基于模糊决策的临床科室主任绩效考核的研究

通过研究临床科室主任绩效考核指标,调动科室主任管理的积极性,增强科室员工质量管理意识和医疗安全意识,促进医院的发展。在分析传统临床科室绩效考核方法不足的基础上,结合模糊决策的概念,提出了一种基于模糊决策的临床科室主任综合评判方法。该方法充分利用了模糊逻辑中模糊决策的概念,对医院临床科室主任进行了模糊意见集中决策和模糊综合评判决策。最后通过具体的数值实验对该方法进行了性能分析,结果证明该方法具有良好的性能。     

公立医院非在编人员工作满意度调查与分析

?????? 目的　通过分析公立医院非在编人员工作满意度影响因素,提出改进建议,以更好地为患者提供优质服务。　方法　满意度问卷调查表采用李克特量表,使用STATA10.0软件进行统计数据分析。　结果　非在编人员工作总体满意度平均得分为（3.66+0.78）分,评价一般。影响满意度的因素有：个人职业期望、科室管理、工作氛围、奖金待遇、学习培训等。　结论　医院应关注非在编员工满意度管理工作,关注不同群体的差异和不同影响因素,有效提高满意度,增强医院的可持续发展力。     

我院优化临床路径环节质控的策略和实践

临床路径作为一项有效的管理方法,在保障医疗安全和提高医疗效率中发挥了重要作用。以医院开展临床路径工作的实践经验为基础,从组织管理和执行实施两个方面,介绍了以加强环节质量控制及提高执行效率为目的的临床路径建设及持续优化策略,探讨完善临床路径管理的有效方法。     

上海市级医院消防安全团队建设的研究与实践

消防安全是医院运行的第一道防线,医院消防队伍对于保障大型市级医院的正常运作有着十分重要的作用。研究通过实地调研和问卷调查形式,对上海市7家市级医院的消防安全团队建设进行分析,并提出改善团队建设的建议。     

我国公立医院补偿强度的多视角研究

通过对公立医院补偿强度进行多视角研究发现,即使在“政府对公立医院投入不足”的局面下,公立医院依然可能出现“营养过剩”的问题。应制定适度并可执行的财政补偿政策,制定合理、有效的税收返还和转移支付制度,放宽社会资本办医融资政策,适当转移土地补偿政策,注重医院软实力建设和加快推进人事制度改革等。     

《医院财务制度（征求意见稿）》中公立医院国有资产管理的优化分析

国有资产管理是医院财务管理的重要内容,但我国公立医院国有资产管理存在着管理目标不当、范围界定不清、权责不明确、信息披露不全面等问题,无法适应新医改的要求。分析了这些不足并探讨了《医院财务制度（征求意见稿）》中公立医院国有资产管理在管理目标和管理范围方面的变化,提出落实医院独立法人地位、完善内部控制制度等改革方向。     

新农合对村卫生室能力建设的激励效应

以贵州省24个县村卫生室为样本,利用准实验对照研究探讨新农合对卫生室的激励效应。结果表明,新农合定点组的设施和人力配备以及功能服务和收益的大部分指标值及其增幅优于非定点组。新农合在一定程度上促进了卫生室的发展,但需进一步提高对卫生室的覆盖面和补偿力度,完善支付方式,并加大财政支持,提升卫生室服务能力,以达到医保双方良性互动的局面。     

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。     

患者就医参与行为实证研究：基于成都市的调查

患者就医全过程参与是客观存在的,研究涵盖了患者就医过程中所传出的、与医疗活动相关的身心投入与努力。文章采用问卷调查方式收集数据,研究患者就医参与行为特征。结果表明,患者就医参与行为包括4个维度：患者参与患者安全行为、遵医配合行为、就医前信息搜集行为以及医患互动交流行为。同时分析了不同人口学背景下的患者在就医参与行为4个维度方面的异同。     

公立医院法人治理下医师绩效考核标准体系创新研究

法人治理结构下,公立医院医师绩效考核尤为重要。但目前的医师绩效考核机制中存在公益性缺乏、重过程轻结果、搭便车和激励惰性以及重热门轻冷门等问题。为此,本文在实证调研和文献分析的基础上,借助德尔菲法和层次分析法,基于公益性、公平性、全面性、客观性和可操作性四个原则,选取人才素质类、价值贡献类和工作效果类三个方面指标,构建出新型公立医院医师绩效考核标准体系。

     

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。     

Bringing culture back in: the class origins and ethnoracial destinations of culture and achievement

ABSTRACT

Notably absent from assimilation scholarship are analyses that seriously engage, rather than dismiss, cultural explanations for differences in group outcomes. That dismissal has left the assimilation scholars ill-equipped to thoroughly respond to popular and quasi-academic explanations that rely on an all-encompassing view of culture to explain immigrant group differences in socioeconomic outcomes. Jennifer Lee and Min Zhou’s The Asian American Achievement Paradox embraces the cultural explanation, but traces the root of an ethnoracial culture to its class origins. In so doing, Lee and Zhou force scholars to contend seriously with ‘culture’ as part of a larger explanation for group outcomes.     

Cultural Competency and Rural Disorder in PNG Health Promotion

ABSTRACT

Health workers in Papua New Guinea strongly emphasise their duty to provide services to the country’s rural majority. Trained to see rural communities as lacking modern discipline and order, they worry that rural people will resist, perhaps with violence, if health workers fail to ‘show respect for culture’. Examining cultural improvisation among nursing students on a rural experience practicum in the Eastern Highlands, I show how students and teachers tried to craft culturally respectful health education. However, when difficulties emerged, local people were described as unable or unwilling to harim tok (understand, heed or follow instructions). The capacity to follow instructions, cultivated through education and Christian faith, was cast as incompatible with Highlands culture. Rural health promotion activities, when they fail to foment major transformation, can help reproduce the ideological construction of the people of the hauslain (village, hamlet) as emotionally volatile and ungovernable.     

基于对立价值构架的医院文化建设实证研究

??????? 目的 了解医院现有和员工期望的文化类型,找到优势文化,为医院文化建设提供参考。方法 使用组织文化评价量表（OCAI）对山西省某医院230名员工进行问卷调查。结果 文化类型现状得分,团队支持型、创新变革型、市场绩效型和层级规范型依次为30.51、22.55、23.41、23.53分;上述文化类型期望得分依次是32.24、24.80、21.06、21.90分。结论 医院的优势文化为团队支持型和层级规范型,员工期望的优势文化是团队支持型和创新变革型。     

Ethnic culture and social mobility among second-generation Asian Americans

ABSTRACT

This review engages with Jennifer Lee and Min Zhou’s The Asian American Achievement Paradox to consider how ethnic culture matters for social mobility among the immigrant second generation. It describes the strengths and contributions of the book, connects it to broader debates on culture, poverty, and mobility, and draws on my own research on the second generation in New York City. It highlights three additional cultural mechanisms that underlie the Chinese (or Asian) second-generation advantage: social class heterogeneity in the co-ethnic community, intergenerational support in the immigrant family, and the belief in achievements as redemption for parental sacrifice. While pointing out the similarities and differences between Los Angeles and New York, it also suggests possible applications of these cultural mechanisms in explaining second-generation achievements.     

Cultural Competence in Diabetes Mellitus Care: An Urgent Need

Background:Multicultural societies exist worldwide. Two important challenges can be appreciated in this scenario. Minority populations, due to a combination of genetic and lifestyle factors, have a particularly high risk for developing type 2 diabetes mellitus (DM). In addition, the quality of health care provided to minority populations, including that for DM, has lagged behind that provided to the white population. Because multiple medical, social, and cultural factors influence the development and progression of type 2 DM, management of patients becomes even more challenging if health care providers cannot identify and address the many contributing factors.Objective:The objective of this article was to raise awareness about the most common social and cultural factors that may influence the development of type 2 DM, progression of the disease, and adherence to treatment plans in patients from culturally diverse populations.Methods:A PubMed search of English-language articles published primarily between 1996 and 2006 was conductedusing the search terms Latino, Hispanic, culture, and diabetes, and a list of social and cultural factors associated with type 2 DM was created based on relevant articles and on the author's expertise and experience in the Latino Diabetes Initiative at the Joslin Diabetes Center.Results:There is increasing evidence that social and cultural factors such as body image, educational level, fears, general family integration and support, health literary, language, myths, and nutritional preferences, among others, may affect the success of the physician patient relationship and influence patients' adherence to treatment. Specific strategies to help clinicians remember to address multiple factors in the day-to-day management of patients with type 2 DM who are from culturally diverse populations include asking questions about patients' personal goals, ascertaining what behaviors they have adopted from mainstream culture, understanding how family ties may affect DM care and prevention, and being aware of patients' educational level when implementing any educational activity.Conclusions:The standards of DM care apply to every individual with this disease and should continue to be the core of every clinicians practice. However, improving health care providers' cultural competence may help improve the quality of care provided to minority groups and may ultimately reduce health care disparities. Increased cultural competence may also improve patient-provider trust and communication, as well as help patients adhere to prevention and treatment plans.     

Disaster as Opportunity? Cyclone Pam and the Transmission of Cultural Heritage

ABSTRACT

Culture, by its very nature, is always at risk of change – whether through transformation, destruction or redefinition. So how might culture be said to be particularly at risk in the context of ‘natural’ disasters, and how are disasters ‘naturalised’ or incorporated under the terms of different cultural regimes? An earlier focus on the impacts to built or tangible heritage is increasingly being balanced by a concern for the transformations wrought by disasters in the intangible heritage of communities. Through the recent event of Cyclone Pam in 2015, and a case study of the World Heritage site of Chief Roi Mata’s Domain (CRMD), we explore the ways in which repetitive natural hazards have shaped culture and tangible and intangible forms of heritage in Vanuatu. We focus in particular on the issue of cultural transmission at CRMD and its relationship to natural hazards through the device of a ‘disaster biography’. Risk can also carry with it the prospect of opportunity, and our paper seeks to understand how opportunity might be present in post-disaster reworkings of culture and heritage.     

Plain Facts

Abstract

The identification of an early lithic horizon in Oklahoma is made and theories concerning its cultural affiliation, site locations, distribution, and artifact typology are described.

The common characteristics of 20 sites in central Oklahoma are listed; site location - on high ground and on tributaries rather than streams; lithic debris found mostly in eroded gullies, quartzite material and core tools predominant on most sites, finished tools found in a minority of sites; Plainview points found at 2 sites and points being generally very rare; and no pottery on any sites.

The culture is equated at the technological 11level11 of the Cochise culture of southern Arizona and New Mexico.     

The Fremont Culture: Its Derivation and Ultimate Fate

Abstract

Aikens (1966) has proposed that Fremont-Promontory culture originated on the Northwestern Plains and representsan Athabascan migration into the Utah area at circa A. D. 500, their descendents, he suggests, were later forced back onto the Plains by the 12th century expansion of Shoshoneans from the Great Basin. He also proposes that FremontPromontory culture was ancestral to Dismal River culture. In this paper an alternative hypothesis is proposed, i.e., that Fremont and then Promontory cultures were sequential developments from an indigenous Utaztecan or proto-Utaztecan base and that there is no direct cultural relationship between theUtah cultures and the Dismal River aspect.