运用品管圈提高门诊收费准确率

目的 尝试通过运用“品管圈”这一工具,提高门诊收费窗口准确率.方法 统计分析造成门诊收费长款的原因,通过采取措施后,分析每万笔门诊收费业务长款笔数是否减少.结果 开展“品管圈”活动后,每万笔门诊收费业务长款笔数由活动前的0.93笔降至0.49笔.结论 开展品管圈活动后,切实提升收费员自身素质,减少门诊收费长款笔数,以及提高收费准确率.     

品管圈在提高病历核算室工作效率中的应用

目的分析品管圈在病历核算室实际工作中的应用情况,验证运用品管圈提高审核工作效率的效果。方法采用SPSS 13.0数据分析软件,统计分析审核班次和审核效率的目标值达标情况,对比分析活动前后50名收费员满意度测评情况。结果每工作日审核班次由活动前的5.91减少至4.99,下降15.57%,工作效率由平均每班次审核23.99例上升至28.06例,增长16.97%,审核班次下降和工作效率上升都表现为高度显著性差异(P<0.01)。结论开展QCC活动,确实提高审核工作效率、审核员的满意度及审核员培训效率。     

品管圈活动在缩短收费窗口门诊患者等候时间中的应用

目的探讨品管圈活动在缩短门诊患者收费窗口等候时间中的应用效果。方法成立品管圈活动小组,梳理门诊患者挂号交费的流程,分析患者在收费窗口等候时间长的原因,根据主要影响因素提出整改措施。结果门诊患者收费窗口等候时间由活动前的292秒缩短为活动后的134秒。结论品管圈活动在缩短门诊患者收费窗口等候时间的效果显著,值得推广和引用。     

品管圈完善医疗收费的管理效果评价

目的：结合医疗收费全过程管理工作特点,通过实施品管圈活动,提高医疗收费工作质量和效率。方法针对医疗收费管理存在的问题,基于品管圈原理和实施步骤,广泛开展品管圈活动。结果通过开展品管圈活动,实现医疗收费规范化、科学化管理,工作质量和效率提高,收费员素质也明显提高。结论品管圈活动的深入开展可促进医疗收费部门科学发展。     

品管圈在提高痛风患者宣教满意率中应用的效果评价

目的:评价品管圈在提高痛风患者宣教满意率方面的应用效果.方法:成立品管圈,运用质量管理工具改进痛风患者住院期间的护理宣教问题,比较对策实施前后,痛风患者的满意率.结果:实施品管圈活动后,痛风患者的宣教满意率由活动前的80％,提高至活动后的93％,超出了预期目标.结论:运用品管圈对痛风患者的宣教进行管理,显著提升了痛风患者的宣教满意率,提高了护理人员的综合素质,提升护理质量,促进团队的发展.     

品管圈在提高收费处满意度第三方调查得分中的应用△

目的：讨论品管圈活动在提高收费处满意度第三方调查得分中的运用。方法：成立品管圈活动小组，梳理患者挂号交费的流程，分析收费处满意度第三方调查得分低的原因，根据主要影响因素提出整改措施并实施。结果：品管圈活动实施后，收费处满意度第三方调查得分由94.11分提高到98.8分，目标达成率为135.94%，投诉率和窗口矛盾次数明显下降，患者满意度大幅上升，收费人员的意识和工作满足感得到增强，积极性、创造性、主动性得到充分发挥，品管圈圈员综合能力和团队凝聚力显著提高。结论：“品管圈”活动在提高收费处满意度第三方调查得分中效果较好。     

门诊服务流程再造的效果评价

目的：评价门诊服务流程再造的实施效果。方法：通过建立信访投诉接待窗口、医保医政服务窗口、门诊疾病引导服务中心、开通移动端支付、引进刷卡签到机及自动发药机等对门诊服务流程进行再造。随机选取流程再造前后患者及家属各300人进行现场问卷调查,对比实施前后的就诊环节、等待时间及满意度。结果：患者候诊时间由 47.12±9.89 min缩短至28.88±5.15 min,满意度从66％提升到89.7％;缴费等候时间由11.40±2.31 min缩短至3.23±1.97 min,满意度从61.3％提升到93.3％;中药取药等候时由12.73±2.99 min缩短至3.57±1.82 min,满意度从52.3％提升到98.3％;复诊等待周期由10.83±2.43 d缩短至2.95±1.24 d;投诉满意度从49.7％提升到91％,整体满意度由57.7%上升至93%,差异有统计学意义（P＜0.001）。结论：门诊流程再造的实施明显缩短了患者的无效就诊等待时间,提升了患者的满意度,提高了门诊效率,改善了患者的就医体验。     

试述收费员的职业道德与职业素养

"三好一满意"活动在全国各家医院开展,作为服务窗口之一的医院挂号、收费窗口,也格外受人关注。据调查目前绝大多数三甲医院的挂号、收费窗口主要由三类人员构成:一是年龄偏大、文化层次偏低的老职工;二是部队复员军人,一般年龄不大,但无专业财务知识;三是合同制收费员,年纪较轻,刚     

门诊西药房药学服务满意度分析与探讨

目的通过调查门诊西药房药学服务满意度情况,并进行分析,从而为提高药学服务质量提供参考。方法采用自制的调查表,调查门诊患者对西药房药学服务的满意度。结果门诊患者对排队等侯取药时间的满意度最低,为93%;其次为西药房药师使用礼貌用语满意度94.6%;再次为西药房药师的服务态度满意度95.8%;再又为西药房药师交待特殊用药的注意事项满意度97%。对满意度各项目进行分析,西药房工作人员超负荷工作是造成满意度偏低的主要原因;其次是药师说话不够婉转,语气生硬,没有使用礼貌用语;再是有些药师缺乏主动服务理念。结论提高患者的满意度,必须在优化取药流程,拓展药师专业技能,开展人性化服务,一切以患者为中心,加强与患者的沟通,规范文明用语礼貌服务,更新服务理念,改善信息系统等方面切实加以解决。     

品管圈对缩短精神科急诊患者就诊等待时间的效果探讨

目的探讨品管圈对缩短精神科急诊患者就诊等待时间的效果。方法选取2019年7月至2020年6月于我院精神科急诊就诊的300例患者作为研究对象,150例予以常规就诊指导的患者纳入对照组,150例予以品管圈就诊指导的患者纳入观察组。比较两组的就诊等待时间及护理满意度。结果观察组的就诊等待时间显著短于对照组,护理满意度评分显著高于对照组(P<0.05)。结论品管圈可缩短精神科急诊患者的就诊等待时间,提高患者的护理满意度。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.