a. Ve ca sa vat chat
Dau tu cho co so vat chat la mot nhiem vu quan trong trong viec nang cao chat luong dich vu cua benh vien. Bdi vi co sd vat chat co tot, hien dai, sach se thi benh nhan mdi cam thay yen tarn trong khi den kham va dieu tri. Do do, dau tu ca sd vat chat phai dap ung duqc nhung yeu cau: thuan tien, hien dai, dong bo va khoa hoc. Cac phdng kham, phdng benh phai tao sang sua, thdng thoang, tao cam giac thoai mai, de chiu cho benh nhan va ngudi nha benh nhan trong thdi gian kham va
nha cam thay thu gian trong qua trinh d lai benh vien.
Hien tai khu vuc can tin da di ddi va ke hoach sua chua da dang hoan thien de di ddi khoa tham dd chuc nang ra khu vuc can tin, sau khi khoa tham dd chuc nang
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dupe di doi, mot phan cu cua khoa tham do chuc nang sat khoa Chan doan hinh anh se duoc danh cho viec cai tao thanh phdng dat may Citi 64 lat cat, phan con lai se quy hoach bd tri lai khu vuc lam viec va vi tri cac ban kham de thuan tien phuc vu nhan dan toi KCB. Tang them phdng kham benh nham dap ung kham 50 benh nhan/ban kham, tang them 2 ban huong dan giup giai dap thac mac va ho trp cho benh nhan.
Ky hop dong vdi cac Cdng ty Tu van xay dung de thiet ke cac hang muc: Xay nha dat may chup mach xoa nen ky thuat sd de chuan bi tiep nhan may tu du an ODA; Cai tao nha de o xy de tang nang luc phuc vu benh nhan; Mo rong nha dieu tri khoa Ung budu, giam ty le 2 BN/giudng; Sua chua he thong phdng chay chua chay bao dam cdng tac phdng chay chua chay do da dupe dau tu tren 10 nam va chua dupe bao duong, cai tao lan nao; Sua chua cai tao khoa Nhi de dam bao dieu kien ve sinh moi trudng, trong tong muc dau tu 9.250.000.000 dong, ngan sach tinh ho trp 1.500.000.000 dong, phan cdn lai do quy phat trien hoat dong su nghiep don vi thuc hien, tat ca cac cdng trinh tren nham muc dich giai quyet yeu cau buc xue do qua tai cua cdng tac kham dieu tri benh, dam bao dieu kien kham dieu tri cua nhan dan, nang cao chat lupng dich vu kham dieu tri va dam bao ve sinh moi trudng, chong xuong cap cdng trinh.
b. Ve trang thiet bi y te
Trang thiet bi y te dong vai trd quan trong trong viec KCB. Chinh vi vay dau tu va su dung co hieu qua cac trang thiet bi y te se gop phan nang cao chat lupng dich vu KCB cua benh vien. Chinh vi vay, de viec KCB dat hieu qua cao, benh vien
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can trang bi them cac loai thiet bi y te nhu dinh hudng danh muc da de ra. Thuc day nhanh tien trinh thuc hien nguon von Du an ODA de tung budc thuc hien chuong trinh hien dai hoa trang thiet bi y te. Uu tien thuc hien trudc cac thiet bi cua cac khoa can lam sang: Xet nghiem, Chan doan hinh anh va Tham dd chuc nang de tang chat lupng, giam thoi gian cho dpi trong qua trinh kham dieu tri cua benh nhan.
Viec day manh dau tu trang thiet bi cho cdng tac KCB, ngudi benh den vdi benh vien se dupe tiep can cac phuong tien may moc chan doan hien dai. Nhd do,
cong tac chan doan va dieu tri dat hieu qua cao, nang cao chat luqng KCB cua benh vien. Viec dau tu trang thiet bi phai di song hanh vdi viec dau tu con ngudi, vi vay
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khi cd ke hoach trien khai mua sam cac thiet bi tren phai kern theo ke hoach dao tao con ngudi de su dung thiet bi do, khai thac triet de va khong lang phi viec dau tu.
CNTT cung la mot phan cua trang bi cd sd vat chat cho benh vien. CNTT la phuong tien trq giup dac luc va cd hieu qua cao trong quan ly benh vien. Dua ung dung CNTT vao viec quan ly benh vien la mot phuang thuc rat tot de gop phan thuc day benh vien phat trien toan dien, tirng budc dap ung duqc yeu cau ve KCB va cham soc sue khoe cho nhan dan. Nhanh chong xay dung he thong phan mem, cac chuong trinh quan ly, dieu hanh benh vien, ho so benh an dien tu thuan tien phu hqp vdi quy md giudng benh. Thiet lap he thong phan mem thong toan benh vien giup cho cac khoa, cac cac sy cd the tim kiem thong tin benh nhan nhu : tien su enh, thudc da va dang su dung... mot each de dang va nhanh chong. Tu do bac sy cd the
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dua ra cac phac do dieu tri nhanh va chinh xac hon ddi vdi ngudi benh. CNTT giup giam sat tu xa viec ke toa thudc cua bac sy kham dieu tri ngoai tru, giup cho nha quan ly phat hien nhung bat thuong va can thiep vao nhung toa thudc chua hqp ly, cd nhu vay bac sy mdi can nhac, than trong khi ke toa cho ngudi benh, giup cho ngudi benh chong hoi phuc, vdi chi phi hqp ly.
Doi ngu nhan vien phong cong nghe thong tin can phai duqc dao tao de cd thd su dung, va quan tri mang LAN tot cho benh vien. Viec ung dung cong nghe thong tin trong quan ly benh vien se nang cao chat luqng va hieu qua cong tac dieu hanh, quan ly kinh te, quan ly KCB, hoat dong chuyen mon cua benh vien; cung cap thong tin phuc vu cac yeu cau cua lanh dao, can bo quan ly, can bo chuyen mon mot each chinh xac, day du, kip thdi.
3.2.3.2. Giai phap ve nguon luc y te
Nguon nhan luc y te la mot trong nhung yeu to cau thanh quan trong trong chat luqng dich vu KCB cua benh vien. Mot nguon nhan luc tot, se rat cd y nghia trong viec trien khai cd hieu qua cac hoat dong va do do nd quyet dinh su thanh cong cua benh vien. Nguqc lai nguon nhan luc kern, du co sd ha tang, may moc
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thiet bi co hien dai den dau di nua thi hieu qua hoat dong cung van han che. Cho nen benh vien phai co chien luoc hoach dinh nguon nhan luc, hoach dinh nguon nhan luc la qua trinh nghien cuu, xac dinh nhu cau nguon nhan luc, dua ra cac chinh sach va thuc hien cac chuong trinh, hoat dong bao dam cho benh vien co du nguon nhan luc voi cac phdm chat, ky nang phu hop de thuc hien cong viec cd nang suat, chat luong va hieu qua cao. Qua trinh hoach dinh nguon nhan luc can dupe thuc hien trong mdi lien he mat thiet vdi qua trinh hoach dinh va thuc hien chien luoc va chinh sach KCB cua benh vien.
- Khuyen khich can bo y te tai benh vien di hoc tap. Tuyen dung du va phu hop vdi nhu cau ve ngudn nhan luc, dac biet la bac si cd trinh do cao.
- Viec tuyen dung vien chuc y te do Sd Y te va Sd Noi vu td chuc tuydn dung tren cd sd bien che giao trong nam va cac vi tri, tieu chi do don vi su dung dd nghi ldn. Chung ta can ddi mdi tieu chuan vd tuydn dung, danh gia viec thuc hien nhiem vu tren ca mat chuyen mon va mat dao due chu khdng chi dua vao bang cdp.
Cong tac dao tao sau tuydn dung cung can dupe chu trong. Can bo y td khi dupe tuydn dung can dupe cu di hoc tap, dao tao chuyen mon phu hop vdi vi tri minh dupe tuydn. Ben canh do, cac can bo y td trong benh vien can phai dupe cu di hoc tap, tiep can vdi nhung kidn thuc, chuyen mon mdi; khi cd nhung cong nghe mdi dua vd benh vien, nhung nhan vien phu trach lam viec vdi khoa hoc ky thuat mdi nen dupe di dao tao dd cd the cd kha nang ung dung cong nghe mdi mot each tot nhat. Tu do nang cao chat luong dich vu cham soc sue khde cho nhan dan.
Hang nam, benh vien to chuc cac buoi tap huan vdi cac chuyen gia y khoa trong nudc de tang them kinh nghiem cho can bo y td. Ngoai ra, benh vien can td chuc kiem tra dinh ky, danh gia xep loai can bo y td, nhan vien lam tot nhiem vu, sieng nang, can cu thi can cd bien phap khen thudng, khuyen khich ; con nhan vien chua dat yeu cau can phai tap trung huan luyen ; nhan vien yeu kern, chua cd trach nhiem can phai phe binh, cd hinh thuc phat khac nhu giam thu nhap tang them. Tir do mdi kich thich dupe y thuc phan dau, tinh than tu giac nang cao trach nhiem va nang luc cua mdi can bo y td.
Nhin chung, benh vien can tap trung phat trien doi ngu nhan vien y te cd chat luong cao khong chi ve hoc ham, hoc vi ma con dong gop trong viec phat trien nhung khoa hoc ky thuat, ngoai ra con phai co tinh than, thai do trach nhiem cao trong cdng viec. Nhu vay, hieu qua trong cdng tac kham va dieu tri mdi duoc nang ao,dap ung duoc nhu cau cua nguoi dan. Ngoai ra, benh vien cung can tang cuong moi quan he hop tac vdi cac benh vien trung uong tren dia ban TP. Ha Noi de tranh thu su ho trq chuyen mon ky thuat, ho trp dao tao theo de an 1816 de ap dung duoc nhieu tien bo khoa hoc ky thuat mdi gop phan nang cao chat luong phdng benh, chua benh cho nhan dan.
Dong thoi, benh vien can tap trung cdng tac giao due chinh tri tu tuong, thuc hien tot 12 dieu y due, chong moi bieu hien, nhung thai do khong tot gay phien ha cho ngudi benh. Nang cao tinh than trach nhiem doi vdi tung can bo, vien chuc;
thuc hien tot quy tac ung xu va quy dinh ve giao tiep. Phan dau xay dung benh vien da khoa tinh Bac Ninh dat danh hieu benh vien xuat sac toan dien dua theo cac tieu chuan cua Bo y te.
cua benh vien”
Viec nang cao hieu qua KCB la mot yeu cau buc thiet cua nganh y te. Day la the hien muc dich dap ung quyen loi duoc KCB ngay cang cao cua nhan dan
Doi mat vdi nhu cau KCB cua ngudi dan hien nay dang ngay mot tang len, nganh y te hien dang doi mat vdi nhieu thach thuc phai vuot qua. Viec nang cao chat luong luong benh vien luon la van de duoc Nha nudc va xa hoi dac biet quan tarn. Vi vay, thach thuc duoc dat ra la lam sao de giam duoc tinh trang benh nhan qua tai, lam sao de giam thieu duoc nhung thu tuc hanh chinh cdn rudm ra va dac biet chan benh ke don lam sao cho chinh xac va co hieu qua. Ben canh do, viec
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nang cao tinh than thai do phuc vu chuyen nghiep cung dang la van de nhuc nhdi doi vdi toan bo he thong y te noi chung va doi vdi mdi can bo y te noi rieng.
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De nang cao chat luong dich vu KCB cung nhu hoan thien cong tac giam dinh BHYT tai Benh vien hien nay tai khoa Kham benh va cac khoa dieu tri benh vien da khoa tinh Bac Ninh vdi yeu to “con ngudi”, “co sd vat chat” da dua ra, nhom cac giai phap vdi yeu to “quy dinh che do” can thuc hien de nang cao chat luong dich vu kham dieu tri ngoai tru cua benh vien nhu sau:
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a. Thiet lap moi quan he truyen thong “thay thudc - ngudi benh ”
Nhung yeu to tang cuong moi quan he thay thuoc-ngudi benh bao gom:
Thay thuoc chu ddng gidi thieu ve minh vdi ngudi benh va gia dinh ho ngay tu khi benh nhan dupe goi vao. Neu ngay tu luc dau, ho dupe don iep, san soc can than thi moi quan he thay thudc - ngudi benh se rat tot va tao tien de cho viec kham chua benh sau nay, nhung cau noi nhu “benh vien se cd gang tao dieu kien de ngudi benh dupe dieu tri va cham soc tot nhat, ddng thdi khuyen khich ngudi benh neu cd ban khoan thi manh dan hoi thay thudc va nhan vien y te” nhu la lieu “ thudc chua benh” va la budc dau tien trong cong viec KCB cua thay thudc moi khi tiep nhan ngudi benh. Bac si va dieu duong true tiep kham cho ngudi benh chu y den van de xung hd vdi ngudi benh sao cho phu hpp.
Trong thuc hanh lam sang khong the nao luong trudc dupe nhung bien chung cd the xay ra. Cd nhung trudng hpp xay ra bien chung do sai sot ve mat chuyen mon cua can bo y te tai benh vien tuy nhien do trudc do can bo y te cd thai do an can, vui ve, hoa nha va quan tam cham soc den ngudi benh va can bo y te cung da thong bao va giai thich can ke rd rang vdi benh nhan va ngudi nha benh nhan ve bien chung va each xu ly nen ho khong he bi kien cao hay lam kho de.
b. Nang cao ky nang giao tiep cho ddi ngu nhan vien y te tai Benh vien Muc tieu: Nham nang cao ky nang giao tiep cho nhan vien y te tai benh vien.
Khi danh gia ve chat luong cua dich vu thi khong chi danh gia ve cac dich vu ky thuat y te ma con danh gia chat luong dich vu y te thong qua viec tiep xue va trong qua trinh cham soc cua nhan vien y te vdi benh nhan va ngudi nha benh nhan. Vay de benh
nhan va ngudi nha benh nhan danh gia tot ve chat luong dich vu y te thi can bo y te can cd cac ky nang sau:
- Nhung van de nhu : cho doi den luot kham, benh nhan phai nam ghep giuong, co trudng hop benh nhan khoi benh, trudng hop benh nhan khdng qua khoi ... luon luon la nhung van de cd kha nang xay ra. Vi vay, khi phat sinh nhung van
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de day viec can bo y te phai lam la giao tiep vdi benh nhan va ngudi nahf benh nhan that nhe nhang va hop ly de ho cd the thdng cam.
- Khi giao tiep vdi nguoi benh can phai an noi nhe nhang, dung muc ; net mat phai hai hoa, cu chi, hanh vi phai hop ly. An tuong dau tien cua ngudi benh khi den kham benh rat quan trong, ho phai cam thay dupe quan tarn, dupe chain soc thi mdi cd the yen tarn va tin tuong giao tinh mang cua ho cho dpi ngu nhan vien y te cua benh vien dupe.
- Trong viec kham va dieu tri nhieu khi cd nhung bien chung xay ra, vi vay, can bo y te phai thudng xuyen lam viec vdi benh nhan va ngudi nha benh nhan de giai thich va pho bien truoc. Cach thuc giai thich va su dong cam cua can bo y te ve nhtrng bien chung se lam cho benh nhan va ngudi nha benh nhan cd the hieu va thdng cam hon.
c. Cai each thu tuc hanh chinh-giam thdi gian cha dai cua ngirai benh
Muc tieu cua cai each cac thu tuc hanh chinh can dua tren nguyen tac dat loi ich cua ngudi benh len tren, lay ngudi benh lam trung tarn. Cac bien phap cai each thu tuc hanh chinh, tap trung cai tien khu vuc kham benh, giam thoi gian cho dpi cua ngudi benh, giam sd luot kham/bac si/ngay, bdi cac sang kien duoi day:
- Ap dung che do hanh chinh mot cua trong day truyen kham benh. Ung dung CNTT vao cong KCB tir khau dau tien la don tiep den khau cuoi cung, lap bang dien tu lay sd kham tu dong, may doc ma vach de han che sai sot va giam thoi gian nhap ma the. Tai khoa kham benh va cac khu nha cua benh vien can bo tri ngudi hudng dan.
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- Bo tri nhan luc hoac cai each quy trinh sao cho thoi gian phai cho dqi cua ngudi benh giam xuong d mot so khau nhu: kham benh, lam cac xet nghiem, thanh toan vien phi.
- Tang sd phong kham, tang ca, tang gid lam viec. Yeu cau can bo y te tai khoa kham benh di lam sdm 30 phut va chi tan ca khi giai quyet xong viec kham chua benh cho ngudi benh; thu bay kham benh nhu ngay trong tuan; Can bo y te phdng kham thong bao sd dien thoai ca nhan de ngudi benh nhan tu van qua dien thoai.
- Day manh ung dung CNTT, phan mem quan ly benh vien phai duoc ket noi toan vien, nhung thong tin ve benh tat cua ngudi benh phai duoc cap nhat lien tuc, thudng xuyen qua mang noi bo cua benh vien. Thong tin cua ngudi benh phai duoc chuyen sang giai doan tiep theo mot each tu dong de giam bdt thdi gian chd doi.
- Dat camera theo doi tai khu cap cuu va kham benh de dam bao an ninh trat tu cho benh nhan, than nhan va khach hang tdi benh vien.
- Bo tri cac ban hudng dan de hudng dan ngudi benh den noi ho can den
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Dong thdi cac benh vien cung co cac bien phap nhac nhd ngudi dan khi den kham benh thi khong nen co hanh vi chen lan, xd day de giu trat tu va mdi trudng lam viec an toan, van minh cua benh vien.
e. Thong tin cho ngudi benh day du, dung muc va kip thdi
- Trong qua trinh kham va dieu tri, ngudi benh can duoc biet nhung thong tin ve benh tat cua minh nhu: muc do nang nhe, phac do dieu tri, cac xet nghiem can thiet; cd nhung thu thuat, phau thuat nao; su dung loai thuoc nao; tien trien den dau hay cd the xay ra nhung trudng hop nao; chi phi KCB va quyen loi, nghia vu cua ho. Nhung thong tin nay phai dam bao day du va dung su that.
- Trudc khi ngudi benh ra vien va bac si va dieu dudng can hudng dan ngudi benh ve theo doi nhung trieu chung sau kham va dieu tri; dong thdi ngudi benh can duoc hudng dan ve che do an uong nghi ngoi, luyen tap su dung thuoc va ngay