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OBJECTIVE@#The national requirements for the fund management of scientific research projects are becoming more stringent, so that it is convenient to carry out scientific research work and can strengthen the regulation of scientific research reagent procurement, so this study explores the standardization of the whole process of the procurement of scientific research reagent supplies in hospitals and new modes of management.@*METHODS@#By exploring the implementation of the centralized procurement management platform, we engage in full process supervision before, during, and after the event.@*RESULTS@#Introduction of centralized procurement management platform for scientific research reagent supplies can normalize the procurement process, ensure the quality of procurement and improve the procurement efficiency on the basis of ensuring the quality of scientific research.@*CONCLUSIONS@#The new model of centralized procurement of full process management based on one-stop service for scientific research reagent supplies is an important part of improving the fine scale management of public hospitals, and it is of great significance in improving the level of scientific research in China and avoiding scientific research corruption.
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Indicators and Reagents , Hospitals, Public , ChinaABSTRACT
Stroke rescue features strong time sensitivity and high complexity. Minimizing the time of consumption in pre-hospital and in-hospital stroke rescue is key to improve stroke rescue efficiency and reduce the disability rate. In December 2017, a tertiary hospital launched the construction of a one-stop stroke rescue platform. This platform was centered on " multi-mode image fusion operating room" , operating as a one-stop rescue mode integrating emergency admission, imaging examination, intravenous thrombolytic therapy, mechanical thrombolytic therapy, postoperative evaluation, and so on. The seamless convergence workflow of pre-hospital, in-hospital and post-hospital could effectively optimize the physical rescue pathway. In order to ensure the efficient and orderly operation of the platform, the hospital adopted such measures as multidisciplinary integration, pre-hospital and in-hospital integration construction, and regional stroke care network. Since its operation in September 2019, the platform has treated more than 1 000 patients by December 2021. The application of the platform had effectively improved the efficiency of stroke rescue, led the development of regional stroke rescue system, and provided the reference for raising the stroke rescue capacity and management level in China.
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@#Objective To summarize the experience and efficacy of "one-stop" left atrial appendage clipping (LAAC) combined with transcatheter aortic valve replacement (TAVR) for patients with atrial fibrillation (AF) and aortic valve disease. Methods From April 2018 to March 2021, 16 patients with AF and severe aortic valve disease underwent "one-stop" LAAC and TAVR in our department. All patients had long-standing persistent AF. There were 10 males and 6 females with an average age of 77.2±6.2 years. CHA2DS2-VASc score was 4.4±0.8 points, and HAS-BLED score was 3.5±0.7 points. Results All patients successfully underwent "one-stop" LAAC combined with TAVR. There was no death during perioperative and follow-up periods. The length of the left atrial appendage base measured during the operation was 37.8±3.5 mm. The types of atrial appendage clip were 35 mm (n=3), 40 mm (n=8) and 45 mm (n=5). The time required for clipping the left atrial appendage (from skin cutting to skin suturing) was 25.7±3.8 min. There was no stroke or bleeding of important organs during the perioperative period. The average hospital stay was 6.8±2.0 d. The follow-up time was 19.6±10.1 months, during which there was no patient of cerebral hemorrhage or cerebral infarction. During the administration of warfarin, 2 patients had subcutaneous ecchymosis and 1 patient had gingival bleeding. Conclusion "One-stop" LAAC combined with TAVR can be safely and effectively used to treat AF and aortic valve disease patients with high risk of thromboembolism and anticoagulant bleeding. The early and middle-term curative effect is satisfactory.
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The economic burden of medication for hemophilia patients is heavy. Charitable donation is a key way to supplement relief funds for the patients. In order to explore the appropriate and efficient usage of the relief funds, Nanfang Hospital was one of the earliest ones that launched the "one-stop finance service" of relief funds. The practice and experience of the service have been widely referred to and applied in other places, and achieved good results. This article reviews the practice and cases, and discusses the significance in reducing the burden of patients and in improving the efficiency of hemophilia relief.
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In order to optimize the clinical service experience and provide efficient, convenient and high-quality logistics services, a multi-campus hospital has taken a series of measures, including establishing a logistics one-stop service center, building a logistics operation and maintenance management platform based on mobile Internet, normalizing quality control circle activities, building logistics command and dispatch center and business data center, and establishing performance evaluation system of logistics service personnel, etc., to provide homogeneous logistics service. The practice of multi-campus logistics management based on one-stop service mode can improve the level of logistics service, improve the clinical experience of logistics service, improve the satisfaction and sense of belonging of logistics staff, and play an important role in improving the rapid response ability of the hospital.
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The authors introduced the construction of one-stop admission service in a large general hospital.Measures were carried out by implementing the measures of one window handling of admission business, building one-stop pre-hospital preparation center, optimizing the operational pattern of pre-hospital examination, strictly controlling the hospitalization time of surgical patients, optimizing the information system according to admission criteria, providing personalized services for clinic and implementing quality monitoring.It effectively improved the pre-hospital examination rate, shortened the waiting time and the average length of stay of the patients undergoing elective surgery, and increased the satisfaction of pre-hospital patients.
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@#Objective To investigate the preoperative localization of pulmonary glabrous nodules. Methods A total of 192 patients admitted to General Hospital of Northern Theater Command from April 2012 to September 2019 were selected for the study. There were 95 males and 97 females at an age of 56.47±11.79 years. All patients completed preoperative examination, and were divided into a positioning group (n=97) and a non-positioning group (n=95) according to whether the preoperative positioning was performed. And the surgical indicators between the two groups were compared. According to the substance of ground-glass opacity, they were divided into a pure ground-glass nodules group (n=23) and a mixed ground-glass nodules group (n=74) in the positioning group and a pure ground-glass nodules group (n=14) and a mixed ground-glass nodules group (n=81) in the non-positioning group . According to the size and distance of the nodules from the pleura and whether the nodules could be detected, the corresponding linear function was obtained. Results The operative time of methylene blue localization group was shorter than that of the no localization group. In the scatter plot, the corresponding diameter and depth of the nodules and the corresponding coordinate points which can be explored were described. And linear regression was performed on all the coordinate points to obtain the linear function: depth=0.648×diameter–1.446 (mm). It can be used as an indication for the preoperative localization of pure ground-glass nodules in Da Vinci robotic surgery. Linear function: depth=0.559 5×diameter+0.56 (mm). It can be used as an indication of preoperative localization of mixed ground-glass nodules in Da Vinci robotic surgery. Conclusion This equation can be used as a preoperative indication for clinical peripheral pulmonary ground-glass nodules.
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OBJECTIVE@#To investigate the effect of the combination of atrial fibrillation (AF) ablation and left atrial appendage closure (LAAC) on cardiac function and the success rate of AF ablation.@*METHODS@#We retrospectively analyzed the data of 56 patients with AF undergoing a one-stop procedure for AF ablation and LAAC in our hospital between May, 2015 and May, 2019. Propensity score matching (PSM) at the ratio of 1:1 was used to select 56 control patients undergoing AF ablation at high risk of stroke, for matching with the hybrid procedure group. The perioperative complications, thromboembolic events, recurrence of atrial arrhythmia and cardiac function were compared between the groups.@*RESULTS@#The two groups of patients were comparable for age, gender, BMI, duration and type of AF, concomitant diseases, CHA2DS2-VASc and HAS-BLED scores (@*CONCLUSIONS@#The combination of AF ablation and LAAC is safe but does not improve the success rate of AF ablation. The one-stop procedure can improve cardiac function of the patients, but AF ablation alone can achieve better improvement of cardiac function.
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Humans , Atrial Appendage/surgery , Atrial Fibrillation/surgery , Catheter Ablation , Retrospective Studies , Treatment OutcomeABSTRACT
Objective: We aimed to explore the feasibility and perioperative safety of performing catheter ablation and left atrial appendage closure (LAAC) in a single (one-stop) session in patients with atrial fibrillation (AF). Methods: This study is an observational study. Consecutive AF patients who underwent the combined procedure of catheter ablation and LAAC with Watchman device of Xinhua Hospital in Shanghai between March 2017 and May 2019 were prospectively enrolled. Baseline, intra-and peri-procedural parameters were evaluated. Results: A total of 358 AF patients (189 males, (69.0±8.0) years) underwent the one-stop procedure. The CHA2DS2-VASc score was 3.2±1.5 and HAS-BLED score was 2.4±1.1, respectively in this patient cohort. Pulmonary vein isolation was achieved in all patients, while additional linear ablation was applied in 180 (50.3%) patients, yielding immediate success rate of 99.7%. Successful Watchman implantation was achieved in all patients. The perioperative serious adverse event occurred in 14 cases (3.9%). including 6 pericardial effusions (1.7%), 1 stroke (0.3%) and 5 vascular complications (1.4%), yielding procedure-related complication rate of 3.4%. In addition, 2 (0.6%) new-onset heart failures occurred postoperatively. There was no major bleeding or death during the perioperative period. Conclusions: Combined catheter ablation and LAAC can be successfully and safely performed in AF patients with high stroke risk. Follow-up data are needed to evaluate the outcome of this one-stop procedure.
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Aged , Female , Humans , Male , Middle Aged , Atrial Appendage/surgery , Catheter Ablation , China , Feasibility Studies , Treatment OutcomeABSTRACT
Simplified outpatient service flow and higher service efficiency can save back-and-forth trips and queuing time of outpatients and better their medical experience. The authors introduced the hospital′s experience in establishing a one-stop multi-functional outpatient service center. This center integrated such departments as outpatient office service, medical insurance office service, and registration & fee payment. Such a " multifunctional post" provided a one-stop service for the patients, hence optimizing the workflow for creating a convenient and fast outpatient service.
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Objective To investigate the feasibility of using optimized protocol of iodine contrast agent with fixed injection time in triple-rule-out CT examination of acute chest pain patients. Methods A prospective study was conducted. The patients who underwent triple-rule-out CT examination of acute chest pain at the Second Hospital of Shanxi Medical University from September 2017 to June 2018 were enrolled. According to the patient's body mass index (BMI), they were divided into BMI ≤ 23 kg/m2 group and BMI > 23 kg/m2 group. The patients in each group were subdivided into two subgroups according to the random number table, and they were given two iodine contrast injection protocols with fixed injection time (14 s). Protocol 1 was performed with 55 mL of total iodinated contrast media: iodinated contrast media was first injected at 5.0 mL/s for 8 s, followed by the same contrast media injection at 2.5 mL/s for 6 s, finally followed by injection of 40 mL of saline at a rate of 2.5 mL/s. Protocol 2 with 60 mL of total iodinated contrast media: iodinated contrast media was first injected at 5.0 mL/s for 10 s, followed by the same contrast media injection at 2.5 mL/s for 4 s, finally followed by injection of 40 mL of saline at a rate of 2.5 mL/s. The primary and objective evaluation was conducted on the image quality of the patients' blood vessels in different segments. The primary score, CT value and contrast-to-noise ratio (CNR) of the pulmonary artery, coronary artery, aorta and total effective radiation dose for the examination were recorded. Results A total of 92 patients were enrolled in the analysis. There were 44 patients in BMI≤ 23 kg/m2 group, in which 22 patients received in protocol 1 and protocol 2, 48 patients in BMI > 23 kg/m2 group, in which 24 patients in protocol 1 and protocol 2, respectively. There was no significant difference in the effective radiation dose between the two subgroups receiving different injection protocols in different BMI groups (mSv: 6.7±1.1 vs. 6.5±0.8 between protocol 1 and protocol 2 in BMI ≤ 23 kg/m2 group; 7.8±1.0 vs. 8.0±1.1 between protocol 1 and protocol 2 in BMI > 23 kg/m2 group, both P > 0.05). In BMI ≤ 23 kg/m2 group, the CT value, CNR and primary scores of pulmonary artery images in patients receiving protocol 2 were significantly higher than those receiving protocol 1 [CT value (HU): 584±110 vs. 472±86 for main pulmonary artery, 561±93 vs. 467±78 for left pulmonary artery, 555±91 vs. 472±83 for right pulmonary artery; CNR: 24.2±7.5 vs. 18.7±4.6 for main pulmonary artery, 23.2±6.8 vs. 18.6±4.8 for left pulmonary artery, 22.9±6.7 vs. 18.8±4.7 for right pulmonary artery; primary score:4.0 (4.0, 4.0) vs. 3.5 (3.0, 4.0), all P < 0.05]; and there was no statistically significant difference in the primary or objective evaluation of coronary artery or aortic image quality between the two protocols. In BMI > 23 kg/m2 group, the CT value, CNR and primary scores of coronary artery and aortic images in patients receiving protocol 2 were significantly higher than those receiving protocol 1 [CT value (HU): 369±63 vs. 315±61 for proximal right coronary artery (RCA), 388±63 vs. 323±63 for proximal left coronary artery (LCA), 328±83 vs. 272±51 for ascending aorta, 348±82 vs. 272±49 for aortic arch; CNR: 15.0±4.6 vs. 12.3±4.7 for proximal RCA, 15.7±3.8 vs. 12.8±5.2 for proximal LCA, 13.2±5.3 vs. 10.4±4.1 for ascending aorta, 14.1±5.3 vs. 10.4±3.9 for aortic arch; primary score: 4.0 (3.0, 4.0) vs. 3.0 (3.0, 4.0) for coronary, 4.0 (3.0, 4.0) vs. 3.0 (2.0, 4.0) for aorta; all P < 0.05]; and there was no statistically significant difference in the primary or objective evaluation of pulmonary artery image quality between the two protocols. Conclusions The effective radiation dose of triple-rule-out CT examination of acute chest pain is relatively low. The low-dose iodine contrast agent application program with fixed injection time can meet the needs of clinical diagnosis of triple-rule-out CT examination of acute chest pain patients. For patients with BMI ≤ 23 kg/m2, both protocols 1 and 2 can obtain excellent image quality; in order to avoid the influence of superior vena cava artifacts, protocol 1 is recommended. For patients with BMI > 23 kg/m2, application protocol 2 can obtain stable, excellent image quality that is more suitable for clinical applications.
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Acute ischemic stroke (AIS) is the most common cerebrovascular disease with high morbidity, mortality and disability. The imaging evaluation of ischemic penumbra has great clinical implication for early diagnosis and reperfusion therapy of AIS. Here, we reviewed the evaluation methods, advangtages and disadvangtages of computed tomography (CT) and magnetic resonance imaging for ischemic penumbra, and discussed the advantages of one-stop multi-modal CT.
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Objective: To compare the middle and long term clinical outcomes of one-stop hybrid coronary revascularization, coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in treating the patients with multivessel coronary artery disease; to explore the optimal indication of one-stop hybrid technology. Methods: Our research included in 3 groups: Hybrid group, n=141 patients received one-stop hybrid coronary revascularization in our hospital from 2006-06 to 2010-16. Meanwhile, 5797 patients received CABG and 4254 received PCI, the major pre-operative risk factors were studied by Logistic regression analysis to calculate propensity score, adjacent matching was used to respectively select 141 subjects from CABG and PCI patients to make 1:1 match with Hybrid group as CABG group and PCI group. EuroSCORE and SYNTAX score were used to make risk stratification in all 3 groups. By EuroSCORE system: low risk ≤ 2, medium risk (3-5) and high risk ≥ 6; by SYNTAX score system: low risk ≤ 24, medium risk (25-29) and high risk ≥ 30. The incidence of major adverse cardiac/cerebral vascular events (MACCE) was compared among 3 groups at different risk stratifications. Results: The mean follow-up time was 4.5 years up to 2015-01. The overall incidence of MACCE was lower in Hybrid group (9.9％) than PCI group (27.7％), P<0.001; while it was similar between Hybrid group and CABG group (19.1％), P=0.150. By EuroSCORE stratification, the incidence of MACCE in low risk and medium risk patients were similar among 3 groups; while in high risk patients, the incidence was lower in Hybrid group than both CABG group (P=0.017) and PCI group (P<0.001). By SYNTAX score stratification, the incidence of MACCE in low risk and medium risk patients were similar among 3 groups; while in high risk patients, the incidence was lower in Hybrid group than PCI group (P<0.001), it was similar between Hybrid group and CABG group (P=0.355). Conclusion: One-stop hybrid technology had the better middle and long term outcomes for treating multivessel coronary artery disease patients with high risk stratification, which provided an alternative strategy in clinical practice.
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Objective To investigate clinical effect and safety of ostium secundum atrial septal defect(ASD) treatment via one -stop hybrid and classical surgical procedures.Methods 45 patients were diagnosed ostium secun-dum simple ASD by ultrasound cardiogram and clinical manifestation,they were divided into one -stop hybrid proce-dure group (n =20)and classical surgical procedure (n =25).Age,gender,weight,post operation hospital day,on -pump time,blood transfusion amount,drainage flow,incision length and incidence of complication between the two groups were compared.Results Age and weight had no difference between the two groups(t =0.40 and 1.64,P >0.05),but the proportion of female cases in one -stop hybrid procedure group was higher than post operation(χ2 =9.45,P 0.05).And one -stop hybrid procedure group was off -pump without blood transfusion.Conclusion One -stop hybrid procedure was simple,could make a quick recovery post operation and was an ideal method for ostium secundum ASD treatment.
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The paper analyzes the necessity to construct the digital resources retrieval platform in hospital.By using heterogeneous database integration technology, it proposes the solution of constructing a one-stophospital digital resources retrieval platform and presents its framework.This retrieval platform can provide human-oriented, differential and intelligent information services and meet the medical staffs'requirements on information resources retrieval to the greatest extent.
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Objective:To investigate the method of how to realize one stop payment service between hospitals, enrich its connotation, and expand its outreach.Methods: The establishment funds unified trading platform can realize the settlement of one stop payment service between hospital, and at the time achieve a unified account management, real-time account transactions, and perfect reconciliation.Results: Through the research, we can conclude that we can realize the one stop payment service between hospitals, and will improve the usage and satisfaction of the system, achieve better results.Conclusion: With the deepening of the one stop payment service model, it will play a greater role; achieve more satisfactory economic and social benefits.
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SUMMARY Introduction: Aimed at providing integrated multi-level crisis intervention to women experiencing violence such as rape, One Stop Crisis Centre (OSCC) in Malaysia is often located in the emergency department. Hence, it is imperative that emergency department healthcare providers possess adequate knowledge and acceptable attitudes and practices to ensure the smooth running of an efficient OSCC work process. Method: To study the knowledge, attitude and practice of rape management in OSCC among four groups of healthcare providers in the emergency department [i.e., the emergency medicine doctors (EDs), the staff nurses (SNs), the medical assistants (MAs) and the hospital attendants (HAs)], a selfadministered questionnaire in the form of Likert scale was conducted from January to October 2013. Correct or favourable responses were scored appropriately. Results: Out of the 159 participants invited, 110 responded (69.2% response rate). As all data sets in the Knowledge, Attitude and Practice sections are non-parametric, KruskalWallis test was performed. Homogeneity of variance was verified using non-parametric Levene test. In all three sections, there are statistically significant differences in scores obtained among the four groups of healthcare providers with H(3) = 16.0, p<0.001 for Knowledge, H(3) = 27.1, p<0.001 for Attitude and H(3) = 15.8, p<0.001 for Practice sections. Generally, the SNs obtained the highest mean rank score in the knowledge and practice sections but the EDs obtained the highest mean rank score in the attitude section. Some of the responses implied that our healthcare providers have the victim-blaming tendency that can negatively impact the victims. Conclusion: Healthcare providers must not only have adequate knowledge but also the non-judgemental attitude towards victims in OSCC.
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Emergency Service, Hospital , Sex Offenses , RapeABSTRACT
OBJECTIVES: The purpose of this study was to look into caregivers who took care of their demented elderly family members in an effort to find out what types of services they actually called for and how to make a diagnosis of demented elderly people, provide treatment to them and make an intervention for their families at the same time. METHODS: The subjects in this study were 61 psychiatrists, neurologists and rehabilitation doctors who were in charge of demented elderly people, and they were members of the Korean Geriatrics Society and Korean Association for Geriatric Psychiatry. RESULTS: As for interest in helping caregivers for demented elderly people get rid of their stress, 45.9 percent (28 doctors) of the medical personnels investigated answered they tended to have lots of interest in that. To get them to dispel their stress, they conducted education (13 doctors), offered supportive treatment and encouragement (24 doctors) or provide mental treatment and encouragement (24 doctors) or provide mental treatment or medication if necessary (8 doctors). CONCLUSION: Medical intervention should be carried out to alleviate the behavioral and psychological symptoms of the elderly with dementia to help their caregivers not to be under pressure. Their stress should be managed in a systematic manner according to the dementia grade of patients they look after. A sort of one-stop service network should be built to lend assistance to main caregivers, and the government should set up a family support policy for them.
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Aged , Humans , Caregivers , Dementia , Diagnosis , Education , Geriatric Psychiatry , Geriatrics , Psychiatry , RehabilitationABSTRACT
OBJECTIVES: The purpose of this study was to look into caregivers who took care of their demented elderly family members in an effort to find out what types of services they actually called for and how to make a diagnosis of demented elderly people, provide treatment to them and make an intervention for their families at the same time. METHODS: The subjects in this study were 61 psychiatrists, neurologists and rehabilitation doctors who were in charge of demented elderly people, and they were members of the Korean Geriatrics Society and Korean Association for Geriatric Psychiatry. RESULTS: As for interest in helping caregivers for demented elderly people get rid of their stress, 45.9 percent (28 doctors) of the medical personnels investigated answered they tended to have lots of interest in that. To get them to dispel their stress, they conducted education (13 doctors), offered supportive treatment and encouragement (24 doctors) or provide mental treatment and encouragement (24 doctors) or provide mental treatment or medication if necessary (8 doctors). CONCLUSION: Medical intervention should be carried out to alleviate the behavioral and psychological symptoms of the elderly with dementia to help their caregivers not to be under pressure. Their stress should be managed in a systematic manner according to the dementia grade of patients they look after. A sort of one-stop service network should be built to lend assistance to main caregivers, and the government should set up a family support policy for them.
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Aged , Humans , Caregivers , Dementia , Diagnosis , Education , Geriatric Psychiatry , Geriatrics , Psychiatry , RehabilitationABSTRACT
BACKGROUND: Asan Medical Center ran a fully automated outpatient laboratory to serve outpatient departments with a rapid turnaround time (TAT; one hour from reception to reporting) for frequently requested test items and thus to make `one stop service' possible. As the number of samples increased, the TAT gradually became longer and eventually showed over one hour for almost all items. METHODS: In October 1998, reorganization of the outpatient laboratory took place. Newly introduced were a priority system for samples, a plasma separate tube instead of the serum separate tube, an on-line simultaneous sample reception system at the time of sampling, and a real-time monitoring system for TAT. RESULTS: With the sample priority system, samples processed for one stop service were 61.0% (476 priority samples out of 780 total samples) for routine hematology, 59.2% (527 out of 890) for routine chemistry, 40.1% (122 out of 304) for urinalysis, 43.2% (89 out of 206) for coagulation tests, and 47.9% (75 out of 157) for diabetic tests. We monitored samples processed as `one stop service' with the real time monitoring system for TAT; among the samples processed as such, 80.1% of rou-tine hematology, 91.9% of routine chemistry, 99.5% of urinalysis, 92.6% of coagulation tests, and 97.6% of diabetic tests showed TAT less than one hour. Average TAT, from the specimen acquisition to the reporting, decreased dramatically after introduction of the system. Average TAT of routine hematology decreased to 53.9 minutes, routine chemistry to 54.6 minutes, urinalysis to 35.2 minutes, coagulation tests to 46.6 minutes, and diabetic tests to 31.9 minutes. And the patient satisfaction index for the outpatient laboratory rose 15% from 81% to 96%. CONCLUSIONS: The outpatient laboratory of AMC shortened the TAT substantially without sacrificing quality and fully met the needs of patients and clinicians after reorganization.