“优质护理服务示范病房”的实施与效果

根据2010年1月卫生部下发的“2010年‘优质护理服务示范病房’活动方案”,我区于3月份开始作为试点病区,对护士的工作模式进行了调整,实施了APN连续性护理排班,采用个人与小组包干相结合,实行护士固定分管床位,落实床边工作制、床边记录制等,由分管床位的责任护士对所管病人实施连续整体护理。试行后,护理服务质量与患者满意度大大提高,同时也提高了工作效率,效果良好。     

医疗集团门诊综合预约系统建设与患者就诊流程优化

开展门诊预约挂号服务是缓解当前居民“挂号难、看病难”的重要改革举措.结合江苏康复医疗集团近两年来建设统一的集团门诊预约系统的经验,对开发、部署预约挂号信息系统进行了探讨和研究.     

不确定性条件下存储时间有限型Flow Shop问题的提前/拖期调度研究

研究了具有不同交货期窗口的Flowshop提前／拖期调度问题，并考虑处理时间的不确定性以及存储时间的有限性，在模糊规划理论基础上，建立了带有提前／拖期的存储时间有限型Flowshop的调度模型，通过中间值最大隶属度算法，将原有的模糊调度模型转化为清晰的调度模型，并应用了遗传算法进行优化求解。仿真实验验证了算法的有效性。     

关于延误时间的平行机排序问题的复杂性

研究了当目标函数和延误时间有关时，带两个服务器的3台平行机排序总是的复杂性。首先证明了P3，S2/si=1/Lmax是强NP-难的，然后证明了另两个问题P3，S2/Pi=1/Lmax和P3，S2/si=1，di=d/Lmax都是NP-难的。     

Extended workshifts and excessive fatigue

SUMMARY  Studies of overtime have pointed to fatigue as a potential factor producing, for example, a three-fold increase in accident rate after 16 h of work, increases in back injuries, hospital outbreaks of bacterial infection, or nuclear-power plant safety compromises. Fatigue has been measured more directly in studies of scheduled long workshifts, where performance decrements in both work-related tasks and laboratory-type behavioural tests have been observed, and significant loss of sleep and increases in subjective sleepiness have been reported. Analyses of accidents or injuries during scheduled extended workshifts, however, have produced equivocal results. Factors which could compound the fatiguing effects of extended workshifts, such as workload, noise, chemical exposure, or duties and responsibilities outside of the workplace, rarely have been studied systematically. It is concluded that extended workshift schedules should be instituted cautiously and evaluated carefully, with appropriate attention given to staffing levels, workload, job rotation, environmental exposures, emergency contingencies, rest breaks, commuting time, and social or domestic responsibilities.     

扁平化排班责任包干制在优质护理实践中的成效

目的 探讨在“优质护理服务示范工程活动”中实施扁平化排班模式结合责任护士包干制护理患者的成效.方法 对骨科病区30名护士按扁平化排班模式优化排班、责任包干制护理患者,分别于实施前后对患者、护士、医生进行满意度调查.结果 实施后患者对责任护士满意度、护士对自身工作满意度、医生对护士满意度显著高于实施前(P＜0.05,P＜...     

Using prediction to improve elective surgery scheduling

Background

An ageing population and higher rates of chronic disease increase the demand on health services. The Australian Institute of Health and Welfare reports a 3.6% per year increase in total elective surgery admissions over the past four years.¹ The newly introduced National Elective Surgery Target (NEST) stresses the need for efficiency and necessitates the development of improved planning and scheduling systems in hospitals.

Aims

To provide an overview of the challenges of elective surgery scheduling and develop a prediction based methodology to drive optimal management of scheduling processes.

Method

Our proposed two stage methodology initially employs historic utilisation data and current waiting list information to manage case mix distribution. A novel algorithm uses current and past perioperative information to accurately predict surgery duration. A NEST-compliance guided optimisation algorithm is then used to drive allocation of patients to the theatre schedule.

Results

It is expected that the resulting improvement in scheduling processes will lead to more efficient use of surgical suites, higher productivity, and lower labour costs, and ultimately improve patient outcomes.

Conclusion

Accurate prediction of workload and surgery duration, retrospective and current waitlist as well as perioperative information, and NEST-compliance driven allocation of patients are employed by our proposed methodology in order to deliver further improvement to hospital operating facilities.     

住院药房人力资源管理系统的研究与应用

目的研究住院药房人力资源管理系统,优化住院药房的人力资源管理模式。方法人力资源管理系统中绩效考核模块采用Excel软件与医院信息管理系统（HIS）,将住院药房工作量进行量化并与绩效挂钩;弹性排班模块根据药房工作人员、工作岗位等情况,利用系统函数合理安排工作人员的班次。结果在全院病床数增加33.33%和出院人次增长46.81%的情况下,住院药房工作人员只增加13.64%。通过应用人力资源管理系统,合理拉开药房人员的绩效分配档次,有效地激发了药房人员的工作积极性,上班人员日均工作条目数增加了40.91%,提高了工作效率,减少了差错事故的发生;合理排班,满足临床需求,使临床医护人员和患者满意度明显提高。结论人力资源管理系统使药房人力资源得到最佳利用和管理,在人力资源管理中具有重要的意义。     

手术室护士岗位管理与绩效考核的实施与体会

通过对手术室护理工作岗位的合理设置,完善与护理服务的数量、质量、技术难度、患者满意度相挂钩的绩效考核体制,做到岗位实施与绩效考核并轨,从而建立稳定的手术室护理工作队伍,充分调动护士积极性,以更好地完成各项工作任务,保证医疗护理工作的正常进行。