The “folk exploration†of hospital evaluation is quietly carried out. The overseas accreditation body represented by the International Department of the United States Medical Accreditation Joint Commission (JCI) has been highly sought after in China in recent years. In addition, the development of third-party hospital evaluation and evaluation institutions based on foreign experience has become a mainstream understanding, and the related exploration has gradually started. In the "Health China 2030" Planning Outline and the "Deepening the Medical and Health System Reform 2016 Key Tasks", clear requirements were also made for the development of third-party medical service evaluation and the introduction of third-party performance evaluation of public hospitals.
Cold review of the hot review
Since the entry into the country in 2000 ISO9000 series certification, overseas evaluation and certification institutions have begun "evaluation output" for China. Over the years, the judging bodies of the United States, Britain, Germany, Norway, Australia and other countries have practiced in China and are intensifying. Yin Ju, director of JCI Asia Pacific, said that 80 hospitals in China have passed the evaluation of the organization, and the number in 2010 is 10.
The Xiangya Hospital of Central South University launched the JCI certification of the International Medical Department in March 2015, and it took 22 months to prepare for the JCI Gold Medal. Zhang Jie, director of the Xiangya Hospital Evaluation Office, told reporters that in addition to participating in the assessment of state organizations in the past few years, the hospital has applied for more than 10 kinds of “private certifications†at home and abroad.
Taking JCI certification as an example, only the certification fee is more than 200,000 US dollars. This is not the various equipments and equipments that the hospital has made to modify and add to the "foreign standards." Some hospitals choose the "foreign standard" to achieve too difficult, after getting the certificate, they will not be able to get it; some hospitals choose multiple sets of evaluation systems, different standards are different, repeat the evaluation to increase the workload, let the medical staff complain .
The hospital is so tossing, is it loyal to the fame and "earning gimmicks"? "On the one hand, the hospital is eager to connect with the international community; on the other hand, JCI does have something to learn from, and should be localized in combination with China's environment." Said that the national authorities review, such as grade hospital review, focusing on hospital system management and overall development. JCI certification is patient-centered, with patients seeking medical treatment as the main line, and constantly pursuing improvements in lean and detail. The combination of the two is a good way to improve hospital quality, service and management. “JCI certification must be reviewed every three years to ensure continuous improvement of quality. If it is only a vain name, and the work is not done, the review will be more difficult.â€
A health administrative department staff who has been in charge of hospital evaluation and evaluation for many years said that it is a progressive performance of the hospital to actively seek self-improvement through evaluation methods, but many institutions with different standards are introduced to evaluate hospitals, especially many foreign institutions. Foreign standards to evaluate domestic hospitals in depth, the rationality is debatable. “All evaluation systems have their own values, especially for the evaluation of public utilities like medical care, involving huge personal information related to the basic right to life. I believe that no country can and should not be completely open.â€
China's third-party evaluation has just started
Third-party evaluation is conducive to improving the social credibility of the evaluation results. In the international arena, especially in western developed countries, independent third-party evaluation has long been the main form of hospital performance appraisal, and has achieved good results and rich experience. China began its relevant exploration attempts in 2008, but it has not yet formed a system, and it lacks systematic theoretical research. (turn down to the second edition) (on the first edition)
In August 2008, Hainan Hospital Evaluation and Medical Quality Supervision Center, the first third-party hospital evaluation agency in China, was established. The center is a subsidiary of the Hainan Provincial Hospital Association. There is no administrative level and no establishment. The evaluation center and the administrative department of health are entrusted. Regrettably, Hainan Hospital Evaluation Center did not continue to play its original role in the new round of hospital evaluation in 2011. "One of the important factors that cannot be avoided is that the model has weakened the power of the government to a certain extent." Liu Tingfang, director of the Center for Evaluation and Evaluation of Chinese and Foreign Hospitals of the Institute of Medical Management, Tsinghua University.
After Hainan, third-party hospital evaluation agencies appeared in Shanghai, Yunnan, Zhejiang, and Jilin. Among them, the evaluation agency of the third-party hospital in Yunnan has an independent legal entity: the institution has begun to pay more attention to the homogeneity of the evaluation personnel in the evaluation criteria, and has a clear charging standard. Du Kelin, deputy director of the Yunnan Provincial Association of Political Science and Education, and president of the Yunnan Provincial Hospital Association, said that the model of Yunnan is commissioned by the project hospital to be evaluated by a third-party agency, and a third-party evaluation report is submitted to the Health and Family Planning Commission at the time of acceptance. Application and self-assessment report.
"Now, the concept of third-party hospital evaluation has been recognized by more and more people. The independent third-party evaluation of hospitals in China has entered the initial stage, but there are still many points that need to be solved and improved." Liu Tingfang said, for example, some third-party institutions The qualifications of the judges are undetermined, the level of the judges is uneven, and there is no uniform standard for fees. A national-level regulatory platform should be established, institutional and personnel access standards should be established, and charging standards should be unified.
The evaluation subject is not the same or the other
Some experts pointed out that the evaluation bodies of independent and non-profit medical institutions in many western countries such as the United States have gradually gained social recognition after decades of development. Since the development of such institutions takes a long time and is influenced by the social culture of the host country, many countries often adopt a government-led approach when establishing a medical institution accreditation system. "How to properly arrange the connection, linkage and integration of external audit and internal evaluation, the government and the industry should work together to introduce a more complete national standard for third-party evaluation system." A health administrative department responsible for hospital evaluation and evaluation for many years. The staff said.
Liu Tingfang pointed out that China should build a “1+3 model†for third-party evaluation of medical and health institutions, including “one†new national hospital accreditation body and personnel certification and access platform, and then “three stages†for functional transformation. In a gradual manner, we will eventually cultivate and build a third-party medical institution evaluation system with Chinese characteristics. In the first stage, the National Health and Family Planning Department shall entrust a qualified academic association to conduct a third-party evaluation. Due to the rapid development of non-public medical and health institutions, management and evaluation are in the initial stage, and there are many problems. The competent department of health and family planning can entrust relevant institutions to evaluate them as a pilot area. In the second stage, in principle, it is still led by the government's health and family planning department, vigorously expanding the commission, cultivating third-party evaluation organizations, and accumulating experience. When the third-party hospital evaluation network covering the whole country is formed, it enters the third stage, that is, it is judged by the government-led hospital and becomes a third-party institution approved by the state for evaluation. The relevant national competent authorities shall supervise and administer the third-party evaluation organization certification and supervision committee and its executing agencies from the legal, regulatory and policy levels.
"There are not many third-party organizations with strong authority at this stage. It is unrealistic to conduct third-party evaluations on a large scale. Hospital evaluation must be led by the government." Liu Dengxiang, deputy secretary of the Party Committee of Xingtai People's Hospital of Hebei Province suggested.
“The exploration of Zhejiang in these years proves that the industry recognition of third-party evaluation is still high. The scientific, impartial, professional and authoritative nature of hospital evaluation also needs government promotion, while cultivating diversified hospital evaluation evaluation subjects, different subjects. Play different roles and complement each other. After all, hospital evaluation is not a concept of one or the other." Yu Lexin, director of the Medical and Medical Management Department of Zhejiang Provincial Health and Family Planning Commission said.
Source: Health News
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