Strategic management of Public Hospitals' medical services.

Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

Roles and methods of performance evaluation of hospital academic leadership.

The rapidly advancing implementation of public hospital reform urgently requires the identification and classification of a pool of exceptional medical specialists, corresponding with incentives to attract and retain them, providing a nucleus of distinguished expertise to ensure public hospital preeminence. This paper examines the significance of academic leadership, from a strategic management perspective, including various tools, methods and mechanisms used in the theory and practice of performance evaluation, and employed in the selection, training and appointment of academic leaders. Objective methods of assessing leadership performance are also provided for reference.

Managerial Decision-making for Daily Case Allocation Scheduling and the Impact on Perioperative Quality Assurance.

Allocation scheduling for daily surgical cases is a decision-making process tasked to anesthesiologists and nurse managers in the operating room (OR). This manuscript focuses on three major areas: the classification and principles of allocation scheduling on workdays in China, flexible strategies of operational decision-making given differences in planned versus actual OR allocations, and perioperative quality implications of anesthesia scheduling. Improved quality and optimal decision-making in daily surgical case scheduling is seen with shift supervisor-based scheduling of staff and cases when compared with staff and case scheduling managed by the departmental director or chief resident.

Construction and Application of a Refined Hospital Management Chain.

Gaining large scale success was quite common in the later period of industrialization for hospitals in China. Today, Chinese hospital management face such problems as service inefficiency, high human resources cost, and low rate of capital use. This study analyzes the refined management chain of the Wuxi No. 2 People's Hospital. This consists of six gears namely "organizational structure, clinical practice, outpatient service, medical technology, and nursing care and logistics" used to achieve maximum scale and benefits. The gears are based on "flat management system targets, chief of medical staff, centralized outpatient service, intensified medical examinations, vertical nursing management and socialized logistics". The hospital took innovative measures. The "one doctor-one patient-one clinic" was well accepted; "one dispensary" shorten the waiting time by 20 min. The 168 rear service hot line "made patients' lives easier; and a red wrist ribbon" for seriously ill patient was implemented to prioritize medical treatment. The core concepts of refined hospital management are optimizing flow process, reducing waste, improving efficiency, saving costs, and taking good care of patients as most important.

Exploration on Construction of Hospital "Talent Tree" Project.

Talent is the core competitive force of a hospital's development. Wuxi No. 2 People's Hospital followed the characteristics that medical talents mature slowly and their growth requires a long period. The innovated "talent tree" project, trained classified talents corresponding to "base-trunk-crown" of a tree, formed an individualized professional training plan with different levels and at different periods. We carried out a relay of the "talent tree" to bring their initiative into play. In practice, we gradually found this as a unique way of the talent construction, which conforms to our hospital's condition. This guarantees sustained development and innovative force of the hospital.

[Behavioral changes of rats after short-term exposure to di-(2-ethyl hexyl) phthalate].

OBJECTIVE: To observe the behavioral changes of rats after subchronic exposure to di-(2-ethyl hexyl) phthalate (DEHP). METHODS: Twenty-four healthy male SD rats were randomized equally into 4 groups, namely the solvent control group (sesame oil) and 3 DEHP groups with daily intragastric administration of DEHP at the doses of 150, 450, and 1350 mg/kg for 28 days. The neurobehavioral changes of rats were evaluated by open-field test (OFT) and elevated plus-maze test (EPM), and the body weight and organ coefficients were measured. RESULTS: The rats showed no significant differences in the performance in OFT or EPM before DEHP exposure. The body weight of the rats increased with the prolonged DEHP exposure, but no significant differences were found between the treatment groups and the control group (P>0.05). From the third week of exposure, the weekly food consumption and the food utilization rate showed significant differences between the treatment groups and the control group (P<0.05 and PP<0.01), and the liver and testis coefficients, but not the kidney coefficient, also differed significantly (PP<0.01, PP<0.01, and P>0.05). In OFT, the total distance of movement was the longest in high dose treatment group (PP<0.05 vs control group), and the durations of stay in the central area, but not the number of times of entry, differed significantly between the 3 treatment groups and the control group (PP<0.05 and P>0.05). In EPM test, however, the performances of the rats was all similar between the 4 groups (P>0.05). CONCLUSION: DEHP can affect the locomotor activity and exploratory behavior of rats after short-term exposure, suggesting its possible hazard in human being.

Enhancement of homing capability of endothelial progenitor cells to ischaemic myocardium through physiological ischaemia training.

OBJECTIVE: To investigate the effects of physiological ischaemia training on the quantity and activity of endothelial progenitor cells in rabbits with intermittent myocardial ischaemia. METHODS: A reversible coronary artery water balloon occluder (5.0 mm inner diameter) was placed around the proximal left ventricular branch and intermittent myocardial ischaemia was induced by deflation and inflation of the occluder. A wire electrode was inserted longitudinally into the epineurium of the sciatic nerve to generate physiological ischaemia training through isometric contraction induced by electrical stimulation. Rabbits were randomly divided into 3 groups: a sham operated group (SO), an intermittent myocardial ischaemia-only group (MI), and an MI plus physiological ischaemia training group (PT). Intermittent myocardial ischaemia was induced with 2-min ischaemia followed by 1-h reperfusion. Physiological ischaemia training was induced by electrical stimulation (40% maximum current strength, 1 ms, 40 Hz), 4-min per session, twice a day, 5 days per week for 4 weeks. At the end-points, endothelial progenitor cells were isolated and cultured for analysis of their migration ability. Endothelial progenitor cells were identified by dual-staining with Dil-labelled acetylated low-density lipoprotein and fluorescein isothiocyanate-labelled Ulex europaeus agglutinin-1. Circulating endothelial progenitor cells (CD34(+)/Flk-1(+)) were counted by fluorescence-activated cell sorter, and capillary density was evaluated by immunohistochemistry examination. RESULTS: Group PT showed the highest migration capacity of endothelial progenitor cells (151 cells, standard deviation 16/high power field) and the highest increase in circulating endothelial progenitor cells (p < 0.01) after 4 weeks' physiological ischaemia training. Capillary density in the myocardium was also significantly enhanced in group PT (p < 0.05). Pearson's analysis demonstrated a positive correlation between the number circulating endothelial progenitor cells and capillary density in the myocardium after 4 weeks' physiological ischaemia training (p < 0.05). CONCLUSION: Physiological ischaemia training may enhance the quantity and activity of endothelial progenitor cells in the blood, resulting in an increase in angiogenesis in the ischaemic heart region.