Platform daytime chemotherapy means that the hospital sets up a fixed area for daytime chemotherapy, and all patients with daytime chemotherapy are treated in the same area. The platform daytime chemotherapy center has the advantages of further optimizing the limited hospital resources, reducing the consumption of medical resources, and improving the efficiency of bed use and patient satisfaction. Its construction is the further sublimation of tumor treatment concept, harmonious relationship between doctors and patients, and humanistic care. This article shares the construction experience of the platform daytime chemotherapy center from the definition, orientation, operation mechanism, ward configuration, drug access, patient access and management mode, and puts forward suggestions that the promotion of the platform daytime chemotherapy center should be carried out from the aspects of policy support, hospital vigorously promoting and self-management breakthrough.
This article outlined the background and the concept of health decision support system (HDSS), discussed its application status in medical service, hospital management, public health management and other fields in the following four developed countries: United States, UK, Canada and Australia. It also introduced the main functions of MYCIN, CPOE, DHCP, Panorama etc., and summarized the above four countries’ successful experiences, including, actively promoting the application of decision support technology in health field through closely combining with the practical needs, valuing evidenced-based resources development and repository research, making scientific health policy to guide the orderly development of decision support systems, and strengthening the construction of E-health infrastructure and core systems, in hopes of providing reference for the development of health decision support system in China.
ObjectiveTo understand the experiences of out-patient services of the elderly patients, and to analyze the impact factors of the satisfaction of elderly patients, so as to produce evidence for healthcare quality improvement. MethodsBased on the data collected from the out-patient survey of the 2015 Evaluation of the National Healthcare Improvement Initiative, we compared the disparities of patient satisfaction among different age-groups, between different geographic regions and different types of hospitals. We conducted multivariate binary logistic regression analysis to identify factors, associated with the satisfaction of the elderly outpatients. We also compared satisfaction of the Chinese elderly patients with healthcare services with other countries. ResultsSatisfaction scores of the Chinese elderly out-patients were statistically significant higher than that of the young and middle aged out-patients in the domains of hospital environment (satisfaction score=4.42), process efficiency (satisfaction score=4.20), and overall satisfaction (satisfaction score=4.47) (P < 0.001). On the contrary, the elderly out-patients were less satisfied in the domain of hospital informationization experience (satisfaction score=4.25) than the young and middle aged out-patients. This was also the case for the three indicators under this domain, including convenient appointment (satisfaction score=4.27), diversified payment methods (satisfaction score=4.24) and self-service devices (satisfaction score=4.26) (P < 0.001). Western region and traditional Chinese hospitals had significantly lower elderly outpatient satisfaction comparing with eastern and central regions, and general & specialist hospitals (P < 0.05). Trustful doctor-patient relationship (OR=3.45), respected and comfortable care (OR=1.45), clear and reliable mechanism and channel for praise and complain (OR=1.39), length of communication time with doctors (OR=1.35) and length of waiting time until consultation is acceptable (OR=1.29) were the major factors associated with the overall satisfaction of the elderly out-patients. The overall satisfaction of the Chinese elderly out-patients is a bit lower than that in our neighboring country Japan. The satisfaction towards length of communication with doctors of the Chinese elderly patients is lower than that in most of the industrialized countries. ConclusionSpecial demands of the elderly patients should be carefully considered by hospitals in the process of developing new appointment methods and hospital informationization with the aim of healthcare improvement. Longer communication time with doctors, shorter waiting time until consultation, improving human care and building efficiency mechanism and channel for praise and complain are the priorities for future healthcare improvement.
Objective To understand the effect and influencing factors of humanistic care on improving the experience of inpatients. Methods Patients were collected from a third grade class A women’s and children’s hospital in June 2015 and June 2016, and their satisfaction was investigated by a third party. The service items of Inpatients Satisfaction Item Score Table in 2015 were analyzed. Appropriate intervention measures were taken to low-score items, such as humanistic knowledge training to all medical staff, improvement health guidelines, implementation of recycling process, carrying out high quality nursing interventions, and so on. The patients satisfaction survey results in 2016 were compared with those of 2015. Results In 2016, the total satisfaction rate (89.94%), and the average score of items ranked the top three (94.64±0.14), including the level of medical technology, medical ethics and the overall evaluation of doctor’s professional ehtics, medical communication and service attitude, were higher than those of 2015 (85.25, 90.86±1.53). The average score of items ranked the last three (89.25±9.21), including hospital ward, hospital environment (clean, quiet and safe), hospital meals and room service, and hospital food quality, was higher than that of 2015 (78.64±2.40). However, compared with the same period in the last year, the rank of hospital environment fell by two places. Conclusions Hardware conditions like physical environment have an important impact on the experience of hospital patients. However, ?humanistic care is the key factor to improve the patients’ inpatient experience and satisfaction.
ObjectiveTo explore the psychological process and needs of the second victims of medical adverse events after the occurrence of adverse events, so as to provide reference for the psychological intervention strategies of medical institutions for the second victims of medical adverse events.MethodsThe second victims of medical adverse events in the First People’s Hospital of Ziyang were selected from April to July 2019. Qualitative research method was used to conduct semi-structured in-depth interviews with the second victims. Colaizzi method was used to analyze the transcripts through reading and rereading, coding, and thematizing. ResultsA total of 22 second victims of medical adverse events were interviewed. The second victims of medical adverse events experienced negative emotional experience, and the desire to seek emotional support was urgent. The psychological process of the second victims of medical adverse events mainly involved five stages: fear, anxiety, depression, guilt and recovery. Emotional support hada positive effect on regression. Conversely, negative or lack of emotional support had a negative effect on regression. ConclusionsThe emotional experience of the second victims of medical adverse events is relatively staged, and the recovery and regression are greatly affected by internal and external factors. Hospital administrators should take active measures and establish an emotional support mechanism for adverse events in order to reduce psychosomatic injuries and improve medical quality and efficiency.
ObjectiveTo sum up staging treatment experiences of hip preservation for avascular necrosis of the femoral head (ANFH) according to China-Japan Friendship Hospital Classification (CJFH Classification).MethodsThe literature about hip preservation of ANFH was extensively reviewed, and a staging treatment method for ANFH was set up base on CJFH Classification and the 28 years of clinical experience in this research group.ResultsAccording to CJFH Classification, the ANFH can be rated as types M, C, and L. And the type L is rated as L1, L2, and L3 subtypes. The staging treatment method for ANFH based on CJFH Classification is set up. Conservative treatment was selected for CJFH-M patients because the necrotic area is small and in the medial non-weight-bearing area. Minimally invasive sequestrum clearance, impacting bone graft, and supporting allogenic fibular graft is selected for CJFH-C patients because the necrotic area is also small and in the lateral non-weight-bearing area. If patients are in CJFH-L1, normal bone area is less than 1/3 on hip abduction radiograph, the sequestrum clearance and impacting bone graft via surgical hip dislocation approach can be selected. If patients are in CJFH-L1, normal bone area is more than 1/3 on hip abduction radiograph, the transtrochanteric curved varus osteotomy can be selected. The rotational osteotomy on the base of femoral neck via surgical hip dislocation approach is for CJFH-L2 patients. Total hip arthroplasty via direct anterior approach is for CJFH-L3 patients.ConclusionThe staging treatment method for ANFH according to CJFH Classification has good short-term effectiveness. But the long-term effectiveness needs further follow-up.
The coronavirus disease 2019 (COVID-19) epidemic has had a serious impact in the world. In the absence of vaccines and therapeutic drugs, disinfection has become an important technical means to block the spread of the virus. By analyzing the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we studied a series of disinfection technologies for COVID-19. During the outbreak of COVID-19, Jinan Second Center for Disease Control and Prevention disinfected the houses of the cases to be investigated in a community. The effectiveness of the disinfection technology was verified through the process of disinfection preparation, sampling before disinfection, field disinfection, sampling after disinfection and evaluation of disinfection effect. Compared the data before and after disinfection, the killing rate of the total bacterial colonies in the air and on the surface of the object was more than or equal to 90%, and no SARS-CoV-2 was detected after disinfection. The results show that the disinfection effect of the disinfection technology meets the standard. Finally, through the analysis of the wrong way of disinfection and the harm of over disinfection, the importance of scientific disinfection and precise disinfection are emphasized, and the research has a good guiding value for prevention and control of the epidemic.
ObjectiveTo explore the real experiences of women of childbearing age with epilepsy during their reproductive decision-making process, and to provide a basis for clinical practitioners in managing the reproductive decision-making of this group of women and implementing decision support. MethodsSixteen women of childbearing age with epilepsy who were hospitalized in the Epilepsy Center of Beijing Tiantan Hospital, Capital Medical Universityi in Beijing from April 2024 to June 2024 were selected through purposive sampling. The Colaizzi phenomenological data analysis method was employed, and the data were organized and analyzed with the aid of Nvivo 11.0 software to extract themes. ResultsThree themes and eight sub-themes were extracted: The majority of patients had reproductive demands (personal role expectations, family and social pressure), Uncertainties in reproductive behaviors and outcomes (uncertainties in the pregnancy process caused by the disease, uncertainties in the reproductive outcome caused by the disease), and Encountering reproductive decision-making predicaments (lack of professional knowledge, conflicting information from different channels, multiple factors influencing reproductive decision-making, and various negative experiences associated with decision-making). ConclusionThe majority of women of childbearing age with epilepsy have reproductive needs and encounter decision-making predicaments. Medical staff should pay attention to their true experiences, offer adequate support and assistance, and help patients extricate themselves from the decision-making predicament to make scientific and rational decisions.
Objective To integrate the falling experience and coping styles of stroke home patients with falls through Meta synthesis, summarize existing problems based on the integration results, and propose suggestions. Methods We searched databases including PubMed, Medline, Embase, Web of Science, etc., from database establishment to January 2023, to collect qualitative studies on stroke patients’ falling experience at home. The quality of included studies was evaluated by “JBI Australian Evidence-based Health Care Centre (2008) Qualitative Research Quality Assessment Criteria”. The results were integrated by integrating methods. Results A total of 6 references were included, and 18 clear research results were extracted. Similar results were summarized and combined to form 6 new categories, and integrated into 3 main themes. The integration results showed that stroke patients with falls had severe psychological problems, poor coping styles, and unmet needs for fall prevention, resulting in reduced social participation and exercise. Conclusions It is necessary to improve the content of fall assessment and provide corresponding fall prevention health education based on the assessment results. It helps stroke patients and caregivers at home to establish correct coping strategies, thereby avoiding the occurrence of falls.
Multi-disciplinary team (MDT) is a leading diagnosis and treatment model widely respected in modern international medical field, which plays an important role in clarifying disease diagnosis, determining treatment direction, and reducing patient time and labor cost. In recent years, China has issued relevant policies to encourage hospitals to vigorously develop MDT. West China Hospital of Sichuan University established a MDT clinic in 2013. Through continuous innovation and bold breakthrough in terms of experience accumulation, clinical resource integration, disciplinary collaboration and other aspects, the hospital breaks the barriers of MDT, timely helps complex severe diseases patients to solve the diagnosis and treatment needs, provides patients with the best personalized treatment plan, and continuously improves the medical experience of patients. Therefore, this article introduces and summarizes the implementation process and experience of MDT outpatient clinic in West China Hospital of Sichuan University.