Objective:To establish a monitoring and evaluation index system for the building project of national children′s regional medical centre (shorted as the evaluation system), so as to provide quantitative supports for output hospitals to fulfil their primary responsibilities and offer guidance for project hospitals to implement target management.Methods:From April to June 2024, through searching literature and policy document, and combining with the actual situation of national regional medical center construction, the initial indicators of the evaluation system were screened. An evaluation system were constructed using two rounds of Delphi method, and the weights of indicators were determined by analytic hierarchy process.Results:This study invited 17 experts. The participation rates of experts in the two rounds of consultation exceeded 90.00%, with an expert authority coefficient of 0.96. The final evaluation system comprised 2 primary indicators, 8 secondary indicators, and 52 tertiary indicators. The primary indicators included project implementation status and project outcomes, with relative weights of 44.44% and 55.56% respectively. Project implementation status included 4 secondary indicators: project organisation, resource allocation, project progress, and safeguard mechanisms. Project outcomes encompassed 4 secondary indicators: healthcare service capacity, regional talent development outreach, and collaborative innovation.Conclusions:The evaluation system established in this study demonstrated a high degree of scientificity and feasibility. It could effectively supported the process management and outcome evaluation of establishing the national children′s regional medical centre. This system provided a scientific basis for enhancing the quality and efficiency of children′s healthcare services, optimising policy formulation and resource allocation.

Lean six sigma (LSS) emphasizes patient demand-oriented, and continuously optimizing prolesses to achieve efficiency and standardization in medical services. Starting in 2021, a specialized children′s hospital (comprising one main campus and three branch campuses) introduced the LSS management method. Through define, measure, analyze, improve, and control, the hospital utilized tools such as questionnaire surveys, SIPOC models, and fishbone diagrams to identify pain points in the building of multi-campus child-friendly hospital and develop improvement measures.To address the main issues of insufficient cross-campus collaboration, significant disparities in service quality among different campuses, unclear functional positioning of each campus, and inadequate integration with social security mechanisms, the hospital implemented a " homogeneity-differentiation-coordination" management mode. The hospital implemented unified diagnosis and treatment standards and clinical pathways, carried out remote consultations and expert rotations, completed mutual recognition of examination and testing results, optimized child friendly labeling and child friendly environment, and built a " hospital-to-hospitals, hospital to medical schools, and hospital to community health centers" linkage platform, etc., to promote the standardization of diagnosis and treatment processes, clear functional positioning of the hospital area, and efficient resource allocation. Through practice, the outpatient appointment rate and patient satisfaction rate in the main hospital had increased from 86.72% and 98.64% in January December 2021 to 91.87% and 99.72% in January December 2024, respectively; The patient waiting time had been shortened from 26.54 minutes to 21.94 minutes, and the efficiency of medical treatment and service experience had been significantly improved. As of 2024, mutual recognition of 214 inspection and testing items had been achieved cross hospital campuses, forming a collaborative pattern of " main hospital leading, campuses support, and resource complementarity", and significantly improving the level of collaboration and child friendly connotation among multi-campus. This practice explored the integration path of multi-campus collaborative governance and child-friendly services, which could provide reference and inspiration for the similar hospitals.

Objective:To establish a monitoring and evaluation index system for the building project of national children′s regional medical centre (shorted as the evaluation system), so as to provide quantitative supports for output hospitals to fulfil their primary responsibilities and offer guidance for project hospitals to implement target management.Methods:From April to June 2024, through searching literature and policy document, and combining with the actual situation of national regional medical center construction, the initial indicators of the evaluation system were screened. An evaluation system were constructed using two rounds of Delphi method, and the weights of indicators were determined by analytic hierarchy process.Results:This study invited 17 experts. The participation rates of experts in the two rounds of consultation exceeded 90.00%, with an expert authority coefficient of 0.96. The final evaluation system comprised 2 primary indicators, 8 secondary indicators, and 52 tertiary indicators. The primary indicators included project implementation status and project outcomes, with relative weights of 44.44% and 55.56% respectively. Project implementation status included 4 secondary indicators: project organisation, resource allocation, project progress, and safeguard mechanisms. Project outcomes encompassed 4 secondary indicators: healthcare service capacity, regional talent development outreach, and collaborative innovation.Conclusions:The evaluation system established in this study demonstrated a high degree of scientificity and feasibility. It could effectively supported the process management and outcome evaluation of establishing the national children′s regional medical centre. This system provided a scientific basis for enhancing the quality and efficiency of children′s healthcare services, optimising policy formulation and resource allocation.

Lean six sigma (LSS) emphasizes patient demand-oriented, and continuously optimizing prolesses to achieve efficiency and standardization in medical services. Starting in 2021, a specialized children′s hospital (comprising one main campus and three branch campuses) introduced the LSS management method. Through define, measure, analyze, improve, and control, the hospital utilized tools such as questionnaire surveys, SIPOC models, and fishbone diagrams to identify pain points in the building of multi-campus child-friendly hospital and develop improvement measures.To address the main issues of insufficient cross-campus collaboration, significant disparities in service quality among different campuses, unclear functional positioning of each campus, and inadequate integration with social security mechanisms, the hospital implemented a " homogeneity-differentiation-coordination" management mode. The hospital implemented unified diagnosis and treatment standards and clinical pathways, carried out remote consultations and expert rotations, completed mutual recognition of examination and testing results, optimized child friendly labeling and child friendly environment, and built a " hospital-to-hospitals, hospital to medical schools, and hospital to community health centers" linkage platform, etc., to promote the standardization of diagnosis and treatment processes, clear functional positioning of the hospital area, and efficient resource allocation. Through practice, the outpatient appointment rate and patient satisfaction rate in the main hospital had increased from 86.72% and 98.64% in January December 2021 to 91.87% and 99.72% in January December 2024, respectively; The patient waiting time had been shortened from 26.54 minutes to 21.94 minutes, and the efficiency of medical treatment and service experience had been significantly improved. As of 2024, mutual recognition of 214 inspection and testing items had been achieved cross hospital campuses, forming a collaborative pattern of " main hospital leading, campuses support, and resource complementarity", and significantly improving the level of collaboration and child friendly connotation among multi-campus. This practice explored the integration path of multi-campus collaborative governance and child-friendly services, which could provide reference and inspiration for the similar hospitals.

Economic contract management is the basic work for the healthy and sustainable development of hospitals. At present, the contract management of some public hospitals in China is still in the stage of contract review text, which cannot meet the needs of high-quality development of public hospitals. Drawing on the practice of full lifecycle management of enterprise contract, the author put forward the concept of hospital contract full lifecycle management based on economic and business matters, and systematically introduced the hospital contract management framework and contract management information function design corresponding to this concept. Based on this concept, the hospital carried out the construction and application of the contract management platform, which significantly improved the standardization, refinement and information level of the economic contract management, and had the reference and promotion significance for improving the contract management level of public hospitals.

Economic contract management is the basic work for the healthy and sustainable development of hospitals. At present, the contract management of some public hospitals in China is still in the stage of contract review text, which cannot meet the needs of high-quality development of public hospitals. Drawing on the practice of full lifecycle management of enterprise contract, the author put forward the concept of hospital contract full lifecycle management based on economic and business matters, and systematically introduced the hospital contract management framework and contract management information function design corresponding to this concept. Based on this concept, the hospital carried out the construction and application of the contract management platform, which significantly improved the standardization, refinement and information level of the economic contract management, and had the reference and promotion significance for improving the contract management level of public hospitals.

Objective:To analyze the role of psychological detachment(PD) and career calling(CC) in the relationship between hospital workplace violence(HV) and turnover intention(TI), so as to provide references for developing effective intervention measures for medical personnel who have suffered from HV.Methods:From October and November 2022, convenient sampling was used to select medical staff from public hospitals in 16 provinces of China, and a questionnaire survey was conducted on HV, TI, PD, and CC. Pearson′s test was used for correlation analysis, and mediation effect analysis and moderated mediation effect analysis were used to explore the role of PD and CC in the relationship between HV and TI.Results:A total of 1 090 medical personnel were included in this survey, of whom 600(55.0%) had been subjected to HV. The findings showed that HV was positively correlated with TI( r = 0.27, P<0.05). From the analysis of mediation effect, HV had a negative predictive effect on PD( β =-0.82, P<0.05). PD had a negative predictive effect on TI( β =-0.31, P<0.05). PD partially mediated the association between HV and TI, with a mediation effect value of 0.25(17.39%). From the analysis of moderated mediation effect, interaction between HV and CC( β =-0.41, P<0.05) and the interaction between PD and TI( β = 0.17, P<0.05) had a moderating effect on the level of TI of medical personnel. Conclusions:HV was an important factor in predicting the TI of medical personnel, with PD partially mediating between HV and TI. The sense of CC played a moderating role between HV and TI, as well as between PD and TI.

OBJECTIVETo investigate the relationship between homocysteine (Hcy), von willebrand factor (vWF), soluble intercellular adhesion molecule-1 (sICAM-1) and the risk of cardio-cerebrovascular events among Inner Mongolians.

METHODSA survey was conducted among 2 589 Inner Mongolians from May 2002 to June 2003, and they were followed up for about ten years. The 182 individuals who developed cardio-cerebrovascular events in the cohort were defined as cases and those whose age, gender and residence 1:1 matched to cases were selected from the individuals who did not developed cardio-cerebrovascular events as controls. Then, a nested case-control study was used to analyze the relationship between Hcy, vWF and sICAM-1 and risk of cardio-cerebrovascular events. Conditonallogistic regression analysis was used to calculate OR values and 95% CI.

RESULTSThe cases had a higher baseline blood pressure, higher prevalence of hypertension and family history of hypertension compared to controls (all P values < 0.05), however, there were no significantly different between TC, TG, LDL-C, HDL-C, FBG, smoking and drinking rates (all P values > 0.05). The M (P(25)-P(75)) of Hcy were 10.68 (7.84-14.98) and 10.02 (6.64-13.94) µmol/L, vWFs were 10.88 (8.14-14.58) and 10.42 (7.97-13.50) mg/L, sICAM-1 were 336.48 (260.68-409.87) and 335.12 (269.87-409.87) ng/ml. They were not significantly different between the two groups (Z values were 0.89, 0.94 and 0.29, respectively, all P values >0.05). After adjustment for the family history of hypertension, hypertension, TC, FPG, BMI, smoking and drinking rate, the conditional logistic regression showed that OR (95% CI) of risk of cardio-cerebrovascular events were 1.00 (0.52-1.93), 2.37 (1.25-4.49), and 0.81 (0.45-1.47) for the participants with increased Hcy, vWF, and sICAM-1, compared with those with normal Hcy, vWF, and sICAM-1, respectively.

CONCLUSIONIn the Inner Mongolians, increased vWF at baseline may increase the risk of cardio-cerebrovascular events, and increased Hcy and sICAM-1 were not significantly associated with the risk of cardio-cerebrovascular events.

Cardiovascular Diseases ; Case-Control Studies ; Cytokines ; Homocysteine ; Humans ; Hypertension ; Intercellular Adhesion Molecule-1 ; Logistic Models ; Prevalence ; Risk ; Risk Factors ; Stroke ; von Willebrand Factor

OBJECTIVETo investigate the relationship between interleukin-6 (IL-6), endothelin-1 (ET-1), E-selectin and the risk of cardio-cerebrovascular events.

METHODSBased on a cohort study in which 2 589 Mongolians had been followed up for 10 years, a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence intervals (95%CI).

RESULTSThe average level of IL-6 (7.66 vs. 8.77 pg/ml), ET-1 (0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml)were not significantly different between the case and the control groups (P > 0.05). Data from the logistic regression analysis showed that IL-6, ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs (95%CI) on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16), 1.10 (0.66-1.85) and 1.19 (0.71-2.00) for the participants with IL-6>23.91 pg/ml, ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml, respectively, compared with those having IL-6≤23.91 pg/ml, ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml.

CONCLUSIONData from our study indicated that the levels of IL-6, ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.

Cardiovascular Diseases ; epidemiology ; Case-Control Studies ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Cohort Studies ; E-Selectin ; blood ; Endothelin-1 ; blood ; Humans ; Interleukin-6 ; blood ; Odds Ratio ; Risk

Objective To investigate the relationship between interleukin-6(IL-6),endothelin-1 (ET-1),E-selectin and the risk of cardio-cerebrovascular events. Methods Based on a cohort study in which 2 589 Mongolians had been followed up for 10 years,a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio(OR) and 95%confidence intervals(95%CI). Results The average level of IL-6(7.66 vs. 8.77 pg/ml), ET-1(0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml) were not significantly different between the case and the control groups(P>0.05). Data from the logistic regression analysis showed that IL-6,ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs(95%CI)on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16),1.10 (0.66-1.85) and 1.19(0.71-2.00) for the participants with IL-6>23.91 pg/ml ,ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml,respectively,compared with those having IL-6≤23.91 pg/ml ,ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml. Conclusion Data from our study indicated that the levels of IL-6,ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.