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The high-quality development requirements for public hospitals,national examination orientations,and DIP medical insurance payment reforms present significant challenges to the refined management of public hospitals.Therefore,it is essential to enhance the operational management of these institutions.This paper aims to develop an operation evaluation index system for clinical departments using the Delphi method for assessing the efficiency of resource input and output across various clinical departments.It provides a scientific basis for decision-making regarding resource allocation,transformation towards re-fined management,and the enhancement of operational guidance for departments.
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Objective To investigate the leadership status and training requirements of administrators in children's hos-pitals in China to develop a leadership training program based on the CIPP model and the specific requirements of children's hos-pitals and strengthen the leadership and management skills of children's hospital administrators.Methods This paper conducted a questionnaire survey among the administrators of children's hospitals in China to investigate the current status and needs of lead-ership training.It constructed a leadership training system and an effect evaluation model for the administrators based on four di-mensions:background,input,process,and result.Results Among the 160 administrators surveyed,85%of the respondents had received for more than a week of management training.But half of them believed that the current amount of management training was inadequate and there was an urgent need for professional or management training.Training contents needed primarily focused on hospital management,humanistic knowledge and literacy,and health management.The trainees were satisfied with the entire training system,including the courses,instructors and the organization.However,they also suggested increasing the fre-quency of offline training and facilitating interactive course discussions.Conclusion This paper systematically analyzes the cur-rent situation and training needs of leadership of administrators in children's hospitals.By doing this,it can accurately identify the need for developing leadership training programs and align the training program with the objective requirements,thereby providing a scientific basis for enhancing the quality of leadership training for hospital administrators nationwide.
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Objective The purpose of this article is to summarize and review the current status of the construction of clinical research evaluation systems in domestic public hospitals,identify existing problems in the evaluation system,and propose development strategies and suggestions.Methods Retrieved relevant articles,dissertations and policies from the past five years(2018-2022),screened the titles,viewed the full texts of 52 selected papers and their references,and summarized them.Results The"five-only"indicators have long been an important indicator for evaluating clinical research in public hospitals,but in today's scientific research environment and policy environment,the"five-only"evaluation system has revealed its utilitarian draw-backs and gradually evolved into a hindrance to scientific research.It is urgent to break through the"five-only"orientation and establish a clinical research evaluation system oriented towards"transforming and applying transformation of scientific research achievements".Conclusion The evaluation system for clinical research should break the previous"five-only"evaluation model based on quantity-oriented scientific research evaluation.We can draw on the framework of the research output,influence,and environment indicators in the UK's REF Excellence Framework model,combine the American APT system and the Chinese STEM indicator dimensions,explore multi-outcome evaluation,integrate developmental indicators,and continuously improve the indica-tor system and application methods in practice to promote the development of clinical research in public hospitals.
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Objective:To construct a rationality evaluation system for medical equipment allocation to providing a basis for procurement and rational allocation of medical equipment.Methods:Focusing on the theme of"rationality allocation of medical equipment"and the research objective of"development of an evaluation system",a questionnaire consultation was conducted on relevant personnel in medical institutions in nine provinces and municipalities nationwide by way of wjx.cnas.The relevant research on the construction of the rationality evaluation system for medical equipment allocation in tertiary hospitals from August 2017 to August 2022 was retrieved from China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP Chinese Science and Technology Journal Database,and China Biomedical Literature Database.The index system was constructed by literature study and improved Delphi method,and the index weight was calculated by Analytic Hierarchy Process(AHP)to determine the evaluation system of rationality of medical equipment allocation.Results:The established evaluation system for the rationality of medical equipment allocation included four primary indicators of allocation reasons and conditions,cost factors,benefit factors,and management factors,as well as 17 secondary indicators.Conclusion:The establishment of the evaluation system for the reasonableness of allocation of medical equipment can help the allocation of medical equipment be carried out more objectively and efficiently and provide a basis for scientific procurement and reasonable allocation of medical equipment.
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Jiangsu Provincial People's Hospital takes the reform of DRG payment method as an opportunity,based on the theory of incentive behavior,uses literature research,expert consultation,and key performance indicator methods to develop evaluation indicators,and applies PDCA management tools to establish a continuously improving medical insurance service quality evaluation system.It introduces the process of medical insurance service quality evaluation system construction and its application in medical insurance performance management,and analyzes the implementation effect:DRG operation is improving,disease group structure is optimized,medical quality and efficiency continue to improve,and medical service evaluation scores are improving.
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Objective:To construct a scientific and technological evaluation system based on the needs of the pilot program for building a national high-quality hospital and establishing a national medical center.Methods:Xiangya Hospital of Central South University gradually improved its academic evaluation system by following the guidelines outlined in national authorities′ documents regarding "abolishing the five only" and "setting new standards", adhering to the guiding principles of "quality, contribution, efficiency, and impact" and employing the principles of "high-standard evaluation, quantitative evaluation, representative work evaluation, and third-party evaluation" .Results:The hospital established a comprehensive, scientific, and quantifiable indicator pool. These indicators were applied to various aspects of medical innovation evaluation, including awarding incentives, discipline assessment, professional promotion, personnel assessment, mentor selection for graduates, and excellence evaluation. Simultaneously, the hospital developed an intelligent platform for medical innovation evaluation and assessment in university-affiliated hospitals based on performance management theory.Conclusions:Through the construction and practice of the Xiangya technology evaluation system, the hospital further improved and optimized its academic evaluation work, guiding researchers to high-quality innovation and efficient translational research, ultimately promoting the high-quality development of the hospital.
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@#The surgical difficulty of congenital heart disease varies greatly. To ensure the safety of surgery and maximize the benefits of patients, various congenital heart surgery scoring systems have been used to evaluate the risk of different complex congenital cardiac operations. However, the complete correction of cardiac anatomical malformations is a common surgical challenge. Recent studies have shown that the correction is closely related to perioperative mortality and postoperative complications, and a new scoring system for the degree of cardiac anatomical malformations has been proposed. Therefore, this review summarizes the literature and discusses different evaluative methods of congenital heart surgery, aiming to optimize the surgical evaluation system for congenital heart surgery, enhance the quality of surgery and improve the prognosis of patients.
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Nosocomial infection control personnel are crucial in ensuring the nosocomial infection management and the implementation of prevention and control measures. The level of their job competency directly determines the quality and standard of nosocomial infection management. This article reviews the research progress of competency requirements and evaluation indicators of nosocomial infection personnel domestically and internationally. It also summarizes the current gaps and primary reasons behind these gaps in China’s research, so as to offer insights for the future development and improvement of the comprehensive capabilities of these professionals.
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China Clinical Cases Library of Traditional Chinese Medicine is built to promote the establishment of a scientific and technological talent evaluation system oriented on innovative value, ability and contribution in the backgroud of breaking the four only and setting new standards required by the document jointly issued by several national administrations and commissions. In the process of the construction, in order to further consolidate the foundation and ensure the quality and authority of case reports, we need to fully understand the origin and development of Chinese medical cases. Therefore, we clarified the development situation of Chinese medical cases by combing the characteristics of ancient and modern case reports, comparing the differences between Chinese and western medical case reports in terms of content and writing requirements, finally formed the main points of systematic case report norms and quality evaluation system, aiming to fully explore the unique advantages of Chinese medical cases in the fields of discipline development, scientific research innovation, clinical practice and guidance, talent evaluation and training, so as to promote its innovative development in a broader direction.
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Objective:To construct a teaching ability evaluation system for diversified general medicine course teachers under the guidance of "one practice and three learning".Methods:A research group was established to search for relevant documents and literature. A framework of evaluation index system was established through drafting and repeated discussion and modification by members of the group, as well as further discuss and modification by experts in general medicine. The framework was used to develop an expert consultation questionnaire on the teaching ability evaluation system for diversified general medicine course teachers under the guidance of "one practice and three learning". Through two rounds of expert consultation, a teaching ability evaluation system for diversified general medicine teachers under the guidance of "one practice and three learning" was constructed. A questionnaire was developed according to the system. The rationality and scientificity of the evaluation index system were verified by questionnaire survey.Results:The teaching ability evaluation system for diversified general medicine teachers under the guidance of "one practice and three learning" included 3 first-level indicators, 15 second-level indicators, and 41 third-level indicators. The general medicine curriculum evaluation questionnaire developed on the system showed that the Cronbach's α coefficient of the overall evaluation system was 0.981. The Cronbach's α coefficients of first-level indicators, including general medicine teaching plan, diversified theory and practice teaching, and comprehensive ability cultivation under the guidance of "one practice and three learning" ideology, were 0.920, 0.919, and 0.923, respectively. The content validity index (S-CVI) of the system was 0.981, and the content validity index (I-CVI) of indicators were 0.826-1.000. The correlation coefficients of first-level indicators and the system were 0.837-0.942 (all P<0.05). The correlation coefficients of second-level indicators and their corresponding first-level indicators were 0.586-0.971 (all P<0.05). The correlation coefficients of third-level indicators and their corresponding first-level indicators were 0.412-0.904 (all P<0.05). Conclusions:Under the guidance of "one practice and three learning", the teaching ability evaluation indicators for diversified general medicine course teachers have high specificity, rationale structure, high feasibility, high reliability, and high practicability. This evaluation system can provide theoretical reference for the training of undergraduate students in general medicine.
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Objective:To develop a homogeneous management evaluation system for clinical observership teaching under the background of national first-class discipline construction.Methods:The preliminary contents of the assessment system were determined through a literature review and expert interviews, and two rounds of questionnaire-based consultation was conducted with 20 experts using the Delphi method. With the use of Excel 2016 and SPSS 26.0, we calculated the coefficient of judgement basis (Ca), the coefficient of familiarity (Cs), the coefficient of authority (Cr), and Kendall's coefficient of concordance ( W ) as well as the mean, standard deviation, and coefficient of variation of all parameters, to identify the specific items and weights for the homogeneous management evaluation system for clinical observership teaching under the background of national first-class discipline construction. Results:In the two rounds of consultation, experts were both 100.00% active in responding to the questionnaires; the coefficients of authority of experts were 0.889 and 0.935, respectively; the coefficients of familiarity were 0.856 and 0.936, respectively; the coefficients of judgment were 0.922 and 0.934, respectively; and Kendall's coefficients of concordance were 0.476 and 0.563, respectively. Finally, 7 first-level items and 21 second-level items were included in the content framework of the homogeneous management evaluation system.Conclusions:The construction process of the homogeneous management evaluation system of clinical observership teaching is complete and reliable, which can provide a reference for the homogeneous management of clinical observership teaching, but further verification and improvement are needed.
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【Objective】 To explore the feasibility of establishing quantifiable evaluation system combined with PDCA in improving blood transfusion medical record. 【Methods】 A working group was set up in our hospital to establish an evaluation system for blood transfusion medical record according to relevant norms and literature. The data from September 2022 to February 2023 were used as the control group, and data from from April to May 2023 as the study group. PDCA was used to analyze the causes for poor quality of medical record. The quality of medical record was continuous improved for two months and the results were analyzed. 【Results】 Comparison between the research group and the control group showed that the score of blood transfusion consent (item A), blood transfusion application (item B), blood transfusion evaluation (item C), blood transfusion serious hazard (item F) increased respectively as 17.50±5.54 vs 21.08±3.75 (P<0.01), 16.22±2.05 vs 17.33±1.85 (P<0.01), 13.05±3.5 vs 14.72±1.97 (P<0.01), 7.9±1.44 vs 8.7±0.92 (P<0.01), and the total score of medical record was 85.36±7.5 vs 93.05±5.04 (P<0.01). The qualified rate of medical record increased from 82.2% to 98.3%(P<0.01). 【Conclusion】 The establishment of quantifiable blood transfusion medical record evaluation system combined with PDCA can help realize timely regulation and standardization of blood transfusion medical record.
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ObjectiveBy investigating the awareness situation of scientific research integrity among scientific researchers, their behavior and attitudes towards scientific research integrity, and the reasons for the occurrence of scientific research integrity, to identify the key influencing factors and risk points, and propose targeted management ideas for scientific research integrity construction. MethodsA web-based questionnaire was used to survey the awareness of scientific research integrity policies, behavior and attitude, and reasons for dishonest behavior in scientific research among scientific researchers at a tertiary A hospital. ResultsA total of 1,385 questionnaires were recovered, with 1,253 valid questionnaires. There were 246 males and 1,007 females, aged between 20 and 60 years old, with an average age of (37.98±8.97) years old. The average awareness rate of policies related to scientific research integrity was 39.44%. Scientific researchers believe that the top three risk points for dishonest behavior in scientific research were paper submission, entrusting third-party services, and the use of research funds. According to the different scientific research work involved by different survey subjects, the respondent population was set up with the attributes of the personnel in the basic information of the survey content on attitudes toward violating scientific research behavior norms, and was divided into four groups. The awareness situation of scientific research integrity policies was negatively correlated with the attitudes towards dishonest behavior in scientific research in the first and third groups. Publication of SCI papers and the awareness situation of scientific research integrity policies were negatively correlated with attitudes towards dishonest behavior in scientific research in the second group. Age and publication of SCI papers were related to attitudes towards dishonest behavior in scientific research in the fourth group, which were negatively correlated with the publication of SCI papers and positively correlated with age. ConclusionThe learning and training, and the rate of policy awareness of scientific research integrity were not high, and the awareness of scientific research integrity policies should be further improved. There are still risks and problems in the key links of scientific research activities, and it is necessary to strengthen the integrity management of the whole process of scientific research activities, establish the correct scientific values of scientific researchers, improve the scientific research evaluation system, and create a good scientific research environment.
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【Objective:】 Evaluating the service quality and medical experience of elderly-friendly medical institutions from the perspective of elderly patients and their accompanying relatives and friends is a specific measure and work focus to promote the construction of elderly-friendly medical institutions, optimize the medical procedures for the elderly, solve the intelligent technology difficulties encountered in the medical process for the elderly, promote public hospitals to fully implement preferential policies for elderly medical services, and continuously improve the health and well-being of the elderly. 【Methods:】 Based on literature analysis and expert consultation, the satisfaction evaluation indicators for elderly-friendly medical institutions were formed. The Analytic Hierarchy Process was used to assign weights to the indicators. And then, the satisfaction evaluation index system for elderly-friendly medical institutions was formed. 【Results:】 After two rounds of Delphi method, and the scoring and demonstration of 15 experts, four primary indicators and 21 secondary indicators were finally formed, and then, assigned weight coefficients to them through analysis. 【Conclusion:】 After the expert demonstration, the satisfaction evaluation system for elderly-friendly medical institutions has good reliability and validity, providing the basis for the construction of elderly-friendly medical institutions and contributing to the formation of a sustainable, systematic, and diversified elderly-friendly service system.
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OBJECTIVE To construct the quantitative evaluation system of regional clinical pharmacists’ professional ability, and provide reference for the evaluation of regional clinical pharmacists’ professional ability. METHODS Twenty-one experts from 18 hospitals in Chongqing were consulted to construct a professional ability index system for clinical pharmacists. TOPSIS model was used to calculate and obtain the expert authority index (EI), and the weighted averaging method was used to construct the judgment matrix. Analytic hierarchy process (AHP) was used to calculate the weights of all indicators for establishing a quantitative evaluation system of regional clinical pharmacists’ professional ability according to the weights of each item. RESULTS The results of TOPSIS showed that the EI range was 0.010-0.100, and the relative authority of experts was distinguished and measured effectively. The results of AHP showed that the judgment matrix of the quantitative evaluation system met the requirements of consistency test (consistency test index CR<0.1). Finally, a quantitative evaluation system for regional clinical pharmacists’ professional ability was established, including 6 sub-objective items (basic ability, clinical practice ability, coordination and communication ability, publicity ability, scientific research and teaching ability, continuous improvement ability) and 25 index items (such as educational background, professional title, clinical pharmacy working years, daily theoretical skills assessment, information ability level, medication education, etc.). CONCLUSIONS A quantitative evaluation system of regional clinical pharmacists’ professional ability has been established. Our study provides a theoretical reference for the quantitative evaluation and optimal management of regional clinical pharmacists.
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@#Abstract: Objective To establish a screening-diagnosis-evaluation system of neonatal congenital heart disease (CHD) suitable for Hainan Province based on the application of percutaneous blood oxygen saturation measurement and cardiac auscultation screening, and to provide a basis for further promotion of the evaluation effect. Methods Screening agencies (all midwifery institutions) used the "double index method" to screen newborns for congenital heart disease. Those who were screened positive for any index were transferred to diagnostic institutions (the people's hospitals of all cities and counties and some tertiary hospitals) for echocardiography examination within 1 week. Those with abnormal results were transferred to the treatment institution (two tertiary hospitals) for reconfirmation and evaluation. All data were managed online. Results In this study, 96 913 newborns born in midwifery institutions in 19 cities and counties were screened, with a response rate of 99.44%. The ratio of male infants (50 836) to female infants (46 077) was 1.10∶1. A total of 2 284 positive patients were screened by dual index method, and ultrasound diagnosis was performed, with the rate of cardiac ultrasonography of 98.07% (2 240/2 284) and a high response rate. A total of 238 cases of congenital heart disease were diagnosed (incidence rate of 0.25%), with the top three main types were ventricular septal defect, atrial septal defect, and patent ductus arteriosus. The sensitivity (88.24%) and Youden index (0.86) of dual-indicator screening for CHD detection were significantly higher than the other separate indicators. Through Kappa consistency test analysis, the consistency of dual-indicator screening with simple heart murmur screening results was excellent, with a Kappa coefficient value of 0.835 (>0.75); the consistency of dual-indicator screening and simple POX screening results was good, with a Kappa coefficient value of 0.429 (between 0.40-0.75), and the differences were statistically significant (P<0.001). By the end of the study, 136 children had undergone open-chest/occlusion surgery, with good postoperative recovery, and the rest were followed up. Conclusions The neonatal CHD screening-diagnosis-assessment technology system established in this study, with close connections between various blocks, high screening response rate and echocardiography examination rate, is beneficial for the early diagnosis and treatment of CHD children, and has certain application value in institutions at all levels in Hainan Province, and is worth further promotion.
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Objective To establish a preliminary evaluation system for gastrointestinal qi stagnation syndrome.Methods On the basis of the systematic evaluation of medical literature in the early stage of the research group,24 high-frequency items were subjected to Delphi method,the item indexes were determined through three rounds of expert consultation,and the proportion value of the indexes was determined by AHP,and the evaluation system of gastrointestinal qi stagnation syndrome was initially constructed.Results A total of 84 valid questionnaires were collected by three rounds of Delphi method,including 15 in the first round,32 in the second round and 37 in the third round.According to the statistics,16 items including distention(stuffy)or distending pain or moving pain(epigastric,abdominal,etc.),belching,borborygmus,flatus,etc.were selected.The order of the proportion of the first level indexes obtained by the analytic hierarchy process from high to low is:clinical symptoms,pulse,tongue;The proportion of secondary indicators from high to low is as follows:distention(stuffy)or distending pain or moving pain(epigastric,abdominal,etc.),pulse string,greasy fur,thin white fur,slippery pulse string,pulse sinking string,light red tongue,flatus,borborygmus,belching,induced or aggravated in case of emotional distress,hiccup,abdominal mass,anorexia,vomiting,belching and swallowing acid.Conclusion Delphi method and analytic hierarchy process have been used to study gastrointestinal qi stagnation syndrome,and an evaluation system has been preliminarily formed.The index structure is reasonable,targeted and has strong clinical practicability.
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Objective Construct a scientific and reasonable evaluation index system for clinical specialties of tradi-tional Chinese medicine in Shandong Province to provide a scientific basis for improving the service capacity of clini-cal specia lties of traditional Chinese medicine.Methods Based on relevant policies and literature research,the analytic hierarchy process and Delphi expert consultation method were used to determine the index system and its weight,and 509 clinical specialties of traditional Chinese medicine capacity levels of 178 medical institutions in Shandong Province were evaluated.Results A scientific and effective evaluation index system for clinical specialty capacity of traditional Chinese medicine in Shandong Province was constructed,with 23 secondary indicators in 5 dimen-sions.It comprehensively evaluats the service capacity and management level of orthopedics and traumatology de-partments of traditional Chinese medicine class hospitals in Shandong Province,uses orthopedics and traumatology as an example.Conclusion Driven by the dynamic monitoring of the evaluation index system,improve the service ca-pacity for clinical specialties of traditional Chinese medicine,guide it to strengthen the internal construction of tradi-tional Chinese medicine,and give full play to the advantages of traditional Chinese medicine characteristics.Increase the support for clinical specialties of traditional Chinese medicine in Shandong Province,and then promote the high-quality development of traditional Chinese medicine.
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Hospital evaluation is a powerful tool for standardizing behavior and ensuring quality, which plays a positive role in improving medical services and hospital management. Establishing an evaluation system for world-class, high-quality and high-level hospitals with Chinese characteristics is an important basis for promoting the high-quality development of public hospitals and moving towards the construction of high-level hospitals. Based on the review of relevant policies and the current domestic and foreign mainstream hospital evaluation system, combined with the practical experience of public hospitals in the high-quality development in China, such as multi-campus management, discipline construction, scientific research innovation, talent construction, management innovation, cultural construction, radiation influence at home and abroad, the author tentatively explored the construction of high-quality and high-level hospital evaluation system from seven aspects of medical quality. It is expected to play a goal-oriented role in promoting the construction of " Chinese characteristics, world-class" hospitals.
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The mixed evaluation system uses the network platform as a carrier to construct a dynamic evaluation model that spans time and space between online and offline, between individuals and teams. Mixed evaluation system of physiology was performed for two years, and the process evaluation and the summative evaluation in the mixed evaluation system showed a good correlation, and the students' learning ability and learning effect showed consistency with the evaluation results. Practice has proved that the mixed evaluation system not only optimizes the traditional evaluation system, but also fully expands the five principles of formative evaluation; however, while reflecting the advantages of the network platform, it also exposes the defects of insufficient supervision of the network platform. Thus, we should further improve the mixed evaluation system of physiology.