Investigation On The Current Situation Of "Three Bases And Three Strict" Level Of Clinical Clinician In A Public Hospital And Its Countermeasures

Background: Public hospitals are the main body of the health care industry all the times,bear social services function,play a crucial role in ensuring public healthy services.However,The contradiction between the increasing health demand and the imbalance development of medical service is intensified.Public hospitals are facing fierce competitive press along with the deepening reform of institutions in the health care and loosening of nonpublic hospitals.In order to survive,the public hospital should start with quality improvement of medical service."Three bases three strict" of clinicians can reflect the ability and medical ethics of physicians very well.We can improve the medical quality and competitiveness of hospital through rising the level of "three bases three strict" of clinicians.Objective: This article aims to analyze the “Three bases three strict”assessment data of clinicians in the(provincial)public hospitals above two level for two consecutive years(2016-2017)and estimate their knowledgeof the "Three bases three strict",to find out their short problem or weak links,and to explore its generic causes and make suggestions for strengthening the capacity of clinicians.Methods: The exam results of 1650 clinicians from the 55 public hospitals above second level who have participated the "Three bases three strict" theoretical and skill tests organized by the City Health Planning Commission in 2016 were included in our study(1650 clinicians in 57 public hospitals were randomly included in 2017).SPSS 11.5 was used for statistical analyses of the exam results including the basic theory,the basic knowledge and basic skills.The descriptive statistical analysis was used for statistical analyses of the exam results among five different regions(province).A value of p<0.05 was considered statistically significant.Results: 1.The average score of the basic theory of clinicians in the city was 61.25±0.72(67.28±20.69 in 2017),and the average score of the basic skills was 68.19±21.12(67.28±20.69 in 2017).2.The average score of the basic theory of clinicians in the third level hospitals was 67.57±9.45 and the average score of the basic skills was 72.43±12.49(74.15±9.90 in2017).The average scores in those two years were significantly higher in the third level hospitals than that in the second level hospitals.(the theory result was 62.2±10.33,and skills result was 65.45±11.54 in 2016;the theory result was 63.42±4.01,and skills result was 64.99±11.39 in 2017,P<0.05)3.The scores in the main urban hospitals were 61.60,70.68 and132.03 respectively(the scores were 64.06,73.28 and 137.34 respectively in 2017),which were the highest in there regions.The descending order of the scores was that in the west,the northeast and the southeast regions.4.The average score of the basic theory in residents,attending,deputy director of the physicians and chief physicians were 61.56±6.78,61.14±7.74,60.30±9.00 respectively(The score were 63.83±7.50,64.27±7.64,63.27±7.81 respectively in 2017).The average score of the basic skills in residents,attending,deputy director of the physicians and chief physicians were 66.63±21.99,69.64±20.36,70.61±20.03 respectively(67.00± 21.59,67.53±20.67,67.66±17.60 respectively in 2017).There were no significantly difference between the two years.5.The average score of the basic theory of clinicians in teaching hospital was 61.24±9.69,and the average score of the basic skills was 74.87±20.67(the scores were67.01±4.23,76.94±14.06 respectively in 2017).The average score of the basic theory of clinicians in the other 49 non-teaching hospitals was61.26±7.05,and the average score of the basic skills was 67.38±21.07(the scores were 63.42±4.22,66.12±11.02 respectively in 2017).The average score of the basic skills in teaching hospital were significantly higher than that in the non-teaching hospitals(P<0.05,t test).Conclusions: The medical unit in hospitals still lack the enough emphasis on medical quality.Some hospitals not carry out the strict training and examination about “ Three bases three strict ”.The examination contentsneed to keep pace with the times,and the examination methods need to improve itself constantly.The city(province)Health Planning Committee could associate the training and appraisals of “Three bases three strict”with performance appraisal system in public hospitals.The public hospitals could associate the training and appraisals of “Three bases three strict”with the very interests of the clinicians.Only in this way could attract attention on the training and assessment.Three bases three strict from top to bottom in all ranks.Through investigating issues,making specific training plan,richen training content,enhancing communications between teaching and non teaching hospital,helping their counterpart hospitals in underdeveloped areas,the public hospitals could promote their “ Three bases three strict”levels as well as basic medical quality step by step.