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.

ISO9000 and the Quality Management System in the Digital Hospital

Summary: ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.

A Study of the Relationships Among Total Quality Management, Executive Ability, and Sustainable Competitive Advantage

It is very important for organization to deal with and balance the challenge of environmental complexity and inner resources scarcity. This study considers total quality management (TQM) as a factor linking internal and external of organization and executive ability as linkage to promote and coordinate internal-external elements and then organization obtains its sustainable competitive advantage. The research surveyed effective samples 252 and used Structural Equation Model (SEM) and discriminated analysis for analysis and testing. The results indicate that TQM positively affects executive ability and firm sustainable competitive advantage. Executive ability affects firm sustainable competitive advantage and has the mediating effect between TQM and firm sustainable competitive advantage. Managerial practice implications, limitations, and future research directions have been discussed.

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery

BACKGROUND Esophageal cancer is one of the most common malignant tumors.The three-dimensional quality structure model is a quality assessment theory that includes three dimensions:Structure,process,and results.AIM To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery.METHODS In this prospective study,the control group received routine nursing,and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care.Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale(GSES)and Exercise of Self-Care Agency scale,respectively.IBM SPSS Statistics for Windows,version 17.0,was used for the data processing.RESULTS This study recruited 112 patients who were assigned to the control and experi-mental groups(n=56 per group).Before the intervention,there was no significant difference in GSES scores between the two groups(P>0.05).After the inter-vention,the GSES scores of both groups increased,with the experimental group showing higher values(P<0.05).At the time of discharge and three months after discharge,the scores for positive attitudes,self-stress reduction,and total score of health promotion in the experimental group were higher than those in the control group(P<0.05).CONCLUSION The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

Quality Management Systems in Chinese Hospitals

Many hospitals in China have imple-mented quality management systems and acquiredcertain standards.However,only a few hospitalshave combined quality management with self-man-agement.In order to properly and effectively imple-ment quality management and ensure the effectiveoperation of quality management systems,hospi-tals must fully realize the relationship between over-all hospital management and quality management,and combine the principles of GB/T19001 Stan-dards with the hospitals’overall activities.

Quality Management Model for Phase I Clinical Drug Trials:A Structural Equation Model

This study aimed to construct a quality management model for phase I clinical drug trials.A cross-sectional survey was conducted and data were collected from 604 respondents at 69 institutions in China engaged in phase I clinical drug trials.Exploratory and confirmatory factor analyses were used to develop the survey tool.Structural equation modeling was used to construct a quality management model for phase I clinical drug trials.The results showed that the final survey tool had good reliability and validity(Cronbach’sα=0.938,root mean square error of approximation=0.074,comparative fit index=0.962,and Tucker—Lewis index=0.955).The model included five dimensions:government regulation,industry management,medical institution management,research team management,and contract research organization(CRO)management.In total,22 measurement items were obtained.The structural equation model indicated government regulation,industry management,medical institution management,and CRO management significantly affected the quality of phase I clinical drug trials(β=0.195,β=0.331,β=0.279,andβ=−0.267,respectively;P<0.05).Research team management had no effect on the quality of trials(β=0.041,P=0.610).In conclusion,the model is valuable for identifying factors influencing phase I clinical drug trials and guiding quality management practices.

Quality Management Model Embodying Circular Economy and Sustainable Manufacture - Quality Concept Models Based on a Chinese Traditional Cultural Principle

Based on circular economy and sustainable manufacture theories, the drawbacks in the existing quality management models are analyzed. The requests that satisfy the big system 'environment-society-economy' are summarized to build up a model. A Chinese traditional cultural principle is applied and the relevant contents are sublimated as the platform to set up the model. The new quality management concept models are put forward: 'T-D-R' three dimension structures and 'ecological quality loop' model, from which the new quality concepts are formed. The paper elaborates the contents and the process of setting up the models. The big system quality problems can be handled by the new quality concept and model that are validated in practice.

Physicians＇ and Managers＇ Approach to Quality --Experience in Italian Hospitals

Literature provides many contributions about quality management and quality improvement. A few authors investigated the kind and strength of contribution to quality from physicians and managers. This study investigates the different approaches of physicians and managers towards managing and improving quality within healthcare organizations. Research questions are focused on the existence of any kind of correlation between physicians＇ and quality managers＇ skills as regards quality management. Do they work independently or is it possible to find out some relationship between their effort in enforcing service quality. In addition to that, the paper investigates if there is a correlation between organization＇s characteristic （dimension, ownership, teaching/not-teaching hospital） and quality of services. The study investigates an Italian regional-wide external assessment program （performed by Joint Commission International） focusing on a selection of item/standard related to physicians and quality managers＇ behaviours. The study did not found significant correlation between behaviours and hospitals＇ structural characteristics as well as between physicians＇ managerial behaviours and managers＇ behaviours as regards to quality. Physicians＇ and managers＇ contributions are independent to each other. The influence of managers on clinical behaviours is weak. Quality management depends mainly on people, not on structural elements.

A model of quality control based on recycling economy and sustainable manufacture

People currentiy pay attention to a hotspot problem that how industrial production is evaluated and controlled based on sustainable development theory. Quality is one of the important indexes. Two mainstream theories guide us to realize the industrial sustainable development： mainly the circular economy and sustainable manufacturing are introduced. The basic characteristics of the sustainable manufacturing are introduced, and that quality management is important contents of sustainable development is indicated. Based on circular economy and sustainable manufacture theories, the drawbacks in the existing quality management models are analyzed. The requests that satisfy the big system ＂environment- society - economy＂ are summarized to build up a model. A Chinese traditional cultural principle is applied and the relevant contents are sublimated as the platform to set up the model. The new quality management concept models are put forward ＂T- D- R＂ three-dimensional structures and ＂ecological quality loop＂ model, from which the new quality concepts are formed The paper elaborates the contents and the process of setting up the models. The big quality problems of the system can be handled by the new quality concept and model that are validated in practice.

职能部门多学科联合诊疗提升医疗质量的实践路径——以浙江大学医学院附属儿童医院为例

医疗质量安全是公立医院高质量发展的基础和前提,多学科联合诊疗(multi-disciplinary treatment,MDT)理念对于医院职能部门协同开展医疗质量管理实践具有重要价值。浙江大学医学院附属儿童医院创新探索符合儿童医院自身特色的质量管理模式,构建职能部门医疗质量MDT实践路径,形成临床科室主动发起会诊,各职能部门多方协同双向互动,精准发现并解决问题,持续追踪并反馈改进的闭环管理流程。该模式实施后,全院医疗质量安全水平全面提升,主要表现为科室一级质控能力增强,绩效考核核心指标优化,患者满意度显著提升,对促进医院高质量发展具有深远意义。

公立医院一院多区财务管理策略探析

随着公立医院迈入高质量发展阶段,一院多区的发展模式日益成为公立医院医疗资源扩容、满足社会医疗服务需求的重要模式。本文分析了公立医院一院多区背景下财务管理现状,通过阐述上海交通大学医学院附属瑞金医院在一院多区财务管理中的建设路径、具体做法以及成效,为公立医院一院多区财务管理提供更多科学建议和借鉴,以推动公立医院实现高质量发展。

公立医院高质量发展背景下医院运营管理工作的探索与思考

加强运营管理是公立医院高质量发展的重要内容,也是实现公立医院高质量发展的必然要求。坚持和加强党对公立医院的全面领导,建立不断完善的运营管理体系和长效机制,健全运营管理人才学习培养机制,以智慧医院建设为契机,提高医院智慧运营信息化管理水平,对公立医院高质量发展具有重要意义。

大型公立医院构建三尺质控模型的实践探索

目的构建“三尺”质控模型,促进医疗质量全面内涵管理。方法构建由“标尺、量尺、戒尺”组成的“三尺”质控模型,具体包括:以各项质量指标的标准化保障质量的基础管理,形成“标尺”;以“标尺”为准绳,落实全面质控和监督机制,保障质量的环节管理,形成“量尺”;运用绩效奖惩等措施落实质量的终末管理,形成“戒尺”。结果“三尺”质控模型的构建形成了全方位医疗质量监督管理机制,强化了医疗质量全面内涵管理,夯实医院高质量发展根基。结论“三尺”质控模型的构建与推广,有助于医疗质量持续改进和医疗服务能力有效提升,为我国各级医院医疗质量持续改进提供参考。

公立医院党员教育管理实践探索

为适应公立医院高质量发展新要求,首都医科大学附属北京安贞医院党委坚持以党的政治建设为统领,夯实制度基础,落地调研指导,推进党建与业务工作深度融合。医院坚持以人民为中心,以党建服务品牌创建为抓手,深化党员学习教育内涵,构建了与医院发展目标相统一、着力服务人民健康的科学精准、务实创新的党员教育管理长效机制。

某地市级公立医院学科与人才队伍建设的实践探索

随着医药卫生体制改革的深入和建立现代医院管理体系的要求,公立医院的建设与发展已从规模扩张逐步向追求内涵质量转变。学科建设与人才培养是公立医院工作的重中之重,是促进医院高质量发展的重要抓手,能直接提升医院的核心竞争力和区域影响力。近年来,某地市级公立医院积极推动学科与人才队伍建设,在学科排名体系、“三尺”长效质控模型、医疗技术全流程闭环管理、科主任目标管理、引进外聘学科带头人、培养中青年优秀骨干人才等方面做了许多探索性的工作,取得了显著成效。这些创新性举措的实施使医院不断提升学科管理水平,持续推进高质量发展。

公立医院医疗质量智慧化管理体系建设路径探讨

加强全面质量安全管理对提升医疗服务水平、保障患者安全和提高医疗效率具有重要意义。在探讨医疗质量智慧化管理体系建设意义和作用的基础上,梳理了数据整合与共享、数据分析与挖掘、智能决策支持、运营优化与效率提升、信息安全与隐私保护、人才培养与数字素养提升的关键路径,提出从政策引导、多方协作、技术创新多方面共同推进的建议。

三级公立医院绩效考核背景下医院运营管理的研究

国家三级公立医院绩效考核开始于2019年,运营效率作为考核的一部分,相关的国家监测指标有9个,包含收支结构和费用控制。绩效考核是医改工作的有力抓手,也是加快现代医院管理制度建立的强劲推手。通过分析某三级甲等口腔专科医院在绩效考核背景下运营效率指标的得分情况,找出原因;并通过加强党建引领,做好医院运营管理体系架构顶层设计,加强医疗质量管理,落实医改相关政策,加强能耗管理,不断提高员工福利待遇,强化公立医院功能定位,提高医疗服务收入占比,绩效分配体现医务人员的劳动技术价值,提高运营管理能力,助推医院高质量发展。

城市医疗集团门诊质量管理指标体系构建研究

目的:构建城市医疗集团门诊质量管理指标体系,为规范和提高城市医疗集团整体的门诊质量提供循证管理依据。方法:以“结构-过程-结果”模型为理论框架,通过文献回顾形成初级指标池,采用德尔菲专家咨询法对20位专家开展两轮次函询,根据函询结果对指标体系进行修改完善。结果:两轮次函询问卷有效回收率100.0%,专家权威系数均大于0.75,KendallW协调系数为0.13~0.39,最终构建的城市医疗集团门诊质量管理指标体系共包括3个一级指标、15个二级指标、46个三级指标。结论:本研究构建的城市医疗集团门诊质量管理指标体系全面、科学、实用,为城市医疗集团门诊同质化管理、搭建连续性服务、医疗流程优化、质量考核评价提供循证依据。

分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响

目的探讨和分析分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响和改善效果。方法选择安徽医科大学第二附属医院402名护士作为研究对象,于2023年3月1日—7月31日开展分层次教学培训,采用回顾性分析,对是否担任过医院感染管控护士的护士知识掌握程度、培训前后护士医院感染防控知识掌握水平和医院感染管理质量进行比较与分析。结果担任过医院感染管控护士的护士医院感染防控知识掌握评分高于未担任过的护士,差异有统计学意义(P<0.05)。培训后,护士在医院感染管理规范、诊疗器械处理程序、医院感染概念、空气消毒方面的知识掌握评分高于培训前,差异有统计学意义(P<0.05);护士在操作技能、应急能力、理论知识以及消毒管理方面的医院感染管理质量评分高于培训前,差异有统计学意义(P<0.05)。结论分层次教学培训的实施,显著提升了护士的医院感染防控知识掌握水平,同时也改善了医院感染管理质量。

公立医院高质量发展新效能研究——基于全面预算管理建设

为推动公立医院高质量发展,向提质增效、精细化管理转变,国家陆续出台相关政策为公立医院全面预算管理提供指引,构建全面预算管理体系,规范公立医院经济运行,提高医疗资源利用效率,更好地提供优质高效医疗卫生服务,为建设健康中国提供有力保障。文章采取政策文献研究、个案分析等方法,对预算管理进行分析研究,提出建设措施,以期为提升公立医院高质量发展新效能提供参考。