Medical quality and safety are the foundation for the high-quality development of public hospitals.The concept of Multi-disciplinary Treatment(MDT)is of great value for functional departments of hospitals to collaborate in carrying out medi-cal quality management practices.Children's Hospital,Zhejiang University School of Medicine explored a new quality manage-ment model,constructed the MDT practice path for medical quality in administration,and formed a closed-loop management process where clinical departments actively initiate consultations,various administrative functional departments collaborate and in-teract in a two-way manner,accurately identify and solve clinical problems,and continuously track and feedback outcomes.After the inception of this path,the overall level of medical quality and safety in the hospital has been comprehensively improved,mainly manifested in the enhancement of quality control capabilities of clinical departments,optimization of core performance e-valuation indicators,and remarkable improvement in patient satisfaction,thereby holding profound significance for high-quality development of the hospital.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective This paper aims to explore patient satisfaction with mobile medical payments in ethnic minority areas and its influencing factors.Methods From May to August 2023,565 ethnic minority patients from 6 villages in 4 ethnic minority autonomous counties in Dehong Prefecture and Pu'er City,Yunnan Province,were selected as research subjects,and 186 Han patients in Kunming were selected as controls.The general information questionnaire,the mobile medical payment will-ingness and attitude survey scale,and the medical cost mobile payment satisfaction survey scale were used to investigate their sat-isfaction with actual situation of medical mobile payment.Additionally,this paper discussed influencing factors affecting satisfac-tion.Results The ethnic minority patients exhibited a significantly lower level of satisfaction compared to the Han patients(39.65±10.43 vs.49.54±7.88,P＜0.05).ethnic minority patients scored significantly lower on the dimensions of satisfac-tion,such as perceived safety,ease of use and usefulness of mobile medical payment compared to the group of Han patients(all P＜0.05).Additionally,they ethnic minority patients showed significantly lower level of willingness and attitude to use mobile medical payment compared to the group of Han patients(P＜0.05).The main factors influencing the significant difference in satisfaction with mobile medical payment were ethnic group,number of hospital visits in previous year,first-time use of mobile medical payment,and educational background(P＜0.05).Conclusion Ethnic minority patients have a low perception of secur-ity,ease of use,and usefulness of mobile medical payments,as well as a low willingness and characteristics for mobile medical payment.Therefore it is necessary to further enhance their experience and satisfaction.In the development of mobile medical pay-ment services hospitals should fully consider the current situation of"illiteracy""semi-illiteracy"and"lack of resources"in re-mote ethnic areas.They should actively develop service platforms and applications suitable for mobile medical payment in ethnic minority areas to continuously enhance service efficiency and quality.