信息不对称下公立医院过度医疗的治理

过度医疗作为医疗实践中的不良现象,是引发医疗纠纷和“看病贵”的重要原因。文章从信息不对称的角度,通过分析我国公立医院过度医疗治理现状,找出当前我国公立医院过度医疗治理存在的问题,提出信息不对称下公立医院过度医疗的治理模式,以期从根本上遏制公立医院过度医疗问题的发生。     

六西格玛管理法对围手术期服务质量改进的影响研究

目的 设计了综合医院围手术期六西格玛管理模式,并进行了试验研究,以评价应用效果。 方法 采用干预性研究方法,设立干预组和对照组。制定和筛选出评价指标,根据前后统计结果,判断总体改善和指标的变化情况。 结果 干预组总体有明显的改善,对照组总体改善不明显;干预组评价指标横比、纵比均有明显的改进。结论 围手术期六西格玛管理模式的应用可明显改善医院医疗服务质量,对医疗服务行为有较大的良性影响,并有利于医院文化建设。     

导师制科教管理模式在分级诊疗中运行的探索

分级诊疗是国家推动基层和社区医疗发展的全新政策,导师制科教管理模式在分级诊疗中的开展目前尚处于起步阶段,在实际实施过程中还存在着一定的问题和不足。如何使导师制科教管理模式在分级诊疗中发挥更大作用,以导师制促进区域医疗联合体（医联体）管理模式的建立、健全导师考核体系以及建立“学校—三级医院—医联体社区医院”3层教育管理体制是医院转型发展关键时期应该尝试的科教管理方法,也是打破医院传统管理模式、提高医院管理效率的一个有效手段。     

极致化医疗服务的理论研究与实践探索

初步探讨了极致化医疗服务满足现实需求、引领行业发展的理论和实践价值,提出了其“坚持以人为本、突出全面质量、追求无限标准”3个方面的理论内涵,并从文化熏陶、教育引导、制度规范和监督约束4个方面探讨了其实现路径。     

医德医风与医院履责对

目的 探讨医院医德医风和医生感知的医院责任履行状况对医生自身责任履行的影响。方法 运用自行设计的调查问卷对我国东、中、西3省、直辖市9个地区的128所公立医院医生进行调查。结果 回归分析显示,医德医风和医院履责对医生自身履责解释力均显著。在控制了个体变量与医院地区级别变量之后,医德医风对医生交易、发展、关系与理念责任的履行均具有显著正向影响（P＜0.001）,而医院履责对医生履责的影响有不同的对应性。结论 医院医德医风对医生自身责任的履行有积极促进作用。医院4类责任的履行状况与医生四类责任履行有紧密关联,但对应性略有不同。     

情景模拟在“医学微生物学”翻转课堂教学中的应用

翻转课堂是实现以学生为中心、提升学生自主学习能力的重要教学方法。随着线上课程的开展和学习平台技术的成熟,学生已能在课前获得足够的资源。然而,习惯于灌输式教育的学生仍缺乏自主学习的动力和方法。为此,我们教研团队尝试采用情景模拟的课堂活动设计来突破翻转环节实施的难点。研究发现,参考临床案例撰写剧本的过程能有效提升学生的自学兴趣和能力。学生课前在线预习时长和章节访问次数,以及参考资料阅读率和小组讨论时长均显著增加。课堂上,学生将课前所学知识在模拟实践中进行练习,促进了师生互动,帮助学生加深对知识的理解,提升学习成绩和满意度,同时也培养了学生的团队合作精神,建立临床思维,提升职业兴趣和能力。因此,情景模拟的融入实现了翻转课堂教学中“课前学”和“课上习”的教学闭环,为进一步推进翻转课堂的开展提供参考。     

A decision support tool for the management of freshwater pest fish incursions in Australia

There are no national emergency response arrangements for freshwater pest fish incursions in Australia. Individual States and Territories vary widely in their current response arrangements to freshwater pest fish incursions, with many being dealt with on an ad‐hoc basis and with varying degrees of efficacy. In recognition of this, the Invasive Animals Cooperative Research Centre funded a project to ‘Advance the development of national emergency response arrangements for freshwater fish incursions in Australia’. One of the recommendations of this project was creating a web‐based support tool (DST) to provide direction and assistance in managing freshwater pest fish incursions. This article describes the DST created. The DST leads the user through a series of questions relating to the species sighting, details of the fish and its capture, and site information at a particular location. These questions address issues that managers must consider when choosing appropriate control techniques. Information entered in two sections (site details and fish details) influence the suggested control techniques. The final product of the DST is a standard online report that contains a summary of all information entered and a ranking of the most common control techniques used in Australia. The report is then submitted to and assessed by the relevant State Government authority responsible for the management of freshwater pest fish incursions. Managers are then able to consider their options, taking into consideration current permits, resources and capability. The DST is anticipated to maximize the speed and quality of freshwater pest fish incursion reporting and to help the responsible government agency decide on the most appropriate management action. The DST will also provide government agency staff access to other relevant information and facilitate consistency in the decision‐making approach by government agencies throughout Australia.     

Ethical Study on the Reform and Development of Medical and Health Services in China

At an early stage of its foundation, new China became clear about the nature of public welfare and quickly developed medical and health services, which was well received by the World Health Organization. The marketization and the reduction of input into medical and health services from the 1980s created severe adverse consequences. After the SARS' outbreak in 2003, China started to give serious consideration to its medical and health system, and to work at developing medical and health services. The new healthcare reform launched in 2009 re‐emphasizes fairness and public welfare, and China's achievements have been remarkable. Of course, there are still many problems to be solved in the reform, which also paves the way for increasing the reform in future.