An retrospective review of the 16-year reforms made by Dongyang People's Hospital for building a corporate governance structure, implementing the president responsibility system under the board of directors, and consolidating the independent legal person status of hospitals. Practices made in the hospital prove that a well-functioning corporate governance structure is key to the separation of hospital administration from service, that of hospital management from operation, and that of hospital ownership from operation right. Moreover, it also serves as an effective model for consolidating the independent legal person status of public hospitals, and promoting their sustainable development, in an effort to carry out reforms in such hospitals.

Objective To explore ways to make public hospitals more economically efficient in compliant with existing health economic policies.Methods The concept Medicare Value Added(MVA)is proposed,and used as a benchmark in summarizing the economic management mechanism reforms in Dongyang People's Hospital during the past five years.Centering on MVA,this mechanism consists of the framework assurance,economic management organizational structure,management tools,ways of business growth,cost control,and financial management.Results During the past five years,the net state-owned assets of the hospital increased 100%,out-patients and emergency patients increased by 129 percent in number,in-patients,by 100%,while the average per capita payment of out-patients hasdropped from 1 57.86 yuan to 1 30.23 yuan,and that of in-patients has been kept as unchanged.Ratio of drugs to total income is maintained below 42%.Conclusions The management approach emphasizing MVA is effective in improving economic efficiency of public hospitals

Mini-clinical evaluation exercise(Mini-CEX) is a new tool used to evaluate clinical skill of internal residents.Through necessity,operation and practice of Mini-CEX applied in internal residents' clinical teaching,the paper makes it known that Mini-CEX is consistent with six requisitions of resident competence raised by Accreditation Council of Graduate Medical Education (ACGME).It increases medical and directorial quality,and is combined with doctor training abroad.Mini-CEX should be spread in training and examination of internal residents.

In view of the current conditions and reasons about the reform of medical and health system in China,the paper expounds the feasibility of authorized operation with state-owned assets of public hospital and the concrete operational pattern from the angle of hospital operational mechanism, which proposes a new idea about how to effectively solve the contradiction between the limited investment on state-owned health resources and the growing demands on medical health.

The paper explored the online real-time system built at the hospital to monitor clinical care quality using EMR.The methodology,procedures and index system were established for real-time clinical care quality control.With the online control in place,significant improvements were found in such care indexes as implementation of essential healthcare regulations,EMR quality,rational drug use and rational blood use,making quality control much efficient than before.EMR-based online clinical care quality control can improve quality of care,make it efficient and guide clinical care and quality control as well.

Due to the insufficient education of medical ethics and tending to medical moral educa-tion, the residents lack the ability to make ethical decisions. Therefore, we applied Four Topics method in the clinical ethics training of residents. The clinical ethics training was divided into three stages, and each stage had different training content and objectives. Dongyang People's Hospital adopted the form of lectures and panel discussions. During the group discussion, the group leader was in charge of case preparation, which came from clinical practice, and then all members applied the Four Topics method to analyze and discuss the ethical conflicts, and make the ethical decision. Through this process, residents' ability to solve ethical problems in clinical practice was enhanced.

Education of evidence-based medicine in clinical research is important in enhancing primary hospital clinical research capacity and quality.Dongyang People's Hospital of Zhejiang Province has carried out evidence-based medicine education and training,and greatly improved the performance of clinical research and development of scientific researchers.

Clinical thinking of Clinicians in Dongyang People's Hospital is gradually shifting from ‘empirical medicine’ to ‘evidence-based medicine’ after popularizing of evidence-based medicine, training core members and implementing multi-layered, multi-channeled, comprehensive and sustainable resident doctor training mode with clear steps and purposes within three years. This paper discussed on reasonable clinical practice of evidence-based medicine in primary hospital and provided realistic basis for the further development and improvement of training of evidence-based medicine in primary hospital.

In order to improve the professional level and service ability of general practitioners, this study is guided by the needs of community medical institutions in the county medical communities. Two small-class training of 15 modules were carried out for a week, taking "2+5" training mode, including 2 days of theoretical teaching and case discussion, and 5 days of bedside teaching. After the training, the theoretical examination, case report and objective clinical structured examination were carried out. Those who passed the examination were issued a certificate of qualification and given corresponding rewards. The results showed that the post-test scores of trainees after training were significantly improved compared with the pre-test scores, and the qualification rate increased from 18.4% to 85.9%. This training mode can be promoted in a wider range, but it should be adjusted appropriately according to the actual situation in various places, and the relevant departments and hospitals should give full support.