OBJECTIVETo develop a conceptual framework for decision-making data elements (indicator) in public health through determining its dimensions, sub-dimensions and their interrelationships.

METHODSOn the basis of literatures review, conceptual analysis and health determinant models, a conceptual framework was set up. This framework construction followed five principles: evidence-based, applicable, public health relevant, systemic and extensible. While, with the principles of conceptualization, objective-orientation, independence, and number-restriction, the domain and subdomains were also developed.

RESULTSA conceptual framework consisting of five domains and 20 sub-domains was developed. The 5 domains were health status, non-medical health determinants, public health system performance, the resources of public health system, and characteristics of community and assurance system. The health outcome included three subdomains of health status, functional status, and death; Non-medicine health determinants domain consisted of health behavior, working and living conditions, personal resources and environmental factors; performance domain was made up of effectiveness, accessibility, efficiency, responsibility and safety; resources domain had institution resources, human resources, financial resources, equipment resources and information resources; The characteristics of community and assurance system domain was the last domain which comprises characteristics of community, public health related policy and assurance system. The complicated relationship between these domains was also described.

CONCLUSIONAs the abstraction of public health system, this conceptual framework comprehensively depicts the components of public health system and complicated process of public health system. This framework conforms to the medical care quality model which is made up of structure, process, intermediate results and outcomes.

Decision Support Systems, Management ; Public Health Informatics ; statistics & numerical data ; Quality Assurance, Health Care

To study the program of evaluating mothers and infants after 6 months of cord blood donation, from June 1998 to February 2004, all mothers after 6 months of cord blood donation were followed-up by phone calls or letters to report on the health condition. The results showed that when 3 195 mothers were visited by phone calls, 18 mothers declined to answer. 392 letter were send to those who could not be found by phone, 15 of whom wrote back. The average time to talk with each mother was approximately 12 minutes. Follow-up on the baby donors showed two cases with chromosome abnormality, one with hypothyroidism, one with neutropenia, one with albinism and 5 dead with unclear reasons. The cord blood components from all these abnormal donors found were discarded. In conclusion, the programs to evaluate mother and baby after 6 months of cord blood donation seems important in quality control of the components stored in cord blood bank.
Adult ; Blood Banks ; Blood Donors ; China ; Female ; Fetal Blood ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Quality Assurance, Health Care ; methods ; statistics & numerical data ; Surveys and Questionnaires ; Time Factors

OBJECTIVEThis study was aimed at evaluating and comparing the quality of life in patients who underwent laparoscopic and open cholecystectomy for chronic cholecystolithiasis.

METHODSThe study included 25 patients with laparoscopic cholecystectomy (LC group) and 26 with open cholecystectomy (OC group). The quality of life was measured with the Gastrointestinal Quality of Life Index (GLQI) preoperatively, thereafter regularly at 2, 5, 10 and 16 weeks after the operation.

RESULTSThe mean preoperative overall GLQI scores were 112.5 and 110.3 in LC and OC group respectively (P>0.05). In the LC group, the mean overall GLQI score reduced slightly to 110.0 two weeks after the operation (P>0.05). The LC group showed significant improvement in overall score and in the aspects of symptomatology, emotional and physiological status from 5 to 16 weeks postoperatively. In the OC group, the GLQI score reduced to 102.0 two weeks after surgery (P<0.05). Significant reductions were shown in the aspects of symptomatology, physiological and social status. The GLQI scores returned to the preoperative level of 115.6 ten weeks after the operation (P>0.05). The patients experienced significant improvements of GLQI sixteen weeks after OC operation (P<0.01~0.05). Within the 10 postoperative weeks, the LC group had significantly higher GLQI scores than the OC group (P<0.05).

CONCLUSIONSLC can improve the quality of life postoperatively better and more rapidly than OC. The assessment of quality of life assessment is a valid method for measuring the effects of surgical treatment.

Adult ; China ; epidemiology ; Cholecystectomy ; statistics & numerical data ; Cholecystolithiasis ; epidemiology ; surgery ; Comorbidity ; Female ; Health Status ; Humans ; Laparoscopy ; statistics & numerical data ; Male ; Middle Aged ; Pain, Postoperative ; epidemiology ; Patient Satisfaction ; Postcholecystectomy Syndrome ; epidemiology ; Quality Assurance, Health Care ; methods ; Quality of Life ; Treatment Outcome

PURPOSE: The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use. METHODS: The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis. RESULTS: Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed. CONCLUSION: The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.
Adult ; Female ; Health Personnel/*psychology ; Hospital Information Systems ; Humans ; Male ; Medical Order Entry Systems ; Medication Errors/*prevention & control ; Medication Systems, Hospital/statistics & numerical data ; Middle Aged ; Perception ; Quality Assurance, Health Care ; Safety Management/statistics & numerical data ; User-Computer Interface

To evaluate outcomes between extraperitoneal robotic single-port radical prostatectomy (epR-spRP) and extraperitoneal robotic multiport radical prostatectomy (epR-mpRP) performed with the da Vinci Si Surgical System, comparison was performed between 30 single-port (SP group) and 26 multiport (MP group) cases. Comparisons included operative time, estimated blood loss (EBL), hospital stay, peritoneal violation, pain scores, scar satisfaction, continence, and erectile function. The median operation time and EBL were not different between the two groups. In the SP group, the median operation time of the first 10 patients was obviously longer than that of the latter 20 patients (P < 0.001). The median postoperative hospital stay in the SP group was shorter than that in the MP group (P < 0.001). The rate of peritoneal damage in the SP group was less than that in the MP group (P = 0.017). The pain score and overall need for pain medications in the SP group were lower than those in the MP group (P < 0.001 and P = 0.015, respectively). Patients in the SP group were more satisfied with their scars than those in the MP group 3 months postoperatively (P = 0.007). At 3 months, the cancer control, recovery of erectile function, and urinary continence rates were similar between the two groups. It is safe and feasible to perform epR-spRP using the da Vinci Si surgical system. Therefore, epR-spRP can be a treatment option for localized prostate cancer. Although epR-spRP still has a learning curve, it has advantages for postoperative pain and self-assessed cosmesis. In the absence of the single-port robotic surgery platform, we can still provide minimally invasive surgery for patients.
Aged ; Blood Loss, Surgical/statistics & numerical data* ; Humans ; Male ; Middle Aged ; Outcome Assessment, Health Care/statistics & numerical data* ; Perioperative Medicine/statistics & numerical data* ; Prostatectomy/methods* ; Prostatic Neoplasms/surgery* ; Quality Assurance, Health Care/statistics & numerical data* ; Robotic Surgical Procedures/statistics & numerical data*

INTRODUCTIONThis study reports our experience of audit and critical incidents observed by paediatric anaesthetics from 2000 to 2010 at a paediatric teaching hospital in Singapore.

METHODSData pertaining to patient demographics, practices and critical incidents during anaesthesia and in the perioperative period were prospectively collected via an audit form and retrospectively analysed thereafter.

RESULTSA total of 2,519 incidents were noted at the 75,331 anaesthetics performed during the study period. There were nine deaths reported. The majority of incidents reported were respiratory critical incidents (n = 1,757, 69.8%), followed by cardiovascular incidents (n = 238, 9.5%). Risk factors for critical incidents included age less than one year, and preterm and former preterm children.

CONCLUSIONCritical incident reporting has value, as it provides insights into the system and helps to identify active and system errors, thus enabling the formulation of effective preventive strategies. By creating and maintaining an environment that encourages reporting, we have maintained a high and consistent reporting rate through the years. The teaching of analysis of critical incidents should be regarded by all clinicians as an important tool for improving patient safety.

Adolescent ; Adult ; Anesthesia ; adverse effects ; methods ; Anesthesiology ; methods ; Child ; Child, Preschool ; Hospitals, Teaching ; Humans ; Infant ; Infant, Newborn ; Medical Errors ; prevention & control ; statistics & numerical data ; Pediatrics ; methods ; Quality Assurance, Health Care ; Retrospective Studies ; Risk Factors ; Singapore ; Young Adult