Evaluation index system of medical quality in clinical departments under the high-quality development of public hospitals / 现代医院

Objective To establish an evaluation index system that can be used for medical quality assessment in clini-cal departments.Methods Based on literature analysis and key informant interview,the Delphi method was used to analyze the-importance and operability of the evaluation index system of medical quality in clinical departments.Results A clinical depart-ment medical quality assessment and evaluation system was established,consisting of 3 primary indicators,14 secondary indica-tors,and 24 tertiary indicators.Conclusion By building a medical quality assessment and evaluation index system in clinical departments,a simple,standardized,and highly operational management model is established for medical institutions to carry out medical quality management.It is conducive to directing clinical departments to focus on medical quality management,improving their medical quality awareness and management level,and promoting the high-quality development of public hospitals.

Establishment and application of medical quality evaluation indicator system in clinical departments of a general hospital / 现代医院

This paper introduces the construction and application of the medical quality evaluation indicator system in clinical departments of a large general hospital.It describes the indicator system's constitution and score setting,summarize the characteristics and application practice of the assessment system,and proposes some ideas for the following improvement,which in order to provide some reference for other hospitals.

Evaluation of Operation Effectiveness of Coronary Heart Disease Center in National Cardiovascular Disease Regional Medical Center / 中国医院管理

Objective To measure and comprehensively analyze the operation efficiency of coronary heart disease Center of National Regional Medical Center for Cardiovascular Disease from the dimensions of department service in-come,department service quality,department service efficiency and department service benefit,and put forward targeted operation management optimization strategies based on the analysis results.Methods The operation effective-ness evaluation index of CHD centers in sample hospitals from 2020 to 2022 was measured by the empirical re-search method from the overall level of the center and the level of clinical departments,and the scores were com-pared and analyzed.Results From 2020 to 2022,the operation effectiveness evaluation index of CHD centers in sam-ple hospitals showed a good trend,increasing from 80.57 points to 82.86 points.The 3-year average score was 81.74;Among them,the score rate of department service benefit dimension is higher,the average is 96.64％;The score rate of department service efficiency was lower,with an average of 68.53％.The departments with the lowest operational efficiency scores from 2020 to 2022 are all A2 departments,with 74.39,72.41 and 75.89 scores respec-tively,mainly due to the relatively low scores of A2 departments in the dimensions of department service revenue and department service efficiency.Conclusion The results of clinical department operation effectiveness evaluation can provide the evidence-based basis for hospital operation management,and hospitals can establish benchmarking management departments according to the evaluation results and take targeted measures to improve the comprehen-sive operation efficiency of departments.

Current situationanalysis of geriatrics construction in guangxi general hospital / 现代医院

Objective To investigate the current situation of the construction of geriatrics in second and third level gen-eral hospitals in Guangxi,analyze the existing problems,and propose suggestions.Methods A self-developed"Survey on the Current Situation of Geriatrics Construction"was used to conduct a questionnaire survey on 250 second and third level general hospitals in Guangxi from April to September 2021.Results A total of 98 geriatrics were established in 196 general hospitals,and the overall number met national requirements.Among them,36 are independent institutions,including 24 tertiary hospitals and 12 secondary hospitals,with 2 172 beds and 1 764 medical staff.Conclusion In the future,Guangxi should ensure the high-quality construction of geriatrics,reasonably allocate geriatric human resources,enhance disciplinary medical service capa-bilities,strengthen overall two-way health connections,and vigorously promote the construction and development of geriatrics in Guangxi.

Evaluation of the Impact of Subspecialty Reform on the Core Medical Operation Indicators of a Clinical Department / 中国医院管理

Objective To evaluate the impact of hepatobiliary surgery in a tertiary public hospital on its core medical operation indicators after the implementation of subspecialty reform.Methods The Department of Hepatobiliary Sur-gery,which implemented the subspecialty reform,was the experimental group,and six surgical departments with-out subspecialties were the control group.Seven indicators in the dimensions of medical quality,medical efficiency,and rational use of medication were collected from September to December 2022,and the difference between the experimental group and the control group was analyzed by the differences-in-differences method using the Septem-ber data before the implementation of sub-specialty reform as the baseline value.Results After the subspecialty re-form,the changes of the indicators of the percentage of discharged patients for surgery,intensity of antimicrobial drug use and average hospital stay in hepatobiliary surgery were better than those of the control group;the percentage of discharged patients for minimally invasive surgery and the percentage of medical service revenue were inferior to those of the control group;the intergroup differences of the two indicators of the percentage of discharged patients for level IV surgery and the case-mix index were not significant.Conclusion By setting up similar control departments in the same period and excluding the influence of external confounding factors on the study results,overall,the core medical operation indexes of hepatobiliary surgery were slightly better than those of the control group,but the advantage was not obvious,which might be related to the short observation time after the subspecialty reform,and its long-term effects need to be continuously followed up and analyzed.

Analysis of operation efficiency and resource allocation of clinical departments in a hospital based on data envelopment andlysis / 中华医院管理杂志

Objective:To establish a calculation model for the operational efficiency and resource allocation of clinical departments in hospitals, for references for hospitals to optimize resource allocation.Methods:The informations including hospitalization time, nursing grade, etc. of inpatients admitted by 32 clinical departments in a tertiary public hospital from January to December in 2021 were extracted. A data envelopment analysis method was conducted on the operation efficiency and input edundancy of the departments. The K-means algorithm was used to divide inpatients into 3 categories according to the level of medical workload. Taking the numbers of doctors, nurses and beds as the input indicators, and the numbers of patients in the 3 categories as the output indicators, a BCC model 1 was established to evaluate the efficiency of resources invested by clinical departments into professional human value. At the same time, a BCC model 2 was established with the total number of patients admitted and medical income as the output indicators to evaluate the efficiency of resources invested by clinical departments into economic benefits.Results:A total of 38 147 inpatients were enrolled. There were 14 departments with overall technical efficiency (OTE) =1.000 in the BCC model 1, 10 departments with OTE=1.000 in the BCC model 2, and 8 departments with OTE=1.000 in the 2 models. As for the input redundancy, 6 departments had high input redundancy in the BCC model 1, 11 departments had high input redundancy in the BCC model 2, and 4 departments had high input redundancy in both models.Conclusions:The model established by this study could effectively evaluate the operational efficiency and input redundancy of clinical departments, identify departments with high workload and low economic benefits, and provide reference for the rational allocation of medical resources in hospitals.

Design and application of performance appraisal program at clinical departments based on the concept of value transfer / 中华医院管理杂志

Performance appraisal is one of the key points of hospital management. The authors introduce a comprehensive hospital performance appraisal scheme based on the concept of value transfer, including qualitative and quantitative index system, weight and appraisal method.In the pilot practice of a hospital, it is found that the appraisal scheme can effectively improve the operational efficiency, social and economic benefits, and has a strong incentive role for employees. This scheme weighs the operability and scientificity of performance appraisal, and provides a reference for clinical department performance appraisal.

Discussion on Formulation Strategy of Medication Indexes in Clinical Departments of Hospital / 中国药房

OBJECTIVE:To understand the formulation method of medication index in clinical departments of the local hospital and the improvement of hospital medication index after the formulation of medication index. METHODS:Retrospective analysis was used to summarize and analyze the formulation,revision and application of 5 medication indexes(the proportion of drug cost in medical income,utilization rate of antibiotics in the inpatients,AUD of inpatients,the proportion of antibiotics cost in drug income,the proportion of national essential medicine cost in drug income)in clinical departments of 4 general hospitals of Nanyang. RESULTS:The medication indexes of clinical departments in 4 hospitals were formulated primarily during 2009-2014. The formulation of medication indexes in clinical departments was passed and implemented by Pharmaceutical Administration and Drug Treatment Committee/Antibiotics Management Group on the basis of the previous indicators of clinical departments. Till 2017,the times of medication indexes revision were 0.42-0.58 time/year. Before the formulation of medication indexes in clinical departments,5 indexes of each hospital were mostly not in line with the regulation of health administration department. During Jul. 2016-Jun. 2017,5 medication indexes of 4 hospitals ranged 32%-41%,47%-53%,30-37 DDD,13%-20%,21%-32%, respectively. Rational drug indexes conformed to the provisions of the administrative department of health basically. The author provided related suggestions about departments in charge of formulating and adjusting medication indexes,methods for the primary formulation and modification of medication indexes,formulation of medication indexes in special department,management measures after the formulation of medication indexes. CONCLUSIONS:At present,the formulation and management of medication indicators in 4 hospitals of local area develop well,and effectively promote the level of clinical rational drug use.

Discuss The Strategy of the Development of Scientific Research Secretary in Clinical Department / 中华医学科研管理杂志

Scientific research management has become a crucial work in each hospital.The quality of scientific research management directly affects the level of scientific research development.Scientific research secretaries act as the direct participants and grassroots community of scientific research management,whose strengths and weaknesses of development related to the level of scientific research management directly.This study put forward several countermeasures on the barriers of hospital scientific research secretaries development,aiming to promote the development of hospital's scientific research and discipline construction.

Practice and experience of the hospital in clinical department management / 中华医院管理杂志

An introduction to the management of clinical departments of the hospital since 2009, featuringthree independence and four unification.The pattern is designed to mobilize department staff′s work enthusiasm,and improve their management efficiency,thus upgrading management of the hospital as a whole.Thanks to such reform,the hospital has scored great outcomes in terms of comprehensive strength,medical quality,disciplinary development and talent cultivation.

An Evaluation of Usage and Utilization of Generic Drugs by Clinical Medicine Departments Using a Questionnaire of Chain Community Pharmacies in Japan / 医薬品情報学

The creation of the National Health Insurance program has greatly contributed to giving Japan the world’s highest level of life expectancy.  However, the cost of medical care in Japan has increased as a result of an aging society.  In response to this reality, the Japanese government initiated a campaign to promote the use of generic drugs (GEs).  In order to clarify some of the trends that contribute to different clinical medicine department usages of GEs, we carried out a survey of 400 pharmacies.  The survey data was analyzed using linear regression analysis.  Analysis of linear equations derived “utilization” that indicated ease of use of GEs, and a “saturation acceptable value (maximum allowed)” that indicated usage of GEs.  The breakdown for different clinical medicine department usages of GEs was determined as the following: psychosomatic medicine or psychiatry was 11±0.13%, internal medicine was 29±0.18%, orthopedics was 18±0.14%, ophthalmology or otolaryngology was 15±0.14%, other departments was 17±0.15%.  Furthermore, the highest utilization derived by linear regression analysis was orthopedics.  The highest acceptable saturation value was for psychosomatic medicine or psychiatry, while the lowest acceptable saturation value was orthopedics.  The results of the study confirm the importance of establishing evaluation methods for GE usage, and that linear regression analysis is a powerful tool for revealing trends in GE usage among different departments.  Additionally, the study suggests that determining GE spread measures is valuable, since they can serve as an aid to future pharmaceutical administration consideration.

Communication between the clinical laboratory and clinical department should be strengthened by multiple pathways / 中华检验医学杂志

Stranging the communication between the clinical laboratory and clinical department,is useful to promote and enhance the quality of tests and clinical examination.The communication work organization and implementation has been effectively guaranteed by managing communication theories and multiple pathways of communication means to strengthen clinical laboratory and clinical department communication.

Bacteria Culturing and Actuality of Drug Resistance in Clinical Departments / 中华医院感染学杂志

OBJECTIVE To explore the situation of bacteriological examination in every clinical department,know distribution and drug resistance of pathogenic bacteria,and offer the help about diagnosis and reasonable using antibiotics.METHODS Using the Microscan A/S-4 to identify the microbes and microbial sensitivity tests according to pathogens from more than twenties clinical departments between 2004 and 2005.RESULTS The clinical delivering rate was low,and samples were dispersive.The samples mostly were sputum,pus,urine and blood,and their rate was 52.15%.The first three pathogenic bacteria were totally 13 kinds of species in all kinds of departments.The main pathogenic bacteria in the internal medicine such as in the department of respiration,department of gerontology,department of endocrinology and so on were mostly Klebsiella pneumonia and Escherichia coli.The main pathogenic bacteria in department of neurosurgery,ICU,department of burn and department of trauma were mostly Pseudomonas aeruginosa,Acinetobacter baumannii/haemolyticus,Enterobacter cloacae and Staphylococcus aureus,These bacteria might lead to nosocomial infections in our hospital too.Their rate was 52% and drug-resistance was serious.A.baumannii/haemolyticus and E.cloacae were only sensitive to imipenem.P.aeruginosa was most sensitive to piperacillin/tazobactem and next to ceftazidime,amikacin and ciprofloxacin.CONCLUSIONS There are the serious phenomena that P.aeruginosa,A.baumannii/haemolyticus and E.cloacae are highly resistant to many antibiotics.We will much more attend and study it.The clinics must attend it and improve the delivering rates of cultured sample.

Construction of Secretary Team of Clinical Department at Medical University / 中华医学教育探索杂志

The teaching secretary of clinical department at medical university is required to be passionate,devoted,qualified and good at writing.The position is reserved for the person with healthy psychology,who knows well to deal with people,political training and sensitivity,advanced qualification.