医疗工艺设计“三段论”

工艺设计是前期策划的重要内容在美国,医院前期策划的整个过程非常复杂,一个500㎡的医院项目,其前期策划对于医疗顾问来说需要1～1.5年的时间。前期策划的重要工作是工艺设计,可以说,前期策划的很多工作都是为工艺设计服务的。前期策划的流程之所以如此复杂,其出发点是要设计师广泛地了解相关的项目、条件,准确界定项     

如何在医疗建筑改扩建前期落实策划——以甘肃省妇幼保健院为例

文章以甘肃省妇幼保健院为例,从图纸策划阶段的工作内容及方法来探讨如何在医院改扩建前期阶段落实策划工作,为其他医院前期策划的研究抛砖引玉。     

医院建筑前期策划亟待关注

相关研究表明，医院的前期策划、总体规划和建筑设计的合理性有助于提高医院整体效益。然而，一些医院却因种种原因对前期策划疏于关注，从而使得医院在老医院的改扩建中，新建建筑在功能和位置定位方面缺乏针对性和全面系统的考虑，使医院错失功能系统整合和梳理的良机。     

析美国医疗建筑前期策划

医疗建筑前期策划对项目设计和建设过程起着关键作用.文章通过对美国医疗建筑前期策划方法的介绍以及对医疗策划团队重要专家角色的分析,认为从全局的角度来审视和策划医疗设施及医疗服务、以行业"专业化"来实现高质量服务是医疗设施领域的发展方向.     

前期策划，医院如何考虑，怎样入手？

建设一个项目对一个单位来讲，所产生的影响至少有几十年，对于建什么功能。先建什么后建什么。要达到什么样的目标，要建设什么样的标准，通过什么样的步骤和措施来实施。都要结合自身的特点和基础条件。进行必要的前期策划，以便系统的研究论证。而做好前期策划，首先就要做好医院的规划设计，只有科学的规划设计。才能提升医疗建筑的可持续发展能力。     

格伦 破解医院前期策划缺失的乱象

北京建筑工程学院教授格伦女士,专于医院建筑前期策划的研究,在我国首次提出“医院建筑前期策划及设计过程的系统化控制措施研究”,其课题项目获2002年国家自然科学基金资助,填补了我国在这方面的空白（该项目已于2005年完成）。近日,记者采访了格伦教授。     

可行性研究及前期策划准备工作在医院改扩建中的作用

通过可行性研究和前期策划准备工作，可以使医院改扩建项目工作建立在科学、公正、经济、合理、客观、可持续发展轨道上，保证了医院改扩建工作符合国家政策和区域卫生规划的要求，从而使医院改扩建工作满足医疗市场、医疗体系的需求，符合医疗改革的需要，避免了医院改扩建项目的先天不足。     

医院建筑规划与设计的理性思考

通过对医院基建项目可行性研究及前期策划准备工作，探讨医院建筑规划、设计与建设 的科学性、经济性、实用性。医院建筑规划、设计与建设应“以病人为中心、以员工为本”，实施“人性 化”规划、设计与建设，符合医疗流程，满足医院对安全与感染的控制和管理。     

居室后期配饰的构思和搭配

在最近几年的家庭装修热中,多数家庭都做了各式各样的多宝格(又称博古架),但在这大小不等的多宝格上摆些什么,成为一个令许多家庭主人大伤脑筋的问题。 其实,这些大小不等的多宝格中,包含了家庭布置的两个步骤,即前期制作和后期配饰。前期制作是指居室空间的重组、顶墙的装修、固定家具的制作以及门窗、阳台等处的改造等等。一般情况下,凡是前期制作的家庭装潢,大多属于不便移动和改变的。居室中的后期配饰,是由户主自行策划(也有请人设计和户主共同策     

李俊杰:整体迁建工程心得

谈起柳州市人民医院的整体迁建工程,院长助理、院办公室主任李俊杰总有说不完的话题.从迁入前的前期策划到后期建设,再到迁入后的具体运营,他均参与其中.在这个过程中,他也从一位医院建筑管理的"门外汉"成长为不折不扣的专家.     

医院门诊综合楼筹建体会

本文通过医院门诊综合楼的筹建过程，在前期规划，总体布局，空间流通设计，建筑工艺与工程合理化、智能化设计、档案的管理、成本的全程控制等方面做了回顾。     

生活垃圾焚烧厂项目前期投资控制研究

项目前期策划是生活垃圾焚烧厂建设的关键环节。在该阶段,技术人员应该对焚烧厂的建设规模、项目选址、技术工艺等方面,进行多方案经济比较和综合评价,由此得出此类项目如何节省投资和做好投资控制等结论性意见,为项目投资决策提供可靠的科学依据。     

Reducing orthopedic implant costs. A physician-driven approach at Mt. Sinai Medical Center, Cleveland

Faced with the closing of its service, the Orthopaedics Department at Mt. Sinai Medical Center, working with Materials Management, began a program to become profitable. Through standardization, appropriate utilization, pre-planning of cases and the development of critical pathways, the service has realized about 40% savings in materials and dropped their average product costs to $2,700 per joint and reduced length of stay by five to six days. The keys have been physician input from the start, teamwork and continuous training.     

The SISTA pilot project: understanding the training and technical assistance needs of community-based organizations implementing HIV prevention interventions for African American women--implications for a capacity building strategy

The disproportionate rates of HIV/AIDS among African American women in the U.S. signify the ongoing need for targeted HIV prevention interventions. Additionally, building the capacity of service providers to sustain prevention efforts is a major concern. The Centers for Disease Control and Prevention (CDC) conducted a pilot project to disseminate the Sisters Informing Sisters about Topics on AIDS (SISTA), an HIV prevention intervention designed for African American women. The project was to inform the diffusion process and examine the training and technical assistance needs of participating community-based organizations. Results demonstrated a need for extensive pre-planning and skills-building prior to implementation.     

Patient at Risk: Emergency medical service providers’ opinions on improving an electronic emergency information form database for the medical care of children with special health care needs

BackgroundPatient at Risk (PAR) is an online database using an emergency information form (EIF) that parents of children with special health care needs (CSHCN) complete to store their child’s medical information. Emergency medical service (EMS) providers can then access PAR during medical emergencies or for pre-planning. PAR was active for over 10 years but use by patients and EMS was limited.ObjectiveTo determine EMS perspectives on why PAR was not used to its full potential and how to improve PAR for EMS.MethodsSeven questions regarding PAR were developed and presented in focus groups at 32 fire/ambulance houses in southeast and central Wisconsin from June to August 2017. Responses were transcribed and reviewed for themes.Results146 EMS providers participated and 11% were aware of PAR. Many did not use PAR because of a lack of follow up or barriers such as limited internet access, inconvenience, other urgent responsibilities, and not knowing when to use PAR. Solutions to these issues include developing or purchasing new technology, involving the dispatch operator in PAR, and returning to a paper-based EIF. The EIF layout and content received very positive reviews with few changes suggested. Most providers felt PAR was important because it would help them provide better care and feel more comfortable treating CSHCN.ConclusionDespite technological and logistical barriers, EMS providers want online EIF databases for pre-planning and utilization during ambulance runs so they can practice more informed and focused care, especially for vulnerable and medically challenging CSHCN.     

The SISTA Pilot Project: Understanding the Training and Technical Assistance Needs of Community-Based Organizations Implementing HIV Prevention Interventions for African American Women-Implications for a Capacity Building Strategy

ABSTRACT

The disproportionate rates of HIV/AIDS among African American women in the U.S. signify the ongoing need for targeted HIV prevention interventions. Additionally, building the capacity of service providers to sustain prevention efforts is a major concern. The Centers for Disease Control and Prevention (CDC) conducted a pilot project to disseminate the Sisters Informing Sisters about Topics on AIDS (SISTA), an HIV prevention intervention designed for African American women. The project was to inform the diffusion process and examine the training and technical assistance needs of participating community-based organizations. Results demonstrated a need for extensive pre-planning and skills-building prior to implementation.     

Facilitators of and barriers to healthy eating and physical activity for Black women: a focus group study in Florida,USA

Black women’s experiences of, perceptions of, and attitudes to healthy eating and physical activity have been suggested as contributors to their high rates of obesity. This paper uses data from four focus groups with Black women aged 18–45?years in Broward County, Florida, to explore their views. Findings suggest that participants were aware of the importance of healthy eating and physical activity, and motivated by wanting to model healthy behaviors for their families, but that ‘healthy’ behavior was perceived as requiring considerable ‘pre-planning’ and commitment. Programs addressing Black women that incorporate their perceptions and work with them to overcome challenges are needed.     

卫生列车实车信息化训练平台的设计

目的:设计一款卫生列车实车信息化训练平台,以实现卫生列车医疗队实车全流程训练。方法:该平台基于Oracle 10g数据库、Android 4.2操作系统设计,使用C#语言开发,采用数据采集层、通信层、业务层和综合应用层4层架构。整个平台采用窗口及模块化管理界面进行功能实现,包含卫勤指挥、伤员转运、检伤分类、收容处置和手术管理等模块。结果:利用该平台可准确地识别伤员,缩短检伤分类时间,实现预案训练,提升卫生列车医疗队指挥员组织指挥和预(方)案执行能力。结论:该平台为医疗队提供全流程训练手段的同时,可提升卫勤信息化训练效果及卫勤保障与救治能力。     

Validation of accuracy in image co-registration with computed tomography and magnetic resonance imaging in Gamma Knife radiosurgery

The latest version of Leksell GammaPlan (LGP) is equipped with Digital Imaging and Communication in Medicine (DICOM) image-processing functions including image co-registration. Diagnostic magnetic resonance imaging (MRI) taken prior to Gamma Knife treatment is available for virtual treatment pre-planning. On the treatment day, actual dose planning is completed on stereotactic MRI or computed tomography (CT) (with a frame) after co-registration with the diagnostic MRI and in association with the virtual dose distributions. This study assesses the accuracy of image co-registration in a phantom study and evaluates its usefulness in clinical cases. Images of three kinds of phantoms and 11 patients are evaluated. In the phantom study, co-registration errors of the 3D coordinates were measured in overall stereotactic space and compared between stereotactic CT and diagnostic CT, stereotactic MRI and diagnostic MRI, stereotactic CT and diagnostic MRI, and stereotactic MRI and diagnostic MRI co-registered with stereotactic CT. In the clinical study, target contours were compared between stereotactic MRI and diagnostic MRI co-registered with stereotactic CT. The mean errors of coordinates between images were < 1 mm in all measurement areas in both the phantom and clinical patient studies. The co-registration function implemented in LGP has sufficient geometrical accuracy to assure appropriate dose planning in clinical use.