Public hospital reform implementation plan
Part 1: Implementation plan for public hospital reform
I. Reform ideas and goals
general idea
With the overall principle of “promoting development, improving efficiency, reducing burdens, and promoting health”, we will seize the opportunity of pilot reform of the total amount of medical insurance funds, focus on the overall work of the hospital, strive to make new breakthroughs in the reform of public hospitals, and promote development through reform. Huiminsheng, strive to make the hospital development more dynamic, patients are more assured, more at ease, more comfortable.
Reform goal
Through the implementation of reform pilot work, accelerate the establishment of a new modern hospital management system, operational mechanism and medical service model with medical service quality, efficiency and satisfaction as the core, strengthen medical quality management, optimize medical service processes, and improve service efficiency. Solve the bottleneck problem of hospital operation and maintain and enhance the core competitiveness of the hospital. Let the people of the people get benefits, the medical staff are encouraged, the hospital is sustainable and healthy, and it can provide reference for the promotion of the reform of the public hospitals in the capital.
Second, the main pilot task
The hospital is mainly responsible for the pilot task of the total advance payment system for medical insurance funds. Establish and implement the pilot tasks with the overall requirements of “unified thinking, high priority, clear objectives, strict management, performance appraisal, and pay-related”.
specific measure
1. Increase monitoring efforts Focus on implementation process management. Adding an internal control system to the doctor's outpatient workstation as an important tool to reduce the average cost of outpatients, using system information prompts, automatic conversion of drugs according to the principle of prescribing, reducing the incidence of errors such as hyperindications and re-opening, avoiding large prescriptions Drug abuse phenomenon, reducing the proportion of drugs. At the same time, improve the quality control standards for clinical and pharmaceutical, inspection and radiology departments, strictly abide by the medical system and technical specifications, and reasonably control the inspection items.
2. Increase incentive mechanism to include the total prepaid fund balance into reward distribution, and link with task completion and comprehensive performance appraisal, encourage medical staff to standardize diagnosis and treatment behavior, rationally check, rational use of drugs, scientific treatment, efficient service, and implement various controls. Fee measures to ensure that the average cost per person is reduced.
3. Improve the restraint mechanism Strengthen the supervision and assessment of the implementation of reform measures.
4. Integrate supervision and management Continue to carry out supervision and rounds of hospital leadership, strengthen investigation and research on major issues in medical reform work, and guide clinical standardization of diagnosis and treatment behavior and rational use of drugs.
5. Strengthen standardized management, comprehensively promote the responsibility system of the attending physicians, give full play to the role of the diagnosis and treatment team, continue to improve the management mode and monitoring mechanism of the attending physicians, and strive to establish an accounting system based on the team of the chief physicians during the year to promote the referral Full implementation of doctors' responsibility system; strengthen the rational use of antibacterial drugs, establish supervision and management of the whole process; continuously improve clinical path management, establish clinical path management indicators, and feedback the implementation of various diseases at the weekly meeting in the hospital; increase quality nursing services Advancement; strengthen the standardized management of doctors, reduce the abuse of antibacterial drugs, reduce large prescriptions, and reduce major inspections. Carry forward the spirit of being good at being pragmatic, daring to reform and innovate, and be brave in challenging problems, and take the patient as the center to realize the continuous diagnosis and treatment model of the whole process.
6. Establish a joint office mechanism to further strengthen the overall coordination and comprehensive management of the total prepaid pilot work, and establish a joint office mechanism for the medical department to “coordinate office, department linkage, clear responsibilities, and time-limited completion” to timely resolve and resolve the existence of the pilot task. Issues in personnel, process and management, speed up the pace of pilot tasks.
Pilot task performance appraisal
Strengthen the two-level refined management of the department. Based on the basic data, the hospital decomposes the total prepaid total control indicators according to the department, and formulates the annual basic value, expected value and challenge value of each department, and serves as the performance appraisal indicator for the year-end department and strict indicator management. With the aim of pursuing social benefits and strengthening management as the core, the main content of ensuring the quality and safety of medical services and improving operational efficiency is to mobilize the enthusiasm of medical personnel and effectively reduce the burden of patients' medical care, and improve the supervision and assessment and compensation system.
Third, key initiatives
In 20XX, in order to ensure the smooth implementation of the pilot work, the hospital will focus on 18 key tasks from four aspects, and go all out to complete the medical reform of the hospital.
Medical service innovation to improve patient experience
Adhere to the innovative medical services as an entry point to further promote the reform of public hospitals, and improve the patient experience of medical treatment as the foothold of hospital reform, and provide a strong guarantee for the sustainable and healthy development of the hospital.
1. Summer special peak summer work In response to the characteristics of a large number of children in the summer accompanied by parents to come to the clinic, optometry, starting from May 20XX, start the summer outpatient preparations; July 1 start the summer work plan. By tapping the internal potential, increasing the amount of ophthalmic services; adjusting the outpatient space, optimizing the treatment process; conducting medical consultation and diverting the peak of the consultation; diversifying the patients to the south, doing a good job in logistics support and other measures to improve work efficiency. Work hard to meet the needs of patients seeking medical care.
2. Continue to promote appointments and treatments, optimize the outpatient service process to promote the “first diagnosis and treatment, post-settlement” mode; actively cooperate with the pilot of the Hospital Administration of Beijing Medical Card; increase the number of sources and expand the service capacity.
3. Dean of the hospital supervised the ward round On the basis of the administrative ward round of the leadership of the hospital in 20XX, the hospital led the supervision and ward rounding system; and supervised whether the director of the department timely checked the house and checked the connotation quality. Through the on-site work of the hospital leadership, timely solve the problems in medical operation and ensure the quality and safety of medical care.
4. Improve the bed occupancy rate special work By taking effective measures to improve the hospital's ability to treat inpatients; implement bed dynamic management, to achieve the bed "reconciliation", ease the hospitalization of patients, the use of bed in the hospital to achieve more than 90%.
5. Shorten the special hospitalization day special work Establish the medical layout adjustment and medical process transformation based on the one-day ward, and actively explore the continuous improvement and continuous improvement of the one-day ward. Efforts will be made to control the average hospitalization day of the hospital within 10 days, improve the utilization efficiency of high-quality health resources, and reduce the number of patients waiting for bed.
6. Strict pharmacy management, standardize the clinical application of antibacterial drugs, improve the management of pharmacy in hospitals, and promote the “special rectification activities for clinical application of antibacterial drugs”. On the basis of consolidating the achievements of previous work, in the year of 20XX, this year, we will further improve the management of antimicrobial drugs by clarifying the responsibilities of various departments, using information technology to promote the rational use of antibacterial drugs, and establishing reward and punishment mechanisms. The preventive use of antibiotics in class II incision surgery and the therapeutic use of antibacterial drugs are the focus of work, ensuring the safety of patients' medications and reducing the cost of medication for patients.
Inspire talents to innovate and enhance core competitiveness
1. Increase investment, build a scientific research management platform, build a hospital scientific research management information platform, and invest a million yuan for the support of the hospital fund project.
2. Introduce talents, strengthen basic discipline construction hospitals, further clarify the working ideas of “stability, reform and development”, take the development of cardiovascular science as a breakthrough, and introduce one of the leaders of cardiovascular science outside the hospital – Beijing high-level health technology leading talents Professor Ma Changsheng. Through its profound knowledge in the field of cardiovascular disease interventional therapy, it has promoted the development of disciplines and become a key discipline of medical technology, cultivates high-level talents with strong technical strength, and enhances the comprehensive strength of hospitals.
3. Cultivate talents, combine subject education with clinical development, improve the establishment and responsibilities of the Beijing Tongren Hospital Talent Work Committee, and further clarify the means and methods for the party to manage talents. Implement financial support; improve the education management system and focus on connotation construction.
Management mechanism innovation, improve hospital operating efficiency
1. Combine medical reform and improve the rules and regulations of the whole hospital to inherit the centuries-old work of colleagues, and combine the new situation and new requirements of medical reform, from six aspects of administrative management, medical quality management, medical service management, personnel management, financial management and security. Sort out and improve various rules and regulations and job responsibilities.
Revise the hospital-level meeting system, control the number and quality of meetings, streamline issues, and improve office efficiency; implement the implementation supervision mechanism of meeting resolutions to ensure timely delivery and full implementation of decisions. Through the combination of perfect system and detailed post responsibility system, it will build a broader platform for continuous improvement of medical quality, medical safety, medical service and performance management.
2. Combine medical reform on hospital performance appraisal methods, revise and improve the performance appraisal system linked to remuneration, further enrich and innovate hospital performance appraisal, and then move from performance appraisal to hospital performance management. Link the performance appraisal to the bonus distribution and re-plan the bonus distribution plan. Through the performance management and compensation management, the simultaneous development of hospitals and employees will be realized, and the income of employees will be improved.
3. The Party Committee provides ideological and organizational guarantee for medical reform. The two assessment systems continue to improve the quantitative assessment of the work of the Party branch and the work evaluation system of the Communist Party members, implement the medical reform policy and performance appraisal, and further improve the attention of party branch secretary and party members to the medical reform work. To provide strong support for medical reform.
4. Cadre training and team building, play the role of the main force Focusing on the central task of medical reform and the mainstream direction of hospital development, strict selection, appointment, evaluation and management of cadres, and the cadre management college as an important platform for medical reform education and training.
5. Build a pool of nursing reserve personnel, solve the shortage of nursing staff, fully mobilize and give full play to the working potential of nurses, prepare for the training of general nursing backbones in the later stage, promote the work of quality nursing services, and propose the concept of establishing a repository of nursing staff. .
6. Strengthen the construction of hospital information, promote the scientific management of hospitals, improve the hospital information system, strengthen the deep application of the system; build a unified electronic medical record system in the three districts; and strengthen the information decision analysis and management functions. Hospital construction innovation, improve medical service environment
Hospital construction innovation, improve medical service environment
1. Establish an outpatient service center with medical reform requirements, promote the construction of a new “one-stop” service model, implement the requirements of the Hospital Authority for establishing an outpatient service center, and set up outpatient service centers in prominent locations in the outpatient halls of the three hospital areas to integrate patients. Outpatient service needs, improve various service initiatives and facilities
2. Expanding the medical service space, improving the outpatient medical treatment environment, reclaiming the original rental commercial houses in the Western and Eastern Districts, and expanding the medical housing; taking the adjustment and transformation of the hospital's three districts as an opportunity to adjust the work flow and improve the internal environment of the hospital. The patient provides a convenient, spacious, clean, bright and comfortable medical environment.
3. The second phase of the Southern District Planning and Construction The second phase of the Southern District is based on the overall layout plan of the hospital's three districts, embodying the “green hospital” design concept, in line with the latest trends in hospital construction, and using scientific and advanced design to achieve safety, efficiency and low cost. run.
Following the overall requirements of the future development of the hospital, it is closely integrated with the comprehensive development of the hospital and the construction of the department, so that the medical resources, hardware environment and management environment are highly integrated and highly unified to meet the long-term development goals of the hospital.
Fourth, safeguard measures
Organizational guarantee
Established the hospital reform leading group and the hospital reform work office.
Mechanism guarantee
1. Implementing project management The competent department shall formulate a project time schedule, and the competent department shall follow the implementation of the decision of the leading group; regularly organize special seminars and office meetings to report the progress of the work to the leading group; the effect is not significant The evaluation and analysis of problems arising during the implementation of the project, coordination of the revised work plan of the relevant department; summarizing the work measures for achieving results, laying the foundation for the promotion of experience.
2. Informatization construction, solid management foundation Continue to improve hospital information construction and establish a data reporting decision-making mechanism. The hospital is required to attach great importance to data statistics, calculation and reporting, strengthen the training of relevant personnel, and do a good job in data quality control.
3. Regulate hospital economic management and standardize financial management. Financial subsidies for hospital infrastructure construction, large-scale equipment purchase, key discipline development, talent team construction, retirees' expenses, and public health tasks are strictly implemented in accordance with financial fund management requirements.
Improve efficiency from cost control. Control operating costs to focus on revitalizing existing resources and reducing operating costs, compressing and reducing administrative expenses and strengthening awareness of conservation.
4. Implementation of comprehensive budget management The overall business objectives of hospital reform and development are decomposed into departments by budgeting, and under the guidance and control of budget management, there are plans and steps to implement. Through the actual analysis and evaluation of the budget situation, the performance evaluation and rewards and punishments of the budget execution department will be realized.
5. Sharing development achievements with employees Focus on making the people's people affordable, fully consider the interests of employees, continuously improve the employee's 'happiness index', and give play to the main role of medical personnel. Through the various channels such as employee representatives, the channels for appealing expression are unblocked, and the value of medical personnel training is reflected through the reform of the hospital personnel training mechanism and incentive and restraint mechanism.
Ideological organization guarantee
1. Strengthen ideological and political construction In the process of promoting the reform of public hospitals, adhere to and strengthen the leadership of the party, and in accordance with the requirements of the scientific development concept, focus on the core, solid fortress, and pioneer, and play the political, ideological and organizational organization of the party organization. Safeguards. Give full play to the role of party branches and league branches, and mobilize and protect the enthusiasm and creativity of cadres and workers.
2. Strengthening the promotion of policy measures Strengthening the publicity of public hospital reform policies and measures through meetings, training, seminars, archives, etc., unifying the thinking of cadres and workers into the medical reform work, and laying the ideological foundation for promoting the reform of public hospitals. Organize hospital management cadres to seriously study and study, improve the medical reform policy level and reform implementation of the hospital leadership team; face cadres above the team leader, hold mobilization meetings, compile medical reform study materials, strengthen policies and measures training; conduct missions to medical staff in the hospital guide.
3. Strengthen internal and external propaganda to lead the work through reporting medical reform information, summarizing and promoting work experience and practices; giving full play to the role of media information platforms such as health information network, hospital official website, and Weibo, and comprehensively reporting the benefits brought by hospital reform to the people. The medical reform policy has been widely publicized, so that all sectors of society can keep abreast of the hospital reform dynamics and reform results, and create a good public opinion atmosphere.
Part 2: Implementation plan for public hospital reform
In order to effectively carry out the work of the national pilot city for the reform of public hospitals in Zunyi City, according to the "Opinions of the Central Committee of the Communist Party of China and the State Council on Deepening the Reform of the Medical and Health System" and the Ministry of Health and other five ministries and commissions on the "Guidelines on Printing and Initiating the Pilot Suggestions for the Reform of Public Hospitals", Actually, develop this plan.
I. Guiding ideology and basic principles
guiding ideology
Adhere to the public welfare nature of public hospitals, put the protection of people's health rights first, separate administrative affairs, separate management, separate medicines, profit-making and non-profit separation, promote institutional innovation, mobilize the enthusiasm of medical personnel, and improve public The hospital operates efficiently and strives to make the people look good. In accordance with the requirements of “appropriate scale, optimized structure, rational layout, quality improvement and sustainable development”, we adhere to the principle of equal emphasis on both Chinese and Western medicine, coordinating the allocation of medical resources between urban and rural areas and regions, promoting the healthy development of public hospitals, and satisfying the basic needs of the people. The demand for medical services will effectively alleviate the problem of expensive medical treatment and difficult medical treatment.
The basic principle
Adhere to the unity of fairness and efficiency, the combination of government leadership and market mechanism; adhere to the dominant position of public hospitals, encourage diversified medical treatment, promote the coordinated development of hospitals of different ownership and management nature; adhere to the combination of development, reform and management, and improve the service system Innovate institutional mechanisms, strengthen internal management; adhere to overall design, orderly advancement, key breakthroughs, systematic summarization; adhere to the reform direction and principles determined by the central government, base on Zunyi City, emancipate the mind, adapt to local conditions, and boldly explore and innovate.
Second, the overall objectives of the pilot, the main tasks
Overall objective
Build a public hospital service system with clear public welfare objectives, reasonable layout, appropriate scale, optimized structure, clear hierarchy, perfect function and high efficiency, explore the establishment of a division of labor coordination mechanism with the primary health care service system, and accelerate the formation of a diversified medical service pattern. To form a relatively scientific and standardized public hospital management system, compensation mechanism, operational mechanism and supervision mechanism, strengthen the internal management of public hospitals, and promote public hospitals to fulfill public service functions and provide safe, effective, convenient and inexpensive medical and health services for the public. . Forming the overall thinking and major policy measures for the reform of public hospitals, laying the foundation for comprehensively promoting the reform of public hospitals.
main mission
1. Strengthen regional health planning. Reasonably determine the function, quantity and scale of public hospitals, optimize the structure and layout, and improve the service system.
2. Reform the management system of public hospitals. Exploring the effective forms of separation of administration and separation of government affairs, establishing a coordinated, unified and efficient public hospital management system, scientifically defining the responsibilities of public hospital owners and managers, exploring the establishment of hospital corporate governance structure, and promoting the professionalization and professionalism of hospital directors Construction.
3. Reform the compensation mechanism of public hospitals. Exploring the specific ways to achieve the separation of medicines, changing the situation in which medical institutions rely too much on the sales revenue of medicines to maintain their operation, gradually eliminate the drug addition policy, rationally adjust the price of medical services, explore the reform of basic medical insurance payment methods, and implement the financial subsidy policy. Implement the Chinese medicine support policy.
4. Reform the operating mechanism of public hospitals. Deepen the reform of the personnel system and income distribution system of public hospitals, improve the economic operation and financial management system of public hospitals; strengthen the internal management of public hospitals, implement various hospital management systems, formulate regulations for the diagnosis and treatment of diseases, promote the implementation, accelerate the construction of information technology, and guarantee medical care. Quality, improve service efficiency, control medical expenses, and facilitate people to seek medical treatment.
5. Improve the supervision mechanism of public hospitals. Implement hospital information disclosure, improve the performance appraisal system of public hospitals, and strengthen medical safety quality and economic operation supervision.
6. Form a diversified medical treatment pattern. Encourage, support and guide social capital to enter the medical service field, improve the policy system, create an environment that creates fair competition, guide, encourage and support the development of non-public medical institutions, promote mutual cooperation and orderly competition among different ownership medical institutions, and satisfy different people. Level of medical service needs.
Third, the scope of the pilot and implementation steps
Pilot principles and scope
In accordance with the principle of easy and difficult, step by step, active exploration, and classified guidance, the Yuqing County People's Hospital was determined as a comprehensive reform and overall promotion pilot in Zunyi City. Zunyi Hospital should carry out pilot projects in terms of service system, internal operation mechanism, hospital management, and standardized training for residents. Other county people's hospitals should focus on strengthening county hospital capacity building.
Implementation steps
The pilot reform of public hospitals in Zunyi City began in 20XX and was implemented in three phases.
1. Develop a pilot work plan. According to the "Opinions of the Central Committee of the Communist Party of China and the State Council on Deepening the Reform of the Medical and Health System" and the Ministry of Health and other five ministries and commissions, "Notice on the Guidelines for the Issuance of Pilot Suggestions for the Reform of Public Hospitals," the "Zhuyi City Public Hospital Reform Pilot Implementation Plan" was formulated and required Approved.
2. Carry out pilot work. According to the requirements of the State Council's "Key Implementation Plan for the Reform of the Medical and Health System", refine the objectives and tasks, and propose reform measures and targets for public hospitals that are promoted and focused on the whole, and explore on the basis of pilot projects in public hospitals at the city and county levels. Reform experience, summarize the reform results, and gradually promote the pilot work of other public hospital reforms.
3. Summarize the evaluation pilot work. Conduct a comprehensive summary of the pilot work, improve relevant policy measures, form an evaluation report, and accept the review and acceptance.
Fourth, the main content of the pilot work
Establish and improve the public hospital service system
1. Strengthen the planning and regulation of public hospitals. In accordance with the provincial people's government health resource allocation standards, regional health planning and medical institutions set planning guidelines, the Zunyi City regional health planning, medical institution setting planning and public hospital development planning shall be formulated to determine the functional positioning of public hospitals at all levels.
2. Establish and improve the municipal medical service system. Make full use of and optimize existing health resources, and establish and improve a municipal-level medical service system with appropriate scale, complete functions, optimized structure, clear hierarchy, and reasonable layout. The Zunyi City Maternal and Child Health Hospital and the Zunyi City Hospital of Traditional Chinese Medicine, which are now managed by Honghuagang District, are assigned to the Municipal People's Government for management, and the municipal maternal and child health hospitals and Chinese medicine hospitals will be established, and the second people's hospital of Honghuagang District will be established. Go to the Municipal People's Government for management and rebuild it into the Zunyi City Infectious Disease Hospital; relying on the Zunyi Medical Affiliated Hospital to build the Zunyi City Psychiatric Hospital. The Zunyi Traffic Hospital, which is now managed by the municipal level, will be transferred to the Huichuan District for management, and the new Huichuan District People's Hospital will be established; the new Pupu New District medical institution will be newly selected in the Xinpu New District.
3. Establish and improve the primary medical service system, and further improve and improve the county, township and village health service networks. Complete the standardization construction of 15 county-level general hospitals in 3 years, complete the standardization construction of 50 central township hospitals, and complete 1700 village health
The standardization construction of the room completed the standardization construction of 8 community health service centers.
4. According to the regional health planning and medical institution setting plan of Zunyi City, actively encourage and guide social capital and enterprise units to invest in the establishment of non-public hospitals.
5. Strengthen the standardization of public hospitals and improve their service capabilities. Support Zunyi Hospital to establish a third-grade hospital; the Municipal Maternal and Child Health Hospital, the Municipal Hospital, the Municipal Infectious Disease Hospital, and the Municipal Psychiatric Hospital are constructed according to the standards of the third-level hospital; all the county and district people's hospitals meet the standards of the second-class hospital; Zunyi County , Renhuai City, Chishui City, Yuqing County and Shuyang County Chinese Medicine Hospital gradually reached the standard of Class A and Chinese hospitals.
6. Establish a division of labor and cooperation mechanism between public hospitals and urban and rural primary health care institutions. The tertiary hospitals mainly provide high-level specialist medical and health services and perform advanced teaching and research tasks; the secondary hospitals mainly provide comprehensive medical and health services and undertake certain teaching and scientific research tasks; the township health centers mainly provide prevention, medical care, health care and rehabilitation services. The Community Health Service Center mainly provides services integrating medical care, prevention, health care, rehabilitation, health education, and family planning technical guidance; the village clinic mainly provides common medical services for rural residents with common diseases and frequently-occurring diseases in rural areas. Implement county-wide integrated management by county. The higher-level hospitals promote the development of primary medical institutions through management guidance, technical support, and personnel training, so that the reform of public hospitals and the sound grassroots medical and health systems work closely together and promote each other. Gradually establish a two-way referral system and explore the establishment of a primary care system for primary medical institutions.
7. Establish and improve a long-term mechanism for counterpart support in urban and rural hospitals, and conscientiously implement 10,000 physicians to support rural health projects. Multi-form, multi-channel strengthen the construction of grassroots health personnel, and gradually improve the quality and ability of hospital personnel. According to the needs of the aided hospitals, the counterpart support hospitals actively support the standardized construction of the aided hospitals by means of hospital management, medical care quality, hospital information management, health talents, appropriate technology, and equipment support, and according to the “Guangzhou Provincial Urban and Rural Hospitals’ counterpart support”. The requirements of the Work Performance Assessment Indicators have solidly promoted the assistance work.
8. Correct and standardize the names of medical and health institutions at the city and county levels in accordance with the regulations of the “Regulations on the Administration of Medical Institutions” and other relevant laws and regulations.
Reform the management system of public hospitals
1. The county people's government is responsible for organizing county-level public hospitals, and other public hospitals are organized by the municipal people's government. To regulate the management of medical institutions, in accordance with the provisions of the Regulations on the Administration of Medical Institutions, the Zunyi Hospital was renamed as the First People's Hospital of Zunyi City, and the Zunyi City People's Hospital, Zunyi City Stomatological Hospital and Zunyi City Orthopedic Hospital, respectively, in Honghuagang District were renamed. Honghuagang District People's Hospital, Honghuagang District Stomatological Hospital and Honghuagang District Orthopaedic Hospital.
2. Actively explore effective forms of separation of management and management. In accordance with the principle of separation of functions between medical service supervision functions and medical institutions, the government will promote the localization management of government health and other departments, hospitals owned by state-owned enterprises and institutions, and gradually realize the unified management of public hospitals.
3. Establish a coordinated, unified and efficient public hospital management system. The municipal and county people's governments shall establish a public hospital management committee. The member units shall be composed of departments such as development and reform, finance, health, human resources, social security, and supervision. The office shall be located in the administrative department of health, assume the functions of the government funder, and be responsible for the main public hospitals. The appointment of the responsible person shall comprehensively supervise the state-owned assets, financial accounting, operational mechanism, distribution system, medical price, medical technical norms and industry style of the hospital.
4. Establish and improve the medical quality evaluation and supervision system of public hospitals. The Public Hospital Management Committee is responsible for organizing medical quality, medical safety, medical services, financial supervision and evaluation, establishing and improving the public hospital supervision system with public welfare as the core, and promoting the reform of public hospitals.
5. The Municipal Development and Reform Commission, the Municipal Editorial Committee Office, the Municipal Finance Bureau and the Municipal Human Resources and Social Security Bureau actively cooperate with the health administrative department to formulate and implement infrastructure construction, staffing, financial input, medical service prices, income distribution, and public hospitals. Supporting policies such as personnel system reform provide guarantee conditions for public hospitals to perform medical service functions.
Reforming the corporate governance mechanism of public hospitals
1. Explore the establishment of a corporate governance structure in public hospitals with the core of the council, and enhance the vitality of public hospitals. The president of the municipal and county public hospitals shall be gradually appointed by the municipal and county public hospital management committees. The president shall act as the legal representative in accordance with the principle of unity of powers and responsibilities, and perform the hospital management functions according to law; the vice president shall be nominated by the president and appointed by the public hospital management committee; the middle cadres shall be appointed by the president. The internal party organizations and social groups in the hospital shall be legally produced in accordance with the regulations of the organization, and shall be appointed according to the organizational procedures; the discipline inspection secretary shall be stationed by the municipal and county party committee discipline inspection and supervision organs to form a power operation mechanism for decision-making, implementation, and supervision.
2. Gradually cancel the administrative level of the president of the public hospital, implement the file management at the former administrative level, and promote the professionalization and professionalization of the president of the public hospital.
3. Establish a performance appraisal management system for public hospitals with public welfare as the core and the incentive and restraint mechanism for the dean. The annual review will be carried out for the dean. If the annual appraisal is unqualified, it will be dismissed for two consecutive years.
Reform the internal operation mechanism of public hospitals
1. Reform the internal decision-making mechanism of the hospital and improve the president's responsibility system. In accordance with the corporate governance structure, the management duties shall be fulfilled. Major decisions, appointment and waiver of important cadres, major project investment, and large-capital use shall be subject to collective decision-making by the hospital leadership team and separate by management and administration, and separated by the public hospital management committee. After execution.
2. Implementing open government affairs and promoting democratic management of public hospitals. In accordance with the principle of active disclosure, the hospital's internal personnel appointment and dismissal, health technology title appraisal, performance appraisal, medical care quality assessment, infrastructure construction, large-scale medical equipment, pharmaceutical equipment, sanitary materials procurement, major events, open the hospital affairs, accept the hospital and Social supervision. Improve the hospital's organizational structure, rules and regulations, and job responsibilities, and promote the democratization, institutionalization, standardization and modernization of hospital management.
3. Strict budget management and revenue and expenditure management, and strengthen cost accounting and control. Strict financial centralization and unified management, strengthen asset management, establish and improve internal control, and implement internal and external auditing systems.
Deepen the reform of the personnel system in public hospitals
1. Strengthen the construction of the health talent team. In order to continuously meet the needs of people's people at different levels of medical and health services, the Municipal Human Resources and Social Security Bureau will work with the Municipal Health Bureau and the Municipal Editorial Committee to formulate preferential policies, and do a good job in health professional and technical personnel business training, job title evaluation, preparation and salary implementation policies. Actively guide the flow of health human resources to the grassroots level, and gradually establish a team of health professionals with sufficient quantity, high quality and reasonable structure.
2. In accordance with the spirit of the Notice of the Provincial Health Department, the Provincial Development and Reform Commission, the Provincial Editorial Committee Office, the Provincial Finance Department, and the Provincial Human Resources and Social Security Department on Printing and Distributing the Implementation Opinions on Strengthening the Construction of County-Level General Hospitals in Guizhou Province, According to the needs of urban development, according to the economic and social development of the city, timely adjust the planning of medical institutions in the central city, and reasonably determine the number, scale, bed and staffing of various types of medical institutions at all levels in the city.
3. Explore the reform of the hospital employment mechanism. After the public hospital bed and staffing control indicators are determined, the establishment, human resources, social security and health departments shall determine the number and standards of hospitals for the admission and introduction of health technicians according to the discipline construction, academic structure and professional structure requirements of hospitals at all levels. The hospital will be hired according to the relevant personnel management system and reported to the Human Resources and Social Security Bureau for relevant procedures. By 2019, the number of people will be basically changed, the quality is not high, the professional structure is irrational, and the age is aging. The establishment and personnel departments are responsible for the supervision of the employment program.
Reform the compensation mechanism of public hospitals
1. Gradually convert public hospital compensation into three channels: service charge, drug add-on income and government subsidy, and change to service charge and government subsidy. Service charges and government subsidies are reasonably determined according to the relevant provisions of the five ministries and commissions such as the Ministry of Health and the Ministry of Finance, taking into account factors such as hospital function positioning, medical insurance fund affordability, local financial supply capacity, income level of urban and rural residents, and affordability for price adjustment. . Give full play to the role of traditional Chinese medicine in disease diagnosis and treatment, preventive health care, and rehabilitation of chronic diseases, and tilt it in terms of medical service charges.
2. In accordance with the provisions of the Implementation Plan for the Establishment of the National Essential Medicine System in Zunyi City, since March 20XX, the National Basic Drug Service System has been implemented in all township hospitals and national community health service centers in the city, and the drug zero plus is implemented. Become a policy. Public hospitals at all levels should also gradually implement the national essential medicine system. The use rate of basic medicines in secondary hospitals is not less than 40%, and that in tertiary hospitals is no less than 30%, and the drug addition policy is gradually phased out. For the reasonable income reduced by public hospitals, measures such as adding pharmacy service fees and adjusting some technical service charges will be adopted to compensate the medical insurance fund and increase government investment.
3. Explore the reform of medical insurance payment methods. City, County Social Security Bureau, New Rural Cooperative Office to improve basic medical insurance costs
Payment methods, actively explore payment methods such as pay-per-use, per capita payment, total payment, etc., timely and fully pay the fees in accordance with medical insurance policies and agreements; implement project management and payment systems for medical assistance and charity; Supplementary insurance, commercial health insurance and road traffic insurance payment methods effectively reduce the burden of medical expenses for the people. Under the premise of strengthening government guidance, reasonably determining the price of medical service guidance, and reasonably controlling the total cost of hospital medicine and the average cost, it is necessary to negotiate the hospital, medical insurance agency to determine the scope of service, payment method, payment standard and service quality requirements.
4. Increase government input. The municipal and county people's governments are responsible for the basic construction of public hospitals, the purchase of large-scale equipment, the development of key disciplines, the retirees' expenses and policy-related subsidies in line with state regulations, and special subsidies for public health tasks undertaken by public hospitals to guarantee the government's designation. Compensation for public services such as emergency treatment, disaster relief, foreign aid, supporting agriculture, supporting the branch and supporting the community will be tilted in the investment policies of Chinese medicine hospitals, infectious disease hospitals, psychiatric hospitals, and maternal and child health centers.
5. Seriously learn from the successful experience inside and outside the province, actively explore the effective form of drug procurement management in public hospitals such as centralized drug distribution in counties, steadily promote the separation of medicines, reform the mechanism of medicine supplementation, and curb the high price of pharmaceuticals and procurement. The unhealthy trend of the link.
Strengthen the management of public hospitals
1. Strengthen the quality management of medical services in public hospitals. Improve and implement hospital management rules and regulations and personnel post responsibility system, improve medical quality management organization, implement disease diagnosis and treatment norms and drug clinical application guidelines, standardize clinical examination, diagnosis, treatment, use of drugs and implanted medical devices, and continuously improve medical care Quality to ensure patient safety.
2. Strengthen the construction of key disciplines and improve the capacity and level of medical services. We will continue to implement the strategy of strengthening the talents and strengthen our efforts. In 2019, the city will have 10 and 30 health professionals with certain influences on the national and provincial health systems, and about 300 young and middle-aged academic and technical backbones of the city's health system. Established 10 medical leading disciplines with certain advantages in Guizhou Province, built 1 or 2 national key disciplines or key cultivation disciplines, and cultivated a group of high-level health professional and technical personnel.
3. Establish an incentive mechanism for health personnel. Established “Zunyi City's outstanding young and middle-aged experts”, “Zunyi City Famous Chinese Medicine” and “Zunyi City's outstanding rural health workers” awards, commending outstanding young and middle-aged experts, famous Chinese medicine practitioners and long-term rooted rural areas , grassroots health personnel who serve the grassroots and contribute to society.
4. Improve hospital services. We will make efforts to shorten patient waiting time and hospital bed day by providing appointment medical services, smoothing emergency green channels, optimizing service procedures, and classifying medical treatment according to the condition. Establish a patient complaint management mechanism, timely and effectively handle patient complaints and medical disputes, and build a harmonious relationship between doctors and patients.
5. Improve the level of hospital information. Promote the informationization of public hospitals with the focus on hospital management and electronic medical records, and improve management and service levels.在加強規範和保障質量的基礎上逐步實行同級醫療機構檢查結果互認，在遵義醫院建立全市數位化遠程會診中心，降低醫療服務成本。嚴格執行衛生部疾病診療規程，推動分病種臨床路徑規範化治療。研究制訂遵義市醫療機構信息化管理的規定和標準，充分利用現
有資源逐步建立醫院之間、上級醫院和基層醫療衛生服務機構之間、醫院和公共衛生機構、醫保經辦機構之間的互聯互通機制，構建便捷、高效的醫院信息平台。
改革公立醫院監管機制
1.實行醫療衛生全行業監管。加強衛生行政部門醫療服務監管職能，建立健全醫療服務監管機制。全市所有醫療衛生機構不論所有制、投資主體、隸屬關係和經營性質，均由衛生行政部門實行統一規劃、統一準入、統一監管。建立完善機構、人員、技術、設備的準入和退出機制，依法實行全行業監管。
2.加強公立醫院醫療服務安全質量監管。依託遵義醫學院附屬醫院、遵義醫院所具有的較高診療技術水平和質量管理水平，制定並建立完善市、縣兩級醫療質量安全控制評價體系和各級各專業醫療質量控制評價組織，加強醫療質量安全評價控制工作，持續改進醫療服務質量。完善各級各類醫院管理評價制度，繼續做好醫院管理評審評價工作。
3.加強公立醫院運行監管。市、縣衛生行政部門要加強對公立醫院功能定位和發展規劃的監管，嚴格控制公立醫院建設規模、標準和貸款行為，加強大型醫用設備配置管理。控制公立醫院特需服務規模，公立醫院提供特需服務的比例不超過全部醫療服務的10%。
4.健全財務分析和報告制度。衛生、財政、審計部門要加強公立醫院財務監管，建立健全公立醫院財務審計和醫院院長經濟責任審計制度，定期或不定期開展公立醫院財務審計。
5.建立社會多方參與的監管制度。全面推進醫院信息公開制度，接受社會監督。強化醫療保障經辦機構對醫療服務的監督制約作用，依照協定對醫療機構提供的服務進行監督，並納入公立醫院考核和評價內容。充分發揮會計師事務所的審計監督作用，加強醫療行業協會在公立醫院自律管理監督中的作用。
6.建立醫患糾紛第三方調解機制，積極發展醫療意外傷害保險和醫療責任保險，完善醫療糾紛調處機制，嚴厲打擊“醫鬧”行為。
建立住院醫師規範化培訓制度
逐步探索建立符合醫學人才成長規律、適應遵義市市情的住院醫師規範化培訓制度，把住院醫師培訓作為全科醫生、專科醫生培養的必經環節。以遵義醫學院附屬醫院、遵義醫院為基地，培養全市各專業合格的住院醫師。
加快推進多元化辦醫格局
積極鼓勵和引導社會資本發展醫療衛生事業，加快形成投資主體多元化、投資方式多樣化的辦醫體制。完善政策措施，鼓勵引導社會力量、社會資本舉辦非營利性醫院。在區域衛生規劃和醫療機構
設定規劃中，要給非公立醫院留出足夠空間。非公立醫院在醫保定點、科研立項、職稱評定、繼續教育等方面，與公立醫院享有同等待遇，在服務準入、監督管理等方面一視同仁。非公立醫院承擔公共衛生服務由市、縣政府採取購買服務的方式解決。落實營利性醫院稅收優惠政策。加強對非公立醫院的監管，引導非公立醫院依法經營、加強管理、嚴格自律、健康發展。
五、試點的組織領導
試點的領導機制
1.成立試點工作領導機構
公立醫院改革試點工作由市人民政府統一領導並組織實施。市人民政府成立公立醫院改革領導小組，由分管副市長任組長，成員單位有市衛生局、市編委辦、市發展改革委、市財政局和市人力資源社會保障局，領導小組辦公室設在市衛生局。市公立醫院改革領導小組要加強對試點工作的領導，及時研究解決試點工作中存在的困難和問題，加強信息交流和培訓指導，適時開展試點評估工作，完善公立醫院改革總體思路和主要政策措施，不斷總結公立醫院改革試點工作經驗，及時向上級有關部門匯報試點工作進展情況。
2.明確領導小組各部門職責
市衛生局：牽頭制定遵義市公立醫院改革試點實施方案、遵義市區域衛生規劃、醫療機構設定規劃、遵義市非公有制醫療機構設定指導意見、公立醫院管辦分開、醫藥分開、醫院法人治理、分配激勵機制、住院醫師規範化培訓、醫院信息化建設、醫院監督管理、醫院人事制度改革、財務會計制度改革、醫療衛生全行業管理實施細則；負責醫療服務體系建設、衛生人才隊伍建設、學科建設、等級醫院創建工作；組織公立醫院改革試點工作調研、檢查、督導、評估、培訓和技術指導；公立醫院改革試點工作相關信息的蒐集、匯總、傳遞；把握正確輿論導向，向新聞媒體通報、交流公立醫院改革試點工作進展；承擔公立醫院改革領導小組辦公室工作。
市編委辦：牽頭負責市、縣衛生行政部門適應公立醫院改革試點工作需要的管理機構設定、工作職能、事權劃分、人員配置；會同衛生、發展改革、財政、人力資源社會保障等部門做好公立醫院管辦分開、醫藥分開、法人治理、人事制度改革、分配激勵機制改革、醫院監督管理等方面的政策指導；承擔公立醫院改革領導小組成員單位的相關工作。
市發展改革委：牽頭負責制定醫療衛生服務體系建設規劃，根據需要安排醫療衛生機構基礎設施建設投資；會同衛生、編委辦、財政、人力資源社會保障等部門做好公立醫院改革實踐中合理制定醫療服務標準、藥事服務收費標準、稅收優惠政策；承擔公立醫院改革領導小組成員單位的相關工作。
市財政局：牽頭負責制定醫療衛生投入方案，建立健全衛生補償機制；會同衛生、發展改革委等部門研究制定公立醫院、非公立醫院相關財稅政策；加強公立醫院分配激勵制度改革、財務會計制度改革的監督管理；承擔公立醫院改革領導小組成員單位的相關工作。
市人力資源社會保障局：牽頭負責制定公立醫院人事制度改革方案、建立以專業技術能力、工作業績和醫德醫風為主要評審依據的衛生專業技術人員職稱評定製度；制定並落實衛生人才隊伍建設的相關政策，合理配置全市衛生人力資源；逐步建立合理的基層醫療衛生專業技術人才隊伍職稱結構；建立完善醫療保障支付制度；承擔公立醫院改革領導小組成員單位的相關工作。
試點的指導、評估和監督
公立醫院改革試點工作領導小組成員單位要按照各自的職責，在市政府的統一領導下，分工合作，充分運用組織、管理、協調、指揮的職能，密切部門之間的配合，加強對試點工作的指導和評估，及時總結試點情況，完善有關政策措施，積極穩妥地推進試點工作開展。
創造良好試點環境
充分利用新聞媒體做好輿論宣傳工作，加強對公立醫院改革試點工作重要意義、指導思想、基本原則、主要任務和政策措施的宣傳，調動廣大醫務人員參與改革的積極性、主動性，爭取廣大人民民眾和社會各界的理解和支持。衛生部門與宣傳部門要緊密配合，加強對公立醫院改革試點的輿情監測與研判，積極引導社會輿論，堅定改革信心，合理引導社會預期。
篇三：公立醫院改革實施方案
I. Reform ideas and goals
general idea
With the overall principle of “promoting development, improving efficiency, reducing burdens, and promoting health”, we will seize the opportunity of pilot reform of the total amount of medical insurance funds, focus on the overall work of the hospital, strive to make new breakthroughs in the reform of public hospitals, and promote development through reform. Huiminsheng, strive to make the hospital development more dynamic, patients are more assured, more at ease, more comfortable.
Reform goal
Through the implementation of reform pilot work, accelerate the establishment of a new modern hospital management system, operational mechanism and medical service model with medical service quality, efficiency and satisfaction as the core, strengthen medical quality management, optimize medical service processes, and improve service efficiency. Solve the bottleneck problem of hospital operation and maintain and enhance the core competitiveness of the hospital. Let the people of the people get benefits, the medical staff are encouraged, the hospital is sustainable and healthy, and it can provide reference for the promotion of the reform of the public hospitals in the capital.
Second, the main pilot task
The hospital is mainly responsible for the pilot task of the total advance payment system for medical insurance funds. Establish and implement the pilot tasks with the overall requirements of “unified thinking, high priority, clear objectives, strict management, performance appraisal, and pay-related”.
specific measure
1. Increase monitoring efforts Focus on implementation process management. Adding an internal control system to the doctor's outpatient workstation as an important tool to reduce the average cost of outpatients, using system information prompts, automatic conversion of drugs according to the principle of prescribing, reducing the incidence of errors such as hyperindications and re-opening, avoiding large prescriptions Drug abuse phenomenon, reducing the proportion of drugs. At the same time, improve the quality control standards for clinical and pharmaceutical, inspection and radiology departments, strictly abide by the medical system and technical specifications, and reasonably control the inspection items.
2. Increase incentive mechanism to include the total prepaid fund balance into reward distribution, and link with task completion and comprehensive performance appraisal, encourage medical staff to standardize diagnosis and treatment behavior, rationally check, rational use of drugs, scientific treatment, efficient service, and implement various controls. Fee measures to ensure that the average cost per person is reduced.
3. Improve the restraint mechanism Strengthen the supervision and assessment of the implementation of reform measures.
4. Integrate supervision and management Continue to carry out supervision and rounds of hospital leadership, strengthen investigation and research on major issues in medical reform work, and guide clinical standardization of diagnosis and treatment behavior and rational use of drugs.
5. Strengthen standardized management, comprehensively promote the responsibility system of the attending physicians, give full play to the role of the diagnosis and treatment team, continue to improve the management mode and monitoring mechanism of the attending physicians, and strive to establish an accounting system based on the team of the chief physicians during the year to promote the referral Full implementation of doctors' responsibility system; strengthen the rational use of antibacterial drugs, establish supervision and management of the whole process; continuously improve clinical path management, establish clinical path management indicators, and feedback the implementation of various diseases at the weekly meeting in the hospital; increase quality nursing services Advancement; strengthen the standardized management of doctors, reduce the abuse of antibacterial drugs, reduce large prescriptions, and reduce major inspections. Carry forward the spirit of being good at being pragmatic, daring to reform and innovate, and be brave in challenging problems, and take the patient as the center to realize the continuous diagnosis and treatment model of the whole process.
6. Establish a joint office mechanism to further strengthen the overall coordination and comprehensive management of the total prepaid pilot work, and establish a joint office mechanism for the medical department to “coordinate office, department linkage, clear responsibilities, and time-limited completion” to timely resolve and resolve the existence of the pilot task. Issues in personnel, process and management, speed up the pace of pilot tasks.
Pilot task performance appraisal
Strengthen the two-level refined management of the department. Based on the basic data, the hospital decomposes the total prepaid total control indicators according to the department, and formulates the annual basic value, expected value and challenge value of each department, and serves as the performance appraisal indicator for the year-end department and strict indicator management. With the aim of pursuing social benefits and strengthening management as the core, the main content of ensuring the quality and safety of medical services and improving operational efficiency is to mobilize the enthusiasm of medical personnel and effectively reduce the burden of patients' medical care, and improve the supervision and assessment and compensation system.
Third, key initiatives
In 20XX, in order to ensure the smooth implementation of the pilot work, the hospital will focus on 18 key tasks from four aspects, and go all out to complete the medical reform of the hospital.
Medical service innovation to improve patient experience
Adhere to the innovative medical services as an entry point to further promote the reform of public hospitals, and improve the patient experience of medical treatment as the foothold of hospital reform, and provide a strong guarantee for the sustainable and healthy development of the hospital.
1. Summer special peak summer work In response to the characteristics of a large number of children in the summer accompanied by parents to come to the clinic, optometry, starting from May 20XX, start the summer outpatient preparations; July 1 start the summer work plan. By tapping the internal potential, increasing the amount of ophthalmic services; adjusting the outpatient space, optimizing the treatment process; conducting medical consultation and diverting the peak of the consultation; diversifying the patients to the south, doing a good job in logistics support and other measures to improve work efficiency. Work hard to meet the needs of patients seeking medical care.
2. Continue to promote appointments and treatments, optimize the outpatient service process to promote the “first diagnosis and treatment, post-settlement” mode; actively cooperate with the pilot of the Hospital Administration of Beijing Medical Card; increase the number of sources and expand the service capacity.
3. Dean of the hospital supervised the ward round On the basis of the administrative ward round of the leadership of the hospital in 20XX, the hospital led the supervision and ward rounding system; and supervised whether the director of the department timely checked the house and checked the connotation quality. Through the on-site work of the hospital leadership, timely solve the problems in medical operation and ensure the quality and safety of medical care.
4. Improve the bed occupancy rate special work By taking effective measures to improve the hospital's ability to treat inpatients; implement bed dynamic management, to achieve the bed "reconciliation", ease the hospitalization of patients, the use of bed in the hospital to achieve more than 90%.
5. Shorten the special hospitalization day special work Establish the medical layout adjustment and medical process transformation based on the one-day ward, and actively explore the continuous improvement and continuous improvement of the one-day ward. Efforts will be made to control the average hospitalization day of the hospital within 10 days, improve the utilization efficiency of high-quality health resources, and reduce the number of patients waiting for bed.
6. Strict pharmacy management, standardize the clinical application of antibacterial drugs, improve the management of pharmacy in hospitals, and promote the “special rectification activities for clinical application of antibacterial drugs”. On the basis of consolidating the achievements of previous work, in the year of 20XX, this year, we will further improve the management of antimicrobial drugs by clarifying the responsibilities of various departments, using information technology to promote the rational use of antibacterial drugs, and establishing reward and punishment mechanisms. The preventive use of antibiotics in class II incision surgery and the therapeutic use of antibacterial drugs are the focus of work, ensuring the safety of patients' medications and reducing the cost of medication for patients.
Inspire talents to innovate and enhance core competitiveness
1. Increase investment, build a scientific research management platform, build a hospital scientific research management information platform, and invest a million yuan for the support of the hospital fund project.
2. Introduce talents, strengthen basic discipline construction hospitals, further clarify the working ideas of “stability, reform and development”, take the development of cardiovascular science as a breakthrough, and introduce one of the leaders of cardiovascular science outside the hospital – Beijing high-level health technology leading talents Professor Ma Changsheng. Through its profound knowledge in the field of cardiovascular disease interventional therapy, it has promoted the development of disciplines and become a key discipline of medical technology, cultivates high-level talents with strong technical strength, and enhances the comprehensive strength of hospitals.
3. Cultivate talents, combine subject education with clinical development, improve the establishment and responsibilities of the Beijing Tongren Hospital Talent Work Committee, and further clarify the means and methods for the party to manage talents. Implement financial support; improve the education management system and focus on connotation construction.
Management mechanism innovation, improve hospital operating efficiency
1. Combine medical reform and improve the rules and regulations of the whole hospital to inherit the centuries-old work of colleagues, and combine the new situation and new requirements of medical reform, from six aspects of administrative management, medical quality management, medical service management, personnel management, financial management and security. Sort out and improve various rules and regulations and job responsibilities.
Revise the hospital-level meeting system, control the number and quality of meetings, streamline issues, and improve office efficiency; implement the implementation supervision mechanism of meeting resolutions to ensure timely delivery and full implementation of decisions. Through the combination of perfect system and detailed post responsibility system, it will build a broader platform for continuous improvement of medical quality, medical safety, medical service and performance management.
2. Combine medical reform on hospital performance appraisal methods, revise and improve the performance appraisal system linked to remuneration, further enrich and innovate hospital performance appraisal, and then move from performance appraisal to hospital performance management. Link the performance appraisal to the bonus distribution and re-plan the bonus distribution plan. Through the performance management and compensation management, the simultaneous development of hospitals and employees will be realized, and the income of employees will be improved.
3. The Party Committee provides ideological and organizational guarantee for medical reform. The two assessment systems continue to improve the quantitative assessment of the work of the Party branch and the work evaluation system of the Communist Party members, implement the medical reform policy and performance appraisal, and further improve the attention of party branch secretary and party members to the medical reform work. To provide strong support for medical reform.
4. Cadre training and team building, play the role of the main force Focusing on the central task of medical reform and the mainstream direction of hospital development, strict selection, appointment, evaluation and management of cadres, and the cadre management college as an important platform for medical reform education and training.
5. Build a pool of nursing reserve personnel, solve the shortage of nursing staff, fully mobilize and give full play to the working potential of nurses, prepare for the training of general nursing backbones in the later stage, promote the work of quality nursing services, and propose the concept of establishing a repository of nursing staff. .
6. Strengthen the construction of hospital information, promote the scientific management of hospitals, improve the hospital information system, strengthen the deep application of the system; build a unified electronic medical record system in the three districts; and strengthen the information decision analysis and management functions. Hospital construction innovation, improve medical service environment
Hospital construction innovation, improve medical service environment
1. Establish an outpatient service center with medical reform requirements, promote the construction of a new “one-stop” service model, implement the requirements of the Hospital Authority for establishing an outpatient service center, and set up outpatient service centers in prominent locations in the outpatient halls of the three hospital areas to integrate patients. Outpatient service needs, improve various service initiatives and facilities
2. Expanding the medical service space, improving the outpatient medical treatment environment, reclaiming the original rental commercial houses in the Western and Eastern Districts, and expanding the medical housing; taking the adjustment and transformation of the hospital's three districts as an opportunity to adjust the work flow and improve the internal environment of the hospital. The patient provides a convenient, spacious, clean, bright and comfortable medical environment.
3. The second phase of the Southern District Planning and Construction The second phase of the Southern District is based on the overall layout plan of the hospital's three districts, embodying the “green hospital” design concept, in line with the latest trends in hospital construction, and using scientific and advanced design to achieve safety, efficiency and low cost. run.
Following the overall requirements of the future development of the hospital, it is closely integrated with the comprehensive development of the hospital and the construction of the department, so that the medical resources, hardware environment and management environment are highly integrated and highly unified to meet the long-term development goals of the hospital.
Fourth, safeguard measures
Organizational guarantee
Established the hospital reform leading group and the hospital reform work office.
Mechanism guarantee
1. Implementing project management The competent department shall formulate a project time schedule, and the competent department shall follow the implementation of the decision of the leading group; regularly organize special seminars and office meetings to report the progress of the work to the leading group; the effect is not significant The evaluation and analysis of problems arising during the implementation of the project, coordination of the revised work plan of the relevant department; summarizing the work measures for achieving results, laying the foundation for the promotion of experience.
2. Informatization construction, solid management foundation Continue to improve hospital information construction and establish a data reporting decision-making mechanism. The hospital is required to attach great importance to data statistics, calculation and reporting, strengthen the training of relevant personnel, and do a good job in data quality control.
3. Regulate hospital economic management and standardize financial management. Financial subsidies for hospital infrastructure construction, large-scale equipment purchase, key discipline development, talent team construction, retirees' expenses, and public health tasks are strictly implemented in accordance with financial fund management requirements.
Improve efficiency from cost control. Control operating costs to focus on revitalizing existing resources and reducing operating costs, compressing and reducing administrative expenses and strengthening awareness of conservation.
4. Implementation of comprehensive budget management The overall business objectives of hospital reform and development are decomposed into departments by budgeting, and under the guidance and control of budget management, there are plans and steps to implement. Through the actual analysis and evaluation of the budget situation, the performance evaluation and rewards and punishments of the budget execution department will be realized.
5. Sharing development achievements with employees Focus on making the people's people affordable, fully consider the interests of employees, continuously improve the employee's 'happiness index', and give play to the main role of medical personnel. Through the various channels such as employee representatives, the channels for appealing expression are unblocked, and the value of medical personnel training is reflected through the reform of the hospital personnel training mechanism and incentive and restraint mechanism.
Ideological organization guarantee
1. Strengthen ideological and political construction In the process of promoting the reform of public hospitals, adhere to and strengthen the leadership of the party, and in accordance with the requirements of the scientific development concept, focus on the core, solid fortress, and pioneer, and play the political, ideological and organizational organization of the party organization. Safeguards. Give full play to the role of party branches and league branches, and mobilize and protect the enthusiasm and creativity of cadres and workers.
2. Strengthening the promotion of policy measures Strengthening the publicity of public hospital reform policies and measures through meetings, training, seminars, archives, etc., unifying the thinking of cadres and workers into the medical reform work, and laying the ideological foundation for promoting the reform of public hospitals. Organize hospital management cadres to seriously study and study, improve the medical reform policy level and reform implementation of the hospital leadership team; face cadres above the team leader, hold mobilization meetings, compile medical reform study materials, strengthen policies and measures training; conduct missions to medical staff in the hospital guide.
3. Strengthen internal and external propaganda to lead the work through reporting medical reform information, summarizing and promoting work experience and practices; giving full play to the role of media information platforms such as health information network, hospital official website, and Weibo, and comprehensively reporting the benefits brought by hospital reform to the people. The medical reform policy has been widely publicized, so that all sectors of society can keep abreast of the hospital reform dynamics and reform results, and create a good public opinion atmosphere.
Part 2: Implementation plan for public hospital reform
In order to effectively carry out the work of the national pilot city for the reform of public hospitals in Zunyi City, according to the "Opinions of the Central Committee of the Communist Party of China and the State Council on Deepening the Reform of the Medical and Health System" and the Ministry of Health and other five ministries and commissions on the "Guidelines on Printing and Initiating the Pilot Suggestions for the Reform of Public Hospitals", Actually, develop this plan.
I. Guiding ideology and basic principles
guiding ideology
Adhere to the public welfare nature of public hospitals, put the protection of people's health rights first, separate administrative affairs, separate management, separate medicines, profit-making and non-profit separation, promote institutional innovation, mobilize the enthusiasm of medical personnel, and improve public The hospital operates efficiently and strives to make the people look good. In accordance with the requirements of “appropriate scale, optimized structure, rational layout, quality improvement and sustainable development”, we adhere to the principle of equal emphasis on both Chinese and Western medicine, coordinating the allocation of medical resources between urban and rural areas and regions, promoting the healthy development of public hospitals, and satisfying the basic needs of the people. The demand for medical services will effectively alleviate the problem of expensive medical treatment and difficult medical treatment.
The basic principle
Adhere to the unity of fairness and efficiency, the combination of government leadership and market mechanism; adhere to the dominant position of public hospitals, encourage diversified medical treatment, promote the coordinated development of hospitals of different ownership and management nature; adhere to the combination of development, reform and management, and improve the service system Innovate institutional mechanisms, strengthen internal management; adhere to overall design, orderly advancement, key breakthroughs, systematic summarization; adhere to the reform direction and principles determined by the central government, base on Zunyi City, emancipate the mind, adapt to local conditions, and boldly explore and innovate.
Second, the overall objectives of the pilot, the main tasks
Overall objective
Build a public hospital service system with clear public welfare objectives, reasonable layout, appropriate scale, optimized structure, clear hierarchy, perfect function and high efficiency, explore the establishment of a division of labor coordination mechanism with the primary health care service system, and accelerate the formation of a diversified medical service pattern. To form a relatively scientific and standardized public hospital management system, compensation mechanism, operational mechanism and supervision mechanism, strengthen the internal management of public hospitals, and promote public hospitals to fulfill public service functions and provide safe, effective, convenient and inexpensive medical and health services for the public. . Forming the overall thinking and major policy measures for the reform of public hospitals, laying the foundation for comprehensively promoting the reform of public hospitals.
main mission
1. Strengthen regional health planning. Reasonably determine the function, quantity and scale of public hospitals, optimize the structure and layout, and improve the service system.
2. Reform the management system of public hospitals. Exploring the effective forms of separation of administration and separation of government affairs, establishing a coordinated, unified and efficient public hospital management system, scientifically defining the responsibilities of public hospital owners and managers, exploring the establishment of hospital corporate governance structure, and promoting the professionalization and professionalism of hospital directors Construction.
3. Reform the compensation mechanism of public hospitals. Exploring the specific ways to achieve the separation of medicines, changing the situation in which medical institutions rely too much on the sales revenue of medicines to maintain their operation, gradually eliminate the drug addition policy, rationally adjust the price of medical services, explore the reform of basic medical insurance payment methods, and implement the financial subsidy policy. Implement the Chinese medicine support policy.
4. Reform the operating mechanism of public hospitals. Deepen the reform of the personnel system and income distribution system of public hospitals, improve the economic operation and financial management system of public hospitals; strengthen the internal management of public hospitals, implement various hospital management systems, formulate regulations for the diagnosis and treatment of diseases, promote the implementation, accelerate the construction of information technology, and guarantee medical care. Quality, improve service efficiency, control medical expenses, and facilitate people to seek medical treatment.
5. Improve the supervision mechanism of public hospitals. Implement hospital information disclosure, improve the performance appraisal system of public hospitals, and strengthen medical safety quality and economic operation supervision.
6. Form a diversified medical treatment pattern. Encourage, support and guide social capital to enter the medical service field, improve the policy system, create an environment that creates fair competition, guide, encourage and support the development of non-public medical institutions, promote mutual cooperation and orderly competition among different ownership medical institutions, and satisfy different people. Level of medical service needs.
Third, the scope of the pilot and implementation steps
Pilot principles and scope
In accordance with the principle of easy and difficult, step by step, active exploration, and classified guidance, the Yuqing County People's Hospital was determined as a comprehensive reform and overall promotion pilot in Zunyi City. Zunyi Hospital should carry out pilot projects in terms of service system, internal operation mechanism, hospital management, and standardized training for residents. Other county people's hospitals should focus on strengthening county hospital capacity building.
Implementation steps
The pilot reform of public hospitals in Zunyi City began in 20XX and was implemented in three phases.
1. Develop a pilot work plan. According to the "Opinions of the Central Committee of the Communist Party of China and the State Council on Deepening the Reform of the Medical and Health System" and the Ministry of Health and other five ministries and commissions, "Notice on the Guidelines for the Issuance of Pilot Suggestions for the Reform of Public Hospitals," the "Zhuyi City Public Hospital Reform Pilot Implementation Plan" was formulated and required Approved.
2. Carry out pilot work. According to the requirements of the State Council's "Key Implementation Plan for the Reform of the Medical and Health System", refine the objectives and tasks, and propose reform measures and targets for public hospitals that are promoted and focused on the whole, and explore on the basis of pilot projects in public hospitals at the city and county levels. Reform experience, summarize the reform results, and gradually promote the pilot work of other public hospital reforms.
3. Summarize the evaluation pilot work. Conduct a comprehensive summary of the pilot work, improve relevant policy measures, form an evaluation report, and accept the review and acceptance.
Fourth, the main content of the pilot work
Establish and improve the public hospital service system
1. Strengthen the planning and regulation of public hospitals. In accordance with the provincial people's government health resource allocation standards, regional health planning and medical institutions set planning guidelines, the Zunyi City regional health planning, medical institution setting planning and public hospital development planning shall be formulated to determine the functional positioning of public hospitals at all levels.
2. Establish and improve the municipal medical service system. Make full use of and optimize existing health resources, and establish and improve a municipal-level medical service system with appropriate scale, complete functions, optimized structure, clear hierarchy, and reasonable layout. The Zunyi City Maternal and Child Health Hospital and the Zunyi City Hospital of Traditional Chinese Medicine, which are now managed by Honghuagang District, are assigned to the Municipal People's Government for management, and the municipal maternal and child health hospitals and Chinese medicine hospitals will be established, and the second people's hospital of Honghuagang District will be established. Go to the Municipal People's Government for management and rebuild it into the Zunyi City Infectious Disease Hospital; relying on the Zunyi Medical Affiliated Hospital to build the Zunyi City Psychiatric Hospital. The Zunyi Traffic Hospital, which is now managed by the municipal level, will be transferred to the Huichuan District for management, and the new Huichuan District People's Hospital will be established; the new Pupu New District medical institution will be newly selected in the Xinpu New District.
3. Establish and improve the primary medical service system, and further improve and improve the county, township and village health service networks. Complete the standardization construction of 15 county-level general hospitals in 3 years, complete the standardization construction of 50 central township hospitals, and complete 1700 village health
The standardization construction of the room completed the standardization construction of 8 community health service centers.
4. According to the regional health planning and medical institution setting plan of Zunyi City, actively encourage and guide social capital and enterprise units to invest in the establishment of non-public hospitals.
5. Strengthen the standardization of public hospitals and improve their service capabilities. Support Zunyi Hospital to establish a third-grade hospital; the Municipal Maternal and Child Health Hospital, the Municipal Hospital, the Municipal Infectious Disease Hospital, and the Municipal Psychiatric Hospital are constructed according to the standards of the third-level hospital; all the county and district people's hospitals meet the standards of the second-class hospital; Zunyi County , Renhuai City, Chishui City, Yuqing County and Shuyang County Chinese Medicine Hospital gradually reached the standard of Class A and Chinese hospitals.
6. Establish a division of labor and cooperation mechanism between public hospitals and urban and rural primary health care institutions. The tertiary hospitals mainly provide high-level specialist medical and health services and perform advanced teaching and research tasks; the secondary hospitals mainly provide comprehensive medical and health services and undertake certain teaching and scientific research tasks; the township health centers mainly provide prevention, medical care, health care and rehabilitation services. The Community Health Service Center mainly provides services integrating medical care, prevention, health care, rehabilitation, health education, and family planning technical guidance; the village clinic mainly provides common medical services for rural residents with common diseases and frequently-occurring diseases in rural areas. Implement county-wide integrated management by county. The higher-level hospitals promote the development of primary medical institutions through management guidance, technical support, and personnel training, so that the reform of public hospitals and the sound grassroots medical and health systems work closely together and promote each other. Gradually establish a two-way referral system and explore the establishment of a primary care system for primary medical institutions.
7. Establish and improve a long-term mechanism for counterpart support in urban and rural hospitals, and conscientiously implement 10,000 physicians to support rural health projects. Multi-form, multi-channel strengthen the construction of grassroots health personnel, and gradually improve the quality and ability of hospital personnel. According to the needs of the aided hospitals, the counterpart support hospitals actively support the standardized construction of the aided hospitals by means of hospital management, medical care quality, hospital information management, health talents, appropriate technology, and equipment support, and according to the “Guangzhou Provincial Urban and Rural Hospitals’ counterpart support”. The requirements of the Work Performance Assessment Indicators have solidly promoted the assistance work.
8. Correct and standardize the names of medical and health institutions at the city and county levels in accordance with the regulations of the “Regulations on the Administration of Medical Institutions” and other relevant laws and regulations.
Reform the management system of public hospitals
1. The county people's government is responsible for organizing county-level public hospitals, and other public hospitals are organized by the municipal people's government. To regulate the management of medical institutions, in accordance with the provisions of the Regulations on the Administration of Medical Institutions, the Zunyi Hospital was renamed as the First People's Hospital of Zunyi City, and the Zunyi City People's Hospital, Zunyi City Stomatological Hospital and Zunyi City Orthopedic Hospital, respectively, in Honghuagang District were renamed. Honghuagang District People's Hospital, Honghuagang District Stomatological Hospital and Honghuagang District Orthopaedic Hospital.
2. Actively explore effective forms of separation of management and management. In accordance with the principle of separation of functions between medical service supervision functions and medical institutions, the government will promote the localization management of government health and other departments, hospitals owned by state-owned enterprises and institutions, and gradually realize the unified management of public hospitals.
3. Establish a coordinated, unified and efficient public hospital management system. The municipal and county people's governments shall establish a public hospital management committee. The member units shall be composed of departments such as development and reform, finance, health, human resources, social security, and supervision. The office shall be located in the administrative department of health, assume the functions of the government funder, and be responsible for the main public hospitals. The appointment of the responsible person shall comprehensively supervise the state-owned assets, financial accounting, operational mechanism, distribution system, medical price, medical technical norms and industry style of the hospital.
4. Establish and improve the medical quality evaluation and supervision system of public hospitals. The Public Hospital Management Committee is responsible for organizing medical quality, medical safety, medical services, financial supervision and evaluation, establishing and improving the public hospital supervision system with public welfare as the core, and promoting the reform of public hospitals.
5. The Municipal Development and Reform Commission, the Municipal Editorial Committee Office, the Municipal Finance Bureau and the Municipal Human Resources and Social Security Bureau actively cooperate with the health administrative department to formulate and implement infrastructure construction, staffing, financial input, medical service prices, income distribution, and public hospitals. Supporting policies such as personnel system reform provide guarantee conditions for public hospitals to perform medical service functions.
Reforming the corporate governance mechanism of public hospitals
1. Explore the establishment of a corporate governance structure in public hospitals with the core of the council, and enhance the vitality of public hospitals. The president of the municipal and county public hospitals shall be gradually appointed by the municipal and county public hospital management committees. The president shall act as the legal representative in accordance with the principle of unity of powers and responsibilities, and perform the hospital management functions according to law; the vice president shall be nominated by the president and appointed by the public hospital management committee; the middle cadres shall be appointed by the president. The internal party organizations and social groups in the hospital shall be legally produced in accordance with the regulations of the organization, and shall be appointed according to the organizational procedures; the discipline inspection secretary shall be stationed by the municipal and county party committee discipline inspection and supervision organs to form a power operation mechanism for decision-making, implementation, and supervision.
2. Gradually cancel the administrative level of the president of the public hospital, implement the file management at the former administrative level, and promote the professionalization and professionalization of the president of the public hospital.
3. Establish a performance appraisal management system for public hospitals with public welfare as the core and the incentive and restraint mechanism for the dean. The annual review will be carried out for the dean. If the annual appraisal is unqualified, it will be dismissed for two consecutive years.
Reform the internal operation mechanism of public hospitals
1. Reform the internal decision-making mechanism of the hospital and improve the president's responsibility system. In accordance with the corporate governance structure, the management duties shall be fulfilled. Major decisions, appointment and waiver of important cadres, major project investment, and large-capital use shall be subject to collective decision-making by the hospital leadership team and separate by management and administration, and separated by the public hospital management committee. After execution.
2. Implementing open government affairs and promoting democratic management of public hospitals. In accordance with the principle of active disclosure, the hospital's internal personnel appointment and dismissal, health technology title appraisal, performance appraisal, medical care quality assessment, infrastructure construction, large-scale medical equipment, pharmaceutical equipment, sanitary materials procurement, major events, open the hospital affairs, accept the hospital and Social supervision. Improve the hospital's organizational structure, rules and regulations, and job responsibilities, and promote the democratization, institutionalization, standardization and modernization of hospital management.
3. Strict budget management and revenue and expenditure management, and strengthen cost accounting and control. Strict financial centralization and unified management, strengthen asset management, establish and improve internal control, and implement internal and external auditing systems.
Deepen the reform of the personnel system in public hospitals
1. Strengthen the construction of the health talent team. In order to continuously meet the needs of people's people at different levels of medical and health services, the Municipal Human Resources and Social Security Bureau will work with the Municipal Health Bureau and the Municipal Editorial Committee to formulate preferential policies, and do a good job in health professional and technical personnel business training, job title evaluation, preparation and salary implementation policies. Actively guide the flow of health human resources to the grassroots level, and gradually establish a team of health professionals with sufficient quantity, high quality and reasonable structure.
2. In accordance with the spirit of the Notice of the Provincial Health Department, the Provincial Development and Reform Commission, the Provincial Editorial Committee Office, the Provincial Finance Department, and the Provincial Human Resources and Social Security Department on Printing and Distributing the Implementation Opinions on Strengthening the Construction of County-Level General Hospitals in Guizhou Province, According to the needs of urban development, according to the economic and social development of the city, timely adjust the planning of medical institutions in the central city, and reasonably determine the number, scale, bed and staffing of various types of medical institutions at all levels in the city.
3. Explore the reform of the hospital employment mechanism. After the public hospital bed and staffing control indicators are determined, the establishment, human resources, social security and health departments shall determine the number and standards of hospitals for the admission and introduction of health technicians according to the discipline construction, academic structure and professional structure requirements of hospitals at all levels. The hospital will be hired according to the relevant personnel management system and reported to the Human Resources and Social Security Bureau for relevant procedures. By 2019, the number of people will be basically changed, the quality is not high, the professional structure is irrational, and the age is aging. The establishment and personnel departments are responsible for the supervision of the employment program.
Reform the compensation mechanism of public hospitals
1. Gradually convert public hospital compensation into three channels: service charge, drug add-on income and government subsidy, and change to service charge and government subsidy. Service charges and government subsidies are reasonably determined according to the relevant provisions of the five ministries and commissions such as the Ministry of Health and the Ministry of Finance, taking into account factors such as hospital function positioning, medical insurance fund affordability, local financial supply capacity, income level of urban and rural residents, and affordability for price adjustment. . Give full play to the role of traditional Chinese medicine in disease diagnosis and treatment, preventive health care, and rehabilitation of chronic diseases, and tilt it in terms of medical service charges.
2. In accordance with the provisions of the Implementation Plan for the Establishment of the National Essential Medicine System in Zunyi City, since March 20XX, the National Basic Drug Service System has been implemented in all township hospitals and national community health service centers in the city, and the drug zero plus is implemented. Become a policy. Public hospitals at all levels should also gradually implement the national essential medicine system. The use rate of basic medicines in secondary hospitals is not less than 40%, and that in tertiary hospitals is no less than 30%, and the drug addition policy is gradually phased out. For the reasonable income reduced by public hospitals, measures such as adding pharmacy service fees and adjusting some technical service charges will be adopted to compensate the medical insurance fund and increase government investment.
3. Explore the reform of medical insurance payment methods. City, County Social Security Bureau, New Rural Cooperative Office to improve basic medical insurance costs
Payment methods, actively explore payment methods such as pay-per-use, per capita payment, total payment, etc., timely and fully pay the fees in accordance with medical insurance policies and agreements; implement project management and payment systems for medical assistance and charity; Supplementary insurance, commercial health insurance and road traffic insurance payment methods effectively reduce the burden of medical expenses for the people. Under the premise of strengthening government guidance, reasonably determining the price of medical service guidance, and reasonably controlling the total cost of hospital medicine and the average cost, it is necessary to negotiate the hospital, medical insurance agency to determine the scope of service, payment method, payment standard and service quality requirements.
4. Increase government input. The municipal and county people's governments are responsible for the basic construction of public hospitals, the purchase of large-scale equipment, the development of key disciplines, the retirees' expenses and policy-related subsidies in line with state regulations, and special subsidies for public health tasks undertaken by public hospitals to guarantee the government's designation. Compensation for public services such as emergency treatment, disaster relief, foreign aid, supporting agriculture, supporting the branch and supporting the community will be tilted in the investment policies of Chinese medicine hospitals, infectious disease hospitals, psychiatric hospitals, and maternal and child health centers.
5. Seriously learn from the successful experience inside and outside the province, actively explore the effective form of drug procurement management in public hospitals such as centralized drug distribution in counties, steadily promote the separation of medicines, reform the mechanism of medicine supplementation, and curb the high price of pharmaceuticals and procurement. The unhealthy trend of the link.
Strengthen the management of public hospitals
1. Strengthen the quality management of medical services in public hospitals. Improve and implement hospital management rules and regulations and personnel post responsibility system, improve medical quality management organization, implement disease diagnosis and treatment norms and drug clinical application guidelines, standardize clinical examination, diagnosis, treatment, use of drugs and implanted medical devices, and continuously improve medical care Quality to ensure patient safety.
2. Strengthen the construction of key disciplines and improve the capacity and level of medical services. We will continue to implement the strategy of strengthening the talents and strengthen our efforts. In 2019, the city will have 10 and 30 health professionals with certain influences on the national and provincial health systems, and about 300 young and middle-aged academic and technical backbones of the city's health system. Established 10 medical leading disciplines with certain advantages in Guizhou Province, built 1 or 2 national key disciplines or key cultivation disciplines, and cultivated a group of high-level health professional and technical personnel.
3. Establish an incentive mechanism for health personnel. Established “Zunyi City's outstanding young and middle-aged experts”, “Zunyi City Famous Chinese Medicine” and “Zunyi City's outstanding rural health workers” awards, commending outstanding young and middle-aged experts, famous Chinese medicine practitioners and long-term rooted rural areas , grassroots health personnel who serve the grassroots and contribute to society.
4. Improve hospital services. We will make efforts to shorten patient waiting time and hospital bed day by providing appointment medical services, smoothing emergency green channels, optimizing service procedures, and classifying medical treatment according to the condition. Establish a patient complaint management mechanism, timely and effectively handle patient complaints and medical disputes, and build a harmonious relationship between doctors and patients.
5. Improve the level of hospital information. Promote the informationization of public hospitals with the focus on hospital management and electronic medical records, and improve management and service levels.在加強規範和保障質量的基礎上逐步實行同級醫療機構檢查結果互認，在遵義醫院建立全市數位化遠程會診中心，降低醫療服務成本。嚴格執行衛生部疾病診療規程，推動分病種臨床路徑規範化治療。研究制訂遵義市醫療機構信息化管理的規定和標準，充分利用現
有資源逐步建立醫院之間、上級醫院和基層醫療衛生服務機構之間、醫院和公共衛生機構、醫保經辦機構之間的互聯互通機制，構建便捷、高效的醫院信息平台。
改革公立醫院監管機制
1.實行醫療衛生全行業監管。加強衛生行政部門醫療服務監管職能，建立健全醫療服務監管機制。全市所有醫療衛生機構不論所有制、投資主體、隸屬關係和經營性質，均由衛生行政部門實行統一規劃、統一準入、統一監管。建立完善機構、人員、技術、設備的準入和退出機制，依法實行全行業監管。
2.加強公立醫院醫療服務安全質量監管。依託遵義醫學院附屬醫院、遵義醫院所具有的較高診療技術水平和質量管理水平，制定並建立完善市、縣兩級醫療質量安全控制評價體系和各級各專業醫療質量控制評價組織，加強醫療質量安全評價控制工作，持續改進醫療服務質量。完善各級各類醫院管理評價制度，繼續做好醫院管理評審評價工作。
3.加強公立醫院運行監管。市、縣衛生行政部門要加強對公立醫院功能定位和發展規劃的監管，嚴格控制公立醫院建設規模、標準和貸款行為，加強大型醫用設備配置管理。控制公立醫院特需服務規模，公立醫院提供特需服務的比例不超過全部醫療服務的10%。
4.健全財務分析和報告制度。衛生、財政、審計部門要加強公立醫院財務監管，建立健全公立醫院財務審計和醫院院長經濟責任審計制度，定期或不定期開展公立醫院財務審計。
5.建立社會多方參與的監管制度。全面推進醫院信息公開制度，接受社會監督。強化醫療保障經辦機構對醫療服務的監督制約作用，依照協定對醫療機構提供的服務進行監督，並納入公立醫院考核和評價內容。充分發揮會計師事務所的審計監督作用，加強醫療行業協會在公立醫院自律管理監督中的作用。
6.建立醫患糾紛第三方調解機制，積極發展醫療意外傷害保險和醫療責任保險，完善醫療糾紛調處機制，嚴厲打擊“醫鬧”行為。
建立住院醫師規範化培訓制度
逐步探索建立符合醫學人才成長規律、適應遵義市市情的住院醫師規範化培訓制度，把住院醫師培訓作為全科醫生、專科醫生培養的必經環節。以遵義醫學院附屬醫院、遵義醫院為基地，培養全市各專業合格的住院醫師。
加快推進多元化辦醫格局
積極鼓勵和引導社會資本發展醫療衛生事業，加快形成投資主體多元化、投資方式多樣化的辦醫體制。完善政策措施，鼓勵引導社會力量、社會資本舉辦非營利性醫院。在區域衛生規劃和醫療機構
設定規劃中，要給非公立醫院留出足夠空間。非公立醫院在醫保定點、科研立項、職稱評定、繼續教育等方面，與公立醫院享有同等待遇，在服務準入、監督管理等方面一視同仁。非公立醫院承擔公共衛生服務由市、縣政府採取購買服務的方式解決。落實營利性醫院稅收優惠政策。加強對非公立醫院的監管，引導非公立醫院依法經營、加強管理、嚴格自律、健康發展。
五、試點的組織領導
試點的領導機制
1.成立試點工作領導機構
公立醫院改革試點工作由市人民政府統一領導並組織實施。市人民政府成立公立醫院改革領導小組，由分管副市長任組長，成員單位有市衛生局、市編委辦、市發展改革委、市財政局和市人力資源社會保障局，領導小組辦公室設在市衛生局。市公立醫院改革領導小組要加強對試點工作的領導，及時研究解決試點工作中存在的困難和問題，加強信息交流和培訓指導，適時開展試點評估工作，完善公立醫院改革總體思路和主要政策措施，不斷總結公立醫院改革試點工作經驗，及時向上級有關部門匯報試點工作進展情況。
2.明確領導小組各部門職責
市衛生局：牽頭制定遵義市公立醫院改革試點實施方案、遵義市區域衛生規劃、醫療機構設定規劃、遵義市非公有制醫療機構設定指導意見、公立醫院管辦分開、醫藥分開、醫院法人治理、分配激勵機制、住院醫師規範化培訓、醫院信息化建設、醫院監督管理、醫院人事制度改革、財務會計制度改革、醫療衛生全行業管理實施細則；負責醫療服務體系建設、衛生人才隊伍建設、學科建設、等級醫院創建工作；組織公立醫院改革試點工作調研、檢查、督導、評估、培訓和技術指導；公立醫院改革試點工作相關信息的蒐集、匯總、傳遞；把握正確輿論導向，向新聞媒體通報、交流公立醫院改革試點工作進展；承擔公立醫院改革領導小組辦公室工作。
市編委辦：牽頭負責市、縣衛生行政部門適應公立醫院改革試點工作需要的管理機構設定、工作職能、事權劃分、人員配置；會同衛生、發展改革、財政、人力資源社會保障等部門做好公立醫院管辦分開、醫藥分開、法人治理、人事制度改革、分配激勵機制改革、醫院監督管理等方面的政策指導；承擔公立醫院改革領導小組成員單位的相關工作。
市發展改革委：牽頭負責制定醫療衛生服務體系建設規劃，根據需要安排醫療衛生機構基礎設施建設投資；會同衛生、編委辦、財政、人力資源社會保障等部門做好公立醫院改革實踐中合理制定醫療服務標準、藥事服務收費標準、稅收優惠政策；承擔公立醫院改革領導小組成員單位的相關工作。
市財政局：牽頭負責制定醫療衛生投入方案，建立健全衛生補償機制；會同衛生、發展改革委等部門研究制定公立醫院、非公立醫院相關財稅政策；加強公立醫院分配激勵制度改革、財務會計制度改革的監督管理；承擔公立醫院改革領導小組成員單位的相關工作。
市人力資源社會保障局：牽頭負責制定公立醫院人事制度改革方案、建立以專業技術能力、工作業績和醫德醫風為主要評審依據的衛生專業技術人員職稱評定製度；制定並落實衛生人才隊伍建設的相關政策，合理配置全市衛生人力資源；逐步建立合理的基層醫療衛生專業技術人才隊伍職稱結構；建立完善醫療保障支付制度；承擔公立醫院改革領導小組成員單位的相關工作。
試點的指導、評估和監督
公立醫院改革試點工作領導小組成員單位要按照各自的職責，在市政府的統一領導下，分工合作，充分運用組織、管理、協調、指揮的職能，密切部門之間的配合，加強對試點工作的指導和評估，及時總結試點情況，完善有關政策措施，積極穩妥地推進試點工作開展。
創造良好試點環境
充分利用新聞媒體做好輿論宣傳工作，加強對公立醫院改革試點工作重要意義、指導思想、基本原則、主要任務和政策措施的宣傳，調動廣大醫務人員參與改革的積極性、主動性，爭取廣大人民民眾和社會各界的理解和支持。衛生部門與宣傳部門要緊密配合，加強對公立醫院改革試點的輿情監測與研判，積極引導社會輿論，堅定改革信心，合理引導社會預期。
篇三：公立醫院改革實施方案
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