Six truths to explain the reason why the public defender can't do well

Basic public health service (hereinafter referred to as public health service) is a systematic and long-term project As the main body of public health service implementation, basic medical and health institutions throughout the country have been exploring the innovation and integration of public health service mode in the past decade However, behind a series of positive and beneficial attempts of grass-roots institutions, the satisfaction of residents, the awareness rate of the project, the service quality and efficiency of public health personnel are still low, which is lamentable Why does this happen? Based on years of working experience, I would like to discuss with you At present, free and voluntary national basic public health services are provided to residents by village clinics, township hospitals, community health service centers (stations) and other basic medical and health institutions However, due to the lack of clear access standards for the implementation of basic public health services in all levels of departments, coupled with the lack of attention paid by the heads of some grass-roots institutions and relevant personnel, the access threshold for basic public health services personnel is too low New employees are often young, unqualified or retired, logistics personnel and temporary workers become the "main force" of the industry Imagine, without basic experience and technology, they can implement 47 basic public health services in 12 categories with high quality and quantity? What's the source of residents' satisfaction and access to services? In any policy, the national level will take into account the imbalance of regional economy and development, although the country will further narrow the gap between regions through comprehensive consideration, economic inclination and other policies However, due to China's vast territory and large population, it is impossible for all regions to take full account of it In some coastal areas, the development of public health has a good advantage because of its obvious location advantage and good economic development foundation Taking the elderly health management in Laoshan District, Dongying Kenli County and other districts and counties in Qingdao as an example, each district and county will give a corresponding special fund subsidy for each 65 year old and above examined when all the supporting funds for basic public health service projects of the state, Shandong Province and county (urban area) are in place As an underdeveloped area in the northwest of Shandong Province, it is not easy to do a good job of "prescribed action" It is not easy to do another "innovative action" for grass-roots organizations or personnel Strictly speaking, the implementation of public health projects in grass-roots institutions is generally the overall responsibility of the president A vice president assists the president to provide basic public health services In addition, a public health department will be set up with a chief of public health department to arrange specific tasks within the Department In theory, it should be a framework system that focuses on one level at a time However, sometimes in order to facilitate work, grass-roots organizations often arrange work and tasks beyond their own level, which will lead to management disconnection and buck passing When providing basic public health services for residents, basic institutions are required to use various forms such as physical examination form and follow-up form according to the requirements of various special service specifications However, with the development of the times, there is a need for information exchange and sharing between grass-roots organizations and regions Software companies have developed a variety of public health information systems Taking Linqing primary medical and health institutions in Shandong Province as an example, from the initial wave software to Zhongyang software, to Liaocheng City, there is not a completely unified crown new software In a sense, the development and utilization of a series of public health software really facilitates the development of basic public health services and improves work efficiency However, there is a chaotic situation in which all kinds of public health software coexist To achieve regional unification, it will take time due to human, financial, material and other factors At present, the grass-roots institutions carry out public health services, and regularly rank the grass-roots personnel in performance evaluation every month, and then cash the rewards and punishments according to the results The general education level of public health personnel in the above-mentioned grass-roots institutions is not high, the quality of personnel is uneven, and the effect, quality and level of project performance evaluation can be imagined In addition, there are some organizations where public health personnel are both referees and athletes That is to say, public health officers often assess themselves Sometimes, performance evaluation is just a formality, not untrue, and there is no way to talk about rewards and punishments The state has been advocating medical and health integration, and Shandong Province has also actively carried out the pilot work in some counties (urban areas) The integration of medical treatment and prevention is to closely link basic medical treatment and basic public health, and form a joint force to provide residents with high-quality, convenient, thoughtful and warm services However, at present, the integration of medical treatment and prevention has not been well implemented in the grass-roots institutions First, it is due to the limitations of the ability and technical conditions of grass-roots personnel Second, medical personnel attach great importance to treatment rather than prevention Third, the basic public health service projects are not attractive As a good starting point of basic public health services, family doctor signing services complement and benefit each other in promoting the implementation of basic public health services, but the important role of family doctor signing services has not been highlighted, the most important reason is that the residents do not believe and recognize the technology of grass-roots institutions From the above analysis, it can be seen that the quality and efficiency of public health service in grass-roots institutions need to be further improved How to continuously improve the technical path and method of service, and optimize the structure and workflow of public health personnel to the greatest extent, the author thinks that the following four aspects should be started The professional ability and professional level of grass-roots institutions have a very direct impact on the quality of basic public health services The recruitment system with high standards and strict requirements is to better ensure the work quality of grass-roots public health personnel Under the premise of high standard selection, the service group should be continuously trained, so that the public health personnel can not only better understand the daily work content, but also improve their own business level, and then calmly handle the problems encountered in the work Therefore, it is necessary to establish a long-term and effective personnel training system Grass roots organizations should regularly carry out project specific training, so that more project personnel are familiar with the objects, contents, processes, requirements, work indicators, etc of each special service specification in the national basic public health service specification (the Third Edition), and improve their own business capabilities while expanding their horizons In the process of training, it is necessary to let the public health personnel of grass-roots institutions learn to understand the contents of the standard, such as the integration of medical treatment and prevention, regular comprehensive physical examination for patients with hypertension, diabetes and the elderly, combined with the first quarter of each year follow-up to carry out relevant services at the same time, so as to avoid the laborious rush of personnel and strive to maximize the service efficiency Grass roots organizations shall use unified forms to provide basic public health services and carry out systematic training on the use of public health software for all staff in close combination with the requirements of the code In order to make the construction of basic public health service information platform more and more perfect, the detailed implementation plan shall be formulated according to the time and task nodes, and special office institutions shall be set up, equipped with independent machine rooms and new equipment In order to promote the equalization of basic public health services, all levels of institutions from the top to the bottom have signed a letter of responsibility, regularly supervise the implementation of basic public health projects, and adopt the method of division of areas and responsibility to people It is necessary to hold semi annual and annual meetings on a regular basis, analyze and summarize the problems and deficiencies encountered in the implementation of basic public health services, and put forward countermeasures to solve the problems In order to reflect the importance of project work, it is suggested to report to relevant departments in the form of notification on a regular basis The county (city) government first establishes a public health work leading group, then the county (city) Health Bureau establishes a public health management office, and then assigns the annual tasks and work objectives to the personnel of each grass-roots organization According to the requirements of the code, public health departments are set up in all grass-roots organizations according to the unified standard, with 12 project leaders, and special office places are set up, such as health and family planning supervision room, maternal and child health care room, disease prevention and control room and other departments, equipped with necessary instruments and equipment In order to implement the equalization of basic public health services in an all-round way, public health responsibilities and systems should be put on the wall, and grass-roots institutions should be urged to implement public health services conscientiously and responsibly With the continuous promotion of public health projects by the state, it is necessary to establish a continuous and perfect daily supervision and evaluation system, supervise the grass-roots institutions to put the national policy of benefiting the people into effect, and strictly implement the rewards and punishments of grass-roots personnel according to the performance evaluation system formulated by the institutions, so as to effectively mobilize the enthusiasm and initiative of the work of the grassroots personnel.