Objective To deliberate on the establishment of a Common Prosperity-oriented multilevel medical security system, with the aim of augmenting the progress of China's social security infrastructure and endeavoring towards the realization of the objective of Common Prosperity. Methods This article elucidates the value of the "Common Prosperity" multilevel healthcare security system. In response to the identified deficiencies within the current system and informed by the practice in Zhejiang Province, the author advances a set of strategic recommendations across four pivotal dimensions: systemic construction, synergy and complementarity, digital empowerment, and multi-stakeholder engagement. Results There were three principal deficiencies in the extant system: a lack of clarity in systemic delineation, a skewed structural equilibrium, and insufficient interconnectivity. Conclusion A coherent and inclusive Common Prosperity-oriented multilevel medical security system is essential for realizing the Common Prosperity. For this purpose, it is critical to ensure policy coherence and inclusivity, enhance synergy and complementarity, boost service efficiency via digital empowerment, and establish a multi-stakeholder cooperation mechanism to advance the comprehensive development and optimization of the healthcare insurance system.

Objective To develop an evaluation index system for health service provision to farmers and to assess its application in an empirical study. Methods Guided by the Rural Revitalization Strategy and the Healthy China initiative, an evaluation index system for the level of health service provision to farmers was developed based on literature review and Delphi method. Subsequently, utilizing a multi-methodological approach, including the Analytic Hierarchy Process (AHP), entropy weight method, linear weighted combination method, Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS, and rank-sum ratio method, this study evaluated the level of health service provision to farmers within the framework of rural revitalization. The assessment was conducted across nine provinces in China from 2017 to 2020, encompassing five dimensions including the content, quality, accessibility, assurance, and coordination of health services. Results In the context of rural revitalization, the health service provision to farmers in China exhibited an overall trend of steady advancement with a pursuit of further improvements. In terms of regional disparities, it was higher in the eastern region than in the central region and slightly higher in the central region than in the western region. While the content of health services was complete and the health service accessibility ranked high, the mobility and equalization of health resources still needed to be improved. Conclusion The evaluation index system for the health service supply to farmers developed within this study is scientifically sound and methodologically rigorous. It can be used for monitoring, alerting, and correcting rural health revitalization efforts. Furthermore, it offers theoretical foundations and empirical data to inform policy formulation by governmental authorities at various levels.

Objective To investigate the application of Internet technology for the implementation of a two-way referral system within urban-rural medical alliances, thereby optimizing the referral pathways between urban and rural healthcare providers. Methods Utilizing the Internet, telemedicine, and other information technologies, and leveraging the infrastructure of Internet hospitals, we constructed a novel model for regional online two-way referral services. Results Following the implementation of this new model, a total of 33 hospitals have been integrated into the system. The number of referrals has significantly increased, rising from 612 to 2,393 cases. The time required for the entry of patient information for two-way referrals has been reduced from 5.0 minutes to just 1.0 minute, while the duration for statistical analysis of referral data has been decreased from 3.0 minutes to 0.5 minutes. These efficiency gains have enhanced the referral process and treatment outcomes, thereby facilitating the coordinated development of medical alliance members within the region. Conclusion The Internet+ two-way referral model within urban-rural medical alliances facilitates the optimal allocation and sharing of medical resources among urban and rural areas. It enhances the efficiency and quality of healthcare services and improves patient experience during their referrals.

Objective To reinforce the Party construction in a public hospital, give full play to the function of the Discipline Inspection Commission "to supervise for ensuring implementation, and promote healthy development", and identify innovative approaches to daily supervision at the Party branch level to promote internal management. Methods By adopting the investigation and patrol inspection (IPI) systems, which are two featured systems of the Communist Party of China, the Party Committee and the Discipline Inspection Commission of a public hospital in Beijing carried out a comprehensive three-year IPI in Party branches and clinical departments. Results A total of 12 hospital-wide generalizable cases were identified, including 188 problematic items in 9 domains, and 160 of these items were urged rectification, with a rectification rate of 85.1%. Conclusion As an innovative approach to daily supervision, IPI can effectively reinforce the Party construction within public hospitals.

This review discussed the social characteristics and emergency characteristics of ethnic areas in Sichuan province, analyzed the current situation of unbalanced development of the emergency medical emergency system and insufficient grassroots rescue capabilities in the region, and proposed the basic strategies to strengthen the construction of medical emergency system via a high emphasis, coordinate planning, balancing software and hardware, and pragmatic and realistic attitudes. Meanwhile, this review described the importance of the daily preparation of system elements, improvement of medical rescue capacities, stabilization of the talent team, and management of construction effectiveness, thus improving the regional medical emergency rescue. Our findings aim to provide references for emergency management in other ethnic areas and promoting the improvement of accessibility and fairness of medical emergencies.

Objective To delineate the distribution of health resources in Yunnan province, assess the equity and efficiency of resource allocation and utilization, and offer recommendations on optimizing health resource allocation. Methods The equity of health resource allocation was gauged using the Lorentz curve, Gini coefficient, and health resources agglomeration degree, and the utilization efficiency was assessed using the three-stage data envelopment analysis (DEA) model and Malmquist index. Results The total amount of various health resources in Yunnan province continued to increase from 2017 to 2022. Health resources were fairly allocated according to population and economy but showed imbalance geographically. After the environmental variables and random interference were ruled out, the average comprehensive technical efficiency of medical and health resource allocation in Yunnan province was 0.971 in 2022, and the utilization of resources in 5 cities/prefectures was not DEA efficient. From 2017 to 2022, the total factor productivity was below 1 in the 13 cities/prefectures, mainly due to technological advances. Conclusion Health resources should be rationally allocated according to population, economy, and geography in different cities/prefectures in Yunnan province, which will help to strengthen technological innovations and regional collaboration in weak areas and gradually narrow the regional gaps, thus raising the efficiency of health resource utilization and meeting the diverse medical needs of residents.

To mitigate medical safety adverse events, foster a culture of learning from errors among healthcare personnel, enhance medical quality, and guarantee patient safety, a tertiary hospital has developed a comprehensive medical safety adverse event management system, which includes formulation of organizational and system standards for hospital-based medical safety adverse event management, establishment of incident reporting and response process, application of diverse quality management tools for the continuous improvement of event handling, effective communication of feedback on the incident treatment results and providing education and publicity, and implementation of an evaluation and incentive scheme for incident reporting and analysis. Subsequent to the adoption of the aforementioned measures, there has been a marked rise in the volume of self-reported medical safety adverse events within the hospital, along with increased efficiency of adverse event resolution and an elevated awareness of continuous quality improvement among the staff.

Objective To quantitatively evaluate the policy text of county medical community in China, aiming to providing references for the optimization of subsequent county medical community policies. Methods Policies related to county medical communities at thenational level in China from 2017 to 2023 were collected, and a policy modeling consistency(PMC) index model was created to quantitatively evaluate county medical community policies in China. Results A total of 12 county medical community policies were included, of which eight were at the excellent level and four at the satisfactory level, with a mean PMC index of 7.39. Conclusion The overall quality of county medical community policy in China is high, but it still needs to be optimized and improved. It is suggested to adjust the policy prescription, combine the short-term, medium-term and long-term goals, continue to improve the content of the county medical community policy, build a diversified incentive mechanism, and promote the high-quality development of the county medical community.

Objective To conduct a systematic evaluation of the residents' demand for Traditional Chinese Medicine (TCM) services in the Chinese grassroots medical institutions. Methods Literature was retrieved from multiple databases, including China National Knowledge Infrastructure (CNKI), CQVIP, Wanfang, China Biomedical, PubMed, Cochrane Library, MEDLINE, Embase, and Science Direct. Studieson the demand for TCM services by residents at grassroots medical institutions were collected from the inception of the databases up to March 2023. The meta-analysis was performed using the Review Manager 5.4 software. Depending on the characteristics and heterogeneity of the included studies, either a fixed-effect model or a random-effects model was employed for the analysis. Results A total of four Chinese-language articles were incorporated into the study, encompassing a cumulative sample size of 3,280 subjects. The meta-analysis revealed that the aggregate demand rate for TCM services was 74% [odds ratio (OR)=0.74, 95% confidence interval (CI): 0.55, 0.94]. More specifically, the demand rates for TCM knowledge services, TCM technical services, and TCM rehabilitation services were 56% (OR=0.56, 95% CI: 0.23, 0.89), 70% (OR=0.70, 95% CI: 0.40, 1.00), and 58% (OR=0.70,95% CI: 0.45, 0.70). Conclusion Chinese residents exhibit high levels of demand for the TCM services and TCM subcategory services offered by grassroots medical institutions.

Objective To investigate the reasons for the same-day cancellation of ambulatory surgery and to explore an optimized management protocol and interventions to minimize the cancellation rate. Methods A retrospective analysis was performed on the cases of same-day cancellation of ambulatory surgery procedures that were centrally managed at the Ambulatory Surgery Center of our hospital from April 2020 to July 2022. The impact of preoperative meticulous management on the cancellation rate was also examined. Results Following the implementation of preoperative meticulous management, the same-day cancellation rate for surgical procedures significantly decreased from 2.44% to 1.88% (χ²=6.064, P=0.014). In particular, the same-day cancellation rate for laparoscopic cholecystectomy significantly dropped to 1.30% (χ2=9.829, P=0.002). Before the introduction of meticulous management, 41.88% of cancellations were attributed to medical factors, 31.88% to disease-related issues, and 26.25% to patient-related factors; after the implementation of meticulous management, the distribution of reasons for same-day cancellations shifted to 25.35% due to medical factors, 39.44% to disease-related issues, and 35.21% to patient-related factors. Conclusion Improvements in preoperative management, surgical management system, implementation processes, capacity-building of medical staff, doctor-patient communication, and patient health education contribute to a substantial reduction in the same-day cancellation rate of ambulatory surgery, thereby benefiting the overall medical quality.

Objective To promote informationization, thus improving the low efficacy and limited workload for a manual transfer of emergency expenses. Methods Based on the informationization upgrade and transformation of the reimbursement process for emergency rescue expenses transferred to hospitalization in a selected tertiary hospital, the actual situations were summarized and analyzed alongside literature review and workflow sorting. Results The application of informationization upgrade was conducive to improving the efficiency of transferring emergency expenses in hospitalization reimbursement and ensuring fund security. Its functions basically run well, and the supported workload significantly increased. Compared with the previous manual mode, the efficiency and quality were significantly improved. Conclusion This measure has improved the hospital's level of convenient medical treatment, and patient's medical experience. In the future, we should continue to strengthen the level of the Internet+ medical insurance management supporting system, and it is recommended to unify and refine the provincial level regional emergency reimbursement policy.

The risk of coronary heart disease (CHD) in rural areas is increasingly serious, facing a series of problems, such as lack of medical resources, obstruction of emergency passageway, and disease management gap. With a S County in northern Jiangsu as a pilot, the Affiliated Hospital of Xuzhou Medical University built a village medical network and a central power grid platform to promote the sinking of high-quality medical resources. An electrocardiogram (ECG) cloud platform diagnosis center was established to smooth the whole-process management of CHD, and strengthen the cooperation of village, county and city hospitals to improve the referral mechanism of emergency patients. These efforts effectively improved the treatment dilemma of CHD patients in the S County. The improvement of the dilemma of CHD treatment in rural areas is grassrooted on a sound institutional cooperation mechanism, alongside the highlight of rural doctors in the network, and advocation of the whole-process management of CHD patients, thus building a regional collaborative prevention and treatment system of CHD.

Objective To analyze the research hotspots and development trends in Party construction in public hospitals in China, aiming to raise the quality and efficiency of Party construction in public hospitals. Methods Literature on Party construction in public hospitals from 2008 to 2023 in the China National Knowledge Infrastructure (CNKI) database was used as data sources. The knowledge graphs were drawn and analyzed using the CiteSpace software. Results A total of 878 articles were included in the study. The volume of papers published from 2008 to 2017 was relatively small but increased from 2018. No large network of collaboration was observed among authors and institutions. The research hotspots mainly included the high-quality development of public hospitals guided by Party construction, the construction of grassroots Party organizations in public hospitals, and the innovative theories and methods of Party construction in public hospitals. Conclusion The number of articles published on Party construction in public hospitals has been increasing. The cooperation frequency among authors and institutions and frequency of cross-regional cooperation are low. Closer academic research cooperation is required. Future research priorities may include enhancing construction of Party style and incorrupt governance, and promoting branding of Party construction, and Internet+ Party construction.

Objective To improve the service capabilities of the county medical community and to build a hierarchical convenient and beneficial pattern of diagnosis and treatment by consolidating the work of tertiary hospitals in counterpart assistance to county-level hospitals. Methods Based on the "one power and three cycles" model, the mechanism of counterpart assistance to county-level hospitals for tertiary hospitals was innovated. Results Three improvements were yielded by the county-level hospitals receiving the counterpart assistance from tertiary hospitals, including the improvements of management level, medical service capabilities, and convenience in asking for medical help. In addition, two enhancements were yielded as well, including the enhancements of the ability of medical personnel to serve the public, and regional influence and radiation power of county-level hospitals receiving the counterpart assistance from tertiary hospitals. Meanwhile, patient satisfactory to county-level hospitals was improved. Conclusion The "one power and three cycles" model dynamically optimizes the cooperation between tertiary hospitals and county-level hospitals to achieve win-win results.

The “one hospital with multiple branches” mode represents not only a shift towards a high-quality development paradigm for public hospitals but also an important progress in healthcare system reforms. In recent years, this mode has been actively adopted and implemented across China. The Jiangsu Provincial Hospital of Traditional Chinese Medicine has embraced the philosophy of prioritizing capacity over size, utilizing its Zidong Branch as a pilot to establish an integrated operation mechanism that fosters differentiated development and homogeneous management. As a result, the outpatient volume has continued to rise, which improved the availability and accessibility of medical care in local areas. Our experience is expected to provide evidence in the construction of other hospital branches.

Objective To construct a clinical data repository (CDR) that facilitates the real-time collection of original database and table data from various systems within a public hospital, thereby underpinning clinical activities, teaching, and scientific research. Methods At the First Affiliated Hospital of Soochow University, the database replication software HVR was utilized to enable the real-time capture of data alterations across various database tables. The results were divided into distinct topics, which were subsequently transmitted to the distributed publish-subscribe messaging system, Kafka, for further processing and dissemination. The data center, mainly based on the open-source distributed relational database TiDB, subscribed the different topics on Kafka to form raw datasets and clean and normalize the original datasets to form a standard dataset. Results A TiDB-powered CDR was successfully established, which cleaned and repurposed the data from over 30 principal medical systems within the hospital, thereby providing robust support for the hospital's varied and complex data requirements. Conclusion Multi-tiered data governance and a standardized, uniform CDR are constructive in enhancing hospital informatization.

Objective To investigate the coupling coordination between healthcare security and economic development in the Beijing-Tianjin-Hebei region following the implementation of the new medical reform in 2009, thereby providing references in the promotion of healthcare security system reforms. Methods Using the entropy method and the healthcare data in the Beijing-Tianjin- Hebei region spanning the period from 2009 to 2020, this study analyzed the capacity of the two systems to develop in a coordinated manner based on both coupling coordination degree and relative development degree. Results The two systems exhibited a strong interrelationship in the Beijing-Tianjin-Hebei region, with all the coupling degree values exceeding 0.9. In the context of coupling coordination, Beijing was characterized by an intermediate level, whereas Tianjin was at the primary level, and Hebei was at the threshold of coupling coordination. Furthermore, there was an upward trend in the coupling coordination degree in the three regions. Both Beijing and Tianjin were experiencing a relative lag in the domain of healthcare security, while Hebei was observed to be trailing in terms of economic development. Conclusion To promote the coordinated development of healthcare security and economic development in the Beijing-Tianjin-Hebei region, reform on healthcare security system should be enhanced. Additionally, there is a pressing need to enhance the integration of healthcare security resources across medical institutions at multiple levels, thereby elevating the residents' perceived accessibility to healthcare services.

Objective To explore the innovative path of medical science popularization in public hospitals under the background of "Internet +" and to promote the high-quality development of hospital health science popularization. Methods Based on the telemedicine platform, the working mechanism of medical science popularization was innovated by establishing a team of medical science popularization experts, taking public demand as the orientation of science popularization, developing special medical science popularization topics, building an Internet medical science popularization platform, optimizing the online and offline medical science popularization system, and establishing a scientific review and evaluation improvement mechanism. Results It has realized the organic unity of systematic, scientific and distinctive medical science popularization, so as to effectively improve the public's scientific quality and health literacy. Conclusion It provides theoretical support and practical path reference for the publicity and improvement of the hospital's image, meeting the public's demand for popularizing health knowledge, and improving the popularity of the hospital.

The rapid socieoeconomic development and healthcare reform in China call for a shift of the medical services towards a "patient-centered" model. Improving the healthcare-seeking experience is essential for deepening healthcare system reform, and an urgent need of implementing the "Healthy China" strategy, and upgrading public satisfaction. Recently, the Chinese government has issued a series of medical reform policies, setting new requirements for public hospital development and upgrading the outpatient services to a higher level. Orientated by patient needs, the Affiliated Hospital of Jining Medical University has constructed an innovative outpatient service model via implementing a series of outpatient management measures such as raising service capacity, simplifying treatment processes, and strengthening smart outpatient construction. The new outpatient service model has shifted from extensive to refined management, improved hospital operations, upgraded core competitiveness, and promoted intelligent, efficient, and humanized hospital development. As a result, the service efficiency and patient satisfaction have been greatly increased. Our experience may provide reference for outpatient management in large tertiary hospitals.

Objective To explore the potential of ChatGPT in the field of integration of medical science and education; to analyze how to improve the efficiency of academic literature retrieval, data analysis, and research decision support through natural language processing technology; and to explore its role in promoting individualized educational content and precise academic research. Methods Through literature review and case analysis, the potential application of ChatGPT in the integration of medical science and education was studied. Countermeasures of ChatGPT in responding to various challenges were analyzed. Results ChatGPT has shown significant application potential in the integration of medical science and education, which could assist researchers in quickly retrieving and analyzing academic literature, optimizing diagnosis and treatment decisions, and improving teaching efficiency and quality. Conclusion ChatGPT has an important application value in the integration of medical science and education, but its widespread application requires continuous efforts in technical optimization, user training, data management and ethical standards. In the future, technical improvement of ChatGPT and interdisciplinary collaboration will be the key to promoting its widespread application in the field of education and scientific research, helping to innovate education models and promote the development of academic research.

Objective To construct a collaborative governance framework for medical alliance in the era of digital intelligence from the aspect of digital intelligence and based on the theories of collaborative governance and actor networks, thus providing new ideas for the transformation of medical digital intelligence. Methods Combined with the current situation of the medical alliance and the development trend of digital intelligence, a collaborative governance framework for medical alliance information in the era of digital intelligence was constructed from five aspects: collaborative drive, actor, process, action, and governance efficiency. Results Medical alliance involved many actors, and there were contradictions and obstacles. By analyzing the roles, processes and behaviors of various actors in the collaborative cooperation, it is concluded that coordinating the distribution of benefits, improving information communication, creating multi-dimensional incentives and strengthening internal and external supervision were the key strategies to promote the formation of synergistic advantages of medical alliances. Conclusion Through the construction of collaborative governance framework for medical alliance and analysis of action strategy, it is hoped to reduce "collaborative inertia", enhance "synergistic advantages", and promote the realization of hierarchical diagnosis and treatment goals.

Objective In response to the national initiative for smart services, to improve the patient service process in hospitals and align with the workflow of medical staff, the introduction of the Intelligent Post-diagnosis System (hereinafter referred to as the system) is aimed to conduct the digitization and informatization of the follow-up and education services. Methods Based on the B/S architecture and the use of a standard operating procedure (SOP) in patient management, follow-up, health education, knowledge database, feedback and system allocation, the current status and demands of clinical setting were analyzed. Data integration and standardization were conducted by targeting the detailed workflow procedure in various departments. Results It realized the interconnection between the hospital's business systems, data platforms, external platforms, system management backend and other applications. Data analysis revealed system deficiencies and pointed out the way for subsequent optimization. Conclusion The system effectively promotes doctor-patient communication, improves work efficiency, and clarifies the direction of optimization. In the future, continuous improvements will be made based on clinical needs and patient feedback to improve the efficiency and quality of medical services.

Objective To explore the basic situation and current status of the development of secondary maternal and child healthcare institutions in Kunming City, and provide a basis for the reasonable allocation of health resources and formulation of relevant policies by higher-level health administrative departments. Methods Data were obtained from the Maternal and Child Health Care Institution Performance Appraisal System and Maternal and Child Health Annual Report of Yunnan Province in 2022. The current status of secondary maternal and child healthcare institutions in Kunming was investigated and analyzed. Results There were big gaps in medical resource allocation, talent team, service capabilities, and information construction between the secondary maternal and child healthcare institutions in Kunming and the healthcare institutions within the jurisdiction. Conclusion A further clarification of functional positioning and development goals, rational allocation of medical resources, optimization of talent teams, improvement of maternal and child health service system, increase in service capabilities and promotion of informatization construction are essential in secondary maternal and child healthcare institutions in Kunming, thus promoting the high-quality development of maternal and child health career.

Objective To identify the current research landscape and key trends in the high-quality development of public hospitals in China using the literature visualization techniques, aiming to offer evidence for advancing the high-quality development of public healthcare institutions. Methods Articles were retrieved from China National Knowledge Infrastructure (CNKI) and Chinese Social Sciences Citation Index (CSSCI) databases as analysis samples. A visual analysis of these articles was carried out using CiteSpace, VOSviewer, and COOC tools in terms of authors, institutions, and keywords. Results Totally 236 articles published between January 2019 and May 2024 were identified, and the number of publications showed a rising trend annually. No significant core author group or highly concentrated research focus was identified in the visualized analysis. Research hot spots focused on hospital management, public welfare, operations management, informatization, health management and conceptual and performance appraisal studies. Conclusion The investigations into the high-quality development of public hospitals are characterized by periodical features and closely related with the policies of the Party and the government. This research topics and scope should be further expanded, along with closer inter-institutional collaboration. The definition and intrinsic aspects of high-quality development of public hospitals should be further clarified. Future research priorities may include policy and institution innovations, technology-driven scientific innovations, continuous quality improvement, and evaluation mechanisms.

Objective To innovate a new mechanism for efficient operation of radiotherapy, thus achieving quality and efficiency enhancement, and comprehensive improvement of patient satisfaction. Methods Problems exited in the entire process of radiotherapy were identified by the SIPOC (Supplier-Input-Process-Output-Customer) model and PCE (Process Cycle Efficiency) analysis. The fishbone diagram, and nominal group technique were used to confirm the priorities to be solved. A continuous improvement plan was developed. The service process was optimized by strengthening information technology construction, establishing efficiency monitoring and performance evaluation mechanisms, and setting improvement goals. The improvement effect was evaluated by the indicators of waiting time for therapy and patient satisfaction. Results The waiting time for therapy was significantly shortened, and the time limit rate (within 10 days of radiotherapy) increased from 18% to 51%. The PCE increased from 12% to 16%. The satisfaction of both healthcare providers and patients was significantly improved. Patient satisfaction increased from 93% to 98%. The satisfaction rate of doctors increased from 80% to 95%, and that of physicists and technicians increased from 85% to 95%. Through the construction of informatization and automatic backend collection of data and information, interconnection and intercommunication of radiotherapy subsystems were achieved. Conclusion An intelligent radiotherapy service model, all-round full-loop management of the radiotherapy process, and improvement of service capabilities greatly improve the patient's medical experience. A visual data management platform is established to realize the interconnection of data streams, strengthening of quality control, improvement of work efficiency, stimulation of sustainable continuous endogenous power and the comprehensive competitiveness of the department.

Objective To explore the collaborative management of "one hospital with multiple districts" medical services from the perspective of high-quality development, and to propose optimization paths for collaborative management and promote the high- quality development of medical services. Methods Through identifying the concept and meaning of the "one hospital with multiple districts", management difficulties and challenges of the "one hospital with multiple districts" were analyzed. Key management points of the "one hospital with multiple districts" were formulated. In a case hospital, innovative management models and distinctive specialty settings were explored. Results Under the concept of "integrated management, homogeneous operation, differentiated competition, and characteristic services", the east and west campuses of the case hospital had their own characteristics in the specialty settings. A robust management of the hospital and collaborative management have achieved, obtaining excellent outcomes in the case mix index (CMI), the absolute value and proportion of fourth-level surgery, revenue and expenditure balance, medical insurance payment, patient satisfaction and other dimensions. Conclusion The optimized paths for the collaborative management of medical services in the "one hospital with multiple districts" are proposed, including strengthening the collaboration of spiritual concepts and cultivating a unique cultural system, coordinating the collaboration of specialty settings and improving the complementary service system, strengthening the collaboration of management systems and highlighting the supply of high-quality services. Following this to better provide patients with high-quality medical services and continuously improve the patient medical experience.

Objective To promote the efficient synergistic development of one hospital with multiple districts, thus providing inspiration and reference for the discipline construction and development of hospitals with multiple districts. Methods Taking the People's Hospital of Xinjiang Uygur Autonomous Region as a sample, a laddering discipline development from the strong and solid foundation to misplaced complementarity and collaborative development was established based on the actual situations (differences in the construction time, functional positioning, construction area, number of beds, and service population of three districts) and scientific planning of discipline layout and positioning in multiple districts. Results In the sample hospital, the construction of a disciplinary competitive advantage pattern for sustainable development in multiple districts was actively explored. The 2.0 stage of differentiated discipline layout with complementary complementation achieved in District A and B. District C developed in the early stage of opening and phased layout of disciplines. An advanced collaborative development of disciplines from 1.0 to 3.0 stage was expected to achieve in the next decade of all the three districts. Conclusion The “laddering” discipline development strategy proposed in this study is in line with the reality of hospitals with multiple districts, but it is still in the early stage of practice with an expected effectiveness to be foreseeable. After the completion of the discipline layout in each district, it is still necessary to adjust the direction of discipline development in a timely manner, in order to maximize the use of resources in the districts, and ensure the medical needs of the hospital and the sustainable development of disciplines.

Culture construction is a key topic for the high-quality development of hospitals. Achieving cultural integration in "one hospital with multiple districts" is a crucial element for the coordinated development, optimized allocation of regional medical resources, and enhancement of the patient's medical experience. With the Shenzhen Dapeng New District Medical and Health Group as an example, the present study analyzes the challenges of cultural integration in the mode of "one hospital with multiple districts". Moreover, we explore the specific practices of achieving cultural integration by formulating a long-term development strategy for cultural integration, building an online and offline cross-regional interconnection system, and building a unified and coordinated hospital cultural brand to achieve the goal of strengthening the group's internal cohesion, promoting a balanced allocation of regional medical services, and improving patients' medical experience. Our findings provide references for the cultural integration of “one hospital with multiple districts” and the high-quality development of regional medical care.

Objective To clarify the reality, application scenario and evolutionary trend of the HFMEA (Healthcare Failure Mode and Effect Analysis) model in Chinese medical quality and safety management, thus providing a reference for the future expansive application and optimized development of HFMEA. Methods Relevant articles on the application of the HFMEA model in medical quality and safety management were searched in China National Knowledge Infrastructure (CNKI) database from 2009 to 2023. CiteSpace 6.2.R6 was used for visual analysis of keywords. Results A total of 383 articles were included, and 236 keywords were obtained. The network density, clustering module value Q, and average clustering contour value S were 0.010 2, 0.716 8, and 0.917 9, respectively. The evolution process of the HFMEA model in China could be divided into three stages: "Origin - Burst - Optimization". Conclusion HFMEA is gradually applied to medical quality and safety management. Its application scenario tends to be diversified, but it is still mainly limited to nursing management field, and its clinical, administrative and logistical applications are weak. Its evolution tends to deepen, but standardized paradigm hasn’t been established. In the future, it is necessary to optimize and strengthen the application by building normative process and mechanism, strengthening multidisciplinary collaboration, and cultivating patient safety culture.

The hierarchical management of surgery is a critical component of a hospital's surgical management system, involving the certification of surgical personnel, the grading of surgical procedures, the oversight of the surgical process, and the tracking of surgical outcomes. Targeting the deficiencies in the pre-2019 surgical management, including a lack of robust organizational structure, a limited array of authorization approaches, and inadequate informatization efforts, our hospital implemented a series of reform measures, including re-organization of the medical quality management committee, development of a surgical grading catalog with mappings among operation names, ICD codes, and medical insurance codes, introduction of dynamic surgical authorization pathways, and reinforcement of informatization initiatives. These changes have led to notable enhancements in both the volume and quality of surgical procedures, as evidenced by practical application and ongoing exploration.

Objective To design an artificial intelligence (AI)-based intelligent quality control system for chest computed tomography(CT) images, thus solving existing issues in the quality control of chest CT (e.g., large manual errors, low efficiency, inconsistent quality control standards, and technical limitations), improving the efficacy of imaging quality control and consistency, and ensuring the quality of medical imaging. Methods The system design included modular, customized quality control, and causal AI quality control to enhance robustness and interpretability. The system functions integrated neural network modules based on the U-Net and ResNet for organ segmentation, skeletal segmentation classification, trunk extraction, noise classification, image quality analysis, and artifacts identification. A dataset containing various quality issues was constructed, and the system was deployed and tested in multiple hospitals. Results The system demonstrated high accuracy in identifying quality issues in chest CT images, with an overall identification accuracy rate of over 80%. The system processed each CT image in an average of 1-2 minutes, which was significantly faster than the time required for manual quality control. In practical application, the system improved the efficiency and consistency of chest CT image quality control, reduced repeated examinations due to image quality issues, and enhanced patient satisfaction with medical services. Conclusion The AI-based intelligent quality control system for chest CT images developed in this study significantly improves the efficiency and consistency of image quality control, reduces the workload of medical staff, and improves the efficiency of film reading and patient experience.

Objective To establish a "double-cycle" closed-loop management system involving both the "large cycle" of overall management and the "small cycle" of individual case management for medical quality and safety adverse events in public hospitals, aiming to provide theoretical and practical references for superior departments and similar hospitals. Methods Based on analytic methods of SWOT(strengths, weaknesses, opportunities, and threats) analysis, questionnaire surveys, and comparative analysis, and the PDCA (Plan, Do, Check, Act) theory, a "double-cycle" closed-loop management system for medical quality and safety adverse events in public hospitals was established, and its implementation effect was evaluated. Results After the establishment of the "double-cycle" closed-loop management system, the incidence rate of adverse events (reported incidence rate) increased from 1.12% to 1.87%. There were significant improvements in the knowledge of adverse events, willingness to report adverse events, and satisfaction with the "double-cycle" closed-loop management system for adverse events (P<0.05). Conclusion Based on the "double-cycle" approach, the "double-cycle" closed-loop management system for medical quality and safety adverse events in public hospitals establishes effective operation, analysis, and feedback mechanisms, which can promptly identify and address potential risks and issues in the medical process, and significantly improve the level of medical quality and safety.

Objective To explore the establishment of a scientific comprehensive quality management system in response to the new requirements for the normalization of hospital accreditation. Methods A comprehensive quality management office was established, and a team of quality control personnel was assembled. Besides, a "Big Quality Control" system with committees as the core was constructed. Quality management issues were identified from both positive and negative aspects through monthly quality control assessments and adverse event reviews, thus continuously improving medical quality. Results Significant improvements were observed in various key indicators, including the hospital's coverage rate of clinical pathway, accuracy of coding the main diagnoses on the front page of medical records, standardized prevention rate of venous thromboembolism, and the incidence of complications in surgical patients. Quality improvement cases have repeatedly won awards, and the hospital's ranking in the performance evaluation of tertiary public hospitals has risen from B++ to the A sequence. Conclusion A clearly structured and efficiently operated "Big Quality Control" system can effectively address the new requirements of hospital accreditation and promote high-quality development of hospitals.

Telemedicine is a new medical service model that breaks medical time and space constraints with information technology, which is of great significance for promoting high-quality development of public hospitals. This article explores the practice of telemedicine in the Third Affiliated Hospital of Sun Yat-sen University in the background of high-quality development of public hospitals. Details include construction of a telemedicine service platform based on the national regional medical center and provincial high-level hospital construction project; promotion of the telemedicine service platform in multiple districts; construction of county-level medical communities assisted by telemedicine; strengthening informationization construction to support the development of telemedicine; strengthening the cultivation of medical talents based on telemedicine remote teaching; and promoting close scientific research cooperation through telemedicine. The above measures effectively promote the optimization of the allocation of medical resources and improvement of medical services. They not only extensively cover medical institutions in multiple provinces, drive the improvement of regional diagnosis and treatment levels, but also assist in targeted assistance work by establishing deep cooperative relationships. This study also discusses the implementation paths of telemedicine under the background of high-quality development of public hospitals. Although there are still many dilemmas in the current remote medical care, joint efforts of various parties on telemedicine are expected to inject new vitality into high- quality development of public hospitals, thus better satisfying the medical and health needs of the people.

Objective To investigate the effectiveness of PDCA cycle in raising the implementation rate of no-touch isolation technique (NTIT) during laparoscopic radical gastrectomy for gastric cancer. Methods A quality continuous improvement team was set up, focusing on enhancing the adherence to NTIT during laparoscopic radical gastrectomy. The team investigated 84 patients who underwent the procedure for gastric cancer at our hospital between October 16, 2022 and March 11, 2023. Factors contributing to the suboptimal implementation of NTIT were identified, and interventions were developed, applied, and evaluated. Results As a result of the PDCA initiative, the compliance rate for NTIT during laparoscopic radical gastrectomy increased significantly from 67.8% to 91.7% (P<0.001). Additionally, the adherence to instrument setup standards significantly increased from 78.0% to 97.0% (P<0.001). Moreover, the physician satisfaction scores rose from 82.0±3.7 to 98.1±4.0. Conclusion The PDCA initiative enhanced the adherence to NTIT during the laparoscopic surgery among operating room nurses, promoted the advancement of NTIT in specialized surgical teamwork within the operating room, and yielded satisfactory surgical outcome.

Objective To explore the application effect of quality control circle (QCC) activities on improving the on-time rate of percutaneous nephrolithotomy (PCNL) surgery turnover. Methods A total of 130 patients undergoing PCNL in the Urology Department from March to October 2023 were selected as the research subjects. They were divided into pre-implementation (65 cases) and post-implementation(65 cases) groups based on the admission time. Conventional nursing care was given to patients of the pre-implementation group. Those in the post-implementation group were managed using QCC methods, with a standardized surgery turnover procedure based on multi-dimensional analysis and management strategies. The time consumption of each link in the surgery turnover of PCNL, on-time rate of turnover, and satisfaction of medical staff were compared between the two groups. Results After the implementation of QCC activities, the surgery turnover time was reduced from 61.81±3.74 minutes to 53.73±3.21 minutes; the on-time rate of turnover significantly increased from 69.23% to92.31%; and the satisfaction of medical staff was significantly improved (P<0.05). Conclusion QCC activities can significantly increase the efficiency of the PCNL surgery process, enhance the on-time rate of turnover, and improve the satisfaction of medical staff.

From the concept of system, this paper analyzes the twelve possible situations of Chinese hospital planning and development during the 15th Five-Year Plan period, including the overall goal of Chinese modernization, high quality development as the theme and top priority, arduous task of a further comprehensive reformation, unprecedented opportunities and pressure brought by the wave of science and technology revolution, complex and diverse health demand with an aging population, further optimization of related policy systems, increasingly fierce market competition within the system, integrated medical and health service system as the goal of system construction, trend of medical service mode innovation, inevitable scientific legalization fine wisdom management, extension of most institutional policy measures at the national and departmental levels since 2009, requirement of a high-quality hospital management cadre team. At the same time, this article proposes opinions on the overall requirements of hospital planning and development during the 15th Five- Year Plan period.

Objective To enhance hospital medical quality management, promote the enforcement of medical core systems, and ensure patient safety. Methods Weak points in core medical systems were identified and corresponding improvements were made, including establishing a three-tier inspection framework, creating a four-tier closed-loop system, setting up a standardized information query system, and introducing a quality inspection and feedback system. Results The compliance rate in the implementation of the core systems increased from 79% to 90%, and the closed-loop compliance rate increased from 22.58% to 100%. The time cost of inspections was significantly reduced. Conclusion Improving the inspection measures can effectively facilitate the supervision and implementation of core medical systems and thus guarantee patient safety.

Objective To explore the surgical grading management and practical effects based on the Total Quality Management(TQM) concept in a large comprehensive tertiary hospital. Methods Guided by the comprehensive, full-time, and full management of the TQM concept, the First Affiliated Hospital, Sun Yat-sen University was the research object. Specific measures and practical effects of the implementation of surgical hierarchical organization management, personnel authorization, and link quality control were introduced. Results The unified surgery class directory library was established in the hospital. The hospital had a proportion of doctors with level 3 and 4 surgery permissions increased by 16.82%, and the level 3 and 4 surgeries accounted for 30.28%. The incidence of complications was reduced by 45.95 %, the incidence of unplanned reoperation was reduced by 48.61%, and the mortality of surgically treated patients decreased by 33.33%. Conclusion By integrating the TQM concept into the management process of surgery, it can improve the quality and safety management level of medical institutions and ensure the safety of surgically treated patients.

Objective To explore the performance of the combination of basket ID plate with electronic atlas for surgical instrument kits in the information traceability management in a central sterile supply department (CSSD). Methods Surgical instrument kits undergoing centralized reprocessing in a CSSD during two different periods were divided into two groups: the control group (kits reprocessed before the implementation of the combination between July to September 2021) and the combination group (kits reprocessed using the combination from July to September 2022). These two groups were compared in terms of information traceability completeness, recovery time, inspection and repacking time, and rates of recycling and packaging errors. Results Following the implementation of the combination approach, significant improvements were observed in the management of surgical instrument kits. The recovery time was reduced from 61.78 seconds to 42.65 seconds (u=11.346, P<0.001), the inspection and repacking time decreased from 386.98 seconds to 369.52 seconds (u=11.346, P<0.001), the recycling error rate decreased from 1.314% to 0.022% (χ²=10.349, P<0.001), the assembly error rate decreased from 1.212% to 0.166% (χ²=5.932, P=0.021), and the information traceability completeness rate increased from 93.01% to 99.83% (χ²=9.264, P=0.011). Conclusion The basket ID plate enables full-lifetime traceability management of surgical instrument kits. The combination of basket ID plate with electronic atlas of surgical instrument kits reduces recovery and inspection/repacking time and enhances the precision of instrument retrieval and assembly, thereby increasing workflow efficiency.