Sunday, June 1, 2008

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。

7 comments:

Samuel Goh Kim Eng said...

For chronic diseases it's prevention and/or cure
With basic medical education for sure
Being helpful for lifestyle more pure
Teaching patients how to better battle and endure

(C) Samuel Goh Kim Eng - 010608
http://MotivationInMotion.blogspot.com
Sun. 1st June 2008.

iamataxpayer said...

why don't your party change to a new name? because i don't see you all doing thing for chinese but than doing it for "$"!

M$A is not for chinese, can't even dare stay firm to tell your MASTER (read: M$A's master, not chinese) that chinese need a new school??

So suggest to change name to M$A, up to you to think what is the "$" stand for.

Samuel Goh Kim Eng said...

For chronic diseases it's prevention and/or cure
With basic medical education for sure
Being helpful for lifestyle more pure
Teaching patients how to better battle and endure

(C) Samuel Goh Kim Eng - 010608
http://MotivationInMotion.blogspot.com
Sun. 1st June 2008.

pharmacyproduct2u said...

放眼世界各国,很奇怪的现象是医院越多,病人越爆满。追根究底还是人类吃错食物。看来USDA Food Pyramid应该是错的食物概念。

collosos said...

In actual reality, there can only be two to choose from for the Malays.

Ultra-right wing Capitalism vs Left-wing liberalism.

Centralism or Moderates are for wimps or people who are unsure or lack of confidence or ignorant and confused people.

If you believe in duality of cosmic forces that exists in our universe, then read on.
The ancient Egyptians and Chinese believe the existence of such forces.

Here are the examples:

Yin vs Yang

Negative vs Positive

Dark vs Light

Proposer vs Opposer

Arts,Social Science, Business students vs Science and Technology students

The art way of attaining power vs The science way of attaining power

Majority-Democracy vs Minority-Socialism

Consumer society vs Producer society

Capitalists vs Production Workers

Profits before people vs
People before profits

Capitalism vs Socialism

Female vs Male

Cold vs Hot

Politicians vs Technocrats-leaders

An inverted pyramid human food chain vs Pyramid human food chain

USA vs China

West vs East

Water-Wood vs Fire-Earth

Bankers-Water vs Intellectuals-Fire

Ketuanan Melayu Ultra-Kapitalist-UMNO-BN
vs
Ketuanan Islam Kebajikan-PR

You can only choose one.
There can only be one that can be placed at the top of the human food chain in your society or nation.

So choose wisely.

dranony said...

If the problem is that of doctors at the government polyclinics being swamped with too many patients to even properly control the blood pressure by more frequent and regular visits (at least initially) to titrate the dose such that blood pressure is adequately controlled, how then are nurses going to help by detecting complications?
Or is the plan for nurses to manage the blood pressure as well as to detect complications?
Might as well get nurses to run the hypertension and diabetes clinics.
True, that education of nurses is important. But then so is education of patients. Should we then be passing the buck to patients instead, and just give them handouts and written literature on how to recognize complications, when the bp is not even well controlled, but yet the patients are told to return for review in 3 months?

eColi said...

Delegating such role of detecting health complications to the responsibility of nurses or paramedics is not a good idea. For your information, there is also an acute shortage of nurses. I have also encountered some nurses who are specially trained in certain field (e.g. diabetic counselor nurse)but left the job later due to promotion or transfer. Therefore, it will not solve the main core issue. The main problem of our OPD or specialist clinics in managing the chronic patients is the shortage of doctors as well as overcrowding of patients. Therefore, outsource patient care for chronic illnesses to private clinics, could be considered.

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