ObjectiveTo construct the terminology standard of hospital quality and safety. MethodsThe draft terminology standard was constructed through group discussions, and the final draft terminology standard was formed after one round of Delphi expert consultation and two rounds of expert consensus meetings. ResultsThe recovery rate of the questionnaire was 100%, and the authority coefficient of experts was 0.87. A total of 15 experts were invited to two rounds of expert consensus meetings. The terminology standard for hospital quality and safety (TCHAS 10-1-1-4—2022) was finally released, including 4 first-level categories, 20 second-level categories, and 370 terms in total. ConclusionThe terminology standard of hospital quality and safety developed in this study is scientific and reliable, which can be used as a tool to assist medical institutions in carrying out standardized management.
Objective To review the literature written in English on hospital performance research and provide theoretical and practical references for research in the field of hospital performance in China. Methods Literature related to hospital performance published from 1972 to 2022 in the Web of Science Core Collection was retrieved. Microsoft Excel 2021 was used to analyze the annual publication volume of English literature in the field of hospital performance. CiteSpace 6.1.R6 software was used for co-occurrence analysis of countries/regions, institutions and authors, research hotspots and frontiers. Results A total of 1447 articles were ultimately included. The analysis of annual publication volume showed that the overall publication volume in the field of hospital performance was on the rise. The co-occurrence analysis of countries/regions indicated that the United States had the highest output of academic papers (548), followed by the United Kingdom and China (120 and 89 respectively). The most productive institution was Harvard University in the United States, and the most productive scholar was Harlan M. Krumholz from the Yale University School of Medicine in the United States. The most frequently occurring keyword was “care”. The clustering analysis of keywords revealed that the keywords in the field of hospital performance research were clustered into 12 categories. The top 5 keywords with the highest burst intensity included “acute myocardial infarction” “indicator” “US hospital” “predictor” and “administrative data”. Keywords such as “public hospital” “financial performance” “performance measurement” “framework” and “organizational performance” began to emerge in 2020 and had continued to the present. Conclusions The research hotspot in the field of hospital performance has shifted from focusing on individual performance to organizational performance. There is still a lot of room for research in this field in China, and the exploration of hospital performance evaluation and management models may continue to be research hotspots in this field in the future.
Venous thromboembolism (VTE) is a high-risk complication in hospitalized patients, especially in patients with orthopedic surgery, neurosurgery, thoracic surgery, cardiac surgery and tumor surgery. It is also a significant cause of patients’ unexpected death and perioperative death. Through establishment of norms of VTE management system and organizational structure, formulation of perfect VTE risk assessment system and prevention and treatment scheme for hospitalized patients, training of all the medical staff for related knowledge, and test operation of the system in key departments, we established a hospital standardized system of venous thromboembolism prevention and management. Our VTE prevention and treatment work achieved good results through multidisciplinary collaboration.
Social Evaluation is an important reference to guide the reform and development of a public hospital. In view of the patient, hospital stakeholders and the public, West China Hospital of Sichuan University creatively constructed a social evaluation system, including patient satisfaction degree, expert appraisal and online public comment, in order to maintain a good medical environment. After several years of construction and application, the system has been quite effective in promote the development of the hospital. In the assessment of patients' satisfaction degree toward the hospital, we made a great improvement.
Objective To explore the impact of personal digital assistant (PDA) information system on surgery operations, so as to provide basis for improving the efficiency of surgery operations and building medical research databases. Methods The data of patients undergoing surgical treatment in Northern Jiangsu People’s Hospital between October 1, 2018 and September 30, 2020 were retrospectively analysised. According to whether to operate the PDA information system, the patients who did not use the PDA information system for surgical treatment between October 1, 2018 and September 30, 2019 were taken as the control group (before the operation), and the patients who used the PDA information system for surgical treatment between October 1, 2019 and September 30, 2020 were taken as the intervention group (after the operation). The quality of surgical operation, the time of anesthesia opening, the time of opening operation, the length of operation, and other operation indicators before and after the operation of the PDA information system were analyzed. Results A total of 59 610 patients were enrolled, including 27 726 in the control group and 31 884 in the intervention group. Compared with before the operation of the PDA information system, the total annual operation increased by 4 158 cases (15.00%), and the average turnover of per operation room increased (17.10%). The average anesthesia opening time is 14.52 minutes earlier. The average operation opening time is 18.25 minutes earlier. Except for gastrointestinal center surgery, thoracic surgery, neurology surgery, trauma center surgery, intensive care unit ward surgery, biliary and pancreatic surgery, hepatosplenic surgery, and other types of surgery (P>0.05), other types of surgeries were statistically significant differences in the operation duration before and after other operations (P<0.05). Conclusions The PDA information system developed based on "VariFlight" quantifies the quality of surgical operations more finely. It can effectively improve the operation efficiency and economic benefits of surgery, shorten the operation time, contribute to the construction of medical research databases.
Due to optimizing medical service resources and improving service efficiency, day surgery has attracted the attention of medical and management experts worldwide. In 2019, day surgery was included as one of the performance assessment indicators of tertiary public hospitals. In recent years, hospital-based day surgery centers have begun to plan and build. Although the basic facilities have been perfectly improved, but how to efficiently and safely operate and manage the centralized day surgery has become the primary problem to clinicians and managers. The purpose of this paper is to introduce how the Day Surgery Center of West China Hospital of Sichuan University uses scientific management tools and establishes a professional multidisciplinary team, so as to carry out efficient operation management and control of medical quality and safety risks of the Day Surgery Center. And then provide practical experience guidance and suggestions with strong feasibility and operability for peers.
Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
ObjectiveTo investigate whether continuous quality improvement (CQI) measures can reduce the episodes of peritonitis. MethodsWe analyzed the data of 114 cases of peritoneal dialysis related peritonitis from January to December 2011 before applying CQI measures and 72 cases from January and December 2012 after applying CQI measures in West China Hospital. Then we studied the episodes, cause and pathogenic bacteria species of peritonitis in peritoneal dialysis patients. We implemented the process of reducing the episodes of peritonitis by applying PDCA four-step design: plan-do-check-act. ResultsThe episodes of peritonitis were reduced from per 60.8 patient-months (0.197/patient-years) to per 66.6 patient-months (0.180/patient-years) after applying CQI measures. The positive rate of pathogenic bacteria culture was both 50.0% before and after applying CQI measures, in which 66.7% were gram-positive cocci. The curing rate of peritonitis was increased from 57 case/times (76.3%) to 87 case/times (79.2%). Switching to hemodialysis rate was reduced from 17 cases/times (14.9%) to 10 cases/times (13.9%). Death cases was reduced from 9 cases/times (7.9%) to 5 cases/times (6.9%). ConclusionThese results show that the incidence of peritoneal dialysis related peritonitis decreases and the curing rate increases through CQI measures.
Patient priority evaluation has been studied and applied abroad for a long time, which is a mature theory and widely used in practice now. This article uses the priority, patients, waiting list and criteria as keywords to search Wiley Inter Science, Web of Science, Scopus Pub Med, The Cochrane Library, Science Direct, Springer, and Jstor database (searching time is up to December 2017), to collect relevant indicators for patient admission priority evaluation. In addition, relevant citations and grey literature were searched, and experts from relevant fields in China were consulted to obtain more comprehensive research literature. On this basis, this article describes the concept of patient admission priority evaluation, and describes the meanings of the indicators and the countries of application from the three dimensions of clinical indicators, expected results, and social factors. It is considered that the research and implementation of the evaluation of the priority of patient admission has been relatively many. However, there are only a few related researches in the country and without unity. There is no systematic patient-related priority evaluation. It is necessary to use foreign mature theory research to establish a hospital admission priority evaluation system suitable for China’s national conditions.
After nearly 30 years of localized development of day surgery in China, in order to enable more patients to enjoy high-quality and affordable day surgery medical services, some medical institutions have begun to try same-day surgery, which means the patient can be operated and discharged within the same workday. With the help of the national three-level diagnosis and treatment service model, it provides continuous medical services and guarantees for day surgery patients through the integration of “hospital-community”. This article first introduces the development history of day surgery, summarizes the definitions and requirements of day surgery in different countries or academic associations, and finally focuses on same-day surgery in China, aims to provide some ideas for the future development of day surgery in China.