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老年性白内障日间手术临床路径模式效果分析 总被引:1,自引:0,他引:1
目的 借鉴国内外日间手术管理经验,在医药分开综合改革的背景下,探索实施老年白内障日间手术临床路径新模式。方法 对首都医科大学附属北京同仁医院2010年(临床路径实施前)、2013年(临床路径实施后)和2016年(日间手术临床路径模式开展后)老年性白内障治疗人均费用、平均住院日、术后感染率进行比较。结果 实施老年白内障日间手术临床路径新模式,平均住院日缩短,人均治疗费用降低,且差异均有统计学意义(P>0.05)。2010年、2013年、2016年的手术感染率都较低,差异无统计学意义(P>0.05)。结论 在保障医疗质量的前提下,老年性白内障日间手术临床路径新模式的实施,不仅提高医院和科室的经济效益,为政府节约医疗资源,而且还能降低患者的治疗费用,提高患者满意度。 相似文献
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目的 调查日间手术病人术后安全性及患者的价值感知、风险感知。方法 问卷调查和电话调查。结果 609例患者调查结果显示:日间手术患者对医疗服务的满意度96.2%,对医疗质量的满意度为95.9%;日间手术患者出院后再住院率为0.05%,再就诊率2.9%;64.9%的患者意识到日间手术模式较住院手术具有更高的便利价值,49.1%的患者意识到日间手术模式的货币价值, 57.0 %的患者意识到日间手术的社会价值;风险感知方面,50.4%的患者担心如果出现不适后,不能得到及时的处理;22.0%的患者对没有医护人员照护下的康复,在心理上的准备不足。结论 日间手术模式是一种安全有效的医疗模式,对这种模式患者具有较高的价值感知,同时也存在较高的风险感知。 相似文献
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目的:近年来,医疗纠纷屡见不鲜,其中不乏军队医院。为此,我们对目前部队医院的医疗风险管理情况进行分析,深入总结军队医院管理存在的问题,并提出相应的对策以加强部队医院医疗风险的防范工作。方法:采取调查问卷方法对10所部队医院的一线医护人员就医疗风险相关问题进行调查,并对结果进行分析。结果:工龄低于5年的医务人员发生医疗风险的比率高于工作5年以上的人员;外科和妇产科医疗风险发生率较高;三级甲等医院医疗风险管理体系较三级乙等更完善。医院的管理制度、医务人员的工龄、科室的设置、风险教育及工作量等均与医疗风险的发生有着密切的关系。结论:部队医院应建立健全的风险预警系统与评价体系,提高医院对医疗风险的管理能力。医务人员应加强风险意识和法制意识,重视医患沟通,以促进医患关系和谐,从而减少或避免医疗纠纷的发生。 相似文献
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医疗安全管理、非医疗安全管理是医院安全管理的两大系统。随着医药卫生体制改革深化,就医模式改变,非医疗安全管理的内涵和外延发生变化,非医疗安全管理领域面临更多危险因素和安全隐患。结合医院非医疗安全管理现状,分析非医疗安全管理存在的问题并提出相关改进建议。 相似文献
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目的:通过对哈尔滨市10家医院医疗风险管理现状调查,掌握医院医疗风险管理情况,找出存在的问题,提出改进对策,为医院制定科学、完善的医疗风险管理体系提供参考。方法:运用文献法、访谈法、特尔菲法、头脑风暴法等方法;应用SPSS、EXCEL统计软件对数据进行统计学处理。结果:三级医院在风险管理体系相比于二级医院更为完善;两级医院在医护人员独立工作能力,医疗药品和设备的准入,医疗风险信息系统使用,医护人员培训满意度等方面均具有较大差异;大多数医护人员愿意主动报告医疗纠纷;医患沟通效果较好,科室之间沟通协作也比较好。结论:目标医院基本上建立了医疗风险管理体系,但是在功能上、风险管理措施的制定及落实上尚不完善,医疗风险管理人员的专业素质有待提高,医院医疗风险管理意识尚需加强。 相似文献
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D W Johnston A Gold J Kentish D Smith P Vallance D Shah G Leach B Robinson 《BMJ (Clinical research ed.)》1993,306(6883):963-966
OBJECTIVE--To establish whether stress management had a larger effect than a control treatment on resting blood pressure, ambulatory blood pressure, and left ventricular mass. DESIGN--A 12 week baseline period of habituation to measurement of blood pressure was followed by randomisation to either stress management or mild exercise for six months and follow up six months later. SETTING--General practice, district general hospital, and medical school. PATIENTS--Of the 184 patients aged under 60 with mild primary hypertension who entered the baseline habituation period, 88 were excluded because they failed to meet the entry criteria or they withdrew from the study. The remaining 46 men and 50 women underwent treatment. INTERVENTIONS--10 clinical sessions and daily practice at home of either stress management based on relaxation or non-aerobic stretching exercises. Mildly stressful 15 minute interviews before and after treatment. MAIN OUTCOME MEASURES--Diastolic and systolic blood pressure in the clinic and during 12 hours of ambulatory recording, and left ventricular mass measured by echocardiography. RESULTS--The patients'' blood pressure fell during habituation (systolic pressure from 152 mmHg to 140 mmHg, diastolic pressure from 98 to 93 mm Hg), but neither resting nor ambulatory blood pressure was changed by the treatments. Left ventricular mass was also unchanged. Blood pressure rose during the stressful interview, but this rise was reduced by stress management (systolic pressure rose by 7.4 mmHg before treatment and by 3.7 mmHg after treatment). CONCLUSION--Stress management of a type advocated for treating mild primary hypertension is ineffective in lowering blood pressure in patients who are well habituated to measuring blood pressure. 相似文献
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Byrd HS Barton FE Orenstein HH Rohrich RJ Burns AJ Hobar PC Haydon MS 《Plastic and reconstructive surgery》2003,112(2):636-41; discussion 642-6
Advances in medicine have improved the delivery of health care, making it more technologically superior than ever and, at the same time, more complex. Nowhere is this more evident than in the surgical arena. Plastic surgeons are able to perform procedures safely in office-based facilities that were once reserved only for hospital operating rooms or ambulatory surgery centers. Performing procedures in the office is a convenience to both the surgeon and the patient. Some groups have challenged that performing plastic surgery procedures in an office-based facility compromises patient safety. Our study was done to determine whether outcomes are adversely affected by performing plastic surgery procedures in an accredited outpatient surgical center. A retrospective review was performed on 5316 consecutive cases completed between 1995 and 2000 at Dallas Day Surgical Center, Dallas, Texas, an outpatient surgical facility. Most cases were cosmetic procedures. All cases were analyzed for any potential morbidity or mortality. Complications requiring a return to the operating room were determined, as were infection rates. Events leading to inpatient hospitalization were also included. During this 6-year period, 35 complications (0.7 percent) and no deaths were reported. Most complications were secondary to hematoma formation (77 percent). The postoperative infection rate for patients requiring a return to the operating room was 0.11 percent. Seven patients required inpatient hospitalization following their procedure secondary to arrhythmias, angina, and pulmonary emboli. Patient safety must take precedence over cost and convenience. Any monetary savings or time gained is quickly lost if safety is compromised and complications are incurred. The safety profile of the outpatient facility must meet and even exceed that of the traditional hospital-based or ambulatory care facility. After reviewing our experience over the last 6 years that indicated few complications and no deaths, we continue to support the judicious use of accredited outpatient surgical facilities by board-certified plastic surgeons in the management of plastic surgery patients. 相似文献
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Quebec Health Minister Dr. Jean Rochon is pushing for a regionalized health care system that favours ambulatory care, day surgery and home care over hospital admissions and acute care in hospital. The Quebec Medical Association is concerned these changes will lower the quality of care in the province. 相似文献
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随着科学技术的快速发展,各类新媒体的出现让部分医疗事件有了更高的关注度。近年来医疗纠纷日益严重,在全媒体时代的背景下,医院舆情危机频繁发生,对医院声誉和医患关系产生较大的不良影响。如何正确的引导网络舆情、降低医院舆情危机带来的不利影响成为急需解决的问题。本研究就全媒体时代医院舆情管理危机展开探讨,从医院舆情管理现状、医院舆情管理所存在的问题及相关的应对措施这三个方面入手,旨在为医院管理者在全媒体背景下控制医院舆情、化解医院突发事件、改善医患关系提供参考。 相似文献
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