Objective To explore the research progress of the multimodal clinical support system (CSS). Methods With recognized development and operation of the multi-model CSS, and compared to the traditional CSS, to explore the research progress of the multimodal CSS. Results Based on the realization of the concept, purpose and characteristics of the multimodal CSS, it has been known that the international research progress of the multimodal CSS. Conclusion The developing and evolving of the CSS model have offered a new assist to the multi-disciplinary treatment model, and have enhanced the improving system associated with the practice of evidence-based medicine. However, the application of clinical support system program (CSSP) in our country still needs more research.
In the context of actively coping with aging, China has introduced a series of health care integration policies. Using the advocacy coalition framework theory, this paper aims to analyze the process of health care integration policy changes in China from three dimensions: policy beliefs, external events and policy learning. The policy subsystem of health care integration in China includes two coalitions: top-down cascade promotion and bottom-up absorption and radiation. External events and policy learning triggered policy change, where policy learning included endogenous learning within the coalition and exogenous learning between the coalitions. A policy impasse occurs when the two advocacy coalitions are at odds, and policy brokers and professional forums can get rid of the policy impasse. In the process of policy change in China’s health care integration, the two major advocacy coalitions have reached a certain consensus. It is recommended to alleviate the problems in the integration of health care by strengthening the external factors in the change of health care policy, enhancing the policy learning in the change of health care policy, and making full use of the information resources in the change of health care policy, so as to promote the high-quality development of the integration of health care.
In Shaanxi, some medical institutions especially the primary medical institutions, have outstanding problems such as unbalanced and inadequate development of infection prevention and control efficiency. The concept, knowledge and attention of infection prevention and control of the medical institution managers need to be improved. With the strong support of the health administration department, the Infection Control Professional Committee of Shaanxi Provincial Preventive Medicine Association has given full play to its functions and explored innovative service models for infection prevention and control in recent years. This paper is written to share the measures and achievements for building a multi-dimensional leadership improvement platform to improve the infection prevention and control ability, aiming to offer a reference for other medical institution managers and infection prevention and control professionals.
To attend the Patient Safety Summit of UK Presidency of the EU 2005, learn and share ideas with each other, participate in discussing and developing the vision and mission as well as goals for patients for patient safety program, seek the common interest for further cooperation so as to help promote the activities on patient safety in healthcare in China.
ObjectiveTo analyze the application status and existing problems of value stream mapping (VSM) in improving medical services at home and abroad, so as to provide decision evidence for hospitals to apply VSM to improve medical services.MethodsUsing “value stream mapping” and “value stream” as search terms, we searched PubMed, Embase, China National Knowledge Infrastructure, CQVIP Journal Database and Wanfang Database (2009-2019), and collected relevant literature on the application of VSM to improve medical services at home and abroad. We conducted bibliometric analysis after confirming the literature according to the inclusion criteria. The standardization of application of VSM was also evaluated.ResultsOf the 299 articles retrieved, 13 studies fulfilled the inclusion criteria. The publication time of the literature was distributed between 2013 and 2019. Of the 8 foreign articles included, the regions to which the first author belonged were 4 in the United States, 1 in Ireland, Norway, Lebanon and Indonesia respectively. Of the 5 included domestic articles, the regions to which the first author belonged were 2 in Zhejiang and Shanghai respectively, and 1 in Guangdong. Of the foreign literature, 5 articles did not clearly state the sample size observed when drawing VSM, 5 articles incomplete drawing elements of VSM, and 3 articles did not show VSM. Of the domestic literature, 2 articles did not clearly state the sample size observed when drawing VSM, 3 articles had incomplete drawing elements of VSM, and 1 article did not show VSM.ConclusionsVSM is relatively more used in high-income and upper-middle income countries. The medical service improvement issues for which VSM is applied are relatively single. The standardization of the application of VSM in domestic and foreign literature needs to be improved overall.
This paper introduces the concept, characteristics, similar concepts, system of knowledge, theoretic model and typical example of improvement science in health care sector, and analyzes a project of quality improvement in order to demonstrate the practical implication. It attempts to provide evidence and reference for future relative studies.
Objective To systematically review the prevalence of depression and anxiety among health care workers in designated hospitals during the COVID-19 pandemic. Methods The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect cross-sectional studies on the prevalence of depression and anxiety among health care workers from December 2019 to April 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. Results A total of 21 cross-sectional studies were included, involving 38 372 participants. Meta-analysis results showed that during the COVID-19 epidemic, the prevalence of depression and anxiety among health care workers in designated hospitals were 31.00% (95%CI 0.25 to 0.37) and 44.00% (95%CI 0.34 to 0.53). The results of subgroup analysis showed that individuals of female, married, bachelor degree or above, nurses, junior professional titles, and non-first-line medical staff had higher prevalence of depression and anxiety. Conclusions During the COVID-19 pandemic, the incidence of depression and anxiety among health care workers in designated hospitals remain high. Therefore, more attention should be paid to the mental health of health care workers in designated hospitals. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verify the above conclusions.
ObjectiveTo explore the comprehensive hospital administrative management system for urban and rural cooperation in the process of medical reform. MethodsBy reviewing literature and interviewing directors of the administrative departments and hospital medical staff, we gradually established and improved the administrative management system for urban and rural hospital counterpart support. ResultsBetween 2010 and 2013, 123 medical workers were dispatched to support eight county-level hospitals, after which the comprehensive capacity, and technology and quality control in those hospitals were largely improved. Till the end of 2013, two of those hospitals were promoted to be grade-three class-B comprehensive hospitals; two were promoted as grade-two class-A comprehensive hospitals; three passed the reassessment to be grade-two class-A comprehensive hospitals; and another three county-level medical centers were promoted to be city-level key disciplines. ConclusionThe comprehensive administrative management system improves the management level of grass-roots hospitals at the county level; promotes the social public welfare of tertiary public hospital counterpart support; facilitates the process of medical system reform at the county level; establishes a series of administrative management modes such as unified support, personnel management, assessment standards and evaluation system; and promotes the sustainability of long-term counterpart support system.
Objective To describe the range of Public-private partnerships (PPP) in the provision of healthcare services, and how the authors have assessed these partnerships. Methods We searched 19 international electronic databases and 3 grey literature databases up to September 2008. Nine websites of relevant organizations and Google were searched for any missing information. Search terms were determined by both health policy experts and search specialists after repeated discussion and pilot searching. Our inclusion criteria were research papers that reported describing or evaluating any public-private partnerships in provision of healthcare services. Two reviewers independently screened, appraised and extracted the data, and disagreements were resolved by discussion or by consulting a third researcher. The studies that scored A or B in terms of quality assessment were analyzed. Results Of the 38 studies included in the analysis, 22 studies aimed to describe strategies, while 16 ones were to evaluate the effectiveness of strategies. The targeted populations were tuberculosis patients, AIDS patients, psychiatric patients, community residents and children. Six partnership mechanisms were categorized: ① formal/ informal contract; ② working group committee; ③ supervision, training and regulation; ④ support and subsidizing; ⑤ integration of health care organizations; and ⑥ co-location. Most of the studies evaluating effectiveness were observational studies. Only three studies were comparative studies, pre- and post- intervention. The results of the most evaluation studies showed that PPP had positive impact on service provision, while it also had some problems and challenges. Conclusion Current studies show that PPP could improve health service provisions to some extent. There are limitations in the range of health services and the depth of the studies, especially evaluation studies that lack rigorous design. However, people should be cautious when they try to learn from the experience from internationally successful PPPs and consider the Chinese context, as the effect of PPP is closely associated with the relevant implementation context.