For tertiary hospitals, there is a very important indicator in the assessment project, which is the bed turnover rate. Generally speaking, the patient's hospital stay should be limited to about one week to be considered a good outcome. On the one hand, the social security fund is more stringent for patients who have been hospitalized for a long time, and after a long stay in the hospital, the social security side may conduct further review of the patient, so the reimbursement to the hospital may be delayed. On the other hand, if a large number of patients are hospitalized for a long time, resulting in the failure of the hospital's top three assessment, it will be a catastrophe for the fourth central hospital - President Song wants to receive support and preferential treatment from various departments, the current academic research cooperation in the fourth central hospital, and a large number of social funding funds, the innate conditions that can be achieved are the golden sign of "top three hospitals". If this signboard is smashed, let alone continue to develop, the Fourth Central Hospital will have to close its doors within a month - unless President Song grits his teeth and stamps his feet and fills this bottomless pit with his husband's property.

The hospital grade assessment is the third biggest nightmare for domestic hospitals. The first two are "nosocomial outbreak of infectious diseases" and "violent medical trouble". As long as it is a doctor who works in a hospital, it is a trembling hearing of it. However, the first two can also be intervened through corresponding regulatory mechanisms and even social forces. But the assessment is different - no one can rely on anyone but yourself. No one will come to help but themselves. At this time, colleagues are not only unreliable, but also have to be careful to fall into the ground, in general, the hospital attaches great importance to the level of assessment, even in the eyes of laymen to the point of incredible.

And the reason why Dean Song is so popular today is also this. It is absolutely not possible to rely on the level assessment to manage the bed turnover rate one or two months before the assessment. If you really meet a patient who needs to be hospitalized for a long time at that moment, the hospital can't just throw the patient out of the hospital for the sake of the turnover rate, regardless of the patient's life, right? In order to increase the average bed turnover rate, all other minor cases have to be discharged or transferred to a lower hospital without a full recovery. This will not only affect the patient's treatment, but also completely disrupt the treatment plan of other doctors. Therefore, as a manager, Dean Song has always asked the doctors below to "raise their ideological awareness at any time and pay attention to maintaining a high turnover rate of hospital beds". Patients who can be accommodated or accommodated, and who can be safely discharged from the hospital to continue follow-up treatment on an outpatient basis, should be discharged as soon as possible.

Although Cao Yanhua's reason for doing this is out of responsibility for patients, from the perspective of management, it is irresponsible to more doctors and patients.

Fortunately, the problem was found during the big round. Dean Song immediately made a decision and asked Ji Youfu to be discharged from the hospital this afternoon. By the way, he scolded Dr. Cao again, and happily deducted his performance bonus of 200 yuan. For Dr. Cao, being criticized is not a big deal. Anyway, that's how everyone came over - what young doctor hasn't been scolded by his superiors? But the performance bonus of 200 yuan can make Dr. Cao feel distressed for a while. Anyway, according to Sun Lien's observation, Dr. Cao Yanhua, who was deducted 200 yuan from his performance bonus, looked like a patient with severe paronychia had been trampled on his toes. The brow was furrowed enough to kill two flies without long eyes, like an old chrysanthemum that had been beaten by frost. The distortion of the face, coupled with Dr. Cao's not outstanding appearance, is really ...... Miserable.

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The big round lasted for two hours, and Sun Lien looked at this formation a little big. Dean Song is definitely planning to find out the bottom of today's trip, and every patient must be questioned in detail, and more than a dozen doctors in the emergency department have been deducted 200 yuan. In the team behind Dean Song, there were more than a dozen old chrysanthemums, and that gloomy and miserable appearance really made Sun Lien feel a lot of pressure.

This group of old seniors has been tossed like this, so when it is their turn, will they still have good fruits to eat? Sun Lien knows very well how much trouble he has caused during this time. Liu Tangchun was a good deputy director, but he was forced to self-exile and went to Africa, which was exchanged for Dean Song personally leading the team to conduct ward rounds. Not to mention that Dean Song would be mad because of this, even the dozen or so old chrysanthemums might be angry with him because of this.

Sun Lien was nervous as he followed the team to the new ward. He glanced at the room number, then sighed and walked forward.

This is Qin Ya's ward.

"Patient Qin Ya, female, 24 years old. Sun Lien began to report the information before Song Wen asked questions. "Because of a sudden coma, he was admitted to the hospital for treatment, and after regaining consciousness, he had involuntary movement of his limbs, and on the same day, he was diagnosed with moyamoya disease through MRI examination. ”

"Why haven't you been discharged from the hospital?" Song Wen's question was still the same sentence, "Isn't it okay to transfer to another hospital for treatment after being diagnosed?"

"The patient was about six weeks pregnant. Sun Lien explained the reason very smoothly, after all, he was the girlfriend of his brother Feng Ming, and he was still more concerned about Qin Ya's illness. "The obstetric department has a consultation opinion that after the eighth week the fetal state is clarified, the decision on whether to operate or not. ”

For Qin Ya, if there is surgery, then there is a chance that this child will not be saved. After all, surgery to treat moyamoya disease is essentially a craniotomy, and it also involves bypassing the brain to relieve temporary ischemia. For pregnant women who have a tooth extraction that can lead to miscarriage, the risks of this procedure are self-evident.

On the other hand, if the child's condition is stable, whether Qin Ya should risk fainting again due to cerebral ischemia and wait for childbirth is also a question that needs to be carefully considered. Although Feng Ming and the parents had long decided to protect the pregnant woman first, the final decision was still to be handed over to the newly formed family for consent. Before the eighth week, whether to perform bypass surgery first or abortion treatment first seems a little too impatient. At the same time, because of the transient ischemic attack and the existence of cerebral arteries, Qin Ya must stay in the hospital in case of sudden fainting or more troublesome cerebral hemorrhage.

"You can be transferred to a cerebrovascular hospital, right?" Song Wen didn't raise his noble hand because Qin Ya was a family member of an employee of his own hospital, and he still had to ask, "Why don't you transfer?"

"We have been in contact with the cerebrovascular specialist, but they are reluctant to accept patients because they are not able to see pregnant women. Sun Lien spread his hands and told the truth.

This is the problem with specialized hospitals, which are able to handle patients who not only fit the scope of the specialty, but also try to be as "simple" as possible and not "complex". It is entirely possible that a cardiovascular and cerebrovascular hospital has a better level of professionalism than a tertiary hospital, but they are unable to deal with conditions beyond the scope of this specialty. Their medical staff do not have the capacity to do so, they do not have the equipment to do so, and more importantly, they are not legally allowed to perform these "treatments that are not within the scope of their registration".

"Then you can't stay like this all the time, you can be transferred to a lower hospital. "Where would Dean Song accept such a simple explanation, "Immediately contact the lower level hospital, transfer the person for two weeks, and wait for the results to come back for surgery." ”

At this time, don't talk anymore, just nod honestly and admit it. After Sun Lien nodded and said that there was no problem, sure enough, the punishment of deducting the bonus also came, "Your bonus this month, deduct eight hundred." ”

Sun Lien is now hundreds of thousands of yuan a month, and the fine of 400 yuan is not worth mentioning. However, for an ordinary trainee, deducting the subsidy of 400 yuan is basically the same as chopping half a piece of meat alive. It stands to reason that Dean Song would never have given such a heavy hand to a Gui Pei - this is because Sun Lien has an extra lot of income, so Dean Song accidentally increased the fine by 400%. But unexpectedly, this fine caused a commotion.

Dean Song ...... "Several doctors in the emergency room who are usually not very eye-to-eye with Zhou Jun came forward to persuade him, "Xiao Sun has just started to treat patients, and it is inevitable that there will be some inconsiderate places in the middle......" Sun Lien didn't react to what these colleagues were doing at first, and after listening to three sentences, he realized that these people were here to intercede for him.

"Xiao Sun is a regular trainee, you deduct his 800 bonus in one go, and he won't have to come to the rescue room hungry next month?" Dr. Cao Yanhua, who was deducted two hundred in a row, also came over and persuaded him, "We will criticize him when we go back and ask him to write a 2,000-word self-review." Fines for things...... Do you want to stop thinking about it?"

Dean Song listened to everyone's pleas with a straight face, and handed a look to Sun Lien, they don't know that you are a rich man now?

Sun Lien responded wordlessly to this look, I thought you would tell them about it.

How bitter the emergency doctor is, only the doctor in the emergency department knows. And the most bitter thing in the emergency department must be the regular training doctor who is about to be deducted from the bonus of 800 yuan.

Sun Lien may have many deficiencies as a doctor, but it can be seen from the way everyone pleads that this kid's popularity is really good. Maybe it's because everyone is a poor person who is about to be deducted 200 yuan, or maybe because in the eyes of the doctors who have survived the training period, deducting 800 wages is forcing people to starve. In short, everyone was excited for a while. Even Dean Song couldn't resist the pressure, and after glaring at Sun Lien again, she waved her hand at everyone, "What are you arguing about? She paused, and re-reported a number, "Two hundred." ”

Before everyone was ready to clamor again, Dean Song presciently added, "If you are still not happy, then these two hundred yuan will be deducted from your salary!"

The scene suddenly fell silent.

Then Cao Yanhua grinned and nodded, "Okay!"

The other doctors laughed too, "Okay!"