新疆某三甲综合医院多学科诊疗服务模式运行现况及改进策略

Research on the operation status and improvement strategy of multidisciplinary diagnosis and treatment service mode in a top three general hospital in Xinjiang

目的分析多学科诊疗服务模式运行现况,查找运行缺陷,为新疆医疗系统进一步持续改善多学科诊疗服务提供参考和建议。方法研究采用定量研究方法,分别对2018年、2019年来本院就诊的患者及本院医师进行现场调查,率和百分比的描述采用卡方检验。结果2019年会诊量为1370人次,同期增长12.48%,MDT会诊量主要以肿瘤MDT为主。患者知晓率为15.43%,2018年医师知晓率为93.83%,熟悉MDT制度及流程仅有18.49%,医师认知情况不佳,70%以上医师认为运行过程存缺陷的环节是MDT“3固定”的模式要求比较难执行(86.50%)和门诊MDT工作制度及流程不够清晰完善(76.64%)。结论多学科诊疗服务工作需要持续完善和优化。加强院外宣传及院内培训力度,重点建设非肿瘤MDT团队及门诊MDT团队,建立激励机制及监督考核制度,进一步完善MDT诊疗服务制度及流程。

Objective To analyze the current situation of multi-disciplinary diagnosis and treatment service mode,and find out the operational defects,so as to provide reference and suggestions for Xinjiang medical system to further improve the multi-disciplinary diagnosis and treatment service.Methods The quantitative research methods were used to conduct field investigation on patients and doctors in our hospital in 2018 and 2019,respectively.Chi square test was used to describe the rate and percentage.Results In 2019,the number of consultations was 1370,an increase of 12.48%over the same period.MDT consultation was mainly tumor MDT.The awareness rate of patients was 15.43%,in 2018,the awareness rate of doctors was 93.83%,and only 18.49%of doctors were familiar with MDT system and process.Doctors’cognition was poor.More than 70%of doctors thought that the defect in the operation process was that the“3 fixation”mode of MDT was difficult to implement(86.50%),and the outpatient MDT system and process were not clear and perfect(76.64%).Conclusion Multidisciplinary diagnosis and treatment services need to be further improved and optimized.Strengthen the publicity and training outside the hospital,focus on building non-tumor MDT team and outpatient MDT team,establish incentive mechanism and supervision and assessment system,and further improve MDT diagnosis and treatment service system and process.