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OBJE CTIVE To explore the rational application and management of antibiotics in burn department of our hospital based on disease diagnosis related groups （DRGs）. METHODS Patients discharged from the burn department of our hospital from July 2020 to June 2021 were selected as the research objects to collect DRG data. The overall application of antibiotics in DRG group with more than 10 cases were analyzed ，and the application of antibiotics in typical disease groups were evaluated horizontally and vertically. RESULTS Among 3 732 discharged cases in the burn department of our hospital ，a total of 3 515 cases were included in 66 DRG groups ，21 DRG groups of which were included in the study. Among 21 DRG groups ，the maximum antibiotics use density （AUD）of antibiotics was 102.20 DDDs/（100 person·d）in AH 11 group，the utilization ratio of antibiotics was 100％，and the combined use rate of antibiotics was 81.82％；case-mix index （CMI）value was 11.49. The minimum AUD was 1.01 DDDs/（100 person·d）in XR 19 group，the utilization ratio of antibiotics was 5.06％，and the combined use rate of antibiotics was 0；CMI value was 0.81. Within the same core group ，AUD increased with the increase of CMI. The horizontal comparison and analysis of WB 11 group showed that there was a large gap in AUD among different physicians. The vertical comparison of AUD in WB11 group showed relatively small changes over time. CONCLUSIONS The horizontal and vertical evaluation of antibiotics based on DRGs can provide new clues for the control of antibiotics and help to realize the fine specialized management of antibiotics.
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Aiming at the current situation of medical equipment management, Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine explored the application of 5G+ Internet of Things and digital twin technology in the intelligent management of medical equipment. Through the intelligent perception terminal, the hospital realized the dynamic acquisition of real data such as the use location, use process and use efficiency of medical equipment, and conducted digital, networked and intelligent monitoring and analysis. At the same time, applications such as medical equipment dynamic management software, medical equipment real-time positioning software, and space environment quality monitoring software were developed. It realized automatic, intelligent and visual management of medical equipment configuration, operation and performance evaluation, achieved fine management based on digital twins, and improved the efficiency of collaborative management of operational resource support.
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Objective:To design an evaluation scale of perioperative fine management, and test it in hospitals, for verifying its effectiveness and sorting out problems in such management.Methods:November 2020 to August 2021, the scale framework was designed by using the process management theories featuring process-oriented control; then the scale was built based on a risk measurement indicators pool created based on policies, literature, standards and expert interview results on perioperative management; an empirical study was made in the end.Results:The scale consists of 209 risk measurement indicators and Likert 5-level scoring method was adopted to measure the possibility of problems in each respect. A total of 99 experts from 31 hospitals participated in the trial of the scale in 2021, and Cronbach α coefficient was 0.997, indicating good consistency among risk measurement indicators. The median of the average scoring of respective risk measurement indicators was 1.69. The most common problems in the perioperative management process include: lack of analysis and countermeasure research on the perioperative fine management; insufficient medical staff; poor awareness of medical staff in standardized and fine management. Conclusions:This scale can quantitatively evaluate respective aspects of perioperative fine management.
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【Objective】 To provide reference for fine management of blood donors by classifying and analyzing different types of blood donors from domestic blood stations. 【Methods】 The resident population of 15 regions in China from 2016 to 2019 were taken as the research object, among which the blood donors were divided into three categories: age-eligible citizens, registered donors and donated donors. The average value and proportion of the three categories were calculated and statistically analyzed. 【Results】 The resident population of the 15 regions varied greatly. The mean 95% CI of the proportion of age-eligible citizens to resident population from 2016 to 2019 was (60.16%, 67.84%); registered donors to age-eligible citizens and resident population was (2.21%, 2.86%) and (1.41%, 1.79%), respectively; donated donors to registered donors, age-eligible citizens and resident population was (84.63%, 91.68%), (1.93%, 2.55%) and(1.23%, 1.59%), respectively. 【Conclusion】 There were differences in the number and proportion of different types of blood donors in different regions. The fine management of blood donors can help blood stations carry out more effective recruitment and retention strategies.
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Single-disease management is an important means of medical quality management, and data is the basis of single-disease management. Aiming at the problem of difficult data collection of single disease in hospital, the authors designed a solution to realize the fine management of single-disease data based on data center. The hospital optimized the data quality through overall management, unified the data collection source based on the data center, built a single-disease intelligent collection platform to complete the data collection, and calibrated the data to ensure its accuracy, so as to form a single-disease index management process and realize high-quality data collection. The average actual backfill rate was as high as 95.7%. On this basis, the hospital optimized the single-disease reporting and quality control management mode to further promote the fine management of medical quality.
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To solve the problems of long waiting time for outpatients, difficulty on implementation of one patient one room initiative, backward appointment method on examination, and imperfect instruction and guidance, a series of fine management measures have been taken place in a tertiary hospital which included dividing the patient waiting queue reasonably, establishing the patient secondary consultation system, improving the outpatient order of two-way management between doctors and patients, establishing one key appointment system for examinations, building hospital intelligent navigation system, and implementing outpatient payment and self-service drug delivery.The results showed, the waiting time of outpatients was significantly shortened ( P<0.001), and the satisfaction of patients in waiting time, hospital guidance and appointment registration was significantly improved ( P<0.05). Fine management mode combining online and offline can effectively increase the efficiency of outpatient service, improve clinical experience, and facilitate the high-quality development of medical services.
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The authors attempted to use information technology in hierarchical management on clinician′s surgical authority. By means of a hierarchical surgery catalogue database, clinicians′ surgical authority is subject to by-level IT-based approval, and such authorities as clinician′s surgical medical advice, application for surgery, and approval of special surgeries are regulated. Thanks to multi-dimensional objective data, clinicians′surgical competence is subject to a dynamic evaluation, hierarchical authorization and reauthorization. These measures further standardize the behavior of the surgeons, and rule out unauthorized operations, thus improving fine management of surgeries and ensuring patient safety.
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Furthering healthcare reform calls for public hospitals to curb unreasonable growth of medical expenses,reduce drug proportion,and lower the costs of medical materials consumed per 100 RMB medical income.In view of the hospital,the authors established a data-based monitoring system for key indicators of medical consumables,formulated an evaluation scheme of rational use,and implemented the corresponding control measures,which provide a reference for scientific control of clinical rational use of the medical consumables.
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Objective: To construct medical consumables management system based on internet cloud platform so as to eliminate the obstacles of information connectivity between the internal system and external supplier in the management of medical consumables and solve the problems of passive management and low efficiency in consumables management. Methods: Through introduced the internet cloud platform to link the internal system of hospitals and the external suppliers. The supplier, product managements and consumables purchasing were completed through the qualification platform and procurement platform. Results: Under the part of internal system were reserved, the internet cloud platform has completed data interchange, and introduced the third party, and innovated the management mode, and established standardization system about the enterprise qualification and product information, optimized original service mode about supply and demand, and shortened the cycle of procurement and supply, and enhanced the efficiency. Conclusion: The internet cloud platform can complete the communication of the information about inside and outside consumables management of medical institution as lower cost, and ensured the accuracy and consistency of data, and provide data support for fine management with higher level includes information sharing, large data analysis and so on.
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Management of hospital water supply facilities is key to its logistics management.This paper cited the domestic water supply facilities management as an example, and summed up practical experiences in both JCI certification and review along with the hospital′s fine management of water facilities.On such basis, it described such aspects as the establishment of management system, operation standards and work flow, implementation of preventive maintenance, renovation, emergency protection, inspection supervision, file management and staff training.These efforts provide reference for how to establish the fine management mode of water supply facilities.
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Objective To apply PDCA circle management method to eliminate redundant medical consumables items and reduce the burden of consumables item information system,so as to realize fine management of medical consumables.Methods The consumables items un-mobilized during 2013 to 2015 were summarized,and the causes were analyzed.The redundant consumables items were sealed up in the materials management system.Results The utilization rate of consumables items were increased from 61％ to 82％,and the target value was 71％,that is,fine management was realized.Conclusion PDCA method can optimize the management of medical consumables items,and enhance the efficiency of materials information system.
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The paper introduces the design and implementation of fine monitoring system of Traditional Chinese Medicine (TCM) project budget,and clarifies the system about the building background,management concept,business process,design architecture and functions and so on.With performance appraisal objective management,fine inquiry,statistical analysis and other functions,this system can improve the accuracy of the budget data,which is of actual guiding significance for the implementation of the TCM project.
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Objective To establish a medical quality evaluation system for gynecology wards in specialized gynecology hospitals by means of DRGs. Methods DRGs method was used to adjust risks of the information of gynecology inpatients discharged in 2016. On such basis, the medical quality evaluation system was built on the three dimensions of medical ability, medical efficiency and medical safety, while a general scoring was obtained by multiplying the scoring of the dimension with its respective weighting coefficients. Results The general scoring of the 10 wards ranged between 0. 89-1. 08, averaging 0. 99. That of Ward B ranked the highest, and Ward I the lowest of the ten. The medical ability scoring ranged between 0. 87-1. 12, averaging 1. 00;That of Ward B ranked the highest,and Ward I the lowest of the ten. Medical efficiency scoring ranged between 0. 93 -1. 23, averaging 1. 00;That of Ward J ranked the highest,and Ward E the lowest of the ten. Safety scoring ranged between 0. 89-0. 99, averaging 0. 94; That of Ward F ranked the highest, and Ward A the lowest of the ten. Conclusions The medical quality evaluation system based on DRGs can effectively evaluate wards of a gynecology department, supporting their fine management.
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Objective To investigate the fine management in the role of infection control management and the effect evaluation in pharmacy intravenous admixture services. Methods From July 2013 to June 2016, infection control management were reviewed retrospectively in pharmacy intravenous admixture services:routine management (from July 2013 to December 2014) and fine management (from January 2015 to June 2016). The settlement of air bacteria formation rate, hand hygiene compliance and accuracy of drug-care workers, and worker′s hand colonization monitoring data before and after the fine management were compared. Results After the implementation of fine management, the settlement of air bacteria formation rate was reduced from 10.42%(120.0/1152) to 4.45%(51.3/1152); there was significant differences (t=3.417, P<0.01).The hand hygiene compliance of drug-care workers increased from 81.50%(1172/1438) to 95.56%(1314/1375), the difference was statistically significant (χ2=1.353, P<0.01);the accuracy rate increased from 86.09%(1109/1172) to 95.13%(1250/1314), the difference was statistically significant (χ2=60.975, P<0.01); workers′ hands colonies number after fine management decreased than before, and there was significant differences (χ2=41.163, P<0.01). Conclusions The fine management has a higher application value in the infection control management of pharmacy intravenous admixture services, which can reduce the settlement of air bacteria formation rate, workers′ hands colonies number, improve hand hygiene compliance and accuracy of drug-care workers, further standardize the worker′s behavior, provide a more secure configuration environment, and guarantee the quality of drug configuration.
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Objective To establish a medical quality evaluation system for gynecology wards in specialized gynecology hospitals by means of DRGs. Methods DRGs method was used to adjust risks of the information of gynecology inpatients discharged in 2016. On such basis, the medical quality evaluation system was built on the three dimensions of medical ability, medical efficiency and medical safety, while a general scoring was obtained by multiplying the scoring of the dimension with its respective weighting coefficients. Results The general scoring of the 10 wards ranged between 0. 89-1. 08, averaging 0. 99. That of Ward B ranked the highest, and Ward I the lowest of the ten. The medical ability scoring ranged between 0. 87-1. 12, averaging 1. 00;That of Ward B ranked the highest,and Ward I the lowest of the ten. Medical efficiency scoring ranged between 0. 93 -1. 23, averaging 1. 00;That of Ward J ranked the highest,and Ward E the lowest of the ten. Safety scoring ranged between 0. 89-0. 99, averaging 0. 94; That of Ward F ranked the highest, and Ward A the lowest of the ten. Conclusions The medical quality evaluation system based on DRGs can effectively evaluate wards of a gynecology department, supporting their fine management.
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Objective To investigate the fine management in the role of infection control management and the effect evaluation in pharmacy intravenous admixture services. Methods From July 2013 to June 2016, infection control management were reviewed retrospectively in pharmacy intravenous admixture services:routine management (from July 2013 to December 2014) and fine management (from January 2015 to June 2016). The settlement of air bacteria formation rate, hand hygiene compliance and accuracy of drug-care workers, and worker′s hand colonization monitoring data before and after the fine management were compared. Results After the implementation of fine management, the settlement of air bacteria formation rate was reduced from 10.42%(120.0/1152) to 4.45%(51.3/1152); there was significant differences (t=3.417, P<0.01).The hand hygiene compliance of drug-care workers increased from 81.50%(1172/1438) to 95.56%(1314/1375), the difference was statistically significant (χ2=1.353, P<0.01);the accuracy rate increased from 86.09%(1109/1172) to 95.13%(1250/1314), the difference was statistically significant (χ2=60.975, P<0.01); workers′ hands colonies number after fine management decreased than before, and there was significant differences (χ2=41.163, P<0.01). Conclusions The fine management has a higher application value in the infection control management of pharmacy intravenous admixture services, which can reduce the settlement of air bacteria formation rate, workers′ hands colonies number, improve hand hygiene compliance and accuracy of drug-care workers, further standardize the worker′s behavior, provide a more secure configuration environment, and guarantee the quality of drug configuration.
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Objective:To realize the real-time bidirectional traceability closed-loop management for consumable so as to ensure the safety and quality of consumables usage. Methods: The RFID technique was adopted in the whole process and fine management system of medical high-value consumables to realize the whole process, fine, informationization and visual management for medical high-value consumables.Results: The management system has realized the whole process, informationization and fine management included of application, review and approval, purchasing, checking, accepting, warehousing, inventory management, warehouse-out and usage for high-value medical consumables.Conclusion: The system based on RFID technique can quickly identify information of consumable, and achieve operation of warehouse-in and warehouse-out in batching. Therefore, it is convenient in operation, and it can efficiently reduce the workload of clinical work and enhance the work efficiency.
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Objective:To realize the real-time bidirectional traceability closed-loop management for consumable so as to ensure the safety and quality of consumables usage. Methods: The RFID technique was adopted in the whole process and fine management system of medical high-value consumables to realize the whole process, fine, informationization and visual management for medical high-value consumables.Results: The management system has realized the whole process, informationization and fine management included of application, review and approval, purchasing, checking, accepting, warehousing, inventory management, warehouse-out and usage for high-value medical consumables.Conclusion: The system based on RFID technique can quickly identify information of consumable, and achieve operation of warehouse-in and warehouse-out in batching. Therefore, it is convenient in operation, and it can efficiently reduce the workload of clinical work and enhance the work efficiency.
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Objective To analyze the medical disputes occurred in the emergency department of our hospital,and discuss the fine management strategy.Methods The medical disputes occurred in 2015 were reviewed.We reviewed the related literature and analyzed the causes of medical disputes by brainstorming and fishbone diagrams.For the root causes,in 2016 to carry out the corresponding fine management.To compare the incidence of medical disputes in emergency department of our hospital before and after the implementation of 1 years,and compare the anxiety and depression scores of 62 emergency medical staff before and after the implementation of fine management.At the same time,satisfaction of emergency services for 60 patients were randomly investigated in 2015 and 2016.Results In 2016,after the implementation of fine management of medical disputes,the percentage of emergency medical disputes was significantly lower than in 2015,and the difference was statistically significant (P ＜ 0.05).Before and after the implementation of fine management,the SAS and SDS scores of emergency medical staff were significantly reduced,and the difference was statistically significant (P ＜ 0.05).At the same time,in the results of random survey,we found that in 2016,the satisfaction rate of patients with emergency technology and service were higher than that in the year of 2015,and the difference was statistically significant (P ＜0.01).Conclusion After fully understanding the causes of emergency medical disputes,the formulation and implementation of the appropriate management strategy can effectively prevent emergency medical disputes,improve the professional and the service satisfaction of emergency medical staff.
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Objective To investigate the effect of fine management in disinfection and sterilization of surgical instruments in Disinfection Supply Center. Method The surgical instrument sterilization and disinfection pass rate differences and operating room personnel satisfaction were investigated. Result The pass rate of disinfection and sterilization in surgical instruments of observation group was 100.0%, the surgeon satisfaction in using surgical instruments was 99.7%. Conclusion Application of fine management in sterilization of surgical instruments in disinfection supply center can improve the passing rate of the sterilization, improve the satisfaction of the surgical staff, and also to ensure the quality of the surgical instrument in sterilization, reduce the risk of infection in patients, protect patient safety, which is worth further clinical application.