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Objective This study is based on the physicians'appraisal system upon HIS system to annually assess the associate chief physicians in clinical departments in the mode of attending in charge. Methods 74 doctors above the title of associate chief physician from 14 departments in such mode were selected as objects of study and evaluated upon relative requirement of the performance appraisal index system by means of brainstorming,expert consulting and so on to confirm the content,standard and scoring method of appraisal.Work efficiency index and work amount can be acquired out of HIS system, while details and problems during the assessment can be dealt together with clinical practice.Finally all index and results were collected through HIS system and total scores of relative doctor can be automatically calculated.SPSS 13.0 statistics software also can be used to descriptively analyze the frequency and percentage data.Results The total appraisal scores and scores in every grade of the 74 doctors,who are attending in charge with title above associate chief physician as well as bearing the same responsibility in both medicine and surgery department,were collected,analyzed and respectively ranked respectively.Conclusion The results of appraisal basically indicate general level of the doctors,as well as provide strong evidence for enhancing human resource management of the hospital, which will continuously improve the basis for assessment to performance of associate chief physician under mode of attending in charge,as well as collect experiences for deeply optimizing program of assessment system.
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Objective To probe into the reliability and validity of the questionnaire on clinical pathways and patients' satisfaction.Methods Investigating the hospital patients' satisfaction with the questionnaire designed by the former Ministry of Health and analyzing the internal consistency and constructive validity through statistical methods.Results Cronbach' s α coefficient of the adjusted questionnaire was 0.947 and those of the each subscale were 0.563,0.968 and 0.820.The split-half reliability of the questionnaire was 0.869.The number of factors is 3 as same as the designed assuming structure,and the cumulative contribution rate of 3 factors was 74.178％.The factor loading of each item was above 0.4,each item of a common factor with a higher load factor.Conclusion Although there are differences from hospital to hospital,this questionnaire is applicable to investigating patients' satisfaction of the clinical pathway management mode in view of the statistical and clinical practice.
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Branding has become a core competitiveness for hospitals.They are faced with the question of how to build and maintain their brand,how to apply PDCA cycle in the management of hospital branding strategy,how to keep up the branding with constant analysis,evaluation and adjustment,for the purpose of sustained development.
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The Delphi method was called into play to determine the level-1 indicator,level-2 indicator and plus-minus indicator for evaluating clinicians of various academic titles,while the ranking method was used to determine the weight of these indicators.The Chi-square test found P＞0.05,proving this indicators system as consistent for clinicians at all levels; the t test found the majority as P＞0.05,indicating the weight of level-2 indicators for dimciam of different titles as different with partial consistence.This system is proved to be scientific,comprehensive,objective and authentic in evaluating clinicians of various levels Targeted evaluation and appraisal system guarantees quality of care and medical safety,which functions as an efficient meansfor better hospital management and better quality of care,paving the wayfor reforms in income distribution system and personnel system in the hospital.
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Objective To identify shortcomings in the current evaluation index system of medical quality. Methods The documentary analysis focused on the existing index system comprises the Hospital Management and Quality Evaluation Standards (2007) by China Hospital Association, Hospital Management Evaluation Guidelines (2005) by the Ministry of Health, and Implementation Rules of Hospital Management Evaluation Standards for Beijing (2007). JCI Accreditation Standards for Hospitals (edition 2) (2003), and New Hospital Accreditation Standards for Taiwan (2005, 2006) were referred to in the study. Results The shortcomings found include the weak operability of indexes, and the deficiency of evaluation indexes from the point of hospital visiting process by patients. Conclusion In view of the hospital visiting process of patients, add more indexes for patients' hospital visiting process,and quantize and highlight the operability of indexes, with summary and optimization of experiences in time by steps.
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To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.
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Objective To investigate prevalence of cervical intraepithelial neoplasia (CIN) among the married women aged 25-54 years in Beijing.Methods With method of cross sectional survey,6339 married women at age of 25 to 54 years were selected randomly in 137 communities of 12 districts or counties in Beijing from March 2007 to September 2008.The cervical smear cytology and high-risk human papillomavirus (HPV) infection of cervical secretion were detected.Women with abnormal cervical cytology were underwent colposcopy and cervical biopsy.Results Among 6339 women,9.58% (607/6339) cases had abnormal cytological results,the colposcopy and cervical biopsy showed the rate of CIN was 5.84% (370/6339) in total selected women and 60.96% (370/607) in women with abnormal cervical cytology,including 4.65% (295/6339) in CIN Ⅰ,0.80% (51/6339) in CIN Ⅱ,0.38% (24/6339) in CIN Ⅲ; 0.06% (4/6339)in early invasive carcinoma (SCC).Based on geographical distribution,the rate of cervical lesions was 4.46% (42/942) in urban areas,6.27% (188/3000) in suburbs and 6.01% (144/ 2397) in outer suburbs (P > 0.05).Conclusion It was found that the incidence of CIN was 5.84% in married women aged 25-54 years in Beijing,which did not show significant prevalence in urban,suburb and outer suburbs region.
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Objective To investigate high risk factors associated with cervical intraepithelial neoplasia (CIN) in married women aged 25 to 54 years in Beijing. Methods From Mar. 2007 to Sep.2008, 6339 married women at age of 25 to 54 years were selected randomly by cross sectional survey in a total of 137 communities of 12 districts or counties in Beijing. The interview was carried out with unified questionnaires, gynecological examination. The cervical smear cytology and high-risk human papillomavirus (HR-HPV) infection of cervical secretion were detected. Women with abnormal cervical cytology underwent colposcopy and cervical biopsy. Odd ratio (OR) and 95% confidence interval (CI) of related high risk factors with CIN were studied by logistic regression analysis. Results Among 6339 women, the prevalence rate of CIN including 4 squamous cell carcinoma (SCC) was 5. 90% (374/6339). By multinomial regression analysis, HR-HPV infection (95% CI: 9. 953 - 15.811 ), History of trichomonas vaginitis (95 % CI: 1. 046 -2. 104), oral contraceptives (95% CI: 1. 087 - 1. 806), age less than 45 years old ( 95% CI: 1. 069 -1. 828) were related with CIN. Conclusion Infection rate of HR-HPV is an independent risk factor of CIN, however, the history of trichomonas vaginitis, oral contraceptives and age less than 45 years old are related risk factors of CIN.
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Objective To investigate high risk human papillomavirus(HR-HPV)prevalence among married women in Beijing and to study the high risk flactors.nethods During March 2007 to September 2008.a total of 6185 married women sampled from 137 communities in 12 districts were screened bv HR-HPV DNA test and cytogical test.The interview was carried out with unified questionnaires.The databage was set up and twice entered in EpiDam 3.0.After checked up,the data were analyzed in SPSS 15.0.Results (1) The HR-HPV infection rate was 9.89%.The HR-HPV infection rate of the city zone,the suburb and the exurb were 9.34%,10.51% and 9.51% (P>0.05).The HR-HPV infection rate of the native and the oudander were 9.53%,11.30% (P<0.05).(2) The age distribution of HR-HPV infection was that the rate was around 10% among 25 to 44 age groups,which was the highest(11.21%) in 30 to 34 age group;then the rate was descended as the age raising,the rate of 50 to 54 age group was the lowest(7.78%).(3) Multiple logistic regression showed that the related risk factors of HR-HPV infection mainly included 1000 RMB and above of family income per person per month.possessing more than 1 sexual partner of her husband,outlander and hish levels of education.(4) The prevalence of cervical intraepithelial neoplasia(CIN)in HR-HPV positive group wag significantly higher than that in HR-HPV negative group(29.76% vs 3.32%,P<0.01).Conclusions(1)The HR-HPV infection rate among aged 25 to 54 years was 9.9% and there was no significant difference in area distribution.(2)The hish risk population which should strengthen screening was the married bearing-age women with high level of family income,outlander,high levels of education and her husband possessing more than 1 sexual partner.(3)HR-HPV infection is the main risk factor for CIN and cervical cancer.while does not provide a causal relationship with them.The high risk population should be checked regularly to understand the development of HR-HPV infection and CIN incidence.
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LDM, a product of the combination of contemporary information network technology and the tradi tional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problerms, including quality control of LDM, delegation of responsibility in IDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new contemplation and exploration for hospital managers.
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LDM, a product of the combination of contemporary information network technology and the traditional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problems, including quality control of LDM, delegation of responsibility in LDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new conternplation and exploration for hospital managers.
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Based on an analysis of the current condition of emergency department facilities in domestic urban hospitals and lessons drawn during the SARS outbreak,the paper argues that due attention ought to be paid to the spread of infectious diseases resulting from the inherent drawbacks in the construction of emergency departments.It presents constructive suggestions on ways in which construction of and medical procedures in emergency departments could meet the requirements for infectious disease prevention and treatment.
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In the past 20 years, emergency medicine in China has witnessed rapid development and emergency care has contributed considerably to safeguarding people's life and health. The emergency departments in most hospitals have completed the transition from being dependent to being supportive and some hospitals have set up autonomous emergency departments. The functions and business scope of emergency care have gradually been clarified. However, some problems remain to be solved in such aspects of emergency care as training, management, scientific research, and professional promotion.