Healthcare Quality Management Research Articles

Healthcare Operations Management: Optimizing Patient Flow and Quality Care in India

Patients' preferences changed from general practice to sub-specialty practice because there was no referral system in place. Most people would rather speak with a medical expert. The cheap medical tariff may make it easier for patients to see a doctor. Patients can see a doctor for even less money thanks to medical insurance companies. In addition, the cost of a doctor's appointment remains the same regardless of how straightforward the case may be. It fosters competition between general practitioners and experts, with the belief that the latter are superior. In addition, confusion and repeated visits to the doctor are caused by a patient's lack of trust in medical professionals and their ignorance of medical procedures. Social Security recipients' hospitals are overworked. The quality of services decreases as the patient base grows. Equipment and facilities are ageing out of date. Providers are forced to restrict their flexibility and ability to adjust to the unique needs of their patients due to staffing shortages and scheduling constraints. Physicians may be forced to refer patients to paramedical departments instead of doing a complete examination in order to deliver a proper diagnosis due to the rising demand for medical services. The current study, which makes reference to India, focusses on healthcare quality management strategies in multispecialty hospitals.

A Proposal for a Unifying Model of Quality Management of Healthcare.

For quality management of healthcare, various ISO-standards are important such as ISO 9001 (quality management systems), ISO 13940 (concepts of continuity of care) and ISO 21298 (functional and structural roles). For concurrent, integrated use of the standards, this paper proposes a unifying conceptual model that integrates essential elements of the standards. The model may be useful to clarify basic concepts such as collaboration, systems-and-structures and realization, as well as the interrelations between these concepts.

Development of Quality Indicators to Evaluate the Quality of Care for People with Differences of Sex Development.

Achieving evidence-based, high-quality medical care is the overarching goal of healthcare quality management. Quality indicators (QIs) serve as proxies to show whether good quality is reached or not. This article describes the development of QI for the evaluation of healthcare quality in the area of differences of sex development (DSD). Following the model of Donabedian, the aim was to develop QI to assess defined relevant aspects of the quality of structures, processes, and outcomes of care in DSD. Ten DSD clinical centres and two self-advocacy groups in Germany included in the DSDCare project were involved in the development of the QI and a benchmarking system. The development of the QI involved several structured steps: analysis of guidelines and recommendations, literature review, qualitative interviews with key stakeholders in the field of DSD, and patients or their carers. QIs were discussed in a multi-stage systematic consensus process and assessed in terms of their relevance, feasibility, and practicability. In a multi-stage systematic consensus process involving medical and psychological experts from a range of disciplines, people with DSD and their families, and representatives of self-advocacy groups, we have developed a set of 37 QIs (22 structure, seven process, and eight outcome quality). The QIs serve to evaluate care in the field of DSD and may add to the German criteria for certification of Centres for Rare Conditions formulated by the National Action League for People with Rare Diseases (NAMSE) in this area of expertise. We have succeeded in developing and jointly adopting a set of QIs that consider a wide range of perspectives on the quality of care for people with DSD and their families. These QIs have been found to be relevant, feasible, and practicable, and they are now used for a yearly quality benchmarking in the participating DSD centres.

Point-of-Care Testing Biosafety Decisions: An Investigation Summary Illustrating Current Decision-Making Process in Ontario, Canada.

Point-of-care testing (POCT) is increasingly being used in healthcare, including hospitals, and POCT-style tests are also used within some laboratories. The principles of biosafety, including risk assessment and containment of biohazardous agents, can be utilized as a foundation to establish policies and procedures guiding safe performance of POCT. However, specific biosafety guidelines for POCT are generally lacking, particularly for those performed outside laboratories by healthcare workers. This study aims to explore POCT biosafety program decision-making infrastructure and oversight in Ontario. The Institute of Quality Management in Healthcare distributed a survey to 249 laboratories in Ontario. There were 11 questions on POCT biosafety practices. The survey had a high response rate of 88.7%. How POCT biosafety decisions were made was variable among respondents. For POCT-style tests conducted within laboratories, the biosafety officer (BSO) and/or the microbiologist were involved in biosafety decisions in 95% of microbiology labs or 55% of other labs. Only 27% of the respondents reported that biosafety decisions were made by BSOs and/or microbiologists when POCT was conducted outside the laboratory. When POCT is performed outside the laboratory, biosafety decisions were made largely by Infection Prevention and Control (IPAC) and POCT laboratory staff. Similarly, training and auditing of staff who perform POCT were mainly done by IPAC and POCT laboratory staff. The survey showed that a wide variety of POCT was being conducted for COVID-19 patients during the pandemic.

The characteristics of leadership and their effectiveness in quality management in healthcare - A systematic literature review and a content analysis.

Effective quality leadership is identified as a critical factor for organisational success. Leadership style has an important role in the implementation of quality management. This systematic review describes the characteristics of leadership in quality management in healthcare, and analyses their association with successful or unsuccessful quality management by using content analysis. Papers published in peer-reviewed journals between 2011 and June 2023 were selected by exploring the Abi/Inform, Business Source Complete, Cinahl, Pubmed and Web of Science electronic databases. Altogether 3014 records were found. PRISMA-protocol was used for selection of studies. 12 original and three review articles were included. Six leadership characteristics were identified that were linked to successful or unsuccessful implementation of quality management. The six categories were strategic, knowledge-oriented, value-based, supportive, participatory and communicative leadership. Supercategories and subcategories of successful and unsuccessful implementation are described. The results can be used to identify the leadership characteristics that promote successful quality management in healthcare organisations. In education for leaders and managers, attention should be in the characteristics and style of leadership and their impact on the effectiveness of quality management.

A bibliometric analysis of the Quality Management Journal: 10 years of publications and the pathway forward

The purpose of this paper is to examine the trends in research published by the Quality Management Journal (QMJ) based on Scopus Indexed publications for a period ranging from 2013 to 2023. The paper intends to offer a bibliometric analysis of the journal by highlighting the contributions made by the journal through document citations, prominent authors, most frequent keywords, and publication trends for the last decade. The analysis provides insight into how the QMJ has contributed to the development of the field of quality management. The journal has remained unwavering in its commitment to uphold both quality and comprehensiveness, thereby leading to widespread acclaim and robust indexing As analyzed from the author keyword analysis the contributions made to the journal can be categorized into seven themes, i.e., Leadership Essentials for Quality Management, Six Sigma & Quality, Quality Management in Services, Stakeholder Involvement for Quality Management, TQM & Continuous Improvement in Manufacturing, and Service Quality and Quality Management in Healthcare. A key theme to emerge from this study is that future research and applications must be robustly framed in relevant theory, to recognize, understand, and articulate implications for practice. Experiential quality will move further along the spectrum of socio-technical or socio-materiality.

A multiphase, multicentre development and validation of two maturity tools assessing the implementation of the FlaQuM co-creation roadmap.

As part of the new Flanders Quality Model (FlaQuM) towards sustainable quality management systems, a co-creation roadmap with 6 primary drivers and 19 building blocks that guides healthcare organizations has been developed. Currently, no assessment tool is available to monitor hospitals' quality management systems implementation according to this co-creation roadmap. Therefore, we aimed to measure the maturity of the implementation of the FlaQuM co-creation roadmap in hospitals. A three-phase approach in co-design with 19 hospitals started with defining the scope, followed by establishing content validity through a literature review, involvement of content experts (n = 47), 20 focus groups with content experts (n = 79), and a Delphi round with healthcare quality managers (n = 19) to test the content validity index. Construct validity was assessed by confirmatory factor analyses and convergent validity by Spearman's ρ correlation coefficients. Based on 17 included existing maturity instruments and subcomponents of content experts, two maturity tools were developed according to the implementation of the FlaQuM co-creation roadmap: (i) a maturity matrix with 52 subcomponents and (ii) a co-creation scan with 19 statements. The overall scale-content validity index varied between 93.3% and 90.0% in terms of relevance and clarity, respectively. In a sample of 119 healthcare professionals, factor analyses revealed a six-factor structure and 16 (84.2%) of the 19 hypothesis for testing convergent validity between both maturity tools were statistically significant. Measuring the implementation of the FlaQuM co-creation roadmap and monitoring its maturity over time should be feasible by using these comprehensive maturity tools in hospitals. Results of both tools should be able to describe the current state of hospitals' implementation of the co-creation roadmap as basis for strategic improvement plans and next steps.

Preparing for another Ebola Outbreak: The impact of viral inactivation methods on commonly measured biochemistry analytes in plasma and urine

IntroductionInfectious specimens containing viruses like Ebola require sample manipulation to ensure the safety of laboratory staff, which may negatively impact biochemistry test results. We evaluated the impact of viral inactivation methods on 25 biochemistry analytes in plasma, and seven biochemistry analytes in urine. MethodsFifteen lithium heparinized plasma specimens with and without gel underwent the following viral inactivation methods: 1) untreated, 2) Triton X-100 treatment, 2) heated for 60 min then Triton X-100 treatment, 3) heated for 60 min, 4) heated for 75 min, and 5) heated for 90 min. Electrolytes, protein, enzymes, glucose, as well as hepatic and renal markers were measured on the Roche Cobas e601, c502 or c702. Urinalysis analytes were measured on the Siemens CLINITEK. Acceptable recovery was based on Institute for Quality Management in Healthcare 2021 guidelines or ± 1 for urinalysis. ResultsPotassium and lactate dehydrogenase were impacted by the presence of gel. Viral inactivation with Triton X-100 had minimal impact on the biochemistry results. Heat inactivation resulted in significant negative bias in alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, creatinine, total protein, amylase, lactate dehydrogenase and creatine kinase. Positive bias in phosphate, aspartate transaminase, total bilirubin, and uric acid were observed after heat inactivation. ConclusionReliable results for commonly measured electrolytes, enzymes and proteins can be obtained after viral inactivation by Triton X-100 treatment at room temperature. However, heat inactivation has significant negative impact on routine biochemistry enzymes and alternative testing processes should be explored.

Total Quality and Innovation Management in Healthcare (TQIM-H) for Performance and Sustainability

In this evolving human society, innovation becomes important in healthcare to serve the need of patients. At the same time, quality is a necessary fundamental in healthcare since healthcare is an industry that involves human lives. Hospitals should manage both innovation and quality together to allow the best organizational performance. However, there is still a gap in integrating quality and innovation in healthcare. Therefore, this article aims to develop the integrated framework of total quality and innovation management in healthcare (TQIM-H) affecting healthcare performance. This article used mixed method methodologies to develop the integrated framework, which consisted of a systematic literature review, interviews with healthcare experts, multiple case studies in the Asia Pacific region hospitals, and triangulation testing with external datasets. From this article, the TQIM-H consisted of seven dimensions, which are Context of the Environment (Internal and External), Leader, Support, Planning, Operation, Tools and Analysis method, and Improvement, all of which resulted in positive healthcare performance, which is the organizational sustainability, including three sustainability impacts: economic, environmental, and social dimension.

Streamlining Healthcare Quality Management with an Web Audit Platform

The quality management of services and products in health institutions covers several areas such as health education, access to information on prevention programs, disease tracking, professional training, availability of diagnostic equipment and therapeutic resources available, which demonstrates the importance that this management has to ensure an efficient administration. To ensure excellence, institutions are generally subjected to audit processes that provides guidance for the implementation of a management system that meets the requirements defined with the aim of improving the quality of the services. Health Organization’s quality management system includes a comprehensive biannual audit program in terms of both requirements and services. However, all registration is done with Excel which is a rudimentary tool that implies unnecessary manual work by the responsible employees. Taking this into account and considering the relevance of the audit, an audit platform was built to improve the efficiency of this process. The platform has three different layers: client, server and database and after analyzing the popularity, community and performance of some technologies, the ones chosen for this application were React, Node.js and PostgreSQL. The developed platform includes professional’s authentication, an audit calendar, data grids to consult data relevant for the audits, the audit grids for the audit teams to fulfill during the process and audit reports.

Healthcare Markets in The U.S. And China: Comparative Analysis of Development Models, Issues, And Prospects

As two of the major healthcare markets in the world, China and the United States each have distinctive healthcare systems and development models as the global healthcare sector continues to develop and change. Significant contrasts exist between these two distinct healthcare models in terms of policy, resource allocation, healthcare quality, and sustainability. The goal of this essay is to examine the healthcare markets in China and the US, including their respective healthcare systems, health insurance programs, cutting-edge medical technology, and related laws and customs. This study hopes to get a thorough grasp of the mechanisms, issues, and future possibilities of the healthcare markets in China and the United States by a comparison study of these elements. Comparative evaluations reveal that while China's healthcare sector has made significant progress toward increasing accessibility, there are still issues with healthcare quality and cost management. The U.S. healthcare system has excelled in terms of innovation and care quality, but inequality and excessive healthcare prices continue to be issues. Both nations will need to collaborate in the future to address their unique problems in order to improve the sustainability and quality of healthcare.

Sustainable quality management in hospitals: The experiences of healthcare quality managers.

Quality management systems are essential in hospitals, but evidence shows a real literature gap on the sustainable implementation of quality. This study aimed to explore and identify enablers towards sustainable quality management in hospitals. Research design and Study Sample: Interviews were conducted with 23 healthcare quality managers from 20 hospitals. Data collection and/or Analysis: Data collection and analysis were conducted simultaneously by using the Qualitative Analysis Guide of Leuven and following the COREQ Guidelines. Thematic analysis from interview transcripts was performed in NVivo 12. The results reveal two categories: (1) quality in the organisation's DNA and (2) quality in the professional's DNA. The first category consists of: bottom-up and top-down management, the organisation-wide integration of quality and an organisational culture shift. The second one consists of: quality awareness, understanding the added value, the encouragement and engagement, the accountability and ownership for quality. Moving towards sustainable quality management systems in hospitals requires a good interaction between a bottom-up approach and leadership to ensure continuous support from healthcare stakeholders. This study contributes to existing conceptual and theoretical foundations with practical insights into sustainable quality management. The findings can guide quality departments and hospital management to regain professionals' commitment to quality and to establish a sustainable quality management system.

Role of Supply Chain Management in Quality of Healthcare Services

Healthcare organizations in Haryana (Kurukshetra) face many supply chain management challenges that can be addressed through effective operational and management decisions. The aim of this paper is to examine the supply chain management of healthcare quality in developing countries, particularly in rural healthcare in Haryana (Kurukshetra), and to consider demographic variables such as gender, age, education level and healthcare experience. Design and Hypothesis Testing Approach Distributed 500 questionnaires to determine the impact of aspects of supply chain management on the quality of health services. 27 of his seven procurement officers and administrative staff in Kurukshetra Haryana. The primary method was to collect data from 73 rural health managers and procurement managers to identify the quality and size of health services. The results of our study show that a combination of timely delivery of health products, specifications, level of health product providers and safety in the rural health sector of Haryana (Kurukshetra) is related to the quality of health services. The scope of this article focuses on employing appropriate human resources and highly trained professionals in supply chain departments to improve the quality of health services in the supply chain. As a practical contribution, this article can help healthcare supply chain managers and organizations do their jobs better or create a competitive advantage by addressing the issues and challenges facing individual healthcare managers, organizations and their partners.

PREDICTION AND PREVENTION OF DISEASE DIAGNOSIS DELAY USING DATA MINING METHODS IN HEALTHCARE QUALITY MANAGEMENT

This study analyzes the issue of disease diagnosis delay in healthcare quality management using data mining methods. The aim is to understand the relationship between several key variables and diagnosis delay for various diseases. The study focuses on the variables of Age, Symptom Duration, Physician Experience, and Diagnosis Delay. Advanced data mining methods are employed to predict and prevent disease diagnosis delays. The results of this study present the findings from the analysis of the collected dataset.
 The dataset consists of patient information, including attributes such as Patient ID, Age, Symptom Duration, Physician Experience, Diagnosis Delay, and Treatment Initiation. Each attribute plays a crucial role in understanding and predicting diagnosis delay. The approach using linear regression yields coefficients [0.03260123, 0.24605912, 0.01765057, 1.09631713], indicating the influence of each variable on Diagnosis Delay. The Mean Squared Error (MSE) value of 0.7926 signifies the model's ability to predict Diagnosis Delay accurately.
 The scatter plot illustrates the linear relationship between actual Diagnosis Delay and predicted Diagnosis Delay. The Pearson's Correlation Coefficient of 0.5222 indicates a moderate positive correlation between the two. However, the residual plot indicates a tendency for underestimation of Diagnosis Delay for higher values.

Digitale Transformation deutscher Gesundheitseinrichtungen

ZusammenfassungEinleitungDie digitale Transformation umfasst u. a. die Projektierung und Implementierung digitaler Anwendungen, Technologien und Maßnahmen und stellt inzwischen das Tagesgeschäft aller Organisationen und Einrichtungen im Gesundheitswesen dar. Im vorliegenden Beitrag werden die aktuellen Tätigkeitsinhalte der digitalen Transformation in Gesundheitseinrichtungen aus Sicht des Qualitätsmanagements dargestellt.MethodenEs erfolgte eine deutschlandweite Befragung von 141 Mitgliedern der Gesellschaft für Qualitätsmanagement in der Gesundheitsversorgung (niedergelassene Ärztinnen und Ärzte, Vertretende von Krankenhäusern, Krankenkassen sowie weiteren Einrichtungen des Gesundheitswesens) über alle Felder der digitalen Transformation, bestehende Projekte und in der Implementierung befindliche digitale Technologien. Anhand von 6 Themenblöcken bewerteten die Teilnehmenden die zeitliche Abfolge und inhaltliche Relevanz für deren Organisation.Ergebnisse82 % der Befragten gaben an, dass die digitale Transformation den Arbeitsalltag beeinflusst bzw. verändert. Die häufigsten Projekte umfassen Themen aus dem Prozess- und Schnittstellenmanagement (53 %) sowie zur Verbesserung der Patientensicherheit (52 %). Häufigste konkrete Vorhaben stellen die elektronische Patientenakte und Themen, die im Zuge des Krankenhauszukunftsgesetzes beauftragt wurden, dar.DiskussionLaut Aussage der Befragten verändert die digitale Transformation Strukturen und Prozesse von Gesundheitseinrichtungen und macht zusätzliche Kompetenzen erforderlich, damit digitale Technologien zielführend und nachhaltig implementiert werden können. Eine strukturierte Koordination der Kompetenzen aller Professionen einer Gesundheitseinrichtung ist erforderlich, um digitale Technologien im Alltag von Gesundheitseinrichtungen zu verankern.

Web-based comparative study of some national experiences of health care quality management.

Since the publication of study results on adverse events to health care in OECD countries, the importance of the national quality improvement strategies has been recognised. To examine how these strategies have been shaped in different jurisdictions, we carried out this study. We conducted a web-based comparative study of international practices. We first defined seven key health care and services quality management functions. We then drew on the experience of authors to make a reasoned selection of 13 countries or states across the world. We determined the distance that separates each of these functions from a country's Ministry of Health (MoH); and examined whether these functions are concentrated in a single organisation or dispersed across several organisations. Afterwards, we correlated our results with the quality level of these countries based on the OECD's health care indicators. Overall, Netherlands, Québec (Canada), Korea, Germany, England (UK), and the United States had at least 50% of their quality management functions controlled by self-regulated organisations. The Market Concentration Index ranged from 937 for the United States to 6800 for Russia. Graphical representation has shown us two health system models. Our results also clearly showed that countries had a better quality of care most often when they belong to model 1 of our taxonomy. These findings will help countries design and implement large-scale health care and services quality strategies for better and safer health care and services.

Protocol for the development of the Expert consensus on sedation and analgesia for neurocritical care patients (2023)

To further standardize the sedation and analgesia treatment for neurocritical care patients, the National Center for Healthcare Quality Management in Neurological Diseases and Chinese Society of Critical Care Medicine organized national experts in this fields to form Working group of the Expert consensus on sedation and analgesia for neurocritical care patients in order to update the Expert consensus on sedation and analgesia for patients with severe brain injury (2013) based on evidence-based medicine. This update aims to provide scientific guidance for the clinical diagnosis and treatment of neurocritical care patients. The working group followed the definition of clinical practice guidelines by the Institution of Medicine (IOM) and the World Health Organization guidelines development handbook and Guidelines for the formulation/revision of clinical guidelines in China (2022) to register and draft the Expert consensus on sedation and analgesia for neurocritical care patients. The working group will strictly adhere to the consensus development process to formulate and publish the Expert consensus on sedation and analgesia for neurocritical care patients (2023). This protocol primarily introduces the development methodology and process of the Expert consensus on sedation and analgesia for neurocritical care patients (2023), including the purpose of the update, the target population, the composition of the consensus development working group, the presentation and collection of clinical questions, evidence evaluation and summarization, and the generation of recommended opinions. This will make the consensus development process more standardized and transparent.

TRIZ inventive principle in healthcare quality and innovation development

PurposeThis research aimed to create inventive principles in managing quality and innovation systems that can be used as a guide for the development of effective innovation projects in hospitals.Design/methodology/approachTotal quality and innovation management in healthcare (TQIM-H) framework and theory of inventive problem-solving (TRIZ) were integrated with results from in-depth interviews with 30 healthcare experts, resulting in TQIM-H inventive principle. The developed inventive principle was validated using 50 effective innovation projects from one of the largest healthcare conglomerates in Southeast Asia.FindingsThe TQIM-H inventive principle consisted of 7 dimensions and 72 procedures for creating innovation in hospitals under the medical quality framework. The principle effectively helps innovators develop innovative solutions that still strictly comply with medical guidelines.Originality/valueInnovation is recognized as a critical factor that helps organizations adapt to global changes and increases the potential for competition, especially in hospitals. However, creating innovation in hospitals has a lower success rate than in other industries because, in general, ineffective innovation development strategies are used and the created innovation is not aligned with regulations and restrictions regarding healthcare quality in the healthcare system.

Delivery system emergency department capacity and its effect on nonsystem service utilization.

Emergency department (ED) use is often seen as a source of excess health care spending, prompting managers to limit ED capacity in their health systems. However, if limited ED capacity in a delivery system leads patients to seek emergency care elsewhere, then health care quality and efficient management may be compromised within the system. The objective of this study was to explore the effect of the Veterans Health Administration (VHA) in-house ED clinician capacity on VHA community care (CC) ED claims. We used administrative data from the VHA to identify CC ED claims and Department of Veterans Affairs emergency physician (EP) capacity for 2014-2019. We used quasi-experimental instrumental variables approach with two different instruments: percent weekday federal holidays and VHA EP full-time equivalents (FTEs). We controlled for VHA ED variables such as ED wait times (door to triage, door to doctor, and door to admission) and demand variables such as alternative insurance coverage, driving time to VHA care, and demographic variables (employment, age, household income, race, gender, and VHA priority status). After instrumenting for capacity with percent weekday federal holidays, we found that one clinic-day capacity (one 8-h ED shift) per 10,000 enrollees increase at the VHA ED will result in a reduction of 61 CC ED claims per 10,000 enrollees. After instrumenting for capacity with EP FTE, we found that one clinic-day capacity (one 8-h ED shift) per 10,000 enrollees increase at the VHA ED will result in a reduction of 48 CC ED claims per 10,000 enrollees. Both of these results are statistically significant at p< 0.001. Our findings imply that offering more in-house ED care, in the form of clinician capacity, can substantially reduce out-of-system ED use. The results may be of interest to integrated health care system managers who prefer their patients to stay within network.

Kaohsiung Municipal Siaogang Hospital, Recipient of the 2022 National Healthcare Quality Award - Distinguish Institution Award Improvement of Institutional Medical Quality and Culture

&lt;p&gt;小港醫院委由高雄醫學大學經營，已深耕南高雄地區24年，本院秉持「服務、品質、效率」的精神，以「全面品質管理」的概念，建構全院各科室醫療品質經營策略，積極營造院內品質改善風氣，培育單位醫品種子，建立激勵制度，鼓勵同仁的參與，並持續參加各類競賽，標竿學習他院且樹立典範。藉由實證醫學及擬真情境來輔助臨床作業，並結合創新醫療，提升醫療價值。&lt;/p&gt; &lt;p&gt;醫療服務品質需要全院共同參與及推動，方能確保品質的卓越及精進，小港醫院秉持病人安全為第一及醫療品質提升為理念，深耕品質多年，努力給予民眾最優質的醫療品質及照護，盼成為最優質的「全人照護暨環境職業醫療特色醫院」。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Siaogang Hospital, which is under the management of Kaohsiung Medical University, has served southern Kaohsiung for 24 years. In the spirit of service, quality, and efficiency, Siaogang Hospital has established a healthcare quality management strategy based on comprehensive quality management to actively promote hospital-wide quality improvement and develop a cadre that is committed to the maintenance of healthcare quality. An incentive system has been established to encourage employee participation in competitions and in learning from other medical institutions and setting examples. Evidence-based medicine and high-fidelity simulation are introduced to support clinical operations, and these measures have also been integrated with innovative healthcare to create added value.&lt;/p&gt; &lt;p&gt;The quality of healthcare services requires the joint effort of the entire hospital to improve and achieve excellence. For years, Siaogang Hospital has always strived to offer top-quality healthcare to the public in its quest to become a medical institution characterized by holistic care and environmental and occupational medicine.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;