Learning from socially driven frugal innovation to design the future of healthcare:A case of mobile Primary Health Center

Background and Aim:Despite their flaws,the low-cost but powerful economical solutions can ensure everyone has access to health.The main aim of this study is to extract characteristics of frugal innovation(FI)and social innovation(SI)for Primary Health Centers(PHCs)in low resource settings(LRS)for sustainable development.We will use the gained insights to design the mobile primary healthcare infrastructure using FI and SI strategies.There is a lack of methodology to design sustainable healthcare infrastructure for LRS.There is a gap in the literature about building sustainable infrastructure to provide basic healthcare facilities essential to the community.This article studies several factors necessary for designing sustainable infrastructure from the lens of FI,SI,and sustainability to develop a mobile healthcare infrastructure for last-mile people.Methods:Started with purposive sampled case studies to find out factors and criteria that most affect the success for an innovation to be frugal,social,and sustainable.The established criteria were used to design,develop,and deploy the mobile Primary Health Center(mPHC).Moving forward,we tested the system designed with stakeholders to gather insights.At this stage we found the feedback loop from the stakeholders and the role of interdisciplinary discussions between experts,medical officers,nurses,patient,and other staff of PHCs during the design,development,deployment,and test stage to be useful in taking design decisions efficiently.Results:The designed healthcare infrastructure of mPHC through the aspects of FI and SI proves to be efficient in providing key healthcare services to LRS.Conclusion:Focusing on essential capabilities and optimizing performance with technology,methodologies,and processes reduces costs in an innovation.Focus on socially inclusive and rebalancing power disparities,overcome societal challenges and improve human capabilities will create a sustainable and novel solution.

The Impact of Total Quality Management on Health Services Improvement, Sana’a Hospitals, Yemen (2017-2020)

Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.

Study on Health Management and Service Model of Chifeng Class 3A General Public Hospital

This study investigates the construction of a health management service mode based on large-scale comprehensive hospitals by analyzing health management service modes at home and abroad,that is,taking the Affiliated Hospital of Chifeng University as an example,establish a health examination hospital,undertake core tasks such as health service operation process,system,monitoring,and system formulation,and take the best medical resources.Attract social medical resources to collaborate and give health service mode of health status monitoring,evaluation,and intervention to health service objects,aided by advanced medical technology.To extend the traditional health management service with the hospital as the protagonist to health management with participation from family and society beyond the hospital,forming a closed-loop,rapid,and efficient health service management system.Thus,through graded quality services,to lessen the difficulties of patients seeing a doctor and to solve the problem of overcrowding and minor ailments in major hospitals.

Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals:A scoping review

Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.

Technology and Health持续质量改进模式在医院卫生管理中的应用价值研究

探讨持续质量改进模式在医院卫生管理中的应用价值。选取2020年1月—2022年7月收治的100例住院患者为研究对象,以2021年1月为时间节点,此前实施常规院内卫生管理(对照组),参与患者50例;2021年1月后医院卫生管理中实施持续质量改进模式(观察组),参与患者50例,均由50名专科医护人员进行卫生管理,随即针对不同卫生管理模式下医务人员的综合能力、院内不良事件发生概率、患者对院内管理满意度、卫生管理质量进行对比评估。经数据对比,观察组医护人员综合能力中,其卫生知识考评积分、卫生质量评分、监督评估积分均较对照组高(P<0.05);同时观察组院内感染、手卫生不合格、废料处理不及时、自我防护不到位等不良事件发生率低于对照组(P<0.05);观察组患者对其所处模式的满意度显著高于对照组(P<0.05);观察组卫生管理质量评估积分中,其安全管控、作业实操、手卫生/消杀、多重耐药菌处理、废料处置等专项积分均较对照组高(P<0.05)。研究发现,通过在医院卫生管理中为患者实施持续质量改进模式,可显著提高院内医护人员个人能力,强化对院内卫生管理重视程度,增加患者对卫生常识的认知,提高患者治疗满意度,降低医护人员错误操作、不当行为的发生率,有着较高临床应用价值。

Assessment of Municipal Solid Waste Management for Better-Quality Public Health and Environmental Sustainability in the Freetown Metropolitan City in Sierra Leone

Managing waste has been an aged-old challenge, especially in developing cities, like the Freetown Metropolitan City. Solid Waste and/or waste in general is an artefact of human activities that can spring from individuals, families, community, commercial/industrial operations etc. This study is a qualitative investigation, and it is intended to gather an inclusive knowledge of solid wastes management for better public health in Freetown, the Capital City of Sierra Leone. Statistical analysis was employed to observe numerical representations on a wide range of selected data. In an attempt to achieve the aim of this research project, reviews of available online resources were exploited, and juxtaposed with everyday knowledge in the existing state of the Freetown’s municipality solid waste management. The study revealed that residents in Freetown produce an average 0.45 kg of solid waste per individual per day. It was further established that biodegradable/organic matters comprise approximately 75% to 85% of total waste stream along with assorted retired furniture, scarp metals and plastic bags as most important recyclable elements. The hitches connected with municipal solid waste management in Freetown have become palpable, spanning from the past decade to date. Among many other factors, an upsurge influx urbanisation after the 11 years brutal civil war that ended in 2001, combine up with insufficient approved dumping sites for waste disposal and institutional incapability stand out. In this project, the contemporary approach of solid waste disposal in Freetown was carefully assessed with efforts to bring out the most feasible alternatives of solid waste disposal and acclaim ways of refining its activities. It was concluded from the study that, solid wastes in the Freetown Municipality must be tackled in a synergetic approach. That is, government corroborating with private solid waste managing actors so as to enhance an excellent better-public health, sustainable environmental, urban economic development and a resourceful energy paradigm.

Smart healthcare: making medical care more intelligent

With the development of information technology,the concept of smart healthcare has gradually come to the fore.Smart healthcare uses a new generation of information technologies,such as the internet of things(IoT),big data,cloud computing,and artificial intelligence,to transform the traditional medical system in an all-round way,making healthcare more efficient,more convenient,and more personalized.With the aim of introducing the concept of smart healthcare,in this review,we first list the key technologies that support smart healthcare and introduce the current status of smart healthcare in several important fields.Then we expound the existing problems with smart healthcare and try to propose solutions to them.Finally,we look ahead and evaluate the future prospects of smart healthcare.

U. S. Academic Medical Centers Under the Managed Health Care Environment

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

Cross Cultural Exploration of the Perceived Health Competence Scale

The eight-item Perceived Health Competence Scale (PHCS) is a measure of self-efficacy in general health management that is used to predict health outcomes and behaviors. The PHCS has been shown to be a reliable and valid instrument but has been used in primarily white European Americans. The PHCS is positively correlated to health status and coping abilities. Younger, healthier populations score higher on the PHCS compared to elderly who are managing chronic illness. This study examined the PHCS in three Midwestern samples: African American elders which revealed two separate factors in PHCS;Native Americans who evaluated the PHCS as a single construct;and a Spanish speaking sample. In the latter sample, findings suggest health competence may be a multi-dimensional construct. Further evaluation of the Spanish version of the PHCS and population characteristics are needed to measure health competence beliefs.

Merit and Evaluation Models for Managers in the National Health System： An Empirical Study

The national health system （NHS） complexity increase requires a review of the managerial human resources evaluation and recruiting methods, considering that nowadays doctors need to improve not just their clinical capabilities, but also managerial competences. At this end it is important to develop performances control models and to identify appropriate results indicators, with the aim of introducing an effective doctors selection system for managerial roles. The paper considers the Italian situation and tests the current evaluation and selection methods, by analysing the literature and the existing legislation and by interviewing experts. Moreover, in order to reach an innovative model, complex organizations have been taken into account as benchmarks. Three different categories of experts have been interviewed and texted： national health care organizations managers, companies managers, and business consultants. The 137 interviewed experts have been asked about four main questions concerning the evaluation for hiring managers as chief medical director, department director, and head of complex units. The conducted research suggests four different options in order to evaluate and to select heads of complex unit for the most strategic roles. By consequence, the analysis shows that required characteristics must be managerial attitudes as well as clinical capabilities.

Lean Management Based Sustainable Transport System for Surat Metropolitan Area in the Context of Industrial Development

Surat city is continuously expanding with industrial development. Despite several flyovers, traffic congestion continues in the heart of city. Therefore, fresh transportation planning is at anvil. Simultaneously, further expansion plan is under consideration to create yet another, the 10th industrial zone. Purpose of this paper is to explore lean management based sustainable transport system for meeting the increasing needs of people and supply-chain. The research examines different mode of transportation like; vehicles on road, rail on the land, and steamers through the sea route to provide connectivity. This study may support the planners of the smart city. The study intends to find how lean management can be integrated to sustainable transport system meeting objectives of lean and sustainability both. Lean management system claims to be capable of eliminating all type of wastes including those associated with transport system. On the other hand, sustainable transport claims to meet the needs of people in personal economic lives, importantly respecting the need of future generations. Therefore, this applied research aims to find a lean and sustainable transport solution. This research work can be seen as descriptive type as it includes survey of location and fact finding enquiries.

The health care economic-industrial complex: Concepts and general characteristics

The strategic role of health care within the Brazilian development agenda has been increasingly recognized and institutionalized. Aside from its importance as a structural element of the Welfare State, health care plays a leading role in generating innovation. Despite this, the productive base of Brazil’s health care system is extremely fragile, jeopardizing both the universal provision of health care services and the country’s competitive insertion in the globalized environment. This suggests the need for a more systematic analysis of the complex relationships that exist between the technological and the social interests involved in the productive base of health care provision in Brazil. Therefore, the purpose of this article is to enhance our understanding of the productive base of health care, especially given its potential to contribute to a socially inclusive development model, which is the ultimate goal in Brazil.

Health 3.0—The patient-clinician “arabic spring” in healthcare

A growing number of citizen-patients and clinicians use Communication and Self-Managed Health Technologies (CSMHT) in their relationship. Doing so, they shift from the current paradigm of dependency to a co-responsibility paradigm in healthcare. Facing the runaway utilization of health services, we need to think “outside the box” to unblock the system. A Health 3.0 development model of governance that position patients as primary members of the clinicians’ team is presented to map this institutional transformation. At the practical level, an MD 3.0 relational model and a Citizen-Patient 3.0 behavioral profile are presented.

Emergency management of nursing human resources and supplies to respond to coronavirus disease 2019 epidemic

Objective:To introduce the emergency management of nursing human resources and supplies of a large general hospital when facing the outbreak of coronavirus disease 2019(COVID-19).Method:The Nursing Department of the hospital fully executed its functional authority to establish a three-level echelon of sustainable support,allocate human recourses dynamically,organize pre-service training,supervise the key working steps,formulate positive incentive methods,and deploy medical supplies scientifically.Result:By taking these strategies,the hospital effectively improved the coping capacity of the nursing team and played a positive role in the prevention and treatment of COVID-19.Conclusion:The emergency management of nursing human resources and material resources for COVID-19 of the hospital is successful.But several deficiencies were identified as well,which indicated that the hospital needs to establish an efficient emergency management system,and pay attention to the practice of nursing emergency plans to enhance coping capacities in public health emergencies.

DEVELOPMENT AND PROSPECT OF GENERALHOPSITAL ARCHITECTURE IN CHINA

This paper presents the development and prospects of hospital architec-ture in China.Some typical hospitals in different periods are introduced, and the fu-ture development of huspital construction is discussed.

Best Practices and Innovative Scenarios of Integrated Patient Data Management to Improve Continuity of Care and Scientific Research

Clinical data have strong features of complexity and multi-disciplinarity. Clinical data are generated both from the documentation of physicians＇ interactions with the patient and by diagnostic systems. During the care process, a number of different actors and roles （physicians, specialists, nurses, etc.） have the need to access patient data and document clinical activities in different moments and settings. Thus, data sharing and flexible aggregation based on different users＇ needs have become more and more important for supporting continuity of care at home, at hospitals, at outpatient clinics. In this paper, the authors identify and describe needs and challenges for patient data management at provider level and regional- （or inter-organizational-） level, because nowadays sharing patient data is needed to improve continuity and quality of care. For each level, the authors describe state-of-the-art Information and Communication Technology solutions to collect, manage, aggregate and share patient data. For each level some examples of best practices and solution scenarios being implemented in the Italian Healthcare setting are described as well.

突发公共卫生事件背景下公立医院医疗物资供应冲突管理

文章基于突发公共卫生事件状态下公立医院医疗物资供应冲突发生的环境、事发经过、情境结果及冲突条件等要素,运用冲突管理有关理论探索冲突的构成要素及其结果、冲突中人员管理的一般性方法及冲突解决途径。在研究中不难发现,强制型管理风格在应对医疗物资全方位供应复杂性工作面前适用性略显不足,知识型员工在保健与激励因素共同负强化下使得人员管理更加如履薄冰,合作型冲突管理能够较为有效地解决冲突窘境。组织中的各类冲突在所难免,冲突的发生与领导管理风格、组织目标一致性、团队成员的激励程度、人际关系的维系与促进等因素息息相关,应关注冲突的管理方法,通过替代性方案建设性地加以解决至关重要。

健康管理护理高质量发展的思考

护士在健康管理中起到了至关重要的作用。文章回顾了我国健康管理护理的起源、发展、实践及专业现状,分析当前存在的问题,并借鉴国外经验,讨论我国未来健康管理护理高质量发展的前进方向,以期对我国健康管理护理的发展提供借鉴。

科技创新应对健康挑战

随着全球化、人口老龄化趋势的加剧和全球气候变化,人类面临的健康挑战日益复杂。全球化带来了全球性健康问题的出现,传染病的传播速度和范围明显增加,影响更加深远;气候变化不仅直接影响着人类健康,还通过改变生态系统和病媒生物分布等方式间接增加传染病暴发风险;与此同时,人口老龄化使得慢性非传染性疾病负担持续攀升,共病等复杂健康问题日益凸显,给医疗卫生健康系统和社会服务保障系统均带来了巨大挑战。而科技创新为应对这些挑战提供了前所未有的机遇,从精准医学到人工智能(AI),科技的进步正重塑健康管理范式。科技创新不仅是现代医学发展的引擎,更是应对未来健康问题的关键。未来应加强卫生健康体系建设、创新医防协同及医防融合机制、加强科技攻关与创新、AI赋能基层能力提升,以更好地应对健康挑战,增进人类福祉。

我国公立医院医生的价值医疗服务动机探究——概念建构与量表测度

健康中国建设行动彰显了以患者为中心的价值医疗理念,对医生医疗服务行为的价值诉求也日益提高。本研究试图将一般公共组织中公共服务动机概念引入公立医院之中,提出“价值医疗服务动机”概念,作为公立医院医生的一种公共服务动机表达。本文通过质性分析和量化测度,建构出“公立医院医生价值医疗服务动机”的概念,包含责任承诺、专业坚守、声誉维护、规范遵从四个概念维度,据此形成价值医疗服务动机量表。研究发现我国公立医院医生具有多维价值特征的医疗服务动机,呈现不同动机表达或行为倾向,在实现以患者为中心的价值医疗目标实践中,不断处理与平衡其中的公共价值冲突。该量表能够为测度医生价值医疗服务动机提供有效工具,为进一步发现医生价值医疗服务动机的影响因素,提升公立医院医疗服务能力、改善医疗行为、促进医患信任等提供理论与实践支持。