ObjectiveTo investigate the efficacy of Quality Control Circles (QCC) in reducing the emergency application times of maintenance hemodialysis. MethodsIn December, 2012, the quality circle was formed by eight nurses and a physician, through brainstorming. The group finally selected "Reducing emergency maintenance dialysis times" as the theme. With the help of questionnaire, interview, and comparative study, we analyzed the emergency situation of maintenance hemodialysis patients, and regulate and implement related policies. ResultsBy QCC practices, the times of hemodialysis declined from 11.7 to 5.3 cases per month, which exceeded our expectations largely. As to the circle members, their problem-solving skills, responsibility, communication skills, self-confidence, motivation and QCC techniques were also improved. ConclusionQCC can not only reduce the times of maintenance dialysis, but also improve the team cohesion, harmony and quality management capabilities.
ObjectiveTo explore the standardized index system of quality control for single disease of day surgery in Shanghai municipal hospitals.MethodsFrom April to November 2020, through literature research and comprehensive analysis of research results, the framework of quality control index system for single disease of day surgery focusing on obstructive sleep apnea hypopnea syndrome surgery and laparoscopic cholecystectomy was constructed; Delphi method was used to evaluate the quality of day surgery in terms of results, objectivity, statistics, sensitivity, accessibility, quantifiability, importance, and guidance. Finally, the final indicators were screened out.ResultsAfter three rounds of Delphi investigation, 18 experts finally formed 14 general indexes and 14 personalized indexes (6 for obstructive sleep apnea hypopnea syndrome and 8 for laparoscopic cholecystectomy) in the single disease of day surgery quality control index system.ConclusionsThe general indexes and personalized indexes quantifying the quality control index for single disease of day surgery are conducive to the standardization and standardized management of day surgery, and can provide a reference for improving the medical quality and safety, and sustainable development of day surgery.
ObjectiveTo explore the effect of quality control circle (QCC) on the management of hospital medication. MethodsAccording to the existing problems between December 2013 and January 2014, we put forward a series of continuous improvement plans, strengthened the nurses training, and intensified the supervision methods from February to May 2014. ResultsAfter the implementation of QCC, the incidence of leakage from drugs significantly decreased from 15.8% to 0.0%; the nurse-related drug management knowledge rate increased from 64.1% to 92.3%. Withdrawal process execution rate increased from 71.8% to 100.0%, and the difference was statistically significant (P<0.05) from February to May 2014. ConclusionQCC activity improves the hospital medication management, increases the nurses' sense of responsibility, and ensures the medical security of hospitalized patients.
ObjectiveTo study the effect of quality control circle (QCC) on the improvement of Intensive Care Unit (ICU) nurses' engagement in working. MethodsModified Gallup's Q12 questionnaire was used to survey ICU nurses of our hospital before and after QCC was carried out, and then we compared the engagement scores. ResultsBefore and after QCC was carried out, ICU nurses' engagement scores were statistically significant (P<0.01). ConclusionQCC in the ICU is an effective way of improving ICU nurses' engagement, which is worth promoting.
ObjectiveTo investigate the current situation of orthopedic quality control and management in county-level regional general hospitals in Guangdong, and to provide a scientific basis for further standardizing the procedures of orthopedic quality control and management in county-level regional general hospitals and continuously improving the work of provincial orthopedic quality control center.MethodsFrom June 2019 to July 2020, online and offline questionnaire survey and field survey were used to investigate the quality control and management of orthopedic departments in 22 county-level regional general hospitals in Guangdong.ResultsAmong the overall scores of the surveyed hospitals, the highest score was 96.5, the lowest score was 72.0. There were 6 hospitals with a total score of “excellent” (accounting for 27.3%). The “facilities and equipment” and “medical quality” of the surveyed hospitals were relatively valued. Taking Guangzhou, the capital of Guangdong as the center, the districts and counties were divided into the east, the south, the west and the north regions, and the difference in overall scores of orthopedics among the four regions was statistically significant (F=6.299, P=0.004). The unqualified rates of department setting, key technology development, average hospitalization days of representative diseases, equipment allocation, personnel allocation, department management and building layout were relatively high, which were 77.3%, 63.6%, 45.5%, 40.9%, 40.9%, 36.4% and 36.4%, respectively. Most hospitals had set up special debridement rooms in orthopedic department (95.5%), and the management and monitoring of the use of antibacterial drugs was mostly reasonable (90.9%). In terms of the level of orthopedic medical treatment, only 3 hospitals with sufficient key technologies reached the standard, accounting for 13.6%, and only 7 hospitals reached the standard of scientific research capacity, accounting for 31.8%. In terms of quality control, the numbers of hospitals with qualified medical record sampling (72.7%), perfect management and supervision mechanism (86.4%) and quality management team in departments (77.3%) were the least. In addition, among the investigated hospitals, beds were in short supply in orthopedic departments, with 12 hospitals accounting for 54.5% being deducted; 16 hospitals (72.7%) were deducted for unqualified doctor-patient ratio and 11 hospitals (50.0%) were deducted for unqualified nurse-patient ratio.ConclusionsThe overall level of orthopedics construction and management in the surveyed hospitals is uneven. The medical professional and technical level is insufficient. It is difficult to meet the practical needs, and there is an imbalance in the ratio of medical personnel. In the future, it is necessary to strengthen the quality control of orthopedic medical care, strengthen the medical technology training of county-level regional general hospitals and increase the medical and health resources and capital investment, so as to improve the quality control of county-level regional general hospitals.
The scientific research on prevention and control of coronavirus disease 2019 (COVID-19) has been a major and urgent task, of which clinical trials occupy a pivotal position in the entire prevention and control system. 204 relative clinical trials of traditional Chinese medicine (TCM) have been registered on Chinese Clinical Trial Registry. Through the analysis of all online public protocols of registered trials, it is found that the clinical studies of TCM in China showed lack of research foundation, tight time and heavy tasks, difficult clinical implementation, and disturbance by changes of the epidemic status. Based on these characteristics, this paper put forward several thoughts and suggestions on the quality management and design improvement for clinical trials of TCM preventing and treating COVID-19, in order to improve the quality of clinical trials in China, provide effective supports for the public health decision-making on the epidemic, and also give a reference for the prevention and control of epidemics in the future.
The promotion of day surgery has improved the procedure of the traditional inpatient surgery and put forward higher professional requirements for medical quality managers. Therefore, medical institutions need the matching norm of medical documents recording and management. The Medical Affairs Department and Day Surgery Center of West China Hospital of Sichuan University keep exploring and practicing new norm which should be conform with the diagnosis and treatment characteristics of the daytime operation mode to insure medical treatment quality and simplify the writing work of medical documents. This new recording norm of West China Hospital of Sichuan University for day surgery should not only meet the basic requirement of the medical record writing, but also stipulate the content detail and add more assessment rules for records grading. Moreover, the new norm could actively explore the management mode of medical record quality for day surgery. For example, by arranging the medical record quality monitors and arousing the working enthusiasm of clinical department and day surgery center through the (hospital and clinical departments) two-level management mode, the medical record writing process could be normalized, and the quality of medical records could also be well guaranteed.
ObjectiveTo investigate the effect of quality control circle (QCC) activity in reducing the temporarily stopping rate of day surgery.MethodsThe QCC activity was carried out from December 2018 to October 2019. By determining the theme of the activity and drawing up the plan, a retrospective analysis of pre-hospital day surgery stoppage status and reasons was performed based on 2 696 patients who had reserved surgery in the day surgery center from December 2018 to February 2019. Based on the data, the goal was determined, and measures were developed and confirmed from May to August 2019. Then the measures were standardized and implemented continuously from September to October 2019. The rate of surgical cessation before the implementation of the measures (from December 2018 to February 2019) was compared with that after the implementation of the measures (from September to October 2019).ResultsAfter the QCC activity, the temporarily stopping rate decreased from 2.89% to 1.34%, and the difference was statistically significant (P<0.001).ConclusionThe QCC activity can effectively reduce the temporarily stopping rate of day surgery, and lay the foundation for continuously promoting the optimization of day surgery resources and quality improvement.
The American Thoracic Society Committee Task Force on Standards for Pulmonary Function had recommended a standardized reporting format for pulmonary function tests due to considerable variability in pulmonary function reports presented to end users, which might lead to potential confusion and miscommunication. This recommendation includes seven parts: overview, introduction, methods, report format, selecting and reporting reference values, grading the quality of pulmonary function tests and conclusions. This document presents a reporting format in test-specific units for spirometry, lung volumes, and diffusing capacity that can be assembled into a report appropriate for a laboratory’s practice. Recommended reference sources are updated, with especially emphasizing to adapt lower limit of normal (LLN) or z score instead of percent of prediction to estimate the abnormal results. This document provides detail and clear explanation on the recommendations, which might improve the interpretation, communication, and understanding of test results. However, parts of recommendation might not be used directly in our clinical practice owing to some specific conditions in China. We suggest to use appropriate normal predictions from Chinese population, to include small airway parameters such as mid-maximal expiratory flow for early detection of pulmonary function deterioration, and to include inspiratory flow volume curve, as well as strengthen the quality control data and figures in the report format.
ObjectiveTo improve health care quality and safety by monitoring the performance of PhilipsPrecedence Dual-head single photon emission computed tomography (SPECT). MethodsWith our own homemade point source and the center of rotation model, in accordance with NEMA standards and manufacturers' design conditions, these three indicators including energy peak position of the instrument, intrinsic uniformity and center of rotation were routinely tested between 2008 and 2012 for the Philips-Precedence Dual-head SPECT in our hospital. In addition, the quality control was performed twice a week, and every year the total number of quality control was basically the same. We calculated the results by the weighted average method. ResultsThe 5-year average energy peaks of detector 1 and 2 were (139.23±0.32) and (138.97±0.45) keV, respectively, and they were both within the range of reference values [(140±3) keV]. In addition, the results of center of rotation were also in the normal range, and kept stable. Based on the analysis of quality-control data, for detector 1, compared with the data of 2008, there was no significant diTherence for central field of vision (CFOV) and useful field of vision (UFOV) in these three years from 2009 to 2011 (P>0.05). The diTherence was only significant between data of 2008 and that of 2012 (P<0.05). For detector 2, compared with the data of 2008, there was no significant diTherence for CFOV and UFOV in 2009 and 2011(P>0.05), while there was significant diTherent in 2010 and 2012 (P<0.05). ConclusionThe uniformity of SPECT will gradually deteriorate with prolonged use. However, regular quality control and maintaining can keep the function stabilization, and enhance the availability rate.