大型综合性医院协同管理模式研究

管理信息化对提高医院管理水平有重要意义。直线式管理结构和复杂行政流程,与当前医院快速发展有许多不适应之处。文章阐述了如何利用信息技术在医院管理中引入协同的理念,通过公开、分析和挖掘有用信息,加强信息的反馈与再利用、建立信息流通的环路,实现人、数据、和流程的协调运作,从而最终实现医院透明化与精细化管理,提高工作效率,打造坚实的医院品牌。     

医用卫生材料存货管理模式的构建研究

??????在分析当前医院卫生材料存货管理中存在的主要问题的基础上,探索构建以库存管理为前提、存货成本控制为重点、资产收益率最大化为目标的卫生材料存货管控模式,以降低医院卫生材料的平均资金占用水平,提升存货周转率,最终加强医院的运营能力和服务能力。

     

卓越绩效管理模式在医院绩效考核中的应用

绩效考核是医院经济管理的重要组成部分,如何通过绩效考核,实现医院发展战略目标,是每个医院管理者正在思考的重要问题。将卓越绩效管理模式融入医院绩效考核,分析其在实际运用过程中的必要性和有效性,并提出相应建议。     

基于HRP构建医院固定资产全生命周期管理体系

借助于医院资源规划（Hospital Resource Planning,HRP）可以实现医院固定资产全生命周期管理。以北京大学人民医院HRP系统为案例,对从资产采购申请至报废处理的全流程优化改造的特点和效果进行研究。通过企业资源规划（Enterprise Resource Planning,ERP）系统、OA系统与设备维护管理系统的整合,可以提高固定资产管理效率,为医院发展奠定坚实的物质基础。医院可以借鉴此模式实现固定资产精细化管理。     

主辅分离下大型公立医院创新发展运行模式探索

创新作为现代医院发展的支点，是医院科学运营的动力。企业医院主辅分离后，通过观念创新、技术创新、服务创新和整体发展规模的精心规划，在决策方向、经营运作、核心能力、整体规模上的重点把握和持续创新，提升了医院科学发展力、市场适应力和持续创新力，实现了医院的跨跃式发展。     

医院临床科室主任绩效评价体系框架的设计

????? 医院临床科室主任作为学科带头人和科室管理者,对医院科室管理水平的提升和医院发展战略目标的实现发挥着重要作用。结合绩效管理理论,对临床科室主任的绩效内涵进行了界定,并构建了临床科室主任绩效评价维度模型和科室主任绩效评价体系框架,为科学、全面地对临床科室主任绩效进行评价提供参考。

     

基于全流程的医院科研项目知识产权管理模式研究

高等医学院校附属医院在实施国家创新战略中具有举足轻重的作用。以科研项目生命周期为切入点,运用概念性决策模型,构建基于全流程的医院科研项目知识产权管理模式,提升医院知识产权管理能力,推动医学科研成果转化。     

我国医院后勤服务协同的现实障碍分析

医院后勤服务的运营不仅涉及与医院医疗服务之间的协调匹配问题,而且也涉及各服务提供商之间的合作问题。尽管医院后勤服务运营中存在着很多协同的机会,但在现实中却存在很多阻碍。从市场、制度、人力资源方面探讨了阻碍协同达成和协同效益发挥的原因,对医院后勤服务水平的提升及行业的发展,推进我国医院后勤社会化进程都具有十分重要的意义。

     

精细化管理在护理技术操作中的应用

医疗服务中的医疗质量、服务质量、运营成本和管理效能等已成为医院管理中关注的重点,为病人提供优质服务必须依靠各个科室的协同与合作,将精细化管理理论引入到医院管理之中,服务质量的精细化是现代医院管理的必然要求[1]。并将其运用在护理管理中,明显提高了护理管理水平,确保了护理质量及安全,减少护理不良事件的发生。     

平衡计分卡在公立医院绩效管理中的应用与实践

通过分析医院面临的内外环境,把平衡计分卡运用到医院绩效管理中,建立了财务收益、客户、医疗服务、学习与成长多角度的绩效评价体系,经过不断完善和改进,取得了患者满意、职工积极性提高、医院可持续发展的良好效果。     

生态系统服务研究在生态红线政策保护成效评估中的应用

生态保护红线政策是中国推进生态保护与建设的宏观政策,其保护成效评估是国内外关注的重大科学问题。在分析国内外生态系统服务研究进展及中国生态保护红线内涵、划定进程及管控要求的基础上,结合生态红线政策与生态系统服务研究的关联及生态系统服务研究在红线政策保护成效评估应用中面临的挑战,提出了红线政策实施效果评估的技术框架和基本思路。开展生态红线政策保护成效评估,能从科学上明确生态红线政策实施对多尺度利益相关者成本、效益的影响,为生态红线政策的综合研究提供框架和科学方法;从政策设计上,为生态红线布局进一步优化提供依据;从制度建设上,提出符合生态红线政策实施的制度框架,推动生态保护红线制度建设由理论走向实践。     

Process development in the QbD paradigm: Role of process integration in process optimization for production of biotherapeutics

Biotherapeutics have become the focus of the pharmaceutical industry due to their proven effectiveness in managing complex diseases. Downstream processes of these molecules consist of several orthogonal, high resolution unit operations designed so as to be able to separate variants having very similar physicochemical properties. Typical process development involves optimization of the individual unit operations based on Quality by Design principles in order to define the design space within which the process can deliver product that meets the predefined specifications. However, limited efforts are dedicated to understanding the interactions between the unit operations. This paper aims to showcase the importance of understanding these interactions and thereby arrive at operating conditions that are optimal for the overall process. It is demonstrated that these are not necessarily same as those obtained from optimization of the individual unit operations. Purification of Granulocyte Colony Stimulating Factor (G‐CSF), a biotherapeutic expressed in E. coli., has been used as a case study. It is evident that the suggested approach results in not only higher yield (91.5 vs. 86.4) but also improved product quality (% RP‐HPLC purity of 98.3 vs. 97.5) and process robustness. We think that this paper is very relevant to the present times when the biotech industry is in the midst of implementing Quality by Design towards process development. © 2015 American Institute of Chemical Engineers Biotechnol. Prog., 32:355–362, 2016     

Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study.

In a multicentre study of sepsis after total hip or knee replacement the operations performed by each surgeon were allocated at random between control and ultraclean-air operating rooms. Records were obtained from over 8000 such operations. In the patients whose prostheses were inserted in an operating room ventilated by an ultraclean-air system the incidence of joint sepsis confirmed at reoperation within the next one to four years was about half that of patients who had had the operation in a conventionally ventilated room at the same hospital. When whole-body exhaust-ventilated suits had been worn by the operating team in a theatre ventilated by an ultraclean-air system the incidence of sepsis was about a quarter of that found after operations performed with conventional ventilation. When all groups in the trial were considered together the analysis showed deep sepsis after 63 out of 4133 operations in the control group (1.5%) and after 23 out of 3922 operations in the ultraclean-air groups (0.6%) (ratio 2.6, 95% confidence limits 1.6-4.2; p less than 0.001). The design of the study did not include a strictly controlled test of the effect of prophylactic antibiotics, but their use was associated with a lower incidence of sepsis than in patients who had received no antibiotic prophylaxis at their operations (0.6% (34/5831) v 2.3% (52/2221); ratio 4.0).     

Integrated system for bioprocess monitoring and diagnosis using a local area network

Bioprocess monitoring and data analysis utilizing a local area network (LAN) is described in which an integrated computer environment provides for real-time monitoring from several remote personal computers with easy evaluation of the current process status and providing a common utilization of fermentation data. The computer network also enhances the decision-making process in the management of the production plant. Bioprocess control utilizing a LAN environment is expected to promote better utilization of fermentation data accumulated through repeated operations and to realize advanced control of fermentation processes. © Rapid Science Ltd. 1998     

Application of quality by design principles to the development and technology transfer of a major process improvement for the manufacture of a recombinant protein

This study describes the application of quality by design (QbD) principles to the development and implementation of a major manufacturing process improvement for a commercially distributed therapeutic protein produced in Chinese hamster ovary cell culture. The intent of this article is to focus on QbD concepts, and provide guidance and understanding on how the various components combine together to deliver a robust process in keeping with the principles of QbD. A fed-batch production culture and a virus inactivation step are described as representative examples of upstream and downstream unit operations that were characterized. A systematic approach incorporating QbD principles was applied to both unit operations, involving risk assessment of potential process failure points, small-scale model qualification, design and execution of experiments, definition of operating parameter ranges and process validation acceptance criteria followed by manufacturing-scale implementation and process validation. Statistical experimental designs were applied to the execution of process characterization studies evaluating the impact of operating parameters on product quality attributes and process performance parameters. Data from process characterization experiments were used to define the proven acceptable range and classification of operating parameters for each unit operation. Analysis of variance and Monte Carlo simulation methods were used to assess the appropriateness of process design spaces. Successful implementation and validation of the process in the manufacturing facility and the subsequent manufacture of hundreds of batches of this therapeutic protein verifies the approaches taken as a suitable model for the development, scale-up and operation of any biopharmaceutical manufacturing process.     

城市公立医院内部运行机制改革模式的探索

介绍了齐齐哈尔市第一医院在明确公立医院改革发展思路的基础上,深化内部决策执行机制、人事管理机制、薪酬分配机制、经济运行机制等公立医院内部运行机制改革的做法,加之管理体制、补偿机制、监管机制及服务体系改革,整体推进城市公立医院综合改革试点进程,以实现“维护公益性、调动积极性、保障可持续性”的改革目标。

     

JL-DRGs在综合医院管理中的应用探讨

目的 探讨JL-DRGs在综合医院管理中的应用。方法 对2012年和2013年运行JL-DRGs管理前后的全部出院病例进行统计分析。结果 2013年开始全面运行JL-DRGs后平均住院日下降17.74%,均次费用下降13.49%,医保超支年度累计减少1 866万元,平均每月医保超支额度下降39.23%,医疗质量、效率均显著提升。结论 JL-DRGs在大型综合医院管理中应用效果好,可以积极促进医院提质升效并降低运营成本。     

Patient-orientated gastroenterology.

Analysis of the first year''s working of a combined gastroenterology clinic in a district hospital has shown that the major benefit was improved patient management. Hospital attendances were reduced, the diagnostic process accelerated, and unnecessary radiological investigations and surgical operations avoided. There were no obvious major disadvantages.     

四川省内异地就医联网结算管理实践探索

四川省内基本医疗保险异地就医联网结算试点工作已全面启动。四川省肿瘤医院作为首批联网试点医院,积极顺应联网结算需求,主动创新、完善服务内涵、畅通服务流程,全面落实了实现异地就医即时结算的主要措施,极大方便了异地就医人群,取得了显著的社会效益。异地就医联网结算是一项全新工作,针对运行中存在的问题提出建议,为完善异地医保的服务与管理提供参考。