BackgroundThe World Health Organization highlights that patient safety interventions are not lacking but that the local context affects their successful implementation. Increasing attention is being paid to patient safety in Mainland China, yet few studies focus on patient safety in organizations with mixed cultures. This paper evaluates the current patient safety culture in an experimental Chinese hospital with a Hong Kong hospital management culture, and it aims to explore the application of Hong Kong’s patient safety strategies in the context of Mainland China.MethodsA quantitative survey of 307 hospital staff members was conducted using the Hospital Survey on Patient Safety Culture questionnaire. The findings were compared with a similar study on general Chinese hospitals and were appraised with reference to the Manchester Patient Safety Framework.ResultsLower scores were observed among participants with the following characteristics: males, doctors, those with more work experience, those with higher education, and those from the general practice and otolaryngology departments. However, the case study hospital achieved better scores in management expectations, actions and support for patient safety, incident reporting and communication, and teamwork within units. Its weaknesses were related to non-punitive responses to errors, teamwork across units, and staffing.ConclusionsThe case study hospital contributes to a changing patient safety culture in Mainland China, yet its patient safety culture remains mostly bureaucratic. Further efforts could be made to deepen the staff’s patient safety culture mind-set, to realize a “bottom-up” approach to cultural change, to build up a comprehensive and integrated incident management system, and to improve team building and staffing for patient safety.
Purpose
The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients’ and medical staff’s perspectives.
Design/methodology/approach
A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.
Findings
A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.
Originality/value
There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients’ consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.
Voluminous diapiric intrusions are present in 3D seismic data from the Liwan gas field area in the Baiyun sag of the Pearl River Mouth Basin, South China Sea. These diapirs are subdivided into magmatic diapirs and mud diapirs according to their seismic signatures and formation mechanisms. Saucer- and mound-shaped reflectors with anomalously high amplitudes distributed throughout the Early Miocene strata are interpreted as sills and laccoliths and are typified as magmatic diapirs. Mud diapirs in the study area can be divided into two types: wavy reflectors occurring at the basement of the sag caused by the gravitational instability of plastically deformed mudstones and columnar upheaval anomalies rooted in Paleogene rift sequences. Gas chimneys are characterized by vertical weak/blank zones accompanied by pull-down effects. Vertical gas chimneys and mud diapirs pierce the Middle Miocene strata. The vast majority of them are triggered by normal faulting; however, no deep-seated faults can be detected around the peripheries of igneous intrusions. Migration forces and pathways are represented by vertical mud diapirs and gas chimneys and thus control the distribution of shallow gases with negative-amplitude anomalies as well as gas hydrates.
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