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.
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.
With the increasing demand for health technology decision making in hospitals, the activities of hospital-based health technology assessment are increasing globally. Several developed countries, such as France, Finland, Denmark, Italy, Canada, The United State and Australia have carried out hospital-based health technology assessment activities. In order to further promote the development of health technology assessment in China and establish evidence-based management and decision-making concept of hospitals, the National Center for Medical Service Administration has carried out theoretical and practical research on hospital technology assessment by fully drawing on foreign advanced experience. This paper introduces the background, object, method and content of the research, the achievements of the pilot project and the prospect of the future, so as to provide a reference for readers to understand the overall situation of the project and related work.
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.
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.
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.
Objective To compare and analyze hospital operation and management models between China and foreign countries, in order to provide reference and guidance for the continuous improvement of hospital management in China. Methods The NVivo software was used to conduct a qualitative comparative analysis of domestic and foreign literature on hospital operation and management models in China National Knowledge Infrastructure, Wanfang, Web of Science, and PubMed until December 2022, and a model for the differences in operation and management between Chinese and foreign hospitals was further constructed. Results Finally, 33 Chinese literature and 21 English literature were selected as the raw materials for NVivo qualitative analysis. A comparative analysis of the operation and management models of Chinese and foreign hospitals from four dimensions: structure, process, results, and continuous improvement showed that there were differences in operation and management systems, talents, processes, finance, refinement, and innovation between Chinese and foreign hospitals. Conclusion Hospital operation and management needs to be deeply integrated with business work, improve the construction of hospital operation and management system, strengthen the competence of operation talents, pay attention to resource cost-benefit analysis, attach importance to the two-way integration of business and finance, optimize the adjustment of operation and management structure, and attach importance to the innovation drive of new technology application, in order to promote the scientific, standardized, refined, and informationalized level of hospital operation and management.
Objective To understand the outpatients, evaluation and demands of the real-name registration system. To implement the new medical reform program deeply. Methods We used the questionnaire named registration questionnaire of West China Hospital designed by ourselves to survey the outpatients and their family members and were filled in the questionnaire by themselves. Results Firstly, real-name registration system in West China Hospital made major contribution to alleviate the difficulties of registration and medical treatment. It achieved a major breakthrough and created a good social benefit. Secondly, patients the most favourite way of registration was by phone. They were satisfied with the platform of the social welfare services very much. Thirdly, the number of appointment registration arrived year by year, while the number of the day registration fell year by year. Conclusion Firstly, we innovate the form of the realname registration system, refine service and do scientific management at the needs of the patient-oriented. Secondly, we strengthen the track of the failure of appointment registration and analyze the causes. We should take measures timely to reduce the rate of the event and improve the real-name registration system. Thirdly, we strengthen the management of the out-patient doctor visiting program and credit services, to improve medical compliance rate and protect the interests of the patients. Fourthly, we explore a scientific research of out-patient real-name registration system to establish a modern hospital out-patient services model.
Under the vigorous promotion of national policies, by the end of 2018, the construction of the national medical consortium has been fully launched, and all public tertiary hospitals have actively participated in the construction of medical consortium. The practice of lead-type close medical consortium in West China Hospital of Sichuan University is an innovative exploration in the context of the new national medical reform. Combining the social responsibilities, location characteristics, functional orientation of West China Hospital of Sichuan University, and the remarkable results of the lead-type close medical consortium, this article elaborats three distinctive features of the lead-type close medical consortium, namely the cooperation between the government and the hospitals as the cornerstone, the hierarchical collaboration as the core, and the medical care and great health as the guiding principle, to provide a reference for the construction of a high-quality and efficient medical and health service system in China.