Lianyungang Municipal People’s Government

　

Notice on printing and distributing the development plan of pre-hospital emergency medical care in Lianyungang during the 13th Five-Year Plan.

Lian Wei Yi Zheng [2017] No.22

County Health and Family Planning Commission (bureau), Development and Reform Commission, Office of Organizational Establishment Committee, Finance Bureau, Price Bureau, Human Resources and Social Security Bureau, Social Affairs Bureau of each functional area, and relevant municipal medical and health institutions:

　　In order to promote the healthy development of pre-hospital emergency medical care in our city, improve the city’s emergency medical service system, continuously meet the people’s growing demand for emergency medical services, and effectively protect people’s life safety, the Municipal Health and Family Planning Commission and other six departments jointly formulated the Development Plan for Lianyungang’s Pre-hospital Emergency Medical Care in the 13th Five-Year Plan (2016-2016) in accordance with the spirit of the National Health and Family Planning Commission’s Management Measures for Pre-hospital Medical Care, the Development Plan for Jiangsu Province’s Pre-hospital Emergency Medical Care in the 13th Five-Year Plan, and the current situation

　 　　May 26, 2017

　　　

Development Plan of Pre-hospital Emergency Medical Care in Lianyungang during the 13th Five-Year Plan

　(2016-2020)

　　In order to further improve the city’s pre-hospital emergency medical service system, accelerate the formation of a pre-hospital emergency management and service model that meets the requirements of the city’s economic and social development, and effectively meet the people’s growing demand for emergency medical services, this plan is formulated according to the spirit of the National Health and Family Planning Commission’s Management Measures for Pre-hospital Medical Emergency, Jiangsu Province’s 13 th Five-Year Plan for the Development of Pre-hospital Emergency Medical Care (2016-2020) and other documents, combined with the current situation of pre-hospital emergency medical care in the city.

　　First, the city’s pre-hospital emergency medical care development status and facing situation

　　(A) the development of pre-hospital emergency medical care in the Twelfth Five-Year Plan

　　During the Twelfth Five-Year Plan period, all counties (districts) conscientiously accelerated the pace of construction in accordance with the objectives, tasks and requirements of the construction and development of provincial and municipal emergency medical systems, which further developed the city’s pre-hospital emergency medical care, played an indispensable role in daily pre-hospital emergency care and emergency medical rescue of various emergencies and natural disasters, and made great contributions.

　　First, the pre-hospital emergency medical network has been continuously improved. The city has a municipal first aid center, four county (district) first aid stations and 42 first aid sub-stations. During the Twelfth Five-Year Plan period, the city added 34 ambulance vehicles, 2 new substations and 15 first-aid points. Ganyu, Guanyun and Guannan have all built pre-hospital first-aid networks covering a certain area, mainly county-level hospitals and central health centers, and Donghai County pre-hospital first-aid network is also under active preparation, basically achieving the service function of reaching the first-aid site in half an hour.

　　Second, the professional team of pre-hospital first aid continues to grow and develop. At the end of the Twelfth Five-Year Plan, there were 303 full-time and part-time employees in pre-hospital emergency medical care in the city. The scale of emergency personnel has been greatly improved compared with the end of the Eleventh Five-Year Plan, forming a relatively complete team of pre-hospital emergency personnel, which played an important role in the treatment of acute and critical diseases and emergency medical treatment of public health emergencies.

　　Third, the pre-hospital emergency medical management is constantly standardized. According to the provincial "Management Specification for the Construction of Emergency Medical Centers (Stations)" and the spirit of a series of documents on ambulance cleaning and rectification, the names of ambulances and special emergency signs in the whole city were unified, the examination and approval procedures of ambulance warning lights and alarms were standardized, and 218 ambulances that were not in compliance were cleaned up, which standardized the ambulance charging behavior and effectively protected the legitimate rights and interests of doctors and patients.

　　Fourth, the ability of pre-hospital emergency services has been gradually enhanced. Since the Twelfth Five-Year Plan, the amount of rescues in the city has increased significantly. In 2015, the total number of rescues by pre-hospital emergency agencies in the city was about 45,000 times, and the total mileage of trips was about 1.6 million kilometers, double that of 2010. The municipal emergency center and the county (district) emergency stations actively participated in the medical rescue of major emergencies, withstood the severe test of emergencies, and their emergency handling capacity was significantly enhanced, which was fully recognized by the people.

　　Although the city’s pre-hospital emergency medical service has made great progress, on the whole, it is still not suitable for the city’s economic and social development and the people’s demand for medical emergency services. There are still many weak links and problems, mainly manifested in the following aspects: First, the pre-hospital emergency network is not sound enough. The number of emergency stations in some rural areas is insufficient and the quality is not high; Second, the total amount of pre-hospital emergency resources is insufficient. The demand for emergency medical services is increasing year by year, but the number of emergency vehicles, personnel and emergency points is not increasing synchronously, which leads to the obvious shortage of the overall allocation of emergency resources and cannot meet the social needs. Third, the development of informatization level lags behind. Lack of information development, application and innovation, lack of management and application of pre-hospital emergency information data, lack of seamless connection mechanism between disease information and in-hospital treatment information.

　　(B) the situation faced by pre-hospital emergency work in the 13th Five-Year Plan period

　　　During the Thirteenth Five-Year Plan period, with the rapid development of the city’s economy and society, the scale of the city continues to expand, crowded places and large-scale activities gradually increase, and the security task will become increasingly heavy. At the same time, with the increase of personnel exchanges at home and abroad, the situation of prevention and control of public health emergencies such as human infection with avian influenza and Ebola is becoming increasingly severe. During the Thirteenth Five-Year Plan period, the overall population size of the city will continue to expand, the degree of aging will continue to deepen, chronic diseases such as cardiovascular and cerebrovascular diseases, diabetes, malignant tumors and respiratory diseases will increase rapidly, high-risk pregnant women will increase, and the incidence of mental diseases and major infectious diseases will increase. It is estimated that the amount of first aid in the city will increase at a rate of about 10% every year during the Thirteenth Five-Year Plan period, and the task of pre-hospital first aid will be very heavy, which puts forward higher requirements and severe tests for pre-hospital first aid work.

　　Second, the guiding ideology and basic principles

　(A) the guiding ideology

　　Adhere to the maintenance and improvement of people’s health level as the starting point, focus on improving the government-led emergency medical development mechanism, vigorously promote institutional innovation, implement policy support, focus on building and developing pre-hospital emergency medical professional teams, improve pre-hospital emergency medical service network, especially accelerate the construction of first-aid points in rural areas, improve the technical level of pre-hospital emergency medical care, improve the timeliness and effectiveness of emergency medical services, and enhance people’s sense of access to pre-hospital emergency medical services. We will fully implement the people-oriented concept, make overall arrangements, integrate resources, rationally allocate and improve efficiency according to standards, and gradually establish a three-level pre-hospital emergency service network system covering urban and rural areas.

　　(2) Basic principles

　　1, government-led, continuous protection. Pre-hospital emergency service has a strong social welfare, which is an important part of the government’s basic public services and social management functions, and also an important symbol of the progress and development of urban civilization. We should give full play to the leading role of the government, coordinate all departments to participate in the construction of pre-hospital emergency medical care, perform the government’s public service and social management functions, give play to the government’s policy-oriented role, and ensure sustainable development.

　　2. Overall planning to meet the demand. The construction of pre-hospital first-aid system should meet the needs of citizens’ first-aid services, combine the overall layout of urban planning, base on the actual situation, reasonably set up network stations (points), and integrate regional pre-hospital first-aid resources to meet the needs of major activities and emergency rescue work.

　　3. Highlight key points and improve the system. Efforts should be made to improve the pre-hospital first aid stations (points) in suburban and rural areas, establish first aid sub-stations in urban-rural fringe areas and new urban areas, establish first aid points in qualified towns and villages to serve rural residents, and form a pre-hospital first aid network covering the whole city and with reasonable layout. It is necessary to equip emergency vehicles and equipment, and strengthen the construction of pre-hospital emergency hardware facilities; It is necessary to strengthen emergency personnel, improve the professional level of pre-hospital emergency practitioners, and build a pre-hospital emergency medical service system with quick response, effective treatment, rapid transfer and coordination with in-hospital treatment.

　　4, unified standards, step by step implementation. According to the relevant standards of the national and provincial health and family planning commission, a standardized pre-hospital emergency system will be established by planning, implementing step by step and completing year by year for the construction of pre-hospital emergency network, vehicles and personnel allocation in the city. Establish and improve various systems and processes of pre-hospital first aid, strengthen quality control, strengthen quality management, and continuously improve the level of pre-hospital first aid service.

　　III. Work objectives

　　(a) the completion of the county (District) independent first aid station.

　　By 2020, the county (district) first aid stations will be established independently. Counties (districts) institutions, finance, development and reform, prices, human resources and social security departments should provide policy support and guarantee within the scope of their duties.

　　　(B) improve the pre-hospital emergency service network

　　By the end of 2020, a three-level pre-hospital emergency medical service system covering urban and rural areas will be established, and the capacity of pre-hospital emergency services in urban and rural areas will be equalized initially, significantly improving the efficiency of pre-hospital emergency services.

　　(3) Enriching the contingent of emergency personnel.

　　Focus on supplementing the number of emergency doctors, take out a certain proportion of empty staff to strengthen the strength of emergency personnel, so as to ensure that the number of pre-hospital emergency personnel is appropriate, the team is stable and the structure is reasonable.

　　(D) Increase the intensity of information construction.

　　Ambulances have wireless transmission function, and more than 80% ambulances in municipal emergency centers and more than 30% ambulances in county (district) emergency stations have wireless transmission of mobile monitoring, so as to achieve seamless docking of critically ill patients before and after rescue.

　　IV. Main tasks

　　(A) to strengthen the pre-hospital emergency medical system.

　　1. Scientifically set up pre-hospital emergency network stations (points). With the population covered by each sub-station (point) being 150,000-200,000 and the average service radius being 3-5 kilometers as the standard, the first-aid stations (points) should be rationally arranged, and a three-level pre-hospital first-aid network of cities, counties (districts) and towns should be constructed. In densely populated areas, the service radius can be appropriately reduced.

　　2. Strengthen the construction of emergency centers and stations. By 2020, the city emergency center will add three or four emergency substations, with more than 70% self-managed emergency substations; The county (district) first-aid station will be built into a county (district) first-aid network with central hospitals as the backbone and non-central hospitals as the support. By 2017, all county (district) central hospitals will be included in the county-level emergency network system, and their operation will be standardized.

　　3. Standardize the construction of first-aid substations (points). According to "Jiangsu Province Emergency Medical Center (Station) Construction Management Standard" and "Jiangsu Province Pre-hospital Emergency Medical Sub-station (point) Basic Construction Standard", standardize the construction of each emergency sub-station (point), and the municipal, county (district) health and family planning administrative department will strengthen the guidance and supervision of the standardization construction of each emergency sub-station and point. More than 80% of emergency substations (points) have reached the provincial construction standards.

　　(2) Enrich and stabilize the team of pre-hospital emergency personnel.

　　Pre-hospital emergency personnel mainly include: emergency doctors, emergency nurses, emergency drivers, stretcher bearers, dispatchers, professional technicians and administrative personnel in communication engineering, information network, emergency vehicles and equipment maintenance. Staffing should be carried out according to the demand, focusing on solving the shortage of pre-hospital emergency doctors, the instability of the team and improving the emergency service level, and efforts should be made to strengthen the construction of pre-hospital emergency professional team.

　　1. Broaden access channels. County, district organization, human resources and social security, finance and other departments should give strong support, give policy inclination in the introduction and recruitment of pre-hospital emergency personnel, and strive to solve the problems of recruiting and staying by increasing government investment. Strive for a certain number of public welfare posts for contract personnel.

　　2. Improve the treatment of emergency personnel. Fully implement the post performance pay system of national and provincial institutions, combine the total performance pay level of other similar institutions in the locality, and comprehensively consider the particularity of the industry, and appropriately tilt the pre-hospital emergency institutions when approving performance pay.

　　3. Cultivate professionals through multiple channels. Explore the feasible path to solve the difficult problem of recruiting pre-hospital emergency medical talents. Explore the establishment of a standardized training model for residents in line with the characteristics of pre-hospital emergency medical specialty, and clarify the training objectives, outlines and contents. Establish a training system for medical ambulancemen, focus on the knowledge and skills of initial emergency rescue at the scene of various emergencies, accidents, trauma and public health emergencies, carry out vocational training for medical ambulancemen, and expand the pre-hospital emergency medical team with basic professional medical ambulance knowledge and skills.

　　4. Explore the establishment of a flexible flow mechanism of talents between pre-hospital emergency care and hospitals. Improve the evaluation standard of professional titles of pre-hospital emergency care, and the doctors of hospital emergency care and other related professions will work in pre-hospital emergency care institutions for one year before being promoted to the title of attending or deputy senior, which will be regarded as counterpart support services at the grassroots level to alleviate the contradiction of shortage of pre-hospital emergency care personnel. Pre-hospital emergency doctors are sent to hospitals above the second level for free further study, so as to improve the comprehensive level of business.

　　(C) to promote the pre-hospital emergency medical system information construction and application

　　1, promote the information construction of pre-hospital emergency medical institutions. Incorporate the information of pre-hospital emergency medical system into the smart health service project, and continuously improve the informatization level of pre-hospital emergency medical service. Unify the data standard of pre-hospital emergency services, establish the management information platform of pre-hospital emergency services, and promote the coordinated operation of emergency medical services in this region. Actively explore pre-hospital first aid+Internet convenient first aid medical services, realize the management of pre-hospital first aid medical institutions and intelligent first aid services, promote the application of big data, mobile Internet and other technologies in the field of pre-hospital first aid services, and give play to the role of information technology in medical treatment of chest pain, stroke and trauma. All ambulances in the city are equipped with on-board GPS and standardized.

　　2. Expand the functions of pre-hospital emergency command and dispatch system. Establish a city-wide pre-hospital emergency command and dispatch system with information sharing, complete functions and interconnection. 120 emergency telephone is the unified emergency telephone in the whole city, so as to achieve unified acceptance, unified dispatch, nearest rescue and rapid response. Strengthen the information sharing and linkage between 120 emergency dispatch information and public security, transportation, emergency management and other related departments.

　　(D) improve the level of scientific scheduling

　　1, improve the municipal 120 command and dispatch center. The county (district) first-aid station accepts the unified dispatch of the municipal first-aid center, realizes the integration of dispatch and command within the city, shortens the dispatch time to the maximum extent, and wins the rescue time for pre-hospital first aid. Increase the number of dispatching seats and improve the ability of command and dispatch and information processing and analysis.

　　2. Explore the first-aid priority hierarchical scheduling mechanism. Improve the specialization and standardization of first aid acceptance and dispatch, strengthen the on-the-job training and assessment of dispatchers, and improve the utilization efficiency of first aid resources.

　　3. Explore the classified management of pre-hospital emergency services. Give priority to ensuring life-threatening pre-hospital emergency services, realize the refined operation of pre-hospital emergency services, and ensure the basic emergency needs of the people.

　　(five) improve the pre-hospital and in-hospital emergency connection mechanism.

　　1. Strengthen the allocation of emergency resources in medical institutions. Strengthen the construction of hospital emergency facilities, emergency medical professional team and emergency medical specialty capacity in accordance with the "Management Standard for Hospital Emergency Department Construction"; Strengthen the management of hospital first aid, implement the rules and regulations of hospital first aid, strictly implement the responsibility system of first diagnosis, implement emergency triage, and guide patients to use emergency medical resources rationally.

　　2. Strengthen the information interaction and cooperation in front and in the hospital. Establish a real-time interactive platform for pre-hospital emergency medical institutions, ambulances and in-hospital emergency information, standardize the workflow of pre-hospital and in-hospital handover, establish a green channel for pre-hospital and in-hospital emergency, and establish and improve a new integrated emergency medical system of pre-hospital emergency, in-hospital emergency and critical care.

　　(six) improve the pre-hospital emergency vehicle configuration.

　　Every 50,000 people are equipped with a monitoring ambulance, and the vehicle is equipped with equipment, medical consumables and other items according to the specifications. Improve the equipment of ambulances with different purposes and performances. The ratio of negative pressure monitoring ambulances to ordinary monitoring ambulances in urban ambulance vehicles is 1:4-1:6. The city emergency center is equipped with 2-3 negative pressure vehicles, 1 newborn transfer vehicle, 1 on-site emergency rescue command vehicle and 1 medical material reserve vehicle. All kinds of ambulances meet the national standards and meet the needs of first aid. Strengthen the fine management and quality control of ambulance quantity and equipment, and scrap ambulance vehicles and equipment according to regulations.

　　(seven) to strengthen the pre-hospital emergency medical discipline construction.

　　Strengthen the construction of pre-hospital emergency medical professional level, encourage pre-hospital emergency professionals to carry out pre-hospital emergency technical innovation, continuously enhance the professional ability of pre-hospital emergency on-site rescue, on-the-way rescue and sudden acute infectious disease treatment, and improve the success rate of rescue. Focusing on the routine of initial treatment of common emergencies, the routine of initial treatment of various trauma, the standard of on-site cardiopulmonary resuscitation, handling and escort, and taking job skills training as a means, we will strengthen the continuing education of pre-hospital emergency medical professionals and cultivate the medical rescue, emergency handling and emergency medical rescue capabilities of pre-hospital emergency professional teams. Establish a municipal pre-hospital emergency medical quality control organization to supervise and evaluate the pre-hospital emergency construction in the city.

　　VI. Safeguard measures

　　(A) the implementation of government responsibility

　　Governments at all levels and relevant departments should attach importance to the construction of pre-hospital emergency care system in the local area, give full play to the function of public finance, increase financial investment in the construction of pre-hospital emergency care system, and ensure that financial investment is gradually adapted to the needs of career development, so as to ensure the normal operation of pre-hospital emergency care medical institutions and improve the conditions such as infrastructure, vehicle equipment and professionals needed for pre-hospital emergency care. Departments of health and family planning, development and reform, organization establishment, finance, human resources and social security, price and other departments should, in light of the characteristics of pre-hospital emergency medical care, strengthen policy support and provide policy services within their respective functions and duties, and jointly promote the construction of pre-hospital emergency system in the region.

　　(2) Strictly supervise according to law.

　　Conscientiously implement the Law on Medical Practitioners in People’s Republic of China (PRC), the Regulations on the Administration of Medical Institutions in the State Council and the Measures for the Administration of Pre-hospital Medical Emergency of the National Health and Family Planning Commission and other relevant laws and regulations, strengthen the access management of pre-hospital emergency institutions, personnel, technology and other service elements in accordance with the law, and strengthen the management of practice and service quality. All ambulance vehicles shall have uniform appearance identification in accordance with the regulations, and be numbered for the record. Without permission, ambulances of any unit or institution shall not use the special ambulance identification;

　　(3) Deepening internal reform

　　Further strengthen the reform of internal operation mechanism and personnel management mechanism, and establish a performance evaluation mechanism that adapts to the characteristics of pre-hospital emergency care industry. According to the Performance Evaluation Index of Pre-hospital Emergency Institutions in Jiangsu Province, combined with our own reality, we should strengthen the performance management and assessment of emergency centers (stations), sub-stations (points) and their personnel, establish a standardized, efficient and dynamic operation mechanism, and improve work efficiency and service quality. In order to mobilize the enthusiasm of pre-hospital emergency professionals, and based on the principle of getting more for more work, excellent performance and equal pay for the same post, we will focus on the first-line emergency, business backbone, key positions and personnel with outstanding contributions, reasonably control the income level of ordinary posts and logistics posts, and widen the income gap.

　　(D) to create a good atmosphere

　　With the help of modern media, we should widely publicize the pre-hospital first aid work, experience and achievements, popularize the popular science knowledge of emergency first aid, constantly improve the public’s awareness of first aid and self-help, change the public’s concept of first aid demand, give full play to the medical rescue function, and ensure the safety of people’s lives. Pay attention to excavating, establishing and publicizing advanced models, lead the way with models, fully display the selfless dedication of emergency workers, strive to build a brand of emergency services and enhance the image of the industry.

　　VII. Implementation and evaluation

　　This plan is a guiding document revised according to the development plan of pre-hospital emergency medical care in the province during the 13th Five-Year Plan and the actual situation of pre-hospital emergency care in the whole city. Counties (districts) health and family planning administrative departments and pre-hospital emergency medical institutions should carefully study and formulate the five-year plan, annual plan and time schedule for the development of pre-hospital emergency medical services in their own regions and units according to this plan and the actual situation of their own regions and units, clarify objectives, decompose tasks, refine measures, pay close attention to implementation, and promote the smooth implementation of the plan. It is necessary to establish a monitoring and evaluation system and mechanism, formulate an index system and methods for monitoring and evaluation, regularly and scientifically monitor and evaluate the progress and effect of planning implementation, supervise the implementation of major projects, find and solve problems and difficulties in the process of planning implementation in time, and ensure the smooth realization of planning objectives.