Research on the improvement of physical examination service quality based on KANO model and quality function deployment / 中华健康管理学杂志

Objective:To establish an integrated model with KANO model and quality function deployment theory to determine the priority of measures in improving the quality of physical examination service.Methods:It was a cross-sectional study. A total of 196 physical examinees from the Health Management Center of the second affiliated Hospital of Dalian Medical University were selected by simple random sampling. Reliability test was used to analyze the reliability and validity of the questionnaire. KANO model was used to determine the importance of physical examination needs in health examination population. The quality function deployment model was used to create the house of quality and determine the priority of the importance of various service measures.Results:In the high important attribute requirements of physical examination, the final importance of emergency ability, outpatient time, professional and advanced equipment are 0.054, 0.052, 0.047 and 0.046 respectively. The measures that needed to be given priority to improve the quality of physical examination services were to improve the quality of medical services (absolute importance=107.5), strengthen skill assessment (absolute importance=70.1), define guidance, consultation and clinic identification (absolute importance=56.2), introduce advanced equipment and facilities (absolute importance=53.7), timely and accurate physical examination report (absolute importance=51.9) and interpretation of physical examination report (absolute importance=50.9).Conclusions:The physical examination center should give priority to the measures such as improving the medical level, strengthening the skill examination, introducing advanced equipment and facilities, defining the guidance of examination, consultation and consultation room identification, and strengthening service management.

Application of quality function deployment technology in extracorporeal membrane oxygenation treatment of patients with critical cardiopulmonary disease / 中华危重病急救医学

Objective:To accurately and effectively identify the most critical needs of extracorporeal membrane oxygenation (ECMO) treatment for patients with severe cardiopulmonary diseases, and to better carry out continuous improvement of medical service quality an patients' satisfaction.Methods:Patients who underwent ECMO and transferred from 56 medical institutions in the Henan Provincial People's Hospital Critical Care Medicine Specialist Alliance [the patients who were transported before applying quality function deployment (QFD) from June 2017 to May 2018 were enrolled as the control group, and patients who were transported after applying QFD from June 2018 to May 2019 were the observation group], medical staff in the alliance hospitals, ECMO transfer teams and transfer driver teams were enrolled as the subjects of the survey. QFD was applied to convert the collected requirements into quality improvement elements for targeted improvement measures.Results:A total of 125 questionnaires were distributed in this survey, and 116 valid questionnaires were collected, including 91 from patients (including 27 from the control group and 64 from the observation group), 10 from the medical staff of the alliance hospitals, 10 from the ECMO transport teams and 5 from the transport driver teams. The questionnaire recovery rate was 92.8%. The improvement elements of ECMO treatment for patients with critical cardiopulmonary diseases were ranked according to the importance, and the top five were as follows: the accuracy of the first diagnosis, the specialization of ECMO team, the guarantee of vehicle safety, the seamless responses, and the smooth coordinated rescue protocol.Conclusion:The top five improvement elements should be prioritized in ECMO treatment of patients with critical cardiopulmonary disease in all hospitals of the Alliance to ensure more accurate and timely treatment.

A comparative study on the human resources deployment of public general hospitals in Pudong New Area / 中华医院管理杂志

Objective:To compare the actual situation and measurement data of human resources deployment in public general hospitals in Pudong New Area, so as to provide a data basis for further optimizing the human resources deployment plan.Methods:The Pudong New Area Health Statistical Information System was used to collect the staffing information and business data of 9 public general hospitals in Pudong New Area, Shanghai in 2019. On such basis, the numbers of officially budgeted positions and actual positions were calculated. Descriptive analyses of the data were performed to compare the theoretical and actual quantities by paired t-test and Wilcoxn signed-rank sum test. Results:The actual number of officially budgeted positions of the 9 hospitals was less than the theoretical number( Z=-2.55, P=0.011), while the actual number of positions was less than that of theoretical number( t=3.36, P=0.010). The proportion of the officially budgeted position shortage at tertiary hospitals(72.77%)was higher than that of secondary hospitals(36.94%). The proportion of position shortage at tertiary hospitals(16.14%)was less than that at secondary hospitals(38.78%). Conclusions:Area-owned general hospitals are in shortage of human resources, while secondary and tertiary hospitals have different needs for human resources. The actual situation of a hospital should be comprehensively considered to develop an optimal deployment plan for human resources.

Emergency deployment of human resources in public emergencies from the perspective of rescue in public emergencies / 中华医院管理杂志

In the case of public emergency, cross regional and institutional deployment of health technicians as a contingency measure is imperative in alleviating the shortage of medical resources and improving the medical capacity in the location of emergency. The authors rounded up common modes of such deployment, namely independent deployment of a complete organization, deployment by job division for individual responsibility, deployment of individuals joining in a cooperative action, and that of expert guidance. In practice, the emergency deployment of health technicians was faced with serial challenges, such as their mobility, interoperability, professionalism, economy and persistence. To improve the performance of emergency deployment, it is necessary to strengthen the routine emergency skill reserve and simulation drill, to formulate " wartime" joint diagnosis and treatment decision-making rules, to build high-level health emergency teams, to establish and improve a complete, flexible and orderly deployment mechanism of such human resources, and to improve the honor award and reward system for health emergency personnel.

Análisis del periodismo ambiental de la prensa en tiempos de pandemia en Colombia / Analysis of environmental journalism in the written press in times of pandemic in Colombia

Resumen Este artículo presenta los resultados de una investigación realizada con el objetivo de comprender la relación entre esta pandemia y el medioambiente, tema crucial en la coyuntura porque la propagación global de la COVID-19 se convirtió en un momento para repensar nuestra relación con el planeta, asunto que los medios contribuyen a debatir. Se hizo un análisis de la cobertura periodística en El Tiempo y El Espectador durante los tres meses de confinamiento estricto. La metodología utilizada fue el análisis del tratamiento informativo a partir de las categorías de cubrimiento y despliegue en el marco de una convergencia mediática. Entre los principales hallazgos encontramos una alta procedencia de información de agencias; predominio de la noticia como género y un promedio de fuentes consultadas cuya calidad favorece la diversidad de voces e intereses. Además, el tema predominante en El Espectador es la reducción de la contaminación por el confinamiento, mientras que en El Tiempo son las acciones desfavorables para el medioambiente. El enfoque ambiental general en las publicaciones es antropocentrista y la narrativa periodística sigue las lógicas análogas, desaprovechando las potencialidades del ecosistema digital.

Abstract This article presents the results of a research conducted with the aim of understanding the relationship between this pandemic and the environment, a crucial issue at this juncture because the global spread of COVID19 became a moment to rethink our relationship with the planet, an issue that the media contribute to debate. An analysis was made of the journalistic coverage in El Tiempo and El Espectador during the three months of strict confinement. The methodology used was the analysis of the informative treatment based on the categories of coverage and deployment within the framework of a media convergence. Among the main findings, we found a high source of information from agencies; predominance of news as a genre and an average number of sources consulted whose quality favors the diversity of voices and interests. In addition, the predominant topic in El Espectador is the reduction of contamination by confinement, while in El Tiempo it is actions unfavorable to the environment. The general environmental approach in the publications is anthropocentric and the journalistic narrative follows the analogous logics, missing the potentialities of the digital ecosystem.

Research on medical service quality improvement of a public hospital based on Kano model and quality function deployment / 中华医院管理杂志

Objective:To study the improvement of medical service quality in a public hospital by integrating Kano and quality function deployment(QFD)technology, so as to provide reference for the improvement of service quality in hospitals.Methods:The Kano questionnaire of patients′ needs was designed, the attributes of patients′ needs were identified, and the importance of patients′ needs was calculated and determined. Then, using the house of quality technology in QFD, the patient needs were transformed into corresponding medical service quality assurance elements, and the improvement priority of each assurance element was determined through calculation.Results:The six quality assurance elements most expected to be improved by patients in the hospital were to improve medical level, strengthen service management, improve supervision and review mechanism, standardize complaint process, ensure drug safety and guidance, and track treatment effect.Conclusions:The integrated Kano-QFD technology can provide an effective methodological reference for improving the quality of medical service.

Design and Implementation of Medical Equipment Rational Deployment Information System Based on ASP.NET / 中国医疗器械杂志

Based on ASP.NET framework, The Intelligent Estimated System for Rational Deployment of Medical Equipment (MERDIS) is designed and developed with SQL Server 2012 database and C# language. The system is used to realize the rational deployment suggestions and evaluation of medical equipment in hospitals. The system input the data of hospital medical equipment and clinical pathway into the database, and then feedback the deployment information to users which are calculated by big data information, so as to achieve the purpose of giving rational deployment of hospital medical equipment.

The 1-year follow-up results of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR) in a single center / 中国胸心血管外科临床杂志

@#Objective    To evaluate the efficiency and safety of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR). Methods    Consecutive patients (n=333) who diagnosed with severe aortic stenosis and underwent TAVR in Zhongshan Hospital affiliated to Fudan University from October 3rd, 2010 to April 21st, 2021 were included. There were 208 males and 125 females aged 76.0±7.0 years. There were 316 patients underwent simple TAVR (simple TAVR group) and 17 patients underwent intraprocedural valve-in-valve deployment following TAVR (valve-in-valve group). Their clinical and echocardiographic outcomes were evaluated and compared. Results    There was no significant difference between the two groups of patients at postoperative 30 d and 1 year in all-cause mortality (4.4% vs. 0, P=1.000; 6.3% vs. 0, P=1.000), incidence of pacemaker implantation (10.4% vs. 17.6%, P=1.000; 11.8% vs. 17.6%, P=1.000), incidence of ischemic stroke (1.3% vs. 0, P=1.000; 1.3%  vs. 0, P=1.000), mean trans-aortic pressure gradient (11.4±6.4 mm Hg vs. 8.9±4.9 mm Hg, P=0.099; 10.5±7.6 mm Hg vs. 11.2±5.2 mm Hg, P=0.432), left ventricular ejection fraction (62.0%±9.0% vs. 57.0%±12.0%, P=0.189; 63.0%±7.0% vs. 60.0%±8.0%, P=0.170), and incidence of mitral valve dysfunction (0.6% vs. 5.9%, P=1.000; 0.6% vs. 5.9%, P=1.000). Conclusion    It is feasible to treat perivalvular leakage with valve-in-valve technology in the procedure of TAVR, and the short and medium-term effects are satisfied.

Stent Graft Implantation into a False Lumen of a Chronic Type B Aortic Dissection after Surgical Abdominal Aortic Fenestration / 日本心臓血管外科学会雑誌

A 57-year-old man, who had suffered chest, back and right leg pain about 10 years before, underwent CT and was found a chronic type B aortic dissection with an enlarged false lumen and a narrowed true lumen that was occluded at the infrarenal abdominal aorta. A conventional surgical repair seemed to be too high risk considering his comorbidities, thus we chose a staged hybrid repair. First, surgical repair of the abdominal aorta with an abdominal aortic fenestration was performed. Then, one month after the first operation, zone 2 thoracic endovascular aortic repair with left carotid-axillary artery bypass was performed. At the second operation, the stent graft was purposely deployed from zone 2 into Th12 level of a false lumen through the fenestration followed by coil embolization of a true lumen just distal to the entry tear. The postoperative course was uneventful and he had no complications at 6 months follow-up. Deploying stent graft into a false lumen could be a feasible option in case deploying into a true lumen is not suitable if the anatomical condition permits.

Redesign Of Breastfeeding Chair For Nursery Room

@#Breastfeeding chair is one of the essential facilities in the airport. This study designs the breastfeeding chair for the nursery room in Minangkabau International Airport. Quality Function Deployment (QFD) was used to investigate the customer requirements by distributing questionnaires to 100 mothers in Padang West Sumatra. Anthropometry data was also measured form those respondents. The study resulted in a design of ergonomic breastfeeding chair which was used features obtained from the voice of the customers. The design has considered the condition of the mother giving birth by normal as well as a cesarean. The design has an adjustable back seat with an angle of 95o,105o, and 110o; it has an adjustable footrest with 120o, 140o, and 180o angles. The chair has a headrest, baby support pad, a portable baby cushion, an adjustable baby bearings. The chair has also equipped with an assemble torn neck, a small drawer on the side of the chair, and a palm rest that can be used or not by adjusting the height.

Post-traumatic stress disorder after military deployment: Status quo and interventions / 第二军医大学学报

Military deployment is an important factor for mental health of deployed military service members. Military deployment operations have increased greatly in recent years, so it is urgent to carry out psychological research. We reviewed status quo of post-traumatic stress disorder and other mental disorders that military deployment members suffered. Furtherly, we sorted out and summarized common psychological health interventions such as psychological screening, psychotherapy and training, and social support in military deployment. In addition, we also discussed the research directions of future military deployment including improving research methods, identifying individual differential targets for post-traumatic stress disorder, localization and militarization of related treatment technologies, and developing psychological training methods for military deployment personnel. We hope this paper can give the policymakers, researchers and those involved in military deployment information for decision-making, psychological assistant work and subsequent psychological research.

Assessment and analysis for deployment appropriateness of medical linear accelerator at hospitals in China / 中华医院管理杂志

Objective To analyze the deployment of medical linear accelerators at 26 hospitals in China, and suggest on the deployment of such accelerators. Methods From June 2017 to November 2018, a total of 26 hospitals were surveyed by stratified random sampling. Descriptive analysis of the deployment and staffing of medical linear accelerators at 26 hospitals, and the deployment appropriateness of the medical linear accelerator was evaluated using the TOPSIS method. Results The number of medical linear accelerators in different types of hospitals was significantly different. The proportion of imported equipment at tertiary hospitals was 80% (12/15) and the proportion of imported equipment at secondary hospitals was 9% (1/11). The professional staff was deployed basically reasonable, and there was a shortage of physicists at some hospitals. The suitability of medical linear accelerators at tertiary hospitals was better than that of secondary hospitals, 80% (12/15) of tertiary hospitals received " good" and above ratings, while 91% (10/11) of the secondary hospitals received " general" and below ratings. Conclusions Hospitals should carry out the allocation of large-scale medical equipment based on their own situations and requirements. Efforts should be paid on training of professional technicians for radiotherapy. It is important to strengthen the management of planning, access and supervision of medical equipment.

Analysis on allocation of large medical equipment in Shanghai / 中华医院管理杂志

Objective To analyze the allocation and equity of Class-A and Class-B large medical equipment in Shanghai, and to compare them with those in other parts of China and in other OECD countries. Methods The data of large medical equipments were collected from the Health and Family Planning Commission of Shanghai, government websites, relevant research reports and the database of OECD. Gene-coefficients were adopted to evaluate the equity of large equipment allocation. Results In terms of Class-A and Class B large equipments like CTs, MRIs and DSAs per million population, the number for Shanghai by the end of 2015, was 1.325, 5.30, 2.13 and 3.81 units respectively. Except for CTs, this figure was higher than national average, yet lower than average of other OECD countries. In addition, the equity in allocation of Class-B large medical equipment was better than that of Class-A large medical equipment in Shanghai. Conclusions The overall deployment level of large medical equipments in Shanghai remains to be increased, and the equity in allocation of Class-A large medical equipment deserves more attention.

Evaluation study of the current deployment of general practitioners and service usage by residents in China / 中华医院管理杂志

Objective To evaluate the current deployment of general practitioners and residents′utilization of services in China, for reference of their optimal allocation across the country. Methods The methods of HRDI and TOPSIS were used to comprehensively evaluate their deployment and residents′utilization of their services in China. Results General practitioners fall short of demand in general, averaging 0.137 1 GP per 1 000 population in China, with unbalanced regional distribution as well. Utilization of residents of general practitioners service remains at a low level, with unbalanced regional distribution as well. As shown in the comprehensive evaluation results, 87.10% of the regions were found with defective deployment and service utilization, featuring " low resources, low utilization" . Conclusions Sizable gapes are found between the eastern, the central and the western regions, in terms of allocation of resources and service utilization. The government should rationalize deployment of general practitioners and minimize such gaps among different regions, in view of local population, geography and health service needs.

Application of PDCA cycle in emergency deployment of defibrillator / 中国医学装备

Objective: To shorten emergency deployment time of defibrillator by using the management method of Deming cycle (plan do check action, PDCA). Methods: The PDCA management method was used to guide the quality control of the emergency deployment of defibrillator. And according to the actual situation of the emergency deployment rehearsal for the defibrillator, the "brainstorming method" was applied to analyze the reasons of the problem, and the main influence factors that affect the emergency deployment time of defibrillator were confirmed. And the specific solutions were formulated according to the "5W1H" method. And then these measurements were implemented and the inspection results were further summarized and analyzed. Results: From February 2016 to September, the average deployment time of defibrillator was 4.14 minutes in the 28 emergency drills. Compared with the pre-implementation of the PDCA management measures, the deployment time was shortened by 40.9%, and it saved 2.86 minutes. Conclusion: The application of PDCA management method can shorten the emergency deployment time of defibrillator, and its effect is obvious. This method can be used in other emergency management and devices management of life support so as to ensure the emergency deployment efficiency of first-aid and life support devices in hospital.

Analysis on the present deployment of large medical equipments in China / 中华医院管理杂志

Objective To analyze the overall deployment of Class-A large medical equipments in China.Methods Data of Class A large medical equipments deployed from 2007 to 2015 were collected and classified regionally,for the purpose of measuring the overall deployment,growth level and plan performance.Results There were 403 large medical equipments in China,a rapid rise of deployment,yet still far below developed countries in terms of per capita deployment.Regional differences were significant.With PET-CT as an example,the plan performance in the east(92.19%)was much higher than the west of China(68.57%);plan performance of Class-A equipments was better,conducive to regulating the increase and distribution.Conclusions The deployment level of Class-A equipments in China is low in general,and calls for better regulation regardless of the planning and management progress.

Efficiency analysis of medical equipment deployment in Liaoning province based on data envelopment analysis / 中华医院管理杂志

Objective To learn the present efficiency of medical equipments at public hospitals in Liaoning province, and provide scientific basis for rational distribution of such resources, and for control of medical expenses.Methods Data envelop analysis (DEA) was used to appraise the deployment efficiency of 2 784 such equipments worth over 100 000 yuan per unit, with equipments randomly sampled from 31 public hospitals in the province.Results The equipment deployment at public hospitals in Liaoning was found at a low level.9.7% of the hospitals were found as relatively efficient, 3.2% of them as in relatively weak efficiency, while 87.1% of them relatively inefficient.Gaps were found between urban hospitals and tertiary hospitals, and rural hospitals and secondary hospitals in their deployment efficiency, as evidenced in overinvestment of equipments and insufficiency of competent operators.Conclusions Hospitals should strengthen their scientific management of the equipments, and emphasize human resource investment, thus elevating the efficiency of equipment deployment.

Medical equipment management based on risk management mode / 医疗卫生装备

Objective To explore medical equipment management to decrease medical risks.Methods A medical equipment risk management model was established to deploy medical equipment rationally,evaluate the risk value of medical equipment,calculate the total risk value of medical equipment of the department and to propose the requirements for medical equipment utilization and management.Results The risks of medical equipment could be decreased by improved medical equipment management in deployment,utilization and maintenance as well as emphases on personnel and regulation.Conclusion Risk minimization is of great significance for medical equipment users and management department.

Analysis on medical equipment deploymentforhospitals directly under or managed by the NHFPC / 中华医院管理杂志

Objective To learn the current deployment and problems of medical equipment at 44 hospitals directly under or managed by the NHFPC,studying the correlation between the number of equipment deployment,and amount of outpatients/inpatients and inpatient surgeries for recommendations on scientific and rational deployment of medical equipment.Methods Literature review,expert consultation and questionnaire survey methods were used to study the use and problems in hospital equipment deployment.EpiData was used to build a database,and the means,standard variations and constituent ratios were applied for descriptive analysis of medical equipment deployment of the hospital departments.The data of hospital equipment usage and staffing,hospital beds,and service volume were subject to correlation analysis.Results 24 of the 44 hospitals were deployed with class-A medical equipment,covering eight types and 43 devices;the 44 hospitals were deployed with 441 class-B equipment of five types;the equipment types in great demand at such hospitals were MRI (77.27%),CT (70.45%),bioanalysis devices (68.18%),conventional radiation devices (52.27%),and conventional equipments (54.55%).The survey found a positive correlation ( P <0.05 ) between the equipments,and the amount of outpatients/inpatients and inpatient surgeries.Conclusions Hospitals should further establish and improve their deployment management system,rationalize their deployment procedures,and use scientific and rational deployment.Such approaches as equipment sharing,centralized management and performance appraisal could be called into play to improve equipment efficiency.

Relationship between organizational intelligence and hospitals agility of shiraz university of medical sciences.

Introduction: Regarding the changing environment of hospitals and necessity of providing services in the shortest possible time and with acceptable quality and cost for patients, attention to innovative and smart approaches and using maximum mental abilities of the organization for increasing hospitals agility seems necessary. In fact, this study aims to answer this question that is there a significant relation between organizational intelligence (and its components according to Albrecht model) and hospitals agility? Method: The present study is applied in respect of aim and descriptive in regard of nature and method and for this purpose, a 368 persons sample was selected by stratifies sampling method among all 8247 personnel working in 15 active hospitals. For data collection in the field of organizational intelligence Albrecht organizational intelligence standard questionnaire and for organization agility, agility standard questionnaire which has been designed based on Goldman agility model were used. Results: Findings showed that there is a positive and significant relation between organizational intelligence and its seven components (strategic perspective, shared fate, desire to change, spirit, knowledge application, union and agreement and performance pressure) with hospitals agility and except intervening variable of educations other intervening variables like age, gender, marital status and working background have no impact on organizational intelligence and hospitals agility. Conclusion: Regarding the results of this study, choosing some solutions for codifying dynamic strategic programs in hospitals and holding training courses of organizational intelligence for informing personnel and managers could lead to increasing of hospitals agility level and providing effective service for patients.