我院非急诊全面预约挂号改革的实践探索

按照北京市医院管理局工作的要求,我院推进实行非急诊全面预约挂号,在多渠道预约挂号、号源梳理、流程再造、便民措施方面重点展开工作,有效改善了既往门诊服务中“三长一短”的现状,提升了患者满意度及一定的社会效益。     

专家门诊预约挂号影响因素分析

??????? 目的 初步探讨影响专家预约挂号率的原因及相应对策。方法 以SPSS 13.0软件分析2012年4月—2013年1月专家门诊情况与预约挂号率的关系。结果 不同门诊时间（季度、周别、午别）、不同专科、不同专家、不同门诊级别以及挂号率与号源使用率对我院专家门诊预约挂号率均有影响。结论 影响专家门诊预约挂号率的因素是多方面的，需采取综合措施，加强医院核心竞争力才是根本。     

医院预约挂号模式在远程会诊调度环节的运用与思考

伴随远程会诊在国内的普及和社会接受度的提升,改变影响会诊建立效率的调度方式对于提升服务水平十分必要。研究者通过借鉴医院门诊所采用的预约挂号方式,结合远程会诊与基于互联网的远程会诊平台结合紧密的特点,建立远程会诊预约挂号新模式。新模式缓解了会诊申请量大与医疗资源协调难之间的矛盾,更加适应医患需求。研究不仅形成了有效的远程会诊分诊调度新方法,也为远程医学行业内的平台升级及服务优化提供了新思路。     

预约挂号平台出票客户端的设计与应用

目的 为预约挂号患者提供出票服务,分流挂号窗口排队人群。方法 设计预约挂号出票客户端,自助服务与人工服务相结合,合理规划业务流程。结果 预约挂号患者不需在挂号窗口排队,可为预约挂号患者提供24小时多地点自助出票服务,同时实现医院对预约挂号第三方支付的财务监管。结论 预约挂号出票客户端极大地方便了患者及医院,具有较好的可行性。     

国内医院预约挂号的现状和建议

随着国家医疗改革的不断深入,卫生部针对国内大部分综合性医院门诊挂号拥挤的现象和因此导致的众多问题,推出了预约挂号的新政。预约挂号实行以来减轻了门诊拥挤,提高了诊疗效率,方便了患者就诊,但在实际推广仍有不足,因此需要推广实名制挂号、构建统一预约挂号平台、加强信用建设、完善医院管理创新、试行社区预约转诊等,实现预约挂号的"人性化、精细化、信息化、社会化"。     

北京市42所医院门诊预约挂号现状调查

目的 通过调查医院门诊预约挂号服务的内容、形式、管理模式等情况,为提高医院门诊预约挂号服务质量提供建议。方法 通过对2011—2013年北京市共计42所医院门诊预约挂号服务进行全面统计分析,了解其门诊预约挂号服务现状。 结果 目前北京市预约挂号工作呈现覆盖范围广泛、形式多样的特点;患者预约挂号使用率提高,就医习惯逐渐改变。结论医院应多部门协作,提供完善的配套制度、足够的人力资源等作为保障,推动预约挂号工作进一步发展。     

某专科医院普通门诊分时段预约挂号的探讨

目的 了解某专科医院普通门诊分时段预约的特点和效果,探索适宜的评价指标、评价方式及提升预约服务的有效手段。方法 通过HIS系统提取2015年7月至2016年3月复旦大学附属妇产科医院杨浦院区4个普通门诊参与预约的12 889人次患者的预约信息及挂号就诊的181 447人次患者的相关数据,比较不同门诊的预约情况、流量分布及预约与非预约患者平均候诊时间等的差异。结果 普通门诊预约率仅7.24%,而爽约率高达25.90%;诊间预约不到全部预约的1%,普通门诊预约患者的平均候诊时间普遍短于非预约患者,无论预约率还是预约效果各科室间都存在明显差异。结论 评价普通门诊的预约情况应对各科室设置不同的基线和目标;结合专科医院的特点推动诊间预约;可将门诊流量监控引入门诊预约管理中。     

应用移动医疗App推进门诊预约挂号工作初探

介绍了北京协和医院应用移动医疗APP推进预约挂号工作的整体情况。结合实际经验,本文指出APP预约挂号功能在开发中应注意“一老一小”人群的使用,提高患者预约的准确性,严格遏制倒号行为,并提出可供借鉴的应对措施。     

预约挂号爽约病人情况调查与对策探讨

目的 了解爽约人群的特点,分析爽约的原因,提出改进措施,提高预约诊疗服务质量。方法 通过立意抽样的方法,采用自行设计的问卷对2009年10—12月有爽约行为的人进行电话调查。 结果 爽约人群以上班族为主,且以本市居民为主,主要原因是因交通受阻。结论 建议加大社会宣传力度,增加预约者取号提示,增设退号专线方便退号,缩短爽约者预约卡停用时间等措施,降低爽约率,提高预约诊疗服务品质。     

QoS and Contention-Aware Multi-Resource Reservation

To provide Quality of Service (QoS) guarantee in distributed services, it is necessary to reserve multiple computing and communication resources for each service session. Meanwhile, techniques have been available for the reservation and enforcement of various types of resources. Therefore, there is a need to create an integrated framework for coordinated multi-resource reservation. One challenge in creating such a framework is the complex relation between the end-to-end application-level QoS and the corresponding end-to-end resource requirement. Furthermore, the goals of (1) providing the best end-to-end QoS for each distributed service session and (2) increasing the overall reservation success rate of all service sessions are in conflict with each other. In this paper, we present a QoS and contention-aware framework of end-to-end multi-resource reservation for distributed services. The framework assumes a reservation-enabled environment, where each type of resource can be reserved. The framework consists of (1) a component-based QoS-Resource Model, (2) a runtime system architecture for coordinated reservation, and (3) a runtime algorithm for the computation of end-to-end multi-resource reservation plans. The algorithm provides a solution to alleviating the conflict between the QoS of an individual service session and the success rate of all service sessions. More specifically, for each service session, the algorithm computes an end-to-end reservation plan, such that it guarantees the highest possible end-to-end QoS level under the current end-to-end resource availability, and requires the lowest percentage of bottleneck resource(s) among all feasible reservation plans. Our simulation results show excellent performance of this algorithm.     

Registration methods in radiotherapy

PurposeThe aim of this study is to present a short and comprehensive review of the methods of medical image registration, their conditions and applications in radiotherapy. A particular focus was placed on the methods of deformable image registration.MethodsTo structure and deepen the knowledge on medical image registration in radiotherapy, a medical literature analysis was made using the Google Scholar browser and the medical database of the PubMed library.ResultsChronological review of image registration methods in radiotherapy based on 34 selected articles. A particular attention was given to show: (i) potential regions of the application of different methods of registration, (ii) mathematical basis of the deformable methods and (iii) the methods of quality control for the registration process.ConclusionsThe primary aim of the medical image registration process is to connect the contents of images. What we want to achieve is a complementary or extended knowledge that can be used for more precise localisation of pathogenic lesions and continuous improvement of patient treatment. Therefore, the choice of imaging mode is dependent on the type of clinical study. It is impossible to visualise all anatomical details or functional changes using a single modality machine. Therefore, fusion of various modality images is of great clinical relevance. A natural problem in analysing the fusion of medical images is geographical errors related to displacement. The registered images are performed not at the same time and, very often, at different respiratory phases.     

肝脏储备功能评估及应用研究

目前,肝脏外科已经进入了精准外科时代,术前准确评估肝脏的储备功能,对于选择合理的治疗方法,把握安全的肝切除范围,减少术后并发症,从而降低患者围手术期的肝功能衰竭的发生率均具有十分重要的意义。本文就综述了肝脏储备功能评估方法及其临床,以期促进精准肝脏外科手术的开展,提高肝脏疾病患者的生存率和生存质量。     

The “Reservation Effect”: Implications for Background Comparisons

A difficult challenge in ecological risk assessment can be determining what constitutes the “background” or ground-state condition for a site. This is because off-site conditions may not reflect to any relevant degree the history of the site itself and may therefore not be appropriate as benchmarks. One of the more important concerns is that underestimates may be made regarding contaminant-related impacts on-site because observations may indicate that community or population quality on-site equals or surpasses that observed off-site. In other cases, overestimates of the degree of contaminant impact may be made if environmental resources on-site are highly managed or devoid of natural communities. As such, management decisions may be confounded by artifacts of non-toxicant-related human influence and will not necessarily appropriately address the contaminant-related issues. Examples of these conditions are discussed herein.     

门诊退号原因调查分析及管理对策

通过对2007—2010年挂号、退号数据的分析研究,得出导致退号的原因中,医疗资源不足、病患家长不愿意长时间等候是首要原因,其他原因既有病患方面的,也有医院管理方面的。通过对各种原因的综合分析,提出改进医院门诊挂号管理的建议：预约挂号——按时间段实名制预约挂号,错峰门诊,以此促进医疗效率的提高。     

农作物种质资源登记区块链模型研究

农作物种质资源工作发展至今取得了巨大的成就,但也存在着农作物种质资源家底不清、共享利用效率不高及种质权属不清等问题,开展农作物种质资源登记工作能够有效解决以上问题.本研究从资源登记信息的流向角度出发,梳理了登记的整体工作流程,并结合区块链技术的优势,提出了农作物种质资源登记区块链网络模型.首先根据农作物种质资源登记的业...     

Optical-CT Dual-Modality Mapping Base on DRR Registration

Optical-CT dual-modality imaging requires the mapping between 2D fluorescence images and 3D body surface light flux. In this paper, we proposed an optical-CT dual-modality image mapping algorithm based on the Digitally Reconstructed Radiography (DRR) registration. In the process of registration, a series of DRR images were computed from CT data using the ray casting algorithm. Then, the improved HMNI similarity strategy based on Hausdorff distance was used to complete the registration of the white-light optical images and DRR virtual images. According to the corresponding relationship obtained by the image registration and the Lambert’s cosine law based on the pin-hole imaging model, the 3D light intensity distribution on the surface of the object could be solved. The feasibility and effectiveness of the mapping algorithm are verified by the irregular phantom and mouse experiments.     

医学图像融合配准技术

图像融合技术在现代医学中扮演着极其重要的角色,是现代医学图像技术研究的重点。图像融合技术中,图像的配准又是其中的重点、难点和热点。本文按照图像变换特性对图像配准进行了分类,对每个类别的不同配准方法(特征点的获取、图像配准的变换等)进行介绍。但是,图像配准是一个尚处在发展阶段的学科,实现配准的精确化、快速化、自动化仍需要进一步的努力。     

使用Radon变换进行二维MRI图像配准

使用了一种基于Radon变换的技术来进行二维的MRI图像配准。MRI的图像配准一般使用灰度配准,而Radon变换一般用于CT图像的重建,虽然现已经存在使用Radon变换进行图像配准,但是比较繁琐,我们对这一配准算法进行了简化。