standards characteristics ; Hospitals ; Health Policy

Disease Management ; Hospitals ; standards ; Humans

OBJECTIVEInjuries are common and important problem in Tehran, capital of Iran. Although therapeutic centers are not essentially established following the constructional principles of developed countries, the present opportunities and equipments have to be used properly. We should recognize and reduce the deficits based on the global standards. This study deliberates the trauma resources and capacities in university hospitals of Tehran based on Arizona trauma center standards, which are suitable for the assessment of trauma centers.

METHODSForty-one university hospitals in Tehran were evaluated for their conformity with "Arizona trauma center standards" in 2008. A structured interview was arranged with the "Educational Supervisor" of all hospitals regarding their institutional organization, departments, clinical capabilities, clinical qualifications, facilities and resources, rehabilitation services, performance improvement, continuing education, prevention, research and additional requirements for pediatric trauma patients. Relative frequencies and percentages were calculated and Student's t test was used to compare the mean values.

RESULTSForty-one hospitals had the average of 77.7 (50.7%) standards from 153 Arizona trauma center standards and these standards were present in 97.5 out of 153 (63.7%) in 17 general hospitals. Based on the subgroups of the standards, 64.8% items of hospital resources and capabilities were considered as a subgroup with the maximum criteria, and 17.7% items of research section as another subgroup with the minimum standards.

CONCLUSIONSOn the basis of our findings, no hospital meet all the Arizona trauma center standards completely. The hospitals as trauma centers at different levels must be promoted to manage trauma patients desirably.

Arizona ; Hospitals, University ; standards ; Humans ; Iran ; Trauma Centers ; standards

China ; Female ; Hematologic Tests ; standards ; Hospitals ; standards ; Humans ; Male

OBJECTIVETo analyze the influence of knowledge about hypertension and clinical competence among physicians in district and community hospitals on management of hypertensives.

METHODSQuestionnaire investigation was used in 9 district and community hospitals in Chaoyang and Haidian district, including 181 physicians and 204 patients with hypertension.

RESULTS(1) The hospitals involved were divided into two groups according to our evaluation on the knowledge of hypertension and clinical competence of physicians. Four hospitals were graded as high-score group and 5 hospitals as low-score group. (2) There was no significant difference on physicians' evaluation between district and community hospitals. There was higher proportion of hypertensives with instructed physical exercises, reducing salt ingestion, psychological balance and weight reduction in district hospitals than those in community ones. (3) The proportion of hypertensives who were examined with funduscopy, ambulatory pressure and instructed with physical exercises, reducing salt ingestion and weight reduction in high-score group was obviously higher than that in low-score group. The control rates of blood pressure, on the days of examination during lastest check-up or the past three months, were significantly higher in high-score group than in low-score group (P < 0.05).

CONCLUSIONKnowledge of hypertension and clinical management competence among physicians in district and community hospitals did influence the management of hypertension and education of physicians and thus should be increased.

Clinical Competence ; standards ; Delivery of Health Care ; standards ; Directive Counseling ; standards ; Education, Medical ; standards ; Hospitals, Community ; classification ; standards ; Humans ; Hypertension ; diagnosis ; therapy ; Patient Care ; standards ; Physicians ; standards

OBJECTIVETo determine the validity of the diagnostic evidence for deceased cases in hospitals.

METHODSAll information collected from medical records of the deceased cases in tertiary care health facilities was input into our database. Four diagnosis levels were determined based on level of diagnostic evidence: level I was based on autopsy, pathology or operative exploration, level II on physical and laboratory tests plus expert clinical judgment, level III on expert clinical judgment, level IV on postmortem assumptions. After the diagnostic evidence of each deceased case was reviewed by a panel of three experts, the diagnostic level of each diagnosis was determined.

RESULTSAmong the 2102 medical cases for verbal autopsy study, only 26 (1.24%) afforded diagnostic evidence for level III. Among the level III evidence-based cases of death, the major causes of death were cardiovascular diseases, respiratory diseases, and gastroenterological diseases. According to some special symptoms and medical histories, these cases could be diagnosed by comprehensive clinical judgment. Only one case met the criteria for level IV.

CONCLUSIONLevel I diagnostic evidence is hard to attain in China because of the traditional concept and economic restriction. The causes for 2101 deaths can be validated by level II or III diagnostic evidence.

Autopsy ; Cause of Death ; China ; Cities ; Hospitals ; standards ; Humans ; Urban Population

The teaching effect of "process management and evaluation" was assessed in resident standardization training plan in acupuncture-moxibustion department of hospital for postgraduates of non-acupuncture-moxibustion speciality. A total of 120 postgraduates of non-acupuncture-moxibustion speciality participating in resident standardization training were randomized into an observation group (60 cases) and a control group (60 cases, 1 case dropped off). In the control group, the conventional training mode was used. In the observation group, the "process management and evaluation" was adopted, in which, the syllabus was refined, various teaching modes were cooperated and the summary was conducted once a week. The training results were evaluated at the end of 1-month shift test and questionnaire was issued in all of the postgraduates of the two groups. In the observation group, the score for theory and the score of each of the items for technical ability, named differentiation and treatment, technical manipulation and physician-patient communication, as well as the total score were all higher than the control group successively (
Acupuncture ; Acupuncture Therapy ; Hospitals ; Humans ; Moxibustion ; Reference Standards

This paper introduced the current situation of medical equipment. Based on the current problems such as technology assessment difficulty, weak consciousness on maintenance management, less quality control during clinic use and backward information level, the standardized management based on the whole process quality control was proposed. Combined the whole process quality control system with the construction of quality management information, the management level of the medical equipment was enhanced. The application of standardized management based on the whole process quality control can make the medical equipment work better in the clinic and set a good foundation for the development of hospital.
Hospitals ; Information Management ; Maintenance ; Quality Control ; Reference Standards

The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.
Acupuncture Therapy ; standards ; Hospitals, General ; manpower ; organization & administration ; standards ; Humans ; Moxibustion ; standards ; Practice Management, Medical ; organization & administration ; standards ; Reference Standards ; Singapore

Construction of research-based surgery department includes standardizing surgical practices, collecting and analyzing clinical data, discovering problems in clinical practices, designing and conducting reliable and high-level clinical research, improving and innovating surgical technologies according to research conclusions, working out technical specifications and promoting them through clinical education, and creating new clinical research needs arised by innovative and cutting-edge technologies and theories. By integrating technology, research, standardization, promotion and evaluation, and making close connections between different parts of clinical practices, scientific research and clinical teaching, it helps achieve coordinated development of surgical practices and translational research, and will finally promote the cultivation of medical talents and the progress of medical technologies. Since 2010, the General Surgery Department of Nanfang Hospital has established the basic idea of subject construction of "research-oriented surgery with data as the core, minimally invasive surgery with laparoscopic as the characteristic, and specialized surgery with high-efficiency service as the guidance", and has taken a series of measures to build it into a well-known research-based gastrointestinal surgery in China. The achievements of this speciaty have emerged from nothing, research platforms from few to many, the talent echelon from following to leading, and the influence from regional to international. The discipline construction has achieved a leap from quantitative to qualitative changes.
Biomedical Research ; standards ; China ; Digestive System Surgical Procedures ; standards ; Gastrointestinal Diseases ; surgery ; Hospitals ; standards ; Humans ; Minimally Invasive Surgical Procedures ; standards ; Program Development ; Surgery Department, Hospital ; standards