Designing a wayfinding system: a co-design approach for a Chinese oncology hospital

For a safe and healthy workplace in the health sector, the International Labor Organization (ILO) and the World Health Organization (WHO) jointly developed HealthWISE, an international technical tool that helps health workers (HWs) to identify workplace hazards and apply low-cost solutions. This study sought to gather experiences and lessons from a Chinese pilot hospital for the scale-up application of HealthWISE. A qualitative study was undertaken at a Chinese public hospital with a ≥5-year application of HealthWISE through in-depth interviews with targeted HWs who participated in the Training-of-Trainer (TOT) workshops, and observations were gathered using evidence from photos and publications, then, thematic analysis was formulated. Driven by motivation, the participants learned from the HealthWISE TOT workshop alongside the favorite and worst parts of it. Positive changes and results of occupational health for HWs occurred after the workshop, the participants trained others and planned to implement HealthWISE within their responsibility. During the COVID-19 Pandemic, the Hospital acted the approaches of protecting the health, safety and well-being of HWs with significant results. Further suggestions on workshop and HealthWISE implementing as well as the national policies were collected. The study indicated the Hospital's experience of leadership and participation, supporting and facilitating, system establishment, and culture creation. The suggestion included keeping staff engaged under a positive safety and health culture, promoting recognition of HealthWISE among public health institutions nationwide, developing online courses for medical colleges, focusing on the alignment among various law systems, and adopting measures under the principle of the hierarchy of occupational hazards controls. This study has demonstrated the systematic improvement of occupational health for HWs by HealthWISE implementation in the Chinese hospital. The valuable experiences and lessons derived here can be shared with other hospitals in China and beyond, especially under the unprecedented challenges of the COVID-19 pandemic, to achieve the goals of safety, health, and well-being for HWs by building a resilient health system.

Background: Efficient use of government funding has been increasingly relevant for the success and sustainability of ongoing health-system reform in China; however, as there is no generic substitution policy, patients and basic health-insurance programs pay more for public-preferred brand originators. Such phenomenon is especially typical in public hospitals. The objective of this study is to estimate the potential cost savings in procurement by Chinese public hospitals when switching from brand originators of anti-hypertensive and anti-diabetic medications to their generic equivalents between 2012–2014.Method: IMS Health volume and value consumption data (IMS China Hospitals Audit system 2012–2014) were used, which covered all Chinese hospitals with 100 beds and above. The top 60% IMS volume consumption of respective anti-hypertensive and anti-diabetic medication with unique dosage form and strength were included. The potential cost savings were calculated from a switch of brand originators with their generic equivalents on the Chinese and international market. An independent sample t-test was conducted to compare the difference of proportion of cost savings in value between the Chinese and international market.Results: An average of 44% (US$44 million) and 87% (US$90 million) and a total of US$1.4 and 2.8 billion (2014 US$) could be saved from a switch from originator brand anti-hypertensives and anti-diabetics to domestically and internationally available generic equivalents, respectively. The differences of cost savings (in proportion) between domestic and international market were statistically significant (α = 0.005, p = 0.003, p = 0.002, p = 0.000).Conclusion: Expensive brand originators dominated the anti-hypertensive and anti-diabetic market in Chinese hospitals between 2012–2014. Preference of brand originators wastes a huge amount of health resources in China and these limited resources could have been used more efficiently. As one of the world’s key generic suppliers, if China wants to use its health resource more efficiently on medicines, comprehensive measures are needed to address both demand-side (consumers’ low trust in the quality of local generics) and supply-side barriers (health professionals’ preference of brand originators).

BackgroundA psychometrically validated instrument to measure patient experience in Chinese public hospitals would be useful and is currently lacking. Our research team developed the Patient-Reported Experience Measure for Care in Chinese Hospitals (PREM-CCH). We aimed to validate this PREM-CCH in the present study.MethodsData were drawn from a cross-sectional patient survey in 2016. Complete responses from 2293 outpatients and 1510 inpatients were included. Separate psychometric evaluation was carried out on outpatient and inpatient PREM-CCHs in terms of exploratory factor analysis, internal consistency, construct validity and criterion validity.ResultsThe validated outpatient PREM-CCH contained 22 items and five Factors, i.e. Communication and information, Professional competence, Medical costs, Efficiency, and Hospital recommendation. The validated inpatient PREM-CCH contained 19 items and six Factors, i.e. Communication and information, Professional competence, Medical costs, Efficiency, Health outcomes, and Hospital recommendation. The PREM-CCH showed satisfactory internal consistency, construct validity and criterion validity.ConclusionsThe PREM-CCH is one of the first validated instruments capturing patient experience of care in the context of Chinese public hospitals. It performed well in the psychometric evaluation. It consists of a basic set of items important to patients that could be applicable to public hospitals in China and actionable to inform quality improvement initiatives.

PurposeUsing a quantitative research method, health-care workers’ (HWs) well-being was taken as the dependent variable while the two independent variables were physical quality and service environment. This study aims to focus on the well-being of HWs in their physical environment.Design/methodology/approachThis study used a hybrid method that is a combination of literature review and questionnaire survey. This study used quantitative research design which is a systematic study of phenomenon by collecting quantifiable data and performing statistical, mathematical or computational techniques. This study is conducted among HWs, with doctors and nurses at four Chinese government hospitals in the southern city of Changzhou (near Shanghai) as participants.FindingsA total of 222 responses were obtained from a random sample of HWs from four hospitals in Changzhou City, Jiangsu Province. Three-fifth of the participants (n = 133, 60%) are satisfied with hospital equipment and half (n = 111.50%) of them are satisfied with the modern technology in place. About one-third (n = 67, 30%) are satisfied with ventilation and only one-fifth (n = 44, 20%) are satisfied with hygiene. Most HWs think it was necessary to provide tests for frontline workers.Originality/valueIn the wake of COVID-19 in 2020, HWs are working long hours every day facing high risk of infection and stress. This research investigates the satisfaction level and the difficulties experienced by HWs based on the current physical environment setting during COVID-19 pandemic.

Objectives: This study investigated workplace violence (WPV) toward frontline health workers under comprehensive interventions to improve the occupational safety and health management system in a Chinese infectious disease hospital. Methods: The risk assessment of WPV using an international questionnaire was conducted in 2018 and 2021 to compare the perceived levels of exposure to WPV and intervention measures before and after the intensification of anti-violence measures in the hospital context. Additionally, qualitative data were collected in 2021 through semi-structured and unstructured interviews, providing complementary information about WPV toward frontline health workers (HWs). Results: After establishing the occupational safety and health management system (OSHMS), the total incidence rate of WPV decreased from 60.90% in 2018 to 34.44% in 2021. Psychological violence declined significantly from 60.90% in 2018 to 33.89% in 2021. The endorsement of precautionary measures increased significantly from 2018 to 2021, including patient screening recognition, patient protocol, shift or rota changes, etc. A thematic analysis of several subthemes shows that HWs had an in-depth understanding of WPV, recognizing its multifaceted consequences in the context of complex risk factors. Conclusions: This study demonstrates a significant decrease in WPV, psychological violence, verbal abuse, bullying/mobbing, and ethnic discrimination after implementing the comprehensive OSHMS.

BackgroundPatient-centred care and patient autonomy is one of the key factors to better quality of service provision, hence patient outcomes. It enables the development of patients’ trusts which is an important element to a better doctor-patient relationship. Given the increasing number of patient disputes and conflicts between patients and doctors in Chinese public hospital, it is timely to ensure patient-centred care is fully and successfully implemented. However, limited studies have examined the views and practice in different aspects of patient-centred care among doctors in the Chinese public hospitals.MethodsA quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China.ResultsIn total, 614 doctors from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the inconsistent views among doctors in terms of their perception and practice in various aspects patient-centred care and patient autonomy regardless of the hospital where they work (category II or category III), their unit speciality (surgical or non-surgical), their gender or seniority. The high proportion of doctors (more than 20%) who did not perceive the importance of patient consultation prior to determining diagnostic and treatment procedure is alarming. This in in part due to the belief held by more than half of the doctors that patients were unable to make rational decisions and their involvement in treatment planning process did not necessarily lead to better treatment outcomes.ConclusionThe study calls for the development of system level policy and organisation wide strategies in encouraging and enabling the practice of patient-centred care and patient autonomy with the purposes of improving the quality of the service provided to patients by Chinese hospitals.

ObjectiveThis study aimed to assess the risk factors associated with workplace violence towards health workers (HWs) in a Chinese hospital.MethodsWe conducted a cross-sectional survey in a Chinese secondary hospital in...

Analysis of hospital infection knowledge, beliefs, behavior, and influencing factors among healthcare workers in Chinese medicine hospitals in Hunan Province

Objective: Medical errors or near misses (MENM) may cause serious negative outcomes for the patients. However, medical professionals with MENM may also be secondary victims. Although the association between MENM and depression among medical professionals has been explored in several previous studies, the possible causal relationship has been explored less, especially in China. In this study, our first aim was to determine the prevalence of MENM among Chinese medical professionals. We also wanted to explore the causal effect of MENM on depressive symptoms based on a propensity-score matching analysis. Methods: A cross-sectional study was conducted among medical professionals in Chinese public general hospitals, and 3426 medical professionals were analyzed in this study. The Center for Epidemiologic Studies Depression (CES-D) scale was used to assess depressive symptoms. Social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS). MENM, social-demographic variables, occupational characteristics, and physical disease were also evaluated in this study. Results: The one-year prevalence of perceived MENM was 2.9% among medical professionals in Chinese public general hospitals. The results of logistic regressions showed that working hours/week (OR = 1.02, p < 0.05) and depressive symptoms (OR = 1.05, p < 0.001) were associated with MENM. After propensity score matching, depressive symptoms were associated with MENM (OR = 1.05, p < 0.001) among medical professionals. The associations between occupational characteristics, physical disease, social support, and MENM were not supported by this study. Conclusions: The one-year prevalence of MENM was low in Chinese public general hospitals, and based on our propensity score matching analyses, the occurrence of MENM may cause depressive symptoms in medical professionals. A bigger effort by health systems and organizations may be helpful for reducing MENM.

A Global Call for Action to Prioritize Healthcare Worker Suicide Prevention During the COVID-19 Pandemic and Beyond.

ObjectiveTo explore the current knowledge and application of vital sign zero and the identify-isolate-inform (3I) system among healthcare workers in China in order to provide a reference for future improvement of healthcare workers' awareness of personal protection and prevention and control measures of infectious diseases.MethodsThe questionnaire was used to investigate the basic information of health care workers, their knowledge and application of Vital sign zero and the 3I system. A total of 602 forms of health care workers from tertiary hospitals were randomly collected and included for analysis.ResultsThe survey showed that 45.30% and 57.30% of the healthcare workers from Chinese tertiary hospitals know about vital sign zero and 3I system while 51.80% and 57.30% of them applied these measures in their clinical practices. Logistics regression analysis results showed that healthcare workers aged 35 years old and below were less aware of vital sign zero than those above 50 years old (OR = 0.405, 95% CI: 0.174–0.942, P = 0.036). Compared with those in Northwest China, healthcare workers who worked in East China (OR = 0.147, 95% CI: 0.031–0.702, P = 0.016), Central China (OR = 0.085, 95% CI: 0.018–0.403, P = 0.002), Southwest China (OR = 0.083, 95% CI: 0.014–0.48, P = 0.006) and North China (OR = 0.201, 95% CI: 0.042–0.966, P = 0.045) were less aware of vital sign zero while the healthcare workers in Northeast China (OR=9.714, 95% CI: 1.091–86.521, P = 0.042), East China (OR = 18.049, 95% CI: 2.258–144.259, P = 0.006), Central China (OR = 25.560, 95% CI: 3.210–203.502, P = 0.002), South China (OR = 11.141, 95% CI: 1.395–88.947, P = 0.023), Southwest China (OR = 23.200, 95% CI: 2.524–213.286, P = 0.005) and North China (OR = 14.078, 95% CI: 1.756–112.895, P = 0.013) had a better understanding of the 3I system than those in Northwest China. Healthcare workers with more than 20 years of working experience showed less knowledge of the 3I system than those with less than 5 years of working experience (OR = 0.409, 95% CI: 0.215–0.77, P = 0.006).ConclusionThe current levels of knowledge and application of vital sign zero and the 3I system in the healthcare workers of Chinese tertiary hospitals need to be improved. The concept of vital sign zero should be incorporated into the prevention triage system of infectious diseases.

International Registry of Otolaryngologist‒Head and Neck Surgeons with COVID-19.

Healthcare workers are at high risk for acquiring COVID-19 and transmitting it to the patients especially to cancer patients in whom the risk of severe COVID-19 is high. We determined the rate of COVID-19 infection among healthcare workers in an oncology hospital and their epidemiological characteristics. Data of infected workers from March 11, 2020, to February 28, 2022 were obtained via Infection Control Committee COVID-19 Surveillance Records and evaluated retrospectively. During this period 58.34% of 2,355 workers were vaccinated with > 3 doses of COVID-19 vaccines. A total of 1,294 COVID-19 attacks developed in 1,181 (50.14%) workers; mean age was 38.08 ± 9.52 years, 744 (63%) were female. Re-infection occurred in 112 (9.5%) workers. Source of infection in 858 attacks (66.31%) was unknown. Hospitalization was needed in 24 (2%) and intensive care unit admission in 1 (0.08%), no death occurred. In the first attacks, 587 (49.70%) were unvaccinated; in re-infections 66 (58.92%) were ≥ 3 doses vaccinated. Hospitalizations were predominantly in the pre-Delta period (16/24: 66.7%, p < 0.05). Re-infections occurred mostly in the Omicron variant period (p < 0.05). Relationship between hospitalization and male gender, age ≥ 50 years, "doctor" profession and presence of chronic diseases were significant (p < 0.05). During the study period, half of the healthcare workers in our hospital developed COVID-19 infection of whom 9.5% re-infected, predominantly during the Omicron variant period. Our findings highlight the importance of taking preventive measures and administering booster vaccine doses even after initial vaccination/infection.

Background and Objectives: Greece, despite its relative blood sufficiency and high international ranking in terms of the number of blood donors compared to its population, faces significant challenges due to the low rate of voluntary blood donors, as well as the demographic aging of the population in the medium to longer term. The purpose of the study is to evaluate the knowledge, attitudes, and practices (KAP) of health professionals at the Oncological Hospital “Metaxa” in Greece, regarding voluntary blood donation (VBD). The objective of this research is to investigate the effect of sociodemographic characteristics of health professionals as regards KAP on VBD and to find factors related to their participation in VBD promotion policies. Methods: The study was based on the review of the relevant literature, followed by empirical research employing the KAP model. The study was conducted on 254 health professionals of the Oncological Hospital “Metaxa.” in the period December 20, 2019 to March 3, 2020, using a questionnaire. The data were analyzed using SPSS version 21 with P value set at 0.05 for statistical significance. Results: The research findings indicate a high score in the knowledge and attitudes of health professionals regarding blood donation (BD), but low performance in the practice. BD correlates to knowledge and attitudes as well as gender. The majority of the health professionals responded positively in terms of their participation in BD programs. Gender, age, professional position, and years of service were associated with participation in BD programs. Conclusions: The results of the research justify the possibility of activating health professionals in policies to promote VBD, to the extent that due to their knowledge and positive attitude regarding BD, they can promote VBD in different population groups and ultimately contribute to an increase in the size of blood supply.

To develop a patient safety culture instrument for use in Chinese hospitals, we assessed the appropriateness of existing safety culture questionnaires used in the USA and Japan for Chinese respondents and identified new items and domains suitable to Chinese hospitals. Focus group study. Twenty-four physicians, nurses and other health-care workers from 11 hospitals in three Chinese cities. Three focus groups were conducted in 2010 to elicit information from hospital workers about their perceptions of the appropriateness and importance of each of 97 questionnaire items, derived from a literature review and an expert panel, characterizing hospital safety culture. understood the concepts of patient safety and safety culture and identified features associated with safe care. They judged that numerous questions from existing surveys were inappropriate, including 39 items that were dropped because they were judged unimportant, semantically redundant, confusing, ambiguous or inapplicable in Chinese settings. Participants endorsed eight new items and three additional dimensions addressing staff training, mentoring of new hires, compliance with rules and procedures, equipment availability and leadership walk-rounds they judged appropriate to assessing safety culture in Chinese hospitals. This process resulted in a 66-item instrument for testing in cognitive interviews, the next stage of survey development. Focus group participants provided important insights into the refinement of existing items and the construction of new items for measuring patient safety culture in Chinese hospitals. This is a necessary first step in producing a culturally appropriate instrument applicable to specific local contexts.