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 analyze the application status of Kanban management in medical service management at home and abroad and to provide a reference for lean medical management practice in China.MethodsUsing the bibliometric method, in China National Knowledge Infrastructure, Wanfang Database, CQVIP Journal Database, Springer Link, Embase and PubMed, we used “Kanban” and “Kanban management” as Chinese search terms, “Kanban system” and “two-bin system” as English search terms to search for literature published from 2009 to 2019. The number of articles published, institutions, authors, citation frequencies, key words, Kanban usage, and improved areas where Kanban was applied in were statistically described and analyzed.ResultsA total of 219 articles were retrieved. Of the 14 articles included in the study, 12 articles were published from 2015 to 2019, 8 articles were published by hospitals, and 9 articles were cited more than or equal to 3 times. The key words were basically the combinations of Kanban and related topics in the field of medical service management, such as quality control and improvement, ward service, high-quality care and process evaluation; 11 articles used Kanban alone. Kanban was used in medicine supply chain management, ward bed management, and material inventory management abroad; and was used in medicine management, emergency room patient management, medical staff performance management, operating room equipment management, and high-quality medical service management in China.ConclusionsKanban as a lean management method was introduced into the domestic medical field late, and the current research development is not balanced. Asa visual management tool, Kanban needs to be extended in the medical field. As a lean improvement tool, Kanban has positive significance in improving medical quality and patient satisfaction. It is suggested that researchers should not be limited to the existing applied research, and can study the application of Kanban in different medical service fields in combination with different lean management tools according to the actual situation of the hospital.
Objective To understand the research status and trend of value co-creation in China’s medical service field, so as to provide reference for the application research of value co-creation in China’s medical service field. Methods China National Knowledge Infrastructure was searched literature about the value co-creation in China’s medical service field retrieved from January 1, 2013 to December 1, 2021. CiteSpace V software is used to draw the keyword co-occurrence map, cluster analysis and timeline view, and analyze the overall process and evolution of literature publication interannual change, journal and discipline distribution, organization and author distribution, literature citation and so on. Results A total of 40 literatures were included, including 30 journals and 10 dissertations. The number of documents on value co-creation research in China’s medical service field showed an increasing trend year by year. The top journals in terms of published papers include Journal of Management Science, Chinese Hospital Management, Journal of Management Case Studies. Southern Medical University, Shanghai Jiaotong University and Tianjin University ranked among the institutions with a large number of documents. The top three authors in the number of published articles were Mai Shumin, Chen Huifang and Wei Qinggang. The relevant literature mainly comes from medicine and health, economy and management science. The research mainly focuses on many hot spots, such as service leading logic, internet medical care, service innovation, patient participation, doctor-patient relationship and so on. Conclusions The hot-spot research trend of value co-creation in the field of medical services in China is prominent, but the overall number of research is insufficient, the theoretical system of value co-creation is fragmented, and the core author group has not been formed yet. In the future, China needs to speed up the value co-creation theory and application research in the field of medical services, and realize the specific and systematic research transformation.
Objective To systematically evaluate the qualitative research on disease experience of breast cancer patients. Methods China National Knowledge Infrastructure, WanFang Data, and Web of Science were searched for qualitative research on disease experience of breast cancer patients till April 15, 2022. JBI was used to evaluate the quality of the literatures, and meta-integration was used to systematic evaluation. Results A total of 36 literatures were included. Among them, there were 177 clear research results, and a total of 14 complete research results were extracted, including positive experience and negative experience, which were summarized into 7 categories. 7 categories included physical experience, psychological experience, family and social support, disease knowledge needs, medical humanistic care, medical treatment process, coping. Two integrated results were synthesized, including disease experience and medical treatment experience. Conclusions In the whole process of breast cancer patients’ illness and medical treatment, they need not only guidance and support, but also medical humanistic care to help them respond to their own changes in a timely manner. The quality of life of patients can be improved by providing them with sufficient disease related information, striving to improve the medical treatment process, establishing and improving their all-round support system.
ObjectiveTo analyze the application status and existing problems of value stream mapping (VSM) in improving medical services at home and abroad, so as to provide decision evidence for hospitals to apply VSM to improve medical services.MethodsUsing “value stream mapping” and “value stream” as search terms, we searched PubMed, Embase, China National Knowledge Infrastructure, CQVIP Journal Database and Wanfang Database (2009-2019), and collected relevant literature on the application of VSM to improve medical services at home and abroad. We conducted bibliometric analysis after confirming the literature according to the inclusion criteria. The standardization of application of VSM was also evaluated.ResultsOf the 299 articles retrieved, 13 studies fulfilled the inclusion criteria. The publication time of the literature was distributed between 2013 and 2019. Of the 8 foreign articles included, the regions to which the first author belonged were 4 in the United States, 1 in Ireland, Norway, Lebanon and Indonesia respectively. Of the 5 included domestic articles, the regions to which the first author belonged were 2 in Zhejiang and Shanghai respectively, and 1 in Guangdong. Of the foreign literature, 5 articles did not clearly state the sample size observed when drawing VSM, 5 articles incomplete drawing elements of VSM, and 3 articles did not show VSM. Of the domestic literature, 2 articles did not clearly state the sample size observed when drawing VSM, 3 articles had incomplete drawing elements of VSM, and 1 article did not show VSM.ConclusionsVSM is relatively more used in high-income and upper-middle income countries. The medical service improvement issues for which VSM is applied are relatively single. The standardization of the application of VSM in domestic and foreign literature needs to be improved overall.
ObjectiveTo analyze the application of visual management in foreign medical service management, and to provide a reference for lean medical management practice in China.MethodsUsing “visual management” and “visual tool” as the search terms, we searched PubMed, Web of Science, Springer Link, ScienceDirect, to retrieve relevant literature on the application of visual management tools to improve medical services in foreign countries. The number of published articles, journals, improvement objectives, measures and effects were analyzed descriptively.ResultsA total of 534 articles were retrieved. According to the inclusion and exclusion criteria, 7 articles were finally included, all of which were published in SCI journals, of which the number of articles in the United States was the highest (5 articles). Among the 7 included articles, 3 articles used face cards, 2 articles used whiteboards, 1 article used electronic Kanban, and 1 article used discharge “traffic lights”. Five articles studied the improvement of doctor-patient communication, and two studied the improvement of bed turnover rate. In the included articles, the contents of visualization mainly include the nursing goals of the inpatient, inspection plan, turnover, discharge plan, and the names and roles of medical staff.ConclusionsVisual management tools have a significant effect on promoting doctor-patient communication and improving hospital bed turnover. The application of foreign visual management tools in wards is relatively mature, and used more in promoting doctor-patient communication. Visual management tools are constantly updated, and electronic tools may gradually become a trend in the future.
As the implementation of the high-quality development policy of public hospitals is faced with the problems of diversified environment and the coordination of execution of complex actors, the network structure has changed from the closed resistance type to the open competition type. At present, China’s high-quality development policy of public hospitals needs to improve the policy system and refine the top-level design; strengthen the executive power of network entities and innovate the joint governance mechanism; optimize the structure of policy tools to improve the resilience and flexibility of the network; implement the performance evaluation mechanism and strengthen supervision. This article is based on policy network theory and provides an in-depth analysis of the current high-quality development policy texts for public hospitals in China, with the aim of providing suggestions for policy development
Objective To analyze and explore positive emotional experiences of patients, in order to provide reference for improving the medical services. Methods Using NVivo software, praise letters from a tertiary hospital in Guangdong in 2020 and 2021 were used as the research object for three-level coding. The positive emotional experiences of patients were explored through tools such as analytic hierarchy process and node item map. Results A total of 8601 patient praise letters were received, and after screening, a total of 8128 valid texts were obtained. In 2020, there were 2570 patient praise letters, including 69 from the emergency department, 638 from the outpatient department, and 1863 from the inpatient department. In 2021, there were 5558 patient praise letters, including 203 from the emergency department, 2071 from the outpatient department, and 3284 from the inpatient department. The most praise letters were from the inpatient department, with a total of 5147 letters (63.3%). There were 2709 letters (33.3%) from outpatient department, and 272 letters (3.3%) from emergency department. The classification of patient praise letters showed that patient praise for the process and individuals were most common (77.4%). After step-by-step encoding, the valid text formed 36 third level nodes, 8 second level nodes, and 3 first level nodes. Patient praise letters mainly focused on emotional evaluation at the first level node, followed by emotional expression and emotional response. Word frequency analysis showed that in terms of positive emotional experiences, the word “thank you” had the highest frequency among patients. In terms of patient perception of service, the term “patience” had the highest frequency. Conclusions When patients express praise for medical services, they pay more attention to the personal performance of medical staff and the experience of the service process compared to the final result. In the process of hospital management, the emotions of patients should be fully considered.
Objective To analyze and evaluate the present status of application of clinical pathway evaluation indexes in China, in order to provide references to establish an evaluation system on clinical pathway. Methods Such databases as CBM (2004-2009), VIP (2004-2009), CNKI (2004-2009) and WanFang Data (2004-2009), and some relevant websites were searched systematically for collecting Chinese literature about domestic clinical pathway evaluation indexes. Results Among the 1 175 articles included, 135 (11%) were published in the core periodicals, 19 (2%) were masterate theses, and 1 021 were other kinds of articles. As to 135 core periodical literature and 19 masterate theses, most of which were graded into the second level of evidence, accounting for 96%. The analysis on the appearance of indexes showed that 87% of inconsistency could be identified between the contents and terms of indexes. Common indexes were summarized as the following four aspects: cost index, clinical index, serving index and quality evaluation index. There were 78% of all the 1 175 articles focusing on the application of nursing and medical education, in which only one masterate thesis used social research methods such as Delphi, focus group, experts scoring (percentile), etc. Conclusion Currently, there are some issues existing in the evaluation indexes of clinical pathway in China, such as low methodological quality of literature, irregularly and randomly using statistical terms, and lack of studies on system construction of clinical pathway evaluation indexes.
Objective To enhance medical quality evaluation by conducting a systematic review and evidence-based synthesis of relevant research. Methods Such databases as CBM (1978 to 2009), VIP (1989 to 2009), CNKI (1990 to 2009), WanFang Dissertation database (1997 to 2009), and relevant websites were searched to identify relevant Chinese studies for the synthetical evaluation on methods evaluating medical quality. Results A total of 216 articles including 184 observational studies, 29 traditional reviews, and 3 experts’ opinions were identified. Twenty-one synthetical evaluation methods were used among 216 articles, and the top three methods which had been quoted more than 30 times were: RSR (19.72%), TOPSIS method (19.03%), and comprehensive index (12.80%). Among the 184 observational research papers, the documents using one kind of comprehensive evaluation took up 89.13% (164/184), the ones using two kinds of evaluation methods accounted for 9.78% (18/184), and those using three kinds of methods accounted for 1.09% (2/184). Conclusion a) The joint use of two or more than two methods is not common. The majority of studies using single comprehensive evaluation method focus on RSR, TOPSIS and comprehensive index method; b) The comprehensive evaluation method is considered non-uniform, some not even standardized; c) Most of the medical literatures do not correct the value of quality assessment; and d) Considerably most studies perform retrospective evaluation with historical data.