Analysis of Hospital Budget Management Control Based on Smart Hospital

Hospitals are crucial healthcare facilities where patients seek treatment,and effective budget management within hospitals significantly impacts their operational efficiency and financial performance.In the age of information technology and advanced healthcare solutions,the emergence of smart hospitals represents a new trend in the medical industry’s evolution.Leveraging modern information technology can enhance the development of hospital IT systems and drive budget management toward greater intelligence.This paper begins by analyzing the influence of smart hospitals on hospital budget control.It then examines the current state of budget management control within smart hospitals.Finally,it proposes several strategies for budget management control in smart hospitals,aiming to provide guidance for relevant stakeholders.

Lagos State Hospital Waste Management Practices: A Descriptive Overview with Stakeholders’ Role and Key Recommendations

Background: Waste generation and its disposal is an essential issue in the sustainability of the environment and the planet’s future. Waste management is essential across sectors, likewise the health sector. Therefore, there is a need to employ extra care and attention to handling waste generated from healthcare facilities to avoid the dangers of poor biomedical waste management. We carried out this study to examine the waste management practice in healthcare facilities in Lagos State. Methods: The study was a descriptive survey carried out in one-thousand two hundred and fifty-six (1256) healthcare facilities in Lagos State. Nine hundred sixty-nine (969) of these facilities are located in urban areas, while two hundred and eighty-seven (287) are rural. The facilities studied are government/public health facilities (15.45%), private-for-profit facilities (82.88%), NGOs, Mission/Faith-Based medical facilities (1.67%). The data collected were analyzed using descriptive statistics. Specifically, we utilized bar charts, frequency, and percentage. Result: The result shows that 98.4% (1236) of the studied facilities are registered with the Lagos State Waste Management Authority (LAWMA), while 1.6% (20) are not registered. 98.5% (191) of the 194 government-owned facilities, 98.5% (1025) of the 1041 private-for-profit facilities, and 98.2% (20) of the 21 NGOs/faith-based health facilities are registered with Lagos State Waste Management Authority. The result also shows that 94% of the healthcare facilities studied in Lagos State use color-coded waste bags to segregate waste at the point of origin. 58.7% of the facilities use red-colored bags, 33.3% use yellow-colored bags, 10.7% use black-colored bags, and 1.3% use brown biohazard bags for segregating Infectious waste. Also, 34.2% of the health facilities in Lagos state use red-colored bags, 36.9% use yellow-colored bags, 11% use black-colored bags, and 4.1% use brown-colored bags to segregate their hazardous waste. Conclusion: Some healthcare facilities in Lagos State do not follow the recommended guidelines for medical waste segregation. Waste generated is not appropriately segregated at the point of origin into the recommended colored bags/bins in some facilities. Thus, a policy and procedure regulating healthcare waste are mandatory. It is important to regularly train healthcare workers on proper waste management practices and encourage staff to read and apply WHO rules in managing healthcare waste. Healthcare personnel should realize that hazardous material is a potential cause of a public disaster.

Innovative Applications of Patient Experienee Big Data in Modern Hospital Management Improve Healthcare Quality

It is important for modern hospital management to strengthen medical humanistic care and build a harmonious doctor-patient relationship.Innovative applications of the big data resources of patient experience in modern hospital management facilitate hospital management to realize real-time supervision,dynamic management and s&entitle decision-making based on patients experiences.It is helping the transformation of hospital management from an administrator^perspective to a patients perspective,and from experience-driven to data-driven.The technological innovations in hospital management based on patient experience data can assist the optimization and continuous improvement of healthcare quality,therefore help to increase patient satisfaction to the medical services.

Management of work place bullying in hospital:A review of the use of cognitive rehearsal as an alternative management strategy

Lateral violence is not uncommon in workplaces.Unfortunately,nursing,a profession that builds its practice on compassion and code of ethics while caring for their patients is not spared from this phenomenon of lateral violence.Studies have reported cases of lateral violence among nurses to occur frequently worldwide.The impact of lateral violence has serious repercussions not only on the health of bullied victims but also on the structure and financial spending of the organisation.More importantly,the potential latent impacts on the patients'safety and health is of great concern.This literature review suggests that the contributing factors towards lateral violence are mainly due to characteristics of perpetrators,victims'reaction to bullying and organisation's characteristic.To mitigate the impact of lateral violence among young and inexperienced nurses,a cognitive rehearsal scripted response is proposed to prevent harassment and bullying incidents from becoming a feature at the workplace for nurses.

Implementation of Knowledge Management in Chinese Hospitals

The implementation of knowledge management （KM） in hospitals affects efficiency and outcomes of hospitals. However, few studies explored the implementation of KM in China. Twenty-two questions were designed concerning KM implementation status in over 50 hospitals. In order to understand the KM level and attitude to KM of the hospital＇s managers, a random sampling survey was conducted among 138 managers from 50 different scales of hospitals in 15 provinces of China. The survey showed that overall level of KM implementation in Chinese hospitals was still low and differed among different scales of hospitals （P〈0.05, or P〈0.01）. In all the hospitals investigated, 63.8% did not implement KM yet, among which 46% even had not planned for that. 49.8% of the hospitals investigated had no training program about KM ever and the main source of hospital staff to get knowledge was internet. It suggested that hospital managers should make much more efforts to get to know and understand theories on KM, so that hospital KM could be promoted more rapidly.

Practice and New Direction of Promoting the Construction of Managing System of Modern Hospital

If we want to enhance the medical level of modern hospital,we not only need to make the career morality and professional capability of the medical staff,but also require the perfection of the governance institution of hospital in accordance with the development of society.That said,the medical staff will provide the patients with the best service,which is significant to the development of hospital.In addition,every hospital should conduct deepening reform of public hospital comprehensively to respond to call of the government.And the hospital should also put forward professional and comprehensive managing system based on the concrete conditions of the hospital.That is how the hospital can serve the people better.That said,this article focuses on how to promote the system of managing the modern hospital.

Construction of an intelligent patient satisfaction assessment system and its application in emergency management

Hospital emergency management work is of great importance which not only related to the life and health of the people but also related to social stability.It is necessary to construct and improve the patient satisfaction assessment system so that doctors and patients can interact in a timely and effective manner,and the hospital can alert or respond promptly.This study constructs a closed-loop emergency management system consisting of patient-end,data center and decision-making-end,and apply the feedback information to hospital emergency management.In the preliminary applications,the system has a significant effect on the hospital emergency management mechanism.The researchers will improve the system in the follow-up study。

Analysis on Nutritional Risk Screening and Influencing Factors of Hospitalized Patients in Central Urban Area

Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area. It is helpful for the early detection of problems in nutritional supports, nutrition management and the implementation of intervention measures, which will contribute a lot to improving the patient＇s poor clinical outcome. A total of three tertiary medical institutions were enrolled in this study. From October 2015 to June 2016, 1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002（NRS2002） for nutritional risk screening, including 8 cases who refused to participate, 5 cases of same-day surgery and 5 cases of coma. A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk. Logistic regression analysis was performed with univariate analysis（P〈0.05）, to investigate the incidence of nutritional risk and influencing factors. The incidence of nutritional risk was 26.35% in the inpatients, 25.90% in male and 26.84% in female, respectively. The single-factor analysis showed that the age ≥60, sleeping disorder, fasting, intraoperative bleeding, the surgery in recent month, digestive diseases, metabolic diseases and endocrine system diseases had significant effects on nutritional risk（P〈0.05）. Having considered the above-mentioned factors as independent variables and nutritional risk（Y=1, N=0） as dependent variable, logistic regression analysis revealed that the age ≥60, fasting, sleeping disorders, the surgery in recent month and digestive diseases are hazardous factors for nutritional risk. Nutritional risk exists in hospitalized patients in central urban areas. Nutritional risk screening should be conducted for inpatients. Nutritional intervention programs should be formulated in consideration of those influencing factors, which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.

Infection Prevention Strategy in General Hospital under Regular Epidemic Prevention and Control

New coronavirus pneumonia spread rapidly all over the world in the first half of 2020, which is a new respiratory disease with strong infectiousness. At present, the epidemic situation in China has been effectively controlled, but the global epidemic situation remains grim, and the National Health Commission has instructed that the prevention and control of new coronavirus pneumonia should become normalized. As outposts for surveillance of public health events, hospitals are an important front in the fight against the epidemic. Therefore, it is very crucial to construct infection prevention and control system actively to contain the outbreak. This paper analyzes and summarizes the normal prevention and control management strategy of Infection Control Branch Management (hereinafter referred to as Hospital Infection-Control Dept) in a certain designated comprehensive third-grade hospital in Guangdong Province and transforms the prevention and control means in emergency state into measures for sustainable development, which also provides basis and reference for Hospital Infection-Control Dept of medical institutions to formulate prevention and control guidelines.

Hospital Hygiene Maternity Hospital Public Lubumbashi Democratic Republic of Congo

Introduction: Public hospitals in the DRC are of significant disrepair, while there is a strong link between the failure of hospital hygiene and the incidence of nosocomial infections. We have conducted a study with the objective of evaluating the structural-functional conditions of hospital hygiene maternity wards of public hospitals in Lubumbashi. Methodology: It was a descriptive cross-sectional study and structural-functionalist whose population consisted of nurses responsible for 7 of 12 maternity hospitals which were selected based on the inclusion criteria. The observation with an observation guide and maintenance using a questionnaire we used to collect data. Results: The results showed that hospital hygiene conditions in maternity wards of public hospitals in Lubumbashi are not good because almost all maternity services and surgery are not always water in the taps (14.3%). The bins were a means for care units, no coding system exists to distinguish the type of waste. The medical waste are mixed and the other waste are burned in the open or in makeshift incinerator with other types of waste. Conclusion: These maternity wards have poor hygiene, staff responsible for this sector did not follow any training in this area. There is need to regulate the sector and train them.

三级医疗机构医院卫生技术评估实施现况

目的分析三级医疗机构医院卫生技术(hospital-based health technology assessment,HB-HTA)评估开展现状,为完善医疗机构HB-HTA的应用提供参考和依据。方法运用便利抽样方法,对国家卫生健康委员会医疗管理服务指导中心HB-HTA工作试点医院和已开展HB-HTA的其他医院进行问卷调查和关键知情人访谈。结果共调查19家三级医疗机构,开展HB-HTA有利于促进医疗机构科学管理决策、保障医疗质量和安全、节约医院预算、提高HB-HTA认知水平。但目前HB-HTA还存在缺乏长期持续开展的激励机制、缺乏HB-HTA相关专业人才和部门、HB-HTA流程过于繁杂、卫生技术评估时效性较差、决策支持效率较低、研究结果推广率低等问题。结论建议加强政策、资金支持,注重加强医院内部卫生技术评估人才的引进和能力培训,积极鼓励和引导医院内部建立具体HB-HTA小组或者部门,探索开发HB-HTA支持决策流程的智能化工具或软件,通过多种方式促进评估成果和评估报告的传播共享,不断完善HB-HTA的开展。

Estimating Security Risk of Healthcare Web Applications: A Design Perspective

In the recent years,the booming web-based applications have attracted the hackers’community.The security risk of the web-based hospital management system(WBHMS)has been increasing rapidly.In the given context,the main goal of all security professionals and website developers is to maintain security divisions and improve on the user’s confidence and satisfaction.At this point,the different WBHMS tackle different types of security risks.In WBHMS,the security of the patients’medical information is of utmost importance.All in all,there is an inherent security risk of data and assets in the field of the medical industry as a whole.The objective of this study is to estimate the security risk assessment of WBHMS.The risks assessment pertains to securing the integrity of the information in alignment with the Health Insurance Portability and Accountability Act.This includes protecting the relevant financial records,as well as the identification,evaluation,and prevention of a data breach.In the past few years,according to the US-based cyber-security firm Fire-eye,6.8 million data thefts have been recorded in the healthcare sector in India.The breach barometer report mentions that in the year 2019,the data breaches found were up to 48.6%as compared to the year 2018.Therefore,it is very important to assess the security risk in WBHMS.In this research,we have followed the hybrid technique fuzzy analytic hierarchy process-technique for order of preference by similarity to ideal solution(F-AHPTOPSIS)approach to assess the security risk in WBHMS.The place of this empirical database is at the local hospital of Varanasi,U.P.,India.Given the affectability of WBHMS for its board framework,this work has used diverse types of web applications.The outcomes obtained and the procedure used in this assessment would support future researchers and specialists in organizing web applications through advanced support of safety and security.

A study on building data warehouse of hospital information system

Background Existing hospital information systems with simple statistical functions cannot meet current management needs. It is well known that hospital resources are distributed with private property rights among hospitals, such as in the case of the regional coordination of medical services. In this study, to integrate and make full use of medical data effectively, we propose a data warehouse modeling method for the hospital information system. The method can also be employed for a distributed-hospital medical service system. Methods To ensure that hospital information supports the diverse needs of health care, the framework of the hospital information system has three layers： datacenter layer, system-function layer, and user-interface layer. This paper discusses the role of a data warehouse management system in handling hospital information from the establishment of the data theme to the design of a data model to the establishment of a data warehouse. Online analytical processing tools assist user-friendly multidimensional analysis from a number of different angles to extract the required data and information. Results Use of the data warehouse improves online analytical processing and mitigates deficiencies in the decision support system. The hospital information system based on a data warehouse effectively employs statistical analysis and data mining technology to handle massive quantities of historical data, and summarizes from clinical and hospital information for decision making. Conclusions This paper proposes the use of a data warehouse for a hospital information system, specifically a data warehouse for the theme of hospital information to determine latitude, modeling and so on. The processing of patient information is given as an example that demonstrates the usefulness of this method in the case of hospital information management. Data warehouse technology is an evolving technology, and more and more decision support information extracted by data mining and with decision-making technology is required for further research.

北京清华长庚医院医管分工协同运营管理模式的探索与实践

介绍北京清华长庚医院探索医管分工协同的运营管理模式,实施临床业务管理与医院运营管理分工协同治理,建立职业化的医院管理人力资源体系,以及取得的成效。

Management status of type 2 diabetes mellitus in tertiary hospitals in Beijing： gap between guideline and reality

Background Diabetes has become one of the most common chronic diseases and the third leading cause of death in China. Many programs have been initiated at national and local levels to address the illness. However, the effect of these programs in daily outpatient clinics is still unclear. The objective of this study was to investigate the management status of type 2 diabetes mellitus （T2DM） and factors associated with it in diabetes clinics of tertiary hospitals in Beijing. Methods A cross-sectional survey was conducted in six tertiary hospitals in Beijing. Control criteria were defined based on 2007 China guideline for type 2 diabetes （CGT2D）. Results A sample of 1151 patients, age （60.8±9.2） years, and with a median disease duration of 7.3 years was included. The hemoglobin Alc （HbAlc） mean level was （7.15±1.50）%, the percentage of patients achieving the targets for HbAlc was 37.8%, blood pressure 65.6%, triglyceride （TG） 48.8%, high-density lipoprotein （HDL） 59.2%, low-density lipoprotein （LDL） 34.0%, and total cholesterol （TC） 42.0%. The factors independently associated with glycemic control were diabetes duration （odds ratio （OR） = 0.95; 95% confidence interval （CI）： 0.919-0.982, P 〈0.01）, body mass index （BMI） （OR=0.914, 95% CI： 0.854-0.979, P=0.01） and smoking （OR=0.391, 95% Ch 0.197-0.778, P〈0.01）. The factors independently associated with blood pressure control were BMI （OR=0.915, 95% Ch 0.872-0.960, P 〈0.01） and male gender （OR=0.624, 95% CI： 0.457-0.852, P 〈0.01）. The factor independently associated with LDL control was education level （OR=1.429, 95% Ch 1.078-1.896, P=0.013）. Conclusions The management status of T2DM patients in tertiary hospitals in Beijing has improved remarkably. However, there is still room for further improvement to reach the guideline target. Long diabetes duration, high BMI, smoking, male gender and low education level were independently associated with poor metabolic control.

An academic emergency department:residents' perspective

BACKGROUND:Since demographic changes have contributed to the growth of emergency medicine,a highly populous nation such as India needs to give physicians associated due credit and recognition.The management of knowledge source must also be conducted with due care as the work environment is completely different from that of any other clinicians.METHODS:The data were collected by direct interaction with residents of the department.Additional information was gathered by observation.The data were verified for validity.RESULTS:This study was to bring out the benefits of proactive decisions that could further enhance the emergency department.But such decisions did not always result in positive responses and improved morale.When such decisions were retracted as it causes misalignment with the existing system.An academic emergency department was expected and physicians should enrich their knowledge about emergency medicine.CONCLUSIONS:The problems faced by emergency department might be similar but the way in which one tackles the situation would be different.Decision making in this hospital may not be the best but it would've been the optimum one given the conditions available.

Gunshot injury to spine:An institutional experience of management and complications from a developing country

Purpose Gunshot wounds are the second leading cause of spinal cord injuries.Surgical intervention for gunshot injury to the spine carries a high rate of complications.There is a scarcity of data on civilian gunshot injuries to the spine in Pakistan.Approximately 60 cases over the last 10 years have been recoded,with unusual presentation and neurological recovery.Thus it is imperative to fill this gap in data,by reviewing cases of civilian gunshot injuries to spine presenting at a tertiary care hospital(Aga Khan University Hospital,Karachi).Methods This is a retrospective cohort study.Patients of all ages who presented to the emergency department of Aga Khan University Hospital,with gunshot injuries to spine between January 2005 and December 2016 were included in the study.Data were collected on neurological status(American Spinal Injury Association score was used for the initial and follow-up neurological assessment),extent of cord transection,motor and sensory deficits.The patients were further grouped into those with cord transection,and those with fractures of the bony spine but an intact spinal cord.These patients were then followed and the outcomes were recorded.Results A total of 40 patients were identified.The mean±SD of patients age was(30.9±9.5)years.Of the 40 patients with gunshot wounds,31 had the medical imaging performed at the facility,and hence they were included in this categorization.The remaining 9 patients were excluded from this additional grouping.Thirteen patients were managed surgically and 27 patients underwent the conservative management.The mean±SD of follow-up was(8.7±7.2)months.In our study,the thoracic spine was the most commonly injured region in gunshot injuries.Of the 31 patients with medical imaging performed at our institute,17(54.8%)had cord transection,of whom 8(47%)ultimately developed paraplegia.Conclusion The prognosis of gunshot injuries to the spine can be varied depending on whether the spinal cord is intact or transected.This will help healthcare providers to plan the further management of the patient and counsel them accordingly.

The Support Network of Total Quality Ensuring and Control for Hospitals

As the result of imperative demand for high quality health service, it is urgent to realize the automation of total quality ensuring and control for hospitals. The development of information technology makes it practicable. It has grown into a new domain of system engineering. This paper puts forward the concept of ″the support network system of total quality ensuring and control for hospitals ″, expounds its idea of system design, the functions and the structure, at the same time introduces its application in Taiyuan Rheumatism Hospital.

Characterization of patients and its relationship with medical complaints

Background Patient characteristics may be an internal factor influencing patient complaints, but in China patient characterization is restricted to patient satisfaction surveys, and few studies have considered the relationship between patient characteristics and patient complaints. The aim of this research was to determine the reasons for complaints. Methods In this study, we analyzed the characteristics of hospitalized patients and explored their relationship with medical complaints. Results The significant factors were age （P=0.045）, hospital cost （P=0.003）, household nature （P 〈0,001）, and education （P 〈0.001）. The complaint rate decreased when the patients＇ age increased （regression coefficient, -0.606; OR, 0.545, and 95%C/, 0.301-0.987）. The complaint rate increased with an increase in hospital cost （regression coefficient, 0.818; OR, 2.266; and 95%C/, 1.320-3.889）. Patients from non-agricultural households had a higher complaint rate （regression coefficient, 1.051; OR, 2.861; and 95%C/, 1.611-5.082）. Patients with higher education levels had lower complaint rates （regression coefficient, -0.944; OR, 0.389; and 95%C/, 0.234-0.647）. Conclusion The survey confirms that older patients and patients with higher education levels had lower complaint rates, while non-agricultural population and patients with higher hospital expenses had higher complaint rates.