ObjectiveTo investigate the effect of quality control circle (QCC) activity in reducing the temporarily stopping rate of day surgery.MethodsThe QCC activity was carried out from December 2018 to October 2019. By determining the theme of the activity and drawing up the plan, a retrospective analysis of pre-hospital day surgery stoppage status and reasons was performed based on 2 696 patients who had reserved surgery in the day surgery center from December 2018 to February 2019. Based on the data, the goal was determined, and measures were developed and confirmed from May to August 2019. Then the measures were standardized and implemented continuously from September to October 2019. The rate of surgical cessation before the implementation of the measures (from December 2018 to February 2019) was compared with that after the implementation of the measures (from September to October 2019).ResultsAfter the QCC activity, the temporarily stopping rate decreased from 2.89% to 1.34%, and the difference was statistically significant (P<0.001).ConclusionThe QCC activity can effectively reduce the temporarily stopping rate of day surgery, and lay the foundation for continuously promoting the optimization of day surgery resources and quality improvement.
ObjectiveTo explore the application of clinical pathway in patients undergoing orthopedic day surgery.MethodsPatients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2020 were selected as the clinical pathway group, and all of them were managed by clinical pathway. Patients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2019 were selected as the routine group, and all of them were managed by conventional clinical methods. The general conditions of patients, physicians’ work efficiency, medical costs and medical quality were compared between the two groups.ResultsThe clinical pathway group included 246 patients, and the routine group included 391 patients. There was no significant difference in gender, age or disease distribution between the two groups (P>0.05). Compared with the routine group, the clinical pathway group had obvious advantages in terms of average time spent by a physician in issuing a medical order each time [(5.64±3.29) vs. (2.12±1.05) min], average number of revisions per physician’s order (1.40±0.24 vs. 0.38±0.19), rate of filing medical records within 3 days (90.28% vs. 97.97%), hospital costs [(7462.10±1035.01) vs. (6252.52±1189.05) yuan], drug costs [(652.21±88.53) vs. (437.17±108.20) yuan], length of stay [(1.23±1.04) vs. (1.02±0.18) d] and delayed discharge rate (7.93% vs. 2.03%), with statistically significant differences (P<0.05). There was no significant difference between the two groups in terms of unplanned reoperation rate, unplanned rehospitalization rate, or patient satisfaction (P>0.05).ConclusionCompared with routine clinical management, clinical pathway management can improve work efficiency, reduce medical cost and improve medical quality more effectively in the implementation of orthopedic day surgery, which has very positive effects and is worthy of promotion and application.
ObjectiveTo improve the hand hygiene compliance in medical staff via quality control circle (QCC) activities. MethodsFrom January to May 2014, QCC activities were actualized throgh selecting the theme, ensuring the plans, confirming the target, investigating the actuality, validating the true reasons, finding out the countermeasure, ensuring the effect. ResultsHand hygiene compliance, accuracy rate handwashing, and awareness rate before the QCC activities was 53.02%, 65.51% , and 45.56%, respectively; while after the activities was 79.91%, 87.39%, 95.44%, respectively; the differences were significant (P<0.001). ConclusionQCC activities may improve hand hygiene compliance in the medical staff; at the same time, it can fully mobilize the enthusiasm of the medical staff , cultivate the spirit of teamwork , and promote quality improvement .
ObjectiveTo investigate the current situation of orthopedic quality control and management in county-level regional general hospitals in Guangdong, and to provide a scientific basis for further standardizing the procedures of orthopedic quality control and management in county-level regional general hospitals and continuously improving the work of provincial orthopedic quality control center.MethodsFrom June 2019 to July 2020, online and offline questionnaire survey and field survey were used to investigate the quality control and management of orthopedic departments in 22 county-level regional general hospitals in Guangdong.ResultsAmong the overall scores of the surveyed hospitals, the highest score was 96.5, the lowest score was 72.0. There were 6 hospitals with a total score of “excellent” (accounting for 27.3%). The “facilities and equipment” and “medical quality” of the surveyed hospitals were relatively valued. Taking Guangzhou, the capital of Guangdong as the center, the districts and counties were divided into the east, the south, the west and the north regions, and the difference in overall scores of orthopedics among the four regions was statistically significant (F=6.299, P=0.004). The unqualified rates of department setting, key technology development, average hospitalization days of representative diseases, equipment allocation, personnel allocation, department management and building layout were relatively high, which were 77.3%, 63.6%, 45.5%, 40.9%, 40.9%, 36.4% and 36.4%, respectively. Most hospitals had set up special debridement rooms in orthopedic department (95.5%), and the management and monitoring of the use of antibacterial drugs was mostly reasonable (90.9%). In terms of the level of orthopedic medical treatment, only 3 hospitals with sufficient key technologies reached the standard, accounting for 13.6%, and only 7 hospitals reached the standard of scientific research capacity, accounting for 31.8%. In terms of quality control, the numbers of hospitals with qualified medical record sampling (72.7%), perfect management and supervision mechanism (86.4%) and quality management team in departments (77.3%) were the least. In addition, among the investigated hospitals, beds were in short supply in orthopedic departments, with 12 hospitals accounting for 54.5% being deducted; 16 hospitals (72.7%) were deducted for unqualified doctor-patient ratio and 11 hospitals (50.0%) were deducted for unqualified nurse-patient ratio.ConclusionsThe overall level of orthopedics construction and management in the surveyed hospitals is uneven. The medical professional and technical level is insufficient. It is difficult to meet the practical needs, and there is an imbalance in the ratio of medical personnel. In the future, it is necessary to strengthen the quality control of orthopedic medical care, strengthen the medical technology training of county-level regional general hospitals and increase the medical and health resources and capital investment, so as to improve the quality control of county-level regional general hospitals.
ObjectiveTo investigate the application and effect of quality control circle (QCC) in the management of hand hygiene for nurses in hemodialysis center. MethodsQCC was applied in the management of hand hygiene in hemodialysis center from March 2013 to February 2014. Factors affecting the compliance and correctness of hand hygiene in hemodialysis nurses were analyzed, and counter measurements were established and applied. Moreover, effect of QCC management was also assessed. ResultsAfter the application of QCC, the compliance and correctness of hand hygiene in hemodialysis nurses increased significantly from 41.02% to 88.46% (P<0.05) and 46.88% to 91.30% (P<0.05), respectively. Moreover, maneuver application, team spirit, professional knowledge, communication and cooperation among nurses were also increased by QCC management. ConclusionThe application of QCC can not only increase the compliance and correctness of hand hygiene in hemodialysis nurses but also improve team cohesiveness, which is worth recommendation and promotion.
The American Thoracic Society Committee Task Force on Standards for Pulmonary Function had recommended a standardized reporting format for pulmonary function tests due to considerable variability in pulmonary function reports presented to end users, which might lead to potential confusion and miscommunication. This recommendation includes seven parts: overview, introduction, methods, report format, selecting and reporting reference values, grading the quality of pulmonary function tests and conclusions. This document presents a reporting format in test-specific units for spirometry, lung volumes, and diffusing capacity that can be assembled into a report appropriate for a laboratory’s practice. Recommended reference sources are updated, with especially emphasizing to adapt lower limit of normal (LLN) or z score instead of percent of prediction to estimate the abnormal results. This document provides detail and clear explanation on the recommendations, which might improve the interpretation, communication, and understanding of test results. However, parts of recommendation might not be used directly in our clinical practice owing to some specific conditions in China. We suggest to use appropriate normal predictions from Chinese population, to include small airway parameters such as mid-maximal expiratory flow for early detection of pulmonary function deterioration, and to include inspiratory flow volume curve, as well as strengthen the quality control data and figures in the report format.
ObjectiveTo improve activities of daily living (referring to Barthel Index) in the older inpatients.MethodsIn January 2016, a quality control circle (QCC) was established. According to 10 steps in activity of QCC, we figured out the causes of low Barthel Index score in older inpatients by using Plato method and Fishbone Diagram which were common methods of QCC. In addition, we designed and implemented a rectification program to improve Barthel Index score.ResultsAfter intervention of QCC, the average Barthel Index score of the older inpatients increased from 72.40±6.42 to 89.30±5.87 with a statistical difference (P<0.01); the satisfaction percent of hospitalized patients increased from 94.5% to 98.7% with a statistical difference (P<0.01). The percentage of registered nurses whose theoretical test score were over 90 increased from 57% to 88% (P<0.01) and the satisfaction percent of nurses increased from 90.5% to 95.6% (P<0.01). Moreover, the member’s ability of learning, discovery, analysis and problem solving, communication, application of QCC skills were improved.ConclusionThe application of QCC activities will increase older inpatients’ Barthel Index score, improve the satisfaction of patients and nursing staff, and enhance the members’ ability of solving problems by using QCC skills.
The scientific research on prevention and control of coronavirus disease 2019 (COVID-19) has been a major and urgent task, of which clinical trials occupy a pivotal position in the entire prevention and control system. 204 relative clinical trials of traditional Chinese medicine (TCM) have been registered on Chinese Clinical Trial Registry. Through the analysis of all online public protocols of registered trials, it is found that the clinical studies of TCM in China showed lack of research foundation, tight time and heavy tasks, difficult clinical implementation, and disturbance by changes of the epidemic status. Based on these characteristics, this paper put forward several thoughts and suggestions on the quality management and design improvement for clinical trials of TCM preventing and treating COVID-19, in order to improve the quality of clinical trials in China, provide effective supports for the public health decision-making on the epidemic, and also give a reference for the prevention and control of epidemics in the future.
Objective To evaluate the application effect of quality control circle (QCC) in improving the number of cases received in the follow-up management of chronic kidney disease (CKD). Methods The outpatient and inpatient CKD patients who were filed in the CKD follow-up management center of West China Hospital of Sichuan University from March 10 to October 10, 2020 were selected. We analyzed the reasons that affected CKD patients’ willingness to file by carrying out QCC, improved the case collection by establishing standardized processes, broadened the collection channels, established a collective team, strengthened training management and education of CKD patients and their families, so as to increase the number of cases received in CKD follow-up management. Then, we observed the score of active ability of QCC members before and after this activity. Results After the implementation of QCC activities, the number of follow-up cases increased from 8 per month to 15 per month. The target achievement rate was 140%, and the progress rate was 87.5%. The ability of all circle members in the evaluation indicators of team training has been improved. Conclusions QCC activity can effectively improve the number of cases received in CKD follow-up management. It is helpful for the medical staff to provide better disease management for CKD patients.
ObjectiveTo study the effect of quality control circle (QCC) on the improvement of Intensive Care Unit (ICU) nurses' engagement in working. MethodsModified Gallup's Q12 questionnaire was used to survey ICU nurses of our hospital before and after QCC was carried out, and then we compared the engagement scores. ResultsBefore and after QCC was carried out, ICU nurses' engagement scores were statistically significant (P<0.01). ConclusionQCC in the ICU is an effective way of improving ICU nurses' engagement, which is worth promoting.