Due to optimizing medical service resources and improving service efficiency, day surgery has attracted the attention of medical and management experts worldwide. In 2019, day surgery was included as one of the performance assessment indicators of tertiary public hospitals. In recent years, hospital-based day surgery centers have begun to plan and build. Although the basic facilities have been perfectly improved, but how to efficiently and safely operate and manage the centralized day surgery has become the primary problem to clinicians and managers. The purpose of this paper is to introduce how the Day Surgery Center of West China Hospital of Sichuan University uses scientific management tools and establishes a professional multidisciplinary team, so as to carry out efficient operation management and control of medical quality and safety risks of the Day Surgery Center. And then provide practical experience guidance and suggestions with strong feasibility and operability for peers.
Efficient disciplinary management in hospitals plays an important role in improving the level of medical services, promoting talent development, elevating research levels, and enhancing the overall strength of hospitals. At present, large comprehensive hospitals are facing increasingly complex challenges and problems in disciplinary construction and management. Bibliometrics, as a tool for literature analysis and evaluation, can assist hospitals in carrying out disciplinary management. This article explores the application and value of bibliometrics in hospital disciplinary management from the perspectives of disciplinary planning, optimizing resource allocation, evaluating disciplinary level, and exploring hot topics and development trends in disciplinary fields, and hopes to provide reference and ideas for peers.
ObjectiveTo investigate the reporting and methodological quality of systematic reviews/ meta-analyses conducted by hospital pharmacists in China, so as to improve the quality of systematic reviews/ meta-analyses in this field. MethodsThe literatures were retrieved from CNKI, WanFang Data, VIP, CBM, CMCI, PubMed, EMbase, The Cochrane Library from the establishment date to March 17th, 2016. According to the inclusive and exclusive criteria, authors independently screened and extracted the published information. Reporting and methodological quality of included reviews were evaluated by PRIMSA statements and AMSTAR checklists. Data analysis was conducted by using Excel 2013 software and SPSS 20.0 software. ResultsOne thousand and eighteen systematic reviews/ meta-analyses were included, including 871 Chinese literatures and 147 English literatures. The average score of PRIMSA was 18.41±2.84, and the average score of AMSTAR was 7.38±1.28. The main problems of PRIMSA were structured summary, objectives, protocol and registration, additional analyses and funding. The main problems of AMSTAR were priori design, status of publication and list of studies (included and excluded). Univariate analysis showed that some factors could improve the quality of methodology and reporting, including studies in English (P<0.000 1), published after checklists' (P<0.000 1), hospital in higher-level (P<0.000 1), illuminating the funding or interest conflict (P<0.000 1). Pearson analysis indicated that linear correlation were detected between PRISMA scores and AMSTAR scores (P<0.000 1), as well as citations and AMSTAR scores (P=0.045). ConclusionEvidenced-based pharmacy in hospital has developed rapidly, the quality of methodology and reporting have increaseed year by year, but further improvement should be considered in different aspects. The methods to evaluate the clinical application of these systematic reviews/ meta-analyses should be developed in the future.
Objective To explore the role of introducing closed-loop management in the decision execution process of hospital president’s office meeting in improving the hospital decision execution and management ability. Methods The topics of the president’s office meeting of Guang’an People’s Hospital from 2021 to 2022 were selected. The topics of the president’s office meeting were divided into 2 groups based on the introduction of closed-loop management. Among them, 2021 was used as the pre-intervention group, and 2022 was used as the post-intervention group. The completion rate of agreed topics, the rate of reconsidering deferred topics, and the impact of closed-loop management on various sequence departments of the hospital before and after intervention were observed. Results A total of 946 topics were included. Among them, there were 499 topics in the pre-intervention group, 305 topics were completed, 38 topics were deferred, and 16 topics were presented for further meetings; after intervention, there were 447 topics, 404 topics were completed, 33 topics were deferred, and 24 topics were presented for further meetings. There was a statistically significant difference in the average completion rate of agreed topics [(60.90±6.30)% vs. (89.62±7.94)%] and the average rate of reconsidering deferred topics [(40.83±18.78)% vs. (65.70±25.62)%] before and after intervention (P<0.05). The average completion rate of agreed topics in administrative, logistic and business sequence increased from (60.13±7.95) %, (67.90±22.13) % and (63.34±18.54) % to (92.41±8.25) %, (88.80±18.78) % and (84.79±18.71) %, respectively. Conclusion The introduction of closed-loop management in the decision execution process of the hospital president’s office meeting can improve the decision-making efficiency and execution ability.
Shortly after Wenchuan earthquake, the administrative leaders of West China Hospital accurately defined the role of the hospital during the medical rescue work as the treatment center for the seriously wounded, the supporting center for the local hospitals/clinics of the disaster areas, and the logistic supporting center for medical teams from other provinces. Integrated leadership of management and with efficient multi-department coordination and cooperation were emphasized. The mode of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of resources were ensured to meet the ever-changing demand from all levels of rescue work. Three stages were defined based on the conditions of the wounded delivered to the hospital, with different main focuses for each stage. Owing to the multi-disciplinary cooperation and concerted efforts of a large number of experts from other provinces or even other countries, effective and efficient medical rescue service has been offered to all the wounded. Up to June 2nd, 2?618 cases from the disaster area have been treated, of whom 1 751 admitted into the inpatient department, 1 135 seriously wounded, 127 admitted into the Intensive Care Unit, 1 239 underwent operations and 77 treated with hemodialysis, with an inpatient mortality lower than 0.7%. Moreover, even during such a period of time, the routine medical service has been offered as regular to patients other than the wounded in the disaster.
Objective To explore the effects of the centralized management of bed use in a large-scale integrated hospital. Methods We selected the staff with good quality for centre work after setting up the bed use centralized management centre in the West China Hospital. Then, we formulated unified an admission principle and incorporated it into the systematic management and control, made a short instructional video for rolling show in the centre so as to let the patient know basic conditions of this hospital before admission; and regulated the admission process for patients’ convenience. Results After more than one year, the centre simplified the in-patient admission procedures, regulated the process, saved nursing manpower (24 persons), and increased patients’ satisfaction (from 89.30% to 93.25%). Meanwhile, the bed use rate was increased and the average length of stay was shortened the to some extent, which improved the order in wards. Conclusion Unified bed use management centre established in large-scale integrated hospitals, can save nursing manpower, simplify the admission process of patients, and meet the need for the development of hospitals, which is worthy of promoting application.
ObjectiveTo explore the distribution of multidrug resistant organism in neonates admitted to the hospital through various ways, and analyze the risk factors in order to avoid cross infection of multidrug resistant organism in neonatology department. MethodsA total of 2 124 neonates were monitored from January 2012 to July 2013, among which 1 119 were admitted from outpatient department (outpatient group), 782 were transferred from other departments (other department group), and 223 were from other hospitals (other hospital group). We analyzed their hospital stays, weight, average length of stay, and drug-resistant strains, and their relationship with nosocomial infection. ResultsAmong the 105 drug-resistant strains, there were 57 from the outpatient group, 27 from the other department group, and 21 from the other hospital group. The positive rate in the patients transferred from other hospitals was the highest (9.42%). Neonates with the hospital stay of more than 14 days and weighing 1 500 g or less were the high-risk groups of drug-resistant strains in nosocomial infection. Drug-resistant strains of nosocomial infection detected in the patients admitted through different ways were basically identical. ConclusionWe should strengthen screening, isolation, prevention and control work in the outpatient neonate. At the same time, we can't ignore the prevention and control of the infection in neonates from other departments or hospitals, especially the prevention and control work in neonates with the hospital stay of more than 14 days and weighing 1 500 g or less to reduce the occurrence of multiple drug-resistant strains cross infection.
Objective To retrospectively analyze the 420 fractured inpatients in the People’s Hospital of Deyang city seven days after the Wenchuan earthquake, so as to provide reference for the improvement of emergency plans earthquakes and the subsequent treatment of fracture patients. Methods The analysis was based on the data provided by the Department of Orthopedics of the Hospital up until July 18,2008. The software Microsoft EXCEL was used for data input, and SPSS 13.0 was used for statistical analysis. Results Up to July 18 420 cases from the disaster area have been treated in the department of orthopedics, including 176 men (41.9%) and 244 women (58.1%), the age was from 1 to 102 years and a median age of 43 years (2 761) among the inpatients. Most patients(328 cases) were sent to the hospital within the first three days after the quake (78.1%), and the number of inpatients were 92 4-7 days after the quake. The wounded were mainly from Mianzhu,Shifang , and Guanghan. The admission fracture diagnoses were tibial fractures (18.8%), fibular fractures (16.6%), and femoral fractures (14.9%). The major treatments were splinting, plaster fixation, or traction for closed fractures (301 cases), internal fixation or external fixation for malreduction (85 cases), and debridement suture and plaster fixation for open fractures (78 cases). Conclusion It is a vital to develop an emergent plan for fracture patients after an earthquake disaster and to strengthen the reserve of medical supplies, personnel training, and individual therapy.