A study of PDCA Cycle in managing hospital medical complaints may introduce such a cycle into the medical complaints control system of a hospital, effectively handling the medical complaints process. Since 2006 when the cycle was introduced into the hospital for medical complaints control, such complaints have been cut back significantly by the end of 2009. Furthermore, such complaints are under control from the start, and prevented from growing into medical disputes, effectively improving quality of care. Such a cycle can effectively avoid medical complaints, enhance medical safety, and build a harmonious doctor-patient relationship.

Quality of care is key to medical safety which has a close bearing on patients’life and health,and on the branding and efficiency of the hospital.Medical safety is one of the key indicators of the overall performance appraisal of the hospital.This novel type of nurse-physician collaboration,abandoning the traditional model of health care,is a new integrated model of health care which improves the overall quality of care,enhances medical safety and patient satisfaction.This paper described in detail the implementation methods and steps of the collaboration,the progress of such a collaboration and its contribution to medical safety are also discussed.

Objective To explore and investigate effective solutions of some issues in the self-development of large-scale compre-hensive hospital ,such as the innovation concept of hospital management ,strengthening the organization and management agencies , improving management efficiency and promoting the establishment of systematized management .Methods Starting from concept innovation ,theory innovation and method innovation of hospital management ,comprehensive applied the advanced concept of hospi-tal management and scientific management methods into the quality of medical care .Results Continuously strengthen the hospital medical quality and safety ,and form hospital-specific quality management system .Conclusion Through innovating the concept ,the-ory and methods of hospital management ,we can effectively promote continuous improving quality of medical care in comprehensive hospital and improve continually core competitiveness of hospital .

This article sumarized a practise-based study of the hospital regarding the management of its medical activities.By means of priotizing medical safety in pre-job and on-the-job eduation,and regular trainings in this regard,a systemized medical safety education ssytem is put in place among medical staff of different types and levels.This achieved the purpose of higher awaress of medical safety in medical practice,and downsized medical complaints significantly.

According to the current meditech conditions in China,we combined the domestic and overseas first aid modes and the problems in severe trauma together and inducted the methods of model study into the procedure of traumatic first aid.The purpose of the study is to establish the procedure of inner-hospital first aid in severe trauma.Through the investigation and practice in Daping Hospital,Third Military Medical University,on the basis principles of organizing first aid with high efficiency,shortening preoperative time and enhancing achievement ratio of remedy,we established the procedure of inner hospital first aid with the typical character of time-control mode.This method can effectively enhance achievement ratio of remedy,decrease the ratio of disability.Moreover,it may promotes the process of entirety,systematization and specialization of inner-hospital first aid in severe trauma.

Objective To study the training methods of equipments for the national medical rescue team,for the purpose of enhanced equipment operation ability of team members and enhanced overall capacity for emergency rescue.Methods Using such methods as investigation and discussion,procedures development,examination standards development,and training and examination.These methods are designed to improve the equipment training methods for the national medical rescue team.Results Following the training,get-ready time of the whole team is cut back from 200 minutes to 90 minutes,and the roll-up time from 170 minutes to 80 minutes.Number of equipments mastered by the whole team has risen from 147 pcs/sets(47.2 ％) to 290 pcs/sets(94.5 ％),while average number of equipments mastered per person has risen from 98 pcs/sets(31.9％) to 185 pcs/sets(60.3％).Conclusion The Equipment Operation Procedures List and Equipment Training and Examination Standards should be made in consideration of the development needs of a national medical rescue team and disaster rescue experiences.In addition,such trainings and examinations as those by means of whole team,groups,and group-section crossing can improve the emergency rescue capabilities of the national medical rescue team.

Objective To observe the influences of modified constraint-induced movement therapy (mCIMT)on lower-extremity walking ability and femoral artery blood flow among elderly patients with stroke. Methods Totally 67 patients with stroke were randomly divided into mCIMT group(n =35) aged ( 73.2 ± 5.2 ) years and neurodevelopmental treatment (NDT) group ( n =32) as control aged(76.4 ± 3.8) years.Patients in control group exercised by NDT 2 h/time,2 times/d,5 d/week for 6 weeks. Patients in mCIMT group exercised including: up and down exercise,100-120 times/d; movement flatbed exercise for 16-20 min/d; upstairs and downstairs exercise,balance training,standing in a single leg exercise,mandatory exercise time of lower-extremity about 4 h/d,5 d/week for 6 weeks.The patients were assessed for lower-extremities motor function using maximum walking speed (MWS),Berg balance scale (BBS),timed up to go test (TUGT) and Fugl-Meyer(FMA-L) at pre-treatment and post-treatment.The change of femoral artery blood flow velocity and lumen diameter on the affected lower limb were observed by color Doppler. Results There were no differences in the above scores,lumen diameter and blood flow velocity before treatment between the two groups (P＞ 0.05).After treatment,the scores of MWS (56.68 ± 6.57vs.45.61 ± 5.34),BBS(46.84 ± 4.05vs.29.84 ± 4.05),TUGT ( 14.55 ± 8.25vs.25.35 ± 8.70)were higher in mCIMT group than in NDT control group (t=15.09,17.38,15.25,all P=0.001)while no difference in FMA-L score between the two groups was found (35.24 ± 7.62 vs.31.32 ±3.28,t=19.99,P＞0.05).Lumen diameter of femoral artery [(9.05±1.15) mm vs.(8.05±0.68)mm,t=6.72,P=0.001] and blood flow velocity[(92.55±18.25)cm/s vs.(69.35 8.7)cm/s,t=6.83,P=0.001] were increased in mCIMT group as compared with NDT group. Conclusions The mCIMT therapy is better in improving the lower-extremity walking function and blood flow velocity of femoral artery.

As the importance of clinical risks management grows hospital management,reducing hospital medical errors for patients safety has become a key quality management process.Failure Mode and effect analysis( FMEA) is a proactive technique for error detection and reduction.In this paper,based on a brief review of it's history of development,described in detail the implementation method and steps of FMEA,mainly introducing the research progress for using FMEA in reducing hospital medical errors.

Objective To enhance the management in identifying the surgical sites to comply with national standards.Methods A nurse-physician collaboration management team was set up to investigate the current identification of surgical sites in every operating room which violates regulations,with the causes analyzed and countermeasures proposed.Working hand in hand,doctors and nurses figured out the management details for preoperatively identifying the surgical sites and reengineering of the surgical process.With the responsibilities clarified and training enhanced,the surgeons,anesthesiologists,ward nurses and operating room nurses were held responsible for the process and improvements of identifying the surgical sites.The number of patients with unreasonable identification of surgical sites was calculated before and after establishment of nurse-physician collaboration management team.Results The reasonable identification rates of surgical sites were 37.94% before the reform and 80.94% after;incorrect use of all types of the surgical site identification can be minimized in the reform.Conclusion The management of nurse-physician collaboration is conducive to enhancing the reasonable identification rate of surgical sites,thus improving the quality of care and correctness of operations.

Objective To determine the feasibility of magnetically labeling and tracking mesenchymal stem cells(MSCs)in vitro by using a gadolinium and fluorescent bi-functionally transfection agent of polyethylenimine.Methods A gadolinium bifunctional transfection reagent complex was obtained after the linear polyethylenimine derivative(JetPEI-FluoR)was incubated with Gd-DTPA.Mesenchymal stem cells isolated from the bone marrows of SD rats were cultured and expanded.The mesenchymal stem cells were incubated with the bi-functional labeling agents.After labeling,the MSCs were examined with fluoroscope and electron microscope and the biological characters were detected including trypan blue exclusion test,MTT,and apoptosis detection.On a 1.5 T MR system,the labeled MSCs were examined with spin echo T1 WI and T2 WI and T1 measurement with mixed sequence.After labeling,the cells were cultured and undergone routine passage.Prior MR examinations were repeated for each passage of labeled cells.All data was statistically prolessed with SPSS for Windows.Results Of 5×105 MSCs incubated with the bi-functional agents,4.25×105 MSCs were successfully labeled,the percentage of labeled MSCs was 85% fluoroscopically.The high density electron particles of gadolinium observed electron microscopically existed around cellular apparatuses,especially around Golgi apparatus.In trypan blue exclusion test,the exclusion rate of labeled MSCs with incubation duration of 3,6,12,24 h was(96.55±2.90)%,(94.17±2.56)%,(97.16±3.12)% and(94.23±2.67)%,respectively.The corresponding exclusion rate of unlabeled MSCs was(95.86±2.67)%,(92.04±2.21)%,(93.38±3.64)%and(92.12±2.53)%,respectively.There was no statistical difference of trypan blue exclusion rate between labeled cells and control unlabeled cells within 24 hours of incubation(F=4.523,P＞0.05).In the proliferation test,the optical absorption value of labeled MSC with 2.5,5.0,10.0,20.0,30.0 and 40.0 μl bi-functional labeling agent was(0.1884±0.0151),(0.1878±0.0190),(0.1741±0.0160),(0.1135±0.0215),(0.1079±0.0145)and(0.0811±0.0079),respectively.The corresponding optical absorption value of unlabeled MSCs was(0.1940±0.0116).The optical absorption value of labeled cells was not affected in case of less than 30.0 μl of Gd-DTPA(q'=0.2225-0.9458,P＞0.05).The apoptosis index for labeled cells and unlabeled cells were 5.08% and 3.86%,respectively.On T1 WI,the signal intensity and T1 relaxation time of unlabeled cells and labeled cells were 240.3±24.7 and(2457±56)ms,336.2±20.7 and(1102±64)ms,respectively,and there were significant statistical difference(t=12.656,17.889,P＜0.01).The minimal amount of cells which was detectable for T1 WI was 5×103.After routine passage,the gadolinium in the cells gradually decreased and could be tracked by MRI until the fifth passage.Conclusions The gadolinium and fluorescent bi-functionally labeling rat bone marrow mesenchymal stem cell by using the transfection agent of polyethylenimine is feasible,efficient and safe.The labeled cells could be tracked in vitro on MR imaging.