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Registered, waiting for consultations, examinations, reports ... The process of access has been simplified, but there may still be some problems with access to a major hospital for patients who are outside the country for the first time, for elderly persons who are alone or for people with special needs。
In may this year, a reference service was introduced in hangzhou. At present, the services cover outpatient and emergency care, providing assistance to patients from pre-diagnostic identification of hospitals, wards and sections, post-hospital registration, waiting lists, examinations and reports. In more than four months of operation, a large number of orders provided real feedback. You're looking for a consultant who wants to be accompanied by a reliable person in the hospital, who can help save time and make less detours, and this help is not just a “worker” in the process。
Interviewee for map
"caremaker is a profession that can effectively help others."
Hu navy was in the garment business. As a result of a serious illness at home, she was accompanied for 12 years and moved in and out of the hospital, where she was familiar with the process. Last year, she took a reference certificate, adding drops at the end of may. “for some patients in the region, hangzhou's large hospital complex has a large number of large and specialized units who are familiar with routes and processes in advance and can spend less time looking and waiting”
On one occasion, a couple from junan went to the hangzhou city to see her daughter, who was unable to accompany her because of her work. Upon receipt of the order, the hu navy familiarized itself with the hospital's route and section location in advance, accompanied the two on the same day to complete the registration, waiting, examination and so on, minimizing the back and back movements in the hospital and helping them to return as planned. There were also patients from jiangsu to hangzhou for examination, and the family wished to return after completing their visit that day. In the case of such patients, the hu navy will be aware of the screening project and hospital layout in advance, familiarize itself with the location of the sections, and then link the process to the actual situation。
“some patients come from outside the country and wish to complete their examinations and visits within one day, if possible. For them, saving time and reducing speed are more realistic needs.” according to the hu navy, the most basic task of the counsellors is to rationalize these non-medical links as far as possible。
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In the case of the patients with whom dr. Deng liyang was exposed, the value of the consultations fell on the other side。
Dan liyang studied nursing and had hospital experience. On one occasion, she received an order from a young visually impaired person from xinjiang who lived alone in hangzhou. The other party was ill-equipped to visit the hospital for abdominal examination. Prior to receiving the order, she made a telephone call to confirm the hospital district and the specific needs and to consider in advance the patient's inability to move。
Upon arrival in the hospital, she accompanied the patient to complete the consultation process, warned in a timely manner in a densely populated area and helped the patient communicate with the doctor. At the end of the examination, she read out the report on a case-by-case basis, as the patient was unable to see the results herself. “what is needed for a patient like this is not just someone to carry the process, but someone to help him get information and understand it.” deng liyang said。
She also accompanied an elderly person who had undergone medical treatment elsewhere. The elderly suffer from oesophagus cancer, their daughters are not locally present and they are not familiar with mandarin, and have difficulty in understanding the hospital self-help equipment, the consultation process and some of the doctor's explanations, which are somewhat stressful. In the course of the consultations, dun liyang assists in completing the medical process while communicating with the elderly and maintaining contact with their families in a timely manner. These experiences have made her feel that for some patients the real difficulty in the medical process is not a specific link, but a barrier to information and psychological pressure when they are in a strange environment。
“some patients still ask questions about medications and re-diagnostics in the community after the completion of the services, and i will repeat them as prescribed by the doctor.” according to the hu navy, these things had long gone beyond the order itself, but she saw the clinician as a profession that could actually help others. Although paid, it is essentially the provision of support when the patient needs it most, and therefore the satisfaction she receives from it is far more than the normal trade in services。
Interviewee for map
"as long as we don't cross the medical border, we can go further."
This demand is not alien to the hospital line。
In 2024, in the context of the national health and welfare commission's national campaign on the theme “improving the experience of patients by improving access to health care”, zhejiang province's central and western medical complex (hangzhou city red cross hospital, hereinafter referred to as the red cross hospital) began to provide its own services, mainly for elderly patients, one of the first hospitals in hangzhou to do so. Previously, hospitals had found that, although the access process had been improving to ease, some elderly patients still had difficulties with e-medicines, self-help devices and online services。
“will not operate the equipment, will not know where to proceed, will not understand the complex medical information, and will even be anxious because of repeated inquiries and searches.” the vice-president of the hospital of the red cross, private zhang, believes that the inclusion of medical services should be reflected not only at the technical and resource levels, but also in the response to the actual difficulties of access to health care, which is “both technical and human”. When the technological divide widens, how does inclusiveness land? This is a question that must be answered for an ageing society.”
During the provision of the services, the red cross hospital has also received a call of appreciation from citizens through the mayor's hotline in the hope that such services will be further expanded. This feedback also shows that there is a real need for patients to support such non-medical links。
This is also one of the reasons why red cross hospitals are willing to explore the possibility of accepting social forces to provide a reference service in the hospital. Previously, the red cross hospital had been heavily dependent on its own staff for its services, with a limited number of individual daily expenses. Hospitals provide space for related services once the drop-in consultations are in place. At present, visits are made to 5 hospitals in hangzhou, where patients can contact the service desk, in addition to making a single appointment on their cell phone。
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Patients are admitted to the hospital, first and foremost through “know the customs”. The red cross hospital takes the initiative to familiarize its counsellors with the overall hospital process, including the distribution of sections, the location of examinations, and the peaks and idle patterns of visits at different times. In the view of zhang national guard, such cooperation is a necessary prerequisite; otherwise, the services of the counsellors would not be available without familiarity with the hospital environment。
In addition to intensive training, there are regular or irregular meetings in hospitals. At the symposium, hospital staff will feed back to the platform on the issues identified on a daily basis, and will also learn from the consultant what is available to improve the outpatient process. This two-way communication contributes to common progress。
At the same time, zhang told journalists that the services would only go further if they did not cross the medical border. “it is clear that the consultations are a medical aid service, not a medical service. A medical practitioner can help the patient to complete the course of his or her work, but he or she cannot substitute for medical personnel to make medical decisions, let alone for the patient or his family.”
“as an example, a medical practitioner cannot give medical guidance to a patient, can not judge whether an examination is necessary or cannot substitute the patient or his family for a medical document to be confirmed by him or her. At the same time, the clinic could not in any way change the normal order of access to the hospital.” zhang national guard said。
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The officials concerned described the entry and training requirements of service providers around these boundaries. Patients must first obtain a medical certificate or a nurse's certificate or a certificate of vocational skills training that can be identified from an official platform, and they must pass the platform's qualification, training, examination and examination. In doing so, the platform also learns about services through user visits, evaluations, etc。
“at the same time, the consultant must be clear as to `what can' and `what cannot'. If the needs of hospitals, wards, wards and patients are identified in advance, assistance in registration, waiting, examination and reporting after admission to the hospital is a service that can be provided by the clinic, and medical advice, medical judgement, medical advice and hospital advice, as well as actions involving the trade in medical resources, must be expressly excluded from the service.”。
Patient services fill the gap between specialized medical services and the actual needs of patients, and take on the functions of referral packages previously performed by family members, volunteers and casual practitioners. As the country's cities that promoted the regularization and size of the services, hangzhou was at the forefront in this area. In 2024, a full-process closed-cycle public-interest consultation service was launched in the xiaoshan region, with a multi-pronged training base for counsellors and pro bono teams, as well as a public-interest consultation shortcut in two cooperative hospitals, providing a replicable sample of practices for the public-interest, standardized landing of the national services。
