大数据思维框架下的医院“质量数据管理中心”的集成构建

目的 应用大数据思维集成构建医院“质量数据管理中心”,实现医院质量管理从数据化运营到运营大数据的适应性变革。方法 将医院数据管理密集的职能科室集成构建为医院“质量数据管理中心”。对其职能重新整合分工,逐步建立对医疗、护理、行管等全方位质量考核评价的独立机构。结果 数据信息集中采集、应用、分析、释放,医院决策速度加快、问题管理到位、效益扩增显著。结论 大数据思维框架下集成构建的医院“质量数据管理中心”可重新整合职能分工,高效利用信息资源,减少跨部门管理、控制信息衰减及流失,可为现代医院管理者借鉴应用。     

刍议转化医学发展与研究型医院建设

研究型医院概念的提出及建设实践,为我国的医院管理和卫生事业的发展开拓新的视野,探索新途径;比起传统医院,更加注重科技创新向成果能力的转化,强调科研与临床相结合,依托专科优势实施转化研究,实现提高临床诊疗水平的目的,使医院科学高效发展。     

医院绩效分配方案的改革与创新

绩效分配方案作为医院发展的引擎,对调动和激发医院职工的工作积极性,推动医院的发展起着举足轻重的作用。以"总量控制、按分计酬"为主线,通过对新、旧两种分配方法的对比分析,把工作量、经济效益以及综合绩效考评有机结合起来。破解了长期以来阻碍医院发展的瓶颈问题,形成了导向清晰、目标明确的绩效分配考评体系,较好地解决了"长期发展与短期增长、医院战略与个人绩效"之间的矛盾。有力地推进了医院的快速可持续发展。     

瑞金市疾控中心提高疾病防控综合能力的实践

瑞金市疾控中心同全国大多数县（市）级疾控机构一样,存在专业人员少、年龄老化、素质不高、能力不足的问题。近10年来,该中心在内部管理、人员培训、激发潜力等方面进行了有益的创新和实践,取得了较好的成效。     

Surgical ethics and the challenge of surgical innovation

Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.     

Small business activity does not measure entrepreneurship

Entrepreneurship policy mainly aims to promote innovative Schumpeterian entrepreneurship. However, the rate of entrepreneurship is commonly proxied using quantity-based metrics, such as small business activity, the self-employment rate, or the number of startups. We argue that those metrics give rise to misleading inferences regarding high-impact Schumpeterian entrepreneurship. To unambiguously identify high-impact entrepreneurs we focus on self-made billionaires (in US dollars) who appear on Forbes Magazine’s list and who became wealthy by founding new firms. We identify 996 such billionaire entrepreneurs in 50 countries in 1996–2010, a systematic cross-country study of billionaire entrepreneurs. The rate of billionaire entrepreneurs correlates negatively with self-employment, small business ownership, and firm startup rates. Countries with higher income, higher trust, lower taxes, more venture capital investment, and lower regulatory burdens have higher billionaire entrepreneurship rates but less self-employment. Despite its limitations, the number of billionaire entrepreneurs appears to be a plausible cross-country measure of Schumpeterian entrepreneurship.Given the prominence of entrepreneurship, it may come as a surprise that there is no consensus on how it should be defined in empirical research. Sometimes entrepreneurship is used to refer to anyone operating a private business, regardless of size and activity. Driven by greater data availability, most empirical studies rely on definitions such as the self-employment rate, the number of startups, and small business activity (1). In other contexts, entrepreneurship refers to the subset of firms that are innovative and growth-driven (2, 3). This Schumpeterian definition of the entrepreneur as an innovator and as a driver of growth dominates in theoretical entrepreneurship research and in entrepreneurship policy (4, 5). Thus, when academics and business leaders were asked to define entrepreneurship, the most common choices were the creation and growth of new ventures and innovation. By contrast, the creation of a mom-and-pop business was not viewed as entrepreneurship (6).Leaving aside the semantic discussion of what exactly constitutes entrepreneurship, there is an important empirical issue of how well commonly used operationalizations capture the rate of Schumpeterian entrepreneurship. An implicit assumption appears to be that countries and industries with a large number of small firms and startups also tend to be those where most innovative high-growth firms emerge.However, an overwhelming majority of the self-employed are not entrepreneurial in the Schumpeterian sense, as they never bring a new innovation to the market and do not plan to grow their business. In the United States, the industries with the largest concentrations of self-employed men are construction, landscaping services, auto repair, restaurants, truck transportation, and farming. For women, the corresponding industries include private households (cooks and maids), child day care services, restaurants, and beauty salons. The majority of small businesses in the United States have no employees other than the owner. Nor do most small businesses eventually grow large. Most small businesses are best described as permanently small rather than nascent entrepreneurial firms.Shane (7) argues that necessity-driven and opportunity entrepreneurs should be treated separately, documenting a negative cross-country correlation between having many high- and low-expectation startups. Baumol (3) distinguishes between “innovative” and “replicative” entrepreneurs, where the former are the type of entrepreneurs studied by Schumpeter (2). Hurst and Pugsley (8) forcefully argue against using self-employment as synonymous with entrepreneurship. They estimate that only 10–20% of small businesses report any innovative activity at all and point out that when new startups were asked about growth ambitions, 75% of respondents stated that “I want a size I can manage myself or with a few key employees” (ref. 8, p. 96). Different types of business owners also differ in terms of personality traits (9).Both types of businesses are important for a well-functioning economy, but their workings are entirely different. Innovative and replicative businesses operate in different ways, but are not easily distinguishable in statistics, which means that special approaches must be designed for empirical analysis.One way through which scholars have attempted to distinguish the different classes of firms is by restricting attention to “high-impact entrepreneurs” (10, 11), which is to say those that grow rapidly. The difficulty of estimating the rate of high-impact entrepreneurship in a standardized way across countries has thus far prevented cross-country comparisons.We propose a measure of high-impact Schumpeterian entrepreneurship across countries using information from the Forbes Magazine worldwide list of billionaires during 2 decades. Our measure of high-impact entrepreneurship is based on the accumulation of wealth for founders of new business ventures. We compare this measure to quantity-based empirical proxies for entrepreneurship such as self-employment, small business ownership, and number of startups. Henceforth in the paper for the sake of brevity, “entrepreneurship” refers to billionaire entrepreneurship, the focus of this paper.For each billionaire, the source of wealth was investigated, allowing us to identify 996 self-made billionaires who became rich by founding new firms. Using these individuals to construct a per capita rate of high-impact entrepreneurship, we show that this measure is robustly and negatively correlated with self-employment rates, small business ownership rates, and the rate of startup activity.     

借鉴国际经验探索中国医疗器械创新发展模式

科技创新是国家和社会发展的最根本动力,医疗科技创新更是与国计民生紧密相关的国家战略。医疗器械产业是我国的战略性新兴产业,借鉴国际经验,探索我国医疗器械科技创新和产业发展的模式问题是新时代的一项重要课题。该研究通过分析国际医疗器械产业现状,深入研究美国斯坦福大学的Biodesign医疗科技创新模式,结合目前我国医疗器械发展现状,从新的时代背景和创新创业的角度出发,探索中国医疗器械创新发展模式,希望为我国医疗科技创新创业的实践提供理论依据。