In 2021, West China Hospital of Sichuan University established a rare disease diagnosis and treatment and research center. The center adopts the rare disease management model of “one cohesion + four integration”, condenses the core of management, integrates clinical resources, regional alliance resources, training resources and research resources, and explores solutions for all-round services for patients with rare diseases. This article aims to explore the rare disease management model of regional central hospitals and introduces the above-mentioned rare disease management model. The purpose of this article is to promote this model, focus on the advantages of clinical departments and research institutes (offices), increase regional integration, give play to the synergy of regional alliances in clinical diagnosis and treatment and personnel training, and use international cooperation as an opportunity to promote breakthroughs in new drugs and technologies for rare diseases to benefit patients with rare diseases in China.
Objective To explore the application effect of a nursing management mode based on Swiss cheese model in safe medication for chemotherapy patients in daytime wards. Methods The study included chemotherapy patients in the Department of Day Care Ward of Tianjin Medical University Cancer Institute & Hospital between February and March 2023 (before improvement) and between June and July 2023 (after improvement). Before the improvement, a conventional nursing management mode was adopted, and after the improvement, a nursing management mode based on the Swiss cheese model was adopted. The medication safety ability of nurses, adverse drug events, and patients’ satisfaction of nursing before and after improvement were compared. Results Finally 150 patients were included before and after improvement, respectively. There was no statistically significant difference in age, gender, educational level, per capita monthly household income, tumor staging, and disease diagnosis between the two groups of patients (P>0.05). The total score of patients’ satisfaction of nursing after improvement was higher than before improvement (22.99±1.52 vs. 20.45±2.14, P<0.05), but there was no statistically significant difference in the dimensions of treatment environment and service attitude (P>0.05). There was no change in the nursing staff before and after the improvement, and a total of 34 nurses were included in the Department of Day Care Ward. The total score of the nurses’ medication safety ability was higher than before improvement [162.00 (160.75, 166.25) vs. 136.00 (135.00, 138.00), P<0.05], but there was no statistically significant difference in the dimensions of improving medication safety issues, multidisciplinary collaboration ability, and nursing professional responsibility (P>0.05). The incidences of adverse events during daytime chemotherapy after improvement were lower than before improvement (P<0.05). Conclusion The nursing management mode based on Swiss cheese model can improve the safety medication ability of nurses, reduce adverse events of chemotherapy medication in daytime wards, and improve patient satisfaction, which can be promoted in clinical practice.
目的 探讨消毒供应中心的管理方法，切实提高其质量。 方法 2008年8月－2010年12月应用PDCA循环管理模式，对消毒供应中心实施标准化、规范化、系统化和科学化的管理。 结果 应用PDCA循环管理模式以来，消毒供应中心的建筑布局及工作流程得以规范；手术器械处置效率、清洗消毒灭菌质量得以提高；手术切口、Ⅰ类手术切口的感染率均得以降低。2009年与2008年、2010年与2008年比较，手术切口感染率均得以降低，差异有统计学意义（χ2=39.95，P＜0.05；χ2=27.80，P＜0.05）；2009年与2010年比较，手术切口感染率差异无统计学意义（χ2=0.02，P＞0.05）。2009年与2008年、2010年与2008年、2010年与2009年比较，Ⅰ类手术切口感染率降低，但差异无统计学意义（χ2=2.83，P＞0.05；χ2=2.21，P＞0.05；χ2=0.05，P＞0.05）。 结论 推行PDCA循环管理模式，促进了消毒供应中心的规范化管理，实现了消毒器械质量控制的前馈控制、过程控制以及反馈控制；拓展了消毒供应专业领域，使医院的现有资源得到了最为高效的利用；使患者安全得到了切实保障。
Day surgery mode is a challenge for surgeons, anesthesiologists, nurses, and managers. Standardized management should be implemented in each management model, no matter centralized management or decentralized management model, by utilizing the theory of enhanced recovery after surgery and information management to establish a system to ensure patient’s safety and medical quality. Only in this way the development of day surgery will be healthy and sustainable.
Objective To analyze the scientific research output of West China Hospital of Sichuan University from 2015 to 2020, so as to evaluate the effectiveness of new scientific research management model. Methods From January 2018, a series of management measures were introduced, including improving research incentive policies, integrating and supporting resources, constructing a scientific quantitative research performance evaluation system, and establishing an information-based research service model. The changes of scientific research output before (2015-2017) and after (2018-2020) the implementation of the management measures were analyzed to evaluate the quality and effectiveness of the management model. Results A total of 10141 high-quality research papers were seized and 2311 research projects were approved. After the implementation of the measures, the absolute number of papers published and projects approved increased significantly. In terms of high-quality papers published after the implementation of the measures, the increase rate reached 46.80%, among which the number of interdisciplinary papers increased by 116.05%, the number of reviews increased by 96.13%, the numbers of papers published in Area 2 and Area 1 increased by 114.67% and 75.00%, respectively, and the number of co-author papers increased by over seven times. In terms of scientific research projects approved after the implementation of the measures, the number of projects approved by the National Natural Science Foundation of China (NSFC) increased by 21.03%, and the number of provincial and ministerial projects increased by 110.17%, with the people in charge becoming younger. The number of principal investigators of NSFC increased by 1.67 times. The number of projects managed by intermediate and undetermined professional titles increased by 64.71% and 68.63%, respectively. The number of projects approved by youth and general fund increased by 30.26% and 14.16% respectively. The number of people in charge of provincial and ministerial projects increased by 1.45 times. The number of projects managed by deputy senior and intermediate titles increased by 1.64 times and 1.54 times, respectively. Key research and development projects, key projects, international cooperation projects, and basic application projects saw a significant increase. Conclusions After the implementation of management measures, the number and overall level of research papers have been improved, and the cross-cooperation between clinical and basic research has been gradually started. The number of projects approved increased significantly, and the project leaders tended to be younger. The high-quality cultivation and continuous growth of scientific research talents achieved initial results.
Day surgery wards have advantages such as the ability to quickly free up beds and possessing necessary medical resources, making them a focal department for the integration of emergency and routine medical care within healthcare institutions. The Day Surgery Nursing Committee of Sichuan Tianfu New Area Medical Association gathered experts from relevant fields, took into account the actual situation and previous practices of integrating emergency and routine medical care in day surgery wards, and developed this expert consensus. It covers the aspects of emergency plans, process mechanisms, spatial preparations, personnel preparations and deployment, material preparations, and information sharing and coordination of the management model of integrating emergency and routine medical care in day surgery wards, so as to provide professional guidance and references for the management model of integrating emergency and routine medical care in day surgery wards, and offer new ideas and methods to maximize patient treatment during emergency situations.
ObjectiveNew Rural Cooperative Medical Systems (NCMS) has been constructed as a financial protection for rural population commencing 2003. With the development of NCMS, there were quite a few management models existing across the nation. In order to assess the management alternatives, we try to explore how to set up a set of indicators to analysis management effect of different management models. MethodsBy literature review, we sorted all qualitative indicators into 8 types. Delphi and Multi-Attribute utility theories were applied to construct the appraisal indicators, including shaping first and second level indicators and assigning the weights for each type of indicators. ResultsWe managed to identify the indicator system which was comprised of 4 types of first level indicators, aiming at claim, manament process, transparency and supervision on accredited hospitals. Besides, there were 9 sub-indicators. ConclusionThe evaluation indicators are constructed for future assessment on management effect of rural health insurance.
Beijing Tongren Hospital, Capital Medical University is a multi-zone hospital, adopting a mixed mood of centralized and decentralized management of ambulatory surgery. In order to guarantee the medical quality and safety, and improve the quality of ambulatory surgery, during the past three years, through homogeneity management in three dimensions, including quality control, efficiency connotation, and service safeguard, the number of ambulatory surgery disease types carried out in the hospital increased from 121 to 251; the working efficiency of the day operating room was improved, and the rate of doctors’ temporary cancellation of operations was reduced from 3.04% to 1.68%; the medical quality index was improved, the rate of unplanned reoperation decreased from 0.173‰ to 0.078‰, and the patient satisfaction increased from 94% to 99%. It shows that the homogenization management is an effective management method to effectively guarantee the quality and safety of medical treatment and improve the quality of ambulatory surgery in multi-zone and mixed management mode.