed in this stage reached 17708, making China the country with the largest number of hospitals reviewed in the world at that time However, there are some problems in pushing forward quickly, and the evaluation of "sports and activity" appears At a meeting of the Ministry of health in 1997, Chen minzhang made a sincere summary While affirming the direction, he confessed that there was "exaggeration, falsification and formalism" The Department of medical administration of the Ministry of health is also reflecting, and began to adjust from the perspective of the connotation standard of the hospital One evening in 1996, Yu Zonghe had dinner with Ma Xiaowei, then the president of the First Affiliated Hospital of China Medical University (now the director of the national health and Health Commission), and mentioned the idea of starting the pilot of the third level special hospitals, "the third level special hospitals should pay attention to the construction of hospital connotation Instead of focusing on scale, we should focus on internal transformation, full use of existing resources, service and quality, and focus on these aspects " Yu Zonghe recalled his imagination at that time He realized that the hospital at that time had "almost all the necessary equipment", and should turn to how to improve efficiency, shorten the average length of stay and other quality indicators Soon after that, the First Affiliated Hospital of China Medical University began to reform the old hospital, changed its internal management under the limitation of scale, and put forward the reform concept of "patient-centered" However, such an autonomous turn is only a case in point In the whole country, it is the general trend to rectify the chaos of hospital evaluation In August 1998, the Ministry of health officially issued a document to suspend the nationwide hospital evaluation In March of the next year, the Department of medical administration of the Ministry of health reevaluated the hospital evaluation work in the past ten years, and concluded that this was a "serious, meticulous, systematic and comprehensive strengthening and rectification process" At the same time, the author holds that although the Ministry of health has formulated a unified evaluation standard, the implementation in various provinces and cities varies widely, resulting in a large gap in the quality of evaluation; some hospitals pay more attention to "hard" than "soft", blindly compare with each other, expand the scale, and compete for equipment; in addition, in order to meet the evaluation, employees are mobilized to work overtime to modify documents and cases, resulting in data fraud Hospital accreditation stopped for 12 years, and it was not restarted until 2011 Chen Xiaohong recalled that although the evaluation of hospitals was suspended in 1998, the research of the Ministry of health has not stopped In 2005, the Ministry of health took the "hospital management year" as an opportunity to issue the "hospital management evaluation guide (Trial)", which is the first new hospital evaluation standard issued since the national hospital evaluation was suspended in 1998 It is the basis for the hospital to strengthen the connotation construction and the health administrative department to "guide, evaluate, inspect and supervise" the hospital During the suspension period, many domestic hospitals began to apply for JCI certification abroad as the goal Among them, hospitals in Zhejiang Province are particularly active In 2006, Shao Yifu Hospital Affiliated to Zhejiang University Medical College became the first hospital in China to pass JCI certification He Qiang, deputy secretary of the Party committee of Zhejiang People's Hospital, explained the reason why JCI is popular in Zhejiang: the local medical market is very competitive Taking Hangzhou as an example, the core urban area has a population of about 5 million and more than 30 top-3 hospitals, most of which have the same strength; secondly, the county-level hospitals in Zhejiang Province have strong capacity Among the top ten county-level hospitals in China, there are four in Zhejiang Province; thirdly, Zhejiang is adjacent to Shanghai, and the patients in the province can easily go to Shanghai for medical treatment and get through medical insurance Even the provincial people's Hospital feels the pressure of competition He Qiang said that the 35 year old hospital was not prominent in the medical circle of Hangzhou in its early years It was even called "Zhaohui hospital" by its peers from the First Affiliated Hospital of Zhejiang University "For evaluation, hospitals have a lot of needs On the one hand, they need to prove themselves, and on the other hand, they need to have a handle on management." "In addition, with the deepening of internationalization, there are more and more overseas patients, and the hospital has passed JCI certification, so it is convenient to connect the commercial medical insurance of overseas patients," he said However, he Qiang felt that JCI was not satisfied with local conditions For example, JCI limits the service volume of medical institutions A certain number of medical staff and treatment facilities can only serve the number of patients of the corresponding scale However, most of the hospitals in China are top three hospitals, and the number of patients is too large to meet the standard requirements of JCI Therefore, in accepting JCI evaluation, the hospital should take various methods to reduce the usual service volume, such as closing some wards Under the JCI standard, Chinese participating hospitals often "tighten their belts and work hard for several months" when they participate in the evaluation Once the evaluation is finished, "they are back to their previous state" In this way, there will be participating in the evaluation for the purpose of participating in the evaluation, and the help to improve the management of the hospital will be limited In this way, on the one hand, under the challenge of intensified competition, hospitals around the world need an authoritative review to prove themselves and improve their management level; on the other hand, the review work in China has been stopped for more than ten years, while the "foreign standard" JCI is not grounded There is an urgent need for a solution to the dilemma Hospitals all over the world are seeking JCI certification, which makes supervisors realize that hospitals have objective requirements for evaluation in their own development process; from the problems existing in daily work of hospitals, we can see the necessity of evaluation Therefore, after a full ten-year suspension, a new round of hospital review was put on the agenda in 2009 Since then, the formulation of standards has lasted for more than two years and revised more than 60 times In September 2011, the former Ministry of Health issued the Interim Measures for hospital evaluation, a new
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