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.
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.
Assembling medical aid teams (MATs) from the provinces outside Hubei was an important China-specific approach to dealing with public health emergencies during the coronavirus disease 2019 (COVID-19) pandemic in Hubei. In integrally taking over the COVID-19 intensive care wards in Wuhan, the Joint 7th and 8th Sichuan COVID-19 MATs applied the methods of modern hospital management to complete the medical task, concerning four key points as guidance by the Communist Party of China, system and regulation establishment, organization construction, and discipline persistence. This paper makes a theoretical summary on the basic management of the Joint 7th and 8th Sichuan COVID-19 MATs, and it is hoped that more COVID-19 MATs could summarize and share their successful management experiences in order to enrich and improve the management theory of MAT.
Hospital-based health technology assessment (HB-HTA) refers to the practice of health technology assessment for hospital management decision-making based on the actual situations in hospitals. It includes processes and methods of health technology assessment carried out in and for hospitals. Under the background of comprehensively promoting the reform of public hospitals in China, HB-HTA is undoubtedly an important scientific method to enhance the fine management of public hospitals and implement the policy of medical reform. This paper introduced the concept, the international and domestic development status, the characteristics of HB-HTA, and put forward the scheme of development of HB-HTA macroscopically, so as to promote the popularization and applications of HB-HTA in China.
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.
Based on the practice of large tertiary hospitals in clinical pathway (CP) entrance management, we implemented a fine CP management model with standardized clinical diagnosis and treatment, and encouraged the department to continuously optimize the path form, expand CP coverage and improve the entry rate in a flexible path. Combining PDCA cycles with CP management, it can promote the realization of management goals and achieve continuous improvement, while providing operable (repeatable) methods to the practice of hospital CP management.
Objective To explore the role of introducing closed-loop management in the decision execution process of hospital president’s office meeting in improving the hospital decision execution and management ability. Methods The topics of the president’s office meeting of Guang’an People’s Hospital from 2021 to 2022 were selected. The topics of the president’s office meeting were divided into 2 groups based on the introduction of closed-loop management. Among them, 2021 was used as the pre-intervention group, and 2022 was used as the post-intervention group. The completion rate of agreed topics, the rate of reconsidering deferred topics, and the impact of closed-loop management on various sequence departments of the hospital before and after intervention were observed. Results A total of 946 topics were included. Among them, there were 499 topics in the pre-intervention group, 305 topics were completed, 38 topics were deferred, and 16 topics were presented for further meetings; after intervention, there were 447 topics, 404 topics were completed, 33 topics were deferred, and 24 topics were presented for further meetings. There was a statistically significant difference in the average completion rate of agreed topics [(60.90±6.30)% vs. (89.62±7.94)%] and the average rate of reconsidering deferred topics [(40.83±18.78)% vs. (65.70±25.62)%] before and after intervention (P<0.05). The average completion rate of agreed topics in administrative, logistic and business sequence increased from (60.13±7.95) %, (67.90±22.13) % and (63.34±18.54) % to (92.41±8.25) %, (88.80±18.78) % and (84.79±18.71) %, respectively. Conclusion The introduction of closed-loop management in the decision execution process of the hospital president’s office meeting can improve the decision-making efficiency and execution ability.
【摘要】 目的 调查四川大学医院管理MBA项目的学员满意度，分析其影响因素，寻求相关启示，为现代医院管理者决策提供参考依据。 方法 以2006年-2010年四川大学医院管理MBA项目学员为研究对象，采用自制的调查问卷，对参与培训的336名学员进行统一的问卷调查，对结果采用logistic回归分析。 结果 发放问卷336份，回收有效问卷320份，有效回收率95%。86.2%的学员表示对培训项目的效果满意。课程内容的实践性、培训组织管理模式、是否有丰富的个案分析等因素与学员满意度有关（Plt;0.05）。 结论 要做好医院管理MBA的培训项目，需要关注影响学员满意度的因素，需在课程内容设计、培训模式改进、案例资料库的甄选等方面努力，从而设计更符合现代医院管理需要的MBA培训课程。【Abstract】 Objective To investigate the satisfaction degree of students in the MBA programs of Sichuan university, analyze the influential factors for the satisfaction degree. Methods Self-made questionnaire was applied in the investigation on 336 students who attended the MBA program of Sichuan University from 2006 to 2010. The investigation results were collected and analyzed by using logistic regression analysis. Results A total of 320 (89.65%) valid questionnaires were retrieved among all the 336 questionnaires assigned. In all the students, 86.2% were contented with the current situation of scientific training program. The content of the course practice, management of training mode and whether there was a rich case analysis were influential factors for students′ satisfaction degree (Plt;0.05). Conclusions The influential factors for students’ satisfaction degree should be taken into consideration in order to better carry out the MBA hospital management training program. More emphasis should be paid on the course design, training mode adjustment and selection of cases, in order to cater for modern hospital managers.
Hospital hosting has made great success in public hospitals. Small and medium public hospitals have made great progress in management and healing with the help of large comprehensive hospitals. The business model of hospital hosting has been used in private hospitals. This study will introduce the differences among each model of hospital hosting and analysis the efficiency in private hospital area.
ObjectiveTo evaluate changes in operational effectiveness after the implementation of ambulatory surgical management in pars plana vitrectomy (PPV). MethodsA retrospective clinical study. 17 528 surgeries in 10 895 eyes of 10 895 patients who underwent minimally invasive PPV on an ambulatory and/or inpatient basis at Tianjin Medical University Eye Hospital from August 2015 to June 2023 were included in this study. Among them, 5 346 eyes in 5 346 cases were male; 5 549 eyes in 5 549 cases were female. The age ranged from 0 to 95 years, with the mean age of (57.74±13.15) years. 6 381 surgeries in 3 615 eyes from August 2015 to December 2018 (the initial period of day surgery) were used as the control group; 11 147 surgeries in 7 280 eyes from January 2019 to June 2023 (the expanded period of day surgery) were used as the observation group. According to the management mode of ambulatory surgery, the observation group was subdivided into the decentralized management group (January 2019 to December 2020) and the centralized management group (January 2021 to June 2023), with 2 905 and 4 375 eyes and 4 646 and 6 501 surgeries, respectively. Changes in the percentage of day surgery, average hospitalization days, and average unplanned reoperation rate were compared. The Mann-Whitney U test was used to compare numerical variables between groups; the chi-square test or Fisher's exact test was used to compare categorical variables. ResultsThe number of cases of daytime PPV performed in the observation group and control group was 7 852 (70.44%, 7 852/11 147) and 24 (0.38%, 24/6 381) cases, respectively, and the average hospitalization days were 1 (1) and 5 (3) d. Compared with the control group, the observation group had a significantly higher percentage of day surgery (χ2=8 051.01) and a considerably lower mean hospitalization day (Z=4 536 844.50), and the differences were statistically significant (P＜0.000 1). The mean hospitalization days in the decentralized and centralized management groups were 2 (3) and 1 (0) d, respectively, and unplanned reoperations were 34 (0.73%, 34/4 646) and 171 (2.63%, 171/6 501) eyes, respectively. Compared with the decentralized management group, average hospitalization days was significantly lower (Z=1 436.94) and unplanned reoperation rate was significantly higher (χ2=54.10) were significantly lower in the centralized management group, both of which were statistically significant (P＜0.000 1). ConclusionPPV ambulatory management model can significantly reduce the average hospitalization day, but also results in higher rates of unplanned reoperations.