Objectives To compare the differences of the medical charity donations between at home and abroad in West China Hospital of Sichuan University, so as to provide the evidence for the management and development of medical charity in West China Hospital and China. Methods A cross-sectional study was conducted to investigate and analyze the current situation and problems of the medical charity donations at home and abroad in West China Hospital from January 2005 to December 2006. Results The total amount of the charity funds at home and abroad was 2.043 mill ion and 14.6 mill ion, respectively. The main target diseases of domestic donation were tumor, hematologic disease, dangerous and severe diseases and congenital heart disease, which accounted for 43.3%, 35.9%, 15.8% and 1.0%, respectivley. While the main targeted interventions and diseases of overseas donation were hearing rehabilitation, prosthetic replacement, cataract and congenital heart disease, which took up 52.1%, 27.4%, 13.7% and 6.8%, respectively. Conclusions There are differences in the amount of charity funds, target diseases, behavioral motivations, organizations, objectives and criteria of the charity donation between the donations at home and abroad. It would probably cause the problems in recruitment, distribution and monitoring of the charity funds. It is suggested that the hospital management committee of charity funds and the related law to regulate the charity behaviors should be developed.
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.
Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
Hospital-based health technology assessment (HB-HTA) refers to the practice of health technology assessment for hospital management decision-making based on the actual situations in hospitals. It includes processes and methods of health technology assessment carried out in and for hospitals. Under the background of comprehensively promoting the reform of public hospitals in China, HB-HTA is undoubtedly an important scientific method to enhance the fine management of public hospitals and implement the policy of medical reform. This paper introduced the concept, the international and domestic development status, the characteristics of HB-HTA, and put forward the scheme of development of HB-HTA macroscopically, so as to promote the popularization and applications of HB-HTA in China.
Objective To compare and analyze hospital operation and management models between China and foreign countries, in order to provide reference and guidance for the continuous improvement of hospital management in China. Methods The NVivo software was used to conduct a qualitative comparative analysis of domestic and foreign literature on hospital operation and management models in China National Knowledge Infrastructure, Wanfang, Web of Science, and PubMed until December 2022, and a model for the differences in operation and management between Chinese and foreign hospitals was further constructed. Results Finally, 33 Chinese literature and 21 English literature were selected as the raw materials for NVivo qualitative analysis. A comparative analysis of the operation and management models of Chinese and foreign hospitals from four dimensions: structure, process, results, and continuous improvement showed that there were differences in operation and management systems, talents, processes, finance, refinement, and innovation between Chinese and foreign hospitals. Conclusion Hospital operation and management needs to be deeply integrated with business work, improve the construction of hospital operation and management system, strengthen the competence of operation talents, pay attention to resource cost-benefit analysis, attach importance to the two-way integration of business and finance, optimize the adjustment of operation and management structure, and attach importance to the innovation drive of new technology application, in order to promote the scientific, standardized, refined, and informationalized level of hospital operation and management.
ObjectiveTo evaluate changes in operational effectiveness after the implementation of ambulatory surgical management in pars plana vitrectomy (PPV). MethodsA retrospective clinical study. 17 528 surgeries in 10 895 eyes of 10 895 patients who underwent minimally invasive PPV on an ambulatory and/or inpatient basis at Tianjin Medical University Eye Hospital from August 2015 to June 2023 were included in this study. Among them, 5 346 eyes in 5 346 cases were male; 5 549 eyes in 5 549 cases were female. The age ranged from 0 to 95 years, with the mean age of (57.74±13.15) years. 6 381 surgeries in 3 615 eyes from August 2015 to December 2018 (the initial period of day surgery) were used as the control group; 11 147 surgeries in 7 280 eyes from January 2019 to June 2023 (the expanded period of day surgery) were used as the observation group. According to the management mode of ambulatory surgery, the observation group was subdivided into the decentralized management group (January 2019 to December 2020) and the centralized management group (January 2021 to June 2023), with 2 905 and 4 375 eyes and 4 646 and 6 501 surgeries, respectively. Changes in the percentage of day surgery, average hospitalization days, and average unplanned reoperation rate were compared. The Mann-Whitney U test was used to compare numerical variables between groups; the chi-square test or Fisher's exact test was used to compare categorical variables. ResultsThe number of cases of daytime PPV performed in the observation group and control group was 7 852 (70.44%, 7 852/11 147) and 24 (0.38%, 24/6 381) cases, respectively, and the average hospitalization days were 1 (1) and 5 (3) d. Compared with the control group, the observation group had a significantly higher percentage of day surgery (χ2=8 051.01) and a considerably lower mean hospitalization day (Z=4 536 844.50), and the differences were statistically significant (P＜0.000 1). The mean hospitalization days in the decentralized and centralized management groups were 2 (3) and 1 (0) d, respectively, and unplanned reoperations were 34 (0.73%, 34/4 646) and 171 (2.63%, 171/6 501) eyes, respectively. Compared with the decentralized management group, average hospitalization days was significantly lower (Z=1 436.94) and unplanned reoperation rate was significantly higher (χ2=54.10) were significantly lower in the centralized management group, both of which were statistically significant (P＜0.000 1). ConclusionPPV ambulatory management model can significantly reduce the average hospitalization day, but also results in higher rates of unplanned reoperations.
Objective To understand the outpatients, evaluation and demands of the real-name registration system. To implement the new medical reform program deeply. Methods We used the questionnaire named registration questionnaire of West China Hospital designed by ourselves to survey the outpatients and their family members and were filled in the questionnaire by themselves. Results Firstly, real-name registration system in West China Hospital made major contribution to alleviate the difficulties of registration and medical treatment. It achieved a major breakthrough and created a good social benefit. Secondly, patients the most favourite way of registration was by phone. They were satisfied with the platform of the social welfare services very much. Thirdly, the number of appointment registration arrived year by year, while the number of the day registration fell year by year. Conclusion Firstly, we innovate the form of the realname registration system, refine service and do scientific management at the needs of the patient-oriented. Secondly, we strengthen the track of the failure of appointment registration and analyze the causes. We should take measures timely to reduce the rate of the event and improve the real-name registration system. Thirdly, we strengthen the management of the out-patient doctor visiting program and credit services, to improve medical compliance rate and protect the interests of the patients. Fourthly, we explore a scientific research of out-patient real-name registration system to establish a modern hospital out-patient services model.
This article conducts a mid-term evaluation of the implementation effect of the “West China-Chenghua Urban Area Medical Service Alliance” from 2016 to 2019 based on structure-process-outcome model. The structure of the alliance included five organizational sections, including the leadership group, West China departments, grassroots organizations, information platforms, and residents and health fan teams, aiming to provide integrated, homogeneous, and accessible medical services centered on residents’ health. The process of the alliance mainly included the joint reforms led by the “combination of government and hospital” and the management mechanism of “politics-people-medicine-network” four links. Alliance performance: in terms of grassroots services, the number of diagnoses and treatments increased, the number of diseases received increased, and the homogenization of test was initially achieved; in terms of grassroots training, several high-quality community doctors were trained, and the number of talents introduced increased; in terms of grassroots scientific research, 3 large-scale scientific research projects were undertaken and 4 articles were published in national-level publications; in terms of grass-roots awards, 5 honorary titles at national, provincial, and municipal levels were gained, and award-winning “zero” breakthrough in national skill competitions and academic conferences was achieved; in terms of alliance satisfaction, the employees in primary medical institutions and West China Hospital of Sichuan University and the residents in Chenghua District were all had high degree of satisfaction. The alliance has achieved innovation in management and services, and the employees and residents are highly satisfied, which is conducive to promoting the realization of the homogeneity of regional medical service capabilities. However, the salary system and capacity improvement of grassroots medical staff should be further explored.
Hospital incident command system is a series of management systems for emergencies response of hospitals from the United States. Some hospitals in many countries have applied this system, but it has not yet been applied in China. In the process of responding to the coronavirus disease 2019 epidemic, West China Hospital of Sichuan University managed coronavirus disease 2019 patients through a standardized and programmatic model using the concept and framework of hospital incident command system, which included organizing hospital incident management team, carrying out incident action plan, space management, personnel management, material management and information management, in order to carry out standardized and procedural crisis response. This article introduces these management measures of West China Hospital of Sichuan University, aiming to provide a reference for establishing a more complete hospital emergency management system in line with China’s system in the future.
Patient priority evaluation has been studied and applied abroad for a long time, which is a mature theory and widely used in practice now. This article uses the priority, patients, waiting list and criteria as keywords to search Wiley Inter Science, Web of Science, Scopus Pub Med, The Cochrane Library, Science Direct, Springer, and Jstor database (searching time is up to December 2017), to collect relevant indicators for patient admission priority evaluation. In addition, relevant citations and grey literature were searched, and experts from relevant fields in China were consulted to obtain more comprehensive research literature. On this basis, this article describes the concept of patient admission priority evaluation, and describes the meanings of the indicators and the countries of application from the three dimensions of clinical indicators, expected results, and social factors. It is considered that the research and implementation of the evaluation of the priority of patient admission has been relatively many. However, there are only a few related researches in the country and without unity. There is no systematic patient-related priority evaluation. It is necessary to use foreign mature theory research to establish a hospital admission priority evaluation system suitable for China’s national conditions.