Investigation Of A Regional Children's Hospital "Network Guidance Hospital" State And Countermeasures

Objective: Under the background of current serious shortage ofpediatric health resources and New-Health-Reformation, on the basis ofimplementation of "Network Guidance Hospital" Project by a regionalpaediatric hospital, basing on needs and expectations of member hospital, toresearch and to evaluate content, methods, problems, expectations ofpreliminary implementation, then to explore the foundation, conditions,purpose, significance, content, methods and both rights and obligations, toconstruct the framework of paediatric alliance model in order to provides theimplementary basis for the cooperation model established between apaediatric hospital and general hospital and to offer the decision basis for thecall to establish a government-led, all levels of hospital-collaborativeconsanguineous paediatric medical association.Methods: To use the combination of quantitative and qualitativeresearch methods, including literature search, depth interview, questionnaireand statistical analysis. To determine the questionnaire items by literaturesearch and depth interview. To describe the status of implementation basedon the summary and analysis of "Hospital Network Guidance" Project from2009to2011. To analyze the implementation effect of project by chi-squaretest and Fisher’s exact probability. To predict the trend of the furtherdevelopment of the project through evaluation of program implementing from2009to2011and investigation of the anticipation about furthercooperation on both sides by hospital administrators and medical staff.Results:"Network Guidance Hospital" Project of a regional paediatrichospital involves provinces of Chongqing, Sichuan, Guizhou and Yunnanand with a total of64member hospitals. From2009to2011the corehospitals accumulated send687experts to implement free clinic, specialtechnical guidance, consultation, medical lecture, and teaching ward-rounds;training5on-the-job graduates from member hospital, accepting651medical staff form member hospital to engage in advanced study, inviting244medical staff from member hospital to attend academic conference(covering9paediatric sub-specialties), cooperating5scientific researchprojects. The project has been implemented by core hospital obtain betterevaluation form member hospitals, was widely recognized to improvingtheir technological capacity, especially on on-the-job graduate training,medical lectures, teaching ward-rounds, free clinic and academicconferences. The incompact features of project impact its implementationeffect and potency. The implementing results of project, the implementationcontent, the professional coverage, and the frequency and intensity of projectexists great difference in every member hospital. Meanwhile the corehospital failed to meet every member hospital’s needs. In addition, due to the67.16%of the member hospitals are general hospital, the guidance only forpediatrics cannot meet the needs of developing all clinical subjects. Conclusion: In order to meet both need of co-development,"NetworkGuidance Hospital” should be led by government and perfected itsorganizational structure of model, at the same time should be expand itscontent and promoted the compact cooperation of bilateral relations. Underthe background of the establishment of "3521" health information project byhealth ministry, and to build telemedical information system, and to organizeefficient cooperation platform; to improve the two-way referral process, andto structure two-way referral system; to strengthen extent of professionalsupport, and to explore doctor-multi-sited-implementation; to supervisemedical quality monitoring, and to enhance the medical quality managementlevel in member hospital. Meanwhile to further expand the influence and thescope of coverage of the core hospital, then play the role of the regionalchildren’s medical center.