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 improve the comprehensive service ability of the hospital, improve the satisfaction of medical care, implement the requirements of fine management, and enrich the connotation of hospital internal performance improvement.MethodsIn July 2017, based on the concept of approach-deployment-learning-integration, the internal performance improvement model of Children’s Hospital Affiliated to Fudan University was constructed to form a management closed loop.ResultsFrom 2016 to 2019, the average length of hospital stay was reduced from 6.90 d to 6.47 d, the patient satisfaction was elevated from 92.89% to 93.80%, the proportion of drugs was reduced from 35.25% to 30.44%, the proportion of materials was reduced from 23.35% to 18.55%, and the proportion of difficult operations of grade Ⅲ and Ⅳ was elevated from 66.98% to 67.68%.ConclusionThe improvement of key performance indicators depends on the implementation of external policies, the integration of scientific management elements, the cooperation of multiple subjects, and the construction of information system.
ObjectiveBased on the localization of resource-based relative value scale (RBRVS) in H Hospital, to implement a surgical performance management model reform with the main surgery as the core, and to construct a more scientific and fair surgical performance distribution system. MethodsA surgical performance management model with the main surgery as the core was constructed. Relevant data such as RBRVS, diagnosis related groups (DRG), case mixed index (CMI), and surgical time of 65 915 inpatient elective surgeries in H Hospital in 2023 were collected and organized. Large sample historical data analysis was conducted using SPSS software, and the rationality of the optimized surgical performance management model was verified through key indicators. ResultsThe total coefficient of multiple orders for surgery in the 22 departments included in the study was highly correlated with the main surgery coefficient (γ>0.85), and the matching coefficients for each specialty were significantly different (P<0.001). The surgical performance management model with the main surgery as the core showed a significant improvement in the key indicators (doctor’s time resource investment and surgical risk and difficulty). ConclusionBy implementing a surgical performance management model with the main surgery as the core, we aim to strengthen the performance orientation that reflects the risks and difficulty of diagnosis and treatment, as well as the value of doctor services. This will guide clinical practice to return to the essence of medicine, support the development of discipline construction, and further stimulate the vitality and motivation of clinical work.
Patient satisfaction is regarded as a key component of measuring and reporting quality of medical services. It is also an important indicator in performance appraisal for public hospitals in China. Based on the literature review on the theories and practices of patient satisfaction assessment in China and other countries and areas, this paper performed an in-depth analysis on the theoretical frameworks and instruments for patient satisfaction assessment, as well as their applications in management practices. Further research and improvements are needed.
ObjectiveTo evaluate the complete blood count performance quality of Sysmex-XN automatic hematology analyzer. MethodsWe investigated the precision rate, residual contamination rate, analytic linearity range, and background counting of Sysmex-XN-B3 analyzer. ResultsThe inner and inter-group precision test showed that the inaccuracy of the analyzer was lower than the allowable standard of 1/4 (CLIA'88). The highest level of residual contamination rate was 0.12%, lower than the standard of manufacturer (≤1%). Linearity evaluation showed that the white blood cell count analytic linear range was from 0.51×109/L to 393.40×109/L, the red blood cell count analytic linear range was from 0.51×1012/L to 8.15×1012/L, the hemoglobin analytic linear range from 15.0 g/L to 244.5 g/L, and the platelet count analytic linear range was from 3.0×109/L to 2 072.5×109/L. Background counting was also lower than the standard of manufacturer. Comparison between the two different series of analyzers showed that the inaccuracy rate of Sysmex-XN-B3 was not only lower than the standard of National Center for Clinical Laboratories, but also lower than the standard of 1/2 (CLIA'88). ConclusionSysmex-XN automatic hematology analyzer has a high performance in capability evaluation. It is an excellent tool for routine hematologic blood examination.
Objective To summarize and analyze the working experience of hospital performance evaluation and reporting system in America, so as to provide decision support to China on such work as establishing objective, scientific and effective hospital performance evaluation system, strengthening government’s supervision to health service, and promoting hospitals’ sound development.Methods American official websites and databases were searched to include relative policies, reports and documents on hospitals’ performance evaluation. Results Typical hospital performance evaluation and reporting system in America included National Healthcare Quality Report (NHQR), Consumer Assessment of Healthcare Providers and System (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS), Leapfrog Group Evaluation System and Thomson Reuters 100 Top Hospitals. Conclusion The enlightenments of American performance performance evaluation systems to China include: a) more attention should be paid to performance evaluation; b) combined evaluation models and results application methods should be considered; c) comparatively scientific evaluation methods and comprehensive evaluation contents should be established.
Regarding the working hours generated by clinical trial project services under the guidance of good clinical practice (GCP), taking the standard process of a cancer project screening period as an example, and relying on a standardized management model, this paper uses standard time measurement methods to calculate the standard time of the 12 regular tasks in the GCP project. On this basis, it analyzes the GCP project process in detail to find out the reasons for wasted performance hours, and proposes a series of improvement methods and suggestions, such as formulating and implementing a target assessment mechanism, developing standard format cards, using double-line operations research to carry out parallel operations, using quadrant method to divide tasks, using site management organization and resources of hospital departments to reduce coordination loss, and introducing big data management systems, so as to make the work process of clinical research coordinators more refined and professional.
ObjectiveTo investigate the distribution of human resources in primary healthcare system of Xinjin county in Chengdu in 2010, so as to provide the evidence for appropriate allocation of health manpower. MethodsWe collected the data of human resources in the regional health information and management platform, and the list of health workers and their registration information. Microsoft Excel 2003 and SPSS 13.0 software were used to analyze data. Resultsa) A total of 1 551 health workers were in Xinjin primary healthcare system in 2010, including 1 124 in tenure position (accounting for 72.5%) and 427 in contract (accounting for 27.5%). b) In county-level hospital (CLH) or community healthcare centre (CHC) or township hospital (TH), the proportion of health professionals were 83.2%, 79.0% and 80.0% respectively; and 28.8%, 27.2% and 28.7% for registered & assistant doctors; 39.3%, 22.7% and 16.2% for registered nurses; 6.7%, 8.3% and 4.7% for technicians; and 5.9%, 6.8% and 6.9% for pharmacists, respectively. c) Health personnel per 1 000 population in CLH, CHC, and TH were 3.10, 1.98, and 1.92, respectively; health professionals per 1 000 population were 2.58, 1.58, and 1.54, respectively; registered & assistant doctors per 1 000 population were 0.89, 0.54, 0.55, respectively; and registered nurses were 1.22, 0.45, 0.31, respectively. The nurse-to-doctor ratios were 1.36, 0.83, and 0.56 nurses per doctor in CLH, CHC, and TH, respectively. The bed-to-nurse ratios were 0.59, 0.38, and 0.19 nurses per bed respectively. d) Most health professionals were junior professionals (about 60%), in college-level education (about 50%), between 25 to 44 years old (20%-70%), work experience between 5 to 19 years (40%-63%). e) Temporary employees in TH accounted for 46.4%, among which 86.6% younger than 35 years old, 23.4% in internship, and 64.1% at clinical position. Conclusiona) The shortage of health personnel is very obvious in Xinjin county with inappropriate proportions of health professionals; b) The stability of health personnel is challenging due to the large proportion of temporary employees in THs; c) health professionals in Xinjin county features a younger population, and in lower professional positions; d)Therefore, the related policies should be adjusted and innovated to enhance the education and training, to maintain the stability of health personnel and to promote the healthy and sustainable development of primary healthcare services.
Objective To assess the public health impacts and needs, to evaluate performance of anti-epidemic efforts after Lushan earthquake, so as to provide references for the following anti-epidemic work. Methods The day of earthquake occurrence was defined as the first day after earthquake. We collected information and data from the Sichuan Provincial Government, the National Health and Family Planning Commission of the People’s Republic of China, the Health Department of Sichuan Province, Sichuan Center for Disease Control and Prevention, and then we compared the situations of disaster, public health situation in stricken area, emergency response, resource deployment, etc. with those after Wenchuan earthquake in 2008, in order to evaluate the performance of anti-epidemic response during 2 weeks, clarify current situations and demands, and offer a proposal for the following work. Results Emergency response was conducted immediately after the Lushan earthquake. The counterpart assistance was considered at the beginning of team arrangement. The number and professional structure of rescue participants were planned according to needs. Three days after earthquake, anti-epidemic staff arrived at every involved county, town, and even village, which achieved full rescue coverage of locations and interventions. The staff helped reconstruct disease surveillance system, protect source of drinking water and environmental hygiene, etc., which resulted in progressive achievement. Two weeks after the earthquake there were no outbreak and public health emergency event occurred in stricken area. Conclusion The anti-epidemic efforts after Lushan earthquake inherit and develop the lessons from Wenchuan earthquake in 2008. Emergency response is timely, orderly, scientific, and moderate. The deployment of policies, technologies and resources has already been completed during two weeks. Anti-epidemic efforts achieve preliminary results. We suggest that key issues of further work should be the implementation of policies, strategies and measures, such as health management at relocation sites, water and food hygiene, disease monitoring, prevention and control, mass vaccination, scientific disinfection, and health education, in order to improve long-efficacy mechanism and stabilize work performance.
In order to establish objective, scientific, effective performance assessment system and strengthen government’s supervision on health service in our country, this research retrieved literature on relevant official UK websites and databases to get the whole picture of NHS (National Health Service) performance assessment policy, documents and reports. Based on the introduction of NHS Performance Assessment Framework (1999), NHS Performance Assessment Framework: Implementation Guidance (2009) and NHS Performance Rating, it summarized and analyzed the experience and measures of NHS Performance Assessment, which enlightened us in the following aspects: a) We should pay more attention to the performance assessment of national healthcare system and spread out the relevant work in China; b) Performance assessment is closely linked with national health policy and its strategic focus; c) Performance assessment centers on quality; d) We should take performance assessment as a strategic tool to improve the healthcare system performance.