对我国民营医院评审的思考

医院等级评审作为医院规范化管理的途径,对民营医院的健康发展具有重要导向意义。自2011年第二周期医院等级评审启动,我国民营医院评审认证日益活跃。文章在回顾总结我国民营医院评审认证经验的基础上,分析了我国民营医院的发展以及医院评审的相关内容,并对民营医院评审提出建议。     

医院评审管理信息系统的建设与应用实践

新一轮医院评审提出了管理模式从粗放的行政化管理转向精细的信息化管理的指导原则,同时引入了自我评价理念和评建并举制度。围绕原卫生部《三级综合医院评审标准》,结合日常质量管理工作,利用信息化、网络化技术,建立了基于多层B/S架构的评审管理信息系统,并遵循PDCA质量改进模式,按照计划组织、执行落实、检查复核与评价改进的工作流程开展信息化评审与质量自评。评审管理信息系统的应用,帮助医院建立起了一整套规范化的自评流程,提升了医院的自评能力,推动了院内质量监测和改进机制的建立,完善了医院的质量管理体系。     

武警部队医院等级评审工作的组织与实施

医院评审是国际上盛行的医院管理、服务质量和医疗安全综合评价制度。武警部队医院等级评审工作,经过健全组织体系,严密组织实施,取得了“以评促建、以评促改”的目标和成效,医院全面建设得到了持续改进和提高。     

中心城区二级综合医院发展路径探讨

紧扣“打基础、强基层，建机制”的国家医改原则，借鉴国内外的成功经验并结实医院的现实情况，创新运行机制和管理方法，初步建立了城市二级综合医院的发展模式，在医院等级评审评价中得到专家的充分肯定。     

医院评价的国际经验及完善我国医院评价体系的设想

医院评审作为有效的质量评价和管理工具,已得到世界各国的重视。从评价标准、评价方法、评价组织等几个方面对国际上典型的医院评价体系作了归纳,结合我国医院评价体系的发展历程和存在问题,提出我国医院评价体系需要更新总体思路、完善评价标准、改进评价方法。     

德国医院透明管理制度与标准解读

在美国JCI及国际ISO质量认证体系逐步进入我国后，德国KTQ评审也以其科学的方式和精确的标准得到了国内的广泛关注，文章将从KTQ评审机构、KTQ评审方法、KTQ评审标准、KTQ信息发布及监管几个方面对德国医院评审制度进行解读，以期为我国医院评审提供借鉴。     

四川省医院分级管理评审方法研究及实践

目的 回顾和总结四川省医院分级管理评审工作,研究医院分级管理评审的发展,探讨医院分级管理评审的新方法。 方法 对四川省开展医院分级管理评审工作以来的资料进行统计和分析,并对相关资料采用EXCEL软件建立数据库,进行统计和归纳,作回顾性描述分析和总结。 结果 四川省在医院分级管理评审工作中坚持标准、兼顾现实、全面考核、突出重点,采用统一数学模型、统一评审程序、统一考核检查程序、统一检查方法和公开评审标准,公开评审程序、公开检查方法的评审方法。有力地推动了四川省医院分级管理评审工作的开展,促进了各级医院的发展,取得了良好的效果。结论 实践证明,四川省采取的“四统一”和“三公开”及坚持“两原则”的评审方法是可行、有效的。     

综合医院研究型学科建设评价指标体系的构建与实践

以某军医大学附属医院的临床学科为研究对象,建立了研究型学科评价指标体系,并应用于医院研究型建设学科的遴选。该指标体系体现了研究型医院学科建设内涵、医院科技创新和科学管理理念、客观指标与专家评审、学科现状和发展愿景相结合的要求,具有较强的科学性和实用性。     

对构建中国第三方医院评审机构的思考和建议

讨论了中国第三方评审机构、设置方法,以及它与政府和其他有关机构之间的关系。评审机构最佳设置地点是高校。这样的设置不仅可使第三方评审迅速步入轨道,而且也有利于培养中国下一代医院评审专业人员和建立医院评审的长久机制。     

基于医院等级评审标准的医疗质量持续改进

新一轮医院等级评审标准中,重点突出了“医疗质量与安全”这一主题。在医院等级评审工作中,构建了医疗质量管理框架,加强了医疗质量管理内涵建设,并结合“医院等级评审回头看”和评审日常监测工作,强化医疗质量持续改进,取得了一定成效。     

综合性医院临床科室目标管理指标体系构建研究

目的 通过建立科学的临床科室目标管理指标体系,指导医院采用量化指标科学评价临床科室发展能力和贡献,为更科学地实施医院目标管理奠定基础。 方法 通过文献调查和专家咨询等方法,构建综合性医院临床科室目标管理指标体系,并以2012年安徽医科大学第二附属医院实践数据进行实证分析。结果 建立包括4个一级指标、15个二级指标、71个三级指标的目标管理评价体系,并实证分析安徽医科大学第二附属医院目标管理考核成效,研究结果与预期目标基本一致。结论 本指标体系可以量化考核临床科室发展能力和贡献水平,与预期目标基本一致,可以为医院改进临床科室考核评价工作提供客观依据。     

对现行医院准入规制实施效果的评价

??????? 目的　通过对现行医院准入规制各项措施的重要性、失效程度等四方面进行综合评价,筛选优先干预措施,为建立有效的医院规制体系提供依据。方法 运用文献研究、现场调查及TOPSIS法对我国医院准入各项措施进行综合比较和评价,筛选优先干预措施。结果 我国医院准入规制改革的优先策略应以强化对公立医院规模、数量、布局管控为重要突破口,辅以对医院人员编制的准入以及对医保定点机构的强化管理手段为支撑。结论 TOPSIS法适宜应用于医院规制优先干预关键点的筛选,我国现行医院准入规制措施亟待改革调整。     

帕累托法则在企业医院医疗人力资源管理中的应用

目的 探索帕累托法则在企业医院医疗人力资源管理中的应用。方法 应用帕累托法则对医院关键成员进行管理,在重点培养科室管理群体和系统培训专长医疗群体的基础上,提升全院医疗整体实力。结果 在床位数逐年增加、床位使用率不断增长、工作量日益攀升以及医疗人员缺编较严重的情况下,医疗工作安全有序运转,取得了良好的社会效益和经济效益。结论 帕累托法则应用于基层医院护理人力资源管理行之有效。     

医务社工与志愿者在医院服务管理中作用的评价

目的 通过实证调查采集患者、医务工作者和志愿者对医务社工及志愿者工作的评价,解析医务社工及志愿者在医院服务管理中的作用。方法 采用问卷调查、文献查阅、深度访谈法,调研上海市三家三级甲等公立医院获取第一手资料。结果 调查结果显示,患者、医务人员及医务管理人员高度认可医务社工与志愿者在医院服务管理的作用。结论 医务社工和志愿者在医院服务管理中能发挥独特的作用,可以增进医患沟通,缓解或预防医患矛盾,给患者更多人文关怀和增值服务,一定程度上解决医患之间的诊治经费问题,提升服务品质、降低人力成本,应当得到全社会更多的重视。     

Fear of Negative Evaluation Biases Social Evaluation Inference: Evidence from a Probabilistic Learning Task

Background

Fear of negative evaluation (FNE) defines social anxiety yet the process of inferring social evaluation, and its potential role in maintaining social anxiety, is poorly understood. We developed an instrumental learning task to model social evaluation learning, predicting that FNE would specifically bias learning about the self but not others.

Methods

During six test blocks (3 self-referential, 3 other-referential), participants (n = 100) met six personas and selected a word from a positive/negative pair to finish their social evaluation sentences “I think [you are / George is]…”. Feedback contingencies corresponded to 3 rules, liked, neutral and disliked, with P[positive word correct] = 0.8, 0.5 and 0.2, respectively.

Results

As FNE increased participants selected fewer positive words (β = −0.4, 95% CI −0.7, −0.2, p = 0.001), which was strongest in the self-referential condition (FNE × condition 0.28, 95% CI 0.01, 0.54, p = 0.04), and the neutral and dislike rules (FNE × condition × rule, p = 0.07). At low FNE the proportion of positive words selected for self-neutral and self-disliked greatly exceeded the feedback contingency, indicating poor learning, which improved as FNE increased.

Conclusions

FNE is associated with differences in processing social-evaluative information specifically about the self. At low FNE this manifests as insensitivity to learning negative self-referential evaluation. High FNE individuals are equally sensitive to learning positive or negative evaluation, which although objectively more accurate, may have detrimental effects on mental health.     

Comparative assay of amyloid and prion contents in yeast cells

Amyloid contents were quantitatively assayed in crude yeast lysates treated with thioflavin T that specifically stained amyloid fibrils. We demonstrated that guanidine hydrochloride (GuHCl) treatment and overexpression of Hsp104p chaperone resulted in the elimination of the [PSI ⁺] factor and that the stable decline in amyloid contents followed from the reduced fluorescence intensity (IF) of thioflavin T. Overexpression of the SUP35 gene coding the protein prionizable to [PSI ⁺] results in the generation of [PSI ⁺] clones with increased thioflavin T IF. Transmission of [PSI ⁺] factor by cytoduction in crossings of recipients with low IF was also accompanied by stable IF enhancement in cytoductants, indicating enriched amyloid contents. Thus, in model experiments, modifying the quantity of [PSI ⁺] factor, a yeast prion amyloid, the change in thioflavin T IF corresponds to the expected shift in amyloid contents, the IF shift behaving as a cytoplasm hereditary determinant. It is concluded that thioflavin T IF allows for the quantitative estimation of amyloid contents in cells. The stable mitotic IF shift induced by agents affecting the prion composition permits the quantitative evaluation of prion contribution into amyloid pool. It is possible to assume that the monitoring of thiophlavin T IF shifts under the exposure of agents affecting prion pattern may be helpful to disclose previously unknown prions in yeast strains.     

Molecular and chemical profiling of ‘sweet flag’ (Acorus calamus L.) germplasm from India

In the present study, molecular (DAMD and ISSR) and chemical (α and β-asarone contents) markers were used to characterize the A. calamus genotypes procured from different parts of India. The cumulative analysis carried out for both DAMD and ISSR markers revealed 24.71 % polymorphism across all genotypes of A. calamus. The clustering patterns of the genotypes in the UPGMA tree showed that the genotypes are diverse, and did not show any specific correlation with their geographical provenances, reflecting the low level of genetic diversity and a high genetic differentiation among the genotypes from the same localities. All the 27 genotypes of A. calamus were also analyzed for α and β-asarone contents, and percentage of essential oil. The genotype (Ac13) from Kullu (Himachal Pradesh) showed maximum (9.5 %) percentage of oil, whereas corresponding minimum (2.8 %) was obtained from the genotypes from Pangthang (Sikkim). Similarly, the highest α and β-asarone contents (16.82 % and 92.12 %) were obtained from genotypes from Renuka (Himachal Pradesh) and Udhampur (Jammu & Kashmir), while lowest α and β-asarone contents (0.83 % and 65.96 %) resulted from Auranwa (Uttar Pradesh) and Pangthang (Sikkim) genotypes, respectively. A. calamus harbours tremendous economic value, and it is therefore, important to identify the genotypes with low α and β-asarone contents for its commercial utilization. Further, this study will help in evaluation and documentation of a large number of diverse genotypes for their value traits.     

Kodamaea Ohmeri Fungemia in an Immunocompetent Patient Treated with Micafungin: Case Report and Review of the Literature

Kodamaea (Pichia) ohmeri is an unusual yeast-form fungus that has recently been identified as an important etiology of fungemia, endocarditis, cellulitis, funguria and peritonitis in immunocompromised patients. We report a case of K. ohmeri fungemia in a 34-year-old hospitalized patient with thrombophlebitis. The patient was admitted to the hospital for evaluation and management of an acquired tracheo-esophageal fistula secondary to an impacted denture. Fever developed on hospital day 22, and physical exam revealed right arm superficial thrombophlebitis at the site of the peripheral venous catheter that was confirmed by Doppler ultrasound. The peripheral vein was removed and blood cultures from hospital day 22 and 23 grew yeast species. The yeast was subsequently identified to be K. ohmeri by Vitek II and API20C and was confirmed by 18S rRNA gene sequencing. The fungemia and right arm phlebitis was successfully treated with a 2-week course of micafungin therapy. This is the first case of K. ohmeri fungemia in a patient that was successfully treated with micafungin.     

Social media user’s knowledge on soil plant relationship in Saudi Arabia

The study aimed to investigate the soil-plant relationship by looking at knowledge levels of social media users. The study examined the relationship between the users’ characteristics and their knowledge on soil-plant relationship. Online survey was designed and distributed to gather the data. The number of response was received from 383 respondents where 375 participants provided completed information and the remaining eight responses were eliminated due to quality standards. The results show most of the participants (68.8%) are moderately depend on social media to acquire knowledge on soil-plant relationship and indicated “Twitter” as the highly utilized platform followed by the “Youtube”. Meanwhile, 48.8% of the participants indicated that social media have a high impact on their knowledge-based information on soil-plant relationship and agricultural contents. Inferential analysis shows there was a significant positive relationship (p < 0.01) between independent variables; Twitter, Youtube, Instagram, and Snapchat and the degree of trust on these platforms, and the level’s knowledge on soil-plant relationship (dependent variable). Only 13% of the variance accounted for the impact of social media on participants’ agricultural knowledge-base can be predicted from the combination of participants’ reliance on a set of social media platforms (Twitter, Instagram, Youtube, and Snapchat). The study revealed the trust and confidence of the users using social media on agricultural information/soil plant relationship had a medium effect in social and educational research.