Notice on Doing a Good Job in Dynamic Service and "Forward Work" of Key Groups in COVID-19

Notice on Doing a Good Job in Dynamic Service and "Forward Work" of Key Groups in COVID-19

Joint prevention and control mechanism [2023] No.4

All provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps joint defense and control institutions, and all members of the State Council joint defense and control institutions:

In order to give full play to the role of comprehensive management of grass-roots organizations and professional services of grass-roots medical and health institutions, adhere to the principle of "early detection, early identification, early intervention and early referral", prevent and reduce the occurrence of severe infections in COVID-19, and ensure the smooth and orderly "peak-shifting transition" of epidemic prevention and control, we hereby notify you of doing a good job in dynamic services for key populations and "moving forward the gateway" as follows:

The first is to build a strong grassroots health defense line.

Joint prevention and control mechanisms at all levels should strengthen overall coordination, increase organization and dispatch, ensure funding, smooth supply channels, organize centralized procurement, and ensure that personnel, drugs and equipment in primary medical and health institutions are in place, and basic drugs and equipment directly reach village clinics and community health service stations. We should pay attention to the frontline staff of epidemic prevention and control, such as primary medical staff, and ensure the on-the-job rate of primary medical staff and the order of basic diagnosis and treatment services through scientific arrangements for job rotation, temporary recruitment, organization of secondary and tertiary hospitals, and mutual support. According to the standard of serving 15%-20% population, primary medical and health institutions should be equipped with Chinese patent medicines, antipyretics, cough medicines and antigen detection kits for symptomatic treatment of COVID-19 infection, so as to ensure that the dosage of drugs in institutions is always kept above 2 weeks. According to the actual situation, all localities will timely distribute small molecule drugs for the treatment of COVID-19 infection to grass-roots medical and health institutions to ensure that grass-roots medical and health institutions can carry out community medical care under the guidance of higher-level hospitals. Strengthen the construction of fever clinics and complete relevant facilities and equipment according to standards. In large-scale residential areas or villages and public facilities, mobile service points should be set up to facilitate residents to obtain medical and health services nearby.

Second, strengthen the contact between key groups.

Counties should strengthen grassroots manpower organization and dispatch, strengthen the responsibility of street and township governments, play the role of grid management, and organize and mobilize villagers' committees and their health committees, social organizations, community workers and volunteers. And ensure that key groups in the grid, such as the elderly over 65, pregnant women, children and the disabled, contact the service support team in the form of package, household and package. The number of people involved in the insurance team should match the number of key personnel contacted, and each team should designate at least 1 medical staff to provide professional guidance. All localities should distribute "health packages" to the elderly, patients with basic diseases and other severely high-risk groups and children in distress, including a certain number of antipyretics, cough medicines, cold medicines, antigen detection reagents, masks and disinfection supplies. We should pay special attention to empty nesters and elderly people who only live with disabled children and strengthen daily contact.

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

Give full play to the role of family doctors in contacting the masses and providing active services, and use non-contact services such as cloud services, telephone, WeChat, video, or face-to-face services such as on-site follow-up to provide health services for key people with solid red, yellow, green and yellow signs, so as to achieve "six implementation in place": take streets and towns as units, and make sure that each community grid guarantee team is in place; Complete the investigation and classification of three key groups, establish a ledger and put it in place; Inform key people or families of the 24-hour contact telephone numbers of institutions and family doctors and put them in place; Contact with key people with yellow and red signs at least twice and three times a week through various means; Dynamically grasp the basic diseases and health status of key populations with red signs, and put them in place; When the key population is infected with COVID-19 or the basic disease is aggravated, timely guidance and disposal are in place, the patients with red signs are immediately guided to seek medical treatment and referral, and the patients with yellow signs are strengthened with symptomatic medication guidance and daily health monitoring. If the symptoms continue to worsen or are not suitable for home after evaluation, they will seek medical advice and referral in time.

Fourth, expand the service of oxygen inhalation and blood oxygen monitoring.

All localities should equip grass-roots medical and health institutions and old-age care institutions with an appropriate number of oxygen bags, oxygen cylinders, oxygen generators and other equipment to ensure that they can provide oxygen therapy or oxygenation services for outpatients, patients treated at home and the elderly in old-age care institutions in time. Increase the number of finger-clamp pulse oximeters, ensure that each community health service center and township health center is equipped with at least 20, and each community health service station and village clinic is equipped with at least 2, so as to monitor the oxygen saturation of medical and hospitalized patients in time. It is necessary to equip each family doctor team, key population support team, pension institutions and welfare institutions with a certain number of oxygen detectors to meet the needs of patrol monitoring, visit monitoring and on-site monitoring. All localities should actively organize the distribution of finger oximeters to key people over the age of 65 who are at serious risk of COVID-19 infection and have difficulty in moving, and guide them to self-test their blood oxygen saturation at home.

Five, give full play to the therapeutic role of traditional Chinese medicine

Adhere to the combination of traditional Chinese and western medicine and traditional Chinese medicine, and speed up the preparation and use of traditional Chinese medicine preparations such as "three drugs and three parties" in grassroots medical and health institutions. According to the local conditions and medication habits, all localities should organize research to determine a batch of agreed prescriptions of traditional Chinese medicine suitable for the treatment of infected patients in COVID-19, put forward a treatment plan of traditional Chinese medicine according to the common symptoms of COVID-19 infection, and treat them according to local conditions and syndrome differentiation. Grasp the principles of "early" and "quick", let Chinese medicine intervene as early as possible in the early stage of COVID-19 infection, and prevent mild patients from developing into severe and critical patients in time.

Six, vigorously expand the pre-hospital emergency transport capacity.

In the county, it is necessary to establish a special class for referral and transfer of critically ill patients, expand 120 transportation capacity and telephone seats, implement road traffic guarantee, ensure that emergency calls can be dialed 24 hours a day, and the response time of vehicles is not significantly delayed compared with daily ones. Strengthen the ambulance equipment in township hospitals and community health service centers, ensure that each institution has at least one ambulance, and accept the unified dispatch of 120. County-level governments should urge streets, towns and villages to implement territorial responsibilities, set up special posts, organize and guide enterprises, institutions, social organizations and volunteers' personal vehicles, set up non-emergency transport convoys, and publish 24-hour hotlines to ensure the transport needs of ordinary patients.

Seven, timely referral of severe high-risk personnel.

For the elderly with high risk of serious diseases such as basic diseases, once infection is found, they should be referred to a superior hospital with diagnosis and treatment ability in time. Critical patients who are first diagnosed at the grass-roots level should be identified quickly and accurately, given oxygen in time according to the actual situation, actively take rescue measures, try to keep the vital signs of patients stable, and be referred in time accompanied by medical staff. All kinds of medical and health institutions at all levels should determine the person responsible for the referral connection, simplify the referral process of critically ill patients, establish and smooth the green channel for referral of critically ill patients, improve the green channel for referral of the elderly in old-age care institutions, and improve the referral efficiency.

Eight, strengthen the training of primary medical personnel.

All localities should formulate training programs for primary medical personnel, and carry out online, offline and lead hospital teaching. Make full use of national, provincial and municipal training resources and actively develop training courses that meet local needs. Strengthen spot checks, strict training and assessment, ensure the training effect, so that grassroots medical staff can master the classification service methods of key populations in COVID-19, observation of infection symptoms, family management and treatment of infected people, treatment and rehabilitation of traditional Chinese medicine, early detection of hypoxemia, assessment and consultation of dyspnea, use of oxygen indicators, important referral indications, indications and correct use of small molecule drugs in a short time.

Nine, strengthen the medical association to lead the hospital to support the grassroots.

According to the principle of regional package, the municipal medical group and the county medical leading hospital should establish a technical guidance group composed of chief physicians such as respiratory department, intensive care unit, pediatrics department and Chinese medicine department. Tour guidance to primary medical and health institutions, training and standardizing the use of small molecule drugs and traditional Chinese medicine "three drugs and three parties" to help improve the first-level prevention ability of serious and serious diseases. Strengthen the overall deployment of health human resources within the medical association, and solve the problem of manpower shortage in primary medical and health institutions by sinking rounds, sending personnel and establishing a telemedicine cooperation network. Third-level hospitals in the city should provide counterpart support to county-level hospitals, improve the ability of county-level hospitals to treat severe COVID-19 infection, and accept the referral of critically ill patients in county-level hospitals.

Ten, strengthen health education in urban and rural communities.

Implement the territorial responsibility of streets, towns and villages, give full play to the role of village committees and volunteers, and let the masses know the basic knowledge of COVID-19 infection, the treatment process, and the 24-hour consultation telephone number of village cadres and local primary medical and health institutions through SMS tips, issuing "knowing cards" and rural broadcasting. Widely distribute simple and easy operation guidelines for early identification of serious diseases and family treatment guidelines to guide the masses to seek medical treatment in medical and health institutions in time when facing the risk of serious diseases.

Eleven, real-time grasp the work dynamics

All localities should improve the monitoring mechanism of township streets, rural community epidemic response and primary medical and health institutions' operation services, and dynamically grasp the development of local epidemic situation, the reception of fever clinics in primary medical and health institutions, the use of drugs and equipment reserves, the infection and attrition of medical personnel, and the service of key populations. , and real-time scheduling of problems or work lags in the province. Strengthen statistical analysis of data, and help the grassroots to solve the difficulties encountered in their work in time. Make full use of information technology, improve work efficiency, reduce the burden on the grassroots, and report the dynamic data and information needed by the country, province and city in time.

Twelve, strengthen the implementation of responsibility and supervision and assessment.

The local joint prevention and control mechanism should strengthen organizational leadership, compact responsibilities at different levels, clarify departmental responsibilities and division of tasks, and ensure working conditions. At the provincial level, it is necessary to strengthen the supervision of the implementation of work and responsibilities at the city and county levels, establish work ledgers, and formulate task lists, problem lists, and responsibility lists to ensure that everything is managed, pieces are available, and things do not last overnight. It is necessary to link the current situation and effectiveness of doing a good job in dynamic service for key groups at the grassroots level and strengthening the work of "health care and prevention of serious diseases" with the assessment, fund allocation and evaluation of related key work, and give full play to the guiding role of assessment and encouragement.

Joint prevention and control mechanism in the State Council

65438+2023 10 _