Chronic Diseases/ 规范化检验防并发危机

I have read that patients with chronic disease like diabetes are to be outsourced to private doctors to reduce waiting time. It looks like a knee jeck reaction to the problem. About 30 percent of the patients in outpatient clinic in government hospital are hypertensive and diabetic. It cannot be denied that these 2 chronic diseases are badly managed.

Often the attending doctors after a very casual routine check of the patient will then prescribe medication by scrambling “repeat above”. Since there are chronic diseases affecting all major organs and with it complication, an important aspect is to be able to detect its complication at its initial stage. Unfortunately, this is often not done. Outsourcing private doctors will not solve this problem. Developing a standardized format in order for the symptoms and signs of this complication can be detected early, then nurses can be specially trained to handle these part of the job and presently. Some nurses in the hospital are pretty good at this except there are inadequate of nurses. I instructed that this format to be developed and special nurses be trained. As to its implementation, I have no idea after I have left. Nurses who are properly trained are often more efficient than the busy General Practitioner. Only when there are early signs and symptoms of complication, then it should be referred to a physician.

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卫生部表示考虑将那些患有长期疾病或非急病患者送往私人诊所接受治疗，以缩短在医院就诊病人的候诊时间。

统计显示，医院门诊部的病人当中，约30％为糖尿病和高血压患者，无可否认的，这两组病人在医院所受到的对待并不太理想。通常，当病人到医院跟进治疗时，医生会为病人进行例常检查，然后一如既往般开药。

长期疾病或慢性疾病会影响人体的主要器官，并引发不同的并发症。因此，在病发初期及早发现或检测其并发症状时相当重要的。但病人和医生比例不成正比，医生无法应所有病人的需求一一执行。

因了解外包计划（outsource）并不能解决上述问题。因此，卫生部已制定一份规范化的并发症体检表格，由受训的护士为这些长期疾病病患进行检测。如果病人出现病发症状，则立即交由内科医生做进一步检验。此做法不但能协助和减轻医生的工作，更重要是可定时观察病人的病情，及早发现并发症状，减低病人出现并发感染得危机。

当然，执行前我们必须确保有足够的受训护士。在我离开卫生部以前，这项计划的研究和策划已将近完成，我也指示部门在各医院遴选和培训护士。至于何时会落实，我也非常关切。