ABSTRACT
The pre-hospitalization service is an important initiative for medical institutions to implement the national reform of the medical security system. In 2018, Zhejiang province proposed the " most run once reform", requiring the establishment of an admission preparation center to carry out pre-hospitalization services. In June 2021, a certain maternal and child health hospital conducted a process reengineering for the pre admission process of the admission preparation center by applying the combined process analysis and failure mode and effects analysis, high-risk points of the hospitalization process were screened, the job value and job functions of each sector were sorted out, and the sector for improvement sector was evaluated, to launch an independent information system, establish a one click automatic import of pre hospital medical orders function, and remove on-site billing physicians from various specialties for improvement measures. The steps of the process had been optimized, inlcuding issuing pre hospital medical orders, waiting for pre-hospitalization, pre-hospitalization, and so on. The completeness rate of pre hospital medical orders, average waiting days before hospitalization, and patient satisfaction scores of pre hospitalization centers had changed from 91%, 2.99 days, and 93.46 points before process reengineering to 92%, 2.44 days, and 95.80 points after reengineering, respectively. This practice had achieved dual improvements in pre admission service quality and efficiency, so as to provide a reference for China′s medical institutions to carry out safe and efficient pre admission services.
ABSTRACT
Objective:To understand the medical experience of patients with early lung cancer in pre-hospitalization, find out the problems and shortcomings in the service process, and provide the basis for improving the quality of medical service under the pre-hospitalization mode.Methods:Through phenomenological research method, 21 pre-hospitalized patients with early lung cancer from September to October 2020 in the First Hospital Affiliated to Guangzhou Medical University were selected by purpose sampling method for semi-structured interviews, and the research data were analyzed by Colaizzi seven-step method.Results:There were four themes in the medical experience of early lung cancer pre-hospitalized patients: the turnover rate of beds was fast, the length of stay and cost of stay were reduced, the inclusion criteria of pre-hospitalization lacked the humanization, admission and examination procedures needed to be optimized and insufficient doctor-patient communication during pre-hospitalization.Conclusions:The implementation of pre-hospitalization mode can make patients′ medical treatment more convenient and efficient, and reduce hospitalization expenses. However, there are still some shortcomings in the management of pre-hospitalization of early lung cancer patients. The pre-hospitalization process should be further standardized, and the communication and management of pre-hospitalization patients during waiting period for out-of-hospital examination should be strengthened.
ABSTRACT
Since the performance appraisal of national tertiary public hospitals was carried out, higher requirements have been put forward for the operation and management of hospitals. Under the premise of ensuring the quality of medical service and medical safety, how to save hospital operating costs and improve the efficiency is an urgent problem for hospital managers. Supported by information upgrading, a tertiary hospital in Guangzhou reformed the treatment process and carried out pre-hospitalization in surgical departments. Data showed that pre-hospitalization can significantly shorten the length of stay, reduce hospitalization costs, and improve the operation efficiency of the hospital.
ABSTRACT
<b>Objective</b>: To assess the characteristics and influencing factors of sleep during a prehospitalization period in liver cancer survivors with frequent recurrences. <b>Methods</b>: A sleep pattern and mental health were analyzed in 12 patients who had recurrences of hepatocellular carcinoma during a pre-hospitalization period. Subjective sleep quality was assessed by PSQI-J, and objective sleep quality was measured with a actigraphic method. <b>Results</b>: The mean age of the subjects was 74.1 years and the mean number of recurrence episodes was 3.7. The mean PSQI total score was 6.7. The subjective assessment showed that 50% of the patients had a poor sleep pattern, required more time to fall asleep, had a shorter duration of sleep, and had poor sleep quality. The objective assessment showed that 50% of the patients slept for less than 360 minutes and that the patients did not have disturbance of sleep induction with a sleep latency of 3 to 29 minutes. The mean time of awakening episodes was 3.3. The hypnotic agent, severe fatigue, and poor mental health were identified as factors of the poor sleep pattern, as assessed by the subjective measures, and the hypnotic agent shortened and influenced the time spent awake after falling asleep. The subjective evaluation of sleep demonstrated inconsistency with the objective evaluation of sleep. Namely the patients with poor sleep pattern had higher sleep efficiency and significant short awakening times. <b>Conclusion</b>: The sleep pattern in liver cancer survivors was influenced by the hypnotic agent, mental health, and fatigue.