1
|
Zhang M, Huang Y, Wu F, Liu D, Wei C, Qin Y. Improving occupational health for health workers in a pilot hospital by application of the HealthWISE international tool: An interview and observation study in China. Front Public Health 2022; 10:1010059. [PMID: 36530713 PMCID: PMC9751410 DOI: 10.3389/fpubh.2022.1010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
Objective For a safe and healthy workplace in the health sector, the International Labor Organization (ILO) and the World Health Organization (WHO) jointly developed HealthWISE, an international technical tool that helps health workers (HWs) to identify workplace hazards and apply low-cost solutions. This study sought to gather experiences and lessons from a Chinese pilot hospital for the scale-up application of HealthWISE. Methods A qualitative study was undertaken at a Chinese public hospital with a ≥5-year application of HealthWISE through in-depth interviews with targeted HWs who participated in the Training-of-Trainer (TOT) workshops, and observations were gathered using evidence from photos and publications, then, thematic analysis was formulated. Results Driven by motivation, the participants learned from the HealthWISE TOT workshop alongside the favorite and worst parts of it. Positive changes and results of occupational health for HWs occurred after the workshop, the participants trained others and planned to implement HealthWISE within their responsibility. During the COVID-19 Pandemic, the Hospital acted the approaches of protecting the health, safety and well-being of HWs with significant results. Further suggestions on workshop and HealthWISE implementing as well as the national policies were collected. The study indicated the Hospital's experience of leadership and participation, supporting and facilitating, system establishment, and culture creation. The suggestion included keeping staff engaged under a positive safety and health culture, promoting recognition of HealthWISE among public health institutions nationwide, developing online courses for medical colleges, focusing on the alignment among various law systems, and adopting measures under the principle of the hierarchy of occupational hazards controls. Conclusion This study has demonstrated the systematic improvement of occupational health for HWs by HealthWISE implementation in the Chinese hospital. The valuable experiences and lessons derived here can be shared with other hospitals in China and beyond, especially under the unprecedented challenges of the COVID-19 pandemic, to achieve the goals of safety, health, and well-being for HWs by building a resilient health system.
Collapse
Affiliation(s)
- Min Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Min Zhang
| | - Yiming Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengyao Wu
- Nanning Fourth People's Hospital, Nanning, China
| | - Dongmei Liu
- Nanning Fourth People's Hospital, Nanning, China
| | - Caiyun Wei
- Nanning Fourth People's Hospital, Nanning, China
| | - Yaqin Qin
- Nanning Fourth People's Hospital, Nanning, China
| |
Collapse
|
2
|
Cai Z, Song H, Huang Z, Fingerhut A, Xu X, Zhong H, Li Z, Zhang Y, Sha D, Bao D, Wang H, Cai B, Hua S, Zhang Y, Sun J, Ye K, Li J, Lu Y, Feng B. Safety and feasibility of laparoscopic surgery for colorectal and gastric cancer under the Chinese multi-site practice policy: admittance standards of competence are needed. Gastroenterol Rep (Oxf) 2022; 10:goac046. [PMID: 36196254 PMCID: PMC9522381 DOI: 10.1093/gastro/goac046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background The multi-site practice (MSP) policy has been practiced in China over 10 years. This study aimed to investigate the safety and feasibility of performing laparoscopic surgery for colorectal cancer (LSCRC) and gastric cancer (LSGC) under the Chinese MSP policy. Methods We collected and analysed the data from 1,081 patients who underwent LSCRC or LSGC performed by one gastrointestinal surgeon in his original hospital (n = 573) and his MSP institutions (n = 508) between January 2017 and December 2020. Baseline demographics, intraoperative outcomes, post-operative recovery, and pathological results were compared between the original hospital and MSP institutions, as well as between MSP institutions with and without specific competence (surgical skill, operative instrument, perioperative multi-discipline team). Results In our study, 690 patients underwent LSCRC and 391 patients underwent LSGC. The prevalence of post-operative complications was comparable for LSCRC (11.5% vs 11.1%, P = 0.89) or LSGC (15.2% vs 12.6%, P = 0.46) between the original hospital and MSP institutions. However, patients in MSP institutions without qualified surgical assistant(s) and adequate instruments experienced longer operative time and greater intraoperative blood loss. The proportion of patients with inadequate lymph-node yield was significantly higher in MSP institutions than in the original hospital for both LSCRC (11.5% vs 21.2%, P < 0.01) and LSGC (9.8% vs 20.5%, P < 0.01). Conclusion For an experienced gastrointestinal surgeon, performing LSCRC and LSGC outside his original hospital under the MSP policy is safe and feasible, but relies on the precondition that the MSP institutions are equipped with qualified surgical skills, adequate operative instruments, and complete perioperative management.
Collapse
Affiliation(s)
| | | | | | - Abraham Fingerhut
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
- Shanghai Minimally Invasive Surgery Center, Shanghai, P. R. China
- Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Ximo Xu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
- Shanghai Minimally Invasive Surgery Center, Shanghai, P. R. China
| | - Hao Zhong
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
- Shanghai Minimally Invasive Surgery Center, Shanghai, P. R. China
| | - Zhigang Li
- Department of General Surgery, Wuxi Huishan District People’s Hospital, Jiangsu, P. R. China
| | - Yingjie Zhang
- Department of General Surgery, Zhoushan Hospital, Zhejiang, P. R. China
| | - Dachong Sha
- Department of General Surgery, Cixi Third People’s Hospital, Zhejiang, P. R. China
| | - Dandan Bao
- Department of General Surgery, People’s Hospital of Wenzhou, Zhejiang, P. R. China
| | - Haibo Wang
- Department of General Surgery, Chinese PLA 107 Hospital, Shandong, P. R. China
| | - Binghua Cai
- Department of General Surgery, Rudong People’s Hospital, Jiangsu, P. R. China
| | - Shangbo Hua
- Department of General Surgery, Kunshan Hospital of Chinese Medicine, Jiangsu, P. R. China
| | - Yanhui Zhang
- Department of General Surgery, Jingjiang Chinese Medicine Hospital, Jiangsu, P. R. China
| | - Jianguang Sun
- Department of General Surgery, Haiyan People’s Hospital, Zhejiang, P. R. China
| | - Ke Ye
- Department of General Surgery, Yueqing People’s Hospital, Zhejiang, P. R. China
| | - Jianwen Li
- Corresponding author. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. No. 197 Ruijin Er Road, Shanghai 200025, P. R. China. Tel: +86-21-64370045; ; Department of Medical Affairs, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. No. 197 Ruijin Er Road, Shanghai 200025, P. R. China; Tel: +86-21-64370045; ; Shanghai Minimally Invasive Surgery Center, No. 197 Ruijin Er Road, Shanghai 200025, P. R. China. Tel: +86-21-64458887;
| | - Yong Lu
- Corresponding author. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. No. 197 Ruijin Er Road, Shanghai 200025, P. R. China. Tel: +86-21-64370045; ; Department of Medical Affairs, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. No. 197 Ruijin Er Road, Shanghai 200025, P. R. China; Tel: +86-21-64370045; ; Shanghai Minimally Invasive Surgery Center, No. 197 Ruijin Er Road, Shanghai 200025, P. R. China. Tel: +86-21-64458887;
| | - Bo Feng
- Corresponding author. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. No. 197 Ruijin Er Road, Shanghai 200025, P. R. China. Tel: +86-21-64370045; ; Department of Medical Affairs, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. No. 197 Ruijin Er Road, Shanghai 200025, P. R. China; Tel: +86-21-64370045; ; Shanghai Minimally Invasive Surgery Center, No. 197 Ruijin Er Road, Shanghai 200025, P. R. China. Tel: +86-21-64458887;
| |
Collapse
|
3
|
Wang J, Peng B, Zhou H, Zhang JH. Dentists' entrepreneurial intention and associated factors in public hospitals in major cities in Guangdong (South China): a cross-sectional study. BMC Oral Health 2020; 20:334. [PMID: 33228603 PMCID: PMC7685661 DOI: 10.1186/s12903-020-01331-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A rapid growth in private dentistry in China has been observed during recent years. Promoting the entrepreneurship of dentists has increasingly received attention in both dentistry and dental education worldwide. However, understanding about the unique features of entrepreneurial behaviors of dentists remains inadequate. METHODS This study examines dentist's entrepreneurial intention (EI), which was represented by his/her intention of leaving the public hospital system to be engaged in the private sector. Through a snowball sampling method, a total of 336 questionnaires from public hospitals in five major cities in Guangdong Province (China) were collected. The association between the dentists' EI and their individual characteristics were analyzed using a logistic regression model. RESULTS In the sample studied, 35.7% of the respondents reported to have EI. Female dentists are less likely to report EI (OR = 0.365, p = 0.001). Dentists in the age group of 36 to 45 years (OR = 14.205, p = 0.012) and those aged over 45 years (OR = 8.45, p = 0.066) reported respectively a much stronger EI than those in their 20s. Compared with intern dentists, attending dentists (OR = 7.812, p = 0.016) and associate/chief dentists (OR = 9.857, p = 0.021) were significantly more likely to report EI. Those with master level (OR = 0.221, p = 0.021) or doctorate degrees (OR = 0.118, p = 0.005) are much less likely to report EI. Meanwhile, those in mid-large hospitals (with 101-200 employees) (OR = 3.554, p = 0.036) and small hospitals (with < 50 employees) (OR = 2.398, p = 0.044) reported a stronger EI than those in large hospitals. Additionally, dentists' entrepreneurial behaviors, risk aversion attitudes and their family background all have significant associations. CONCLUSIONS Since dentistry is a knowledge-intensive industry, dentists' entrepreneurial behaviors have their own features. The findings by this study suggest that, accumulation of practical skills in a dental career, as implied by age, professional qualifications and leadership skills, help to promote EI, whereas an academic oriented education degree per se does not. Dentists in mid-large and small hospitals, rather than in top large hospitals in China, have higher EI. Additionally, female dentists may need more social supports to develop a higher EI. These findings have practical implications for the promotion of EI among dentists.
Collapse
Affiliation(s)
- Jiabi Wang
- School of Business, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macao S.A.R., China
| | - Bin Peng
- School of Business, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macao S.A.R., China
| | - Hongzhi Zhou
- Nokia Solutions and Networks System Technology (Beijing) Co., Ltd., No. 1, Wangjing East Road, Chaoyang District, Beijing, 100101, China
| | - Jing Hua Zhang
- School of Business, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macao S.A.R., China.
| |
Collapse
|