教学式深度帮扶助力国家级贫困县医院医疗水平提升的调查  

A survey on effectiveness of using teaching type deep assistance from high-rank hospital to improve medical level in national poverty county hospital

作　　者：赵志伶[1] 孟超[2] 雷瑞芳 么改琦[1] 张云峰 王攀峰[4] 李振荣[5] 苏春燕[6] Zhao Zhiling;Meng Chao;Lei Ruifang;Yao Gaiqi;Zhang Yunfeng;Wang Panfeng;Li Zhenrong;Su Chunyan(Department of Intensive Care Unit,Peking University Third Hospital,Beijing 100191,China;Department of ENT,Peking University Third Hospital,Beijing 100191,China;Department of General Surgery,People's Hospital of Daning County,Linfen 042300,Shanxi,China;Department of Oncology and Radiotherapy,Peking University Third Hospital,Beijing 100191,China;Department of Laboratory Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Nephrology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院危重医学科,北京100191 [2]北京大学第三医院耳鼻喉科,北京100191 [3]山西省大宁县人民医院外科,山西临汾042300 [4]北京大学第三医院肿瘤放疗科,北京100191 [5]北京大学第三医院检验科,北京100191 [6]北京大学第三医院肾内科,北京100191

出　　处：《中国中西医结合急救杂志》2021年第3期257-260,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：国家卫生健康委“技术推广扶贫”试点项目(2019-171)。

摘　　要：目的评估北京大学第三医院(北医三院)对基层医院教学式深度帮扶的效果.方法2018年10月北医三院派驻高级职称临床专家担任受援医院山西省大宁县人民医院的行政职务,从管理角度进行教学式深度帮扶,规范诊疗流程,建立质量管理月报,组织开展国家级学习班授课、理论授课、临床技能指导、教学查房等多种帮扶方式.通过问卷调查方式了解大宁县人民医院职工对教学式深度帮扶效果的主观评价、最受欢迎的教学方式及教学内容,比较帮扶措施落实前(2018年1月至12月)和帮扶措施落实后(2019年1月至12月)医院门诊患者数、手术患者数等客观数据,评估教学式深度帮扶的效果.结果共109名医务人员和43名管理层人员接受问卷调查,认为深度帮扶对临床工作帮助很大、帮助还可以的人员比例明显高于认为没有帮助、有一点帮助的人员比例〔39.4%(43/109)、56.0%(61/109)比0.9%(1/109)、3.7%(4/109),均P<0.05〕;认为深度帮扶对学科发展帮助很大的人员比例明显高于认为没有帮助、有一点帮助的人员比例〔51.2%(22/43)比2.3%(1/43)、11.6%(5/43),均P<0.05〕;认为深度帮扶对管理水平帮助很大的人员比例明显高于认为没有帮助、有一点帮助及帮助还可以的人员比例〔53.5%(23/43)比0%(0/43)、25.6%(11/43)、20.9%(9/43),均P<0.05〕;帮扶后认为诊疗流程不规范的人员比例明显低于帮扶前〔7.0%(3/43)比32.6%(14/43),P<0.05〕.深度帮扶后,大宁县人民医院年门诊患者数和年手术量均较帮扶前有所增加〔年门诊患者数(例次):59685比54206,年手术量(例次):778比405〕.调查显示,医务人员需求最高的教学方式为临床技能培训〔72.5%(79/109)〕,其次为专题学习班授课〔61.5%(67/109)〕,教学查房的需求比例较低〔28.4%(31/109)〕;医务人员对教学内容需求的比例从高到低依次为培养临床思维〔56.9%(62/109)〕、学习最新医疗技术〔55.0%(60/109)�Objective To evaluate the effectiveness of teaching type deep assistance carried out by Peking University Third Hospital on the improvement of grass root hospitals'medical level in national poverty county.Methods In October 2018,the clinical experts from Peking University Third Hospital held an administrative post of People's Hospital of Daning County in Shanxi Province and from management point of view to proceed multiple teaching types of deep assistance,including standardizing the diagnosis and treatment process,establishing monthly report on quality control,organizing and carrying out national grade continuing educational program,giving lessons of theoretical knowledge,training clinical skills,teaching rounds,etc.A questionnaire survey was carried out to understand the medical staff's subjective evaluation regarding the effect of teaching type deep assistance,the most welcome teaching mode and its contents;before(January to December 2018)and after(January to December 2019)the implementation of supportive measures,the objective data on the yearly outpatient visits and the number of surgical patients were calculated and compared to evaluate the effect of teaching type deep assistanc.Results A total of 109 medical staff and 43 management staff accepted the questionnaire survey.The percentage of medical staff who believed that the deep assistance helped clinical work very much and those who considered of some help were significantly higher than those of medical staff who considered of no help and a little help[39.4%(43/109),56.0%(61/109)vs.0.9%(1/109),3.7%(4/109),all P<0.05].The percentage of medical staff who believed that the deep assistance helped discipline development very much was significantly higher than those of medical staff who considered of no help and a little help[51.2%(22/43)vs.2.3%(1/43),11.6%(5/43),both P<0.05].The proportion of staff who believed that the deep assistance helped develop administration level very much was significantly higher than those considering of no help,a little help and som

关 键 词：教学 深度帮扶 质量管理 国家级贫困县 县医院 

分 类 号：G63[文化科学—教育学]