According to the Ho Chi Minh City Health Department, in 2020, there are 18,395 dissatisfaction responses recorded through the automatic survey system in the hospital (BV). The unsatisfied contents when arriving at the hospital include: parking service; The process of purchasing drugs and distributing medical insurance drugs (medical insurance) takes a long time; the toilet is not clean; seats waiting for exams and tests; consultation and medical examination (BS); waiting time for tests, ultrasound, film …
Meanwhile, the results of the hospital experience survey (patients) in 79 public and private hospitals in Ho Chi Minh City showed that more than 40% of patients were not satisfied with the hospital admission procedures, more than 20% Of the patients were not satisfied with the discharge procedure and the doctor examined the doctor before entering the hospitalization department. Regarding the discharge procedure, patients complain of an average of 450 minutes (7.5 hours) to complete the discharge procedure.
Chorus “wait”
The leader of a class 1 public hospital in Ho Chi Minh City said the process of hospitalization and patient discharge is not complicated, fast or slow in part due to implementation. As the patient enters the hospital, according to the procedure of the patient “waiting” for the doctor. After the examination, the doctor only ordered the tests. Patients go “waiting” to do the necessary tests and then “wait” again to see the results, if the patient is right, the doctor will only be hospitalized. Then the patient went to pay an advance and was transferred to the boarding school. But the midwife often waits to gather many documents before taking the patient one time, so the first has to “wait” for the next. If you want to take patients to departments, they have to “wait” to drive (electric car if you go far, or drive on foot). Therefore, the time for patients to go to the inpatient department will be long due to the chorus … “wait”.
According to the leader of the Ho Chi Minh City Orthopedic and Traumatology Hospital, the average hospital has 20-25 hospitalizations every day, the patient takes 60-90 minutes from the time of registration, see the doctor, take X – Quang and returned to the doctor for admission to the hospital. Patients admitted to the emergency hospital, hospitalized during the day, are not included. Reform of administrative procedures can reduce patient time by 20-30%.
Questioning how to reform so that patients do not complain of waiting too long for hospital admission, Dr. Pham Quoc Dung, director of Hospital District 11, said taking the necessary tests to have the correct indication for hospitalization for the patient. Depending on the number of patients overcrowded or less, but when patients arrive at the hospital for examination, the doctor sees signs of a serious need to be immediately hospitalized for treatment, they do not need to do the tests first.
Why does the discharge from the hospital take almost half a day?
According to the leader of a class 1 public hospital, when patients leave the hospital, generally from 8 to 9 am each day, the doctor is examined, evaluated and discharged. But every morning the doctor often examined many patients. When the doctor finished examining all the patients, recording the records, until approximately 10-11 o’clock, the preventive nurse, the administrative nurse access the records, they complete the records including the list of techniques, medications, expenses. the health insurance fee is paid, the patient’s share pays; and the administrative nurse gathered all the files. At approximately 1 pm, the departmental administrative nurses bring the hospital discharge records to the general planning office for approval; Now, there are tens to hundreds of records at the same time. If the record is flawed, the general planning department should return it to the correction department; The file is approved, then it is transferred to the finance department for later approval, if it is incorrect, it will be returned for correction. Followed by hundreds of patients or family members waiting to pay hospital fees. This time is from 14 to 15 hours.
Regarding solutions to prevent patients from waiting for a prolonged hospital discharge, according to Dr. Pham Quoc Dung: “With patients discharged from the hospital, we are implementing reforms that on each shift, the nurse must complete the procedure before the transfer. Administrative statistics for patients, that is, statistics from technical lists, drugs used by patients, always calculate the cost of use for patients. When the patient is discharged from the hospital, it is not necessary to recalculate, so it will be very fast. Mr. Dung also added that it is necessary to resolve patients discharged from the hospital in one session. For example, the morning a patient is discharged from the hospital, then at 11:00 pm he will leave the hospital; in the afternoon, when he was discharged from the hospital, at 2:00 pm he would leave the hospital. On the other hand, with digitization, digital signature, patient visits or hospital discharge, when the doctor issues the prescription, the pharmacy also receives and prepares the medicine immediately, the patient only needs to give the prescription and receive the medicine. Greatly shorten the waiting time for patients.
