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Retrospective Analysis on Clinical Pathway Literatures 临床通路文献回顾性分析
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.910899
Xian-Tao Huang, Xueliang Wu, J. Xue, Limin Yang
AbstractObjective. To consult related documents, retrospectively study related research literature regarding the implementation of clinical pathway in China, and obtain knowledge of the status quo of clinical pathway application and the trend of its development in China. Method. Using the full-text databases of the China National Knowledge Infrastructure-China Hospital Knowledge Database (CHKD) periodicals as the data source, 1996–2010 as the time period and clinical pathway as the retrieval method to search for the literature data; performing analysis and research by processing data with Excel software, and using the literature metrology method, process analysis and retrospective research method. The Chinese literatures regarding clinical pathway between 1996 and 2010 are counted in terms of the distribution of basic research, application research and development research, respectively. Result. A total of 1,172 documents of clinical pathway research from 1996 to 2010 are obtained, and it is noted that th...
AbstractObjective。查阅相关文献,回顾性研究中国实施临床路径的相关研究文献,了解中国临床路径应用现状及发展趋势。方法。以中国国家知识基础设施-中国医院知识库期刊全文数据库(CHKD)为数据源,以1996-2010年为时间段,以临床路径为检索方法检索文献数据;运用Excel软件对数据进行处理,采用文献计量法、过程分析法和回顾性研究法进行分析研究。1996 - 2010年临床路径的中文文献分别按基础研究、应用研究和开发研究的分布进行统计。结果。共获得1996 - 2010年临床路径研究文献1172篇,值得注意的是…
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引用次数: 0
Comprehensive Evaluation of a Hospital's Medical Quality by Principal Component Analysis 基于主成分分析法的医院医疗质量综合评价
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.912009
X. Liang, Lijuan Huang
AbstractObjective. To evaluate comprehensively the quality of medical practices in a hospital from 1998 to 2012 by principal component analysis, and provide an objective and scientific theoretical basis for the long-term scientific management of the hospital. Methods. Choosing nine representative indicators that can reflect the medical quality of the hospital from the statistical forms of the hospital, after performing the standardized data conversion of the original data, calculating the comprehensive value of each year by using the principal component analysis, so as to carry out a comprehensive evaluation. Results. The medical quality of the hospital in 2012 ranks on top (evaluation comprehensive value F = 3.546), followed by that of 2011 (evaluation comprehensive value F = 1.951) and the worst is 1998 (evaluation comprehensive value F = − 2.012); the general trend shows gradual improvement since 1998 (evaluation comprehensive value F rises from − 2.012 to 3.546). Conclusion. The principal component an...
AbstractObjective。运用主成分分析法对某医院1998 ~ 2012年的医疗实践质量进行综合评价,为医院的长期科学管理提供客观、科学的理论依据。方法。从医院的统计表格中选择9个能反映医院医疗质量的代表性指标,对原始数据进行标准化数据转换后,利用主成分分析法计算每年的综合值,进行综合评价。结果。2012年医院医疗质量最高(评价综合值F = 3.546), 2011年次之(评价综合值F = 1.951),最差的是1998年(评价综合值F =−2.012);总体趋势从1998年开始逐渐改善(评价综合值F从−2.012上升到3.546)。结论。主成分是……
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引用次数: 1
Standardizing Diagnosis Writing and Improving DRGs Data Quality 规范诊断书写,提高DRGs数据质量
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.910904
Jie Liu
AbstractObjective. In 2013, Beijing medical insurance has achieved total expense pre-payment. The DRGs is one of the important evaluation tools for inpatient payment management; in order to improve the uploading quality of the DRGs data, it is necessary to standardize the writing of the diagnosis in the first page of the medical record. Method. To improve the diagnostic accuracy by strengthening the DRGs knowledge publicity and training, establishing a standardized database of synonyms for diagnostic names, by means of the information network, and using information technology to establish a visual platform for writing the diagnosis. By comparing the DRGs data in our hospital with the data of Beijing in the past two years, the hospital administrators and clinicians can understand where the problem lies in the diagnosis writing and the gap in the grouping of related data between our hospital and the average level of the same at Beijing. Result. The clinicians’ levels of writing the diagnosis and the quality...
AbstractObjective。2013年,北京医保实现了费用全额预付。DRGs是住院患者支付管理的重要评价工具之一;为了提高DRGs数据的上传质量,有必要规范病案首页诊断的书写。方法。通过加强DRGs知识的宣传和培训,建立标准化的诊断名称同义词数据库,借助信息网络,利用信息技术建立可视化的诊断编写平台,提高诊断准确率。通过将我院近两年的DRGs数据与北京市的DRGs数据进行比较,医院管理者和临床医生可以了解到诊断书写的问题所在,以及相关数据分组与北京市平均水平的差距。结果。临床医生的诊断书写作水平和质量……
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引用次数: 0
Comparative Analysis on Special Quality Control of Malignant Tumor Medical Record 恶性肿瘤病案特殊质量控制的比较分析
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.912025
Ye Peng, Xugang Zhang, Yichao Han, Na Xie, Xiufang Yang, Xiu-Li Zhang
AbstractObjective. To know the problems in medical record writing and diagnosis and treatment through the quality control of the malignant tumor medical records, identify the causes, and formulate measures for improvement, to standardize the diagnosis and treatment of malignant tumors. Methods. A total of 500 discharge malignant tumor medical records from June to August 2012 and 500 discharged malignant tumor medical records from June to August 2013 are randomly selected. The medical record quality control experts use a “special quality control table of malignant tumor” for quality control and statistical analysis. Results. After special medical record quality control, the defect rates of eight items, namely the diagnostic basis, name of the disease diagnosed, therapeutic scheme, pathological report, image report, informed consent, doctor's advice upon discharge and disease coding, are obviously reduced (P = 0.00) in the malignant tumor medical records, compared with those before quality control. Conclusi...
AbstractObjective。通过对恶性肿瘤病案的质量控制,了解病案书写和诊疗中存在的问题,查明原因,制定改进措施,规范恶性肿瘤的诊疗。方法。随机抽取2012年6月至8月出院恶性肿瘤病历500份,2013年6月至8月出院恶性肿瘤病历500份。病案质控专家采用“恶性肿瘤专用质控表”进行质控和统计分析。结果。病案专项质量控制后,恶性肿瘤病案诊断依据、诊断疾病名称、治疗方案、病理报告、影像报告、知情同意、出院医嘱、疾病编码8项不良品率较质量控制前明显降低(P = 0.00)。Conclusi……
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引用次数: 0
Defect Analysis and Strategy Discussion of Admission Notes Written by Interns of Cardiology Department 心内科实习生入院须知缺陷分析及对策探讨
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.912024
Shuquan Song, Dehou Yao, Yanna Li, Xueqin Zhou, Siyun Fu
AbstractObjective. To analyze the defects of admission notes written by interns of the cardiology department and to discuss strategies of improving their quality. Sixty-nine admission notes of our department from May 2013 to December 2013 were retrospectively analyzed according to the requirements of the Basic Criterion of Documentation of the Medical Record, which was issued by the Ministry of Health in 2010. Results. The defective medical records accounted for 82.6% (57/69), of which those having inaccurate general item filling accounted for 21.7% (15/69), those having problems in the filling of chief complaint accounted for 26.1% (18/69), those having problems in the filling of the history of present illness accounted for 62.3% (43/69), those having omission or inaccurate description in the fields of past history, personal history, menstrual obstetrical history and family history accounted for 20.3% (14/69), those having problems in the physical examination accounted for 46.4% (32/69), and those having...
AbstractObjective。目的:分析心内科实习生入院记录存在的缺陷,探讨提高入院记录质量的对策。根据卫生部2010年发布的《病案文件基本规范》的要求,回顾性分析2013年5月至2013年12月我科69份住院记录。结果。不良病历占82.6%(57/69),其中一般项目填写不准确的占21.7%(15/69),主诉填写有问题的占26.1%(18/69),现病史填写有问题的占62.3%(43/69),既往史、个人史、医患史等有遗漏或不准确描述的占82.6%(57/69)。月经、产科史及家族史占20.3%(14/69),体检中有问题者占46.4%(32/69),有问题者占46.4%(32/69)。
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引用次数: 0
Variation in Clinical Pathway Implementation Process and Discussions on Countermeasures 临床路径实施过程的变异及对策探讨
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.912010
Muhui Cao
AbstractObjective. To analyze the reasons for variation in the clinical pathway implementation management process and to explore effective measures to improve the pathway access completion rate. Methods. By evaluating the pilot management cases of clinical pathway implementation from August to October in 2013, the main reasons for variation in the clinical pathway implementation process are found, analyzed one by one and discussed, so as to put forward corresponding countermeasures and improvement measures. Results. There are three main reasons for variation in the clinical pathway implementation management. The variation factors and the variation ratio are that the patient factors account for 50.00% and the medical worker factors account for 9.38%, respectively, and the medical process and condition factors account for 40.63%. The improvement measures that are put forward are directed at the reasons for variation, so as to improve the completion ratio. Conclusion. The leadership in the hospital should pa...
AbstractObjective。分析临床路径实施管理流程变化的原因,探讨提高路径获取完成率的有效措施。方法。通过对2013年8 - 10月临床路径实施试点管理案例的评估,找出临床路径实施过程中出现变化的主要原因,逐一分析并进行探讨,提出相应的对策和改进措施。结果。临床路径实施管理存在差异的主要原因有三个方面。变异因素和变异率分别为:患者因素占50.00%,医务人员因素占9.38%,医疗过程和条件因素占40.63%。提出的改进措施是针对变化的原因,以提高完成率。结论。医院的领导应该…
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引用次数: 1
Analysis of the Current Situation in the Archiving of Inpatient Medical Records, and Its Continuous Improvement 住院病案归档现状分析及持续改进
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.910907
Mei Yang
AbstractObjective. To improve the archiving rate of discharge medical records of clinical departments by continuously improving the method of archiving the medical records of discharged patients. Method. The archiving rate of medical records was calculated and those medical records for which archiving was delayed, were analyzed statistically, to propose improvement measures according to the archiving time and discharge time on the medical records of discharged patients in various departments, which were counted by a medical record entry system during April 2012 and September 2012 as well as April 2013 and September 2013. Result. For 4,714 discharge medical records from April to September in 2012, the two-day archiving rate was 81.5%, and the seven-day archiving rate was 95.7%; however, after the improvement measures were taken, there were 5,557 discharge medical records in the whole hospital from April to September in 2013, the two-day archiving rate was 97.6%, and the seven-day archiving rate reached 99....
AbstractObjective。通过不断改进出院患者病历的归档方法,提高临床科室出院病历的归档率。方法。根据2012年4月- 9月、2013年4月- 2013年9月病案录入系统统计的各科室出院患者病案的归档时间和出院时间,计算病案归档率,并对延迟归档的病案进行统计分析,提出改进措施。结果。2012年4 - 9月出院病历4714份,2天存档率为81.5%,7天存档率为95.7%;但采取改善措施后,全院2013年4 - 9月出院病历5557份,2天存档率97.6%,7天存档率99....
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引用次数: 0
Study on Management Status Quo of the Medical Record Departments of General Hospitals in Fujian Province, and the Influencing Factors 福建省综合医院病案科管理现状及影响因素研究
Pub Date : 2014-04-23 DOI: 10.3109/23256176.2014.910897
Y. Lou
AbstractObjective. To understand the management status quo and the main influencing factors in the medical record departments at 46 general hospitals of seven cities in Fujian province through a survey, and to put forward relevant countermeasures and suggestions. Method. Surveying the basic information, medical record personnel allocation, education level and professional title, degree of attention given by the leadership, training of the employees, and the future development of the medical record departments at 46 general hospitals of seven cities in Fujian province by using questionnaires, setting up a database with Epidata3.0, and performing statistical processing and analysis with SPSS13.0. Result. Through the survey, it is seen that the administrative ownership of the medical record department at the general hospitals is not clear, the educational qualifications of the workers of the medical record offices are lower, the professional title and the specialty constitution are unreasonable, and there is...
AbstractObjective。通过调查了解福建省7个城市46家综合医院病案科管理现状及主要影响因素,并提出相关对策建议。方法。采用问卷调查的方式,利用Epidata3.0建立数据库,利用SPSS13.0进行统计处理和分析,对福建省7个城市46家综合医院病案科的基本情况、病案人员配置、学历及职称、领导重视程度、员工培训情况及未来发展情况进行调查。结果。通过调查发现,综合医院病案科行政权属不明确,病案室工作人员学历较低,职称和专业构成不合理,存在……
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引用次数: 0
Extension of External Medical Record Service 扩展外部医疗记录服务
Pub Date : 2014-03-31 DOI: 10.3109/23256176.2014.902179
Ting Yang, Wei Wu, Junhua Wang, Xiaomei Fang
AbstractThe present system of medical record copying suffers from certain drawbacks. Patients coming from other cities, and their agents, run around hospitals to copy medical record information, the copying applicant does not have all the necessary certificates with him, etc. Now, attempts are being made to change the ways in which this system works. These days, the medical record copying process and the approval system are illustrated in each ward of a hospital, and medical record copying notices are distributed. A patient is encouraged to inform the doctor-in-charge to copy the hospital discharge medical record and the patient prepares all the necessary and stipulated identification documents. When the patient leaves the hospital, the doctor sends the completed medical record to the medical record room as soon as possible for the purpose of archiving and copying; if the record cannot be transferred to the room for various reasons, the staff at the room register copying reservation for the patient needin...
摘要现行病案复印制度存在一定的弊端。来自其他城市的病人和他们的代理人在医院跑来跑去复制病历信息,复制申请人没有携带所有必要的证明,等等。现在,人们正在尝试改变这一体系的运作方式。目前,在医院的各个病房都有病历复印流程和审批制度的说明,并分发病历复印通知书。鼓励病人通知主治医生复印出院病历,病人准备所有必要和规定的身份证明文件。患者出院时,医生尽快将填写好的病案送到病案室存档、复印;如果由于各种原因无法转移到病房,病房挂号处的工作人员会根据病人的需要复印预约。
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引用次数: 0
Evaluation of Performance of Departments in a Hospital Using Principal Component Analysis 用主成分分析法评价医院各部门绩效
Pub Date : 2014-03-31 DOI: 10.3109/23256176.2014.902177
Xiaojuan Du, Changju Wang, Ling Zheng
AbstractObjective. To comprehensively evaluate the performance of 36 departments, so as to provide reference to improvement in operating capacity of the departments and search basis for the formulation of quantitative evaluation of the hospital. Method. Selecting eight representative indexes, standardizing treatment as per the original data with the Excel using the model of standard deviation of the mean, and performing the principal component analysis to the new processed variables using SPSS 13.0 software. Result. The performances of 36 departments are evaluated comprehensively and objectively, wherein the performances of the departments with the serial numbers 20, 32, 19, 18, 3, 2, and 1 are in the lead, and the departments are classified into first-class and second-class departments. The performances of the departments with the serial numbers 9, 15, 23, 25, and 34, which are classified into fourth-class department, are the bottom five. Conclusion. The principal component comprehensive evaluation ranki...
AbstractObjective。对36个科室的绩效进行综合评价,为科室运营能力的提升提供参考,为医院量化评价的制定寻找依据。方法。选取8个代表性指标,采用均值标准差模型,用Excel按原始数据进行标准化处理,对新处理的变量使用SPSS 13.0软件进行主成分分析。结果。对36个部门进行全面客观的绩效评价,其中编号为20、32、19、18、3、2、1的部门绩效处于领先地位,并将其分为一级和二级部门。编号为9、15、23、25、34的部门被划分为第4类部门,其业绩排名倒数5位。结论。提出了主成分综合评价方法。
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引用次数: 0
期刊
Chinese Medical Record English Edition
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