The time motion study of an out-patient department in a tertiary care hospital in Tamil Nadu

Background: The time taken by the patients during their visit to the hospital out-patient department (OPD) at various service delivery points, the time motion study and by assessing the patient satisfaction regarding the hospital out-patient department, the present study was conducted. This study established the clinical workflow of various events and the operational efficiency of the out-patient department in a busy tertiary care hospital in Tamil Nadu. Methods: The data pertaining to the time motion study was recorded in hours, minutes and seconds. The patient satisfaction questionnaire (PSQ-10 item questionnaire) was requested by interviewing the patients. The data was statistically analyzed using Microsoft Excel and the SPSS v26.0. Results: The maximum time spent was at the investigation counter 00:15:12 and SD was ±00:08:56. The total average waiting time spent during the hospital visits was 00:32:25±00:18:17. The patient satisfaction questionnaire revealed that the overall satisfaction was found to be good in 38 (62.3%) and excellent in 10 (16.4%). Conclusions: The time spent at the investigation counters which was at the peak can be reduced by prioritization and faster case work-up. The staffing pattern was adequate except on government holidays, there were no particular delay in the OPD care setting.

Perfil demográfico, epidemiológico e clínico de pacientes com covid-19 segundo desfecho clínico: um estudo retrospectivo com pacientes admitidos em uma unidade hospitalar / Demographic, epidemiological, and clinic profile of COVID-19 patients by clinical outcome: a retrospective study with patients admitted to a medical unit / Perfil demográfico, epidemiológico y clínico de pacientes con covid-19 según resultado clínico: un estudio retrospectivo con pacientes ingresados en un hospital

O surgimento da covid-19 impactou o cenário de saúde mundial e a compreensão do perfil desses pacientes pode auxiliar no desenvolvimento de medidas e análise de como ocorreu o controle da doença. Assim, este artigo visa descrever o perfil demográfico, epidemiológico e clínico de pacientes com covid-19, internados em uma unidade hospitalar, durante 2020 e 2022. Realizou-se uma pesquisa observacional, de caráter retrospectivo e descritivo, baseada no levantamento e análise de dados de prontuários de pacientes com covid-19, assistidos por uma unidade hospitalar em Barreiras (BA). As informações coletadas foram relacionadas a aspectos demográficos, epidemiológicos e clínicos desses pacientes. Participaram do estudo 1355 indivíduos, sendo que houve predominância em pacientes do sexo masculino (61%), faixa etária entre 40 e 59 anos (44,6%), permanência inferior a cinco dias (51,8%) na instituição de saúde. Acerca do desfecho clínico, houve maior frequência em pacientes que tiveram a alta hospitalar (69,5%). Quanto à sintomatologia na admissão, observou-se predominância de pacientes com temperatura corpórea inferior a 38 °C (91,6%). Ademais, mais frequência em relatos de cefaléia (64,9%), desconforto respiratório (58,1%) e tosse (79,8%). Constatou-se que o perfil dos internados foi de alta hospitalar, idade entre 40 e 59 anos, permanência menor que cinco dias, sem comorbidades. No que se refere aos sintomas, observou-se prevalência de cefaléia, desconforto respiratório, sem disgeusia. Quanto à oxigenoterapia, houve uso expressivo de oxigenação extracorpórea.

COVID-19 onset impacted the global health scenario and understanding the profile of these patients can help us develop measures and analyze how the disease was controlled. Hence, this article described the demographic, epidemiological, and clinical profile of COVID-19 patients admitted to a hospital unit, during 2020 and 2022. An observational retrospective and descriptive research was conducted based on data survey and analysis of COVID-19 patient records from a hospital unit in Barreiras, Bahia, Brazil. Data on demographic, epidemiological, and clinical aspects of the patients were collected. A total of 1355 individuals participated in the study, mostly male patients (61%) aged 40 to 59 years (44.6%) and hospital stay of less than five days (51.8%). Patient discharge (69.5%) was the prevalent clinical outcome. Regarding symptoms at admission, we observed a predominance of patients with body temperature below 38 °C (91.6%). Additionally, there were frequent reports of headache (64.9%), respiratory distress (58.1%) and cough (79.8%). Results confirmed a profile of patient discharge, age between 40 and 59 years, hospital stay of less than five days, without comorbidities. Prevalent symptoms were headache and respiratory discomfort, without dysgeusia. Regarding oxygen therapy, there is expressive use of extracorporeal oxygenation.

El surgimiento de la covid-19 generó impactos en el ámbito de salud mundial, y comprender el perfil de los pacientes puede auxiliar en el desarrollo de medidas y analizar cómo se controló la enfermedad. Este estudio tuvo por objetivo describir el perfil demográfico, epidemiológico y clínico de los pacientes con covid-19 ingresados en un hospital en el período entre 2020 y 2022. Se realizó un estudio observacional, retrospectivo y descriptivo a partir de una búsqueda y de análisis de datos de historias clínicas de pacientes con covid-19 ingresados en un hospital de Barreiras, en Bahía (Brasil). Se recolectaron datos sobre aspectos demográficos, epidemiológicos y clínicos de estos pacientes. En este estudio participaron 1.355 personas, de las cuales hubo un mayor predominio de pacientes del sexo masculino (61%), de grupo de edad de entre 40 y 59 años (44,6%), con estancia inferior a cinco días (51,8%) en el centro de salud. Respecto al resultado clínico, hubo una mayor frecuencia en pacientes que recibieron el alta hospitalaria (69,5%). En cuanto a la sintomatología de ingreso, predominó temperatura corporal inferior a 38 °C (91,6%). Además, hubo frecuentes relatos de cefalea (64,9%), malestar respiratorio (58,1%) y tos (79,8%). Se constató que el perfil de los hospitalizados fue el alta hospitalaria, edad de entre 40 y 59 años, estancia inferior a cinco días, sin comorbilidades. En cuanto a los síntomas, hubo mayor prevalencia de cefalea, malestar respiratorio, sin disgeusia. Respecto a la oxigenoterapia, hubo un uso significativo de la oxigenación extracorpórea.

Bacterial profiling, sensitivity and resistance pattern of neonatal sepsis in neonatal intensive care unit of tertiary care hospital

Background: This study aimed to identify the distribution of pathogens and their antimicrobial resistance patterns in the neonates admitted to the NICU of a tertiary care hospital in northern India.Methods: After obtaining written informed consent, neonates with confirmed or suspected cases of neonatal sepsis (n=167) aged 0-28 days were included. As soon as the baby arrived, all the clothes were removed and kept in a pre-heated warmer. Before administering I/V antibiotics, all the routine and culture samples were taken. The clinical data were collected and analysed using SPSS.Results: Most of the neonates were from lower middle class, out-born, LSCS, early preterm, and low birth weight (LBW). 167 neonates had culture-confirmed infections [blood culture positive (13.8%) and sepsis screen positive (86.2%)]. Gastric aspirate cytology was positive in 61.7% of patients. Maximum cytology-positive cases were seen in neonates with EOS. The most common risk factors were birth asphyxia. 142 individuals were discharged, with 72.5% diagnosed with EOS and 89% with LOS. There was a significant difference in gastric aspirate cytology when associated with expiry and discharge. Out of 167 neonates, 13.77% were culture-positive for neonatal sepsis. Out of 23 organisms, 82.6% were resistant, while, 17.4% were not. Staph aureus was the major causative organisms. Among the Gram Positive and Negative bacteria, the highest sensitivity was observed for imipenum. All gram-positive bacteria were resistant to cotrimazole, tobramycin, and erythromycin.Conclusions: Implementation of effective preventive strategies to combat the emergence of antibiotic resistance is urgently needed.

Pattern of mortality in a tertiary care teaching hospital according to the 11th Revision International classification of disease

Background: Mortality is the oldest known health care indicator and a valuable tool for planning and managing in hospitals. Identifying the causes of mortality in hospital is important to monitor the health of the nations, identifying priorities and burden of disease analysis to attempt to estimate the causes of loss of healthy life. Hence this study was done to know the causes of death as per International Classification of Diseases (ICD) 11 among patients who died in Hangal Sri Kumareshwar Hospital in the year 2023. Methods: A retrospective descriptive study was conducted from 01 January to 31 December 2023 in Hangal Sri Kumareshwar Hospital. All mortality data of the year 2023 in the hospital were included in the study. The content of format included demographic variables of patients on the patient record like age, sex, address, mortality and its causes and classified according to ICD 11. Collected data was analyzed using percentages and Chi-square test. Results: Out of 505 deaths in Hangal Sri Kumareshwar Hospital and Research centre in 2023, 305 (60.40%) were males and 200 (39.60%) were females. Majority of deaths (31.48%) occurred between 41 to 60 years age group followed by 31.29% deaths occurring between 61 to 80 years age group. Regarding cause of death according to ICD-11, majority (24.16%) had a circulatory disease followed by 16.24% due to an infectious disease. Conclusions: The National Health Program to combat non communicable diseases has been implemented and the 12th five-year plan has made specific provision for the management and control of non-communicable diseases.

Epidemiological profile of reported road traffic accident cases to emergency medicine department of a teaching medical college in South Karnataka

Background: The study delves into the pressing issue of Road Traffic Accidents, a significant public health concern worldwide, particularly in low- and middle-income nations. With the backdrop of the 2030 Agenda for Sustainable Development, road safety has gained paramount importance. This research aims to comprehensively examine the multitude of factors influencing RTAs by analyzing data sourced from individual interviews, case summaries, and medico-legal records from a tertiary care hospital's Emergency Medicine Department. Methods: A hospital-based cross-sectional study conducted at JSS hospital, Mysuru. Data from 1525 retrospective cases spanning (2019-2021) and 114 prospective cases from December 2022 to January 2023 were analyzed. A pre-tested, semi-structured proforma gathered socio-demographic variables, etc. Analysis revealed a surge in accidents in 2021 compared to previous years, with a majority occurring between 8 pm to 8 am. Primarily in the 21-30 years age group. Over the three-year period, 72 fatalities were recorded, predominantly among males. Results: The study identified significant associations between RTAs and factors such as gender, vehicle type, mode of transportation, and referring hospital. Lower education levels correlated with increased risk, highlighting the importance of road safety education. Additionally, a striking urban-rural disparity was noted, with majority of RTAs occurring in rural areas. Conclusions: Overall, this study underscores the complex nature of RTAs and highlights the importance of addressing multiple risk factors to effectively mitigate road traffic injuries. By understanding these factors, policymakers and healthcare professionals can develop targeted interventions aimed at reducing the burden of RTAs and promoting safer road practices.

Configuração das Redes de Atenção à Saúde no SUS: análise a partir de componentes da atenção básica e hospitalar / Configuration of Health Care Networks in the SUS: analysis based on primary and hospital care components

Resumo O estudo procura apontar diferentes configurações de Redes de Atenção à Saúde na atenção básica e hospitalar, a partir de características de cobertura, qualidade e resolubilidade nas macrorregiões de saúde. Estudo transversal, utilizou a técnica de análise de cluster e segmentou 103 macrorregiões em distintos perfis de cobertura, qualidade e resolubilidade: grupo 1 (alta cobertura/AB e média/AH; baixa qualidade AB-AH com alta resolubilidade); grupo 2 (alta cobertura/AB e baixa/AH; baixa qualidade AB-AH com média resolubilidade); e o grupo 3 (alta cobertura/AB e média/AH; alta qualidade AB-AH com alta resolubilidade). A cobertura na AB foi classificada como alta para 100% da população brasileira, e na AH, baixa para 9,70% e média para 90,29%. Qualidade/AB-AH é baixa para 58,54% e alta para 41,15%. A resolubilidade é alta para 90,29% e média para 9,70%. No Brasil, verifica-se expansão da cobertura com baixa qualidade/AB, insuficiência de leitos hospitalares e baixa qualidade/AH com alta resolubilidade. Todavia, prevalece alta qualidade AB-AH no Sudeste e no Sul. A estruturação das redes de saúde ainda se configura de baixa resolutividade, demandando estímulos à governança de arranjos interfederativos.

Abstract This study seeks to point out the different configurations of Health Care Networks in primary care (AB) and Hospital Care (AH), dimensioned based on coverage, quality, and resolvability characteristics in health macro-regions. Cross-sectional study used the cluster analysis and segmented 103 macro-regions into different profiles of coverage, quality and resolubility: group 1 (high coverage/AB and medium/AH; low quality AB-AH with high resolubility); group 2 (high coverage/AB and low/AH; low quality AB-AH with medium resolubility) and group 3 (high coverage/AB and medium/AH; high quality AB-AH with high resolubility). Coverage in AB was classified as high for 100% of the Brazilian population and in AH low to 9.70% and medium to 90.29%. Quality/AB-AH is low for 58.54% and high for 41.15%. Resolubility is high for 90.29% and medium for 9.70%. In Brazil, there is expansion of coverage with low quality/AB; shortage of hospital beds and low quality/HA with high resolution. However, in the Southeast and South, high AB-AH quality prevails. The structuring of health networks is still characterized by low resolution, demanding incentives for the governance of inter-federal arrangements.

Ectopic pregnancies at a tertiary care centre: a five-year retrospective study

Background: Ectopic Pregnancy results in significant morbidity. Our aim during present study was to understand age wise, parity wise distribution of cases, risk factors, clinical presentation and management of ectopic pregnancy which may be useful in lowering morbidity and mortality.Methods: A five-year retrospective study was done from 2019 to 2023; comprising detailed medical records of detected cases of ectopic pregnancies admitted to the tertiary care centre.Results: Incidence of ectopic pregnancy during present study was 0.40%. 65.48% of ectopic pregnancy cases recorded in the age group of 21-30 years. Majority of parity wise cases were multipara (63.95%). There were no risk factors noted in 34.01% cases. Majority of the cases (65.95%) had one or the other distinguishable risk factor. 21.68% cases had history of Tubectomy, while 19.38% ectopic gestation had history of abortion. Most of the patients presented with clinical presentation of amenorrhoea 59.89%. 55.83% cases had bleeding per vaginum, while 47.71% had pain in abdomen. Most common ectopic pregnancy site was ampulla, with 63.95% cases. Ultrasonic findings showed ruptured ectopic pregnancy in 59.39% cases and unruptured in 30.45%. Regarding mode of management in the cases, surgical management with unilateral total salpingectomy (56.79%) was most commonly performed, followed by salpingoopherectomy (14.81%).Conclusions: Ectopic pregnancy is a common obstetric emergency leading to first trimester morbidity and mortality. Diagnosis of these cases requires a high index of clinical suspicion and early intervention often is lifesaving. Hence, knowledge of the disease related trends and timely management is the key for successful outcomes in such cases.

Clinical profiles and causes of ascites in children at a tertiary care hospital, Bangladesh

Background: Ascites is an accumulation of serous fluid within the peritoneal cavity. Combined analysis of laboratory data and clinical and pathological details are essential for establishing a differential diagnosis. In children of Bangladesh our context, etiologies behind ascites are not yet studied well. The aim of our study was to evaluate the causes of ascites in the basis of clinical feature and laboratory investigation in children.Methods: This was a cross-sectional retrospective descriptive hospital-based record review of a tertiary center of hospital, Bangladesh. All children aged between 6 months to 17 years with ascites, irrespective of their primary cause admitted in pediatric ward were included in this study. The study was conducted during September 2019 to September 2020. During this period, 50 children presented with ascites were enrolled in the study.Result: The mean age was 8.174. The age range of the patients was from 6 months to 17 years. Twenty-eight (56.0%) of them were males and 44% of the participants were female. Maximum 54% have duration more than 7 days. The most common previous symptoms were fever (68%) and jaundice (38%) followed by bleeding manifestation (30%). The most common etiology of ascites was Chronic liver disease with portal HTN (48%), followed by abdominal tuberculosis (14%).Conclusion: This study found that CLD with Portal HTN is the most common cause of ascites in pediatric age group and second most common cause is infectious cause e.g. abdominal tuberculosis. This also highlighted that the presenting symptoms and laboratory parameter that guided to find out the causes of ascites.

ANTIFUNGAL STEWARDSHIP: MITIGATING INAPPROPRIATE PRESCRIPTIONS IN VULVOVAGINAL CANDIDIASIS IN TERTIARY CARE HOSPITAL, CENTRAL INDIA

This study aims to reduce the inappropriate prescriptions of antifungal medications for vulvovaginitis candidiasis in a tertiary care hospital in central India. An ambispective, observational study was conducted in the Department of Pharmacology of MGM Medical College and Maharaja Yashwantrao Hospital in Indore, MP, over three months (i.e.,12 w from August to October 2023). The study encompassed a retrospective analysis of prescriptions for vaginal candidiasis over a period of five weeks in August-September 2023, followed by a prospective analysis over the subsequent five weeks of September-October 2023post-implementation of interactive training sessions, discussions, and antifungal guidelines for two weeks. From a total of 130 randomly selected prescriptions, 69 prescriptions were perused retrospectively, while 61 prescriptions received prospective analysis. The post-implemented audit showed a marked reduction in antifungal prescriptions with a difference of 12.4%. An increase in the documentation of examination findings was also observed, from 46.7% to 69.7%. This implementation successfully mitigated inappropriate prescriptions of antifungals, with sustained reductions demonstrated over the 3 mo of the study period, emphasizing the effectiveness of educational interventions.

Fetomaternal outcome in patients with eclampsia: study in a territory care hospital in Bangladesh

Background: Eclampsia, a severe complication of preeclampsia, poses significant risks to both the mother and the fetus. Understanding the specific factors influencing these outcomes in the context of Bangladesh is crucial for improving maternal and neonatal healthcare in the region.Methods: A retrospective cohort study was conducted at department of gynaecology and obstetrics, Jashore Medical College Hospital, Jashore, Bangladesh reviewing medical records of 155 patients diagnosed with eclampsia over a January 2020 to December 2020. Data on maternal age, gestational age, clinical presentation, management strategies, and fetal outcomes were collected and analyzed.Results: Preliminary findings suggest that maternal age, gestational age at onset, and timely interventions play crucial roles in determining the fetomaternal outcomes in eclampsia cases. Maternal mortality rates, neonatal morbidity, and mortality rates were assessed in relation to these factors. Additionally, the study investigates the impact of various management approaches, including antihypertensive medications, and magnesium sulfate therapy on these outcomes.Conclusions: Eclampsia continues to pose significant risks to both mothers and infants in Bangladesh. Inadequate antenatal care appears to contribute to the severity of cases. The high rate of emergency cesarean sections underscores the need for vigilant monitoring of high-risk pregnancies. Efforts to improve antenatal care utilization and implement timely interventions are crucial to mitigate the adverse fetomaternal outcomes associated with eclampsia in this setting. Further prospective studies are warranted to explore preventive strategies and optimize management protocols for better outcomes.

Effects of internet shutdown among medical students of a tertiary care hospital in Imphal, Manipur: a cross-sectional study

Background: The internet shutdown has become a global issue affecting the academic activities of medical students. Due to civil unrest in Manipur, a Northeastern state in India, the internet has been shut down for the past several months. Therefore, the study was undertaken with the objective to determine the magnitude of the effects of the internet shutdown among the medical students of a tertiary care hospital in Manipur. Methods: A cross-sectional study was conducted in July 2023 among 135 medical students of a tertiary care hospital using a convenience sampling method. Data were collected by using a self-administered structured questionnaire. Data analysis was done by using SPSS software version 26. Results: The mean age of the participants was 21±1.8 years. The study found that the majority (93.3%) of medical students opined that the internet shutdown affected their daily activities. Most of the participants (83.7%) stated that their study was affected by the current internet shutdown. Only (39.2%) of participants faced problems in submitting online forms. Most of the participants (71.1%) had a bad experience during the internet shutdown. Conclusions: The internet shutdown affected most of the participants in their daily activities. Most of the participants felt they were missing out on information and opportunities. Most of the participants rate their overall experiences as bad during the internet shutdown.

Prevalence, patterns of clinical presentation, and the outcome of treatment of diabetes mellitus among paediatric patients in a tertiary care facility

Background: Diabetes mellitus is a multi-systemic disease condition characterized by elevated blood glucose level which can be due to relative or absolute deficiency of insulin secretion or action or a combination of both in humans including paediatric patients which disproves the thought that it is a disease of adults alone. Methods: The study was a retrospective descriptive cross-sectional full population study that involved getting the total population of 7880 paediatric patients that presented to the hospital facility within 3-years (from January 2019-December 2021) and from the total population getting the patients diagnosed with diabetes mellitus. A well-structured proforma was used to collect the relevant data needed from the case files of the patients. Statistical data analysis was done with SPSS version 25. Results: The study showed that out of 7880 paediatric patients that presented to the facility, 20 of them were diagnosed and treated for diabetes mellitus giving a prevalence of 0.25 per 100 patients. The paediatric patients diagnosed with diabetes mellitus were aged 8-18years; 11 females and 9 males. This study showed that about 75.0% of the paediatric patients with DM fully recovered following treatment and was subsequently discharged; however about 95% of these patients were lost to follow-up. Conclusions: Adequate measures needs to be put in place to ensure that the management of these patients are highly optimal and does not constitute much financial burden to the caregivers, in order to improve compliance to treatment and hence reducing morbidity and mortality associated with the condition.

Studies on the Influence of Three-level Assistance Model Based on Narrative Nursing Theory on the Mental Health of Medical Staff / 昆明医科大学学报

Objective To explore the impact of the three-level assistance model based on the narrative nursing theory on the mental health status of medical staff.Methods 140 medical staff working in a third class hospital in Xiangyang City were selected as the research object.The three-level assistance model based on narrative nursing theory was used to intervene them from September 2021 to July 2022.The symptom self-assessment scales before and after the intervention were compared.Results Before the intervention,the total score of SCL-90(156.37±32.56)points and the scores of various symptom factors of medical staff were higher;After the intervention,the total score of SCL-90(133.35±43.48)points and the scores of various symptom factors were lower than those before the intervention and the difference was statistically significant(P<0.05).Conclusion The three-level assistance model based on narrative nursing theory can reduce the total score of SCL-90 and the scores of various symptom factors,improve the mental health status and mental health level.

Current situation of and countermeasures for achievement transformation and management in tertiary medical hospitals in Shanghai / 现代医院

Objective To investigate the current situation of achievement transformation in tertiary medical hospitals in Shanghai and propose countermeasures for the existing problems to enhance the effectiveness of achievement transformation.Methods A questionnaire survey was done on the transformation and management of scientific research achievements in 47 terti-ary hospitals in Shanghai.Meanwhile,interviews were carried out among the managers and researchers from these hospitals.Re-sults In the past three years,the rate of transformation achievements in the hospitals was only 2.8%.In the achievement trans-formation existed such problems as weak awareness of scientific researchers,low patent quality,lack of full-time managers,and inflexible management mode.It was also believed that there is a need to improve main responsibilities,achievement management,system establishment,personnel training,resource sharing,department coordination and other related aspects.Conclusion The rate of achievement transformation in tertiary medical institutions in Shanghai is at a lower level.There are numerous problems and difficulties in the transformation.Therefore,urgent efficient countermeasures are needed to promote the transformation of a-chievement.

Statistical analysis of 159 cases of surgical complications in a cancer hospital / 现代医院

Objective To investigate the causes and countermeasures of 159 cases of surgical complications and reduce the incidence of surgical complications.Methods According to the statistical caliber of surgical complications in"Operation Manual for Performance Appraisal of National Third-level Public Hospitals(2023 Edition)",the data of discharged surgical pa-tients from January 1,2021 to June 30,2023 were extracted from the medical record management system,and the data were sor-ted by EXCEL software and statistically processed by SPSS statistical software.The difference was statistically significant(P＜0.05).Results There was no gender difference.There were 57 cases of surgical complications at the age of 70-79.The most complications of thoracic surgery were 45 cases;The main surgical complications were grade Ⅲ and Ⅳ operations,accounting for 99.37％,and the titles of the chief surgeon were chief physician and deputy chief physician,accounting for 94.34％.Among 159 cases of surgical complications,pulmonary artery thrombosis ranked first,accounting for 15.72％.Conclusion The man-agement of surgical complications needs the support of information technology,strengthening preoperative risk assessment,impro-ving the grading management system of surgery,reducing the number of postoperative complications and reducing medical risks.

Construction and application of performance appraisal data monitoring and management system for tertiary public hospitals / 现代医院

The performance appraisal of public hospitals is the most official and authoritative assessment and evaluation of tertiary public hospitals in China,and it is an important measure to guide hospitals to improve their internal management level and achieve high-quality development.In this study,a data monitoring management system based on the performance appraisal indicators of national tertiary public hospitals was developed and constructed through intelligent collection and reporting,report in-tegration,visual analysis,data drilling,etc.,which realized the one-stop dynamic management of indicators,optimized the data filling process of national examination indicators,improved the data quality and credibility,and promoted the integration of na-tional assessment and hospital assessment.the intelligent management level of the hospital has been improved,which provides strong support for the hospital's refined operation management and scientific decision-making.

Analysis of Hospital Bed Efficiency of Tertiary Public Hospital in Shandong Province / 中国医院管理

Objective To analyze and evaluate the hospital bed efficiency and development trend of 54 tertiary public hospitals in Shandong Province from 2013 to 2020 and to provide a reference for improving efficiency in the use of hospital beds and rationally allocating medical and health resources.Methods Based on the panel data of 54 tertiary public hospitals in Shandong Province from 2013 to 2020,three indicators of bed utilization rate,bed turnover times and the average length of stay of patients were selected to describe the differences of bed use efficiency in each category by using variance analysis and to evaluate the bed use efficiency in tertiary public hospitals in Shandong Province.Results The results of the study show that the bed utilization rate of tertiary public hospitals in Shandong Province decreased from 2013 to 2020,but it is still higher than the national average level.The results of variance analysis showed that in 2019,the overall bed utilization rate of 54 third-level public hospitals reached 95.9%,which was overloaded.The number of bed turnover and the average day of hospitalization were improved,but there were significant differences in bed use efficiency among hospitals with different bed size and institutional attributes(P＜0.05).Conclusion Shandong Province should strengthen the rational allocation of medical resources,improve the level of hospital management,formulate relevant policies to promote the rational use of hospital bed resources,and further improve hospital bed efficiency.

Status Analysis of Unplanned Reoperation in Cardiac Surgery Department of a Provincial Grade A Tertiary General Hospital / 中国医院管理

Objective To analyze the current situation of unplanned reoperation in cardiac surgery and to discuss the management measures of unplanned reoperation.Methods The information of patients undergoing cardiac surgery in a class A tertiary comprehensive hospital during 2018-2022 was collected to analyze the incidence of unplanned reoperation,major ca uses,disease types,surgica l moda lities and Complications.Results A tota l of 3902 patients underwent surgery,of whom 73(1.87%)underwent unplanned reoperation.The main cause of unplanned reoperation was bleeding(50%).The disease types with the highest unplanned reoperation composition ratio were coronary heart disease(38.4%),and the disease types with the highest incidence were dilated cardiomyopathy(11.1%).The average hospitalization cost,the average length of hospitalization,mortality rate and medical dispute rate of patients who had unplanned reoperation were significantly higher than those who did not have unplanned reoperation,the difference was statistically significant(P=0.001).Conclusion The hospital should strengthen the perioperative management of cardiac surgery,focus on supervising disease types and surgical modalities with high incidence of unplanned reoperation,and strictly implement the system of operation classification and the system of reporting unplanned reoperation to ensure the quality of patient surgery.

Analysis on the Factors Influencing the Human Resource Allocation in Tertiary Public Traditional Chinese Medicine Hospitals / 中国医院管理

Objective Starting from the actual numbers of health personnel of tertiary public hospitals of Traditional Chinese Medicine(TCM),to quantitatively analyze the influencing factors on the allocation of human resources and obtain a prediction model.Methods The balanced panel data from 517 Tertiary Public TCM Hospitals in the period of 2011-2020 were collected,and the two-way fixed effects model was used to empirically analyze the impact of scale,demand and other factors on the actual number of health personnel in these hospitals.Result The number of beds is a key factor affecting the human resource allocation of Public TCM Hospitals,and various factors such as de-mand,policy,price,efficiency,and administrative management also have significant impacts on the allocation.The demand for outpatient services,government financial support,and efficiency of resource utilization are all promoting factors,while the increase in human resource prices,income generation efficiency,and administrative manage-ment levels have negative effects.A prediction model is proposed.Conclusion The planning principle of matching bed numbers with human resources allocation is in line with the actual environment.When predicting the total personnel allocation or authorized strength,various factors should also be fully considered,which can provide reference for the formulation of human resource policies in Public TCM Hospitals.

Construction of Performance Evaluation Index System for Head Nurses in Tertiary Grade A Hospitals in Heilongjiang Province / 中国医院管理

Objective To construct the performance evaluation index system of head nurses in tertiary grade A hospitals in Heilongjiang Province,in order to provide reference for clinical nursing management.Methods Through literature analysis and theoretical research,the framework and content of performance evaluation index system for head nurses in tertiary grade A hospitals in Heilongjiang Province were preliminarily established,and two rounds of expert letters were conducted by Delphi method,and finally the performance evaluation index system for head nurses in tertiary grade A hospitals in Heilongjiang Province was established.Results The evaluation index system of head nurses'performance in a tertiary grade A hospital in Heilongjiang Province included 5 first-class indicators,14 second-class indicators and 49 third-class indicators,and the expert consultation was highly reliable.Conclusion The construction of the performance evaluation index system for head nurses in tertiary hospitals in Heilongjiang Province can not only provide reference for nursing managers and researchers at all levels of medical institutions in the province,but also provide practical guidance for head nurses to improve their own nursing management level.