The Hospital Medical Advisory Committee—The Cabinet of the Medical Staff

Before a hospital medical staff can realistically accept responsibility for the professional practices of its members, a principle initially fostered by the American College of Surgeons and adopted by both the Canadian and American accreditation programs, it must have an effectively functioning medical staff organization. The medical advisory committee is the most important committee of the medical staff organization. A representative composition, adherence to sound administrative principles, and recognition of its prime functions of co-ordination, supervision and jurisdiction will permit this committee—and the total medical staff organization—to discharge adequately the very important responsibilities delegated to them by the governing board of the hospital. Properly structured medical staff bylaws with clearly defined terms of reference assist the smooth functioning of the “cabinet” of the medical staff and safeguard the prerogatives of the individual members of the staff.     

Multipurpose Intensive Care Unit in a District General Hospital

The advantages of a four-bedded purpose-built general intensive care unit in a district general hospital are described. In addition to 1,447 inpatients treated between January 1968 and December 1971 the unit was used to conduct outpatient investigations. This has filled an important gap in conventional arrangements, and is practical and economical. The unit has proved to have advantages, not only for seriously ill patients but also has benefited the hospital in other ways. It has been of material assistance in recruiting and training nursing and medical staff and has been welcomed and supported by patients and their relatives. It has also attracted practical support from voluntary organizations whose generosity has enabled much additional equipment to be purchased.     

A Concept of a Pathology Institute

Scholarly achievement is the aim of a pathology institute. In a medical faculty it serves undergraduate, postgraduate teaching, practice and research. Historically, scholarly achievement in these fields has been promoted through the teaching responsibility of the university and hospital. With the increasing volume of work, knowledge and complexity of research, adequate performance in these fields is best obtained by limiting the volume of fixed duties for each individual. At the same time, depth of knowledge is gained by encouraging specialization to complement clinical specialties. This arrangement will guarantee that the teaching and research of the department are disease-oriented, which is the central theme of pathology. With a highly specialized staff there must be a core of intradepartmental conferences common to all staff and those in training. With this form of organization dedicated to the undergraduate and postgraduate teaching, the objectives of scholarly achievement in teaching practice and research will be obtained.     

医院医疗器械维修中存在的问题及维修管理对策研究

近几年来,随着科学技术的发展和医院规模的扩大,社会对医疗技术要求不断提高,因此,高端医疗器械和新型医疗设备需求加大,医疗器械管理与维修也需跟进。医疗器械的正常使用在医疗工作中有着举足轻重的作用,可提高医疗人员的工作效率,提升临床诊治的水平,但其在改善医疗条件的同时也存在一系列的问题,若无法保质和及时维修医疗器械,对正常医疗设备的使用具有严重影响,延误患者的就诊与治疗。目前医院医疗器械维修中存在的维修人员整体素质偏低、管理机制不健全、维修技术落后、医疗器械维修人员不足、缺乏积极性及再学习的机会、医疗器械缺乏定期保养和管理等实际问题,导致医疗器械维修效率低,本文就以上问题展开讨论,旨在为医院维修管理的制定提供参考。     

Organization of work with nursing staff in Central City Hospital of Verkhnyaya Pyshma town during mass hospitalization of patients with pneumonia caused by Legionella

Data on organization and carrying out of preventive and antiepidemic measures in hospital during hospitalization of more than 197 patients with Pontiac fever and pneumonia caused by Legionella were presented. Directions and formats of work with medical personnel, including those invited from other medical institutions, as well as their information support were determined. Optimal choice of organizational, and educational technologies, as well as ways to control of compliance with implemented measures by the staff allowed to prevent cases of nosocomial infections in patients and medical personnel.     

Laboratory technicians; the Clinical Laboratory Law and its meaning to private physicians

The present laws and regulations relating to clinical laboratories in California are the outcome of over a quarter century of cooperative development. The medical profession, public health department, laboratory workers, and the legislature have worked together in this development.At first the system of certifying technicians and laboratories was on a voluntary basis. The clinical laboratory law in effect legalized and made generally applicable a system which had already been accepted voluntarily. The application of the clinical laboratory law provides physicians a reasonable assurance that competence and reliability will prevail in clinical laboratory operation. Of great importance is the conduct of proper training programs by approved laboratories. Since modern medical practice is so dependent on accurate clinical laboratory work it is essential that special effort be directed by physicians toward influencing young people to enter the profession of medical technology.     

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。     

Voluntary Health Insurance Coverage in California, 1961: A Report of the Bureau of Research and Planning, California Medical Association

Almost 7 out of every 10 of the estimated population of 16.2 million persons in California, were covered under some form of voluntary health insurance at the end of 1961. The forms of protection included hospital, surgical, regular medical and major medical expense benefits. The per cent of the civilian population of California covered for surgical benefits was slightly over 66 per cent, while 56 per cent were covered for regular medical expense benefits. Comparable percentages for the United States are approximately 74 per cent (hospital), 69 per cent (surgical), and 51 per cent (regular medical). While the percentage of the State's population covered for hospital and surgical expenses is below that for the United States, it is higher for regular medical expense benefits. The rate of increase in coverage for the different forms of health care protection in California exceeded the rate of population growth during the one-year period ending 1961. The foregoing summary and the information in the accompanying text, does not reflect the total number of persons in California who receive or are eligible for health care services. A large variety of government financed programs on local, state and federal levels either finance or provide such services to an estimated 40 to 50 per cent of the California population, which does not have voluntary health insurance coverage. No current data are available regarding the number of persons who do not desire voluntary health insurance coverage for a variety of personal or financial reasons.     

新生儿抚触的研究进展

新生儿抚触作为儿科护理的新理念,是一种对新生儿健康十分有益的自然健康医疗技术。开展新生儿抚触对新生儿有特别重要的意义。抚触可以促进婴儿体格和智能的发育、增进睡眠、稳定情绪;抚触可以增强免疫力、促进食物的消化和吸收;抚触可以促进早产儿生长发育、新生儿缺氧缺血性脑病患儿的康复;抚触可以降低新生儿黄疸、避免发生胆红素脑病;抚触可促进母婴之间情感交流;抚触可利于产后妈妈的恢复。总之,无论是对家庭、社会、医院、还是对新生儿自身来讲,抚触都是非常有意义、重要且必要的,作为家长及医院工作人员都应该了解并掌握新生儿抚触的方法以及注意事项,因此,在临床工作和家庭中都应该积极主动的广泛开展新生儿抚触,目前各国都在研究并开展新生儿抚触这种护理技术,未来新生儿抚触将会被越来越多的家庭所认识并在医院中和家庭中广泛开展。     

以服务导向临床科室绩效考核与薪酬分配制度设计

公立医院科室的薪酬分配及绩效考核工作是加强医疗质量安全和经济运行监管、完善满意度工作、转变公立医院管理机制的一项重要工作。从医院管理者的立场出发,提出了以服务为导向的公立医院薪酬分配及绩效考核的重点内容和思路设计,宏观统筹服务效率、服务质量、服务态度、成本控制、科研教学可持续发展等因素,系统化建构新医改大背景下院科两级的薪酬分配新模式,期望在现有大环境下医务人员、医院管理者、社会等多方能达到一种共赢的稳态发展状态。     

部队医院文职人员管理的探索与研究

随着部队医疗机构人事编制的调整,军队医院及疗养院为缓解人员严重短缺的问题,通过公开考核面向社会招聘具有专业资格的非现役文职人员。文职人员作为军队疗养院的聘用制人员已成为医护工作的主要力量。因此,完善文职人员的管理工作是提高医院医疗质量的重点。本文通过分析文职人员聘用、教育、生活福利待遇及公务事业、社会保险等文职人员管理制度,探讨各项管理制度的特点及作用,提出适合我院推行的文职人员管理制度,即充分利用社会人才资源,建立健全文职人员管理评价体系,提高文职人员献身部队、服务军队的积极性和创造性。     

积极的防护意识与健全的防护体系在传染病医院内的影响与效应

目的:通过提高防护意识和进一步完善防护体系实现对传染病医院的全面管理.方法:随机将我院2009年3月至2011年11月的两个病区患者及医护人员作为研究对象,向所有患者发放调查表对政策调整前后的满意程度进行调查,通过针对医护人员防护意识的强化教育和医院设施及防护体系的调整与完善以评估对患者住院期间的临床效应与影响.结果:全院上下的积极防护意识普遍增强并完善健全了防护体系,从而显著降低了感染率,患者满意度反馈良好.结论:通过提高医护人员防护意识和健全医院防护体系有助于进一步减少院内感染,提高医院医疗质量和服务水平.     

哈尔滨市十家医院医疗风险管理现状分析姜乃浒毛静馥△齐英△吴国松赵璐郭思佳刘行宇

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。     

重塑组织边界：深圳医务社会工作的经验与反思

医务社会工作是医院与社会工作机构跨越组织边界的合作。通过对深圳医务社会工作的个案分析,揭示了医院与社会工作机构之间存在制度边界、物理边界、认同边界,具体表现为业务流程与管理规范的隔离、服务空间与信息流通的壁垒、主体间的认同困境,阻碍了医务社会工作的开展。医院主动开放边界的举措与社会工作机构主动渗透的策略促进了组织合作,重塑了组织边界,但也存在一定的不足。     

患者满意评价指数模型研究

医院是社会文明服务的窗口,医德医风关系到医院和医务人员自身的声誉。患者对于医疗服务的满意度对医院的生存和发展有着重要影响,随着医疗机构之间的竞争愈演愈烈,医疗服务的满意研究受到了更多的重视。患者的满意度与医院忠诚度二者是相辅相成的关系,只有满意的患者才能成为医院的忠诚顾客,再通过这些忠诚顾客的口碑影响其他患者,医院的形象才能得以提升。目前医院患者的满意研究出现了一个特殊的现象：对各类病人的满意研究得出了高的满意率,但社会对医院服务的强烈批评却屡见不鲜。本文分析了目前患者满意评价体系存在的问题,并以服务管理领域顾客满意理论为指导,通过分析患者满意的影响要素以及各要素的相互关系,探讨医院患者满意评价模型构建方法。     

The concept of establishing autonomous occupational safety and health in hospitals: an abstraction proposal

Currently, in many hospitals in Indonesia, the Occupation Safety and Health Committee in the Hospital (OSH-CH) is evenly distributed. It is based on the instruction of the Health Department of the Republic of Indonesia that obliges each hospital to establish the committee the main function of which is to prepare necessary equipment for risk management essential in the hospital. OSH-CH must also be responsible for upgrading the accreditation process of the hospital as to work units on occupational safety, fire control and disaster preparedness. However, in fact, OSH-CH has insignificant power as many people, especially the manager of the hospital, may expect. OSH-CH tends to be stagnant and irresponsive. In other words, it tends to be non-professional. The reasons are: (1) the staff of OSH-CH work as part-timers, (2) they have minimum understanding about OSH, (3) they do not have incentive and enough budget, (4) it is only to show that the hospital "obeys" the orders of the authorities, (5) managerial support within the hospital is minimal, and (6) there are no significant cases of work-related accidents and illnesses. These explain the reasons why OSH-CH has no significant power and the progress of its program is so slow. For some large hospitals this often leads to inefficiency and ineffectiveness of the organization, and in some cases it may even tend to create difficulties in conducting risk control. Based on these reasons, it is recommended to establish an autonomous OSH work unit that operates on the basis of structural and formal organizational operations. The paper aims to discuss the proposed concept of the autonomous OSH work unit established in hospitals, particularly for large hospitals. It is urgent to develop long-term capacities of the unit to sustain its reliability.     

新冠肺炎疫情防控背景下医院文化建设的思路与方法探析

摘要：随着疫情的不断蔓延，新冠肺炎目前已成为全球范围内共同关注的重大公共问题。新冠肺炎疫情出现之后，医院广大医务人员积极响应党和国家的号召，义无反顾地投入疫情防控"战役"之中，将救死扶伤以及大爱无疆等新时代医疗卫生职业精神内化成"抗疫精神"；该精神不但反映了医务人员的责任以及担当，而且是医院可持续发展的有效动力，更是医院文化建设的关键内容。医院文化主要是指各级医疗机构在开展医疗工作过程中潜移默化所形成的一种特殊文化氛围和价值观，不仅在公共卫生体系中占据重要地位，同时可能直接或间接影响医院长期竞争力的发展。尤其是在目前新冠肺炎疫情防控之中，文化建设可发挥着特殊的作用，有效提高服务效率以及服务质量。本文结合疫情防控背景下的医院相关疫情防控措施，探析医院抗疫文化建设的思路和策略，以提高医院品牌形象以及业内影响力，继而促进医院整体文化建设的更深、更高层次发展。     

论＂医德＂的基本范畴

医德是医疗卫生领域精神文明建设的重要部分,也是调整医务人员与病人、医务人员之间以及与社会之间关系的行为准则。医德范畴是指人们对现代医务人员职业道德和医患关系的总结,它不仅概括了医生所应履行的职责义务,而且反映着一段时间内医患关系的本质。本文通过对医德范畴内,医生的权利和义务、责任和良心、功力和荣誉、审慎和保密四类问题的阐述,探讨当下医生在工作中应该保持何种心态,如何与患者进行沟通,以期更好地提供医疗服务。     

Experience with a Diabetic Service in an “Open” Hospital

A survey of the management of diabetes mellitus in an “open” hospital, Calgary General Hospital, was conducted in 1954 by reviewing the records of 100 consecutive diabetic admissions and by interviewing medical, nursing and dietetic staff members. The diabetic state was controlled satisfactorily by diet and insulin, but early diabetic complications and patient education tended to be overlooked by physicians. Diabetic management from the nursing, administrative and dietetic standpoints was considered to be inefficient, unpredictable and incomplete.In 1955 a comprehensive diabetic service was instituted which co-ordinated the activities of medical, nursing and dietetic staffs and provided for patient education. A repeat survey conducted in 1961, in which the records of 87 consecutive diabetic admissions were reviewed, showed marked improvement in all areas of diabetic patient care.Objections to voluntary conformity by staff members were surprisingly absent. The institution of a diabetic service is recommended for all hospitals as a means of improving diabetic care.