Application of traditional indexes and adverse events in the ophthalmologic perioperative medical quality evaluation during 2010-2012

AIM: To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital. METHODS: The relevant data of perioperative period were collected in our hospital during 2010-2012, and the medical quality of perioperative period was evaluated by using the traditional evaluation indexes and adverse events. Whereby, the traditional indicators include vision changes, improving of intraocular pressure, diagnostic accordance rate before and after operation, cure improvement rate, successful rescue rate, and incidence of surgical complications, etc Adverse events are associated with ophthalmologic perioperative events including pressure sores, postoperative wound infection, drug adverse events, and equipment related adverse events. RESULTS: There were 1483, 1662 and 1931 ophthalmic operations in our hospital in the year 2010, 2011 and 2012, respectively. From traditional index analysis, the proportions of vision improvement for each year were 96.43%, 96.76% and 97.32%, respectively; the rates of intraocular pressure improvement were 87.50%, 85.72% and 90.17%, respectively ( P <0.05); the diagnostic accordance rates before and after operation were 99.86%, 99.94% and 99.90%, respectively; cure improvement rates were 99.73%, 99.93% and 99.84%, respectively; the successful rescue rates were 82.98%, 81.46% and 76.66%, respectively; the complications incidence rates were 18.44%, 17.52% and 17.97%, respectively. The negative factor analysis results showed that: among all the patients of ophthalmic surgeries in our hospital during 2010 and 2012, only one case of postoperative wound infection was found in 2011, and also only one case of tumbling in 2010. The adverse drug events for each year were 1 case (0.07%), 2 cases (0.12%), and 4 cases (0.21%), respectively; the medical device adverse events for each year were 3 cases (0.20%), 5 cases (0.30%), and 6 cases (0.31%), respectively. Noticeably, only one case with postoperative infection of endophthalmitis was found in 2011. Moreover, no pulmonary infection or pulmonary embolism occurred during the three years. The perioperative adverse event rates for each year were 0.34% (5/1483), 0.48% (8/1662) and 0.52% (10/1931), respectively. Though incidence was rising during the three years, no statistical significance was observed (P>0.05). It is the same case with drugs and medical devices adverse events (P>0.05). CONCLUSION: Traditional indicators reflect an excellent operation of the perioperative ophthalmologic quality, whereas adverse events analysis indicates some underlying problems. Compared with the traditional indexes for medical quality evaluation, the index of adverse events is more reasonable and easier to make an objective evaluation for medical quality of ophthalmologic perioperation, facilitating further refine analysis. Reasonable application of the adverse events indicators helps hospital to make the detailed quality control measures.

Establishment of a Comprehensive Evaluation System on Medical Quality Based on Cross-examination of Departments within a Hospital

INTRODUCTIONThe management of medical quality is the core element of hospital management, and it is reflected in every part and aspect of medical behavior. Strengthening the management on medical quality is crucial in ensuring medical safety, promoting the ability of clinical diagnoses and treatments as well as the increasing the efficiency of medical service, Oil this basis, the establishment and operation of a comprehensive evaluation system on medical quality is not only the foundation in ensuring the orderly operation of the medical behavior and medical safety but also an effective means in continuously improving the quality of medical management.

"Ten Thousand"Project to Cultivate the Professional Quality of Medical and Nursing Students:A Case Study of Suzhou Vocational and Technical College of Health

With the continuous development of the economy and the continuous improvement of people's requirements for the quality ofmedical care, medical staffs in hospitals need to have good professional qualities to better provide quality services for patients.Higher vocational colleges are an important training base for medical and nursing skilled personnel in China, but most medicaleducation focuses on students' professional knowledge and skills education, often neglecting the cultivation of professional quality.Taking Suzhou Vocational and Technical College of Health as an example, in this paper, a preliminary analysis of the currentsituation of training medical and nursing students' professional literacy in higher vocational colleges based on the "ten thousand"project was carried out, and its importance and significance discussed.

Quality Medical Services at Doorway——Beijing's community-based medical institutions

For years suffering from hypertension, Mrs. Zhang, now in her 60s, is a frequent visitor to Beijing Dewai Community Hospital in her neighborhood.＂I feel too painstaking to go to a ＇big hospital,＇＂ she says. ＂Buses are always overcrowded and slow, not suitable for people like me. Besides, community-based medical institutions charge less for treatment of the same diseases.＂

The Practice of Pharmacist-Driven Antimicrobial Stewardship Based on Value-Based Healthcare

Objective To evaluate the effect of pharmacist-driven antimicrobial stewardship based on value-based healthcare in a tertiary hospital in China.Methods The application of plan-do-check-action(PDCA)cycle and antimicrobial stewardship(AMS)were respectively used to improve the rational use of antimicrobial agents in prophylactic and therapeutic.Data were collected and the effect was assessed during the management period(2016-2019).Results and Conclusion From 2016(before implementation)to 2019(after implementation),the rational use of antibiotics were obviously enhanced in outpatients,inpatients,and emergency department.For instance,the utilization rate in type I incision operation was decreased from 26.42%to 14.60%(P=0.000),the daily doses of antibiotic per 100 patient-days decreased from 49.34±2.97 to 35.89±4.96(P=0.000),and the average antibiotic expenditures dropped from 948.53 yuan to 526.30 yuan(P=0.000).There was no significant change in infection rate,nosocomial mortality rate,and the length of hospital stay.After the implementation of clinical pharmacist-driven antimicrobial stewardship based on value-based healthcare,the consumption and cost of antibacterial have been greatly reduced.Therefore,the pharmacist-driven antimicrobial stewardship increases its value。

Quality metrics and outcomes among critically ill patients in China:results of the national clinical quality control indicators for critical care medicine survey 2015-2019

Background:It is crucial to improve the quality of care provided to ICU patient,therefore a national survey of the medical quality of intensive care units(ICUs)was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods:This was an ICU-level study based on a 15-indicator online survey conducted in China.Considering that ICU care quality may vary between secondary and tertiary hospitals,direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions.Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia(VAP),catheter-related bloodstream infections(CRBSIs),and catheter-associated urinary tract infections(CAUTIs).Results:From the survey,the proportions of structural indicators were 1.83%for the number of ICU inpatients relative to the total number of inpatients,1.44%for ICU bed occupancy relative to the total inpatient bed occupancy,and 51.08%for inpatients with Acute Physiology and Chronic Health Evaluation II scores≥15.The proportions of procedural indicators were 74.37%and 76.60%for 3-hour and 6-hour surviving sepsis campaign bundle compliance,respectively,62.93%for microbiology detection,58.24%for deep vein thrombosis prophylaxis,1.49%for unplanned endotracheal extubations,1.99%for extubated inpatients reintubated within 48 hours,6.38%for unplanned transfer to the ICU,and 1.20%for 48-hour ICU readmission.The proportions of outcome indicators were 1.28‰for VAP,3.06‰for CRBSI,3.65‰for CAUTI,and 10.19%for in-hospital mortality.Although the indicators varied greatly across provinces and regions,the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years.The overall mortality rate has dropped from 10.19%to approximately 8%.Conclusions:The quality indicators of medical care in China’s ICUs are heterogeneous,which is reflected in geographic disparities and grades of hospitals.This study is of great significance for improving the homogeneity of ICUs in China.