Administrative process reform in eastern coastal Chinese public hospitals: a policy and practice review

China's public hospitals are currently at a crucial point in their journey toward high-quality development. The operational efficiency of administrative processes directly impacts overall hospital performance and healthcare service quality. Constrained by traditional hierarchical management models, some public hospitals still face practical challenges such as lengthy approval procedures, difficulties in interdepartmental coordination, barriers to information sharing, and misaligned service awareness. The lengthiness and inefficiency of administrative processes not only make it difficult to provide clinical services but also encroach on healthcare professionals' time for patient care, increasing their non-clinical workload. This, in turn, affects the patient experience and patient safety and has become a major obstacle to the high-quality development of hospitals. However, existing research has largely focused on optimizing individual functional modules or the application of specific management tools, lacking in-depth exploration of holistic and systematic improvements to administrative processes. Furthermore, there is a scarcity of integrative research that combines international best practices with China's local bureaucratic culture, personnel systems, and IT infrastructure, resulting in a lack of practical guidance and replicability. This study focuses on administrative process reform in public hospitals, employing a case study approach. It examines the administrative practices of a large public hospital in a coastal city in eastern China as its research case. It systematically examines the hospital's specific operational plans, innovative practices, and practical outcomes in establishing an administrative Multidisciplinary Diagnosis and Treatment Team (MDT) collaborative governance mechanism, reengineering multi-functional service processes, and restructuring logistics departments under a large-department system. Concurrently, it compares international literature to analyze administrative reform experiences from advanced healthcare management nations like Singapore and Japan, conducting localized qualitative analysis for adaptation. At the theoretical level, this study employs a descriptive single-case design based on secondary data to expand the application and interpretation of bureaucratic theory, collaborative governance theory, and organizational process reengineering theory in the administrative context of public hospitals. At the practical level, unlike existing research that tends to focus on policy recommendations, this study systematically presents a comprehensive operational framework for administrative MDTs-covering institutional design, operational processes, and performance evaluation and oversight. It reveals the interplay between process reengineering and digital transformation, as well as between technological empowerment and institutional restructuring, and has tentatively established a reform pathway that combines an international perspective with local adaptability which may enhance the efficiency and effectiveness of public hospital administration. Building on this foundation, it proposes a public hospital administrative process reform strategy centered on system restructuring, technological empowerment, and talent cultivation. It also outlines the core principles that reforms must adhere to, with the aim of providing a preliminary practical reference for public hospitals with similar conditions to break free from the constraints of traditional management thinking and establish a modern administrative management system that is responsive, flexible, and efficient.