Nowadays, many hospitals advocate humanized management, which is people-oriented. Every service can only improve service quality and patient satisfaction by starting from the convenience of patients. The service concept of "people-oriented" is a significant breakthrough in hospital service and management concepts. The author combines his 7-month study at Shizuoka Prefectural General Hospital in Japan and his personal experience of visiting medical institutions such as the Shizuoka Cancer Center, to gain a close understanding of how Japanese medical services respect, understand, and care for patients, and how they provide humanized and warm services. By drawing inspiration from the humanistic management and service of Japanese hospitals, we can inspire the improvement of hospital management quality and reform and innovation.
Humanized medical environment
A warm medical atmosphere. The outpatient hall and corridors of the hospital, as well as the aisles of various consultation rooms, are adorned with various landscape paintings or calligraphy, allowing people to immerse themselves in the beauty of natural scenery and the blessings of safe recovery, forgetting the pain, tranquility, and feeling care. On the windowsills and bookcases of various medical consultation rooms, nursing desks, outpatient clinics or wards, various cute handicrafts or artificial flowers such as stuffed animals and dolls are placed, making the originally mysterious and even frightening medical environment full of warmth.
Obvious signage within the hospital. Entering the outpatient hall, there are enthusiastic and proactive medical guides from service personnel. At each intersection of the hospital, arrows and road signs of different departments are marked with different colors in all directions from the ground, walls, to the ceiling. Patients and their families who can read can easily find the consultation room or department they want to go to with the guidance of road signs. I have hardly encountered the common situation where medical staff in domestic hospitals are pulled by patients every three to five times to ask for directions.
Considerate convenience facilities. The hospital's outpatient hall, emergency room entrance, and many public places such as stairs and elevators can see neatly arranged bed type carts, wheelchairs, luggage carts, and child carts. Patients can use these transportation tools for free during the medical treatment process. In addition, the hospital has placed public rain gear and plastic bags in these public places for emergency use by patients.
Scientific architectural structure. The hospital adopts an accessible design concept to arrange a road structure that extends in all directions within the hospital. Various carts and wheelchairs can easily and smoothly reach every consultation room and ward in the hospital. Not only does it ensure the fast and convenient transportation of patients, but it also reduces the potential adverse effects of vibrations during transportation on patients. In addition to designing accessible passages and handrails specifically for people with disabilities, the hospital toilets are also equipped with nurse call devices to prevent accidents for patients during toileting.
Family style special ward. Efforts should be made to create a family oriented environment for some long-term hospitalized patients in hospitals. A public kitchen has been specially set up in some special wards to provide convenience for family members to visit and cook meals; The ward has an activity room equipped with pianos, books, magazines, and handicrafts. Patients with stable conditions can chat, relax, and even engage in small-scale singing, dancing, and other entertainment here; Even when hospitalized patients are exposed to saline, they are not "confined" to the hospital bed due to treatment. Patients can freely move around the ward with a wheeled saline rack equipped with an infusion pump. The configuration of a regular ward is a small refrigerator for each patient, a TV set, and headphones (patients can watch TV without interfering with each other), and a small safe is installed in a fixed cabinet drawer. The end-of-life care ward not only has regular ward configurations, but also has specially arranged rooms for family accommodation in the ward, providing care and support to end-of-life patients who particularly need emotional support.
Harmonious doctor-patient relationship
A humanistic doctor-patient relationship. Medical staff treat patients with genuine respect and sympathy, just like their own family members. A doctor visiting a ward communicates with patients like visiting relatives and friends, observing their condition and understanding their emotions. At the same time, they politely greet their families, communicate with them, and seek cooperation. Medical staff politely use honorific names for patients and never use the patient's bed number as their title. Even when doctors and nurses take over internal shifts, they still refer to patients as Mr. or Ms. The nurse always maintains a smiling service and politely receives every patient with respect and courtesy. Medical staff should explain any medical treatment to patients in advance, demonstrating their care and respect for them everywhere. Patients' respect and trust in doctors often naturally manifest, and whether in hospitals or in society, medical staff are a profession that is respected and appreciated. This kind of mutual courtesy and respect, mutual trust and integrity between doctors and patients is a friendship and comrade relationship full of human feelings.
Comprehensive intervention nursing services. From the moment the patient enters the ward, the responsible nurse provides detailed ward introduction, hospitalization precautions, nursing service items, and other admission services, as well as an hospitalization manual. Throughout the entire hospitalization process, patients will also receive specialized guidance related to the disease. Nurses in regular wards have regular rounds twice a day, while there are regular rounds and call responses during other times. Each patient has a nursing observation record every day, which is completed by the nurse during the ward round. The nurse is required to be familiar with the patient in charge, and usually the head nurse and responsible nurse in the ward can remember the name of each patient. In addition to medical care, nursing services also provide a large amount of daily care, such as haircuts, shampoos, body rubs, and showers for patients with mobility difficulties, and providing a horizontal shower machine for patients who are seriously ill and bedridden, elderly, and weak; Provide accompanying care for patients undergoing various instrument examinations, such as undergoing endoscopic examinations with a dedicated escort. Cover the patient with blankets during the examination and take care of their recovery and rest after the examination. When a patient is discharged from the hospital, the nurse should provide guidance on discharge to the patient.
A team of clerks with special responsibilities. In addition to professional medical services, the ward also has a team of clerks with cultural qualities, mainly young women. The job responsibilities of a clerk are to provide assistance beyond medical services, such as assisting in handling patient admission and discharge procedures, receiving visitors, answering phone calls, and other daily affairs of the department. The biggest characteristic of a clerk's job is to accompany patients and serve them at any time. They transport patients to the medical consultation or examination room, and have friendly conversations with patients to comfort their daily life issues. Good words are better than good medicine, so the assistance of the clerk sometimes has a physical and mental therapeutic effect that medical methods cannot achieve, alleviating the patient's tension and relieving the worries of the patient's family.
A standardized and orderly medical appointment system. In Japan, known for its high work pressure and fast pace of life, the concept of time is also reflected in medical services. Both outpatient and inpatient appointments have a standardized and comprehensive appointment system. As long as patients seek medical attention on time, the hospital ensures that patients can see the agreed doctor at the agreed time. The appointment system greatly reduces the waiting time consumed by patients outside of diagnosis and treatment, and also greatly optimizes the hospital's medical environment, allowing patients to enjoy high-quality services in both time and environment.
Respect the rights of patients and protect personal privacy. Both the patient list in the doctor's office and the bedside card in the ward only have the patient's name and not the patient's name. What kind of illness a patient suffers from and the severity of the illness are kept confidential as patient privacy, and hospitals and medical staff have no right to disclose it. During the medical process, any examination that exposes the patient's body must be isolated from unrelated personnel (usually by pulling up the curtain). Even in front of the medical staff conducting the examination, efforts should be made to reduce the exposure area of the patient's body. For example, during colonoscopy, the hospital will provide disposable pants with open crotch. Patients have the right to autonomy in the inpatient ward. They can paste their favorite pictures or family photos on the walls of the ward, and place objects such as dolls and toy dogs on the tabletops and cabinets of the ward. Adults are no exception, and daily necessities are also freely arranged according to the patient's wishes and convenience.
Comprehensive medical services
Advanced medical equipment. First-class medical technical personnel and first-class medical service attitude need to achieve first-class medical quality and service effectiveness on the first-class medical instrument and equipment platform. Japan's advanced technological level has enabled the most advanced medical equipment to be first applied in clinical practice, reflecting humanized medical services from the practical results of early relief of patient pain. Japan's strong economic foundation enables medical institutions to have sufficient medical equipment resources, ensuring that everyone enjoys first-class medical services. For example, in Japan, endoscopes are used for each patient, and other contact devices are also disposable. Significantly reducing cross infection in the hospital and relieving patients' concerns. Patient oriented humanized services are demonstrated as a strong technological and material foundation.
Networked information management. The hospital's networked information management system greatly reduces the incidence of errors and accidents. The hospital establishes a unique information code for each patient. From the moment the patient is admitted, they wear a "patient identification tape" on their wrist with their name, hospitalization number, and computer barcode. Before any examination or treatment, medical staff will double check the patient's name and the "identification tape" on their wrist. In the process of medical services, hospitals design various blood and fecal test forms (including test tubes), special examination forms (such as pathology forms), and clinical treatment forms (such as oral medication, intravenous infusion, and blood transfusion) as unique computer barcode documents for patients. Medical staff not only rely on manual double checking of patient names, but also add a network verification program through computer card swiping, and even encounter elderly and weak patients with hearing impairment and language difficulties, Not afraid of identity verification issues. The portable laptops equipped by medical staff can not only input patient information into the network information database at any time, update electronic medical records at any time, but also swipe and verify computer barcodes at any time. The injection syringe is labeled with a computer barcode with the patient's name and medication name, and various infusion bottles that have already been injected with medication and transfusion bags that are ready for transfusion are also labeled with the patient's name and computer barcode. The construction of hardware such as computers and networks has built a convenient and accurate patient information management platform for humanized medical services.
Medical quality is the lifeline of hospitals and also the lifeline of patients. Only with medical quality and medical safety can hospitals provide humanized services and patients enjoy humanized services. In Japan, the Hospital Quality Management Committee assumes the responsibility of medical quality control. The committee shall revise the standardized diagnosis and treatment steps for various common diseases according to disciplinary organization, including diagnostic procedures, precautions, standardized medication, etc; Doctors in various departments strictly follow the "manual" provided by the Quality Management Committee for diagnosis and treatment operations. In addition to strictly following the quality management diagnosis and treatment procedures by medical staff, strict management is implemented for drugs, especially anesthetics, in the ward. Each ward is also equipped with a pharmacist responsible for or assisting in the quality supervision and management of drugs. While strengthening quality control, hospitals do not obscure the possibility of medical accidents. The hospital has a medical safety room specifically responsible for accidents (or errors), prevention of hospital infections, safe blood transfusion strategies, and rational use of antibiotics. Each ward has dedicated personnel responsible for registering various major and minor errors. The medical safety room regularly summarizes and analyzes the results on a monthly and annual basis, and provides feedback to medical staff to propose new preventive measures, continuously preventing accidents from happening through prevention systems and prevention systems, Provide humanized and reassuring services to patients.
Transforming the medical environment and creating a warm atmosphere of humanistic care
The humanistic neon enclosure, hospital signage, convenient facilities, accessible buildings, and star rated services all create a humanized medical environment, which directly affects the diagnosis and treatment effectiveness and medical mood of patients. From the construction of Japanese humanized medical environment, we are inspired to pay attention to the importance of humanistic care and service concepts in the construction of hospital environment. We need to consider creating a convenient and comfortable medical environment for patients while building taller, larger, and more beautiful large hospitals. Create accessible passages to provide convenience for people with disabilities and patients with difficulty walking. Reasonably designing the medical treatment process not only facilitates patient consultation, but also helps to save time for critically ill patients. Implement optimized and beautified "environmental engineering" to achieve flowers, grass, and greenery. The consultation room and ward should be designed as indoor homes and outdoor gardens, creating a warm medical environment. Medical staff should have a generous and dignified appearance, a warm and sincere attitude, and a friendly and smiling service to alleviate patients' nervousness, alleviate the pain and psychological pressure caused by the disease.
Change doctor-patient relationship, respect patient rights and personal privacy
The rights of patients include equal medical treatment, disease awareness, information, and privacy protection. In the process of diagnosis and treatment, although medical personnel are in an active dominant position in technology, they need to avoid a sense of superiority. Patients are in a passive obedient position in terms of knowledge, so the hospital must supervise whether medical personnel uphold patient rights in their services.
Hospitals and doctors should establish more institutionalized communication with patients and their families, accurately introduce the condition to patients, and patiently explain medical information; Discuss with patients the pros and cons of different treatment options (such as surgical and non surgical treatment) and the likelihood of different outcomes; From the perspective of patients, consider the time, cost, and family impact required for disease treatment and rehabilitation, and help patients make the most suitable choices based on their own condition and family background. Only by establishing a cooperative relationship full of sincerity and mutual respect between doctors and patients can patients feel at ease and doctors increase their confidence, which is the best embodiment of humanized medical services.
Hospitals and doctors need to change the "exposed" medical practice of "one person diagnosis and treatment, multiple people watching". Examinations of exposed bodies should try to minimize exposure by covering patients with curtains or screens. Strictly abide by professional ethics and confidentiality for illnesses involving personal privacy. In medical activities, it is necessary to change the impolite habit of calling the patient's bed number instead of the patient's name. We should respect the personal habits of patients, and the bedside table and cabinet in the ward should allow patients to freely place daily necessities. We should change the military camp style requirement of "one bottle and one cup at the bedside" fixed placement in the past, and prioritize patient comfort, convenience, and benefit for recovery.
Improve service philosophy and establish a people-oriented mindset
Comparing the quality of medical services in Chinese and Japanese cities, we do not lack "hard power", but rather "soft power". Especially in the economically developed eastern region, the difficulty in fierce competition in the medical market is no longer the construction of hardware, but the improvement of software. Whoever wins patients wins the market, and whoever wins the development of the hospital. Hospitals must establish the fundamental purpose of putting people first, and regard patient satisfaction as the management philosophy and practice guidelines.
On the basis of continuously improving hardware equipment, hospitals should continuously create new measures for convenience, establish networked management, simplify medical procedures, increase service windows, and shorten waiting times. Reasonably layout the diagnosis and treatment process in the outpatient department, use human resources and physical facilities such as medical guides and guide signs, and maximize the convenience of patients. Promote appointment outpatient services and establish smooth green channels.
Hospitals should embody people-oriented approach in environmental construction and service support. The hall and consultation room should be carefully decorated with civilized blessing slogans, allowing patients to experience a friendly, warm, and valued atmosphere in the hospital, and allowing medical staff to unconsciously cultivate professional habits of respecting, helping, and facilitating patients. The hospital provides free convenient services such as wheelchairs, stretchers, and boiling water in public places. New or renovated hospitals must consider logistics service projects, such as 24-hour hot water supply, establishment of small supermarkets, self-service bookstores, automatic safes, hair salons, and photo studios; The ward has activity rooms and patient clubs, children's playgrounds in pediatrics, family delivery rooms in obstetrics, and family rooms for end-of-life cancer patients.
Hospitals should strive to develop innovative, high-tech, and cutting-edge medical research while vigorously developing and introducing various minimally invasive, painless, practical, and advanced clinical technologies, such as painless abortion, painless gastroscopy (colonoscopy), and new laparoscopic surgeries, to provide high-quality and humanized medical services to patients with first-class technology.
Hospitals should strengthen professional ethics and knowledge training for their workforce based on people-oriented and patient satisfaction. Especially, employees should be organized to learn emerging edge disciplines such as psychology, sociology, and ethics to adapt to the new medical model and comprehensively meet the needs of patients. Win the trust of patients, win the praise of society, and gain a broader space for hospital development.
