Hospital Management Level Research Articles

Empirical study of China′s hospital management using methodology of World Management Survey

Objective To explore methods to measure the management level of Chinese hospitals in natural conditions of Chinese hospitals, for improvement of their operation efficiency. Methods The methodology of World Management Survey(WMS) was introduced, and the questionnaire was localized using expert consultation method.Double-blind telephone interviews were conducted to investigate the management level of Chinese hospitals in the four dimensions of standardized operation, performance monitoring, target setting and talent management. Results The management level of hospitals in China varied greatly from places.Among them, the hospital management scoring was found to range from 2.50 to 2.75 in most cases, averaging 2.55.These hospitals scored relatively poor at the four specific management practices of hospital layout(2.48), performance communication(2.27), talents retention, and clarity and comparability of objectives(2.45). Management level of a hospital was correlated to such factors as its history, ownership form, human capital and hospital size. Conclusions This study uses WMS methodology to quantify Chinese hospital management.The overall management level of Chinese hospitals is expected to improve with much gaps to cover.At this stage, it is imperative to solve the unbalanced and inadequate development of hospital management levels, among regions, hospital grades and forms of ownership. Key words: Hospital management; World Management Survey; Measurement; Appraisal; Telephone interview

Connecting Intelligent Things in Smart Hospitals Using NB-IoT

The widespread use of Internet of Things (IoT), especially smart wearables, will play an important role in improving the quality of medical care, bringing convenience for patients and improving the management level of hospitals. However, due to the limitation of communication protocols, there exists non unified architecture that can connect all intelligent things in smart hospitals, which is made possible by the emergence of the Narrowband IoT (NB-IoT). In light of this, we propose an architecture to connect intelligent things in smart hospitals based on NB-IoT, and introduce edge computing to deal with the requirement of latency in medical process. As a case study, we develop an infusion monitoring system to monitor the real-time drop rate and the volume of remaining drug during the intravenous infusion. Finally, we discuss the challenges and future directions for building a smart hospital by connecting intelligent things.

Improved quality of care based on role exchange experiences

From year 2013 to 2016, the Beijing Municipal Administration of Hospitals has carried out the role exchange campaign at 22 municipal public hospitals. Through this experience, we can increase mutual trust between doctors and patients and enhance the level of hospital management. The campaign adheres to the principles of hospital public welfare, hospital service, patient safety, medical quality management, and continuous improvement, nursing management and quality control, and hospital management. Key words: Hospital administration; Role exchange; Experience; Medical service; Improvement

The application of failure mode and effect analysis in the retrospective management of high-value consumables in implant operation

Objective The failure mode and effect analysis (FMEA) were used to monitor the managerial process of high-value consumables in the implantation surgery, and establish the traceable management process for high-value consumables of the implantation surgery. Methods FMEA was used to carry out risk assessment process, formulate specific measures for improvement. The risk priority number (RPN), the qualified rate of the management index of implant surgical consumables, the patients satisfaction, and the number of adverse events reported were compared before and after the implementation of this process management. Results After FMEA was used to conduct management over implant surgery consumables, the RPN value decreased dramatically due to difficulty of traceability, information recording, and imperfect management system, thereby showing that the difference was statistically significant (t=16.655, 10.664, 9.321, P<0.01). Quality management measures: the access to consumables meets the requirements, complete information record, quality of stock consumables, paste bar code standard, charge accurate, return visits and records on time, consumables traceability, patient satisfaction rate were 99.2% (373/376), 96.7% (363/376), 99.5% (374/376), 95.6% (361/376), 98.6% (371/376), 95.7% (360/376), 100.0% (376/376), 97.1% (365/376), respectively after the implementation of this process management, which were higher than 90.9% (355/390), 81.8% (319/390), 94.2% (367/390), 91.3% (356/390), 84.7% (330/390), 87.3% (341/390), 87.5% (342/390), 91.8% (358/390) before the implementation of this process management, thereby showing that the difference was statistically significant (χ2=7.149-49.371, P < 0.01). The number of adverse consumables event reports increased from 0 up to 5. Conclusions It was feasible and effective to improve the level of hospital management and ensure the safety of patients by using the FMEA model in the implantation surgical high-value consumables. Key words: Failure mode and effect analysis; Surgical consumables; Operating room

Current status and prospect of perioperative thrombus management in gastrointestinal cancer

Thanks to the progress of surgical theory and skills, as well as the application of modern medical devices in general surgery, both the occurrence of perioperative complications and mortality of gastrointestinal surgery have significantly reduced recently. However, it is still far from optimal in terms of the perioperative venous thromboembolism (VTE) management in gastrointestinal cancer, and what is responsible for that? This paper aims at finding out the reasons contributing to the current status, giving suggestions for how to make improvement at both disease level and hospital management level. At the same time, while paying attention for the prophylaxis of VTE, there have been more and more patients receiving antithrombotic treatment require elective or emergent surgery in clinical practice, due to aging and increased incidence of cardiovascular disease year by year. How to balance the bleeding and thrombosis risk for these patients during perioperative periods is also a question we are going to discuss. In conclusion, as to the issue of the management of perioperative thrombosis, there will be a long way for Chinese doctors to go. Our peers should pay more attention to this problem and take more efforts, so that the thrombotic complications in surgical patients can be reduced.

Establishment and application of the critical value monitoring platform

To evaluate the items of critical values and alert limits of the test results, to optimize the critical values report procedure, to modify the laboratory information system (LIS) and the hospital information system (HIS), the critical values monitoring platform was designed. Through the monitoring platform, the critical value report rate and critical value report timely rate could be calculated, so reduce medical risks and improve the level of hospital management.(Chin J Lab Med, 2016, 39: 7-9) Key words: Clinical laboratory information systems; Factor analysis, statistical; Critical illness

基于数据库网络的护理岗位分层绩效考核体系的建立与成效分析

目的：通过医院的数据库网络信息化管理平台为依托，建立护理人员岗位分层绩效考核系统，提高肿瘤专科医院护理人员工作效率及服务品质。方法：根据Delphi法确定由护士工作量、工作质量、职称、年资、岗位及学历组成的护理人员层级绩效考核系统嵌入医院的HIS系统，实施对护士的层级绩效考核，比较层级绩效考核前后护士离职率、患者对护理工作满意度、护士医生对护理工作满意度、护理质量得分等情况。结果：层级绩效实施后护士离职率低于实施前(p < 0.05)，护理质量检查得分高于实施前(p < 0.05)，实施前后患者对护理工作满意度、护士医生对护理工作满意度均有差异有统计学意义(p < 0.05),实施前后护士护理工作绩效评价自评与他评均有差异有统计学意义(p < 0.05)。结论：基于数据网络化的护理岗位层级护理绩效管理体系，有利于提升肿瘤专科医院护理人员的工作效率及职业价值，提高医院整体管理水平及服务品质，有力促进优质护理服务的深化。 Objective: Based on the hospital database network information management platform, we establish the nursing staff post hierarchical performance evaluation system and improve the quality of service of the hospital nursing staff. Methods: According to the Delphi method which determines the workload of nurses, quality of work, title, seniority, position and degree of nursing staff level of performance appraisal system get into the hospital HIS system to appraise the implementation of performance level of nurses, level of performance assessment and nursing turnover rate, the patient to nurses the work degree of satisfaction, doctors and nurses to nurses the work degree of satisfaction and nursing quality score, etc. Results: The after implementation of the level of per-formance of nurse turnover rate is lower than before (p < 0.05); the nursing quality examination score is higher than before (p < 0.05); the implementation of the patients before and after nursing job satisfaction, doctors and nurses to nursing job satisfaction were different with statistical signi-ficance (p < 0.05); the implementation of before and after the nurses’ work performance evaluation of self rating and other rated the differences were statistically significant (p < 0.05). Conclusion: Based data networking nursing post level nursing performance management system can enhance the tumor hospital nursing staff’s work efficiency and occupation value, improve the hospital management level and service quality, and have a strong impetus to the deepening of the quality of nursing service.

The Libyan civil conflict: selected case series of orthopaedic trauma managed in Malta in 2014

AimThe purpose of this series of cases was to analyse our management of orthopaedic trauma casualties in the Libyan civil war crisis in the European summer of 2014. We looked at both damage control orthopaedics and for case variety of war trauma at a civilian hospital. Due to our geographical proximity to Libya, Malta was the closest European tertiary referral centre. Having only one Level 1 trauma care hospital in our country, our Trauma and Orthopaedics department played a pivotal role in the management of Libyan battlefield injuries. Our aims were to assess acute outcomes and short term mortality of surgery within the perspective of a damage control orthopaedic strategy whereby aggressive wound management, early fixation using relative stability principles, antibiotic cover with adequate soft tissue cover are paramount. We also aim to describe the variety of war injuries we came across, with a goal for future improvement in regards to service providing.MethodsProspective collection of six interesting cases with severe limb and spinal injuries sustained in Libya during the Libyan civil war between June and November 2014.ConclusionsWe applied current trends in the treatment of war injuries, specifically in damage control orthopaedic strategy and converting to definitive treatment where permissible. The majority of our cases were classified as most severe (Type IIIB/C) according to the Gustilo-Anderson classification of open fractures. The injuries treated reflected the type of standard and improved weaponry available in modern warfare affecting both militants and civilians alike with increasing severity and extent of damage. Due to this fact, multidisciplinary team approach to patient centred care was utilised with an ultimate aim of swift recovery and early mobilisation. It also highlighted the difficulties and complex issues required on a hospital management level as a neighbouring country to war zone countries in transforming care of civil trauma to military trauma.

The application of DRGs technology by the hospital health manage professionals

By using the diagnosis related groups(DRGs) method, we analyze and compare the rationality and feasibility of outcomes and human resources distribution of clinical specialties and health care professionals. It may increase the hospital management levels and feasibility. The introduction of DRGs for the majority of hospital management may enhance the performance evaluation and human resource levels in the hospitals. Key words: DRGs; Hospital management; Performance evaluation; Human resources

The application of Kano model analysis in midwife outpatient service quality management

Objective To explore the Kano model analysis in the application of midwife outpatient service quality management. Methods Kano questionnaire was consisted of 24 items, including five parts, environment facilities, service evaluation, service technology, the team service, delivery service' quality. Using the Kano model analysis, the impact factors of the midwife outpatient service quality in five different quality attributes were determined. It included property and had the opposite answer to the question, charisma, essential properties and one property. Results By identifing the quality index classification of the pregnant women with satisfactory service quality to midwife outpatient service, attributable to a property were 1,2,3,4,8,9,10,14,20,21; attributable to mandatory attributes were 13, belonging to the charm of the property had 5,6,7,11,12,15,16,17,18,19,22,23,24. Midwives outpatient had most of charisma attribute, 54.2% (13/24) of the total; The second was one attribute, 41.7% (10/24) of the total. The technology level of midwife was essential attribute. Conclusions Kano mode analysis technology will be introduced to the midwife outpatient service quality management to provide decision reference for improving the quality of the hospital management level, improve maternal satisfaction, improve the obstetric operation efficiency. Key words: Kano model analysis; The midwife outpatient service; Quality of service

Composition Analysis of the Top Ten Diseases of Hospitalized Patients in a University Hospital, between 2008 and 2012

AbstractObjective. To acquire information on the disease composition and entity distribution of hospitalized patients, to provide evidence for improving the service level of hospital management and strengthening disease prevention. Methods. To conduct syn-position statistical analysis on the hospitalized patients by age and gender, according to the annual statement of disease classification at our hospital, from 2008 to 2012, on the basis of ICD-10. Results. Between 2008 and 2012, the top 10 diseases accounted for 90.97% of the total diseases, of which the top 5 diseases were, respectively, circulatory diseases, respiratory diseases, digestive diseases, diseases of the urogenital system, and injury and poisoning. Respiratory diseases (26.1%), circulatory diseases (20.9%) and digestive diseases (16.8%) ranked as the top three for a long time, and circulatory diseases, diseases of the urogenital system, and injury and poisoning, had a tendency to increase. Conclusions. In order to further guarantee the leve...

Animal's feeding cost accounting of the scientific researches in hospital

Due to lack of cost accounting,the scientific researches charge differently of experimental animals in every hospital.Animals feeding costs include two parts,direct costs and indirect costs.Through gathering statistics of different kinds of animals and cumulative feeding amounts of different researches,the article calculates the indirect costs of each research,this approach can make up deficiencies for the current management method and improve hospital management level. Key words: Scientific researches; Experimental animals; Cost accounting of the animals

Continuously improve the medical care quality and hospital management level through medical information system construction

Background The construction of medical information is important to improve the hospital medical care capability, the management decision-making level of health and the hospital operational efficiency. The construction of medical information system of the first Affiliated Hospital of Zhejiang University was begun in 1980s. Nowadays the comprehensive hospital information services and management platform have been established, centering on electronic medical records and clinical pathway. The establishment and use of these information systems played an important role in improving the degree of patient satisfaction, enhancing hospital efficiency and healthcare quality, protecting the safety of healthcare, and reducing healthcare costs.

Employment of 360-degree evaluation and performance report evaluation

Objective To search for a scientific and feasible system for performance appraisal of hospital management staff, and enhance the level of hospital management. Methods The 360-degree evaluation and improved performance report evaluation are called into play to examine such staff. Examiners include the superiors, peers (heads of clinical and technical departments and those of administrative departments), inferiors and others (representatives of the faculty congress and staff congress). Results Outcomes of the two evaluation methods found 8 of the top ten as overlapping, and 8 of the bottom ten as overlapping as well. 80% overlapping between the two prove the results as highly similar, and a relativity analysis found the general results of the two methods as highly consistent. Conclusion United applic of the two methods can effectively examine the management staff and improve their management capabilities. Key words: 360-degree evaluation; Performance report evaluation; Hospital management staff; Examination

Application of infusion management system in pediatrics outpatient infusion room

Objective To guarantee the identification of the chilchen and safety of infusion, and to enhance work efficiency of the nurses. Methods Infusion management system was applied in outpatient infusion room in the department of pediatrics. Results From August to November 2009, 15 212 cases of infusion were completed, without any infusion accident. Real-time and the quantitative management was realized. Conclusions The infusion management system builds a harmonious infusion environment, raises the level of hospital management and the overall image and establishes a high s tandard, high grade and high efficiency infusion service pattern. Key words: Outpatient infusion; Pediatrics; Infusion management system

SWOT analysis of Shanghai medical resources serving the Pan-Yangtze River Delta

From the aspects of advantages, barriers, opportunities and challenges, this paper analyzed the environmental factors of Shanghai medical resources serving people in the Pan-Yangtze River Delta. As envisaged by the author, such services will provide medical resources information to patients from outside Shanghai, probe into feasible ways to medical insurance based on experiences drawn from serving such patients, help with the resources integration of medical systems in Shanghai, and probe into the potentials of telemedicine and distant medical e-learning, as well as improve hospital management levels and service functionality. Key words: Shanghai; Medical resources; Service; Pan-Yangtze River Delta; SWOT analysis

Towards knowledge-based systems in clinical practice:: Development of an integrated clinical information and knowledge management support system

Given that clinicians presented with identical clinical information will act in different ways, there is a need to introduce into routine clinical practice methods and tools to support the scientific homogeneity and accountability of healthcare decisions and actions. The benefits expected from such action include an overall reduction in cost, improved quality of care, patient and public opinion satisfaction. Computer-based medical data processing has yielded methods and tools for managing the task away from the hospital management level and closer to the desired disease and patient management level. To this end, advanced applications of information and disease process modelling technologies have already demonstrated an ability to significantly augment clinical decision making as a by-product. The wide-spread acceptance of evidence-based medicine as the basis of cost-conscious and concurrently quality-wise accountable clinical practice suffices as evidence supporting this claim. Electronic libraries are one-step towards an online status of this key health-care delivery quality control environment. Nonetheless, to date, the underlying information and knowledge management technologies have failed to be integrated into any form of pragmatic or marketable online and real-time clinical decision making tool. One of the main obstacles that needs to be overcome is the development of systems that treat both information and knowledge as clinical objects with same modelling requirements. This paper describes the development of such a system in the form of an intelligent clinical information management system: a system which at the most fundamental level of clinical decision support facilitates both the organised acquisition of clinical information and knowledge and provides a test-bed for the development and evaluation of knowledge-based decision support functions.