Hospital Administration and Medical Practices

Reflections on and Insights from Australia’s Nursing Workforce Planning and Forecasting

Baiyue An — 2024-12-02

Objective: This study aimed to analyze nursing planning in Australia and integrate it with the current situation of nursing planning in China to provide suggestions for the latter. Method: A literature review was conducted to examine nursing planning-related literature in both Chinese and English. Results: In 2014, Australia updated its nursing workforce planning on the basis of the HW2025 initiative and simulated various scenarios, such as comparative, demand restriction, skill mix, comprehensive, moderate self-sufficiency, productivity improvement, 65-year-old retirement age, and retire intention scenarios. These simulations projected the changes in supply and demand for registered nurses in 2025 and 2030, providing insights and references for nursing workforce planning in China. Conclusion: China’s nursing planning should focus on nursing supply and demand and may draw on the scenario simulation method adopted by Australia.

Leveraging digital innovations to enhance diversity & inclusion in clinical research

Idayat N. O. Babalola — 2024-12-02

Rowing in the same direction to achieve organizational goals: Integrating mentoring, leadership training, and coaching to manage and evaluate individual performance

David C. Read — 2024-07-29

Academic medicine provides ample opportunities and resources for medical innovation, but presents unique challenges for physician-scientists, support staff, and hospital administration. In an environment that prioritizes individual research-related productivity for professional advancement, how can management guide its workforce toward common organizational objectives? Here, we describe an approach that aligns individual goals to a high-level strategic plan continuously by combining annual goal setting, performance management, mentoring of early career faculty, leadership training, and professional coaching to achieve the three pillars of the academic mission: patient care, research and teaching.

Practice and effectiveness of medical technology management in specialized hospitals based on the concept of total quality management

Ang Zhao — 2024-12-02

Background and Objectives: This study explores the practice and effectiveness of medical technology management in specialized hospitals based on the concept of total quality management (TQM). Methods: Focusing on a specialized tertiary respiratory hospital and guided by the framework of TQM theory, this research takes robotic surgery as an example to delineate whole-process management measures and systems for medical technologies, especially restricted technologies, and analyzes the technology’s practical performance. Results: In 2021, the filing of robotic surgery technology for record was officially approved, marking the start of its clinical use; throughout the year, a total of 710 surgeries were performed. Robotic surgery outperformed traditional surgical approaches in terms of unplanned reoperation, intraoperative and postoperative blood transfusion, and 14-day readmission rates. Conclusion: Implementing relevant measures in technology access management, quality supervision, and performance incentives for robotic surgery may not only promote the vigorous development of the technology but also enhance medical quality and ensure patient safety.

Operation Strategies of the Supplier, Demander, and Third Party under the DRG/DIP Reform

Yinglin Niu — 2024-11-08

In this study, we analyze the operation strategies of the supplier, demander, and third party involved in the current process of China’s health insurance reform. Specifically, we summarize the relevant literature on the reform of healthcare insurance in China and abroad, explore the current changes in healthcare policy, and identify the main problems in the current diagnosis-related group/diagnosis-intervention packet (DRG/DIP) payment method reform. Based on our analysis, we propose strategies that can satisfy the needs of the supplier, demand side, and third parties and offer valuable suggestions to enhance the healthcare security system and promote the DRG/DIP payment method reform.

Kaiser Permanente: Highlights of an integrated care delivery system

Karin Cooke — 2024-12-02

Accident Prevention “Awareness” System for Intravenous Drip Infusion Operations - Construction and Evaluation

Shuko Muraoka — 2024-12-30

The purpose of this study was to evaluate an infusion rate monitoring system (Tritech, Inc.) in a clinical setting and to identify challenges in using the system as an alternative to an infusion pump to prevent inappropriate infusion rates (excessive or insufficient).

The system monitors the infusion rate and sends an alert to the nurse call system if the rate deviates from a preset limit. Unlike infusion pumps, this system does not adjust the infusion rate. A survey was conducted to evaluate the performance of this system in a clinical setting.

The infusion rate monitoring system was installed in 76 patients. Questionnaire responses were received from all 24 nurses involved in the study. Results regarding the usability and specifications of the infusion rate monitoring system showed that 24 (100%) were positive about the size, 23 (96%) about the weight and durability, and 22 (92%) about how the components were attached. The causes of alerts were 54 (35%) for infusion stoppage, 52 (34%) for overinfusion, and 32 (21%) for communication errors. The main causes of communication errors were transfers out of the patient room and transfers to the toilet in the patient room. This was due to the fact that the operating range of the system was 3 m from the receiver. To extend this range, new specifications need to be developed to cover a wider area.

A tool to assess the components of a safe and quality medical handover

Clara Forbes — 2024-02-22

Background: Robust medical handovers are paramount to ensure patient safety throughout the course of a hospital admission. Anecdotal evidence within our Australian tertiary hospital suggested that medical handovers were typically less structured when compared to allied health handovers. Medical handovers at our hospital had never been evaluated before, and the development of a questionnaire to assess the key components of a safe and quality handover was necessary. This tool would evaluate our medical handovers, and identify potential areas for improvement in both the tool, and medical handover practice. Methods: Based upon a literature search, and local and national guidelines of best practice, the tool was created around six key components of quality medical handovers—members involved in handover, environment and logistics, structure and content, management plans, patient-related and documentation. The tool was developed to audit the after-hours team handover at our 600-bed tertiary hospital. The tool was trialled at 20 medical handovers for our after-hours team, results were captured on REDCap, and data analyzed. Results: The tool was useful in assessing a wide range of key medical handover components and highlighting areas for improvement within our medical handovers. Through this trial, limitations were discovered in the tool that can be incorporated into future revisions of the tool. Conclusion: Overall, this study provided valuable insight into medical handovers by identifying current clinical practice and highlighting areas for improvement. The broader utility of this tool is the ability of other health services to evaluate their own medical handover, or serve as a starting point to develop their own audit tool.

Analysis of day surgery implementation in a large public hospital from the perspective of high-quality development

Ji Peng — 2024-07-26

Objective and Methods: This study aimed to analyze the impact of day surgery on patients’ medical expenses, length of hospital stay, medical service effectiveness, and medical experiences. Data collection and questionnaire surveys were conducted in patients undergoing day and non-day surgery in a sample hospital from 2019 to 2021. This study examined patients’ baseline characteristics, waiting times for treatment, medical expenses, surgical effects and medical experience. Results: The waiting time for treatment and medical expenses in the day surgery group was lower than those in the non-day surgery group. The day surgery group significantly outperformed the non-day surgery group concerning experience in medical convenience and accessibility. The differences were statistically significant (P < 0.05). Conclusion: Under the premise of ensuring medical quality and safety, day surgery implementation can reduce patients’ waiting time for health service, alleviate the economic burden of inpatient surgery, and enhance their overall medical experience.