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Infection prevention and control(hereinafter referred to as " infection control" )practitioners are the backbone of infection control teams of individual departments. Their capacity-building is key to improving the management efficiency at both hospital and department levels, which can effectively ensure medical safety. Since 2017, a tertiary traditional Chinese medicine hospital had scored desirable results based on the analysis of the problems existing in their capacity-building. In its explorations, the hospital attempted to improve the professional competency and management ability by the following measures. These measures included improving and standardizing the organization and management, establishing an on-the-job training system, formulating an annual management manual of department′s infection control teams, implementing a cross inspection system and patrol system of the practitioners during an epidemic, establishing an assessment and evaluation system and incentive mechanism, establishing infection control elite teams, and building a mode dominated by infection control doctors. These experiences can provide reference for optimizing the capacity building of the infection control practitioners.
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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.
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OBJECTIVE@#To analyze the long-term trends of the changes in the equity of China's health workforce allocation to provide a reference for the more balanced and orderly development of China's health system.@*METHODS@#The Gini coefficient was used to evaluate the degree of equity in the allocation of health workforce between regions, and the Gini coefficients for the allocation of doctors and nurses based on population and regional gross domestic product (GDP) distribution were calculated respectively.@*RESULTS@#In 2019, the number of licensed (assistant) physicians per 1 000 population in China was 2.77, and the number of registered nurses per 1 000 population was 3.18. The Gini coefficient for the distribution of licensed (assistant) physicians by population was 0.141 in 2002, decreasing to 0.081 by 2014 and then remained stable. The Gini coefficient for the distribution of registered nurses by population was 0.164 in 2002 and decreased to 0.066 in 2018. The Gini coefficient for the distribution of licensed (assistant) physicians by GDP was 0.236 in 2002, decreased to 0.169 in 2013, then increased to 0.183 and remained stable. The Gini coefficient for the distribution of registered nurses by GDP was 0.206 in 2002, decreased to 0.150 in 2013, and then increased each year to 0.180 in 2019. The equity of the allocation of registered nurses by population was worse than the equity of the allocation of licensed (assistant) physicians in 2002, and in 2016, for the first time, exceeded that of licensed (assistant) physicians.@*CONCLUSION@#Equity in the allocation of health workforce across China has improved, but the improvement in equity between regions has hit a bottleneck, with health workforce allocation in the western regions still relatively scarce. Although nursing workforce allocation equity caught up with licensed (assistant) physicians, the number of licensed (assistant) physicians is close to that of developed western countries, while there is a large gap in registered nurses. It is recommended that the relevant authorities make good long-term planning for health workforce, further increase the policy for the introduction of health workforce in the western region, and increase the supply of healthcare services in the western region with the help of digital transformation of healthcare and internet healthcare. At the same time, they should further increase investment in resources for higher nursing education and actively plan to cope with the ageing population.
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Humans , China , Health Equity , Health Services , Health Workforce , WorkforceABSTRACT
Objective:To analyze the staff salary status and the influencing factors in traditional Chinese medicine(TCM) hospitals implementing the salary system reform in Sichuan province in 2020, for reference in optimizing the salary system reform of such hospitals.Methods:Cluster sampling and institutional survey were used to collect the salary information of 26 TCM hospitals in 21 cities(prefectures)of Sichuan province implementing the salary system reform in 2020. Such information was then subject to descriptive analysis, while the influencing factors of salary were subject to one-way analysis of variance and generalized linear model multifactor analysis.Results:15 428 staff from 26 TCM hospitals were included as the research objects. In 2020, personnel expenditure accounted for 40.23% of the total expenditure, and 24.34% of which came from financial subsidy in 26 TCM hospitals. The average annual payable income per person was(149 312±74 288)yuan, 67.82% of which being performance pay. Analysis of variance showed that there were significant differences among the salary levels of staff in different economic regions, hospital grades, hospital levels, gender, educational background, position, seniority, performance pay ratio, employment in the government system and other natures, senior and other professional titles, doctors and other positions( P<0.05), and the differences were still statistically significant after adjustment by generalized linear model( P<0.05). Conclusions:The reform of the salary system of Sichuan TCM Hospitals has basically achieved equal pay for equal work, and the income of low-level personnel has been improved. However, the salary level was not very motivated and the salary structure was not guaranteed. It is necessary to strengthen financial precision subsidies, increase the proportion of personnel expenditure, so as to support the increase of the absolute value of salary in non-core economic areas, improve the salary structure, reasonably widen the salary gap among different educational backgrounds and positions, further optimize internal distribution, and ensure the sustainable development of Chinese medicine talents.
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Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.
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The professional title evaluation of health professionals needs to highlight the clinical performance and actual contribution, and make full use of the information system of medical and health institutions to collect relevant data as an important basis for such evaluation.Based on this, the project team innovatively developed a " clinical work data extraction system" , to extract and calculate the performance indexes of clinicians using data from homepages of medical records. Meanwhile, the team established a reference scale based on the data in the hospital quality monitoring system; developed a " health workers evaluation data platform" , visually presenting the comparison results between the clinical work performance evaluation data of a clinician, and the reference scale and the data of other applicants. In the 2021 annual evaluation of senior professional titles among some medical institutions directly under the National Health Commission and such provinces as Sichuan, Shandong and Chongqing, this method was used to extract homepage data of medical records of 7 833 applicants from 39 medical specialties in 1 416 medical institutions, and finally 6 093 people (77.79%) completed the calculation of clinical work evaluation index data. The initial application results showed that the evaluation of senior clinicians′ professional competence based on homepage data of the medical record was feasible in the senior professional title evaluation of various medical institutions at all levels equipped with the electronic medical record database system, and could effectively present the performance level and actual contribution of the applicant.
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Optimizing the salary system of general practitioners and establishing a compensation incentives mechanism fitting its needs, would contribute effectively to the development of the general practitioner system in China. Fully leveraging the salary incentive system, the United Kingdom(UK) effectively improved the working enthusiasm of general practitioners and its quality of primary medical services, and limited its medical expenses as well. The authors expounded the incentive mechanism of general practitioners′ salary in the UK from such dimensions as salary model and salary structure, and introduced the implementation effect. Based on Robbins′ comprehensive incentive theory, the authors introduced the internal logic of the UK′s general practitioners′ salary incentive mechanism. Based on the UK experiences, along with existing problems in China, the authors recommended on setting up value-based salary levels, optimizing the salary structure, and establishing a dynamic adjustment mechanism. These ideas are expected to help optimize the salary incentive mechanism for general practitioners in China.
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Under the situation of regular epidemic prevention and control of COVID-19, the hospitals need to establish an emergency personnel pool and update it regularly. The author introduced the experience of establishing and managing the emergency personnel pool in a hospital, including the use of information technology to achieve scientific grouping and dynamic management, strengthening the emergency response ability, epidemic prevention and control training and assessment of all staff, ensuring their mental health and logistics support, and improving the performance assessment, salary and welfare system of emergency personnel.From December 2021 to May 2022, the members of the emergency personnel pool completed a total of 62 emergency support tasks. The response time and team gathering time of all emergency tasks were reduced to less than 1 hour. A total of 4 421 medical personnel were sent. The nucleic acid test results of COVID-19 during the tasks were negative, the infection rate was zero, and no adverse events occurred.
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Health manpower is key to the functioning of the health system. There exists a general need to strengthen health human resources in countries at large as they achieve universal health coverage. Through the systematic collection and sorting out of the declarations, initiatives, guidelines in the world and topics at the World Health Assemblies on health manpower-related issues since 2000, this paper summarized and analyzed the key issues and trends on health manpower planning, education and training, international migration, and compensation management, in order to provide reference for China′s health manpower management and practice.
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The authors systematically reviewed the progress of health human resources development, personnel management system and conceptual changes from 2011 to 2020 in China, and analyzed the status quo in this regard. The past 10 years have witnessed rapid progress of health human resources, namely better personnel management system and constant innovation in human development concepts. As required by the strategy of empowering the country with talents in the new era, as well as the overall promotion for the Healthy China initiative and the high-quality development of the health industry, higher requirements have been put forward for the quantity and quality, structural distribution and management innovation of health human resources. Therefore it is necessary to further expand the coverage of talents work and innovate talents policy, thus keeping the upgrade of the capability and competence of health talents.
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In the context of the construction of " double sinking and double upgrading" in Zhejiang province, a provincial hospital explored a pilot talent working mechanism of " provincial hospital recruit staff and county hospital get experts" in the process of cooperating with county hospitals. In view of the problem that high-quality medical human resources were difficult to sink, with the flexibility of the reform of post filing and staffing, we put forward the idea of " provincial hospital recruit staff and county hospital get experts" , established key support disciplines, recruited staff by provincial hospitals, and arranged experts to precisely " sink as needed" to help disciplines of county hospitals. It helped to explore the establishment of a long-term mechanism to promote the flow of excellent medical talents to remote mountain areas, built a " specialized community" of provincial and county hospitals, and improved the medical service capacity, medical quality and discipline construction of county hospitals.
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Objective:To explore the influencing factors of turnover intention of pre-hospital emergency nurses in Beijing, and provide references for reducing the turnover rate of pre-hospital emergency nurses and stabilizing the pre-hospital emergency nursing team.Methods:Pre-hospital emergency nurses from 2 emergency centers in Beijing were selected as the survey objects, and a self-designed questionnaire was used to conduct an online survey in September 2019. The questionnaire covered such aspects as the main demographic characteristics, workload, doctor-patient relationship, professional identity, job burnout and turnover intention. Descriptive analysis was conducted for the data, while rank-sum test and Kappa consistency test were used for univariate analysis, and ordered logistic regression analysis was used for multivariate analysis.Results:A total of 340 valid questionnaires were received, among which 41.5% (141) of the nurses said that they occasionally considered quitting, 11.7% (40) said they often considered quitting, while the scoring of professional identity was (33.29±6.00), and that of job burnout was (63.70±14.90). Univariate analysis showed that age, work units, self-rated health status, professional identity, job burnout, seniority, workload, doctor-patient relationship, and pressure of title promotion were significant ( P<0.05). The results of multivariate analysis showed that job burnout, average number of car trips per shift, and self-rated health status were positively correlated with turnover intention, while professional identity was negatively correlated with turnover intention ( P<0.05). Conclusions:The turnover intention of pre-hospital emergency nurses in Beijing was found at a high level. The authorities are recommended to rationalize the scheduling system and increase the staffing of pre-hospital emergency nurses; establish the diversion policy, title promotion system and post risk special allowance for such nurses; and train medical aid workers to undertake the transfer and lifting of patients, so as to reduce the turnover intention of these nurses.
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Objective:To explore the driving mechanism contributing to doctors′ turnover intention in public hospitals based on the grounded theory.Methods:" Willingness or intention for doctors to quit public hospitals" was used as the theme word, and the literature was retrieved from CNKI published from January 1, 2017 to January 1, 2022. Based on the grounded theory, NVivo 11.0 software was used for a qualitative analysis of the literature. The three-level coding method of open coding, axial coding and selective coding was used to identify the main categories affecting the willingness of doctors to quit public hospitals. On this basis, the driving mechanism model was integrated. In-depth interviews with hospital managers were used to test the theoretical saturation.Results:When 31 papers were coded, four level-1 influencing factors of the formation of doctors′ turnover intention in public hospitals were summarized: career selection deviation, practice reality, perceived experience and external opportunity. Among them, perceived experience was the direct driving factor; career selection deviation was the initial driving factor, and the practice reality was the key driving factor, both of them affected the perceived experience; external opportunity was the possible driving factor.Conclusions:In order to prevent doctors from willing to leave, the following measures are expected: the hospital management should improve both its recruitment evaluation indexes and recruitment effectiveness; pay attention to doctors′ psychological capital management and cultivate positive perception; promote the reform of performance pay, emphasize fairness and value; pay attention to employee relationship management and build a supportive hospital culture.
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Este manuscrito objetiva relatar uma prática de Educação Permanente em Saúde para qualificação do processamento e esterilização de materiais de uma Central de Materiais Esterilizados em um cenário de Estratégia Saúde da Família, a partir da integração ensino-serviço. A experiência foi realizada em uma Unidade Básica de Saúde situada no Oeste de Santa Catarina, durante o segundo semestre de 2016, envolveu estudantes e docentes de uma universidade pública e 11 trabalhadores da Estratégia de Saúde da Família. Realizou-se reunião com a coordenação, roda de conversa com os profissionais e elaboração de instrumentos (checklist e procedimento operacional padrão). As atividades de Educação Permanente em Saúde favoreceram a transformação da práxis dos atores do serviço e da academia, possibilitando o diálogo corresponsável pela qualificação da assistência, segurança do paciente e gestão do trabalho.
This manuscript aims to report a Permanent Education in the Healthcare field to qualify the materials processing and sterilization in a Material Sterilization Center in a practice scenario of Family Health Strategy, based on the service-learning integration. This experience was conducted in a Health Center located in the West of Santa Catarina, during the second semester of 2016, involving students and professors of a public university and 11 workers of one Family Heath Strategy. A meeting was held with the coordinator, a round-table discussion and the elaboration of tools (checklist and standard operating procedure). The activities of Permanente Education in the Healthcare field have favored the praxis transformation of those working in the service and academia, enabling a responsible dialogue for qualification of care, patient safety, and work management.
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Primary Health Care , EducationABSTRACT
Introdução: A saúde coletiva constitui-se como um campo de saber voltado para a compreensão da saúde e a explicação de seus determinantes sociais, e o âmbito de práticas direcionadas prioritariamente para a sua promoção. Pela sua caracterização, a saúde coletiva é um campo que possui potencialidades para contribuir na reorientação das práticas de saúde das diferentes profissões da área da saúde, como a fonoaudiologia. No Brasil, o fonoaudiólogo iniciou sua prática voltada para a saúde escolar, entre as décadas de 1920 e 1940, com práticas embasadas na pedagogização da saúde e medicalização da educação. Entre 1950 e 1970, direcionou seu trabalho para os consultórios particulares e clínicas de reabilitação. Nos anos 90, com o recém criado Sistema Único de Saúde (SUS), foram identificadas lacunas na atuação do fonoaudiólogo, iniciando-se os estudos para repensar a sua formação no contexto da saúde pública. Objetivo: Analisar a formação em saúde coletiva nos cursos de fonoaudiologia de Instituições de Educação Superior (IES) públicas. Método: Para a produção dos dados foram realizadas entrevistas com informantes-chave discentes e docentes de sete IES públicas do Nordeste. As entrevistas foram gravadas, transcritas, categorizadas e analisadas através da Análise Temática de Conteúdo. Além disso, foi realizada uma análise documental de currículos lattes dos docentes fonoaudiólogos responsáveis pelos componentes curriculares de saúde coletiva nas IES públicas brasileiras identificados através da técnica "bola de neve". Esta análise permitiu identificar o perfil da formação, atuação e publicação dos docentes. Os dados produzidos foram organizados no software IBM SPSS versão 20, gerando estatísticas descritivas, e sendo realizada a análise de correspondência múltipla. Resultados: Identificou-se na análise das entrevistas dos estudantes que esses possuem experiências formativas na saúde coletiva que favorecem uma aprendizagem no SUS, mas que possuem fragilidades na interprofissionalidade e na integração de conteúdos. Já nas entrevistas com os docentes, observou-se que os cursos de fonoaudiologia possuem uma heterogeneidade na abordagem sobre saúde coletiva e um predomínio da metodologia tradicional nos currículos, o que favorece uma fragmentação do conhecimento. Na análise da formação, atuação e produção docente foi possível visualizar a existência de docentes que não possuíram uma formação pós-graduada em saúde coletiva e que publicam artigos na área da clínica fonoaudiológica. Adicionalmente, é possível perceber a existência de diferenças no perfil de formação e atuação dos docentes quando se analisa essa realidade nas regiões do país, sendo a região Nordeste a que possui mais docentes com formação, atuação e publicação na área da saúde coletiva. Conclusões: Na região Nordeste, apesar da saúde coletiva cumprir o papel de problematizar e inserir a formação do fonoaudiólogo no contexto do SUS, necessita-se da superação da lógica fragmentada na formação dos estudantes, de tal forma que outros componentes curriculares também sejam corresponsáveis pela constituição de profissionais com o perfil para atuação no SUS. Adicionalmente, no contexto nacional, a identificação da existência de docentes que são responsáveis por componentes de saúde coletiva, mas não possuem formação e publicação nessa área, alerta para uma consequente fragilização da saúde coletiva na fonoaudiologia (AU).
Introduction: The public health is constituted as a field of knowledge that aims to understand health and explain its social determinants, and the scope of practices aimed primarily at promoting it. Due to its characterization, public health is a field that has the potential to contribute to the reorientation of health practices of different health professions, such as speech-language-hering sciences. In Brazil, the speech-language-hearing therapists practice focused on school health, between the 1920s and 1940s, with practices based on health pedagogization and medicalization of education. Between 1950 and 1970, it directed it's work to private offices and rehabilitation clinics. In the 1990s, with the recently created Unified Health System (SUS), public gaps were identified in the performance of the speech-languagehearing therapist, beginning studies to rethink their training in the health context. Purpose: To analyze public health training in speech-language-hearing undergraduate programs at public Higher Education Institutions (HEIs) in the Northeast. Method: For the production of the data, interviews were conducted with key informants, students and professors from seven public HEIs in the Northeast. The interviews were recorded, transcribed, categorized and analyzed through Content Thematic Analysis. In addition, a documentary analysis of the lattes curricula of the speech-language-hearing teachers responsible for the public health curricular components in the Brazilian public HEIs was identified using the "snowball" technique. This analysis allowed to characterize of the training, performance and publication of these teachers. The data produced were organized in IBM SPSS software version 20, generating descriptive statistics, and correspondence analysis was performed. Results: It was identified in the analysis of the students' interviews that they have training experiences in public health that favor learning in SUS, but that have weaknesses in interprofessionality and in the integration of content. In the interviews with teachers, it was observed that speech-languagehearing undergraduate programs have a heterogeneous approach to public health and a predominance of traditional methodology in curriculum, which favors a fragmentation of knowledge. In the analysis of the teacher education, performance and production characterization, it was possible to visualize the existence of teachers who did not have postgraduate training in public health and who publish articles in the field of speechlanguage-hearing clinic. In addition, it is also possible to notice the existence of differences in the characterization of training and performance of teachers when analyzing this reality in the regions of the country, with the Northeast region having the most teachers with training, performance and publication in the area of public health. Conclusions: In the Northeast region, although public health problematizing and inserting the training of speech-languagehearing therapist in the context of the SUS, it is necessary to overcome the fragmented logic in the training of students, so that other curricular components are also co-responsible for the constitution of professionals with the profile to work in the SUS. Additionally, in the national context, the identification of the existence of professors who are responsible for public health components, but who do not have training and publication in this area, alerts to a consequent weakening of public health in speech-language-hearing science (AU).
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Universities , Unified Health System , Educational Measurement , Speech, Language and Hearing Sciences/education , Qualitative Research , Workforce , Document AnalysisABSTRACT
Objective:To analyze the changes in the number and workload of pediatricians, for evidences in further optimizing the allocation of pediatrician resources and formulating relevant policies in China.Methods:According to data from the National Bureau of Statistics and the " China Health and Health Statistics Yearbook", descriptive analysis was made to investigate the changes in the number and workload of pediatricians in China from 2010 to 2019.Results:During 2010 and 2019, the number of pediatric practitioners(assistants) increased from 115 800 to 158 500, and the growth rate was faster than that of the children aged 0-14 years, but slower than that of overall medical practitioners(assistants). The number of pediatric practitioners(assistants) per thousand children in China had grown steadily from 0.52 to 0.67, compared with the burden and the workload of medical practitioners nationwide, the workload of pediatricians was still relatively heavy.Conclusions:The number of pediatricians had increased gradually between 2010 and 2019, and the effects of various policies began to work, while the workload was still heavy. It is recommended to further develop a salary system and supporting policies in line with the characteristics of pediatrics sector, and focus on such problems as unbalanced and inadequate distribution of pediatricians.
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Medical record information is the core data source for diagnosis related groups(DRG)payment, and high-quality of medical record information is the foundation for DRG payment. The development of medical record management towards medical record information management, pushes up the demand for high-quality medical record information management professionals in hospitals. The conventional practice of professional training had resulted in such setbacks as professionals mismatch, long pre-employment training period, and large demand for continuing education. Based on the triple helix model theory, the study established a production-education integration training mode of university-government-hospital for medical record information management professionals. Capacity development was set as the goal and job demand as the guidance, for effectively integrating the educational resources, and promoting the model of " posts linked to training, employment following graduation" production-education integration training. The aim is to expand the quantity of talent team and improve the quality of talent training, thus effectively easing the shortage of medical record information management professionals.
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Objective:To establish a scientific and reasonable nurse scheduling model for ward nursing during COVID-19, to achieve collaborative and efficient scheduling of manpower and materials, and to provide an algorithm basis for the computerized scheduling as well as references for optimizing manpower scheduling in public health emergencies.Methods:The qualitative interview method was used to learn the challenges in nursing manpower scheduling at designated hospitals. In view of the nursing scheduling in the mild case wards during the pandemic and the premise of meeting the needs of different shift types and patient care, the goal was set as minimizing the consumption of nursing human resources and protective equipments. The objective functions, constraints and corresponding parameters were established. A multi-objective integer programming model was established by MATLAB software for solution by CPLEX solver.Results:Two objective functions, three hard constraints, two soft constraints and corresponding parameters were established. Calculations by the model so established found that a 28-day period requires at least 62 nurses, and at least 52 nurses in the contaminated wards, including 7 nurses in the department of intensive care, the infectious and the respiratory wards respectively. This number could meet in general the needs of epidemic care. In comparison, the manual scheduling of the mild care wards during the pandemic in February 2020 needed at least 69 nurses, and 61 in the contaminated wards, yet with a failure to meet all constraints.Conclusions:The model can solve the scheduling challenges in public health emergencies, namely numerous shift types, different nursing needs in different types of shifts, and complex staff structure.Furthermore, the model can save manpower and materials, serving a useful reference for manpower scheduling.
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Objective:To study the willingness of the medical staff of tertiary hospitals to be dispatched to work for a long time at the district hospitals under the " municipal trusteeship of district-ownership hospitals" mode, and explore the key factors that affect their long-term willingness, for references of optimizing the incentive system of the model.Methods:A questionnaire was designed as guided by the two-factor theory. In May 2019, a typical sample survey was made to investigate 103 medical staff of two tertiary hospitals in Beijing on their willingness to be dispatched to hospitals of district ownership. The survey covered such aspects as their basic personal information, hygiene factors(family responsibility, interpersonal connections expansion, mobilization and encouragement of leaders, etc.), and incentive factors(personal career development, greater potential giving play to their own talents, self-achievement, etc.). Descriptive analysis and univariate hypothesis testing were used to compare the differences of the dispatch willingness of staff of different characteristics. Meanwhile, an ordinal multinomial logistic regression model was built to analyze the influence factors of long-term dispatch willingness of these staff along with individual in-depth interviews.Results:The medical staff when they were dispatched to work at the entrusted hospitals for a long time, were concerned mostly with top six factors. These factors refered to a reasonable incentive(rewards)mechanism, family responsibility, colleague evaluation of the entrusted hospital, interpersonal connections expansion, personal career development, and potential unlocking. Those staff with dispatch experience had higher willingness to be dispatched than those without( P <0.05). The former saw higher of their personal career development resulting from the dispatch(3.91 points), while the latter saw higher their post-dispatch salary incentive mechanism(3.95 points). Compared with common medical staff, medium and high level management staff were more willing to be dispatched for a long time( H=14.536, P<0.001). Leadership mobilization in hygiene factors and personal career development in incentives factors were the key drivers for the long-term willingness of medical staff to be dispatched( P<0.05). Conclusions:The willingness of medical staff to be dispatched for a long time needs to be strengthened in the " municipal trusteeship of district-ownership hospitals" mode. Managers of the district-ownership hospitals should take into full consideration, the needs of different categories and levels of medical staff dispatched, guarantee the remuneration and performance pay of these staff, and enable their career track planning, hence mobilizing their incentives, and increase their willingness to work at such hospitals for a long time.
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Objective:To develop an occupational stress management system for medical staff, in order to provide scientific reference for management actions.Methods:From January 2019 to July 2020, a stress management system initially took shape based on employee assistant program(EAP)and the assessment-prevention-control-evaluation organizational stress management model, pinpointing pediatrics featuring high occupational stress as the breakthrough point. Other means called into play include literature review and semi-structured interviews of pediatric managers and staff, for the purposes of learning the status of stress management. Delphi method was also used to learn by correspondence the occupational stress management system as seen by pediatric experts. The weight of items was determined by percentage method.Results:Eight managers and eight pediatric staff were interviewed, with four topics identified. Twenty experts participated in 2 rounds of Delphi inquiry by correspondence, and the recovery rates were 91% and 100% respectively. The authority coefficients were 0.78 and 0.80, and the Kendall coordination coefficients were 0.17 and 0.14(both P<0.01). The finalized occupational stress management system consists of 5 level-1 indicators, including organization system, stress assessment, stress prevention, stress control and effect evaluation, as well as 21 level-2 indicators and 71 level-3 indicators. Conclusions:The occupational stress management system of medical staff is scientific, reliable and comprehensive, serving as a useful reference for the hospital management in their occupational stress management work.