Notice on the dynamic service and "gate forward" work of the new crown key people

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Notice on the dynamic service and “gate forward” work of the new crown key people

Joint prevention and joint control mechanism comprehensive hair [2023] No. 4

Provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps joint prevention and joint control mechanism (leading group, command), the State Council joint prevention and joint control mechanism member units.

To give full play to the integrated management of grass-roots organizations and primary health care institutions professional services, adhere to the “early detection, early identification, early intervention, early referral”, prevention and reduction of new coronavirus infection serious illnesses, to ensure the prevention and control of the epidemic “to meet the peak of the section” smooth and orderly. Now on the current do a good job of key populations dynamic services and “gate forward” work notice as follows.

First, build a strong and tightly woven grassroots health protection line of defense

Joint prevention and control mechanisms at all levels should strengthen coordination, increase organization and dispatch, implement financial security, smooth supply channels, organize centralized procurement, to ensure that grassroots medical and health institutions are equipped with personnel, drugs, equipment in place, the necessary drugs and equipment directly to the village health room and community health service stations. To care for grassroots medical personnel and other front-line personnel in the prevention and control of the epidemic, through scientific arrangements for shift rotation, temporary recruitment, the organization of second- and third-level hospitals to send down, mutual support and other ways to ensure that grassroots medical personnel on duty and the order of basic medical services. To serve the population of 15%-20% of the standard for the primary medical and health institutions with the full allocation of the new crown virus infection symptomatic treatment of proprietary Chinese medicine, antipyretic drugs, cough medicine and antigen detection kits equipped to ensure that the institution can be used to always maintain the amount of more than 2 weeks. All localities according to the actual, timely distribution of small molecule drugs for the treatment of neo-coronavirus infection to primary medical and health institutions, to ensure that primary medical and health institutions under the guidance of higher hospitals can carry out community medical treatment. Strengthen the construction of the fever clinic, in accordance with the standard allocation of relevant facilities and equipment. In larger residential communities or villages and public facilities, to set up mobile service points and other ways to facilitate residents to obtain medicine and health services nearby.

Second, strengthen the key people package contact

County (city, district) to strengthen grass-roots manpower organization scheduling, strengthen the responsibility of the street township government, play the role of grid management, organizations to mobilize the village (neighborhood) people’s committee and its public health committee, social organizations, community workers, volunteers, etc., to the street township as a unit through the package (village), package households, package people, etc., clear grid 65 years old and above, maternity, children, people with disabilities and other key Group contact service package team. The number of people involved in the team should match the number of key groups served, and each team should designate at least one medical staff to provide professional guidance. All places should issue “health kits” for the elderly, patients with underlying diseases and other high-risk groups with serious illnesses and children in difficulty, including a certain amount of antipyretics, cough medicine, cold medicine, antigen detection reagents, masks, disinfection supplies, etc. Special attention should be paid to the elderly who are empty nesters (living alone) and those who live with disabled children only, and strengthen daily contact.

Third, take the initiative to do a good job of dynamic services for key groups

The family doctor will play the role of contacting the masses and providing active services, using non-contact methods such as cloud services, telephone, WeChat, video or face-to-face services such as door-to-door follow-up visits, to provide health services for key groups of people with red, yellow and green signs, and to achieve the “six implementations in place”: to clarify the implementation of each community grid team in place by streets and towns; to complete the survey and classification of the three types of key groups and to establish The three types of key people survey classification and establish a ledger in place; the institutions and family doctors 24-hour contact consultation telephone number to the key people or family in place; through a variety of ways to the yellow and red mark key people contact at least 2 times a week and 3 times a week respectively in place; dynamic grasp of the red mark key people basic disease and health status in place; key people infected with new coronavirus or The red labeled infected people are immediately guided to seek medical consultation and referral, the yellow labeled infected people are guided to strengthen symptomatic medication, health monitoring is conducted daily, and those whose symptoms continue to worsen or are assessed to be unsuitable for home are promptly referred for medical consultation.

Fourth, expand oxygen and blood oxygen monitoring services

All localities should equip primary health care institutions, elderly institutions with the appropriate number of oxygen bags, oxygen cylinders and oxygen machines and other equipment to ensure that they can provide timely oxygen therapy or oxygen filling services for outpatients, home treatment patients and elderly people in elderly institutions. Increase the number of finger clip pulse oximeters (hereinafter referred to as finger oximeters) to ensure that each community health service center and township health center is equipped with at least 20 or more, and each community health service station and village health office is equipped with at least 2 or more, to carry out blood oxygen saturation monitoring for patients attending the clinic and hospitalization in a timely manner. A certain number of finger oxygen meters should be equipped for each family doctor team, key population package team, elderly institutions and welfare institutions to meet the needs of rounds monitoring, visit monitoring and in-place monitoring. All localities should actively organize the distribution of finger oxygen meters for key people over 65 years old who are at risk of severe neocoronavirus infection and have mobility problems, and provide guidance on self-measurement of blood oxygen saturation at home.

V. Give full play to the role of Chinese medicine treatment

Insist on the combination of Chinese and Western medicine, Chinese medicine and accelerate the “three drugs tripartite” and other Chinese medicine in primary health care institutions equipped and used. According to the local reality and medication habits, each place should organize research to determine a number of Chinese medicine agreement prescriptions suitable for the treatment of patients with new coronavirus infection, for the common symptoms of new coronavirus infection, classification of Chinese medicine treatment plan, according to local (county, township, village) to make appropriate, evidence-based treatment. Seize the principle of “early” and “fast”, so that Chinese medicine can intervene in the early stage of neo-coronavirus infection, and timely curb the development of mild patients to heavy and critical ones.

VI. Vigorously expand pre-hospital emergency transport capacity

The county (district and city) should establish a special class for the referral and transfer of critically ill patients, expand the 120 transfer capacity and telephone seats, and implement road traffic protection to ensure that the emergency telephone number is dialed 24 hours a day, a car is dispatched, and the response time is not significantly delayed compared to daily. Strengthen the township health centers and community health service centers with ambulances, to ensure that each institution at least one, and accept the 120 unified dispatch. The county (city) governments should urge the streets and towns to implement local responsibilities, set up special posts, through the organization and guidance of the jurisdiction of enterprises and institutions, social organizations, volunteers personal vehicles, the formation of non-emergency transfer fleet, the announcement of a 24-hour hotline to protect the needs of ordinary patient transfer.

VII. Timely referral of persons at risk of serious illness

For infected patients with high risk of serious illnesses such as advanced age combined with underlying diseases, once the infection is detected, they should be promptly referred to higher level hospitals with treatment capability. For primary care patients with serious illnesses, they should be quickly and accurately identified, and according to the actual situation, oxygen should be supplied in a timely manner, active resuscitation measures should be taken to maintain the patient’s vital signs as stable as possible, and timely referral should be made in the company of medical personnel. Various types of medical and health institutions at all levels should determine the person responsible for the referral interface, simplify the referral process for seriously ill patients, establish and smooth the green channel for the referral of seriously ill patients, improve the green channel for the referral of elderly people to elderly institutions, and improve the efficiency of referral.

Eight, strengthen the training of grass-roots medical personnel

Each place should develop training programs for primary medical personnel, and carry out a variety of training such as online, offline, and lead hospitals down to lead teaching. Make full use of national, provincial, municipal and other relevant training resources, and actively develop training courses that meet local needs. Strengthen spot checks and strict training assessment to ensure the effectiveness of training, so that primary medical personnel (including rural doctors) will be proficient in the short term in grading and classifying service methods for key populations of the new crown, observation of infection symptoms, home management and treatment of infected persons, Chinese medicine rescue and rehabilitation treatment, early detection of hypoxemia, assessment and interrogation methods for respiratory distress, use of finger oxygen meters, important referral indications, and small molecule drugs Indications and correct use of small molecule drugs, etc.

Strengthen the support of the leading hospital of the medical association to the grassroots

In accordance with the principle of subdivision, the leading hospitals of urban medical groups and county medical communities should establish technical guidance teams composed of physicians who are directors (deputy directors) of the departments of respiratory medicine, critical care, pediatrics, and traditional Chinese medicine, to conduct touring guidance to primary medical and health institutions, train the standardized use of small molecule drugs and traditional Chinese medicine “three drugs tripartite”, and help improve To help improve the ability of the grassroots to prevent serious illnesses. Strengthen the coordination and deployment of human resources for health within the medical association, and solve the problem of manpower shortage in primary medical and health institutions by sinking rounds, posting personnel, and establishing telemedicine collaboration networks. Urban tertiary hospitals should provide counterpart support to county hospitals, improve the ability of county hospitals to treat severe cases of new coronavirus infections, and accept referrals of severe cases from county hospitals.

Ten, strengthen urban and rural community health education

The implementation of streets, townships local responsibility, play the role of village (neighborhood) committees, volunteers, etc., for the pre-registration of key populations, through SMS alerts, the distribution of “know card”, rural radio and other forms, so that the public know the basic knowledge of the new coronavirus infection, the consultation process, village (neighborhood) cadres and the location of primary health care institutions 24-hour consultation telephone number. Widely distribute simple and easy to use operation guide for early identification of serious illnesses and home treatment guide to guide the public to go to medical and health institutions in a timely manner when there is a tendency of serious illnesses.

XI. Real-time grasp of work dynamics

All localities should improve the monitoring mechanism for epidemic response and the operation and services of primary health care institutions in townships and streets, rural communities, and dynamically grasp the development of the local epidemic, the reception of fever clinics in primary health care institutions, the use of drugs and equipment stockpiles, the infection and attrition of medical personnel, and the services of key populations, etc. Real-time dispatching of work in the province where there are problems or work lags behind. Strengthen the statistical analysis of data and help the grassroots to solve the difficulties encountered in the work in a timely manner. Make full use of information technology to improve efficiency, reduce the burden on the grassroots, and timely reporting of dynamic data and information needed by the state and provinces and municipalities.

Twelve, strengthen the implementation of responsibility and supervision and assessment

All local joint prevention and control mechanism to strengthen organizational leadership, layers of responsibility, clear departmental responsibilities and division of tasks, to protect the working conditions. The provincial level to strengthen the supervision of the work carried out at the municipal and county levels and the implementation of responsibilities, the establishment of a work ledger, the development of a task list, a list of issues, a list of responsibilities, to ensure that everything is managed, everything has been done, do not overnight. To do a good job of grassroots dynamic services for key populations, to strengthen the “health, prevention of serious illnesses” and the effectiveness of the work carried out and related key work assessment, funding allocation, evaluation and evaluation of merit, etc. are linked to effectively play the role of assessment incentive guide.

The State Council joint prevention and control mechanism integrated group

January 3, 2023