Recently, the Shandong Provincial Health and Family Planning Commission issued the "Guidelines for the Construction and Management of Family Doctor Studios and Family Doctor Service Points and Health Posts (2018 Version)" to guide family doctors to sign contract services, proposing that primary-level medical and health institutions can use existing general practice The outpatient clinic is upgraded to a family doctor's studio, or set up in conjunction with the medical consortium expert outpatient clinic and joint outpatient clinic.
General practice clinic upgraded to family doctor studio
"Standard" proposes that primary-level medical and health institutions can upgrade the existing general outpatient clinic to a family doctor's studio, or set it up in conjunction with medical consortium expert outpatient clinic and joint outpatient clinic. A family doctor's office can also be added to the TCM clinic in the TCM comprehensive service area as a fixed place for TCM general practitioners to provide family doctor contract services. The house area of the family doctor's studio is not less than 10 square meters. The TCM family doctor's studio should be equipped with the equipment needed to provide TCM services.
Health post is a comprehensive place to provide multiple services
For the construction of health post, the "Standard" clearly states that the health post is a comprehensive place set up by grassroots medical and health institutions to provide residents with self-service testing, personalized health education, and family doctor signing services. It should be equipped with height, weight, blood pressure, blood sugar, waist circumference , Hip circumference, Chinese medicine constitution recognition equipment, or all-in-one medical equipment that meets the standards and functions of the above test items.
The following is the full text of "Guidelines for the construction and management of family doctor studios and family doctor service points and health stations (2018 version)"
Guidelines for the construction and management of family doctor studios and family doctor service points and health stations (2018 version)
1. Family Doctor Studio
The family doctor studio is the main place where the family doctor service team of the primary-level medical and health institution provides services. The family doctor service team uses the family doctor's studio to provide contracted residents with personalized privacy protection of basic medical care, public health and health management services, such as general diagnosis, common disease, chronic disease, general diagnosis and treatment, appointment, referral, and joint consultation or remote consultation , Health assessment, management plan formulation, follow-up and other performance services.
1. Primary medical and health institutions can upgrade the existing general outpatient clinic to a family doctor's studio, or set it up in combination with the medical consortium expert outpatient clinic and joint outpatient clinic. If the setting is more centralized, you can set up a family doctor contract service area. A family doctor's office can also be added to the TCM clinic in the TCM comprehensive service area as a fixed place for TCM general practitioners to provide family doctor contract services.
2. The area of the house is not less than 10 square meters. Place diagnostic tables (at least for the family of 2-3 people in the family doctor team to work at the same time), medical chairs, diagnostic beds, screens or curtains, water and other facilities (in accordance with the requirements of hospital control). Conditional grassroots medical and health institutions may be equipped with all-in-one integrated diagnosis and treatment equipment. The TCM family doctor studio should also be equipped with the equipment needed to provide TCM services.
3. Equipped with telephones, computers, printers, fixed telephones and residents' information collection equipment, and an information system that communicates with the organization.
4. Institutions where the house area is small and cannot be renovated, nurses or public health personnel within the family doctor team can also set up a workbench outside the clinic to ensure that contracted residents are provided with comprehensive and continuous services, so that contracted residents run less.
(3) Management requirements
1. Naming and identification. It is uniformly named "XX Team Family Doctor Studio", and a unified signboard is hung outdoors (see the attachment for the reference sign style). If it is combined with the medical conjoined experts, the identification plate of the medical conjoined expert consultation room should be added. The interior is personalized according to service characteristics and expertise while maintaining the same style as the health post.
2. Team visits. Provide services in the form of team visits, through effective connection between team members and outpatient service processes, allow residents to complete all basic medical, public health and health management services they need to receive in the course of a diagnosis and treatment, highlighting the integrity of the team The characteristics of comprehensiveness and continuity of contracted services.
3. Directional triage. Patients in the family doctor's studio are mainly contracted residents, and areas with conditions can use informational means to gradually make residents take the initiative to use contracted service resources by making appointments, registering for automatic directional triage, etc. It is necessary to fully guarantee the time for contracted residents to visit the clinic (about 15 minutes), fully reflect the concept of comprehensive and full-cycle health services in the process of diagnosis and treatment, and enhance the sense of access to contracted services for contracted residents.
4. Public listing. The family doctor's studio should list the basic information of the family doctor team members (name, title, contact information), fixed sitting time, location and time of patrol and service supervision telephone, etc.
2. Family Doctor Service Point
The family doctor service point is a place where the family doctor service team provides patrolling services for contracted residents in communities, villages, etc. The outpatient service mainly provides contracted residents with health consultation, health management follow-up, chronic disease patients' discharge or referral visits, and reasonable medication guidance. The contracted services mainly include health consultation, health education, medication guidance and follow-up. Diagnosis and treatment services that require contracted services and require additional payment from residents.
(2) Infrastructure and equipment
1. Diagnosis table and chair;
2. Stethoscope, thermometer, sphygmomanometer, blood glucose meter and other portable outpatient equipment.
3. Portable resident information collection and patrol information recording equipment terminal.
(3) Management requirements
1. The unified name is "XX team + community and village name family doctor service point", and a unified nameplate is hung outdoors (see the attachment for the reference style of the nameplate). It can be established in village clinics, community health service stations, community pension institutions, neighborhood committees, community comprehensive public service places, community day care centers, etc. Encourage the independent establishment of houses, if the conditions are not met, they can be mixed.
2. The family doctor service team should formulate a patrol plan and disclose the patrol time and arrangements to the residents to facilitate residents to take the initiative to receive services at the community family doctor service point.
3. At the township, village (or center, station) level, the grassroots medical and health institutions, township health centers and community health service centers that form a family doctor contract service team should sign contracts with village clinics and community health service stations Evaluation and quality management of residents' basic medical care, public health and health management services, with a focus on providing targeted comprehensive services to contracted residents whose conditions change, control is unstable, compliance is low, and diseases are complicated
4. Areas with conditions can establish a patrol appointment mechanism to make the best use of limited patrol time and team service resources. Family diagnosis and treatment services such as family patrols and family beds can be carried out simultaneously in conjunction with community patrols.
5. Patrols are conducted in teams. Team members are required to wear uniforms and badges to establish safety awareness and pay attention to protect the privacy of residents.
6. The team should record the patrol information through electronic or paper methods, and ask the residents to confirm by signature and other methods.
3. Health Station
(1) Service function
The health post is a comprehensive place set up by grassroots medical and health institutions to provide residents with self-service testing, personalized health education, and family doctor signing services. The main service functions include collecting and summarizing resident health information, establishing or updating resident health records; providing health education prescriptions and group or individualized health education; carrying out basic public health service projects and family doctor contract service policy promotion, providing face-to-face contract and routine health management service.
1. Community health service institutions and township health centers choose independent houses or areas close to the waiting area or basic medical and public health service areas, and are not mixed with clinics and treatment rooms.
2. In principle, the area is not less than 30 square meters (if the business room is tight, it should be at least 20 square meters), warmly arranged, soft colors can be used instead of traditional white, equipped with comfortable chairs or sofas, drinking water equipment, etc. .
3. Equipped with medical equipment such as height, weight, blood pressure, blood sugar, waist circumference, hip circumference, Chinese medicine constitution recognition equipment or all-in-one machine that meets the above test items; qualified institutions can increase lung function, electrocardiogram, bone density , Medical equipment for cardiovascular function testing and health management equipment such as body composition analysis. Encourage qualified areas to combine with the construction of national physical fitness monitoring points carried out by the sports department to promote physical and medical collaboration.
4. There are tools such as oil control, salt limit, BMI table, and residents' balanced diet pagoda, etc., with instructions for use, illustrations and precautions for use, and a reference range of normal values for various test results. Provide various kinds of health education materials, public doctor contract services, basic public health service policies and other promotional materials through magazines, color pages, multimedia and other forms.
5. Equipped with an information system that supports identification, self-service detection, data upload, result printing and query interaction.
(3) Management and work requirements
1. Uniformly named "health station", hang a unified sign (see the attachment for the reference style of the sign), set up a display board to briefly introduce the health station service functions.
2. Equipped with trained staff, responsible for self-service health testing guidance, policy consultation, health education and other daily management.
3. Establish rules and regulations such as health post management system, work flow, operation specifications, emergency plans, and implement standardized and institutionalized management.
4. The health post mainly serves permanent residents in the jurisdiction. Residents will receive services with valid certificates such as ID cards or resident file information cards. Key populations such as contracted residents, patients with chronic diseases, and elderly people over 65 years of age are preferred.
5. As a main place for health education activities of primary-level medical and health institutions, health post stations formulate annual and monthly work plans for health education, regularly carry out health education activities, promote health concepts such as "My Health and My Management", and have a prominent position in the organization or Open on the electronic screen. During the working day, at a fixed time every day, take the initiative to guide the residents or family members to participate in the use of health management tools, self-health monitoring guidance, bone exercise, etc. which are short, time-consuming, strong in participation, easy to learn, and suitable for waiting or after the consultation. Health education and health promotion activities.
6. The health post station conducts self-service tests for residents, and provides or sends self-service test results, but does not diagnose and treat diseases. For residents with abnormal or positive signs, it is recommended to go to the corresponding family doctor's studio or clinic for further diagnosis and examination.
7. Residents under the guidance of a family doctor service team or a licensed (assistant) physician or nurse equipped with a health post can conduct health tests that can be used as family doctors to sign service performance and basic public health services to establish or update health Archives, the basis for health management follow-up of key populations, and test data can be directly entered into residents ’health archives through the information system interface. The data obtained by residents without self-test under the guidance of professional medical personnel cannot be used as the basis for performance or follow-up.
8. Establish a health post and its supporting information system, necessary information confidentiality and security measures to avoid detection data leakage