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.
Participating in patients for patient safety program will help place patients at the center of efforts to improve patient safety. This paper presented a brief introduction to patients for patient safety program and its significance and functions.
Objective To investigate the depression status，score of asthma control test (ACT) and quality of life in asthma patients before and after health care education according to Global Initiative for Asthma guidelines.Methods 59 enrolled outpatients with asthma were asked to self-administer the CES-D (center for epidemiologic studies-depression) scale，ACT scale and the quality of life (QOL) questionnaire respectively.All the patients were educated and treated by health care professionals under the guidance of GINA 2004.After average of 2.5 months ± 15 days，they were asked to self-administer all the scales and questionnaire mentioned above once again on return visit.The data was collected and analyzed statistically based on whether or not the patient had depression according to the CES-D score and the data before and after the education was compared statistically.Results （A）40.7% (24/59) of the patients had depression emotion before guided treatment，and after that the percentage significantly decreased to 13.6% (8/59) (Plt;0.05).（B）Comparing the depressive and non-depressive groups，there was significant difference in 3 of 5 domains in QOL excluding limitation of activity and self concern about health (Plt;0.05) before guided treatment.While on return visit 3 domains in QOL excluding limitation of activity and psychologic status had shown a significant difference (Plt;0.05).There was no significant difference in ACT score before guided treatment，while wise versa after that (Plt;0.05).（C）Before guided treatment the depression status was inversely correlated with 3 in 5 domains of QOL (symptoms of asthma，psychologic status and response to irritant)，as well as QOL as a whole (Plt;0.05)，but not with the other two domains of QOL scale and ACT score.After guided treatment，the depression status had inverse correlation with QOL and 3 in 5 domains of QOL scale (excluding limitation of activity and psychologic status) (Plt;0.05)，as well as ACT score (Plt;0.05).Conclusions The symptoms of asthma and response to irritants are common factors that influence the depressive emotion in asthma population.While psychologic status and self concern about health are both important factors that can not be overlooked.Health care education is important for asthma patients in view of appropriate treatment，symptom control and relief of depression emotion.
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.
Objective To provide scientific evidence for the establishment of medical specialist system in China by investigating the history, current situation, problems and countermeasures of medical specialties training at home and aboard. Method The principle and theroy of evidence-based medicine were adopted. The information before Dec. 31, 2003 of Pubmed, CBM, official website, some journals, most frequently used search engines and medical monograph were systematically reviewed. Included literatures were assessed and graded according to the pre-defined criterias. Results A total of 1 319 studies (1 298 in English, 21 in Chinese) were included, among which only 6 were related to the classification of medical specialties. Based on the information from official website of USA, Canada, UK, Singapore, Australia and China (including HK and Taiwan), it showed that China has the largest number of medical specialties, followed by that of USA. In China, the number of medical specialties has more than that of the disciplines in clinical field, which was followed by resident training programs. Some specialties were duplicate, or not international standardized. Conclusions The classification of medical specialties should be developed consecutively, which comprehensively considered the international trend, characteristics of doctor training and the current situation. Specialties whose training program are well-established and developed should initiate firstly. Others will be put into practice gradually after being fully exprienced.
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.
ObjectiveTo analyze the choice of initial antibiotic treatment for health care-associated pneumonia (HCAP). MethodA retrospective study was conducted in patients with HCAP hospitalized in the Emergency Department of West China Hospital from January 1st to December 31st, 2014. A total of 156 HCAP patients were divided into anti-multidrug-resistant treatment group (group A, n=72) and quinolone monotherapy group (group B, n=84). The baseline characteristics, comorbidities, severity, pathogen distribution, antibiotics and clinical outcomes were compared between the two groups. ResultsIn group B, there were 46 males and 38 females with the age of (59.9±10.9) years, and the pneumonia severity index (PSI) score was 89.5±22.7; in group A, there were 44 males and 28 females with the age of (62.2±12.2) years, and the PSI score was 94.4±23.6. The differeces between the two groups were not significant (P>0.05). The duration of using antibiotics in group B was (14.5±3.7) days, which was longer than that in group A[(12.8±3.8) days, P=0.005]. The detection rate of multidrug-resistant bacteria, the proportion of changing antibiotics, the average length of hospitalization, the proportion of using mechanical ventilation, the proportion of patients transferred into Intensive Care Unit and 30 days mortality in group B was 17.9%, 34.5%, (16.9±3.6) days, 11.9%, 9.5%, and 4.8%, respectively; which were similar to those in group A[15.3%, 22.2%, (17.3±3.9) days, 16.8%, 12.5%, and 4.2%, respectively] (P>0.05). ConclusionsIt is unnecessary for all HCAP patients to receive anti-multidrug-resistant treatment. We should regard the risk factors and the popular local features of microbiology to determine the choice of antibiotic treatment.
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.
ObjectiveTo study whether emotional management can alleviate the occupational burnout of the health care providers. MethodsFrom May 1st 2015 to February 29th 2016, we sampled the medical workers of a class-3 grade-A hospital randomly, and performed the emotional management through self-emotion management and professionals-conducted emotion-management. The discrepancies before and after intervention were studied using Maslach Burnout Inventory General Survey (MBI-GS). ResultsIn total, 100 medical workers were enrolled in our study, of which there were 27 males and 73 females. There were 11 doctors and 89 nurses. The average age was (34.5±5.6) years. According to the MBI-GS survey, there were 69 medical workers suffering from occupational burnout. There were significant statistical differences before and after intervention in the MBI-GS scores in four aspects including emotion exhaustion, work status, sense of achievement and the total scores (P＜0.05). ConclusionThe medical workers can alleviate the occupational burnout under the self-management or professionals-conducted management of emotion.