Objective To investigate the situation of MRI examination in children in outpatient and inpatient departments of the Sichuan Provincial People’s Hospital from 2010 to 2012, so as to provide favourable basis for the choice of imaging examination in children. Methods The materials of electronic reports of MRI examination in paediatric inpatient and outpatient departments from 2010 to 2012 were collected, categorized, and analyzed. Results a) 2 148 children underwent MRI examination in the Sichuan Provincial People’s Hospital from 2010 to 2012. The total number of patients increased with year. Boys were more than girls. The positive incidence was slightly decreased. The number of outpatients was more than inpatients, but the positive incidence was lower in outpatients. b) The total numbers of examination position were increased with year and the number of single position examination was the most (accounted for than 85% of the total numbers). The main examination positions included: head, MRA of the head, cervical column, knees, lumbar column, pituitary gland, thoracic column, and abdomen. The examination positions diversified gradually. The application of examination technique also increased gradually. c) The systemic disease spectrum of positive cases in MRI examination included 9 categories, which accounted for 42.86% of ICD-10. The nervous systematic disease, muscle, skeleton and connective tissue disease were the categories. The major disease types were stable during the recent 3 years. The increase was obvious in injuries of the knees, malacosis and atrophy of the brain, the deformity of the brain. Conclusion The total numbers of the patients and positions examined increased gradually with year in the Sichuan Provincial People’s Hospital from 2010 to 2012. The applications of MRI in the head, limbs and joints, and soft tissues were more extensive. Children diagnosed as positive results had diseases of the central nervous system, limbs and joints, and connective tissue disease.
ObjectiveTo analyze the application of artificial pricing system in wound care clinic. MethodsWe retrospectively analyzed the pricing and charging by five nurses with artificial pricing system between January and May 2013 in the wound care clinic of a grade-A level-three hospital in Beijing. Among the 1012 times of pricing, 448 were out-of-pocket cases, 372 were insurance cases and 192 were military cases. ResultsGenerally, the average fee of the three types of cases had no significant difference (P>0.05). The military case was a little higher than the other two kinds of cases, and the cost of insurance cases was the lowest of all. There were no significant difference between the average price of out-of-pocket cases and military cases, and the general average price, but there was some differences in the aspect of insurance pricing. In the insurance cases, two nurses' pricing was significantly lower and one significantly higher than the general average (P<0.05). ConclusionThe artificial pricing system is unstable and uncertain, and it has high risk on patients'safety in wound care clinic.
The Wound Care Center of West China Hospital of Sichuan University is motivated by professional and high-quality solutions to patients’ wound problems. It has explored and carried out a variety of wound treatment modes, such as wound care specialist clinic, wound nursing expert clinic, integrated wound multiple disciplinary team clinic and complex and difficult wound consultation. Under the multi-mode management of wound treatment, patients with all levels and all types of wounds are treated in an orderly manner, which has effectively promoted the development of wound care to a deeper level, a wider range and a higher level. This paper introduces the experience of multi-mode wound treatment in Wound Care Center from the aspects of organizational structure and treatment process, wound outpatient management, wound treatment competence matching and multi-mode operation. The purpose is to provide a reference for the management of related departments in similar hospitals.
General outpatient surgery is quite common in outpatient department at hospitals. In order to optimize the patient visit flow, the Day Surgery Center, Medical Affairs Department, Outpatient Department, Surgical Anesthesia Center and some relevant departments of West China Hospital of Sichuan University implemente whole process management of patients undergoing general outpatient surgery. Based on the practice of general outpatient surgery, West China Hospital of Sichuan University summarized and drafted the management protocol of general outpatient surgery from the aspects of organizational structure, management system and emergency plan, in order to provide a reference for the standardized development of general outpatient surgery in China.
Objective To investigate the current status of multi-disciplinary team (MDT) in outpatient clinics of medical institutions in Sichuan, and to provide reference for further promoting the MDT model in outpatient clinics. Methods In November 2022, questionnaires were distributed to the outpatient management personnel of Sichuan Outpatient Management and Medical Quality Control Center from various medical institutions. The questionnaire included the basic information of the survey subjects and medical institutions, the current status of outpatient MDT work, the current status of operation and management, and the internal and external influencing factors of MDT development. Results A total of 106 questionnaires were received, of which 104 were valid. There were 70 hospitals that had provided outpatient MDT services, with a development rate of 67.31%, mainly concentrated in the past 5 years. A total of 60 hospitals (85.71%) had established MDT related systems, but only 14 hospitals (20.00%) had carried out relevant quality evaluation work. Among the 104 outpatient management personnel surveyed, 83.65% believed that the external factor affecting the development of outpatient MDT was the lack of correct understanding of MDT by patients, and 78.85% believed that the internal factor affecting the development of outpatient MDT was the low participation enthusiasm of departments and doctors. Conclusions The outpatient MDT in Sichuan is still in its early stages of development, and the outpatient MDT model has not yet been unified in terms of establishment standards, organizational methods, operational management, and fee standards. In the future, relevant departments and medical institutions still need to work together to promote its sustainable development.
Objective To explore the application of risk assessment of nosocomial infection control in outpatient departments, so as to find out the high-risk departments and high-risk links of nosocomial infection, and to provide basis for the formulation of nosocomial infection prevention and control measures in outpatient departments. Methods The improved risk assessment tool was used to evaluate the nosocomial infection management risk in the outpatient departments of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. We evaluated risk indicators and risk levels from three dimensions: likelihood of risk occurrence, severity of consequences, and integrity of the current system. Results Among the evaluated outpatient departments, the departments with extremely high risk levels included pediatric fever outpatient department (147.8 points), pediatric outpatient department (141.2 points), emergency internal medicine department (139.4 points), and pediatric emergency department (138.8 points). The departments with high risk levels included internal medicine outpatient department (138.4 points), dermatology outpatient department (136.0 points), otolaryngology-head and neck surgery outpatient department (135.6 points), and ophthalmology outpatient department (134.0 points). The risk assessment scores of 31 outpatient departments showed a normal distribution. The evaluation results of various risk indicators showed that among the 26 risk indicators, there were 2 extremely low risk, 4 low risk, 6 medium low risk, 7 medium high risk, 4 high risk, and 3 extremely high risk. The 3 extremely high risk indicators were lack of nosocomial infection prevention and control knowledge, patients with difficult to identify diseases (air/droplet transmission) seeking medical treatment, and crowded waiting areas for patients. Conclusions The comprehensive risk assessment of outpatient departments can screen out high risk outpatient departments and find out the main risk links. We can concentrate resources on key departments, prevent key risks, and improve the efficiency of nosocomial infection control.