A report of Shaoyang Municipal Central Hospital optimizing medical service and setting up a new professional style

 
"People come to a city for the sake of life, and live in the city for a better life" -- -- ancient Greece Aristotle
Since the reform and opening, most of us choose to enter the city, and stay in the city in order to live a better life. In this process, as part of the supporting software and hardware construction failed to follow up, for example, not enough doctors, limited health resources, poor medical services and hospitals, the level of living comfort is not high.
Hospitals in a city, in a sense, are a byword for urban civilization. A hospital’s ethics, techniques, styles, comprehensive ranking position in the medical field and comments from people can reflect , to some extent, happiness values and a sense of security of the life of people living in this land. What does Shangyang Municipal Central Hospital, a 3-A comprehensive hospital, want to do for the city and its citizens? To answer the question, Shangyang Municipal Central Hospital has made beneficial explorations and efforts to catch up and achieve a great-leap-forward development.
In this city, there are more and more various hospitals. so people have more and more opportunities to enjoy high quality medical resources, and also they have more and more options. This is a good thing. But most of the time, there are problems, such as "difficulty in receiving medical care", “expensive visit to a doctor ", no trust between doctors and patients, and bad professional atmosphere. They appear in front of the hospital, hindering its development, and what’s more, doing harm to the vital health rights and interests of citizens. Therefore, in the new situation of health care reform, how to enhance medical ethics, to be devoted to patients in a noble way and to provide clear just medical atmosphere are an important task for a hospital. Shangyang Municipal Central Hospital has made achievements.
Symptoms: medical ethics are not upright and just, medical services are still imperfect
"Doctors and nurses’ service attitude needs improvement", "individual doctors accept gifts from the patient's family", "hospital facility is poor without enough toilets”, “some doctors smoke in wards", "bill can't read easily with too many unclear items" and "acquaintances jump the queue"... These problems are clearly listed in the annual report of the survey about people’s satisfaction carried out by the Central Hospital. In 2012, Central Hospital men, daring to reveal scars and face problems, put the problems on the “operation table”.
The clinic building now being used was built in 1986. Because of the then limited construction technology and the hospital’s poor economic capacity, the structure and utilization of the building are defective. With the urban development of nearly three decades, these defects conflict the development of hospital and people’s demands. Outpatients were increasing; registration, fee payment and tests were done in different places; procedures were complex and thus required a lot of time; diagnosing rooms were relatively not enough; patients lined up long; doctors were so overloaded with work that they had to decrease the time for the diagnosis of each patient, as a result they could not examine and communicate with patients fully and carefully, which effected badly medical treatment; there were no lifts so patients, even those old, pregnant and disabled, had to climb up stares; and there were hidden security dangers due to the crowded stares. They saw all the problems and realized that they should seriously prevent the problems going on, provide convenient service to the people and construct a green passage for life.
Prescription: build up an educational system and improve medical service
Education is not only an effective method to optimizing serving style, but also the fundamental of anti-corruption and building up an honest and clean unit. On July 26, 2013, the Municipal Central Hospital specially invited Doctor Zeng Yuping from Xingxing Village, Liuduzai Town, Longhui County, winner of the Nomination Award of The 3rd National Honesty Moral Models, and Head Nurse Zeng Yunhua form Shaoyang Psychosis (brain) Hospital, winner of The 1st Moral Models Of Shaoyang City, to give speeches in order to educate all the staff in morality and service style.
The hospital signed “the 3-level promise-duty deed” with each worker. The deed puts forward clear demands and requirements in professional ethics, service quality, service attitude and other issues.  For two months, 852 frontline employees participated in the "service from heart" training, which improved the employees' service consciousness and service quality. These measures effectively  helped raise the staff’s consciousness of treating diseases, saving lives and serving the people wholeheartedly.The hospital also strengthened the medical and nursing management continuously, enhanced the level of medical technology, and put an end to all kinds of medical accidents and major errors. The Municipal Central Hospital insisted on building up the Party unit, improving medical service and stopping unjust actions in pharmaceutical sales and medical services. This kind of education provided a powerful guarantee for eliminating patients’ questions, bettering hospital-patient relationship, maintaining hospital’s public image, and harmonizing society.
In order to let Shaoyang citizens enjoy easy and comfortable medical service and better health, in  April, 2012, the hospital decided to transform and enlarge the clinic building. In addition, the hospital began perfecting service procedures, refining subject classification and strengthening internal management. Since then, outpatient service has grown to116000 person-time per year, encreasing by19.8%; average patient’s waiting time has reduced by 30%; outpatients’ satisfaction has risen by 8%, up to 78%... A year has passed, the Municipal Central Hospital has presented a persuasive answer to itself and the people.
In April 2012, the hospital began to beautify and transform the clinic building. On the west side of the clinic building, a five-story building has been built with diagnosing rooms of 1700 square meters. The functional area has been perfected, including the charge hall, the clinical laboratory,  the injection rooms, the gynecology offices, the obstetrics rooms, the dermatology rooms, the electrocardiogram rooms and the pediatric restoration center. And the outpatient service building has been decorated on a large scale. At the same time, patients’ waiting time is saved by means of adding service windows, opening registration ahead of time, implementing "all-in-one-card" outpatient self-service system, and setting up the appointment platform of medical services. With the completion of the construction of the west-winged clinic building,outpatients are decentralized, which improves the efficiency of outpatient service.
According to the demands of “thee-good and one-satisfaction” ( good service, good quality, good medical ethics, public satisfaction) issued by the Ministry Of Health, the time a patient spends in registering, paying fee and getting medicine is no more than ten minutes. In answer of the demands, the Municipal Central Hospital jointed the Telecom Company in setting up a 114-expert-platform of appointment registration service. Since the platform was launched, it functions very well. It works in the following way. The registration source, the experts’ scheduling arrangements and the information about their specialities are transmitted to 114-expert-platform. A resident can call 114 to make an appointment registration (7 days in advance, excluding the call day). He can select an expert he wants. After the successful registration, the system automatically sends back relevant information in the form of text message to his cellphone. Then he can visit the expert as he is informed.Not only is the platform beneficial to patients in medical consultation, making visiting plan and reducing waiting time, but also it is helpful to improving hospital’s management, the work efficiency and the quality of health care, and therefore helpful to reducing medical security risk.
Service refinement makes the whole medical procedures become sweeter, quieter, warmer, more relaxing and more comfortable; What the Central Hospital people want to bear are the "kind heart" of noble medical ethics, the “good technique” of bringing health and life to patients, the "universal love” of general feelings and the “universal giving" of practicing profession.
Symptoms: treatment costs can not read clearly nor be reached.
"Work hard for decades but a disease brings one back to before liberation." Although the saying is partial, it speaks out the bitterness and helplessness of patients and their families after the medical treatment fee is paid.
How to eliminate patients’ misunderstanding and discontentment, to reduce the overall medical costs, to ensure medical quality, to improve service and to let patients’ easily restore the health of body and mind? These are problems the staff of the Central Hospital strive to solve. They dare not slack off. With dedication, responsibility, wisdom, innovation, and determination, they want to explore a new way of improving medical service quality and decreasing medical expenses.
Prescription: make each link transparent and save costs for patients
“Drawing water with a sieve” leads to a bad feeling. If you and your family go to the hospital and find that you fail to see a doctor for the reason that it is not a work day, then you certainly feel anxious. What can be done to reduce inconvenience for patients?
To solve the problem, in April 2011, the Central Hospital began to implement the "no holiday hospital".The hospital opened outpatient service, emergency treatment of all the departments every day normally throughout the year in order to relieve patients’ traveling tiredness and solve the problem of "difficult to see a doctor". Especially this summer, the working day started an hour earlier than in other seasons because patients arrived at the hospital earlier with summer season coming. "Whenever you go to the hospital there are doctors. You will not waste your time and spend money lodging in a hotel." said a patient from Xinning County.
A patient’s expenses begin when he takes the first step from home to the hospital.Taking traffic tools, making registration, receiving a diagnosis, getting medicine, hospitalized or home treatment. Each link is closely connected with the word "money". What can be done to reduce a patient’s economic burden?
The costs of examination and medicine attract attention mostly. “ Is it worthwhile to spend so much money?" Does the doctor deliberately charge a high price of medicine?" These questions are often raised by patients and their families. And these often become factors that cause misunderstanding and friction between doctors and patients. In order to fulfill the promise of " trustable hospital" and "transparent hospital”, the hospital, on the one hand, actively have  information known to the public, and on the other hand, consciously strengthen self-discipline, with practical action to try to reduce the economic burden of patients. The hospital strictly obeys the charge standard of Hunan provincial medical service. Prices of all items are displayed openly on the electronic screen and the bulletin board in the outpatient service hall. A list of daily costs is timely provided to the patient. Doctors and nurses are demanded to put an end to irrational drug uses, unnecessary tests and private charges. The work against commercial corruption work is constantly done. Financial items are put under public supervision. All these measures the hospital has taken aim to ensure that patients have a fair, just, open, cheap and proper medical service.
The standard of a genuinely good hospital is neither the profits it earns nor the number of patients it treats, but the money and time it saves for patients. Through the constructive regulation, the Central Hospital is performing its promise of “three falls” (drug preportion falls by 3%, average hospitalization by 1.1 days, and average per-time expense by 5%). 
The hospital carries on a dynamic monitoring. It sets a standard volume of drug sales for each month, that is, the amount of antibacterial drug sales is no more than 450000 yuan per month, specialized medicine sales no more than 300000 yuan per month. If a department breaks through, the hospital authorities will have a warming talk with the director. Meanwhile, a punishment is carried out on the department. Operation process optimization and rational allocation of surgery days and surgical rooms effectively improve the efficiency of operation. The operations in the whole year has risen by more than 1100 sets. The average number of operations on the same table  in a day has risen from 40 to 70-80. These measures greatly save the limited health resources  and alleviate the actual contradiction between citizens’ increasing demands and limited medical resources.  
Dedicated efforts lead to remarkable achievements. Among more than 800 city-level hospitals across the country, the Shaoyang Municipal Central Hospital is widely recognized as a best in the field of medical technology service. In 2012 and 2013, it consecutively entered the list of the national 100 most competitive municipal hospitals. And patients’ hospitalization expense per capita is lower than that in most hospitals in Hunan province. It ranks "fourth from bottom” among the provincial first-class hospitals in the third quarter of this year. This “fourth from bottom” is not a .shame but a glory for a province-level 3-A hospital.  (translated by Yi Daoqun)