Digital Quality Control Of Outpatient And Emergency Department

Background:Outpatientand Emergency Department is one of the most important parts of a hospital. As the hospital window, it is not only the comprehensive embodiment of the quality of its medical treatment and a reflection of the level of diagnosis and treatment, but also a measurement of the whole management level. At present, there are deficiencies in many aspects of Outpatient and Emergency Department medical service quality. First, with the flaws of medical record management, no standard writing norm and loss of medical record, medical institutions at all levels are very serious on the quality of medical records, but it is common that they generally attach most of attentions to medical history of patient hospitalized, with modicum attentions to that of Outpatient and Emergency Department, and that writing medical records is not complete, specific and timely. Second, Outpatientand Emergency Department process has been following the traditional mode, leading to a serious "3long1short", which means long queuing time waiting for register, diagnosis and paying, but a short time for seeing a doctor.2. Register is out of order all the time. It’s common that patients or their relatives queue all night to register to see expert doctors, which also provides an opportunity for some to make profit from selling registers.3. Special preparation before auxiliary inspection, inspection booking, far distance among inspection departments make patients’ completing an inspection a huge waste of time, and virtually increased patient retention time.4. Unclear and imperfect guiding signs make patients disoriented, increasing hospital patient flow and wasting the patient much non-medical time. Third, Doctor-patient relationship is increasingly getting worse. The heavy workload causes bad service attitude; jumping the queue by some patients acquainted with medical staff sows the seeds of the doctor-patient crisis.Objectives:With the aid of digital hospital and medical quality management theories, based on the plethora results of construction of digital hospital Outpatient and Emergency Department in our country, and taking a military general digital hospital Outpatient and Emergency Department as a case, we study the medical quality control methods to provide some references for digital hospital construction.Contents:1. the domestic and foreign digital hospital construction to the present situation of medical quality control.2. a military general hospital digital hospital construction process, a foundation for following analysis.3. a digital Outpatient and Emergency Department information system framework.4. and patients "One-Card" use.Results:1. A military general hospital construction process.From2000to2007, according to the military headquarters and military region deployment, this hospital had accomplished the framework construction of the internal network, satellite network, military network and so on, and implement the "No.1Military Medical Project" and "No.2Military Medical Project" as well as the military medical system, etc. At the same time, in order to meet the hospital need, it independently developed the reagent management, department information query system, Outpatient and Emergency Department comprehensive management (emergency room workstation, observation room doctor station, observation room nurse station), cost accounting (new income statistics, cost management, labor subsidy management), the introduction of the electronic government affairs, clinic doctor station, electronic medical records, laboratory information system (LIS), rational drug use system, etc, this paper improved the digital hospital construction foundation work.Since2008, the hospital has spent more than60million RMB in information construction, the new outpatient surgery building, specialized subject building and authority comprehensive office building the deployment of the implementation of the intelligent building system, the reconstruction of the connection, military network, satellite network, private network four network system, under the floor and college building construction two national A level standard room, as the main and backup data center, realize different tolerant to double10,000M, redundancy link way to safeguard network high availability, update server for all kinds of more than30Taiwan, the deployment of the user terminal more than1800sets, set up the digital hardware platform.2. A military general hospital this constructionHospital construction gradually formed with the connection, private network and satellite network three network systems, covering medical treatment, management, economy, scientific research four traffic information system.Combined with the construction and development needs, the hospital is in the system software development and introduction of demands a lot of manpower and financial resources, its application software level and function to achieve the basic requirements of digital hospital. At present, the hospital information network platform application system software of nearly90, digital hospital begun to take shape.3. Information system frameworkThis information system framework is mainly composed of card information system, drug management system, inspection information system (LIS), image transmission and storage system (PACS), intensive care information system, emergency integrated information management system, clinical anesthesia information system, medical insurance systems.4. Medical quality control methodPatient safety control method. Bar code technology in a hospital is widely used in LIS system, this mobile transfusion management system, prescription drug subsystem, etc. For medical personnel in the drug, blood transfusion and adjuvant therapies, serologic testing or other clinical test specimens, or in the patient identity confirmation provides reliable safety recognition.Medical accessibility and consistency control method. In the accessibility, a military general hospital is the introduction of the practice of outpatient self-help guiding diagnosis system, according to the patients’ pain site, guide patients to choose medical department, intelligent recommend related medical departments, experts, see a doctor route, and display the current number source situation. With open online booking, telephone appointment, field booking a variety of ways make an appointment. In the coherence, the hospital in the new system of electronic medical records (EMRS) and this "all-in-one-card" system, under the support of realized this doctors in clinic in can view the patient’s prescription, check the inspection result, disposal, always medical information, etc. Realize the continuity of patient medical record. The rights of patients and families control method. Clinic doctor stand this prescription, medical records, inspection declaration, etc all realize computer real-time print, put an end to the "tadpole writing", allowing patients to clear know the doctor’s diagnosis and treatment.The research and development of hospital cost list inquiry system. Realize the public medical service price, clinic and hospital patients cost list query, surrender gold query, outpatient service home visit arrangement inquires the, patients drug use, the price of drugs and medical valuation, convenient real-time patients know their medical expenses and the remaining sum inside card.Control method of diagnosis and treatment. A military general hospital intensive care system realization, the patient’s vital signs of the automatic acquisition and automatic confirmed orders to reduce the manual operation link to realize the emergency department ICU data real-time fast, effective integration, agile sharing, help clinical nursing information comprehensive, systematic preservation and analysis.Control method of drug management and use. A hospital outpatient emergency care to patients with a doctor print prescription to this self-service machine take credit card number, medicine queue subsystem to patients to deduct pay in gold, this medicine pharmacy computer will immediately print patients pendulum medicine list, this medicine by pendulum medicine single for medicine. Due to the pendulum medicine only for automatic printing, to avoid the manual writing, identify errors. And before the patient medicine prescription drug system for drug again confirmed to avoid the manual pendulum medicine appeared with the wrong drug and at the same time avoids the wrong drug patient’s condition.Patient medical process control method. A military general hospital fees for this process to do a significant transformation, realize the orders implement point charges from the patient queue pay cost of bitterness. Its principle is the patient to see a doctor for a medical before card or the bank and the hospital agreement card, a stored value card prior storage a fee, medical process all the pay cost behavior are orders implement point completed, patients need not to charge window queue pay cost, so as to shorten the waiting time go to a doctor.Medical data evaluation and analysis of data control method. The system for the user to provide data show auxiliary decision support, especially for different department and different business between medical data integration, statistics.Card using patients situation analysis. Most part of the patients received surrender gold mode, replenishing the crowd younger, at one’s own expense patients and new farming together with the number of top up high, self-help rechargeable equipment use less number.Conclusions:Compared with the traditional medical quality control, digital medical quality control method in this patient safety, medical accessibility and consistency, the rights of patients and their families, the treatment of patients, drug management and use, medical process, evaluation and utilization of data showed a strong advantage. Digital control of the gripper strongly promotes the medical quality control efforts. Through the medical information and management information digital implementation of data acquisition, processing, storage, transmission, sharing, realize the real-time monitoring, quality control, the completion of the medical quality effectively, incessantly monitoring and management.Use full information. The hospital realizes the digital medical information sharing all domain, and intelligent diagnosis and provides supporting information, and promotes the whole hospital diagnosis and treatment level of ascension.Medical documents standards. But the written form change. Outpatient prescription, treatment single, inspection report, an application form, such as electronic template set juice and use, and paperless transfer completely solve the unclear writing caused by the wrong fee, hair wrong drug problem. And the use of digital platform realizes the network communication, not easy omission and save working time effect. Doctors and nurses don’t meet the doctor’s advice to complete the rapid communication and accurate execution.Information management completely changes the traditional operation procedure and unifies registration, consulting, to calculate, charge integration. Triage queue is scientific and orderly, reducing unnecessary patients waiting time.At the same time, most of the patients received surrender gold model that hospital "all-in-one-card" promotion has obtained certain resultInnovations:The general theory is that medical quality control in the construction of hardware and software control of the spindle, but this article from digital means the actual service function view, this paper analyses the a military general hospital medical quality control of this control method at the same time, from the user, the level of patients with analysis of the use of "all-in-one-card"...