As the medical industry continuously raises its demands for efficiency and quality, hospital performance management has gradually become the focus of reform. The Resource-based Relative Value Scale (RBRVS) evaluation system, as an effective performance evaluation tool, has been adopted and implemented by numerous hospitals both domestically and internationally. Based on the analysis of the current status of performance reform using RBRVS in hospitals at home and abroad, this article comprehensively introduces the origin, development, and basic principles of RBRVS. Furthermore, it provides an evaluation of the difficulties encountered in the practical application of this system and suggests optimization measures.
ObjectiveTo explore the comprehensive hospital administrative management system for urban and rural cooperation in the process of medical reform. MethodsBy reviewing literature and interviewing directors of the administrative departments and hospital medical staff, we gradually established and improved the administrative management system for urban and rural hospital counterpart support. ResultsBetween 2010 and 2013, 123 medical workers were dispatched to support eight county-level hospitals, after which the comprehensive capacity, and technology and quality control in those hospitals were largely improved. Till the end of 2013, two of those hospitals were promoted to be grade-three class-B comprehensive hospitals; two were promoted as grade-two class-A comprehensive hospitals; three passed the reassessment to be grade-two class-A comprehensive hospitals; and another three county-level medical centers were promoted to be city-level key disciplines. ConclusionThe comprehensive administrative management system improves the management level of grass-roots hospitals at the county level; promotes the social public welfare of tertiary public hospital counterpart support; facilitates the process of medical system reform at the county level; establishes a series of administrative management modes such as unified support, personnel management, assessment standards and evaluation system; and promotes the sustainability of long-term counterpart support system.
With the development of economic globalization and the complication of enterprise management, the level of internal control has become an important part for measuring the quality of management, risk prevention, competitiveness and operational efficiency of modern enterprises. As a special economic organization, hospitals have some defects in terms of internal control environment, organization of control system, risk management and implementation system, supervision, control and evaluation system. Based on the “Medical Institutions Internal Control Provisions of Finance and Accounting (Trial)” and “A Lecture on Medical Institutions Internal Control of Finance and Accounting”, this article gives some suggestions on how to improve the management of hospital internal control.
Objective To explore the application and effects of Seminar case teaching method in teaching surgical nursing. Methods Nursing students of the Yiyang Junior Medical College were divided into two groups (140 students/group). Seminar case teaching was applied in the trial group, while traditional teaching method (classroom teaching or instruction) was applied in the control group. The two groups used the same materials, and were taught by the same teacher team during the same course. After the courses, surgical knowledge and skills were evaluated using theory exams and operation tests (tools included communication ability scale as well as the California Critical Thinking Dispositions Inventory Scale for students’ ability and quality levels, and an anonymous questionnaire for teaching satisfaction) were analyzed between the two groups. Results The scores of the trial group were higher than those of the control group in theory exams and operation tests, with a significant difference (Plt;0.01). The before-after score differences of communication skills and critical thinking ability of the trial group were also higher than those of the control group, with a significant difference (Plt;0.01). The result of the anonymous questionnaire showed that, the students in the trial group had better satisfaction about Seminar case teaching method. Conclusion Seminar case teaching method applied in surgical nursing teaching is feasible and effective, which is better than traditional teaching method in improving knowledge, ability, and quality of nursing students.
Objective To summarize the online practice teaching experience in laboratory medicine during the coronavirus disease 2019 (COVID-19) epidemic, and explore a new practice teaching mode of laboratory medicine which can provide a reference for improving the efficiency and quality of laboratory medicine education. Methods From June 8th, 2020 to June 30th, 2020, an online questionnaire survey was conducted in teachers and students who participated in online internship teaching and learning during the COVID-19 epidemic to evaluate the effect of online internship teaching and compare the advantages and disadvantages of online and offline internships. ResultsA total of 65 valid questionnaires were collected from 35 students and 30 teachers. There was no statistically significant difference in the satisfaction scores of intern students between online and offline internships [median (minimum, maximum): 100 (80, 100) vs. 100 (80, 100), P>0.05]. Among the teachers surveyed, 90.0% thought that the pre-teaching preparation for online internship teaching was more complicated and time-consuming, 60.0% thought that the online teaching was more difficult, and 63.3% thought that online internship could not achieve the expected results. Both the teachers and students believed that online and offline internships had their own advantages and disadvantages, and they could learn from each other. Conclusions The present online practice model cannot replace the traditional offline practice. A diversified practice model combining online and offline can help further develop and improve medical laboratory practice teaching.
Objective To investigate the effects of evidence-based medicine (EBM) course on clinical medical students and to propose teaching advice. Methods Using a predesigned questionnaire, we conducted an investigation on the literature retrieval, knowledge of EBM terms, and subject attitude of clinical 5-year and 7-year medical students before and after EBM course, and then an interview was performed to collect the opinions of the students. Data was statistically analyzed. Results After the course, average reading time and frequency of literature retrieval increased significantly compared to the situation before EBM course (Plt;0.05). Knowledge levels of main EBM terms related to practice increased significantly (Plt;0.05). 5-year medical students’ ability of literature appraisal also increased (Plt;0.05). In this interview, these students suggested that course time of literature retrieval and screening should increase and medical statistics should be reviewed. Conclusion Through the study of EBM course, both knowledge and attitude of students changed a lot, and combining case teaching with EBM course has a better teaching effect. Learning the concepts and techniques of EBM for clinical medical students can help them apply medical research evidence correctly in clinical practice, and train their self-learning ability.
Objective To provide a reference for the best evidence-based medicine (EBM) education modelby retrospective analysis and summary the EBM education model of the EBM center of Lanzhou University for medicalpostgraduates. Methods To utilize students’ spare time we changed the traditional teaching method, and instead used problem based learning and academic discussions to teach postgraduates how to design and apply research. Results Sixtytwo postgraduates were trained and completed 73 research papers and registered 33 Cochrane systematic reviews. Twentythree papers were published in foreign journals (SCI) as first authors, 34 papers were published in domestic journals. Five students received awards in the academic conference of Lanzhou University. Conclusion Medical students will benefit from taking part in EBM research. This education model will help them not only understand the methods of clinical research and EBM and improve the quality of their research and their cooperative skills, but also master related clinical knowledge.
ObjectiveTo explore the efficacy of reforming head nurse inspection and supervision outside the eight-hour administration, in order to ensure seamless quality management. MethodsFrom January 2014, reform was carried out on the name, form, content, and standard of head nurse inspection and supervision, including the combination of casual and work wear, seamless management outside the eight-hour administration, complete management with key emphasis, fine evaluation with objectives and emphasis, the combination of feedback and summarizing, and the combination of written and oral report. ResultsAfter the implementation of 6-month reformation, the head nurses involved in inspection increased from 102 in January 2014 to 124 in June 2014, the departments involved in inspection increased from 276 to 332. After the implementation, the ward environment management and nurses' working state were improved. Adverse events (pressure ulcer, fall/drop from bed) were decreased. The qualified rate of patient identification arose. Patients and their relatives had a higher rate of medication and disease knowledge, and nurses had a higher rate of knowledge on the responsibility for diagnosis and major nursing points. The differences before and after the reform were significant (P<0.05). ConclusionThe elaborating reform can promote the efficiency of head nurse inspection and supervision, and ensure the nursing quality and safety outside the eight-hour administration.
The main approaches to medical education reform that have been introduced elsewhere in the world, including the integration of basic and clinical sciences into organ-based model, the establishment of a Center for Faculty Development and problem-based learning (PBL) have been introduced to the College of Medicine, Chung Shan Medical University (CSMU) since the mid 1990s. The process of developing the PBL approach can be divided into the following stages: Observation (1994-2000): In this stage, CSMU observed the practice and effectiveness of PBL programs in other domestic and foreign medical schools. At the same time, we assessed the possibility of introducing PBL to Chung Shan. When the authority decided to introduce PBL, a PBL committee was inaugurated. Preparation (2000-2002): In this stage, tutor training took place, as well as PBL case writing workshops to reach consensus among the faculty. To reduce the total amount of curricula and traditional teaching hours, we combined and simplified related curricula, so that one and half weekdays were reserved for PBL tutorials and students’ self-study. A preliminary course about how to learn well, including the philosophy and methodology of learning as well as evidence-based medicine (EBM), was integrated into premedical curricula. Practice (2002-2004): In light of the number of trained tutors and written cases that have been prepared, and the desire that the PBL would be successful from the start, CSMU chose to introduce PBL to the clinical curricula first in a hybrid curriculum design. This meant that the traditional teaching was retained at the beginning. Evaluation of PBL by the students was done at the end of each semester. Tutor meetings were held twice per semester. Advancement (2004-2006): In this stage, PBL was introduced to the basic medical curricula as well as to the premedical general curricula. Based on our experience and comprehensive evaluation, a PBL guidebook for tutors and students has been published and delivered to both groups. We also developed an on-line evaluation system containing the evaluation forms for students and tutors. Excellence (2006 onwards): In this stage, the PBL website and learning resources will be further developed, and we are designing the system for on-line PBL practice.In conclusion, the introduction to PBL for medical education is reasonable and feasible. It requires b administrative support, a long-standing and high commitment of the PBL committee, consensus among the faculty and an appropriate planning and evaluation mechanism.