Objective To summarize and analysis the working experience of healthcare performance evaluation and reporting experience in local health administration department of Australia, and provide decision support to China on such work as establishing objective, scientific, effective healthcare performance evaluation system, strengthening government’s supervision over health service and improving healthcare system management efficiency. Methods Searching official networks and databases of Australia, and finding out relevant policy, reports, and documents on healthcare performance evaluation. Results Typical healthcare performance evaluation systems in Australian are as follos: National Health Performance Framework (NHPF), the National Healthcare Agreement（NHA）and Review of Government Service Provision. Conclusions These programs in Australian is enlightening to these work in China that performance evaluation should be the prior tool in health system to management and reform, the performance measurement indicators systems should emphasize the quality safety and health fair.We should set up scientific and flexible index inclusion criteria and open report and compare performance information.
ObjectiveTo measure and evaluate the economic burden of hospital infection in Sichuan, and provide a basis for targeted economic evaluation of healthcare-associated infection (HAI).MethodsIn hospitals participating in the 2016 Sichuan provincial prevalence survey of HAI, matched cases were used to extract cases and controls, and then a multi-center nested case-control study was conducted.ResultsA total of 225 pairs/450 patients were selected in 51 hospitals, and 175 pairs/350 patients were successfully matched. The median of the difference of hospitalization costs between matched-pairs were RMB 3 362.0, and the difference was statistically significant (Z=3.275, P<0.001).ConclusionsThe hospitalization costs caused by HAI should be given special attention in the current medical insurance reform. Efforts need to be taken to reduce the hospitalization costs caused by HAI.
Objective To investigate the values of pneumonia severity index ( PSI) , CURB-65,plasma procalcitonin ( PCT) , C-reactive protein ( CRP) measurements for evaluation the severity of healthcare-associated pneumonia ( HCAP) .Methods A retrospective observational study was conducted on 92 hospitalized patients with HCAP admitted between June 2010 and December 2011. They were divided into different groups according to different severity assessment criteria. The variance and correlation of PCT,CRP,WBC and percent of neutrophil ( Neu% ) levels were compared among different groups. ROC curvewas established to analyze PSI, CURB-65, PCT and CRP levels for predicting the motality of HCAP patients.Results In the severe HCAP group, PSI and CURB-65 scoring and serum PCT, CRP, WBC, Neu% levels were significantly higher than those in the non-severe HCAP group( P lt; 0. 05) . In the high-risk HCAP group, PCT, CRP, WBC and Neu% levels were significantly higher than those in the low-risk HCAP group according to the PSI and CURB-65 scoring criteria( P lt;0. 05) .WBC and Neu% levels were also significantly higher than those in the moderate-risk group. PSI and CURB-65 scoring were positively correlated with PCT and CRP levels. PSI scoring gt;120 points or CURB-65 scoring gt;2 points on admission were predictors of mortality. Conclusions PSI and CURB-65 scoring are correlated with severity of HCAP. Combining serum PCT and CRP levels can improve the predictive accuracy of the severity of HCAP.
With the continuous development of medical technology, ambulatory surgery or day surgery is becoming a new and very efficient medical service model in China. However, infection prevention and control in ambulatory surgery center has not yet attracted the attention of infection control practitioners. This paper analyzes the necessity, status quo, and entry point of infection prevention and control work in ambulatory surgery centers. Recommendations in the field of risk assessment, engineering control, behavior management, surveillance, and antimicrobial stewardship are provided to infection control practitioners as well.
Objective To investigate the situation and related factors of influenza vaccination among healthcare workers in Sichuan, and provide a basis for the formulation of the strategy of influenza vaccination. Methods From August 1st to August 6th, 2022, healthcare workers from 21 prefectures and cities in Sichuan province were selected by the hospital infection quality control centers to conduct an online questionnaire survey for status and related factors of influenza vaccination. Single factor analysis of vaccination rate was carried out by χ2 test, and the related factors of influenza vaccination were analyzed by binary multiple logistic regression model. Results A total of 3264 copies of questionnaires were distributed, and 3244 valid copies were recovered, with an effective recovery rate of 99.4%. The vaccination rate of influenza vaccine in the surveyed healthcare workers was 56.9% (1846/3244). The gender, age, professional title, position, department, hospital type, hospital nature, hospital level, influenza awareness, and influenza vaccination willingness were the factors resulting in statistically significant differences in influenza vaccination rate among healthcare workers (P<0.05). Binary multiple logistic regression indicated that age≥35 years old [odds ratio (OR)=0.799, 95% confidence interval (CI) (0.681, 0.937), P=0.006], the educational background being bachelor degree or above [OR=1.221, 95%CI (1.036, 1.439), P=0.017], position [nurses vs. doctors: OR=1.339, 95%CI (1.112, 1.612), P=0.002; technicians vs. doctors: OR=1.849, 95%CI (1.278, 2.676), P=0.001], the hospital type being specialized hospital [OR=1.804, 95%CI (1.446, 2.251), P<0.001], hospital level [secondary vs. primary hospitals: OR=0.344, 95%CI (0.271, 0.437), P<0.001; tertiary vs. primary hospitals: OR=0.526, 95%CI (0.413, 0.671), P<0.001], influenza awareness [fair vs. poor: OR=1.262, 95%CI (1.057, 1.508), P=0.010; good vs. poor: OR=1.489, 95%CI (1.142, 1.940), P=0.003], vaccination willingness [OR=4.725, 95%CI (4.009, 5.569), P<0.001] were related factors of influenza vaccination in healthcare workers. The influenza awareness was good in 416 healthcare workers (12.8%), fair in 1989 (61.3%), and poor in 839 (25.9%). The correct rate of influenza vaccination frequency was the highest (82.7%), while the correct rate of influenza contraindication was the lowest (3.2%). Among the healthcare workers, 2206 (68.0%) were willing to be vaccinated, of whom 1548 (70.2%) believed that they could protect people with weak immune function around them after vaccination; 1038 were unwilling to be vaccinated with influenza vaccine in the near future, of whom 335 (32.3%) believed that they had strong immunity and did not need to be vaccinated. Conclusions The influenza vaccination rate of medical staff is related to a variety of factors. Strengthening the publicity and education, and encouraging hospitals to provide free influenza vaccination, especially the correct understanding of contraindications, may be helpful to improve the vaccination rate.
ObjectiveTo comprehensively evaluate the essential public health service in Xinjin county of Chengdu from 2009 to April 2011, so as to provide evidence for improving primary healthcare system reform in Chengdu city. MethodsThe data was collected from the Xinjin county-wide health information system. The electronic health records, chronic disease management, childbirth management and mental health were quantitatively described and compared. Resultsa) In 2010, 88 772 residents had the physical examination and health assessment, among which, 14 497 (16%) were detected with some health problems. The average cost per positive detection was RMB 122.5 yuan. b) Up to April 2011, 98.2% of people in Xinjin county have their health records but the proportions were ranged from 68.08% to 109.02% in different primary healthcare providers. The details of the most health records were incomplete. c) 7 318 patients with hypertension and 2 187 diabetes mellitus were detected, and among them, 90.1% of patients with hypertension and 95.1% of patients with diabetes had their health records for chronic diseases management. d) The rate of stillbirth or neonatal mortality was lower than 4‰. There was no maternal death in the 8 years. But the cesarean section rate was about 61%. e) 97.3% of the patients with mental disorders were supervised in 2010, which was reduced by 2.7% compared to 2009. Conclusionsa) There is low proportion of all the residents in Xinjin having physical examination and health assessment and the rate of diseases detection is low as well. b) There is very wide coverage of health records for residents in Xinjin county, nearly universal coverage. c) The health records for the chronic disease patients were well-established, but the early detection rate of the chronic diseases is low. d) High proportion of the patients with mental disorders is supervised. e) The strategy that only county-level hospitals could provide obstetrical service instead of township hospitals is successful to reduce the neonatal mortality and maternal mortality. However, the cesarean section rate is high. f) It acts, to some extent, as a model to successfully improve the essential public health service and management based on the conuty-wide healthcare information system. However, the data quality, data mining and data utilization should be further improved
With nearly four decades of progress in healthcare-associated infection prevention and control in China, the national quality control efforts in this field have been ongoing for the past ten years, advancing rapidly with significant achievements. Over the last decade, the team of infection control professionals involved in quality management and control in China has consistently expanded, accompanied by an enhancement of their skills. Management capabilities have steadily grown, and operational mechanisms have been continuously refined. As public hospitals transition into a new phase of high-quality development, emphasizing refined management models and intrinsic development of medical quality, it becomes crucial to further fortify the foundation and foster innovation in infection control work to ensure quality. This article provides an overview of the establishment and implementation of the National Center for Quality Control of Infection Prevention and Control, examines the current shortcomings and challenges in the field, and collectively explores the positioning and direction of the development of quality control efforts for infection prevention and control in China.
This paper expounds the classification and characteristics of healthcare-associated infections (HAI) surveillance systems from the perspective of the informatization needs of HAI monitoring, explains the determination requirements of numerator and denominator in the surveillance statistical data, and introduces the regular verification for auditing the quality of HAI surveillance. The basic knowledge of machine learning and its achievements are introduced in processing surveillance data as well. Machine learning may become the mainstream algorithm of HAI automatic monitoring system in the future. Infection control professionals should learn relevant knowledge, cooperate with computer engineers and data analysts to establish more effective, reasonable and accurate monitoring systems, and improve the outcomes of HAI prevention and control in medical institutions.
Objective To explore an AI-based method for automated hand hygiene monitoring and to compare the effectiveness of three algorithms (UniFormerV2, TDN, C3D) in recognizing hand hygiene steps in surgical settings, thereby aiding hospital infection control. Methods From April to October 2024, we non-invasively collected 641 video recordings of healthcare staff performing hand hygiene at four-bay scrub sinks in two tertiary hospitals using overhead HD cameras. The dataset was annotated by five trained experts for model training and validation. Results Following training on 385 samples, internal validation (n=119) showed the C3D model achieved 81% accuracy, 87% recall, and an 83% F1-score. The TDN model achieved 93%, 91%, and 92% for the same metrics. The UniFormerV2 model outperformed both, with an accuracy, recall, and F1-score of 93%—an improvement of over 10 percentage points compared to traditional CNNs (TDN, C3D). It also achieved an 84% accuracy in external validation, demonstrating strong generalization. Conclusion The UniFormerV2 model is more accurate than CNN-based models for hand hygiene step recognition and shows robust performance in external validation. It presents a viable tool for healthcare facilities to enhance hand hygiene management, ultimately improving medical quality and patient safety.
This article introduced the structure and features of the medical safety and quality management system of New South Wales (NSW) of Australia. The system was funded by government with overall design, multi-sectors involvement, and explicit roles of government, hospitals, and independent third parties. The system also developed national and state-wide regulations, policies, standards and their certification. The NSW Health Incident Information Management System (IIMS), the guidelines and interventional programs were also established to decrease the medical risk and ensure the healthcare quality. This system will be used for reference to the national medical risk and quality management system of China.