Together

Qin Su didn't do what Director Jiang said, just take a few glances and sign in the past, and check the work of other hospitals. This is not an easy thing to do, and there are too many ways to do it.

The inspection department of their hospital has carried out CNAS certification and accreditation, but the hospital they are going to inspect has not participated in this certification.

When Qin Su went back, she went to Li Minhui, the laboratory management teacher, and asked, "Director Jiang is going to the trusteeship hospital for evaluation and inspection. This matter was transferred to me. Did you send me the documents?"

Qin Su is too busy. The account of his unit's office system is also used by Li Minhui and Mr. Li. After reading the incident in the system, Mr. Li will tell him quickly if Qin Su needs to deal with it, but this time he is going to review on behalf of Director Jiang. Teacher Li didn't mention this matter in advance, so he asked this question.

Teacher Li said: "Recently, there are too many things and too busy, director, I come to work in the morning, and I haven't had time to drink saliva, and I haven't had time to look at the office system. I don't know about it."

When Qin Su heard her talk, she immediately felt sorry, because Chen Ru, another administrator teacher, had left, and now the entire laboratory only had Mr. Li as the administrator teacher.She is not only responsible for the chores of the entire laboratory, but also responsible for being his assistant, so busy that she always has to work overtime.Qin Su thought that he must recruit another person. He had already written a recruitment application to the personnel department, but so far no applicant who met his requirements had appeared. The personnel teacher was already annoying him. After all, other experiments Recruiting people in the office is already determined, and it's just going to the personnel and going through the motions. Qin Su's recruitment here is really letting the personnel cast a wide net for him and then carefully screen.The teacher in charge of personnel, if it wasn't for Qin Su's good looks, he would have slapped Qin Su in the face for saying that they have too many things to do in the laboratory.

Qin Su himself also felt that the conditions for this recruitment were too harsh, for example, he had to work for at least five years, which made countless applicants who wanted to use him as a transfer point daunting.A person with a career plan would never apply for his position here.

Qin Su apologized: "Mr. Li, I'm really sorry for keeping you too busy recently. However, the recruitment is already in progress, and someone will come to share some of it for you soon. Some things I can do by myself, I also do it myself first. The office system, I just look at it myself."

Teacher Li hurriedly said a lot of polite words to him, and then hurried out to do other things. Qin Su called the postdoctoral fellow Qin Ling to come over, saying that she had already applied for her postdoctoral fellowship and would stay in school after leaving the station, and let her do it on her own. Then go to the teacher of personnel affairs to ask what procedures she has to go through.

Qin Ling was very grateful to him, and knew that it was not easy for Qin Su to do this.After all, although there are many postdoctoral fellows, there are very few places to stay in the school, and there are still a few who can stay.

A few years ago, Qin Su couldn't have this kind of face to let the person he wanted to stay. Now he has this kind of face, but it is the accumulation of academic achievements in the past few years, and the unit is afraid that he will resign and leave, so give him this kind of face. open mouth.

Since Qin Ling wants to stay in school, she can stay in the laboratory forever, and Qin Su asked her to share a little work for Teacher Li. Qin Ling has her own projects to be busy, and before she leaves the station, she has both papers The quantity requirements, as well as the requirements for the impact factor, are not low, so her own project has already filled her with full capacity, but Qin Su has provided her with a lot of help in her work, so facing Qin Su is actually a big challenge. She graciously accepted the request of "not in accordance with the contract, but be reasonable".

Qin Su looked at the emails and notifications in the office system. In just one day, there were a bunch of unprocessed things. It took him more than an hour to deal with these things, and then contacted how to check the trusteeship hospital according to the notification. He called the secretary of his review team, who warmly welcomed him to join their review team, and then sent him a bunch of documents and forms to be read in the early stage. Qin Su faced those documents and forms, because it was the first I did this once and watched it for a while before I understood the evaluation method, and then printed out all the materials and marked the places that I didn't understand one by one.

Because it was inconvenient to ask other people, Qin Su went to the hospital in the afternoon to ask Director Jiang about it. Fortunately, the inpatient department was only a few minutes away, and he soon arrived at Director Jiang's ward, and the single ward where Director Jiang lived was also convenient for him. ask questions.

Qin Su felt sorry: "You have such an illness, and I keep disturbing your rest."

On the contrary, Director Jiang was very excited: "It's okay, just ask me if you don't understand anything. I sleep the rest of the time, and I fainted a long time ago, and I don't want to sleep. It would be better to talk to you."

Qin Su showed Director Jiang the places he had marked, and Director Jiang answered him one by one. Half an hour later, Qin Su basically figured it out, but there was still a problem.

He said: "I checked on the Internet and found that this managed hospital has a bad reputation. Why did we manage this hospital in the first place?"

Director Jiang shrugged his shoulders and said, "This is still the legacy of my predecessor... Well, you understand, he left behind. Why did we manage this hospital in the first place? Go to the review, probably to untie it, the internal information I inquired means that. That's why I said, you just go to investigate, don't have any scruples."

Qin Su sighed. Naturally, they have no say in matters involving the management.

In the evening, during the video chat with Xing Wenfei, Qin Su was dealing with matters while talking to him, and because he was so sleepy, he even yawned.

Xing Wenfei saw that he was so sleepy, and he was still typing on the computer to handle his work, so he smiled and said, "Honey, go to sleep. Get up and do it tomorrow."

Qin Su glanced at the phone. On the screen of the phone, Xing Wenfei was no less busy than him, and he was also dealing with work.Qin Su rubbed her eyes and said, "I'm going to review our managed hospital next time, and I'll be on a business trip for a week in total. I'll deal with all the other work first."

Xing Wenfei let out an "oh" and asked, "There are quite a lot of managed hospitals in your hospital."

Qin Su nodded, "I didn't know how to do these tasks before, but now I just help Director Jiang. Because there are no other high-ranking officers in the department."

Xing Wenfei said: "Will you be very tired?"

Qin Su: "It should be fine. It's just that I'm doing this job for the first time, so I'm afraid that something might go wrong."

Xing Wenfei said, "What could go wrong?"

Qin Su thought for a while and said, "There should be no problem. It's just that in this kind of thing, you have to speculate on the intention of the leader, and nothing else is fine."

Xing Wenfei said: "You still have to speculate on the leader's intentions? But it's nothing, you rate it according to the truth, does the leader dare to come to trouble you?"

Qin Su said, "That's not true."

Xing Wenfei: "So, no problem."

Qin Su said: "The XX hospital we manage, I checked, and their reputation is very bad. Probably the leader wants to untie it and no longer manage it. But I am not familiar with other members of their review expert group, and the specific situation is unknown. It’s too clear, I’ll ask them again when I go to review.”

Xing Wenfei had a hospital himself, so he was very interested immediately, and said, "I'll check this XX hospital for you, maybe I'll know more about it than you."

Qin Su stopped typing and turned her head to look at the phone, "Ah, isn't this very good?"

Xing Wenfei smiled: "What's wrong with that. I think the owner of the hospital is out of his mind. With your hospital as the backer, he has made such a bad reputation. Let's see if we can go here. Mix it up."

Qin Su was stunned for a moment, and he only said a few words. Xing Wenfei actually thought of grabbing a business to make money. He didn't know what to say for a while, Xing Wenfei continued: "Husband, it's okay , I won't involve you in it."

Qin Su: "..."

After being taken aback for a while, Qin Su smiled and said, "I'm going to bed. I'm too sleepy."

The computer showed that the time was past one o'clock in the morning, "Go to sleep quickly."

Xing Wenfei nodded: "Okay."

"Good night, Xiaowen." Qin Su said.

Seeing that he was going to turn off the video chat, Xing Wenfei hurriedly said, "Do you want to watch my..."

Qin Su looked into the camera: "What?"

Xing Wenfei smiled and said, "My abs."

Qin Su: "..." Turning off the video with a blushing face, the two of them were working while chatting via video, and two hours passed.

**

The first managed hospital that Qin Su went to with the review team of inspection experts was the one with the worst reputation.

Qin Su was on the way, and had already read the self-examination materials submitted by the hospital. They themselves wrote it very well, as if there was nothing wrong with it.

When we got to the hospital, a short meeting was held to explain, and everyone dispersed to investigate each matter.

This hospital has an infection department, which treats tuberculosis patients, so Qin Su came here, but the hospital is not big, and the laboratory department is not big. There are only seven or eight staff members engaged in microbiology testing, and they carry out some common bacteria tests. , tuberculosis is one of them.

But this hospital is different. Microbiological testing is also divided into several groups, so when I came here for inspection, I had to have people from each group.

Now this hospital is in a miserable situation. In the face of these experts with sharp eyesight and years of experience in the field of intensive research, any problem can be seen.

Qin Su silently checked the work she wanted to check against the review form for a while, and soon found many problems, or basically all of them. Looking at the things in the hospital's LIS system, she found even more problems.

After the other colleagues had almost communicated with the laboratory staff, he communicated the problems he found with the head of the department.

For example: "Why did you check the blood samples of more than 1600 patients last year for tuberculosis antibodies, and only 16 were positive for the antibodies, and for these patients, I randomly checked 20 people in the system, and the samples sent by the infection clinic were 2, accounting for 90.00% Ten, the rest are samples from inpatients in other departments in the hospital, accounting for 500%. But I checked, you have diagnosed tuberculosis, and your own report stated that there were more than 500 people, and more than 16 people, even if these [-] positive antibodies were all Including, you calculate how high your antibody test positive rate is, why do you keep using this product, the result is of no value to patients, isn't it? And you are using this product all year round! "

The person in charge smiled and said: "We also know this, but what products to buy is not up to our department, it is what we buy and what we use."

Qin Su shook his head, "Then you didn't go to protest? Your own work, the result is so bad. The first may be a problem with the quality of the product, and the second may be a problem with the quality of your work."

The other party could only smile.

Qin Su felt powerless and said, "You only carried out smear and antibody tests, didn't you?"

The other party nodded: "Teacher Qin, look, our micro-inspection department is very small, and we don't make much money. We sent a report to the leader, saying that we will allocate a larger laboratory and carry out more testing items, but the leader doesn't agree. Approved, we have nothing to do."

Qin Su didn't know what to say. Of course, everyone in each position has their own difficulties, but: "The quality of the work of the antibody just now is very poor. You agree with this result."

Naturally, the other party couldn't refute and could only laugh.

Qin Su said again: "I saw your smears, your laboratory did not keep the previous films at all, and there is no daily internal quality control record, and the quality of the samples is not high. I have read the data in your system, and your sputum smears The positive rate of the film is as low as only a few percent, and even the positive rate of the bronchoscopy is so low. The projects you carry out are all so poor. How can you ask for more testing items? You can do a good job. Your indoor laboratory What is the interim quality control doing?"

The other party was frowning, and said: "We have so few people, and the daily workload is extremely heavy, there is nothing we can do."

Qin Su didn't want to say anything more, so after filling out all the items on the form, he asked him to sign it.

The other party sighed, knowing that it would be useless to plead with him, so he signed.

Qin Su thought that his work here was over, and he only needed to hand over the form to the review team leader of the inspection team. Unexpectedly, his colleagues in the clinical infection department called him and asked him to help.

Qin Su had no choice but to rush over.

The colleague who investigated the tuberculosis department of the Department of Infectious Diseases is a young female colleague, probably because she is too well maintained. It seems right to say that she is in her twenties, and she is also in her thirties, but judging by her momentum and expression, she may be 40 years old. .

Qin Su knew her well and had a project cooperation, so the other party asked Qin Su to help out casually, and the other colleagues probably felt embarrassed to ask Qin Su to help.

Qin Su went over and asked, "Teacher Kang, what's the matter?"

Dr. Kang said: "Their medical records here are messy, I type out the list of patients who I think have problems, and you go to the LIS system of their laboratory for me, and check their test results one by one to see if they are correct. Scribbling. They actually said that the results of the LIS system cannot be found here, so you can help me to check and see what else they can say!"

Qin Su took the list and agreed.Dr. Kang's personality is even hotter than Director Jiang's. It happens from time to time for patients to complain to her after being scolded by her. It must be less psychologically burdensome to scold the doctors here than to scold the patients.

Qin Su went to the laboratory system to check for her, and found that there were indeed some problems, there were falsifications in the data, and some patients' test results were clearly negative, but the medical records were written as positive.

Qin Su took the test results back to the outpatient clinic, and Dr. Kang was really furious after seeing Qin Su's results. Coupled with other problems found, he fired at all the doctors who would be in charge of this outpatient clinic.

She withholds patients from various clinical departments in the hospital and does not refer them, and scolds the outpatient clinics for not keeping some patients who should be hospitalized or have follow-up treatment.

There is a big problem here. The outpatient clinic does not keep patients in the hospital or they cannot keep the patients for follow-up treatment. Each department of the hospital keeps the patients in their own departments for treatment. When the patients find out that they have other problems, they are not sent to the department they should go to. ...

It is completely vicious competition inside, and the outside is also a mess.

However, the inpatient department is not within the scope of Dr. Kang's examination. She scolded, and those present who do not belong to that area are just listening, and have nothing to do with her.

Dr. Kang was not ashamed to see everyone, but he was proud of the fact that it had nothing to do with him, and he was even more furious.

So I stopped scolding the problems of other departments, and only looked for the problems of this department.

"Why is the hospital's test result negative, but the patient's medical record is positive? Is this a falsified medical record? Can you take this responsibility?"

A fat doctor stood up and said: "The patient was tested in another hospital before and was positive, so we found out that it was negative here, and he was written positive in the medical record. It should be that the medical record was written irregularly. , not marked as the results of other hospital examinations. It is absolutely impossible to falsify the results."

Dr. Kang snorted coldly, "I am very convinced that I have written so many copies irregularly. What is written in your medical record, the serum TB-DNA test is positive."

She asked Qin Su: "Professor Qin, are you right?"

Qin Su had been standing silently by the side listening to Dr. Kang's anger. At this time, he could only stand up and look at the medical records, and said, "This patient should have tested positive for TB-DNA in alveolar lavage fluid. I have paid attention to this patient before." test results."

Dr. Kang: "Look at your medical records, are they all written by interns? They are written by interns. You should also check them?"

The doctors were afraid to speak.

Dr. Kang also said: "The quality of your sputum is not up to standard. The quality of your sputum is so low. You want to have a higher rate of etiological diagnosis here? And you rely on X-rays to diagnose patients, and you can do it yourself in the system. Take a look, are you 80% sure of the diagnosis? I’m sure you’re not 50% sure, so you just give the patients medication. Look at the patients in the system, many of them came for a visit. After that, I stopped coming. Tuberculosis is a disease that requires long-term treatment. These patients have not come back. Have you ever thought about the reason? Is it because your level is so poor that people can’t believe it, or your attitude is too bad. Are you willing to come back again? Why don’t you work more carefully. Anyway, you are also the top three, and you are still our managed hospital.”

Most of the people were ashamed by her scolding, and some were very unconvinced and said, "Mr. Kang, it's very boring for you to say that."

Dr. Kang sneered: "Why do you call it boring? Could it be that I deliberately embarrass you, not your own work?"

The other party said: "You are a well-known expert, of course you don't know the pain in our place. Like us, we have made a lot of efforts to make the quality of sputum left by patients higher, but the patients don't listen at all. Just spit at will. The nurses also went to persuade them, but the patients thought they were deliberately embarrassing them, so they scolded the nurses. These situations will definitely not happen in your place. When it comes to doing work more carefully, don’t we want to do our work well? Be more careful? We are not full-time tuberculosis doctors. In addition to sitting in the tuberculosis clinic, we also need to see other diseases. Every morning, we have to look at [-] clinic numbers. We start work at eight o'clock. We can't get off work at noon. After a quick meal, we have to go to another clinic. We dare not persuade those patients at all, and say a few more words, saying that we just want to make their money and don't listen to us at all. And now we are killing doctors and wounded There are so many things about the doctor, how dare we talk about it, they can see the doctor how they want, this is their right in the first place."

The author has something to say: Today I will talk about another knowledge point.

Why do multiple tests are often required to determine a certain disease.

When many patients see a doctor, they always complain that the hospital prescribes too many checklists. There are two possibilities. The first is that so many tests are needed to better diagnose the specific disease.For example, as a tester, I believe in the test results more than if the doctor tells me what is wrong with me [Of course I am also the target of harassment]. The second situation is that the hospital is really bad. I issued a checklist that does not need to be checked, just to make money.But generally the first case is more common.Because the second situation is very likely to be found out by the review, the leader may be criticized.

For example, two days ago, when we talked about tuberculosis testing, using a method called IGRA (if you have seen tuberculosis, you will probably see its product name, such as T-SPOT.TB, etc.) is better than checking antibodies. Much more accurate, but very expensive, basically hundreds of dollars.But this is only an indirect way of inspection. Diagnosis is one of the indicators of tuberculosis. It needs to be combined with other data to diagnose whether it is active tuberculosis.But even if this expensive test is done, this test may be interfered by other factors, because its principle is that Mycobacterium tuberculosis secretes ESAT-6 and CFP-10, and like Mycobacterium kansasii, These two will also be secreted, which will cause certain misdiagnosis.

Of course, this misdiagnosis is a very small matter compared to misdiagnosing tuberculosis as lung cancer, or misdiagnosing lung cancer as tuberculosis.

Therefore, it is very important to correctly diagnose what kind of disease it is. Otherwise, if you take medicine and hurt your body, but it is completely wrong, it will make the original condition worse.

Many times we have to do tests for acquaintances, or acquaintances of acquaintances. When the diagnosis is tuberculosis, they are relieved, after all, it is much better than lung cancer.

Tuberculosis can be cured. Ordinary tuberculosis (that is, non-drug-resistant) can be cured in six months to a year without affecting other life; drug-resistant tuberculosis takes longer, and the treatment of drug-resistant tuberculosis is very expensive.

So if you or your acquaintances get this disease, you must get early treatment and standard treatment, so as not to become drug-resistant tuberculosis, it will be too much to suffer.

It can also be seen here that it is very important to follow the doctor's advice.

Of course, whether the doctor's order is effective is a matter of asking both the doctor and the patient. The team I know has done research on the importance of the doctor's attitude towards the patient to the patient's compliance. The doctor's attitude will have a strong impact on the patient. role.Therefore, friends who are doctors and colleagues really need to practice Qi-nourishing Kungfu. Maybe everyone's attitude has more important effect on whether the patient is cured than the prescribed plan.

【It's free to speak, don't worry about being charged】