社区开发“防漏免等极简管理系统”以实现社区卫生服务智能化输出的实践探索研究

Development of a'No Omissions and No Waiting Minimalist Management System'for Smart Delivery of Communitybased Health Services:a Practical Exploration

背景当前的社区卫生服务管理系统未能打通管理对象、服务内容、服务流程、服务资源配置各环节直达居民终端。目的深入分析社区卫生服务的特点后可以发现,其管理完全可实现智能化,本研究基于此假设,尝试改造两条代表性社区业务线,以观察其智能化运行可行性、运行结果和是否值得推广。方法2016年12月-2019年6月,借助上海市静安区彭浦镇第二社区卫生服务中心新建契机,通过一线观察分析寻找原因,挖掘成因找对策,最终提出“防漏免等极简管理系统”解决方案并将其信息化。进一步将“防漏免等极简管理系统”信息化工具应用在社区妇幼保健和中医骨伤门诊两个基本服务模块。结果运行结果显示,“防漏免等极简管理系统”在遗漏防控、服务总量、候诊时间、资源空置等4项指标上提升了社区卫生服务管理能效。结论以把握社区卫生服务独特特征为前提、提炼出防漏免等管理和设计思想的“防漏免等极简管理系统”,可用于指导社区卫生服务各个工作条线的改善,以此全面提升社区卫生服务的居民体验度和打造自身的核心竞争力。

Background The current community health service management system fails to stipulate the management object,service contents,service process,and service resource allocation to all residents directly.Objective To attempt to improve two representative service lines of the community health center(CHC)to observe the feasibility,results and promotion value of their smart operation based on the assertion of the management of community-based health services can be smart concluded from intensively analyzing the delivery features of such services.Methods By analyzing the causes of the omission of healthcare tasks and inappropriate queue management observed in a first-hand opportunity in the newly established Jingan District Pengpu Town Second Community Health Center,we put forward countermeasures,and developed a minimalist task reminder and queue management system named as"no omissions and no waiting minimalist management system",and informationized it during December 2016 and June 2019.Then the informationized system was used in two essential service modules of community-based maternal and child health care clinic and TCM bone injury clinic to test it effectiveness.Results The operation results showed that the system led to improved efficiency of community health service management in four indicators:omission prevention and control,total service load,waiting time for consultation,and idling time reduction of resources.Conclusion Our system,aiming at addressing the problems of omission of healthcare tasks and inappropriate queue management in the CHC,may be useful in improving the service lines of community healthcare,by which residents'experience of receiving community health services,and the core competitiveness of the CHCs may be enhanced comprehensively.