Abstract:
OBJECTIVE:To empirically assess the quality of hospital care in China and trends over a 5-year period during which the government significantly increased its investment in healthcare. DESIGN:Retrospective, observational study comparing hospital quality between two periods: October 2012-March 2013 and October 2017-March 2018. SETTING:1-2 of the most reputable large tertiary hospitals in each of the 25 provinces in Mainland China (total of 33). PARTICIPANTS:Adults 18 years or older admitted with acute myocardial infarction (AMI) (n = 7031), cerebral ischaemic stroke (n = 12 008), chronic obstructive pulmonary disease (COPD) (n = 11 836) and bacterial pneumonia (n = 4263). MAIN OUTCOME MEASURES:Process-based quality measures, including seven AMI measures, three stroke measures, four COPD measures and six pneumonia measures. RESULTS:In 2012/2013, Chinese hospitals had variable performance on AMI measures, including prescribing aspirin on arrival (80.7%), and discharging patients on aspirin (79.2%), β-blockers (60.8%) or statins (75.8%). This was similar for stroke cases and pneumonia cases. Smoking cessation advice was given at high rates across conditions though rates of influenza/pneumococcal vaccines were performed <1%. In 2017/2018, Chinese hospitals experienced no differences across most quality measures. Performance declined for two measures: aspirin on arrival for AMI cases and blood cultures before antibiotics for pneumonia cases. Performance increased for two measures: percutaneous coronary intervention within 90 min in ST segment elevation myocardial infarction cases (66.6% vs 80.1%, p<0.001) and statins at discharge for stroke cases (64.7% vs 78.7%, p<0.001). Compared with US hospitals, Chinese hospitals underperformed across most measures. CONCLUSIONS:Chinese hospitals had low and variable performances across most quality measures for common medical conditions. Quality of care generally does not appear to be improving post national health reform. The Chinese government should include quality of care improvement in its health reform priorities to ensure patients receive appropriate and effective care.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Jian W,Figueroa J,Woskie L,Yao X,Zhou Y,Li Z,Li C,Yao L,Yip WCdoi
10.1136/bmjqs-2018-008938subject
Has Abstractpub_date
2019-12-01 00:00:00pages
963-970issue
12eissn
2044-5415issn
2044-5423pii
bmjqs-2018-008938journal_volume
28pub_type
杂志文章abstract:BACKGROUND:A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcare safety improvement, but little attention has focused on developing a common set of definitions, dimensions and measures. OBJECTIVES:Specific objectives of this literature review include: summarising definition...
journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
doi:10.1136/bmjqs.2010.040964
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Realising the full potential of the WHO Surgical Safety Checklist (SSC) to reduce perioperative harm requires the constructive engagement of all operating room (OR) team members during its administration. To facilitate research on SSC implementation, a valid and reliable instrument is needed for measuring OR...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2015-004448
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abstract:INTRODUCTION:Individual effort and practice systems contribute to quality performance, but the nature of their contributions remains unclear. METHODS:This study assessed the roles of individual attributes and behaviours versus practice attributes in quality performance by assessing general internists' perceptions of f...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2010.048991
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:There is widespread recognition that leadership skills are essential for effective performance in the workplace, but the evidence detailing effective leadership behaviours for surgeons during operations is unclear. DATA SOURCES:Boolean searches of four on-line databases and detailed hand search of relevant ...
journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
doi:10.1136/bmjqs.2010.040295
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Educational interventions to improve teamwork in crisis situations have proliferated in recent years with substantial variation in teamwork measurement. This systematic review aimed to synthesise available tools and their measurement properties in order to identify the most robust tool for measuring the team...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008260
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. OBJECTIVES:(1) Test the psychometric properties of a brief four-item burnout ...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-002831
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Existing evidence indicates that reducing nurse staffing and/or skill mix adversely affects care quality. Nursing shortages may lead managers to dilute nursing team skill mix, substituting assistant personnel for registered nurses (RNs). However, no previous studies have described the relationship between nu...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008948
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:We sought to investigate the formal and informal ways preregistration students from medicine, nursing, pharmacy and the allied healthcare professions learn about patient safety. METHODS:We drew on Eraut's framework on formal and informal acquisition of professional knowledge to undertake a series of phased ...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2013-001905
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:To evaluate the impact of implementation of a dedicated intensivist-led medical emergency team (IL-MET) on mortality in patients admitted to the intensive care unit (ICU). METHODS:All adult ward admissions to the ICU between July 2002 and December 2009 were reviewed (n=1920) after excluding readmissions and ad...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-000393
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To determine the association between daily levels of registered nurse (RN) and nursing assistant staffing and hospital mortality. DESIGN:This is a retrospective longitudinal observational study using routinely collected data. We used multilevel/hierarchical mixed-effects regression models to explore the asso...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008043
更新日期:2019-08-01 00:00:00
abstract::Progress in reducing diagnostic errors remains slow partly due to poorly defined methods to identify errors, high-risk situations, and adverse events. Electronic trigger (e-trigger) tools, which mine vast amounts of patient data to identify signals indicative of a likely error or adverse event, offer a promising metho...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008086
更新日期:2019-02-01 00:00:00
abstract::In a high-reliability organisation (HRO), safety and quality (SQ) is an organisational priority, and all workforce members are engaged, continuously learning and improving their work. To build organisational capacity for SQ work, we have developed a role-tailored capacity-building framework that we are currently emplo...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2016-006240
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Root cause analyses of surgical complications are of high importance to ensure surgical quality, but specific details on technical causes often remain unclear. Identifying subclinical intraoperative incidents attributable to technical errors is essential for developing rescue mechanisms to prevent adverse ou...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-003816
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The American College of Surgeons' Trauma Quality Improvement Program (TQIP) provides trauma centres with performance reports on their processes and outcomes of care relative to their peers. This study explored how performance reports are used by trauma centre leaders to engage in performance improvement and ...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008797
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Human auditing has been the gold standard for evaluating hand hygiene (HH) compliance but is subject to the Hawthorne effect (HE), the change in subjects' behaviour due to their awareness of being observed. For the first time, we used electronic HH monitoring to characterise the duration of the HE on HH even...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2019-010310
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The safety-and-quality movement is now two decades old. Errors persist despite best efforts, indicating that there are entrenched overt and perhaps less explicit barriers limiting the success of improvement efforts. OBJECTIVES AND HYPOTHESES: To examine the perspectives of five groups of healthcare worker...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-051755
更新日期:2012-09-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-001011
更新日期:2013-05-01 00:00:00
abstract::Cystic fibrosis (CF) is a chronic disease requiring patients to have frequent specialty healthcare visits to delay progression of lung disease, prevent and treat failure to thrive and initiate early interventions to prevent acute illness and complications. The CF Foundation recommends that patients have visits with th...
journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
doi:10.1136/bmjqs-2013-002345
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:Emergent evidence suggests that patients can identify and report safety issues while in hospital. However, little is known about the best method for collecting information from patients about safety concerns. This study presents an exploratory pilot of three mechanisms for collecting data on safety concern...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2015-004260
更新日期:2017-01-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2015-004112
更新日期:2016-07-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2009.038166
更新日期:2011-06-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2019-010088
更新日期:2020-06-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjqs-2012-001730
更新日期:2014-02-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-003429
更新日期:2015-02-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2013-002395
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Outcome benefits of using the WHO Surgical Safety Checklist rely on compliance with checklist administration. OBJECTIVE:To evaluate engagement of operating room (OR) subteams (anaesthesia, surgery and nursing), and compliance with administering checklist domains (Sign In, Time Out and Sign Out) and checklis...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2015-004545
更新日期:2016-12-01 00:00:00
abstract::The use of statistical process control (SPC) charts in healthcare is increasing. The primary purpose of SPC is to distinguish between common-cause variation which is attributable to the underlying process, and special-cause variation which is extrinsic to the underlying process. This is important because improvement u...
journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
doi:10.1136/bmjqs-2012-001373
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Due to the multitude of questions in the Hospital-Consumer Assessment of Healthcare Providers and Systems (H-CAHPS) survey, it may be difficult to decide where quality improvement efforts should be focused. Our organisation has supplemented the survey with a 'patient complaints' section. The s...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2015-004371
更新日期:2016-10-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-001450
更新日期:2013-10-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2013-002024
更新日期:2014-05-01 00:00:00