Implementation Plan 1 of County Medical Association in p>217

In order to further deepen the comprehensive reform of medical and health system in our county and accelerate its realization? First consultation at the grass-roots level, two-way referral, rapid and slow division and treatment, and linkage up and down? The graded diagnosis and treatment mechanism, so that the masses can enjoy quality medical services nearby, according to the spirit of the notice of "Guiding Opinions on Promoting the Construction of Medical Consortium in Fujian Province (Trial)", combined with the actual situation of our county, this plan is formulated.

I. general idea

medical consortium refers to a vertical cooperative organization formed by voluntary consultation among medical and health institutions of different grades, categories, regions and affiliations according to the needs of coordinated development of medical services. ? Zhenghe county regional medical association? (hereinafter referred to as the medical association), in accordance with the principles of first diagnosis at the grass-roots level, two-way referral, quick and slow division and treatment, up-and-down linkage, resource sharing and mutual benefit, with Zhenghe County General Hospital (county hospital, county hospital of traditional Chinese medicine, county maternity and child hospital) as the lead unit, the county medical association is composed of eight township hospitals and two community health service centers. In accordance with the principles of unchangeable administrative affiliation of member units, unchangeable legal entity, unchangeable ownership of property rights, unchangeable legal responsibilities, unchangeable basic functions, unchangeable employee status and unchangeable supervision mechanism, the medical association will give full play to the advantages of diagnosis and treatment technology in county-level hospitals, take collaborative service as the core, technical support as the support, focus on overall management of medical services, and focus on rational utilization of existing medical resources, and gradually realize a closer integrated management form of people, finance and materials.

II. Objectives and tasks

In 217, the pilot project will be launched first, and the county hospital and Tieshan Health Center will explore the establishment of a loose medical consortium linked by technology, talents, management and interests, and the county hospital of traditional Chinese medicine and Lingyao Health Center will establish a close (trusteeship) medical consortium integrating personnel, assets, technology, services, information and management. By 217, we will gradually form a medical association operation system with clear powers and responsibilities, clear functions, effective operation and benefits for the masses, promote the coordinated development at the county and township levels, improve the allocation and utilization rate of medical resources at the county level as a whole, continuously improve the level of medical technology and service capabilities, reduce the outflow of hospitalized patients, and accelerate the realization? Small illness does not leave the country, serious illness does not leave the county? The goal of medical reform, timely sum up the experience of medical associations and gradually expand the coverage.

iii. organizational structure and governance form

the medical consortium implements the leadership management system of the board of directors, with the principal responsible person of the lead hospital as the chairman, the principal responsible person of each member unit as the vice chairman, and the office of the board of directors is located in the lead hospital. The board of directors shall formulate the articles of association of the medical association, and define the organization nature, purpose, task, organization members, management system, scope of duties, rights and obligations, working rules and other provisions of the medical association. The close medical association should establish a corporate governance structure, stipulate the rights and obligations of the board of directors, management, medical institutions and other relevant parties by formulating articles of association, coordinate the allocation and integration of resources within the medical association, and promote the vertical flow of high-quality resources.

(1) Responsibilities of the Council Office:

1. Be specifically responsible for the implementation of various tasks and do a good job in the guidance, supervision, assessment and evaluation of the Medical Federation Branch. The main person in charge of both units is the first person in charge, and the heads of various departments give strong support and do their best to promote the work of the medical association to ensure the expected results.

2. The Medical Association Office holds a medical association work meeting once a month to summarize the problems existing in this month's work, study the solutions and arrange the tasks for next month.

(2) Licensing:

The original institutional setup and administrative affiliation of township health centers (community health service centers) in the member units of the medical association remain unchanged, and the first name of the unit remains unchanged, so it is added. Zhenghe county general hospital medical association? Branch? Brand.

iv. Operation and management

(1) Establish and improve the system of graded diagnosis and treatment and two-way referral

1. Member units of the medical association establish and improve relevant systems, explore and introduce various measures to facilitate and benefit the people in seeking medical treatment, and guide the masses to make their first visit in the medical association branch. For patients who need to be transferred up or down, the two sides establish a contact system, and designate a special person to be responsible for providing? One stop? Referral service.

2. Establish a two-way referral system between medical associations, establish referral files, and formulate reasonable, convenient and smooth two-way referral rules according to the principles of voluntary, graded diagnosis and treatment, continuous treatment, safety and convenience, and minimizing the burden of patients' medical expenses. Only under the premise of two-way referral can we enjoy the medical insurance tilt policy.

3. In line with the principle of being responsible for patients and gradually improving the diagnosis and treatment level of doctors in lower-level hospitals, the doctors at higher levels have the obligation to follow up and guide the patients in the medical association; Doctors in lower hospitals have the right to participate in ward rounds for patients who are transferred from medical association to hospital.

4. Specific referral requirements shall be implemented in accordance with the two-way referral system and process regulations.

(II) Enjoy resources * * *

1. Realize the unified allocation and use of bed resources in member units of the medical association.

2. distribute rescue drugs (epinephrine, norepinephrine, isoproterenol, lobeline, nikethamide, cedilanid, etc.) to the branch free of charge.

3. Carry out the procurement of pharmaceutical consumables with quantity, and solve the problem of difficult distribution due to low consumption in primary health centers.

4. provide technical support for equipment maintenance.

5. Be responsible for the quality control work of inspection, imaging and pathology in the medical union branch, and guide and supervise the inspection and imaging work of member units.

6. undertake the disinfection and supply work in the center of the medical union branch, and the medical union branch agrees that the general hospital will consult the disinfection and supply center for unified distribution according to the specific conditions of each hospital.

7. On the premise of unifying quality control standards and ensuring medical safety, expand the scope of mutual recognition of inspection results in medical associations and reduce repeated inspections. The mutual recognition of inspections must be carried out on the premise of meeting medical safety standards, and can be gradually recognized according to projects and implemented step by step.

8. Make full use of the continuing education resources of the general hospital to achieve the goal of * * * learning together. Notify the relevant personnel of the medical association branch to participate in the continuing education and training every month.

9. Actively carry out emergency linkage mechanism. Relying on the political and health information cloud platform, the emergency medical management information system is built in the medical association, and the emergency coordination and linkage mechanism is established to realize the timely sharing and communication of emergency information and the centralized allocation and use of emergency resources.

(3) personnel exchange

1. Provide free further study for medical staff in medical union branch, and adopt? One-on-one teaching Mode, train a group of medical staff who can diagnose and treat common diseases and frequently-occurring diseases and clearly diagnose chronic diseases for primary medical institutions.

2. actively explore the establishment of a working mechanism of exchange and rotation of medical staff between county-level public hospitals and primary medical and health institutions, and implement a personnel management system of unified recruitment, unified management, unified use and unified training.

(4) Technical guidance

1. Help the medical union branch to establish and improve the internal management, public health, medical services, medical safety and other related work systems, further optimize the workflow, and improve the medical service capacity and management level of the medical union branch.

2. Explore and develop clinical pathway management, electronic medical records and other service means within the medical association. Accelerate the management of clinical pathway and gradually realize the standardized treatment of single disease.

3. according to the needs of each hospital, arrange corresponding specialists to the medical union branch at any time to carry out consultation, difficult case discussion, teaching rounds, appropriate technical guidance and other collaborative services.

4. Build a remote diagnosis and treatment platform among the member units of the medical association, and improve the quality and efficiency of medical services by means of information technology; Gradually realize the functions of remote consultation, remote specialized diagnosis (pathology, examination, imaging, etc.), two-way referral, emergency command and so on.

5. Establish WeChat group and QQ group of medical associations to build an information platform for learning and communication.

(5) Improve the performance distribution mechanism of member units of medical association

Implement performance appraisal according to the two-way referral situation, service quantity, quality and patient satisfaction of member units, fully mobilize the enthusiasm of medical staff at county and township levels, and establish and improve the internal performance distribution mechanism of member units. The specific implementation rules shall be formulated separately by the member units of the medical association.

(VI) Carry out health service management

Accelerate the informatization construction of member units of medical association, realize the effective connection between residents' health records and diagnosis and treatment information as soon as possible, and realize the safe interconnection of medical service information among member units of medical association. Pay attention to the combination of general practice and specialty. Specialist doctors in secondary hospitals and general practitioners in medical union branch can jointly diagnose and treat related diseases to improve the health management level of residents.

(VII) Relevant policy support

1. Referral of patients in the medical association will gradually simplify the referral and reimbursement procedures of the new rural cooperative medical system (NCMS) according to the hospital transfer policy, and cancel the second deductible line of the two-way referral of NCMS in the medical association. Relax the scope of clinical drug use in primary medical institutions, and take the medical insurance (new rural cooperative medical system) drug reimbursement catalogue as the primary drug catalogue to meet the needs of two-way referral.

2. If the patients who are not within the scope of diagnosis and treatment subjects in primary medical institutions or who have acute, dangerous, difficult or serious diseases are first diagnosed by primary health centers (community health service centers) and transferred to higher-level hospitals in the county for treatment, the reimbursement ratio of the new rural cooperative medical system shall be implemented according to the policies of township health centers (community health service centers).

3. In order to promote the sinking of high-quality medical resources at the county level, medical staff from superior hospitals in the medical association who have been working in township hospitals for more than 6 months are regarded as going to the countryside before promotion, which is the main basis for evaluating and appointing professional titles. Medical staff in primary health centers (community health service centers) go to higher hospitals to study and work as advanced studies. Encourage the medical staff and managers of higher-level hospitals in the medical association to serve as presidents, academic leaders and heads of management departments in primary medical institutions, check and guide the two-way referral work, improve the management level at the primary level, and give priority to promotion and reuse for outstanding performance.

4. in order to speed up the construction of medical association, on the premise of not increasing the expenditure of primary medical institutions, and at the same time, taking into account the fact that medical staff from higher hospitals can serve at the grassroots level with peace of mind, the personnel relationship of medical staff assigned from higher hospitals remains unchanged, and the salary and salary are paid by the original unit (not lower than the same level of the original unit). For the leading pilot units that have established medical associations and completed the established assessment indicators, the county medical management committee will extract a certain proportion from the central financial subsidy funds for the comprehensive reform of county-level public hospitals to give subsidies, and the units that have established close medical associations will be subsidized by 2, yuan per year, and the units that have established loose medical associations will be subsidized by 1, yuan per year. The funds are mainly used for transportation, accommodation subsidies and rewards for medical staff.

(8) Establish and improve the assessment mechanism

1. Establish and improve the internal assessment mechanism of medical associations. The Board of Directors of the Medical Association shall establish an assessment mechanism for the operation of the medical association, and take the performance of functional positioning responsibilities, division of labor and cooperation, capacity improvement and compliance with the articles of association of the member units in the medical association as the assessment indicators. In the assessment, it is found that members who violate the target requirements and basic principles may be required by the lead hospital to make rectification, and their membership will be terminated if they do not make rectification or rectification is not in place.

2. Strengthen the functions of industry supervision and management. The administrative department of health and family planning is responsible for guiding the construction of the medical association, regularly or irregularly checking the operation of the medical association, and promptly correcting the behaviors of the member units in the medical association that violate the target requirements and basic principles. There is a medical association that seriously violates the target requirements and basic principles. The health and family planning administrative department ordered the lead hospital to dissolve the medical association, and held the main person in charge of the lead hospital and the main person in charge of the relevant member units accountable.

3. Improve the performance appraisal mechanism of medical associations. The administrative department of health and family planning should take the implementation of the responsibilities and tasks of medical institutions at all levels in the medical association, the improvement of grassroots talent structure and service ability, the implementation of two-way referral, the implementation of the first diagnosis and graded diagnosis and treatment system at the grassroots level as the main contents of performance appraisal. The assessment results are linked to the hospital grade evaluation, the total performance salary of the hospital, the financial allocation, the appointment and removal of the president, and the medical insurance payment.

V. Organizing and implementing

(1) Strengthening organizational leadership. Implementing the vertical integration of medical resources and promoting the construction of medical consortium is an important goal and task of the comprehensive pilot of medical reform. All medical and health units should earnestly strengthen the organization and leadership, implement their responsibilities, make unified planning for the construction of medical complexes in accordance with the requirements of this implementation plan, clarify the construction objectives and schedule, and actively and steadily promote the implementation.

(2) Strengthen supervision and guidance. It is necessary to carry out regular supervision, understand the situation of medical association construction, sum up the experience of different modes of medical association construction in time, understand the new situation and new problems in the work, put forward suggestions for improvement, and enhance the initiative, foresight and creativity of the work.

(3) Actively publicize and guide. It is necessary to strengthen public opinion propaganda, strive for the understanding and support of all social sessions on the construction of medical associations, and form a social atmosphere to promote reform. Guide patients to gradually change their habits of seeking medical treatment, and form the behavior of basic first consultation, step-by-step referral and two-way referral for medical treatment, laying the foundation for the formation of a graded diagnosis and treatment pattern. 217 county medical association implementation plan 2

In order to fully implement the spirit of deepening the reform of the medical and health system by the municipal party committee and the municipal government, give full play to the overall benefits of county medical and health resources, accelerate the promotion of close medical associations in counties, townships and villages, and let the people enjoy quality medical and health services nearby, according to the Guiding Opinions of the General Office of Xining Municipal Committee and the General Office of the Municipal Government on Printing and Distributing the Close Integrated Medical Association in Xining (Ning Ban Fa [211]

first, the overall requirements

adhere to? Protect the basics, strengthen the grassroots, and build mechanisms? Principle, adhere to the direction of serving people's health, integrate and optimize the medical and health resources in the county, and set up a compact integrated medical consortium (hereinafter referred to as the medical consortium) with county-level hospitals as the core, composed of township hospitals (including community health service centers, the same below) and their village clinics. Leading? Role, the implementation of management, management, personnel distribution, promote the medical and health work center of gravity down and sinking of high-quality medical resources, improve the comprehensive service capacity, service efficiency, technical level and management level of medical and health institutions, and strive to make more than 9% of patients see a doctor in the county.

II. Formation Method

According to the principle of administrative division and convenient medical treatment for the masses, three compact integrated medical consortia were established with the first and second people's hospitals in the county and the hospital of traditional Chinese medicine in the county as the core hospitals. The specific formation methods are as follows:

(1) The first medical consortium in Huangzhong County. The first people's hospital of the county is the core hospital, and it consists of seven township (center) health centers and 152 village clinics in Shangxinzhuang, Tianjiazhai, Xibao, Tumenguan, Ganhetan, Qunjia and Dayuan.

(2) Second Medical Association of Huangzhong County. It is composed of the second people's hospital of the county as the core, seven township (center) hospitals of Lanlongkou, * * * He, Lijiashan, Shangwuzhuang, Haizigou, Handong and Dacai, Doba community health service center and its 224 village clinics.

(3) Huangzhong County Third Medical Association. It is composed of county traditional Chinese medicine hospital as the core, county Tibetan medicine hospital, Rouchard community health service center and its 2 village clinics. Huangzhong County First People's Hospital, Huangzhong County Second People's Hospital and Huangzhong County Chinese Medicine Hospital were added respectively? Huangzhong County No.1 Medical Treatment Consortium Core Hospital