Improvement of outpatient service processes based on BRP theory and information technology: a case study of the University of Hong Kong-Shenzhen Hospital

JEL Classification: M15 – IT Management, I12 – Health ProductionCurrently, due to some irrational allocation of medical and healthcare resources, a considerable proportion of state-of-the-art medical equipment and talented medical personnel are concentrated in large urban hospitals. This situation is particularly common in 3A hospitals (3A hospitals are hospitals which are equipped with more than 501 beds, can provide medical and healthcare services with high-level specialty to various regions and with scores higher than 900 according to the grading standard), which are often crowded with patients. According to the normal outpatient process, patients need to undergo a prolonged procedure from registration, treatment, laboratory test, diagnosis to drug dispensing. Often patients have to spend a long time waiting for treatment, receiving tests and paying for medical care. The congestion of patients at certain time-consuming processes allows doctors little time to check and treat patients thoroughly. As a result, doctors are often unable to make accurate and comprehensive diagnosis. Considered the window of a hospital, outpatient service is extremely important. Whether the design of its process is reasonable and whether its management is able to maximize interests for patients will directly affect the hospital’s medical level, and even its social benefits and reputation. Therefore, it has become a major issue for a hospital achieves to optimize the business process of its outpatient service. Outpatient process, as a core business process of a hospital, is critical to improving the quality of its medical service, upgrading its performance and minimizing its operating costs. Therefore, re-designing the outpatient process of a hospital can help enhance its comprehensive strength by endowing it with a core competence. In addition, the hospital will be impelled to provide patients with more convenient medical services with higher quality and lower price. This work conducts a case study on The University of Hong Kong-Shenzhen Hospital (HKU-SZH), which was the first to implement an outpatient appointment registration system. This thesis gives an anatomy of the outpatient process of the hospital through various methods and theories, such as literature review, field research, expert consultation, Business Process Reengineering Theory and Information technology, aiming to identify objectives and strategies of the case hospital in improving its outpatient process. The study consists of: - An investigation into the current situation of HKU-SZH’s outpatient registration process: through questionnaires and structured interviews, the defects and weak links in the hospital’s appointment registration model were analyzed. A structural equation model for existing outpatient processes was established and the influence of different variables on patients’ satisfaction level as well as the correlation between these variables was analyzed by means of a simulation model. - Research on outpatient process reengineering: with the needs and satisfaction of patients as a goal, this thesis reexamines the strategic goals and internal and external environment of HKU-SZH on the basis of Business Process Reengineering Theory, Queuing Theory, Six Sigma Theory and Information technology. This thesis improves HKU-SZH’s registration process, using methods of order modification, integration, simplification and automation and materializes the process by network technology and outpatient information system. - An empirical study on outpatient process: this thesis conducts a systemic and empirical analysis in a functional integration of registration and payment, process reengineering research through information technology (development of new functions of appointment system) and an empirical study on queuing theory. - Research on local adaptation of outpatient process: this thesis explores solutions and suggestions for HKU-SZH with the objective of optimize its outpatient process through the perspectives of hospital organizational structure, information technology, human resources, building of outpatient culture and optimization of waiting cost. By means of outpatient process reengineering, this thesis aim to increase the case hospital’s efficiency and raise its patients’ satisfaction so that the hospital may enhance its comprehensive competence. In addition, an effective and operable methodology will be generated, which is expected to serve as a reference for other hospitals to improve their operation and their management.Atualmente, devido a alguma atribuição irracional dos recursos médicos e de saúde, uma proporção considerável de modernos equipamentos médicos e pessoal médico talentoso estão concentrados em grandes hospitais urbanos. Esta situação é particularmente comum em hospitais 3A (hospitais 3A são os hospitais que estão equipados com mais de 501 camas, e que podem fornecer serviços médicos e de saúde com alto nível de especialidade para diversas regiões e com pontuações superiores a 900 de acordo com o padrão de classificação), que são frequentemente sobrelotados com pacientes. De acordo com o processo ambulatório normal, os pacientes precisam passar por um procedimento prolongado desde o registo, tratamento, análise laboratorial, diagnóstico, até à distribuição de medicamentos. Muitas vezes os pacientes têm de passar um longo tempo de espera para tratamento, para receber testes e para pagar por cuidados médicos. O congestionamento de pacientes em determinados processos demorados, leva a que os médicos tenham pouco tempo para verificar e tratar os pacientes completamente. Como resultado, os médicos são muitas vezes incapazes de fazer um diagnóstico preciso e abrangente. Considerado a montra de um hospital, o serviço ambulatório é extremamente importante. Se o desenho do seu processo é razoável e se a sua gestão é capaz de maximizar os interesses dos pacientes, irá afetar diretamente o nível médico do hospital, e até mesmo os seus benefícios sociais e reputação. Portanto, tornou-se um importante problema para um hospital conseguir otimizar o processo do seu serviço ambulatório. O processo ambulatório, como um processo de negócio nuclear de um hospital, é fundamental para melhorar a qualidade do seu serviço médico, aumentar o seu desempenho e minimizar seus custos operacionais. Portanto, reprojetar o processo ambulatório de um hospital pode ajudar a aumentar a sua força global dotando-o de uma competência essencial. Além disso, o hospital será impelido a oferecer aos pacientes serviços médicos mais convenientes com maior qualidade e menor preço. Este trabalho apresenta um estudo de caso sobre o Hospital da Universidade de Hong Kong-Shenzhen (HKU-SZH), que foi o primeiro a implementar um sistema de registo de consulta externa. Esta tese apresenta uma análise do processo ambulatório do hospital através de vários métodos e teorias, como a revisão de literatura, pesquisa de campo, consultas a especialistas, teoria da reengenharia de processos e tecnologias da informação, com o objetivo de identificar os objetivos e estratégias do hospital na melhoria do seu serviço ambulatório. O estudo consiste em: - Investigação sobre a situação atual do processo de registo ambulatório de HKU-SZH. Através de questionários e entrevistas estruturadas, foram analisados os defeitos e pontos fracos no modelo de registro de consultas do hospital. Um modelo de equações estruturais para os processos ambulatórios existentes foi estabelecido, e a influência de diferentes variáveis sobre o nível de satisfação dos pacientes, bem como a correlação entre essas variáveis foi analisada por meio de um modelo de simulação. - Investigação sobre a reengenharia do processo ambulatório. Tendo as necessidades e satisfação dos pacientes como objetivo, esta tese reexamina as metas estratégicas e o ambiente interno e externo de HKU-SZH com base na Teoria da Reengenharia de Processos, Teoria das Filas, Teoria Six Sigmae Tecnologias da Informação. Esta tese melhora o processo de registro de HKU-SZH, usando métodos de modificação, integração, simplificação e automação e materializa o processo através de tecnologias de rede e um sistema de informação para o processo ambulatório. - Estudo empírico sobre o processo ambulatório. Esta tese conduz uma análise sistémica e empírica sobre a integração funcional de inscrições e pagamentos, a pesquisa de reengenharia de processos através de tecnologias da informação (desenvolvimento de novas funções do sistema de consultas) e um estudo empírico sobre a teoria das filas. - Investigação sobre a adaptação local do processo ambulatório. Esta tese explora soluções e sugestões para o HKU-SZH para otimizar seu processo ambulatório através das perspetivas de estrutura hospitalar organizacional, tecnologias da informação, recursos humanos, construção da cultura do ambulatório e otimização do custo de espera. Por meio do processo de reengenharia do serviço de ambulatório, esta tese visa aumentar a eficiência do processo de internamento e aumentar a satisfação dos seus pacientes para que o hospital possa aumentar a sua capacidade global. Além disso, foi gerada uma metodologia eficiente e operacionalizavel, a qual se espera possa servir como referência para outros hospitais, para melhorar o seu funcionamento e a sua gestão

Sustainability in design: now! Challenges and opportunities for design research, education and practice in the XXI century

Copyright @ 2010 Greenleaf PublicationsLeNS project funded by the Asia Link Programme, EuropeAid, European Commission

The influence of Chinese cultural custom and policy practice on doctoral supervision in the management discipline in China

Although China has the largest population of doctoral candidates and doctoral graduates in recent years, China currently still suffers from a shortage of effective supervisors, particularly who have a high reputation, working in high ranking universities. Two reasons cause this result. One reason is the number of doctoral candidates has dramatically increased in last four decades, and more than half of the candidates prefer to commence their doctoral journey in high reputation universities. The other reason is because most doctoral supervisors in these universities are generally selected only from the group of ‘Professor’, so the number of doctoral supervisors is limited. As a result, Chinese doctoral supervision, particularly in high ranking universities, has drawn the increasing attention of researchers. Compared to other disciplines, the Management discipline is a very popular and emergent subject in China. According to a report in 2015, four of the top ten popular subjects are linked with the Management discipline (EOL 2015). Furthermore, the theory and practice in the Management discipline is influenced by traditional culture and present policies (Guo, Y 2014; Lv 2011). Therefore, the effective doctoral supervision in the Management discipline in China has been focused on, rather than other disciplines. Much research on effective doctoral supervision in Western countries has been conducted (Agu & Odimegwu 2014; Collins 2015). However, there is little published research focusing on Chinese doctoral supervision, particular in the Management discipline. In this thesis, I argue that the Chinese cultural custom, and present policy practice influence doctoral supervision. Qualitative methods were used and case study was adopted in this research. The researcher collected the data via face to face, one to one interviews from a leading Chinese university in Beijing. All 39 interviewees, who were from three groups including students, supervisors and graduates, who studied or worked in this university, participated in this research are volunteers. A theory has been established from this thesis through refining the data results with the assistance of Nvivo 10.0 software. This theory includes two models: the model of doctoral supervision in Management and the pinde model. The model of doctoral supervision indicated that within the influence of cultural custom and policy practice of China, Chinese doctoral supervisors had two main duties: cultivating people and delivering academic knowledge and skills. Based on the two main duties, even if Chinese doctoral supervisors would offer the individual one-to-one training for each doctoral candidate, they preferred to do more group-way education and pinde education during the whole doctoral supervision process. The results from all interviews emphasised that doctoral supervisors remain in familial relationships with their candidates and use family-style approach to manage their candidates. This theory also indicated a pinde model in the contemporary Chinese academic system. The findings in this study contribute to fill in the knowledge gap of doctoral supervision in China and the Management field, and provide a valuable Chinese theory. It is important, because the theories or models from Western countries do not necessarily work well within the Chinese context

Chinese elements : a bridge of the integration between Chinese -English translation and linguaculture transnational mobility

[Abstract] As the popularity of Chinese elements in the innovation of the translation part in Chinese CET, we realized that Chinese elements have become a bridge between linguaculture transnational mobility and Chinese-English translation.So, Chinese students translation skills should be critically improved; for example, on their understanding about Chinese culture, especially the meaning of Chinese culture. Five important secrets of skillful translation are introduced to improve students’ translation skills

Routledge Handbook of Chinese Medicine

The Routledge Handbook of Chinese Medicine is an extensive, interdisciplinary guide to the nature of traditional medicine and healing in the Chinese cultural region, and its plural epistemologies. Established experts and the next generation of scholars interpret the ways in which Chinese medicine has been understood and portrayed from the beginning of the empire (third century BCE) to the globalisation of Chinese products and practices in the present day, taking in subjects from ancient medical writings to therapeutic movement, to talismans for healing and traditional medicines that have inspired global solutions to contemporary epidemics. The volume is divided into seven parts: Longue Durée and Formation of Institutions and Traditions Sickness and Healing Food and Sex Spiritual and Orthodox Religious Practices The World of Sinographic Medicine Wider Diasporas Negotiating Modernity This handbook therefore introduces the broad range of ideas and techniques that comprise pre-modern medicine in China, and the historiographical and ethnographic approaches that have illuminated them. It will prove a useful resource to students and scholars of Chinese studies, and the history of medicine and anthropology. It will also be of interest to practitioners, patients and specialists wishing to refresh their knowledge with the latest developments in the field. The Open Access version of this book, available at http://www.taylorfrancis.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 licens

THE PLA IN CHINA’S FOREIGN AND SECURITY POLICY-MAKING: DRIVERS, MECHANISM AND INTERACTIONS

Abstract This dissertation develops a “dynamic bargaining” thesis, in which a two-level bargaining game among three actors (the Chinese Communist Party (Party), the People’s Liberation Army (PLA), and the civilian foreign affairs system) determines the level of influence the PLA exerts over China’s foreign and security policy-making since 1978. This dissertation is based on 138 interviews with active-duty and retired military officers, 125 interviews with policy-makers and analysts in China, and original Chinese-language sources and secondary documents. The dissertation divides China’s foreign and security policies into “high” policies – those that are sensitive and core national interests and require the intervention of China’s top leader – and “low” policies – those that are tactical in nature and constitute the majority of China’s foreign and security policies. The dynamics of a “reliance-control model” determine the PLA’s influence in “high” policies. The top leader’s political reliance on the PLA is the first and foremost necessary condition for such Party-military bargaining to occur. Once this necessary condition is met, the extent to which the top leader is able to establish “effective control” over the PLA helps determine the PLA’s access and hence the level of its influence. In “low” policies, the PLA’s level of influence depends on its bureaucratic bargaining with the civilian foreign affairs system, in particular the Ministry of Foreign Affairs (MFA or MOFA). Such bargaining has operated on the basis of four rules of the game, namely the advantage of: early entry during times of overwhelming external threats; strong allies/weak opponents; strong motivations; and supportive public opinion. The level of influence the PLA exerts in the policy-making process is also partly determined by its motivation. The PLA is a military force in transition, and its motivation to intervene during the policy-making process is determined by three sets of dynamics: inward vs. outward orientation; professionalization vs. politicization; and unity vs. inter-service rivalry. This dissertation argues that the PLA has a political orientation of being “progressive moderates” in China’s domestic politics, which contributes to its preoccupation with its internal mission and deepens the differentiation between the Party’s and military’s interest, outlook, and goal. As a result of its own evolution, the PLA is likely not seeking major armed confrontation, but may be more welcoming of continuous friction and low-intensity wars of limited scope. Advisor: David M. Lampton Secondary Reader: Kent Calder Chair: Francis Fukuyama Committee Members: Bruce G. Blair and Michael D. Swain