实行感动服务促进军队伤病员管理

现代服务业已进入“感动服务”新阶段。感动服务是服务工作的创新。军队医院实行感动服务,能有效地提高服务质量和军队伤病员的满意度,增进医患之间的感情,使军队伤病员能自觉地遵守院规,配合诊疗,服从管理,从而有利于促进军队伤病员的管理,保持医院良好的工作秩序,防止发生意外。我院实行感动服务促进军队伤病员管理受到总后首长的称赞和上级的肯定。我们的体会是：     

浅谈感动服务在医疗服务中的应用

服务行业在许多国家的国民生产总值 (GDP)中的比重已超过制造业和农业。现代服务业已进入“感动服务”新阶段。感动服务是服务工作的创新。“感动服务”在企业中已被广泛应用 ,许多企业大力开展“感动服务”活动 ,有些公司的名称则称为某某感动服务有限公司。在医疗服务中 ,2 0 0 3年 2月 2 1日北京武警总医院的网页上出现了“感动服务”的提法。现就感动服务在医疗服务中的应用问题探讨如下。1　什么是感动服务感动服务是现代服务理念的提升 ,是服务工作的创新。在医疗服务中实行的感动服务 ,是先进医院文化的重要组成部分 ,是有效的竞争…     

我院门诊实施感动服务的意义

目的探讨门诊实施感动服务的意义。方法回顾性分析我院门诊2013年实施感动服务的相关资料,并分析感动服务对于我院的临床价值。结果开展感动服务后,有效增加门诊病人就诊量及病人收治,提高患者满意度,提升护理服务质量。结论病人不仅需要医院先进设备,更需要医务人员的高超技术和人性化服务。     

门诊实施感动服务的意义

目的感动服务是建立在满意服务的基础上一对一的人性化互动服务;是融技术、设备、环境、服务为一体的超值服务。结果门诊是医院的“窗口和门面”,是面向社会,服务病人的重要场所,建立和实施感动服务,让病人感到温暖,增加门诊就诊人次。结论病人不仅需要医院的一流设备,医师的高超技术,更需要人性化的服务。     

“感动护理服务”在特需病房应用的效果观察

目的观察"感动护理服务"在特需病房应用的效果。方法树立"感动护理服务"理念,全面护士培训,做好细节护理,提供上门延续护理服务等。结果实施"感动护理服务"后,患者、医生对护理服务的满意度明显提高,护士对自身职业的认同感提升显著。结论在特需病房应用"感动护理服务",能明显提升患者、医生、护士的满意度,提高患者对医院的忠诚度。     

感动服务在急诊剖宫产手术中的应用

目的探讨感动服务在急诊剖宫产手术中的应用效果。方法对2008年1月~2010年6月期间976例行急诊剖宫产手术患者术前、术中、术后实行感动服务护理。结果患者享受到超值护理服务。结论感动服务在急诊剖宫产手术中的应用,提高了医院的美誉度、服务质量,取得了良好的社会效益。     

感动性服务在护理中的应用进展

当今社会,患者的护理需求在内容和形式上发生了较大变化,逐渐形成了多元化护理需求,护理感动性服务作为优质护理的最高层次体现,也是人性化关怀护理的具体体现,适应了多元化护理发展的需求。护理感动性服务来源于服务位阶的三层次理论,在护理工作中,当患者满意程度大于患者需求时,患者感动,为护理感动性服务。护理感动性服务在我国已经形成初步规模,在表达性要求和操作性要求及就医环境方面都有具体要求,护理感动性服务促进护理科学文化体系的形成,实现了护理人员的自身价值,提升服务层次和质量,增强患者满意度,对护理工作人员及其医院发展都极为重要。     

CS营销战略在医院的应用与实践

分析了患者满意的结构、患者对医疗服务的期望层次和患者满意的内在逻辑,明确了CS营销战略在医院经营诊断中的作用.提出了医院实施CS营销战略应努力向患者提供更多的感动服务,培养人文型的医护人员,推行员工满意策略,构建诚信医院.     

现代医院质量管理的金标准--"病人满意率"

借鉴现代企业的管理理念,探讨质量服务管理的目标就是“顾客满意”和“感动服务”,将病人满意率纳入医院质量控制的重中之重,并从医学的科学属性上阐述了实施“大质量观”的必要性,以促进医院诚信文化建设的全面提升。     

创建优质护理服务示范病区

目的 创建优质护理服务示范区.方法 ①营造学术氛围,强化素质,变满意服务为感动服务;②关注细节 ,开展优质服务;③关爱生命,以精湛的专业技术救死扶伤. 结果 取得了病人满意、医院满意、社会满意的效果.     

Development of an internal medicine clerkship by a department of medicine

In this report, the author summarizes the creation and evolution of an internal medicine clerkship in three large teaching hospitals undergoing transition from affiliated hospitals to the university hospitals of a new medical school. The creation of the clerkship has had major effects on the perceptions of both the residents and the faculty of their roles as teachers and evaluators. The methods felt to be particularly successful in facilitating the transition of the hospitals are emphasized: a preceptorship for medical students, monthly grading conferences for students, and evaluations by the students of the clerkship, the house staff, and the faculty.     

Hospital doctors' assessment of baseline spirometry

Baseline spirometry is useful in diagnosing and managing pulmonary disease. In a questionnaire survey of 100 hospital doctors in two hospitals in the Mersey region, their views and ability to interpret baseline spirometry was assessed. Of the 70 doctors who responded, 65% felt they could accurately interpret baseline spirometry. However, only 12% accurately interpreted all five vitalographs in the questionnaire. The majority (72%) felt they had not had adequate teaching in interpretation of spirometry, and 63% would prefer a report from a respiratory technician. These result suggest that improvement needs to be made in interpretation of baseline spirometry.     

Surgical training posts in Northern Ireland: assessment by surgeons in training.

Northern Ireland has one of the largest surgical training programmes in the United Kingdom. The surgical trainees' assessment of the quality of training provided has been collated prospectively since 1983, and provides a useful insight into the strengths and weaknesses of the programme, as well as the training value of individual posts. The overall quality of clinical training in surgery was considered to be well above average, but some registrars felt that supervision of operative surgery could be improved. Clinical research was considered to be of average quality in the teaching hospitals but below average in district general hospitals. In the current climate of restriction of the number of training posts in general surgery, the views of the trainees should not be neglected in assessing which posts are best suited for training.     

Learning opportunities for Australian prevocational hospital doctors: exposure, perceived quality and desired methods of learning

OBJECTIVE: To survey prevocational doctors working in Australian hospitals on aspects of postgraduate learning. PARTICIPANTS AND SETTING: 470 prevocational doctors in 36 health services in Australia, August 2003 to October 2004. DESIGN: Cross-sectional cohort survey with a mix of ordinal multicategory questions and free text. MAIN OUTCOME MEASURES: Perceived preparedness for aspects of clinical practice; perceptions of the quantity and usefulness of current teaching and learning methods and desired future exposure to learning methods. RESULTS: 64% (299/467) of responding doctors felt generally prepared for their job, 91% (425/469) felt prepared for dealing with patients, and 70% (325/467) for dealing with relatives. A minority felt prepared for medicolegal problems (23%, 106/468), clinical emergencies (31%, 146/469), choosing a career (40%, 188/468), or performing procedures (45%, 213/469). Adequate contact with registrars was reported by 90% (418/465) and adequate contact with consultants by 56% (257/466); 20% (94/467) reported exposure to clinical skills training and 11% (38/356) to high-fidelity simulation. Informal registrar contact was described as useful or very useful by 94% (433/463), and high-fidelity simulation by 83% (179/216). Most prevocational doctors would prefer more formal instruction from their registrars (84%, 383/456) and consultants (81%, 362/447); 84% (265/316) want increased exposure to high-fidelity simulation and 81% (283/350) to professional college tutorials. CONCLUSION: Our findings should assist planning and development of training programs for prevocational doctors in Australian hospitals.     

Medical grand rounds: alive and well and living in Canada.

Grand rounds have long been the principal educational activity of departments of medicine at teaching hospitals. Several recent articles have suggested that there has been a general deterioration in the quality of grand rounds. To evaluate their status in Canada we mailed a questionnaire to the chairmen of the departments of medicine at the 53 Canadian teaching hospitals; of the 48 responses received (91%), 38 were from chairmen, 5 were from senior department members, and 5 were from chief residents. The results indicated that grand rounds continued to be the principal teaching exercise of the departments. Of the respondents 98% felt that the quality had improved or stayed the same. The overall attendance was considered to have improved or remained unchanged for the past decade by 75%; 25% thought that it had declined. The diminished emphasis on patient-related topics concerned 10%. The respondents gave numerous suggestions, which should help organizers to improve the impact of grand rounds on learning.     

Interactions with the pharmaceutical industry: experiences and attitudes of psychiatry residents, interns and clerks.

OBJECTIVE: To examine the type and number of interactions of psychiatry residents, interns and clerks with sales representatives of pharmaceutical companies and the attitudes of physicians-in-training toward these interactions. DESIGN: Survey conducted with the use of a self-report questionnaire. SETTING: Seven teaching hospitals affiliated with the Department of Psychiatry, University of Toronto. PARTICIPANTS: All 105 residents, interns and clerks training in psychiatry at the seven teaching hospitals between October 1993 and February 1994 were eligible; 74 completed questionnaires, for a response rate of 70%. One respondent was excluded from the analysis. OUTCOME MEASURES: Number of personal meetings and "drug lunches" attended, number of drug samples and promotional items received and estimated value of gifts received by each physician-in-training during a 1-year period as well as attitudes of residents, interns and clerks about interactions with pharmaceutical representatives. RESULTS: Median number of personal meetings reported was 1 (range 0 to 35), of drug lunches attended was 10 (range 0 to 70), of promotional items received was 2 (range 0 to 75) and of drug samples received was 1 (range 0 to 20). Trainees' median estimate of the value of gifts received was $20 (range $0 to $800 Fewer than one third felt that pharmaceutical representatives were a source of accurate information about drugs; however, 71% (52/73) disagreed with the statement that representatives should be banned from making presentations. Although only 15% (11/73) felt they had sufficient training about meeting with pharmaceutical representatives, 34% (25/73) felt that discussions with representatives would have no impact on their prescribing practices, and 56% (41/73) felt that receiving gifts would have no impact on prescribing. Fewer than half said they would maintain the same degree of contact with representatives if they did not receive promotional gifts. The more money and promotional items a physician-in-training had received, the more likely he or she was to believe that discussions with representatives did not affect prescribing (p < 0.05). Clerks, interns and junior (first-year and second-year) residents attended two to three times more drug lunches than senior (third-year and fourth-year) residents, and significantly more junior than senior residents felt that pharmaceutical representatives have a valuable teaching role. Junior residents were three times more likely than senior residents to have received drug samples. CONCLUSIONS: Interactions between pharmaceutical representatives and psychiatry residents, interns and clerks are common. The physicians-in-training perceive little educational value in these contacts and many, especially clerks, interns and junior residents, disavow the potential of these interactions to influence prescribing. Therefore, supervisors of postgraduate medical training programs may wish to provide instruction concerning potential conflicts of interest inherent in these types of interactions.     

Early experiences of laparoscopic cholecystectomy in five irish hospitals

There are many concerns about the widespread introduction of laparoscopic cholecystectomy. The initial experience of five hospitals in introducing laparoscopic cholecystectomy was reviewed. Three hundred and eight patients were operated upon, and the operations were completed laparoscopically in 279 (91 percent). One patient sustained a diathermy injury to the right hepatic duct. There was no mortality and the overall morbidity was 10 percent. Mean postoperative stay was 3.6 days. The participating surgeons considered training workshops to be desirable and felt that trainees should be supervised for at least ten cases. Laparoscopic cholecystectomy can be safely introduced and performed, and it should be considered in all patients undergoing cholecystectomy.     

Doctors’ attitudes about prescribing and knowledge of the costs of common medications

Introduction  Compliance with medical therapy may be compromised because of the affordability of medications. Inadequate physician knowledge of drug costs may unwittingly contribute to this problem. Methods  We measured attitudes about prescribing and knowledge of medication costs by written survey of medical and surgical non consultant hospital doctors and consultants in two University teaching hospitals (n = 102). Sixty-eight percent felt the cost of medicines was an important consideration in the prescribing decision, however, 88% often felt unaware of the actual costs. Only 33% had easy access to drug cost data, and only 3% had been formally educated about drug costs. Doctors' estimates of the cost of a supply of ten commonly used medications were accurate in only 12% of cases, too low for 50%, and too high for 38%. Conclusions  Interventions are needed to educate doctors about drug costs and provide them with reliable, easily accessible cost information in real-world practice.     

Role of the general practitioner in the delivery of surgical and anesthesia services in rural western Canada.

OBJECTIVE: To determine the present role of general practitioners (GPs) in the delivery of surgical and anesthesia services in rural western Canada. DESIGN: Survey by mailed questionnaire in November 1993, with telephone follow-up of nonresponders. SETTING: Rural British Columbia, Alberta, the Yukon Territory and the Northwest Territories. PARTICIPANTS: Administrators of 148 rural hospitals; of the 121 who completed it 101 represented hospitals that met the inclusion criteria (fewer than 51 beds and serving a population of 15,000 or less). OUTCOME MEASURES: Hospital characteristics, type of practitioners providing surgical and anesthesia services, length and location of GPs', surgical and anesthesia training, types of surgical procedures performed by GPs and opinions of administrators regarding the delivery of surgical services in their community. RESULTS: Surgical services were provided by 56 (55%) of the 101 hospitals; at 45 (80%) they were provided by GPs, and at 33 (59%) they were provided by GPs with limited additional surgical training. Fifteen (27%) of the 56 hospitals were said to rely solely on GPs with limited surgical training for surgical services. At 45 (80%) of the 56 hospitals anesthesia services were provided by GPs, all of whom had limited additional training in anesthesia; 36 (64%) were said to rely solely on GPs for anesthesia services. Just over three quarters (76% [74/98]) of the administrators felt that their community's surgical needs were well met. CONCLUSION: GPs with limited specialty training continue to play a role in providing surgical and anesthesia services in rural western Canada. This has implications for postgraduate training programs in Canada.     

THE JOURNAL

With the first of this year''s issues some changes are being made in the form of the Journal to mect the desires of those who are asking for a larger amount of clinical and general material. It has been felt by some that our Journal has to meet the needs of not a few to whom general medical Iiterature is a luxury of which they get but little and that the Journal should be of greater assistance to them in their daily work in their hospitals in respect to the problems which they have to meet, the type of work they have to tackle and the rarer cases which from time to''time they may encounter.