Objective To summarize and analyze the experience of Canadian hospital report, including report contents, indicators system and result application, so as to provide basis for improving Chinese hospital information report and enhancing healthcare regulation. Methods Official networks and databases in Canada were searched, and relative policies, documents, research reports and information reports were included. Results Canadian Hospital Report Project carried out by Canadian Institute for Health Information was effective for gathering and comparing hospitals’ information, and regulating healthcare service. Ontario Hospital Report Project, as a local policy based on national hospital report project, was a good example of local government to improve healthcare service regulation. Conclusion Canadian Hospital Report and Ontario Hospital Report enlighten us that, carrying out the comparison of hospitals in the same type, ensuring the comparability of data, setting comprehensive and scientific report contents and indicators, and emphasizing the self-evaluation function and self-improvement function of the hospital performance evaluation.
Through reviewing the implementation of outpatient appointment services around the whole country, the problems of current outpatient appointment services were analyzed, which included imperfect information platform, low rate of medical experts’ visit on schedule, high rate of breaking the appointment by outpatients, and the new inequity caused by opaque information on the outpatient appointment service. The strategies were put forward to address the problems, including the integration of different social resources, cooperation and sharing, enhancing supervision to increase experts’ visit rate, establishing a new model for outpatient appointment service to decrease the breaking of appointment, and opening information to ensure the fair and impartial appointment.
Objective To understand the outpatients, evaluation and demands of the real-name registration system. To implement the new medical reform program deeply. Methods We used the questionnaire named registration questionnaire of West China Hospital designed by ourselves to survey the outpatients and their family members and were filled in the questionnaire by themselves. Results Firstly, real-name registration system in West China Hospital made major contribution to alleviate the difficulties of registration and medical treatment. It achieved a major breakthrough and created a good social benefit. Secondly, patients the most favourite way of registration was by phone. They were satisfied with the platform of the social welfare services very much. Thirdly, the number of appointment registration arrived year by year, while the number of the day registration fell year by year. Conclusion Firstly, we innovate the form of the realname registration system, refine service and do scientific management at the needs of the patient-oriented. Secondly, we strengthen the track of the failure of appointment registration and analyze the causes. We should take measures timely to reduce the rate of the event and improve the real-name registration system. Thirdly, we strengthen the management of the out-patient doctor visiting program and credit services, to improve medical compliance rate and protect the interests of the patients. Fourthly, we explore a scientific research of out-patient real-name registration system to establish a modern hospital out-patient services model.
Objectives To compare the differences of the medical charity donations between at home and abroad in West China Hospital of Sichuan University, so as to provide the evidence for the management and development of medical charity in West China Hospital and China. Methods A cross-sectional study was conducted to investigate and analyze the current situation and problems of the medical charity donations at home and abroad in West China Hospital from January 2005 to December 2006. Results The total amount of the charity funds at home and abroad was 2.043 mill ion and 14.6 mill ion, respectively. The main target diseases of domestic donation were tumor, hematologic disease, dangerous and severe diseases and congenital heart disease, which accounted for 43.3%, 35.9%, 15.8% and 1.0%, respectivley. While the main targeted interventions and diseases of overseas donation were hearing rehabilitation, prosthetic replacement, cataract and congenital heart disease, which took up 52.1%, 27.4%, 13.7% and 6.8%, respectively. Conclusions There are differences in the amount of charity funds, target diseases, behavioral motivations, organizations, objectives and criteria of the charity donation between the donations at home and abroad. It would probably cause the problems in recruitment, distribution and monitoring of the charity funds. It is suggested that the hospital management committee of charity funds and the related law to regulate the charity behaviors should be developed.
Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
Social Evaluation is an important reference to guide the reform and development of a public hospital. In view of the patient, hospital stakeholders and the public, West China Hospital of Sichuan University creatively constructed a social evaluation system, including patient satisfaction degree, expert appraisal and online public comment, in order to maintain a good medical environment. After several years of construction and application, the system has been quite effective in promote the development of the hospital. In the assessment of patients' satisfaction degree toward the hospital, we made a great improvement.
ObjectiveTo investigate whether continuous quality improvement (CQI) measures can reduce the episodes of peritonitis. MethodsWe analyzed the data of 114 cases of peritoneal dialysis related peritonitis from January to December 2011 before applying CQI measures and 72 cases from January and December 2012 after applying CQI measures in West China Hospital. Then we studied the episodes, cause and pathogenic bacteria species of peritonitis in peritoneal dialysis patients. We implemented the process of reducing the episodes of peritonitis by applying PDCA four-step design: plan-do-check-act. ResultsThe episodes of peritonitis were reduced from per 60.8 patient-months (0.197/patient-years) to per 66.6 patient-months (0.180/patient-years) after applying CQI measures. The positive rate of pathogenic bacteria culture was both 50.0% before and after applying CQI measures, in which 66.7% were gram-positive cocci. The curing rate of peritonitis was increased from 57 case/times (76.3%) to 87 case/times (79.2%). Switching to hemodialysis rate was reduced from 17 cases/times (14.9%) to 10 cases/times (13.9%). Death cases was reduced from 9 cases/times (7.9%) to 5 cases/times (6.9%). ConclusionThese results show that the incidence of peritoneal dialysis related peritonitis decreases and the curing rate increases through CQI measures.
The advanced management is the foundation of the long-term development of hospital. How to break the barriers between institutions, explore and set up formal management system and operating mechanism is a headache faced by many public hospitals. By bringing in Project Management (PM) theory to establish up the management reform will be a smart way. This study reported the examples of the PMs of West China Hospital of Sichuan University, summarized the management experiences, revealed the great value of PM, and provided references for the managers of hospitals.
ObjectiveTo understand the inpatient classification and influence factors of hospitalization expenses, so as to provide basis for hospital management. MethodsThe diagnosis and treatment data of inpatients in a grade A tertiary hospital in 2013 were collected, the percentile method were used to describe the expenses distribution, the K-means clustering method was applied to classify the inpatients, the rank-sum test was utilized to analyze the differences of the costs among different groups, ICD-10 was applied to analyze the diseases distribution, and the median regression was used to analyze the influence factors. ResultsThere were 175 333 inpatients in total. The median of the expenses was 10 016.31 yuan RMB. The inpatients might be classified into seven groups with different expenses (P=0.0001). For inpatients who had no "blood transfusion cost", the top three factors of cost category were operation, laboratory test, examination; for who had "blood transfusion cost", the top three factors of cost category were blood transfusion, laboratory test, examination. There were 2 147, 2 182, 1 499, 1 301, 2 059, 22 and 14 kinds of diseases (ICD-10 four-digit code) respectively among the seven groups. The influence factors could be summarized into patient-related and diagnosis & treatment-related ones. ConclusionThe costs of operation, blood transfusion, laboratory test, and examination affect the inpatients classification greatly. The results could be of help to inform the admission of patients, the expense control and the disease management.
Hospital hosting has made great success in public hospitals. Small and medium public hospitals have made great progress in management and healing with the help of large comprehensive hospitals. The business model of hospital hosting has been used in private hospitals. This study will introduce the differences among each model of hospital hosting and analysis the efficiency in private hospital area.