On the Integrated Solution
to Rapidly Improve
Traditional Medical Service Capability

Abstract
The theory on rapidly improving traditional medical service capability, first proposed by Mr. Jian Di, details a methodology to rapidly integrate traditional medicine into mainstream medicine (also known as western medicine) in China.  

There are two kinds of legally permitted Traditional Chinese Medicine (TCM) diagnosis and treatment modes. The first is diagnosed and treated by a doctor. The second is diagnosed by a doctor and treated by a nurse. The research shows that the second mode can be accepted and implemented by hospitals more quickly and effectively with greater success rates, and much higher patient satisfaction.  

Jianhe TCM hospital is the first in China to implement this theory. The consultants analyzed the patients’ medical record information to determine who had received TCM treatment. Based on the analysis, they provide an integrated solution proposal according to the new theory. The solution was accepted and implemented by the client. Medical service capability was greatly improved within few months. 

Keywords: TCM; hospital; medical service.

1. Background of the theory
1.1 Worldwide
On May 25, 2019, the world health organization adopted the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems ICD-11. The traditional medical disease-diagnosis which originated in ancient China and now widely used in China, Japan, Korea and other countries was included in the ICD-11. The publication of the ICD-11 shows the high attention and determination of the World Health Organization to promote the development of traditional medicine.

1.2 In China
 For thousands of years’, TCM has been widely recognized for its obvious therapeutic effect, its safety and simple treatment method, and affordable medical costs. However, western medicine holds the dominance in medical markets, while the TCM program only occupies a low share of treatments, even in the TCM hospitals. The health regulators have set a minimum limit on the usage amount of TCM service for TCM hospitals. But even so, it is hard for the TCM hospitals to reach the minimum limit for the lack of professional technicians and the long-term training period. To meet the requirement of residents and health regulators, Jianhe TCM hospital had an urgent need to improve its traditional medical service capability. 

1.3 Background of the practice of the theory
The theory to rapidly improve traditional medical service capability was first developed by Mr. Jian Di. Considering its creative and newly-developed nature, it can only be spread and accepted by the clients we have served. Jianhe TCM hospital, as a long-term client, holds a high degree trust for JYWJ. As a result, the president of Jianhe TCM hospital began discussions about this project as soon as the theory was published.

2. Project objectives
Jianhe TCM hospital had an urgent need to rapidly improve its traditional medical service capability and to serve more residents in the community. The project objective was to improve the TCM-by-nurse service capability and to differentiate the competitive position of Jianhe TCM hospital. 

3. Theory basis of the project
There are two basic TCM diagnosis and treatment modes. In the first mode, the patient is both diagnosed and treated by a qualified doctor. An example of this is acupuncture. In the second mode the patient is diagnosed by a doctor and treated by a nurse. An example of this is scraping therapy. Mr. Jian found that the second mode is 4 to 8 times more efficient than the first one. Thus, if the hospital were to focus on developing programs diagnosed by a doctor and performed by nurse, the TCM programs would serve more patients.

4. Project diagnosis of the hospital
At the beginning of the project, Mr. Jian assessed the operational status of the hospital. He found it had unclear hospital development goals, a small number of the professional technicians and service programs (especially nurse performed programs), low work efficiency, and inadequate marketing, management organization and performance assessment systems.  

5. Project measures
Mr. Jian then clearly defined the basic strategy to improve traditional medical service competitiveness by providing more programs diagnosed by a doctor and performed by a nurse.

 A TCM-by-nurse management department was established to manage all the nurses that would deliver medical services. (This was a first in China.) A human resources plan was then developed to hire, train and assess doctors and nurses according to their medical service capability. 

A medical service program was the formulated than included a plan for a detailed supporting devices procurement plan. 

A marketing plan was formulated specifically for the TCM programs. 

Finally monitoring and management measures and a performance assessment system were put in place. 

6. Project result
6.1 Rapid hospital development  
After the project, there were 40 programs performed in clinics and 56 in inpatient departments in 2018. The monthly service time of programs performed by nurses is 314 in 2017, 393 in 2018 and 549 in 2019, with the annual growth rate is 25% in 2018 and 74.5% in 2019. The income of TCM program is 5.41 million yuan in 2017 and 7.46 in 2018 with the growth rate is 38%; and income in 2019 is expected to be 10 million yuan with growth rate is 134%. The income change is shown directly and clearly in chart 1.

CHART 1: 
Monthly income of TCM program in Jianhe TCM hospital

6.2. High patient satisfaction
After the project, more patients had access to and accept the TCM service performed by nurses. And the patient’s compliance increased from 59% to 71% while the patient’s satisfaction increased from 73% to 91%.

6.3 Social influence
After the project, the rapid development of the hospital created high attention in the medical industry. Fifteen additional hospitals accepted similar consulting projects. The theory has helped the development of traditional medicine and ensure that TCM services are more accessible to residents. 

6.4 Boost to the internationalization of traditional medicine
As the traditional medical diagnosis is included into the ICD-11, traditional medicine will get increased acceptance globally. Increasing numbers of people will be able to choose traditional medical service for its safety, simplicity, and inexpensive characteristics. It is difficult and time-consuming for any country to develop large numbers of professional doctors, but easier and quicker for them to develop a few doctors and lots of nurses. The results of this project demonstrate that these practical measures can drive the awareness and application of traditional medicine internationally.

7. Conclusion
The theory on rapidly improving traditional medical service capability is practical and simple. Hospitals can rapidly master traditional medical service capability and at the same time solve the problems of the long-term training of professional technicians. By following this theory, a hospital can increase it patience services capability rapidly, with high patient satisfaction. The traditional medical service capability can be improved rapidly nationwide, and the internationalization of traditional medicine be even further increased with the resulting positive outcomes and ensuing positive publicity.