Multi-disciplinary team（MDT） is a best model to provide the optimal diagnosis and treatment strategy for difficult and complex diseases. It is of great significance to promote the MDT diagnosis and treatment mode for improving the quality of outpatient medical service. This paper briefly introduces the origin, concept and application of MDT at home and abroad, and puts forward the directions that should be paid attention to and solved according to the problems existing in China, including promoting MDT vigorously and creating a good MDT culture. At the same time, we should continue to improve the outpatient MDT management system, develop suitable management plan, management system, workflow, quality control system, performance evaluation system for the hospital, build multi-disciplinary network information platform and establish monitoring mechanisms.
Objective To explore the application of risk assessment of nosocomial infection control in outpatient departments, so as to find out the high-risk departments and high-risk links of nosocomial infection, and to provide basis for the formulation of nosocomial infection prevention and control measures in outpatient departments. Methods The improved risk assessment tool was used to evaluate the nosocomial infection management risk in the outpatient departments of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. We evaluated risk indicators and risk levels from three dimensions: likelihood of risk occurrence, severity of consequences, and integrity of the current system. Results Among the evaluated outpatient departments, the departments with extremely high risk levels included pediatric fever outpatient department (147.8 points), pediatric outpatient department (141.2 points), emergency internal medicine department (139.4 points), and pediatric emergency department (138.8 points). The departments with high risk levels included internal medicine outpatient department (138.4 points), dermatology outpatient department (136.0 points), otolaryngology-head and neck surgery outpatient department (135.6 points), and ophthalmology outpatient department (134.0 points). The risk assessment scores of 31 outpatient departments showed a normal distribution. The evaluation results of various risk indicators showed that among the 26 risk indicators, there were 2 extremely low risk, 4 low risk, 6 medium low risk, 7 medium high risk, 4 high risk, and 3 extremely high risk. The 3 extremely high risk indicators were lack of nosocomial infection prevention and control knowledge, patients with difficult to identify diseases (air/droplet transmission) seeking medical treatment, and crowded waiting areas for patients. Conclusions The comprehensive risk assessment of outpatient departments can screen out high risk outpatient departments and find out the main risk links. We can concentrate resources on key departments, prevent key risks, and improve the efficiency of nosocomial infection control.
Under the policy background of deepening the reform of the hierarchical diagnosis and treatment system in the country, large public hospitals, as centers for the diagnosis and treatment of difficult and severe diseases, face multiple challenges such as difficulty in patient appointment, difficulty in precise diagnosis and treatment, and difficulty in continuous medical care. To overcome this series of severe challenges, West China Hospital of Sichuan University has established a “panoramic” outpatient diagnosis and treatment service system for difficult and severe diseases based on the pain points of patients seeking medical treatment. This system optimizes the entire diagnosis and treatment process through innovative measures such as pre-diagnosis “three convergences”, during-diagnosis “three guarantees”, and post-diagnosis “three connections”. It not only significantly improves the efficiency and quality of diagnosis and treatment, but also provides patients with a high-quality and convenient medical service experience, offering a practical example for large public hospitals to address the diagnosis and treatment challenges of difficult and severe diseases.
