Basing on the special geographical environment, population, economic level and medical conditions of the areas along the plateau railway, as well as the policy requirements of primary healthcare institutions in China, combining the reality and early practice of the areas along the plateau railway in China, the High Altitude Medicine Committee of Sichuan Medical Association gathered the experts in the field of high altitude medicine in China, and launched the Expert Consensus on Basic Requirements for Primary Healthcare Institutions in Areas Along the Plateau Railway. Its content covers the scale and layout, infrastructure, personnel allocation and service capacity, material allocation of primary healthcare institutions in areas along the plateau railway, and provides professional guidance for primary healthcare institutions in these areas.
Objective To review the adverse event of hysterectomy caused by postoperative infection after cesarean section, formulate prevention and control strategies in combination with risk assessment tools, promote the standardization of perioperative management, reduce the medical burden on pregnant women, and improve patient satisfaction. Methods The two adverse events of hysterectomy caused by postoperative infection after cesarean section that occurred in the obstetrics ward between October and November 2024 were selected as the research objects. A root cause analysis and risk assessment team composed of personnel from multiple departments was established. Through interviews, observations, and data review, the potential failure modes and causes were sorted out. The risk priority number (RPN) was calculated to determine the high-risk factors. Improvement strategies were formulated and implemented. After two-month implementation, the RPN scores and the compliance of various measures before and after the implementation were compared. Results Before the improvement, the total RPN of the healthcare failure mode and effects analysis was 367.8. When rechecked in January 2025, the total RPN after the improvement dropped to 105.7, and no serious adverse events occurred again. The compliance and passing rates of various operations significantly increased: the intervention rate for maternal malnutrition rose from 17.5% to 48.6%, the passing rate of appropriate timing for prophylactic use of antimicrobial agents before surgery increased from 50.5% to 81.0%, the compliance rate of scrubbing the vagina with disinfectant before surgery increased from 15.0% to 60.0%, the implementation rate of standardized skin disinfection during surgery rose from 66.7% to 95.2%, the passing rate of aseptic techniques and hand hygiene operations during surgery increased from 75.0% to 95.2%, and the timely submission rate of specimens from infected patients increased from 29.4% to 47.6%, and all these differences were statistically significant (P<0.05). Conclusion The combination of healthcare failure mode and effect analysis and root cause analysis can effectively improve adverse events during the perioperative period, optimize the perioperative management of cesarean section, and reduce the risk of infection.
In the context of collaboration between healthcare and education systems, in order to promote competency-oriented medical education reform and improve the clinical capabilities of medical students at all levels, it is urgent to enhance the organizational guarantee to establish a stable teaching team in university-affiliated hospitals. As the National Clinical Teaching and Training Demonstration Center, West China School of Medicine / West China Hospital of Sichuan University has taken the lead to explore the building of a full-time teaching team for clinical practice teaching, innovating and implementing the system of “Full-time Practice Teaching Post”. This innovative measure ensures the whole-process management, teaching, and assessment of medical students, strengthens teacher training and top-level design of teaching and research, improves the incentive mechanism for teachers, applies multiple teaching resources and novel teaching methods, and finally improves the quality and culture of clinical practice teaching.
With the fast advancement of information technology and artificial intelligence, the conventional medical service model has been presented with new growth potential. Internet-based health care has become one of the unavoidable future delivery methods for diagnostic and therapeutic services. Internet-based hospitals are being deployed in medical facilities throughout. The extension of offline to online diagnosis and treatment will need new standards for the personal competency of physicians as well as new requirements for medical education and staff training. In the context of universal Internet diagnosis and treatment, research on the full-cycle training of medical talent will play a clear guiding role in the development of physicians’ skills. By evaluating the relevant literature on competence model and interviewing the behavior events of working physicians in e-hospitals, together with the real situation of current medical students and doctor training barriers, this article aims to improve the quality of remote healthcare via provide related path for enhancing the periodic medical education based on the competency variables.
ObjectiveTo investigate primary healthcare workers' knowledge, attitude and behaviour, and explore the way of guidelines' popularization, application and surveillance mechanism in primary healthcare institutions. MethodsHealthcare workers in seven township hospitals in Gaolan county, Gansu province were given a questionnaire to test their knowledge, attitudes and behaviour regarding Clinical practice guidelines. ResultsAmong the 143 distributed questionnaires, 143 valid were retrieved. The results showed that 80% of respondents knew the guidelines and 51% had used guidelines in treatment, 32% obtained guidelines mainly through distribution by affiliations. The most popular type of guidelines was self-developed by native departments. Respondents (37%) considered difficult availability of guidelines major barriers to popularization, 74% failed to receive training about guidelines, 88% looked forward to special organizations in charge of disseminating guidelines and conducting related training on how to apply guidelines. ConclusionPrimary healthcare workers report low awareness of, attention to and compliance with clinical practice guidelines. The greatest challenge for guidelines' popularization in township hospitals is difficult availability and it is of vital importance for primary institutions to enhance guidelines' implementation and strengthen learning and conduct training.
Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.
The Second People’s Hospital of Yibin was taken over by West China Hospital of Sichuan University into its close hospital alliance, and simultaneously undertook the task of construction of regional hospital alliance in Yibin city. The article introduces the experiences of the Second People’s Hospital of Yibin in the high-quality development of novel healthcare system. Led by West China Hospital of Sichuan University and based on all-level medical institutions in Yibin, the Second People’s Hospital of Yibin preliminarily established a four-level hierarchical medical system as “province, city, county, village” model, according to the guide of governments within the whole region. It aims to propose a “Yibin model exploration” in hospital alliance construction based on the western regional situation.
ObjectiveTo analyze the application status of Kanban management in medical service management at home and abroad and to provide a reference for lean medical management practice in China.MethodsUsing the bibliometric method, in China National Knowledge Infrastructure, Wanfang Database, CQVIP Journal Database, Springer Link, Embase and PubMed, we used “Kanban” and “Kanban management” as Chinese search terms, “Kanban system” and “two-bin system” as English search terms to search for literature published from 2009 to 2019. The number of articles published, institutions, authors, citation frequencies, key words, Kanban usage, and improved areas where Kanban was applied in were statistically described and analyzed.ResultsA total of 219 articles were retrieved. Of the 14 articles included in the study, 12 articles were published from 2015 to 2019, 8 articles were published by hospitals, and 9 articles were cited more than or equal to 3 times. The key words were basically the combinations of Kanban and related topics in the field of medical service management, such as quality control and improvement, ward service, high-quality care and process evaluation; 11 articles used Kanban alone. Kanban was used in medicine supply chain management, ward bed management, and material inventory management abroad; and was used in medicine management, emergency room patient management, medical staff performance management, operating room equipment management, and high-quality medical service management in China.ConclusionsKanban as a lean management method was introduced into the domestic medical field late, and the current research development is not balanced. Asa visual management tool, Kanban needs to be extended in the medical field. As a lean improvement tool, Kanban has positive significance in improving medical quality and patient satisfaction. It is suggested that researchers should not be limited to the existing applied research, and can study the application of Kanban in different medical service fields in combination with different lean management tools according to the actual situation of the hospital.
At present, China has entered an aging society facing the dual challenges of “growing old before becoming affluent” and “aging without adequate preparation”, leading to significant eldercare pressures. With the rapid development of smart healthcare, the elderly population’s diverse, differentiated, and personalized medical demands have become increasingly prominent, presenting new challenges for geriatric healthcare services. This article elaborates and analyzes the elderly healthcare policies and the healthcare challenges faced by the elderly under China’s national strategy for actively addressing population aging. It also introduces the practical experience of intelligent elderly medical assistance in West China Hospital of Sichuan University from the aspects of enhanced appointment coordination mechanisms, refined treatment workflow optimization, and upgraded patient-centered service provisions. The research ultimately proposes actionable management strategies to achieve intelligent continuity in geriatric care delivery.
ObjectiveTo evaluate the current status of primary healthcare system reform in Xinjin county, in order to provide baseline data for improving the healthcare service system and population health in Chengdu. MethodsPrimary health care services and population health in Xinjin county were quantitatively described and compared. Resultsa) Eleven township hospitals (100%) and 89 village clinics (66.42%) were upgraded according to the national standards. The management of 60 village clinics were integrated with township hospitals. And 417 and 76 essential healthcare services were provided by township hospitals and village clinics, respectively. b) In 2010, the number of outpatients and inpatients in Xinjin county were increased by 24.2% and 46.3% respectively compared to those of 2009, while the costs per outpatient visit and inpatient discharge were reduced by 21.5% and 18.6% respectively. c) In 2010, health records of 98.2% of population in Xinjin county have been established; 96.3% of pregnant women were managed systematically; 98.8% of children immunization programs were implemented; 100% patients with severe mental disorders and about 78% with hypertension and diabetes were in follow-up and treatment; and 28.8% of total population got the free physical exams in 2010. d) The essential medicine accounted for 96.7% of total types of medicines and 97.8% of total expenditure of medicines in primarily healthcare institutions in Xinjin. The cost of medicine management was reduced from 8.5% to 4.2% while the medicine turnover rate was increased by 50%. e) Average life expectancy in Xinjin county was 77.97 years, infant mortality rate was 6.82‰ in 2010; and there was no maternal death in recent 8 years. f) The regional healthcare information system was established covering three-tier rural health care network spanning the county, township and village. Conclusiona) The primary healthcare system reform in Xinjin county improves the infrastructure of primary care system, the utilization of essential medical care, essential public health service, and essential medicines. b) Life expectancy, infant mortality rate and maternal mortality of Xinjin county are better than the average levels in Sichuan province and China. Xinjin county is a representative pilot county for healthcare service system reform in Chengdu city and a nice model to successfully promote healthcare system reform based on regional healthcare information system.