Objective To construct a quality evaluation index system for healthcare-associated infection (HAI) management, and conduct an empirical evaluation on the quality of HAI management in clinical departments. Methods The literature research method and panel discussion method were adopted to initially form the framework of HAI management quality evaluation index system, and the Delphi method and the analytic hierarchy process were used to establish the index system and determine the weights from January to December 2018. Eight comprehensive evaluation methods, such as osculating value method and technique for order preference by similarity to an ideal solution method, were used to evaluate the quality of HAI management in clinical departments of West China Hospital, Sichuan University in 2018. Kendall’s coefficient of concordance (W) was used to assess the consistency of the results. The clinical departments were ranked by the standardized total scores, which were the means of the normalized scores of the eight methods. Results A quality evaluation index system for HAI management with 3 first-level indicators and 15 second-level indicators was established finally. The results of the eight comprehensive evaluation methods for the quality evaluation of HAI management in 39 clinical departments of West China Hospital, Sichuan University were consistent (W=0.952, χ2=259.800, P<0.001). The standardized total score of Department 18 was 100, which ranked the first place. Conclusion The HAI management quality evaluation index system constructed in this study could be used in clinical departments to evaluate the quality of HAI management in combination with comprehensive evaluation methods.
ObjectiveTo investigate the incidence and trendency of healthcare-associated infections (HAIs) in a pediatric intensive care unit (ICU) of a hospital, identify the main objectives of infection control, and formulate corresponding preventive and control measures.MethodsA prospective targeted monitoring method was adopted to investigate HAIs in the pediatric ICU of a hospital from January 2013 to December 2018.ResultsFrom January 2013 to December 2018, the number of target ICU patients was 11 898, the number of patient-days was 55 159; 226 HAIs occurred, the HAI case rate was 1.90%, the incidence of HAI per 1 000 patient-days was 4.10‰, and the adjusted incidence of HAI per 1 000 patient-days was 1.21‰. The main infection site was respiratory tract [83 cases (36.7%)], with ventilator-associated pneumonia in 73 cases (32.3%); secondly, 69 patients (30.5%) had bloodstream infection, among which 48 (21.2%) had non-catheter-related bloodstream infection.ConclusionHospital targeted monitoring is helpful to grasp the situation and trend of HAIs, define the main target of infection control, and formulate corresponding preventive and control measures, which can effectively reduce the incidence of HAIs.
ObjectiveTo analyze the main input and output of healthcare reform in China, and to provide references for improving the policies and measures of healthcare reform in China in future. MethodsData from the National Health Services Survey, and the China Statistical Yearbook etc. was collected to compare and analyze the allocation of health resources, health status of residents, health service utilization, and medical burden before and after healthcare reform. ResultsDuring the reform from 2009 to 2013, hospital health and technical personnel increased year by year. In 2013, the proportion of health and technical personnel in hospitals was up to 61.4% of the total national health technical personnel. In 2013, 65.19% of government expenditure on healthcare was used for disease treatment, and only 14.59% was used for disease prevention. Compared with the year of 2008, the two-week prevalence rate of residents increased by 5.2%, the chronic disease prevalence rate increased by 9% in 2013. Compared with the year of 2009, the annually diagnosed and treated patients increased 18.2 billion person-time, the annually discharged patients increased 59.65 million person-time in 2013. The individual residents paid 52.49% of total medical expenses. ConclusionSince the healthcare reform, China's central and local governments have imputed a large number of health resources into hospitals for "disease treatment". That partly improved the utilization of residents' health service, but the two-week prevalence rate and chronic disease prevalence rate are rapidly growing. There is still high burden of medical expenses for the residents. China's healthcare model should be changed from "treatment-centered" to "prevention-centered" in future.
The increasing need for healthcare services in rural areas cannot be satisfied because of the lack of healthcare professionals, and poor medical education and training. These result in the low competency of rural healthcare workers. Therefore, the medical education system needs to be reformed in order to improve healthcare human resources in rural areas.
Objective To set up healthcare device-technology deployment assessment model and procedures through establishing the assessment parameter system between the functions of the clinical technical requirements and devices. Methods The bidirectional assessment parameter system developed by the literature review and Delphi, then combination weighting calculated by the combination weighting method, and the proposals for function deployment performed on the cluster analysis. Results The positive coefficients of twice Delphi were 75.56% and 87.50%, respectively. The effective recovery rates of the questionnaire were higher. The structure of the bidirectional assessment parameter system acquired according to the data mining and review, Delphi and integrated analysis. We calculated the weighting for the required functions and the deployed functions of the ventilator in the ICU, ER and RR. We listed the absolute importance and rank. The proposals for the function deployment of the ventilator which met different needs in fields of the critical care medicine were produced by the cluster analysis, ranking absolute importance and the calibration of weighting based on the investigation for actual function utilized rate. Conclusion It studies healthcare device-technology deployment assessment model by sequential integrated methods and sets up bidirectional assessment parameter system based on clinical technical function requirement, and the result is effective.
Objective To summarize and analysis the working experience of healthcare performance evaluation and reporting experience in local health administration department of Australia, and provide decision support to China on such work as establishing objective, scientific, effective healthcare performance evaluation system, strengthening government’s supervision over health service and improving healthcare system management efficiency. Methods Searching official networks and databases of Australia, and finding out relevant policy, reports, and documents on healthcare performance evaluation. Results Typical healthcare performance evaluation systems in Australian are as follos: National Health Performance Framework (NHPF), the National Healthcare Agreement（NHA）and Review of Government Service Provision. Conclusions These programs in Australian is enlightening to these work in China that performance evaluation should be the prior tool in health system to management and reform, the performance measurement indicators systems should emphasize the quality safety and health fair.We should set up scientific and flexible index inclusion criteria and open report and compare performance information.
Objective To analyze the policy and guideline, the institutional management and the operation mechanism of ICU medical risk management in the United Kingdom, the United States, Australia, Canada and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. Methods Such databases as PubMed, EMBASE, The Cochrane Library were searched to include the literatures such as the guideline documents and the research reports on ICU medical risk management in the United Kingdom, the United States, Australia, Canada and Taiwan; the institutional management and the operation mechanism of the risk management in the above four countries and one area were comprehensively analyzed, and especially the UK model was highly emphasized. Results A total of 31 literatures were included, including 1 guideline, 5 reviews, 2 investigative reports and 23 research documents. The United Kingdom guided the ICU risk management in forms of the standard and the guideline, formulated a clear tool of event classification and corresponding response mechanism. The United States learned from Australia’s experience and established the ICU safety reporting system; both of them regarded ICU as one part of the medical risk management and set up a special management column. Conclusion The ICU risk management with the independent report system in the United Kingdom is brought into the scope of national patient safety management, and is regarded as the relative complete system at present. In Australia and the USA, the national institutions are in charge of setting up the research projects of ICU risk management; the industry associations and the non-governmental organizations lead the risk research; and the experimental units popularize gradually after self-application.
Healthcare-associated infections pose a significant challenge to healthcare institutions, severely threatening healthcare quality and patient safety. To enhance the quality of infection prevention and control across healthcare facilities at all levels, promote standardization, and drive continuous quality improvement, quality control centers for infection prevention and control have been established nationwide and have played a crucial role. This article conducts an in-depth analysis of the functions, current development status, and key challenges faced by these quality control centers throughout their evolution, aiming to provide insights for future advancements in quality control systems.
This article introduced the structure and features of the medical safety and quality management system of New South Wales (NSW) of Australia. The system was funded by government with overall design, multi-sectors involvement, and explicit roles of government, hospitals, and independent third parties. The system also developed national and state-wide regulations, policies, standards and their certification. The NSW Health Incident Information Management System (IIMS), the guidelines and interventional programs were also established to decrease the medical risk and ensure the healthcare quality. This system will be used for reference to the national medical risk and quality management system of China.
Electronic skin has shown great application potential in many fields such as healthcare monitoring and human-machine interaction due to their excellent sensing performance, mechanical properties and biocompatibility. This paper starts from the materials selection and structures design of electronic skin, and summarizes their different applications in the field of healthcare equipment, especially current development status of wearable sensors with different functions, as well as the application of electronic skin in virtual reality. The challenges of electronic skin in the field of wearable devices and healthcare, as well as our corresponding strategies, are discussed to provide a reference for further advancing the research of electronic skin.