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Objective:To explore the application and effect of multi-level quality control system (referred to as “quality control”) in health management center setting.Methods:The health management center of Hanzhong Central Hospital constructed a multi-level quality control system of “hospital-department-unit” and “department-unit-quality-controller” in August 2019. A total of 83 619 people who underwent physical examination in the Health Management Center of Hanzhong Central Hospital from August 2018 to July 2020 were selected as the subjects. 32 009 people who underwent physical examination from August 2018 to July 2019 were selected as the control group, and 51 610 people who underwent physical examination from August 2019 to July 2020 were selected as the experimental group. The timely notification of important abnormal results and the follow-up of the “four-high” population (hypertension, hyperglycemia, hyperlipidemia, and hyperuricemia) were observed. Two thousand satisfaction questionnaires and two thousand physical examination reports were collected from the institutions who had received both physical examination in the Health Management Center of Hanzhong Central Hospital for two consecutive years. The physical examination items of the above clients were basically the same. The satisfaction rate of the two groups of physical examination and the qualification rate of the physical examination reports were measured respectively.Results:The results showed that the timely notification rate of important abnormal results (99.4% vs 96.6%), follow-up rate of “four-high” population (hypertension 95.1% vs 91.2%, hyperglycemia 95.3% vs 91.6%, hyperlipidemia 94.6% vs 92.3%, hyperuricemia 92.7% vs 86.4%), satisfaction rate of physical examination (physical examination environment 94.0% vs 91.3%, service attitude 96.4% vs 91.9%, waiting time 97.6% vs 95.4%, physical examination process 98.3% vs 96.8%, professional level of medical staff 97.2% vs 95.1%), and qualified rate of physical examination report (accuracy of input information 99.5% vs 98.1%, accuracy of main examination conclusion 99.4% vs 97.3%, normative sorting 99.8% vs 98.8%, rationality of health advice 99.2% vs 96.8%) in the experimental group were significantly higher than those in the control group (all P<0.05). Conclusion:The establishment of a multi-level quality control system in health examination service can improve the timely notification rate of important abnormal results, the follow-up rate of the “four-high” population, the satisfaction of physical examinees, and the qualified rate of physical examination reports.
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The construction of county and district medical community is an important measure for high-quality medical resources to "double sink and improve". In this study, we have initially constructed a medical equipment quality control system for members of the regional medical community. The current situation of lack of professional medical equipment management personnel and quality control equipment in primary medical institutions has been alleviated, the quality control level of medical equipment in primary medical institutions has been improved, and a new management model for quality control of primary medical equipment has been explored.
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Equipment and Supplies, Hospital/standards , Materials Management, Hospital/organization & administration , Quality ControlABSTRACT
Objective To construct the schistosomiasis diagnostic reference laboratory in Jiangsu Province, and to examine the role and diagnostic efficiency of the reference laboratory. Methods A schistosomiasis diagnostic reference laboratory was built in Jiangsu Province according to the requirements of the construction of the national schistosomiasis diagnostic reference laboratory in China. Inter-laboratory comparisons were conducted and the diagnostic capability of grassroots laboratories was evaluated in Jiangsu Province. Results The organization structure, environmental conditions, administration and quality systems of the schistosomiasis diagnostic reference laboratory in Jiangsu Province all met the requirements for construction of the national schistosomiasis diagnostic reference laboratory in China, and the schistosomiasis diagnostic reference laboratory in Jiangsu Province was issued a certificate of a province-level schistosomiasis diagnostic reference laboratory. During the 6 inter-laboratory comparisons performed by national schistosomiasis diagnostic reference centers of China, the qualitative and quantitative results of each detection item were all in agreement with the reference samples (Kappa = 1), and the diagnostic capability was identified excellent. The results of indirect hemagglutination assay of 426 serum samples from 4 grassroots laboratories were re-examined, and the mean coincidence rate was 94.13% (range, 92.08% to 96.25%) with the grassroots laboratories, with a mean Kappa value of 0.85 (range, 0.83 to 0.86) and a mean missing rate of 10.19% (range, 0 to 17.65%). Conclusions The schistosomiasis diagnostic reference laboratory has been successfully established and effectively operated in Jiangsu Province, which plays an active role in improving the capability of schistosomiasis diagnostic equality in the province.
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Objective To construct the schistosomiasis diagnostic reference laboratory in Jiangsu Province, and to examine the role and diagnostic efficiency of the reference laboratory. Methods A schistosomiasis diagnostic reference laboratory was built in Jiangsu Province according to the requirements of the construction of the national schistosomiasis diagnostic reference laboratory in China. Inter-laboratory comparisons were conducted and the diagnostic capability of grassroots laboratories was evaluated in Jiangsu Province. Results The organization structure, environmental conditions, administration and quality systems of the schistosomiasis diagnostic reference laboratory in Jiangsu Province all met the requirements for construction of the national schistosomiasis diagnostic reference laboratory in China, and the schistosomiasis diagnostic reference laboratory in Jiangsu Province was issued a certificate of a province-level schistosomiasis diagnostic reference laboratory. During the 6 inter-laboratory comparisons performed by national schistosomiasis diagnostic reference centers of China, the qualitative and quantitative results of each detection item were all in agreement with the reference samples (Kappa = 1), and the diagnostic capability was identified excellent. The results of indirect hemagglutination assay of 426 serum samples from 4 grassroots laboratories were re-examined, and the mean coincidence rate was 94.13% (range, 92.08% to 96.25%) with the grassroots laboratories, with a mean Kappa value of 0.85 (range, 0.83 to 0.86) and a mean missing rate of 10.19% (range, 0 to 17.65%). Conclusions The schistosomiasis diagnostic reference laboratory has been successfully established and effectively operated in Jiangsu Province, which plays an active role in improving the capability of schistosomiasis diagnostic equality in the province.
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OBJECTIVE:To promote the development of hospital clinical pharmacy.METHODS:The measures which promoted the development of hospital clinical pharmacy after established by Jiangsu quality control system for pharmacy management were introduced.Through collecting clinical pharmacy indexes (the number of clinical pharmacists,the range of clinical pharmacy practice,the number of clinical pharmaceutical practice,the number of therapeutic drug monitoring (TDM),the number of reported ADR,etc.) in Jiangsu Province Pharmacy Management Quality Control Network Reporting System established by Quality Control Center during Jan.2014-Dec.2016,the development of clinical pharmacy in Jiangsu hospital were analyzed.RESULTS:The measures formulated and adopted by Quality Control Center included expanding the scale of clinical pharmacists training,strengthening the training of rational use of antibiotics,formulating provincial rational drug use standard,carrying out pharmaceutical quality control circle activities,etc.The data of clinical pharmacy indexes were collected from 61 hospitals.The results showed that,compared with Jan.2014,the number of clinical pharmacists in sample hospitals increased from 4.72 to 5.86 in Dec.2016;the number of involved special departments increased slightly;clinical pharmacy practice (weekly rounds number,medication history writing,case analysis,medication guidance,drug counseling) increased significantly;the number of beds managed by clinical pharmacists reached 289 beds;the types of TDM increased from 7.38 to 7.87,the number of yearly monitoring was 1 293;the number of monthly reported ADR increased from 14.71 to 19.34,but the number of consultation,new/severe ADR decreased slightly.CONCLUSIONS:Both service ability and service level of clinical pharmacy in 61 hospitals in Jiangsu have been improved by the establishment of the provincial quality control system for pharmacy management.
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OBJECTIVE:To refine the quality standard of pharmacy intravenous admixture service(PIVAS),and provide refer-ence for improving the work quality of PIVAS. METHODS:Through establishing quality management organization and developing quality standard rules,quality control system for PIVAS in our hospital was constructed and total quality management was conduct-ed. Numbers of quality problems before(Jul. 2013-Jun. 2014)and after(Jul. 2014-Jun. 2015)its implementation were compared, and the effects were evaluated. RESULTS:117 management systems and 14 link quality standards and rules were made,including staff behavior standards,quality standards for drug management,supervision and inspection of quality standards,etc. Numbers of quality problems dropped from 358 to 177 after the implementation,the ratio of dispensing errors accounted for the total dispensing declined from 0.35? to 0.17?(P<0.05). CONCLUSIONS:The construction of quality control system and the implementation of quality control standards and rules in PIVAS of our hospital has improved the quality of PIVAS work.
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The hospital is one of the main subjects for application of Chinese herbal pieces (CHP) which is the prescription drug for Chinese medicine clinical prevention and treatment of disease. The quality of CHP in hospital has a direct impact on clinical effect and is related to the health of the patients. But presently the market of CHP is chaotic with the prominent issue. The cultivation, the production and processing, the storage management and operation of CHP are not standardized. Simultaneously, the supply method of CHP is cut off from the right of the hospital to know the source and production process of CHP. The hospital is restricted to the supply enterprises of CHP. This situation makes a great obstacle to the quality control of CHP in hospital. The quality control system of CHP in hospital is composed of the source and the quality management of CHP. The quality control system of CHP includes the measures such as the purchasing management, acceptance of storage, storage and maintenance, and personnel capacity improvement. The prescription-based processing of Chinese materia medica should play an important role in this system. The whole process traceability system and the guarantee function of the market supervision system of Chinese medicinal materials should also be taken effect. In this way, the dominant position of hospital in the quality control system of CHP is strengthened.
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Objective To develop a real-time electronic nursing records quality control system based on No.1 Military Medical Project to solve the existing problems in range,representativeness of detection results,information feedback,information storage and etc.Methods An integrated platform was implemented for information acquisition,integration and display on the bases of No.1 Military Medical Project as well as the interfaces with information management systems for electronic nursing records,clinical laboratory examination,medical examination,imaging and etc,which had the functions of auto monitoring of timeliness and logic of electronic nursing records,manual quality control of the connotation as well as the feedback,statistics and analysis on the problems.Results The system behaved well in stability,compatibility,and could be used for real-time and dynamic control of electronic nursing records,timely information feedback and statistical analysis.Conclusion The system contributes to the quality control of electronic nursing records,and is of great significance for its enhancement.
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Traditional Chinese medicine (TCM) products are the finished products by adopting certain preparation processes according to the profile of the herbs, with Chinese herbs or decoction pieces as the raw materials.Among their adverse reactions to the organs, hepatotoxicity can not be ignored. As a new stage of quality control in TCM, dynamic quality control system of the multidemensional structure process emphasized on the research of the effectiveness and safety, focused on the pretreatment, preparation process,dosage forms and drug delivery methods to control the quality of TCM preparation products and reduce the generation of hepatotoxicity.In this paper, we will start from these factors to discuss the causes of hepatotoxicity underlying drug products and hope to provide the reference for developing low toxicity and high quality modern Chinese medicine products.
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Traditional Chinese medicine(TCM) preparation is one of the most important aspects in the development and quality control of traditional Chinese medicine, and its security problem becomes more and more serious. It is worthy to note that the liver, as the main drug metabolic organ, bears the brunt of the damage caused by TCM preparations. In this paper, the author attempts to explore the relationship between TCM preparations and hepatotoxicity based on the processing chains from crude drugs to the end product. Besides, the author hopes to clarify the underlying mechanism of hepatotoxicity of TCM preparations and provide basis and guidance for the quality control and rational clinical use of the preparations as well as the development of modern TCM preparations with high quality and low toxicity.
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Objective:To explore the application effect of PDCA quality management combined with hospital quality control system in Doula delivery of primipara.Methods:Our hospital started to implement the quality management model of PDCA from Jul 2014. According to the different nursing management methods, primipara were divided into treatment group and control group. Primipara in control group from Jan 2013 to Jun 2014 received the traditional nursing mode,primipara in the treatment group from Jul 2014 to Sep 2015 received PDCA quality management combined with hospital quality control system in Doula delivery.Nursing satisfaction, the production process of the status, mode of delivery, postpartum hemorrhage, neonatal outcome were compared between the two groups.Results:In the treatment group,the first,second,third and the total labor time were significantly shorter than that in the control group (P<0??05).The probability of natural childbirth way in the treatment group was significantly higher than that in the control group,postpartum hemorrhage amount was significantly less than that in the control group (P<0??05),the rate of neonatal asphyxia was significantly lower than that in the control group,Apgar score was significantly higher than that in the control group (P<0??05). Nursing satisfaction in the treatment group was higher than that in the control group (P<0??05). Conclusion:The clinical efficacy of PDCA quality management combined with hospital quality control system in Doula delivery of primipara can be effectively improved,can significantly shorten labor time,and improve the neonatal outcome.
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OBJECTIVE:To ensure the stability of electronic data capture(EDC)system in drug clinical trials and to improve the quality of drug clinical trials. METHODS:The quality control system for EDC system was established and introduced from the formulation of quality control process,establishment of data standard,trial project management,daily management,trial project design,system operation,system function,etc. RESULTS & CONCLUSIONS:Data standard have been achieved through estab-lishing EDC quality control system by our hospital based on attributable,legible,contemporaneous,original and accurate principle. The management of trial project and daily management are conducted through data registration,staff training,the formulation of da-ta management plan,fault emergency treatment,database backup;multiple verification of support data,data lock and export,trial report autogeneration and other functions have been realized by formulating related standard operation instruction,program file,op-eration manual and quality record. Those aspects improve facticity,accuracy and integrality of data in clinical trials,and lay a foun-dation for further data mining.
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Objective:The role of the medical instruments in clinical diagnosis and treatment is getting more and more important, especially the application of new technologies and equipment promote and improve the level of clinical diagnosis and treatment, and the advantages bring the gospel to the patients. However, due to the limitations of technologies, tools, design and lack of materials, the medical instruments introduced to the hospital existing defects. Meanwhile, operation staff’s inadequate knowledge poses potential hazard to the health care’s quality. Methods: So now days when referring to the medical quality control, we should and must concern about the quality control of medical equipment to improve health care quality control standards. The essay comes forward preliminary method to carry out medical equipment quality control system established work with the dissecting of the present health care quality situation. Results:These jobs are the basic, whether to carry out the job and promote health care quality management depend on the practice of competent departments and professionals. But most hospitals are reusing and repurchasing and ignoring the medical equipment control quality, these situations need to be correct immediately. Conclusion:Otherwise, the development of medical technologies will increased the risk and damage to the improvement of health care, even the price of life.
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Objective To evaluate the quality of domestic hepatitis C diagnostic reagents objectively,and to build up the quality control systems for assessment of hepatitis Cdiagnostic reagents.Methods4080 serum samples from blood donors were collected and detected with EIA kits.146anti-HCV positive and negative samples were selected and tested repeatedly by two different imported ( Murex and Ortho) and domestic anti-HCV EIA kits(InTec,ZHONGSHAN BIO-TECH,WANTAI and KHB),then confirmed by CHIRON RIBA HCV 3.0 and PCR qualitative reagents.The samples were tested by nucleic acid quantitative assay and the RNA positive samples were detected by genotyping reagents.ResultsThe quality control systems of diagnostic reagents of anti-HCV and HCV RNA were constructed.Each quality control system was consisted of 50 samples,including 20 anti-HCV/HCV RNA positive,20 anti-HCV/HCV RNA negative and 10 diluted specimens for sensitivity evaluation.The positive samples with dominant HCV genotypes in China contained strong,moderate and weak positive samples.The negative samples involved those S/CO value ( signal-to-cutoff ratios ) close to threshold.Conclusion The quality control systems established in this study are suitable for assessment of the new and improved domestic hepatitis C diagnostic reagents.
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Based on the medical immunology exquisite course of Dalian city,we expound the guiding thought,construction and system evaluation of medical immunology test bank,in order to normalize examination,consummate teaching quality control system and improve teaching quality.