Beijing three 3 armour hospital 15 well-known expert team practice level

"Frozen" visit, I hang on?

The reporter Jun-ping wang

April 22, 2016 08:12 source: People's Daily - the People's Daily

The temple of heaven in Beijing hospital has formed four well-known expert team, well-known professor yong-jun wang led the cerebrovascular disease expert team. The graph is yong-jun wang (right) in patients with diagnosis and treatment.

The xinhua news agency Li wen is taken

S didn't line up, no relationship, not spend high price, "accidentally" hung up the visit

First patient hang team doctor, team, in principle, an unlimited number. Well-known experts only accept hospital level referral, no longer separate registered abroad

Wang, 30, from shandong Texas to hang yong-jun wang, vice President of the Beijing tiantan hospital. Local doctors said, her illness only yong-jun wang can see it, but don't look for dealers, basic not visit.

Holding the idea to try, wang came to the temple of heaven hospital outpatient reception staff said, famous experts don't foreign registered now, can only hang expert team members. She I don't know what, the expert group is a thought just don't have to look, dealer, then hung up the expert team members Du Wanliang number.

Wang was accidentally drowned while swimming last August, after the first pain, recurrent left lower limb weakness. Head mri examination showed on the left side of the bottom section of cerebral infarction, tip of left middle cerebral artery angiographic M1 segment stenosis, but three days later review not seen obvious abnormity. Du Wanliang doctor after that patients with unknown etiology, referral to yong-jun wang.

After two days, wang and her visit to see the famous experts yong-jun wang. Yong-jun wang believes that active patients with onset, when swimming chest pressure increases, the possibility of paradoxical embolism exists. He opened a foaming test checklist, inspection results show positive patients, prompt patent foramen ovale or pulmonary arteriovenous fistula. Yong-jun wang was in the hospital for wang, her income was in the hospital.

With single hospitalization, wang and her happy came too suddenly, didn't go to spell physical line, no client relations, also didn't pay high prices for dealers, but "accidentally" hung up the visit.

Thanks to Beijing's famous experts team level of diagnosis and treatment mode. Original famous experts can only hang once a week, now team every Monday to Friday, the outpatient service every day; Originally experts one person sees a doctor, is now well-known expert team in a doctor. Famous expert team, no one visit is hard to find.

Beijing hospital authority director in luming, Beijing choice of clinical patients with strong professional, high academic level, demand big number, source nervous cause, well-known experts to form a team, the formation of diagnosis and referral mechanism within the team level. On March 1, xuanwu hospital, tongren hospital, and the temple of heaven hospital three city hospital set up 15 well-known expert team, began to introduce the hospital internal hierarchy system of diagnosis and treatment.

Tiantan hospital, said zhang yue, deputy director of the outpatient registers team first patient visits, according to the team internal referral standards set by the hospital and confirmed by clinic doctors need referral specialists. Well-known experts only accept hospital "patients need to be" as the only according to the hierarchy of the referral, no longer separate registered abroad. Any team, in principle, primary-care physicians according to patients condition diagnosis, treatment, and issue the corresponding checklist.

It is understood that well-known expert team to make an appointment in three ways: one is direct booking expert team primary-care doctors; 2 it is outside of the team in our hospital patients with other doctors in clinic, according to the illness needs, through the court system of referral to the well-known expert team. Due to different major hospital doctors have a referral permissions are different; Three is related to collaboration can be referral hospital patients to the well-known expert team.

S watching experts, patients had not

According to the allocation of resources, to really famous expert diagnosis and treatment of patients receive timely diagnosis and treatment of knotty disorder, a specialist resources use efficiency, avoid blind "experts"

A brain artery in patients with moderate occlusion, appear on one side of the body. What should do craniotomy surgery? Beijing tiantan hospital, zhang dong a member of expert group make up our minds, to patient referral to zhang dong.

Zhang dong carefully inquired about the illness, the patient morbidity due to alcohol, evaluation index compensatory don't have too big problem. If you can avoid triggers, are unlikely to happen again there will be no serious consequences. Zhang dong finalized, the patient to avoid the surgical operation.

Specialized in medical industry, the patient condition can accurate judgment, the key in the doctor. Build well-known experts team, judge condition priorities of the primary-care doctor is responsible for the task. If the disease belongs to a mysterious illness, accord with standard of the expert team of referral, well-known experts in primary-care doctor responsible for referral to make an appointment.

Patients with the well-known expert team, but may not have the chance to meet famous experts, by primary-care doctor delay treatment?

Zhang dong said, after the patient registration, the first step in the first team of specialized subject doctor accepts, they are all the medical clinical practice for many years, specialized subject ZhuanBing clinical experience is very rich, have a higher level of diagnosis and treatment, can satisfy the needs of most patients disease diagnosis and treatment. Only patients need through the referral of knotty, by famous experts in diagnosis and treatment. Well-known experts within the team on all members of the medical treatment quality control.

According to statistics, the city's 15 experts team, in addition to the 15 well-known experts, and the attending physician, and even chief physician, deputy director of 87 members, of doctor of vice director of the chief physician of eight, 31, 45% of the team members. Luming that explore internal level to establish hospital mode, can make the real need of famous expert diagnosis and treatment of patients receive timely diagnosis and treatment of knotty disorder, a specialist resources use efficiency, avoid the phenomenon of "seek expert" blindly. For example, Beijing tiantan hospital professor falls after expert team was founded, falls I accepts the difficulty of severe cases accounted, increased from 40% in 2015 to 90%.

At present, the well-known experts in 15 patients with internal team has not set clear referral criteria, whether that means need to be patient to well-known experts, all decided by the team doctors within yourself. Experts generally believe that clinical is complex, referral to have flexible lever, simply identified as "small" or "illness" is obviously not appropriate.

Pilot run for more than a month since the famous experts I accepts patients structure proportion has certainly changed, the difficulty in severe cases of improved significantly, the team in the referral, doctor order is good, the evaluation of patients with satisfaction, medical personnel recognition. The Beijing hospital authority, according to the latest figures as of April 15, 15 well-known expert team members a total of 649 people, visit a reception was 6955 people, the follow-up 6435 patients, total 14508 patients with diagnosis and treatment. Among them, the famous experts accepts 1188 people, by the members of the team directly to 1151 person-time, famous experts referral reservation team outside referral 37 m.

S precious expert resource allocation for patients with "most in need"

Adjust and perfect the evaluation system of performance appraisal, set according to the degree of disease factor score, cannot because experts accepts services reduce and cause less income

Zhang dong out three times a week the clinic. Well-known experts team, in addition to the morning of the first week less than usual 5-6 patients of average outpatient service, after a week visits the number of patients with no too big changes. Zhang dong said, such as vascular malformation, bypass ischemia complicated severe preoperative assessment, team members not sure will be referred to him, his work is not overloaded.

Some famous experts team accepts the number of patients compared to the past also does not have too big change, and the young doctor because in own "halo" in the well-known expert team, accepts patients increased. Some experts worry that if the team doctor enough experience, well-known experts are destined to difficult to "eat".

Expert group consultation mode to improve the efficiency of the well-known experts, to increase the chance of a mysterious illness patients treated with well-known experts, compressing the dealer living space. But also inevitably affect the expert's personal interests, this relationship to the team of experts can be replicated in the city.

How to encourage a well-known experts "group" service? According to the requirements of the Beijing development planning commission, the municipal hospital authority, the pilot hospitals will study revised performance appraisal method, outpatient visits, the assessment of famous experts no longer used no longer according to the workload of commission performance bonuses in the form of cash, but the rate of diagnosis and treatment of difficult diseases, referral implementation team, team role play, talent cultivation and echelon construction, etc. As a team as a whole and the performance appraisal of the famous experts.

In fact, the expert team duty in reversed transmission of hospital personnel salary system reform. If you can't with synergy for the performance of the distribution system reform, the hospital expert group is a paper executive orders, difficult to maintain for a long time. Said zhang yue, the temple of heaven in Beijing hospital are adjusting and perfecting the evaluation system of performance appraisal, emphasis on set according to the degree of disease factor score to work performance appraisal experts, not because of the experts accepts wants to reduce its revenue. Hospital total wages of the famous experts in last year's performance, a new way to safeguard expert performance distribution income only grow.

In luming think the active exploration team of experts in Beijing hierarchy diagnosis model, not only solve the "most in need of patients to visit" and not "problem, also promote quality more efficient allocation of medical resources. Internal hierarchy at the same time, "exploring to establish hospital model, is the important measures to carry out the classification diagnosis and treatment." By specialist ZhuanBing outpatient service form, he says, by famous experts, led by participating in medical team of specialized subject doctor, at different levels, based on condition, tie-in appropriate diagnosis and treatment schemes for different condition of patients and doctors. Through team level referral, difficulty of diagnosis and treatment of critically ill patients receive timely experts, fully improve the using rate of resource scarcity experts.

In luming, said the next step, according to the degree of professional ability, patient demand, shortage of source number, the structure of the human resources conditions, such as brewing in the city hospital to form a more professional well-known expert team, promote the implementation of hospital hierarchy diagnosis model and the scientific and rational medical order, was to help find the most suitable experts, established between the doctor and the doctor's referral, consultation mechanism and the path, let the hospital clinic open up internal level.

The People's Daily (April 22, 2016, 19)