基于《医疗服务重点环节沟通指南》的和谐医患关系构建

当前医患矛盾和纠纷事件时有发生,与医患之间的沟通不到位有着密切的关系。无锡市人民医院通过调研、实践,明确医疗服务沟通中的重点环节,建立标准化的医患沟通模式,编出符合当前实际的“医疗服务重点环节沟通指南”,并将其应用于临床,从而实现强化以医方为主导的医患沟通理念、提升沟通能力、融洽医患关系、促进医院发展的目标。     

医院重症监护单元有效医患沟通的实践探索

通过对影响重症单元医患沟通有效性原因的分析,运用无锡市人民医院编写的“医疗服务重点环节沟通指南”,建立科室医患沟通规范,进行医护人员沟通品质的培育,利用新媒体技术等促进重症监护单元医患沟通的有效化,降低医疗投诉,构建和谐医患关系。     

我院优化医技检查流程的实践探索

平均住院日是衡量医院医疗效率的重要指标之一。对临床一线医师 “平均住院日延长原因及管理瓶颈”的调查发现,“医技检查时间长”（45.75%）是影响平均住院日的主要原因。因此,将医技检查流程分解为开单预约、检查等待和报告出具三个阶段,对症下药,通过自动预约、分时段检查、电子签名体系和PACS系统上线等信息化手段,显著提升医技检查效率,同时缩短平均住院日,提高患者满意度。     

医院检查预约流程优化与设计

医院各医技科室的传统检查预约服务流程存在弊端,各检查系统各自管理检查预约登记和确认,无法做到资源共享,且患者等待时间过长。为了解决以上问题,对医院的检查预约流程进行了梳理和优化,提出对医院多个检查科室的预约登记进行统一管理,为各检查科室提供统一的检查预约平台,实现统一预约和自助预约相结合,并开通智能提醒服务将患者预约和排队信息告知患者。     

“医药分开”下医技科室绩效管理改革的探索

在北京市“医药分开”改革的背景下,医院作为改革试点医院,探索建立基于医疗成果的岗位管理绩效考核与分配新机制。文章主要介绍了新的绩效管理方案在医院医技科室的实践应用。新的方案探索将医技工作的操作难度、风险大小、工作时长等方面作为考核因素,力求通过新机制的建立,合理地提高医技科室的工作量与工作质量,调动医技工作人员积极性,真正体现医务人员的价值。     

营利性医院医疗服务自主定价政府监管的思考

营利性医院医疗服务自主定价是践行十八届三中全会“市场在资源配置中起决定性作用”在医疗服务领域的举措。对营利性医院医疗服务自主定价进行阐述,并通过分析营利性医院医疗服务自主定价出现的问题,提出完善其政府监管的具体途径：完善政府对营利性医院自主定价的引导措施,完善营利性医院自主定价信息公示,畅通政府监管的信息传输渠道以及政府监管部门加大对违规自主定价的处罚。     

医务人员视角下的医患关系影响因素研究

目的 从医务人员视角出发,分析医患关系的现状、存在的问题及其原因。方法 选取广东省10所医院,以“科室”为层,抽取1 125名医务人员对医患关系认知状况进行问卷调查。结果 86.21%的人认为当前医患关系更加紧张,影响医患关系的主要因素依次为医疗技术方面、候诊服务、医患沟通、非医疗技术方面、医院管理。患者抱怨最多的是药价贵和排队时间长,分别占29.7%,26.9%。结论 医务人员对医患关系信心不足,医生技术水平、医患沟通、医院管理是当前改善医患关系的重点。     

基于双百记账法的医院财务绩效评价体系构建

为实现对医院临床、医技科室进行科学、公正的绩效考评,医院依据医院收入特点,一方面将收入以“双百”记账的方式双向分别计入临床科室和医技科室,另一方面也将成本以“双百”计账的方式双向分摊给临床科室和医技科室,从而使医院管理者能够在同一平台下对医院收入与成本进行科学测算。双百记账绩效考核核算体系的建立,实现了对医院内部科学、精准、公正的核算,同时也避免了绩效管理独立于财务核算体系之外进行成本核算的问题。

     

公立医院社工志愿服务失灵成因与对策探讨

医院志愿服务活动是社会志愿服务的重要组成部分,而社工作为医疗志愿服务的主体关系到医疗志愿服务的质量和发展。公立医院社工志愿服务中出现的“志愿失灵”问题具有其特殊的表现形式。通过分析公立医院社工志愿服务失灵产生的原因,对医院志愿服务专业化建设提出对策。     

计算机医院病案图象管理与统计系统

一、概述 病案是记载医师对病人的健康状况、疾病的发生、发展、诊疗、护理等各阶段的详细过程及医技部门的各项检查结果和病情转归等内容。通过病案的个案分析和整体分析,可提供大量的医疗质量、技术信息、总结经验、指导医疗工作,评定医师、科室和医院的医疗质量、技术水平、工作效益和社会效益。病案是医学教育和医学科研的重要资料,并提供预防保健数据,还具有法律作用。病案有如此     

Investigation of the mechanism of temperature sensitivity of the electroreceptors of ampullae of lorenzini

In experiments on Black Sea skates (Raja clavata), the potential of the receptor epithelium of the ampullae of Lorenzini and spike activity of single nerve fibers connected to them were investigated during electrical and temperature stimulation. Usually the potential within the canal was between 0 and –2 mV, and the input resistance of the ampulla 250–400 k. Heating of the region of the receptor epithelium was accompanied by a negative wave of potential, an increase in input resistance, and inhibition of spike activity. With worsening of the animal's condition the transepithelial potential became positive (up to +10 mV) but the input resistance of the ampulla during stimulation with a positive current was nonlinear in some cases: a regenerative spike of positive polarity appeared in the channel. During heating, the spike response was sometimes reversed in sign. It is suggested that fluctuations of the transepithelial potential and spike responses to temperature stimulation reflect changes in the potential difference on the basal membrane of the receptor cells, which is described by a relationship of the Nernst's or Goldman's equation type.I. P. Pavlov Institute of Physiology, Academy of Sciences of the USSR, Leningrad. I. M. Sechenov, Institute of Evolutionary Physiology and Biochemistry, Academy of Sciences of the USSR, Leningrad. Pacific Institute of Oceanology, Far Eastern Scientific Center, Academy of Sciences of the USSR, Vladivostok. Translated from Neirofiziologiya, Vol. 12, No. 1, pp. 67–74, January–February, 1980.     

Principles of organization and evolution of systems of regulation of functions

Evolution of living organisms is closely connected with evolution of structure of the system of regulations and its mechanisms. The functional ground of regulations is chemical signalization. As early as in unicellular organisms there is a set of signal mechanisms providing their life activity and orientation in space and time. Subsequent evolution of ways of chemical signalization followed the way of development of delivery pathways of chemical signal and development of mechanisms of its regulation. The mechanism of chemical regulation of the signal interaction is discussed by the example of the specialized system of transduction of signal from neuron to neuron, of effect of hormone on the epithelial cell and modulation of this effect. These mechanisms are considered as the most important ways of the fine and precise adaptation of chemical signalization underlying functioning of physiological systems and organs of the living organism