口腔专科医院门诊服务标准化管理实践与探讨

口腔专科医院门诊服务标准化管理是门诊服务质量管理的基础?根据大型口腔专科医院门诊诊疗工作特点,重新构建门诊服务标准化体系,制定行之有效的标准化培训机制,规范与细化培训内容,开展一系列有针对性的培训,努力提升服务标准化管理的实用性与人性化水平?运用多种考核考评机制对培训的效果?在实际工作中的常态化运行情况及成效进行评价,与此同时,持续改进服务质量控制体系,达到标准的凝练和细化,从而有效地提升了门诊服务的质量和效率?强化标准化管理降低了门诊管理的成本,形成了良好的工作秩序,从多方面减轻了管理人员的劳动强度?     

综合性医院门诊部为部队服务的精益管理

将精益管理理念引入综合性医院门诊为部队服务工作;使用精益管理工具,评估门诊为部队服务工作;通过改善服务流程和新增服务措施,提高为部队服务工作水平.     

以人为本 提高门诊服务质量

目的提高门诊服务质量,使门诊工作更安全、快捷、有效地为各类人群提供健康服务。方法优化服务流程,方便病人就医;调整急诊区布局,改变工作模式;增加节假日、双休日门诊;切实解决病人就诊"三长一短"现象。结果大幅度地提高了门诊各项业务指标、经济指标、医疗安全以及患者满意率。结论医院管理体制改革和门诊管理模式的转变,达到社会效益和经济效益双丰收。     

基于医院预约模式的门诊业务流程再造

结合医院24小时门诊自助服务和多种挂号预约服务模式,对门诊业务流程进行优化.同时,关注门诊服务处与收费处工作,加强对预约工作的分析评价.门诊业务流程的优化与再造,将对医院预约和自助服务起到巩固强化和积极推动作用.     

如何加强门诊管理的体会

门诊是医院医疗工作的重要组成部分，只有强化门诊管理，才能搞好门诊工作，本文从实践的角度探索门诊管理的方法和措施，从整章建制、加强考核、简化门诊服务流程到改善门诊条件、提供人性化服务，取得了较好的效果。     

优化口腔科门诊导诊工作的实践与思考

目的探讨口腔科门诊导诊工作的发展思路与新模式。方法实施人性化、个性化、交互式导医服务模式,规范导医工作流程、合理安排人员资源、加强导诊素质培训、改善口腔门诊就诊环境等。结果提高了门诊导诊服务人员的工作积极性及护理质量,减少了医患纠纷的发生。结论设置并优化口腔科门诊导诊工作适应了当今口腔医疗市场的多层次需求,构建了和谐的医护患关系。     

综合性医院门诊服务流程管理研究

综合性医院门诊是医院面向社会的窗口,门诊医疗服务工作直接影响到医院整体竞争实力。以某院门诊相关诊疗信息和现场调研为基础,分析了目前门诊医疗服务中存在的问题,讨论了门诊运营管理中流程理念的应用,提出门诊医疗服务流程管理的重点和相关建议。     

门诊管理措施初探

门诊是医院的前沿阵地,门诊工作的好坏直接影响医院的声誉,进而影响医院的社会效益和经济效益,特别是在当前医疗服务市场激烈竞争的情况下。医院运转要求得良性循环,就必须要不断提高门诊的服务质量。而门诊的服务质量是与门诊人员的基本素质分不开的。因此,必须采用...     

有针对性地加强门诊管理

通过分析医院门诊的工作特点,提出门诊工作管理要点,从合理安排人力资源、加强技术力量、严抓规章制度的落实、更新服务观念、人性化服务等方面入手,搞好门诊管理,取得了较好的效果。     

谈门、急诊人次的统计

门诊统计就是在门诊工作范围内 ,收集门诊医疗服务活动有关资料 ,进行整理与分析 ,反映门诊医疗服务的数量 ,研究门诊工作变动趋势及其规律性 ,为提高门诊工作质量和工作效率 ,加强门诊科学管理提供数据。诊疗总人次数是门诊统计的基本内容之一 ,其包括的主要内容是门诊总人次和急诊总人次 ,这二个指标数值资料的来源有二种 :一是由挂号人员填写的门诊挂号日报表 ,二是由门诊医生或导诊护士填写的门诊医师诊疗工作日志 ,一般医院统计人员只是选择其中一种方法 ,对门、急诊人次进行统计 ,以完成院内及上级主管部门所需的统计报表 ,笔者认为无…     

Health care reform and family planning services

With the reforms expected for US health care, the question remains as to the impact on family planning services. Although the focus is on health care finance reform, the mix of patients seen, the incentives for decision making, and the interactions between health care providers will change. Definition of key concepts is provided for universal access, managed competition, and managed care. The position of the obstetrician/gynecologist (Ob/Gyn) does not fit well within the scheme for managed health care, because Ob/Gyns are both primary care providers and specialists in women's health care. Most managed health care systems presently consider Ob/Gyn to be a specialty. Public family planning clinics, which have a client constituency of primarily uninsured women, may have to compete with traditional private sector providers. "Ambulatory health care providers" have developed a reputation for high quality, cost effective preventive health care services; this record should place providers with a range of services in a successful position. Family planning providers in a managed competition system will be at a disadvantage. 3 scenarios possible under managed competition are identified as the best case, out of the mainstream, and most likely. The best case is when primary reproductive health care services, contraception, sexually transmitted disease screening and management, and preventive services are all obtained directly from reproductive health care providers. Under managed care, this means allowing for an additional entry gatekeeper to specialized services. The benefits are to clients who prefer seeing reproductive health care providers first; reproductive services would be separated from medical services. The out of the mainstream scenario would place contraceptive services and other preventive services as outside the mandated benefits. The government would still provide Title X type programs for the indigent. The most likely scenario is one where primary care providers offer contraceptive services, and some family planning providers would expand their services to include nonreproductive health care. Abortion services are presently out of the health care mainstream, and efforts will need to be made to identify impact on reproductive and family planning practices and to advocate for specific provisions in health care reform.     

The structure of health care service--so-called the worried well patients and psychosomatic medicine

The desire of people to receive the best health care services without difficulty is an instinctive one. However, defects in public health education and the irresponsible or sometimes sensational medical information released by the mass media are causing an excessive increase in the population's demand for health care services. As a result, so-called "worried well" patients are increasing and health care institutions are crowded with such patients, who play a major role in increasing national medical spending. On the other hand, it is difficult to say that health care institutions are providing satisfactorily continuous, consecutive and comprehensive health care services. Needless to say, in dealing with worried well patients, the health care institutions should make efforts towards early detection of disease, if any, but at the same time, a psychosomatic approach should be made, considering patients as holistic people with both a mind and body. To this end, interdepartmental and interhospital liaison becomes very important. From the viewpoint of comprehensive health care services, the author presents in this paper such cases where the health care services provided are regarded as defective in terms of continuity and points out the importance of systematized health care information and systematized health care services at all health care levels from primary to tertiary.     

Organizing health care within political turmoil: the Palestinian case

Palestinians were given control over their own health services in late 1994. Since then they have been facing the challenge of reorganizing disordered health services into a cohesive, regulated and sustainable health care system. This paper focuses on the experience of organizing health care during political instability. It considers the ways that health care is currently provided and funded in the Palestinian Territories. The patterns of accessibility to health care services in terms of insurance coverage and provision (physical allocation) of services are discussed. Finally, the major health care policy changes in this transitional period are examined.     

Acute health care service use among elderly home care clients

Utilization of acute health care services accounts for a substantial proportion of health expenditures in Canada, and is associated with compromised health and autonomy for older persons. Using the Resident Assessment Instrument for Home Care (RAI-HC), this cross-sectional study of 683 elderly home care recipients sought to distinguish clients who were more likely to use acute health care services; i.e., hospital admissions, emergency room visits. Clients with nutritional problems were 2.58 times more likely to have used acute health care services than clients without nutritional problems. Among clients with a poor social support system, those with nutrition problems were 5.95 times as likely to have used acute health care services. Poor self-rated health, and greater functional dependency were also signif- icantly associated with acute health care use. This study provides a profile of elderly home care clients who are at risk of using acute health care services, which may facilitate targeted efforts to prevent unplanned acute health care use.     

The costs of hospital services: a case study of Evangelical Lutheran Church hospitals in Tanzania.

The health care systems of many developing countries are facing a severe crisis. Problems of financing services leads to high patient fees which make institutions of Western health care unaffordable for the majority of the rural poor. The conflict between sustainability and affordability of the official health care system challenges both local decision-makers and health management consultants. Decisions must be made soon so that the existing health care systems can survive. However, these decisions must be based on sound data, especially on the costs of health care services. The existing accounting systems of most hospitals in developing countries do not provide decision-makers with these data. Costs are generally underestimated. The leadership of the 16 hospitals of the Evangelical Lutheran Church in Tanzania is currently analyzing how the existing health care services should be restructured. Therefore, reliable estimates of the costs of hospitals services are required. A survey on 'Costing of health services of the Evang. Luth. Church in Tanzania' was prepared, which summarizes the results of seven months of field investigations in Lutheran hospitals. The major findings are that the costs of providing adequate services are much higher than expected. The most important factors determining these costs are the administrative efficiency of the hospital and the scope of services offered. The paper closes with some recommendations on how to improve the services in order to make them both affordable for the rural poor and financially sustainable for the Church. It is concluded that even the best improvement of technical efficiency will not safeguard the survival of the hospital-based health care services of the Lutheran Church in Tanzania. These findings call for a reallocation of health care resources to lower levels of the health care pyramid.     

Organizing mental health services: an evidence-based approach

BACKGROUND AND AIMS: Health policy makers and program developers seek evidence-based guidance on how to organize and finance mental health services. The Swedish Council on Technology Assessment in Health Care (SBU) commissioned a conceptual framework for thinking about health care services as a medical technology. The following framework was developed, citing empirical research from mental health services research as the case example. FRAMEWORK: Historically, mental health services have focused on the organization and locus of care. Health care settings have been conceptualized as medical technologies, treatments in themselves. For example, the field speaks of an era of "asylum treatment" and "community care". Hospitals and community mental health centers are viewed as treatments with indications and "dosages", such as length of stay criteria. Assessment of mental health services often has focused on organizations and on administrative science. There are two principal perspectives for assessing the contribution of the organization of services on health. One perspective is derived from clinical services research, in which the focus is on the impact of organized treatments (and their most common settings) on health status of individuals. The other perspective is based in service systems research, in which the focus is on the impact of organizational strategies on intermediate service patterns, such as continuity of care or integration, as well as health status. METHODS: Examples of empirical investigations from clinical services research and service systems research are presented to demonstrate potential sources of evidence to support specific decisions for organizing mental health services. RESULTS: Evidence on organizing mental health services may be found in both types of services research. In clinical services research studies, service settings are viewed as treatments (e.g. "partial hospitalization"), some treatments are always embedded in a service matrix (e.g. assertive community treatment), and, where some treatments are organizationally combined (e.g. "integrated treatment" for co-occurring mental disorder and substance abuse), sometimes into a continuum of care. In service system research, integration of services and of the service system are the main focus of investigation. Studies focus on horizontal and vertical integration, primary care or specialty care and local mental health authorities - each of which may be conceptualized as a health care technology with a body of evidence assessing its effectiveness. IMPLICATIONS: A conceptual framework for assessing the organization of services as a health care technology focuses attention on evidence to guide program design and policy development. Mental health services research holds promise for such decision-making guidance.     

Determinants of the use of maternal health services in rural Bangladesh

Utilization of health services is a complex behavioral phenomenon. Empirical studies of preventive and curative services have often found that use of health services is related to the availability, quality and cost of services, as well as to social structure, health beliefs and personal characteristics of the users. In this paper an attempt is made to examine the factors associated with the use of maternal health care services in Bangladesh on the basis of data from a survey of maternal morbidity in Bangladesh, conducted by the Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERHT). The results from both the bivariate and multivariate analyses confirmed the importance of mother's education in explaining the utilization of health care services. Female education retains a net effect on maternal health service use, independent of other women's background characteristics, household's socioeconomic status and access to healthcare services. The strong influence of mother's education on the utilization of health care services is consistent with findings from other studies. Women whose husbands are involved in business/services also positively influenced the utilization of modern health care services. However, the study results are inconclusive with respect to the influence of other predisposing and enabling factors, such as women's age, number of previous pregnancies and access to health facilities. Multivariate logistic regression estimates do not show any significant impact of these factors on the use of maternal health care. The influence of severity of disease condition in explaining the utilization of maternal health care appears to be significant. Multivariate analysis indicate that women having had a life-threatening condition are little over two times more likely to seek care from a doctor or nurse to treat their maternal morbidities.     

Feasibility of a tailored intervention to improve preventive care use in women

BACKGROUND: Women age 50 years and older are in need of multiple preventive health care services. Despite recent improvements in rates of delivery of preventive care services, especially within managed care organizations, substantial numbers of women are still being underscreened. Efforts to improve delivery of preventive care services have often focused on one outstanding service despite the fact that patients often are in need of many services. METHODS: A total of 893 women age 50 to 55 years were mailed a self-administered survey to identify outstanding preventive health care service needs. Patients in need of three or more outstanding preventive health care services were identified from survey respondents to participate in a feasibility study evaluating a tailored, customized intervention called Tic Tac Health. RESULTS: Five-hundred ninety-one women returned the survey (67%). Four-hundred forty-eight (76%) women were in need of one or more preventive health services; 92 (16%) were in need of three or more. Twenty-two patients (24%) completed the Tic Tac Health card. The women who completed the card were similar to those who did not. CONCLUSIONS: Despite documented physician visits, presence of managed care health insurance, and a designated primary care provider, a significant number of women are still in need of multiple preventive health services. An intervention targeting multiple preventive health services was demonstrated to be both feasible and effective. Further evaluation via a randomized controlled trial should be conducted to determine if an intervention like Tic Tac Health would be an effective modality for improving rates of receipt of multiple preventive health care services.     

Improving public health through access to and utilization of medication assisted treatment

Providing access to and utilization of medication assisted treatment (MAT) for the treatment of opioid abuse and dependence provides an important opportunity to improve public health. Access to health services comprising MAT in the community is fundamental to achieve broad service coverage. The type and placement of the health services comprising MAT and integration with primary medical care including human immunodeficiency virus (HIV) prevention, care and treatment services are optimal for addressing both substance abuse and co-occurring infectious diseases. As an HIV prevention intervention, integrated (same medical record for HIV services and MAT services) MAT with HIV prevention, care and treatment programs provides the best "one stop shopping" approach for health service utilization. Alternatively, MAT, medical and HIV services can be separately managed but co-located to allow convenient utilization of primary care, MAT and HIV services. A third approach is coordinated care and treatment, where primary care, MAT and HIV services are provided at distinct locations and case managers, peer facilitators, or others promote direct service utilization at the various locations. Developing a continuum of care for patients with opioid dependence throughout the stages MAT enhances the public health and Recovery from opioid dependence. As a stigmatized and medical disenfranchised population with multiple medical, psychological and social needs, people who inject drugs and are opioid dependent have difficulty accessing services and navigating medical systems of coordinated care. MAT programs that offer comprehensive services and medical care options can best contribute to improving the health of these individuals thereby enhancing the health of the community.     

上海市普陀区孕产期卫生服务利用研究

目的了解普陀区本市产妇和外来产妇孕产期卫生服务利用情况,分析孕产期卫生服务利用的影响因素。方法通过对产妇的问卷调查,了解产妇及家庭一般情况、孕产期卫生服务利用情况。数据由Epidata2.1软件建立数据库,使用SPSS11.0软件对录入资料进行统计分析。结果 1、本市、外来产妇在孕产期卫生服务利用方面差异有统计学意义。2、本市、外来产妇在产时、产后卫生服务利用方面差异有统计学意义。3、产妇年龄、丈夫户籍、丈夫文化程度、家庭经济状况是孕产期卫生服务利用的影响因素。结论 1、本市产妇孕产期卫生服务利用情况优于全国其他地区,且近几年有所提高。2、外来产妇孕产期卫生服务利用情况有所改善,但与本市产妇比较仍有明显差距。3、外来、本市产妇在产时卫生服务利用方面存在差异。4、调整卫生服务策略,提高孕产期卫生服务利用。