医联体视角下标准化体系建设在卫生适宜技术培训与推广中的应用

Applying a standardized system to the training and promotion of appropriate health technology from the perspective of regional medical alliances

目的探讨如何构建标准化卫生适宜技术培训与推广工作体系,依托区域医联体上下联动工作机制,有效推动卫生适宜技术培训与推广工作的开展与落实。方法采用德尔菲法构建适宜技术遴选方案,培训与再培训的培训模式、柯氏培训评估方法实现培训体系的闭环管理,通过KPI法建立效果评价与绩效考核管理体系,最终基于PDCA循环法建立一套科学、统一、客观、完整、持续有效的标准化卫生适宜技术应用、推广体系。结果构建了一套融合4种管理手段的标准化体系,并遴选和推广了12项卫生适宜技术。通过区域医联体的带动作用,学员培训后6个月的理论知识掌握率为98%,技术掌握率为92%,医联体成员单位学员的参与率、出勤率、理论知识掌握率、技术掌握率均高于非医联体成员单位学员。结论医联体视角下的全流程标准化体系建设能够有效促进卫生适宜技术的推广,有助于强化社区卫生服务中心的服务定位,有利于进一步推进分级诊疗。

Objective To explore how to establish a standardized framework for the training and promotion of appropriate health technology,and effectively promote the implementation of the work on the basis of the linkage mechanism in regional medical alliances.Methods Delphi method was employed to develop the selection plan for appropriate health technology and the mode of training and re-training.Kirkpatrick model was used to realize the closed-loop management of the training,and KPI method was applied for management system of effect evaluation and performance appraisal.Finally based on PDCA circulation method a set of application and promotion system for standardized appropriate health technology was established,which was scientific,unified,objective,complete,sustainable and effective.Results A standardized system was developed for the integration of four kinds of management and twelve appropriate health technologies were selected and promoted.Through the driving effect of regional medical alliances,the theoretical knowledge pass rate of the trainees was 98%and the technical pass rate was 92%after 6 months of training.The participation rate,attendance rate,theoretical knowledge pass rate and technical pass rate of the trainees from medical alliances were higher than the counterparts from non-medical alliances.Conclusions From the perspective of medical alliances,the whole-process standardized system can effectively enhance the promotion of appropriate health technology,help to strengthen the service orientation of community health service centers,and facilitate the further promotion of hierarchical diagnosis and treatment.