The Construction of Essential Elements of Standard Complex and Establishment of Comprehensive Standardization Path for Community Health Services

doi:10.12114/j.issn.1007-9572.2020.00.193

Abstract

Abstract: Background　The community health services in China is still under continuous development and improvement，and the construction of its comprehensive standardization will play an important role in the urban planning and operation.As the first research and construction unit in Shanghai，Gumei Community Health Service Center in Minhang District has accumulated rich experience in this regard and achieved certain results.Objective　To carry out the construction of comprehensive standardization with community health services as the object，and summarize the relevant methods and experience of element construction and path construction in the construction process in order to provide a reference for peers to carry out relevant comprehensive standardization construction.Methods　From April to October in 2015，the overall goal of comprehensive standardization for community health services was clarified through the literature review and policy review.The overall framework of the comprehensive standardization system for community health services was formed through the systematic analysis.The relevant elements of the comprehensive standardization system was drafted through the expert consultation.From November 2015 to March 2016，the relevant elements were matched with elements in the current international and domestic standards through standard bench marking.Finally，the specification and manual of a standard construction path of the standard complex for community health services was formed through the standardized construction of experts.Results　The community health services standard complex finally constructed was divided into three basic systems：a basic standard system for general services with 6 sub-systems，including standardization guidelines，terminology and acronym standards，symbol and sign standards，and a total of 165 standards；a service guarantee standard system with 9 sub-systems，including environmental standards，safety and emergency standards，contract management standards，and a total of 196 standards；and a service provision standard system with 5 sub-systems，including service specifications，service provision specifications，and quality control specifications，and a total of 370 standards.Conclusion　It is feasible to construct a comprehensive standard complex for community health services in China.The construction of this standard complex should meet the work requirements of comprehensive standardization while embodying industry characteristics.With reference to the experience of advanced standards at home and abroad，such as the evaluating standards of the Joint Commission International，the actual environment and work requirements of community health service centers in China should also be considered.

Key words: Community health services, Comprehensive standardization, Elements, Path, Construction

摘要： 背景　我国社区卫生服务仍在持续发展完善中，以其为对象进行综合标准化建设，对其规划运行有重要作用。上海市闵行区古美社区卫生服务中心作为上海市首个研建单位，在该方面积累了较为丰富的经验并取得了一定成果。目的　以社区卫生服务作为对象开展综合标准化建设，总结建设过程中的相关要素构建和综合标准化路径构建方法及经验，为同行开展相关综合标准化建设提供参考。方法　于2015年4—10月，通过文献回顾和政策梳理，明确社区卫生服务综合标准化的总目标；采用系统分析法，形成社区卫生服务标准综合体系的整体框架；采用专家咨询法，形成社区卫生服务标准综合体系相关要素图。于2015年11月—2016年3月，通过标准对标，将社区卫生服务标准综合体系的相关要素与国际、国内各现行标准进行匹配；通过标准化专家工程建设，形成社区卫生服务中心标准综合体的标准建设操作路径规范和手册。结果　最终构建的社区卫生服务标准综合体分为3个基本体系：服务通用基础标准体系，包括标准化导则、术语与缩略语标准、符号与标志标准等6个子体系，共165个标准；服务保障标准体系，包括环境标准、安全和应急标准、合同管理标准等9个子体系，共196个标准；服务提供标准体系，包括服务规范、服务提供规范、服务质量控制规范等5个子体系，共370个标准。结论　构建我国社区卫生服务标准综合体具备可实施性，构建社区卫生服务标准综合体应当符合综合标准化工作要求，同时体现行业特征，参考国际联合委员会（JCI）评审指南等国内外先进标准体经验，还应当考虑我国社区卫生服务中心的实际环境与工作要求。

关键词: 社区卫生服务, 综合标准化, 要素, 路径, 构建

WANG Kouzhu,YANG Weina,MA Xuedong, et al. The Construction of Essential Elements of Standard Complex and Establishment of Comprehensive Standardization Path for Community Health Services　[J]. Chinese General Practice, 2020, 23(16): 2002-2006. DOI: 10.12114/j.issn.1007-9572.2020.00.193.
王扣柱,杨薇娜,马学东等. 社区卫生服务标准综合体的要素构建与综合标准化路径建立研究[J]. 中国全科医学, 2020, 23(16): 2002-2006. DOI: 10.12114/j.issn.1007-9572.2020.00.193.

References

［1］沈治平．目标引导下的路线图：试论综合标准化的标准综合体［J］．中国标准导报，2014，23（3）：46-49．
［2］国家标准化管理委员会，国家质量监督检验检疫总局．综合标准化工作指南：GB/T12366-2009［S］．北京：中国标准出版社，2009.
［3］李永斌，卢祖洵，王芳，等．社区卫生服务机构促进基本公共卫生服务均等化调查分析［J］．中国卫生事业管理，2011，28（5）：332-333，338．
LI Y B，LU Z X，WANG F，et al．Surveying the progress of community health service institutions promoting the equalization of basic public health services［J］．Chinese Health Service Management，2011，28（5）：332-333，338．
［4］中共中央　国务院关于深化医药卫生体制改革的意见［EB/OL］．（2009-03-17）［2019-08-24］．http://www.gov.cn/test/2009-04/08/content_1280069.htm.
［5］梁万年．社区卫生服务的概念、功能与意义［J］．实用全科医学，2003，1（1）：6-9．DOI：10.16766/j.cnki.issn.1674-4152.2003.01.003.
［6］解亚红．我国城市社区卫生服务：内涵、问题及思考［J］．中国行政管理，2010，26（12）：99-102.
［7］周玉华．我国社区卫生服务现状的研究分析［J］．中国医学创新，2014，11（7）：147-149．
［8］原上海市卫生局，上海市经济体制改革委员会，上海市发展计划委员会，等．关于发展上海城市社区卫生服务若干意见［Z］．2019.
［9］李涵，杨朔，张隋．社区服务标准化发展演化与战略选择［J］．中国标准化，2013，56（2）：39-41．DOI：10.3969/j.issn.1002-5944.2013.02.010.
LI H，YANG S，ZHANG S．Development evolution and inevitable tendency of community service standardization［J］．China Standardization，2013，56（2）：39-41．DOI：10.3969/j.issn.1002-5944.2013.02.010.
［10］沈治平．目标导向的标准化系统工程：综合标准化实践中的系统特征［J］．中国标准化，2014，57（8）：49-53．DOI：10.3969/j.issn.1002-5944.2014.08.15.
SHEN Z P．Target-oriented standardization system engineering：the feature of comprehensive standardization practice［J］．China Standardization，2014，57（8）：49-53．DOI：10.3969/j.issn.1002-5944.2014.08.15.
［11］马娜，张秀春，晏绍庆，等．现代服务业内涵及其标准化发展思路分析［J］．中国标准化，2009，52（8）：17-19．DOI：10.3969/j.issn.1002-5944.2009.08.006.
MA N，ZHANG X C，YAN S Q，et al．The connotation of modem service and the train of thought on its standardization development［J］．China Standardization，2009，52（8）：17-19．DOI：10.3969/j.issn.1002-5944.2009.08.006.
［12］彭磷基．国际医院管理标准（JCI）中国医院实践指南［M］．北京：人民卫生出版社，2008.
［13］谢秀丽，卢传坚，李慧，等．医院标准体系构建的理论及方法研究［J］．标准科学，2013，6（2）：39-42．
XIE X L，LU C J，LI H，et al．Theory and method of standard system construction in Chinese medicine hospital［J］．Standard Science，2013，6（2）：39-42．
［14］张霄潇，孙磊，冯雪，等．中医药标准化体系建设现状、问题与对策探讨［J］．中国中药杂志，2019，44（21）：4745-4750．
ZHANG X X，SUN L，FENG X，et al．Current status，problems and countermeasures of construction of standardization system of traditional Chinese medicine［J］．China Journal of Chinese Materia Medica，2019，44（21）：4745-4750．
［15］李宽．构建融合综合标准化的企业标准基本体系［J］．中国标准化，2013，56（6）：62-65．DOI：10.3969/j.issn.1002-5944.2013.06.014．
LI K．Establishment of enterprise standard basic system based on comprehensive standardization［J］．China Standardization，2013，56（6）：62-65．DOI：10.3969/j.issn.1002-5944.2013.06.014.

[1]	SHI Guoqing, ZHANG Yongzhe, BAI Yu, ZHAO Zixia, ZHENG Xiaomin, ZHANG Beiru. New Advances in the Treatment of Primary Membranous Nephropathy [J]. Chinese General Practice, 2026, 29(21): 3064-3072.
[2]	LI Zhenyu, ZHU Qiong, CHEN Rong, LU Jing, YU Zhijie, SHEN Fulai, SHEN Yi, FENG Yu, LIU Mei. A Single-group Community Intervention Trial on Improving the Service Efficiency of Contracted Residents Via an Enhanced Medical-preventive "Micro" Integration Service Package [J]. Chinese General Practice, 2026, 29(21): 3020-3027.
[3]	FENG Yuxi, WANG Jinjin, CAI Yi, ZHU Runzhi, ZHU Qin. Research Progress on Protein Lactylation in Kidney Diseases [J]. Chinese General Practice, 2026, 29(21): 3056-3063.
[4]	LI Wenping, CHEN Jianhua, XU Jiapei, JIN Xue, PAN Zihan, CHI Chunhua. A Scoping Review on the Empowerment of Community Elderly Health Services by Digital-Intelligent Health Management Platforms [J]. Chinese General Practice, 2026, 29(21): 2938-2949.
[5]	AN Yanhong, WANG Shidong, LI Xiaoran, GUO Jiayang, WANG Zhe, SHA Peilin, MENG Yijun, LI Xiaoxuan, SHI Xue, YU Zexing, XIAO Yonghua. Study on Risk Factors and Nomogram Prediction Model for Diabetic Kidney Disease: Based on Contrast-enhanced Ultrasound Technology [J]. Chinese General Practice, 2026, 29(21): 2995-3003.
[6]	PANG Shu, SUN ying, JIANG Chunyan. Comparison of the Effectiveness of Fried's Frailty Phenotype and the FRAIL Scale in Assessing Pre-frailty among Community-dwelling Older Adults Undergoing Health Examinations [J]. Chinese General Practice, 2026, 29(19): 2664-2670.
[7]	MAO Ruixiao, FENG Zhenzhen, LIU Wenrui, WANG Jiajia, LI Jiansheng. Analysis of the Temporal and Spatial Evolution of TCM Syndromes in Idiopathic Pulmonary Fibrosis in the Past 30 Years [J]. Chinese General Practice, 2026, 29(19): 2678-2687.
[8]	ZHAO Xinxin, SUN Xiaoting, LUO Xinhao, SUN Jin, PENG Derong, ZHENG Jialin. Research on the Localization of the Patient-centered Medical Home Model in China: Adaptation Mechanisms, Challenges, and Pathway Analysis [J]. Chinese General Practice, 2026, 29(19): 2608-2613.
[9]	JIANG Quanrui, FENG Xiang, LIU Dan, LI Tao, YANG Zhou, LI Jiangshan, LIU Xiaowei, LI Wu. Effects of Pressing Intervention on Myofascial Trigger Points in Rats Based on cAMP/PKA/P-RyR1 and Intracellular Ca²⁺ Content [J]. Chinese General Practice, 2026, 29(18): 2513-2522.
[10]	CHEN Yiping, ZHANG Jianmei, LI Yanhu, LI Rui, ZHANG Ruiping, YANG Ping. Advances in the Diagnosis and Treatment of Post-COVID-19 Condition of Myocardial Injury [J]. Chinese General Practice, 2026, 29(18): 2585-2592.
[11]	ZHANG Mingyue, HOU Yan. Research Progress of Exhaled Nitric Oxide and Alveolar Nitric Oxide in Interstitial Lung Diseases [J]. Chinese General Practice, 2026, 29(18): 2571-2576.
[12]	CHEN Yan, SHEN Dequan, SHENG Renlei, CHANG Yujie, YANG Jiaqi, DING Jie, SUN Zhifang, WANG Dahui. Influencing Factors and Importance Ranking of the Utilization of Primary-level Traditional Chinese Medicine Preventive and Health Care Services for the Elderly [J]. Chinese General Practice, 2026, 29(16): 2182-2189.
[13]	CHEN Bihua, LIN Qiyi, LI Wuhua, SU Jin, TU Liping, SHI Lan, DING Xiaoqin, YI Chuntao. The Influencing Factors and Mechanisms of the Work Output Level of Family Doctor Teams from the Perspective of Team Effectiveness [J]. Chinese General Practice, 2026, 29(16): 2167-2173.
[14]	FU Mingyuan, YU Xiaoyi, GE Caiying, KONG Min. Impaired Awareness of Hypoglycemia: Prevalence and Determinants among Community-based Patients with Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2026, 29(16): 2252-2258.
[15]	ZHENG Zelu, ZHOU Jun, LIANG Zhi, WANG Xuehui, XU Feng, LI Oujing, XIAO Hong, LIU Xiaoyu, YANG Qingmei, ZHANG Mei, LIN Na, MI Baohong, CHEN Weiheng. Comorbidity Profiles and Treatment Patterns of Osteoarthritis Patients: a Cross-sectional Study Based on Community Medical Records [J]. Chinese General Practice, 2026, 29(16): 2205-2213.