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Objective:To explore the influence of organizational management mode and regional medical resource allocation on thrombolysis rate of stroke.Methods:A cross-sectional study was carried out in 61 thrombolytic units distributed at 16 administrative districts of Shanghai to collect information including the number of imaging equipment, neurologists and nurses, hospital organization and management mode, thrombolytic rate, etc. Using SPSS 19.0 statistical software, simple linear regression analysis and chi square test were used to analyze the correlation between related indexes and thrombolysis rate.Results:There was no linear correlation between imaging equipment, human resources and regional thrombolysis rate. The key factor to improve thrombolysis rate was the organizational management of stroke( OR=1.488, 95% CI=1.357-1.631, P<0.001). Conclusions:An effective hospital organization and management model, including the establishment of multi department cooperation, stroke emergency team, stroke green channel, can significantly improve the thrombolysis rate of stroke.
ABSTRACT
Objective To establish a comprehensive evaluation system for clinical pathway quality for evaluation and verification.Methods Literature retrieval, clustering mergers and experts consultation method were used to determine indicators for clinical pathway quality evaluation, while gray correlation method was employed to calculate indicators weight coefficient and to evaluate indicators scoring,and sum indicators weighted scoring, so as to establish a clinical pathway quality comprehensive evaluation model.Indicator data of Shanghai′s 18 tertiary hospitals were used for verification.Results A total of 12 evaluation indicators, such as entry rate, mutation rate, completion rate and average length of stay were selected.After the weight calculation and grade scoring, the mathematical model of clinical pathway quality comprehensive evaluation was constructed.Data of these hospitals were put into the evaluation system for assigning ratings calculation, harvesting the overall score and ranking of each hospital.These data can help find out key management and key hospital intervention indicators in the next stage.Conclusions Different hospitals will be put on the same platform for comparison in this clinical pathway evaluation system, and the results can be quantified.The authors suggest that the next stage of health administration focus on the management of the hospitals and the key management of the sectors, making possible the prospective management of clinical pathways.