中美两国医院感染管理体系的比较分析

通过对中美两国的医院感染监测体系和医院感染控制管理体系的发展研究对比其不同点,借鉴国外先进的管理经验,提高我国医院感染控制管理的水平。并引入循证医学的理论,提高我国感染控制工作的科技内涵。     

以病人为中心的现代化医院后勤管理模式的建立

现代化的强有力的整体后勤保障是现代化医院管理的重要条件,也是坚持“以病人为中心”的重要保证.随着医院改革的不断深入,医院后勤管理必须转变观念,引进国外先进管理模式,在坚持＂以病人为中心,服务为宗旨,满意为目标＂原则的指导下,探索适合我国国情的医院后勤管理新模式。     

以病人为中心的现代化医院后勤管理模式的建立

现代化的强有力的整体后勤保障是现代化医院管理的重要条件,也是坚持“以病人为中心”的重要保证。随着医院改革的不断深入,医院后勤管理必须转变观念,引进国外先进管理模式,在坚持“以病人为中心,服务为宗旨,满意为目标”原则的指导下,探索适合我国国情的医院后勤管理新模式[1     

平衡计分卡在医院战略管理中的应用研究

平衡计分卡作为实施战略管理的重要工具由于其自身特点,在医疗领域将会有更广泛的应用前景.本文分析国内外平衡计分卡(BSC)在医院战略管理中的应用研究和进展,指出我国医院对平衡计分卡这一绩效、战略管理方法的研究与国外存在差距,还未形成适合我国国情的理论方法体系,应用的实际经验积累较少.     

医院中药药事管理的现状分析

随着我国医疗事业的不断发展,中药药事管理越来越重要,而且已经成为了医院建设与管理制度完善的有效措施。本文对医院中药药事管理的现状进行了分析,还提出了构建医院中医管理实战型策略,希望可以促进医院中药管理体系的建设,使我国医疗水平越来越高,并实现医院中药药事科学化、统一化的规范性管理。     

中医医院标准体系框架构建研究

对医院实施标准化管理、开展管理水平标准认证是医院提升管理服务水平的一条有效途径,开展标准化管理已形成医院发展的一种趋势。在标准化理论指导下,探讨了我国中医院构建医院标准体系的基本框架及其内外环境分析,以期为我国中医院标准化管理提供有益参考。     

药物管理的现状及应对措施

随着医药改革进程的不断推进,我国加强了对于医院服务水平和服务质量相关标准的建立和核查。药物管理作为医院深化改革的主要内容之一,如何改变药物管理现状,成为人们关注的焦点,加强医院的药物管理工作可以有效推动医院的科学现代化建设。因此,本文浅析了药物管理的重要作用,进而对当前我国医院药房管理的现状及问题进行了深入分析,并在文章最后具有针对性的提出相应的解决措施,进而能够在最大程度上改善我国医院药物管理的现状,推动我国药物管理实现现代化的管理。     

基于企业资源计划系统的医院运营管理公理化设计

在深化我国医药卫生体制改革的过程中,为适应医院日益增长的管理需求,将企业资源计划（ERP）理念运用到医院运营管理中,以实现对医院运营的有效管理为目标,运用独立公理对医院运营管理ERP系统进行功能设计,降低设计的复杂性,改善了医院运营管理的运作流程,提升了医院整体运营效益,提高了医院运营管理的水平,是实现医院战略的有力保障。     

医院绩效评估实践的发展

通过总结相关文献对部分国外医院绩效评估项目进行了描述，对这一领域的发展进行了简要总结。分析表明评估的基本框架已经得到广泛认可，评估项目需要结合特定的对象得以实施，注重反馈和改进措施。同国外的实践相比，国内的医院绩效评估实践需要深化细节，并同公立医院的内部绩效管理相融合。     

域外医院财务管理的经验及其对我国的启示

医院财务管理是医院管理的重要组成部分,加强和完善医院财务管理是医院可持续性发展的有效保障。在科学界定医院财务管理内涵的基础上,分析了我国医院财务管理中存在的问题,介绍了域外医院财务管理的理论和实践经验,最后提出了完善我国医院财务管理的建议和对策。     

Overseas doctors and the staffing structure of hospitals.

The introduction of the new immigration rules will considerably reduce the number of overseas doctors available for junior hospital appointments over the next five years. To offset this sponsorship schemes should be offered by universities and colleges comprising training courses, entry to examinations, and hospital appointments, and training programmes should be adapted to make objectives attainable in the four years available to overseas doctors. Employment of overseas doctors can ease the transition within the staffing structure to fewer juniors and more consultants, but planning is urgently required, and in particular the service and manpower needs of the National Health Service must be considered.     

计算机仿真技术在优化就医序列中的应用研究

积极推进预约诊疗服务、方便群众看病就医、缩短病人无效等候之间,是公立医院改革的重要课题,优化就医序列是解决上述课题的有效方法。通过计算机仿真技术充分挖掘现有医疗资源,可以优化调度资源,提高医院服务能力和质量。在分析了国内外计算机仿真技术在医院管理优化就医序列中的应用,初步研究了存在问题,并提出了相应的发展对策。     

British Aid to Medical Schools in Developing Countries

If the British allocation for overseas aid is increased more generous agreements could be made with host universities and with expatriate staff. It would greatly stimulate overseas service by specialist trainees if the professional colleges and the universities agreed that they would be willing to substitute in their training programmes a year or two of service in an overseas medical school for one or more of their orthodox appointments. Consideration might be given by the councils for postgraduate education to ways of facilitating service overseas by specialist trainees and young consultants. The suggestion of the Royal Commission for the expansion of departmental staff establishments and training pools requires that the temporary expatriate occupying a supernumerary post is absorbed into the establishment on his return. While this may be done now in individual cases by personal arrangement a national agreement between universities and the N.H.S. would be necessary for these secondments to be made on the large scale commensurate to the need.For other returning young doctors not yet in specialist training schemes an assurance that applications for appointments by those who had worked in developing countries would receive favourable weighting, by both university and N.H.S. selection committees, would be very helpful.     

The Overseas Doctors Training Scheme: failing expectations.

The Overseas Doctors Training Scheme needs appraisal. Set up 10 years ago to improve the quality of postgraduate training that overseas (non-European) doctors receive in Britain, the scheme has been popular, but it is questionable how far it has achieved its aims. If Britain is to continue to employ large numbers of overseas doctors in training grades, both through the scheme and through independent arrangements, the apparent mismatch between their expectations and the reality of what Britain offers must be tackled.     

Advanced training for ambulance crews: implications from 403 consecutive patients with cardiac arrest managed by crews with simple training.

Sixty seven ambulance staff in Nottinghamshire completed a simple extended training programme in managing cardiac arrest and using a defibrillator. This enabled around one third of the ambulance emergency shifts to be manned by such a crew, with a defibrillator as part of their standard equipment. Forty four of 403 consecutive patients who suffered cardiac arrest in the community were managed by these crews and survived to leave hospital. The training programme does not include endotracheal intubation, intravenous infusion, or drug administration. The new official advanced training course for ambulance crews, which includes these skills, is inappropriate in its methods and may delay widespread introduction of emergency ambulances equipped with defibrillators.     

第一届国际青年生态学者论坛综述

为促进中国青年生态学者与海外生态学者的交流与合作,由海外优秀华人生态学者发起的第一届"国际青年生态学者论坛"于2009年6月29-30日在兰州大学举行.本次论坛的交流内容包括了植物一土壤互作关系、区域生态系统结构与功能、生态安全与生态规划、全球变化生态学和环境可持续发展等,表明国内生态学的发展正逐渐从传统的基础理论研究向应用型研究转变.报告内容也从一定程度上反映了我国生态学发展的学科特点、演变方向和分布格局,我国生态学研究逐渐形成了东北、华北、西北和东南四大中心,且各自具有一定的地域特色.文章最后对会议的组织形式和未来规划提出了建议.     

Job sharing at a children's hospital: evaluation by medical staff.

OBJECTIVE--To evaluate job sharing for registrars at Princess Margaret Hospital for Children, Perth, by seeking responses from members of the relevant medical teams. DESIGN--A questionnaire was sent to all 126 medical staff within the hospital (and three managers in medical administration) asking their views on job sharing for registrars. OUTCOME MEASURES--Whether job sharing should continue, who should do it, at what stage of training, and the effects on patient care. RESULTS--Among the 77 respondents (60%) there was broad support for the continuation of job sharing at the hospital: only 5 of 37 consultants and 2 of 19 non-job sharing registrars rejected the idea (with a further 4 consultants uncertain). 43% Of the consultants who had worked with job sharing registrars thought continuity of care was adversely affected. CONCLUSION--The committee for physician training of the Royal Australasian College of Physicians emphasises that advanced training should be flexible, with a wide range of opportunities for individuals to plan an appropriate training programme in line with their personal goals. This study has shown that job sharing for registrars at Princess Margaret Hospital for Children allows this choice. Action on concerns over any adverse effects on patient care should resolve any persisting disquiet.     

Cost-Effectiveness of Screening and Treating Foreign-Born Students for Tuberculosis before Entering the United States

Introduction

The Centers for Disease Control and Prevention is considering implementation of overseas medical screening of student-visa applicants to reduce the numbers of active tuberculosis cases entering the United States.

Objective

To evaluate the costs, cases averted, and cost-effectiveness of screening for, and treating, tuberculosis in United States-bound students from countries with varying tuberculosis prevalence.

Methods

Costs and benefits were evaluated from two perspectives, combined and United States only. The combined perspective totaled overseas and United States costs and benefits from a societal perspective. The United States only perspective was a domestic measure of costs and benefits. A decision tree was developed to determine the cost-effectiveness of tuberculosis screening and treatment from the combined perspective.

Results

From the United States only perspective, overseas screening programs of Chinese and Indian students would prevent the importation of 157 tuberculosis cases annually, and result in $2.7 million in savings. From the combined perspective, screening programs for Chinese students would cost more than $2.8 million annually and screening programs for Indian students nearly $440,000 annually. From the combined perspective, the incremental cost for each tuberculosis case averted by screening Chinese and Indian students was $22,187 and $15,063, respectively. Implementing screening programs for German students would prevent no cases in most years, and would result in increased costs both overseas and in the United States. The domestic costs would occur because public health departments would need to follow up on students identified overseas as having an elevated risk of tuberculosis.

Conclusions

Tuberculosis screening and treatment programs for students seeking long term visas to attend United States schools would reduce the number of tuberculosis cases imported. Implementing screening in high-incidence countries could save the United States millions of dollars annually; however there would be increased costs incurred overseas for students and their families.     

Recruitment of doctors to non-standard grades in the NHS: analysis of job advertisements and survey of advertisers

Objectives To estimate the proportion of advertised non-consultant hospital posts that do not conform to nationally recognised terms and conditions of service and to investigate why these posts exist, who fills them, and what the doctors in such jobs do.Design Analysis of job advertisements and a cross sectional survey of advertisers.Setting Job advertisements in one of the leading UK publications listing hospital doctor vacancies (BMJ Careers).Results Nearly a quarter of non-consultant posts advertised in the two study periods (23% and 21%) were for non-standard grade posts. A questionnaire was sent to the medical staffing officer for each post. Of 430 questionnaires sent out 192 (45%) were returned. 98 trusts said they advertised non-standard grades because there was no more funding from the deanery for approved posts and 75 because service needs could not be met by doctors in training grades. In 132 posts (69%) the post holder would be required to do on-call work, and 50 advertisers (26%) required on-call duty for 1 in 5 or more frequently, which would conflict with the European Working Time Directive. 131 advertisers (68%) expected the posts to be filled by doctors from outside the European Economic Area.Conclusions Non-standard grade posts are mostly being created to meet service requirements when there is no more funding for standard training posts and are expected to be filled by doctors from overseas. Doctors in such posts can be more easily exploited and their careers hindered. The Department of Health''s annual census should include non-standard grade doctors.     

我国光形态建成研究回顾

对国内和海外中国科学家在植物光形态建成领域的研究进行了简要的总结和回顾。本文内容包括光敏色素调节的反应及其信号转导,蓝光反应及其信号转导,光周期调节及光形态建成的其他几个方面。