[Retracted] Study on Health Care Service Standard of Chronic Disease Management Based on Process Reengineering and the Delphi Method

Table 4

Standard plan of hospital chronic disease management and nursing service.

Field	Dimension	Hospital chronic disease management and nursing service standard plan and its measurement standards
1. Chronic disease management and nursing service organization construction	1.1 Organizational structure	The chief nurse is responsible for the chief supervision, and the chief nurse is responsible for department supervision
	1.2 System construction	The head nurse of each ward is responsible, with 2 nurses assisting
	1.3 Facilities	Complete rate of basic and specialized equipment configuration ≥80%
	1.4 Human Resources	Establishment of admission qualifications for chronic disease nursing staff in various specialties
2. Enrollment of patients with chronic diseases	2.1 Inclusion criteria	All specialties set clear criteria for the inclusion of chronic disease patients
3. Establish personal chronic disease files	3.1 File content	Completion rate of health file content ≥95%
4. Develop a chronic disease management plan and intervene	4.1 Intervention plan	All specialties set up chronic disease intervention plans with specific time points
5. Evaluation of the effectiveness of chronic disease management	5.1 Outcome of the disease	Chronic disease complication rate within 2 years ≤30%