浅析医院药房改革

目的通过药房改革确立新的药学服务模式。方法药房引进新的服务理念，药师重新调整工作模式，建立门诊综合药品超市。结论有利于平抑药价，化解医患矛盾，普及药学知识，促进合理用药，减少不良反应。     

谈我院自助卡的设计与实现

目的：通过医院自助卡的设计与实现,方便患者就医,解决看病难、看病贵的实际问题。方法：将二代身份证放在自助发卡机上,插入相应面值的人民币,从自助设备中弹出诊疗卡,患者用诊疗卡直接到各科室进行看病缴费,并可以自助查询打印自己的检验结果。结果：实现了医院自助诊疗卡发放、充值、挂号、缴费、查询与发票、凭条打印,同时还实现了自助化验单打印、自助住院费用清单打印等功能。结论：在医院信息建设中通过自助卡的应用,实现就诊一卡通,并建立实名制账户。解决了患者看病过程中需要多次排队等待的现象,提高医疗质量和效率,有效避免医疗信息重复采集和资金安全等问题。     

301模式一卡通自助服务设计与实现

自助服务终端同时与HIS系统、银行系统和北京医保中心3个系统实时连接、交互业务数据。病人使用中、农、工、建等四大银行的银行卡,在自助服务终端上即可完成挂号、缴费、银行卡扣费等操作。使用银行卡,从源头上保证了病人在医院身份的实名信息,在医院内,银行卡除本身金融功能外同时具有病人标识作用。301模式除支持传统的预交金模式外,还包括具有特色自助服务和功能,挂号、预约取号、自助办理医疗卡、白助充值、自助缴费和自助打印检验报告单及执行地计价等。传统上这些都是常规的、需要排队的非医疗活动,通过在大量白助设备中部署这些功能,减少了病人排队次数,改善了病人就诊体验。     

Supermarket discounts: Are they promoting healthy non‐alcoholic beverages?

Aim:  The present study investigates the role of supermarket discounts in promoting healthy choices through evaluation of discounts applied to non-alcoholic beverages in New Zealand supermarkets.
Methods:  Discount information was collected from four supermarkets in the Wellington region over a four-week period. These included two supermarkets aimed at customers of a high socioeconomic status and two aimed at low-socioeconomic-status customers. The beverage brand and size were recorded along with the original and discounted prices. The beverages were classified into green (drink most), amber (drink in moderation) and red (drink less) categories based on the Waitemata District Health Board Beverage Guidelines.
Results:  A total of 1487 discounts were documented over the four-week period with the majority (57.6%) of these from the high-socioeconomic-status supermarkets. A higher percentage of beverage discounts were classified as amber (40.9%) or red (44.1%) rather than green (14.9%) across all beverage groups except water ( P  < 0.001).
Conclusions:  This research suggests that less healthy beverages are discounted more frequently and to a larger extent than healthier beverages, but a nationwide study is required to confirm this. It appears likely that supermarkets could play a role in promoting healthy beverage choice if they refrain from discounting amber and red products.     

高价值医用消耗品在医院手术室的仓储式管理

本文介绍了我院手术室库房管理的创新方法,重点介绍了二级库房的开放式管理模式及与计算机网络连接,通过人机对话方式实现对高价值医用消耗品自助领用,从而使手术室的高价值消耗品做到零库存管理。     

无人自助云药房在医院门诊药房第二类精神药品管理中的应用

目的:评价无人自助云药房在医院门诊药房第二类精神药品管理中的应用效果。方法:引入门诊药房第二类精神药品无人自助云药房,对门诊第二类精神药品进行规范化管理,对比分析无人自助云药房使用前后医嘱药品调配时间、医嘱药品调配差错率和特殊药品管理效率。结果:无人自助云药房实现了第二类精神药品不开锁自动调剂,每张处方平均耗时由使用前的(29.17±4.41)s降至(15.20±4.06)s,差异有统计学意义(t=5.22,P<0.05)。云药房使用前处方调配差错率为3.80%,使用后处方调配差错率为1.27%,两组处方调配差错数量比较差异有统计学意义(t=10.75,P<0.05);药品专人管理时间由使用前的平均(5.66±2.13)h/d降为(2.58±1.07)h/d,差异有统计学意义(t=21.25,P<0.05)。结论:无人自助云药房减少了药品暴露风险,可保证门诊特殊药品的专人规范化管理,保障患者用药安全,为探索构建精神专科医院精细化、规范化和现代化的智慧药房提供新思路。     

利用门诊综合服务自助平台优化门诊流程实践

以扬州市第一人民医院为例,介绍其基于信息化支撑平台的门诊流程优化实践,分析门诊服务自助平台运行现状及存在的问题,基于排队理论中的M／M／s模型,构建医院门诊缴费排队模型,揭示门诊排队缴费问题的特征,研究自助终端的分担率与人工窗口平均队列长和患者平均等待时间之间的关系。     

门诊“六自助”一站式服务的应用与效果

目的改进服务,为患者提供优质、快捷、安全的诊疗服务。方法 ＂六自助＂集挂号、预约、充值、缴费、查询、打印报告于一体的医疗信息系统和服务设备,以简化患者就诊流程,以信息化互动,医疗资源共享,为患者提供一站到位服务。结果实施＂六自助＂一站式服务患者挂号时间明显减少（P〈0.01）,侯药时间明显减少（P〈0.01）、付费时间明显减少（P〈0.01）,总耗时减少与实施前比较有统计学意义（P〈0.01）。2011年门诊量比2010年门诊量上升9.6%。＂上海市卫生系统万人问卷满意度＂由2010年的95.1%提升至95.4%＂,符合患者利益需要,符合医疗质量管理要求。结论 ＂六自助＂一站式服务顺应了医疗市场发展需要,医院取得了良好的社会效益、经济效益。     

Using social norm nudges in supermarket shopping trolleys to increase fruit and vegetable purchases

Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in twenty Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test if shopper purchasing behaviour can be modified to purchase more F&Vs using social norm nudge messages (prompts) placed in shopping trolleys. Placards giving the message that the majority of shoppers purchased F&Vs at each shop were placed in shopping trolleys. Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the quantity (kg), total and F&V spending (Australian dollars) for intervention versus control trolleys. We also conducted a short intercept survey that was administered independently from the research study day. Shoppers who selected trolleys with the social norm nudge placards (n = 109) purchased 1.25 kg more F&Vs (Intervention: mean = 5.45 kg, SD = 4.23 kg, 95% CI 4.65 kg, 6.26 kg vs. Control: mean 4.19 kg, SD = 3.75 kg, 95% CI 3.48 kg, 4.90 kg, p = 0.020, Cohen's d = 0.32) and spent an extra $9.10 more on F&Vs compared to shoppers in the control group (n = 109; Intervention: mean = $36.20, SD = $26.30, 95% CI = $31.24, $41.26 vs. Control: mean $27.10, SD = $24.00, 95% CI = $22.50, $31.67, p = 0.008, Cohen's d = 0.36). The social norm nudge placard shows promise in modifying shoppers' purchases to buy more F&Vs. Larger studies are required to elucidate and confirm these findings over the longer term.     

Using a divider nudge in supermarket shopping trolleys to increase fruit and vegetable purchases: A feasibility study using an intervention design

Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in 16 Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test the feasibility of covertly modifying shopper purchasing behaviour to purchase more F&Vs using a visual divider nudge message (prompts) covering the entire base of shopping trolleys. Placards provided a visual representation of the recommended proportion of the trolley base that should be allocated to fruits and vegetables (implied social norm). Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the weight (kg), total spending and F&V specific spending (Australian dollars) for intervention versus control trolleys for one weekend day only. We also conducted a short intercept survey that was administered independently from the research study day on non-trial shoppers. Shoppers who selected trolleys with the divider nudge placards (n = 102) purchased equal weight of F&Vs (Intervention: mean = 6.25 kg, SD = 5.60 kg, 95% CI = 5.14 kg, 7.35 kg, vs. Control: mean 6.03 kg, SD = 5.17 kg, 95% CI = 5.01 kg, 7.04 kg, p = 0.768) and spent equal amounts on F&Vs compared to shoppers in the control group (n = 102) (Intervention: mean = $41.46, SD = $36.68, 95% CI = $34.25, $48.66, vs. Control: mean $39.85, SD = $33.30, 95% CI = $33.34, $46.39, p = 0.744). There was no difference in the total spending between groups (Intervention: mean = $135.99, SD = $90.10, 95% CI = $118.29, $153.68, vs. Control: mean $155.68, SD = $96.46, 95% CI = $136.73, $174.63, p = 0.133). The divider nudge placard did not lead to any difference in shoppers' purchases of F&Vs. However, this study demonstrates the feasibility of testing a cheap, simple and easy supermarket nutrition intervention. Larger studies are required to elucidate and confirm these findings over the longer term.