The national policy on high-quality development of hospitals proposes to strengthen information technology support and actively promote the multi-disciplinary team (MDT) model. How to use the “Internet Plus” technology and operation mode to promote MDT communication and improve the efficiency of diagnosis and treatment in the digital and intelligent information age is a direction worthy of attention and research. This paper systematically reviews the current development status of MDT informatization construction at home and abroad. Based on the current challenges and opportunities, it makes prospects for the future development of MDT informatization construction from the aspects of strengthening the digital and intelligent support of MDT operation, connecting MDT “information silos”, and deepening the construction of MDT supervision and effect evaluation system, etc.
Objective To verify the reliability and validity of a self-developed satisfaction evaluation questionnaire for outpatient department employees in public hospitals, and to provide suitable tools for conducting such surveys. Methods Two anonymous surveys were conducted on all employees of the Outpatient Department of West China Hospital of Sichuan University in July 2019 and November 2021, respectively. Questionnaire items were screened using methods such as item distribution, coefficient of variation, and decision value, and the reliability and validity of the questionnaire were evaluated using Spearman-Brown coefficient and Cronbach’s α coefficient, exploratory factor analysis, and confirmatory factor analysis. Results The final questionnaire retained 14 items, which could be divided into two dimensions: work conditions and interpersonal environment, and the overall fit index of structural equation model model were as follows: χ2/ν=6.957, standardized root mean square residual was 0.061, root mean square error of approximation was 0.147, goodness-of-fit index was 0.796, adjusted goodness-of-fit index was 0.719, normed fit index was 0.849, relative fit index as 0.819, incremental fit index was 0.868, Tucker-Lewis Index was 0.841, comparative fit index was 0.867. The combined reliability of the two factors in the questionnaire was 0.94 and 0.91, respectively. The average variance extraction was 0.67 and 0.76, respectively, and the square root of the average variance extraction was 0.82 and 0.87, both of which were greater than the correlation coefficient of 0.71 between the two factors. The Spearman-Brown coefficient of the final questionnaire was 0.913, and the Cronbach’s α coefficients for the overall and two dimensions were 0.953, 0.937, and 0.910, respectively. Conclusion The reliability and validity of the satisfaction evaluation questionnaire for outpatient department employees in public hospitals are good and can be applied to practical surveys.
In response to the current situation of regional medical and health hierarchical diagnosis and treatment services and the existing problems in the continuity of medical services, this article applies supply chain management methods, system collaboration theory, and service ecosystem concepts to treat medical consortia as an organic whole. Based on the quality and efficiency of disease management in the whole life cycle of patients with difficult, complex and severe diseases, a multi-level and multi-disciplinary medical service supply chain model of difficult, complex and severe disease medical consortium is constructed with four core elements: patient flow, service flow, technology flow and information flow. This article provides a certain reference for the implementation of regional hierarchical diagnosis and treatment and the formulation of relevant policies in China from the perspective of theoretical research.
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.
Objective To investigate the current status of multi-disciplinary team (MDT) in outpatient clinics of medical institutions in Sichuan, and to provide reference for further promoting the MDT model in outpatient clinics. Methods In November 2022, questionnaires were distributed to the outpatient management personnel of Sichuan Outpatient Management and Medical Quality Control Center from various medical institutions. The questionnaire included the basic information of the survey subjects and medical institutions, the current status of outpatient MDT work, the current status of operation and management, and the internal and external influencing factors of MDT development. Results A total of 106 questionnaires were received, of which 104 were valid. There were 70 hospitals that had provided outpatient MDT services, with a development rate of 67.31%, mainly concentrated in the past 5 years. A total of 60 hospitals (85.71%) had established MDT related systems, but only 14 hospitals (20.00%) had carried out relevant quality evaluation work. Among the 104 outpatient management personnel surveyed, 83.65% believed that the external factor affecting the development of outpatient MDT was the lack of correct understanding of MDT by patients, and 78.85% believed that the internal factor affecting the development of outpatient MDT was the low participation enthusiasm of departments and doctors. Conclusions The outpatient MDT in Sichuan is still in its early stages of development, and the outpatient MDT model has not yet been unified in terms of establishment standards, organizational methods, operational management, and fee standards. In the future, relevant departments and medical institutions still need to work together to promote its sustainable development.