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71.
随着智能技术的强力驱动和普及应用,图书馆正在向智慧化转型。以黑龙江中医药大学图书馆智慧化建设实践为例,从用户需求的视角设计调查问卷,归纳了图书馆用户需求类型,将智能技术与用户需求深度融合,从基础设施层、技术驱动层、数据运行层及智慧应用层4个层面构建图书馆智能化业务架构,实现多方位全息智能互动,推动图书馆向高级智慧阶段发展。 相似文献
72.
我国基层医疗卫生机构在承担基本公共卫生服务和基本医疗服务项目方面存在绩效考核体系和支付制度不完善的问题。英国质量与结果框架(QOF)经过多次调整,最新版本更加注重慢性病防控与疾病管理质量。本研究从管理与运作体系、指标体系的演变历程及新版(2021—2022年版)指标构成、计分规则和按绩效付费规则等方面对英国QOF进行介绍,并剖析了英国新版QOF的设计细节和运行情况。本研究发现,英国QOF是一个以结果为导向的质量控制系统和以报酬为导向的激励机制,其以主要慢性病及其危险因素为管理重点,通过设置三级指标体系,并规定指标分值和每分值对应的金额,实现将全科诊所服务质量与其绩效报酬相联系,能够从整体上提高英国卫生系统的效能。借鉴QOF的经验,我国应完善基本公共卫生服务规范与绩效考核指标体系、基层门诊慢性病支付方式,促进基本公共卫生服务资金和基本医疗保险基金的统筹使用。 相似文献
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Background
Burnout is a major concern in human service occupations, mainly characterizing in emotional exhaustion and depersonalization. There is very limited research dealing with burnout in orthopedic surgeons. Exploring burnout prevalence, risk factors, and intraoperative irritability-related incidences is necessary to improve the quality of life for surgeons.Methods
The study population consisted of 202 registered adult reconstructive doctors in China. Burnout was measured using a normalized translated version of the Maslach Burnout Inventory-Human Service Survey. Demographics, professional characteristics, and intraoperative irritability-related questions were also collected by electronic questionnaires. Statistical analysis was performed using SPSS 22.0.Results
The overall rate of burnout was 85.1%. Variables significantly associated with high emotional exhaustion scores included poor sleeping time per day (P = .008), more nights on call per week (P = .048), and absence of research (P = .014). For depersonalization, absence of marriage (P < .001) and more nights on call per week (P < .001) were selected as risk factors. The incidence of losing temper in operation is 58.9%, significantly higher in senior surgeons (P = .001). Three major reasons for irritation during operations included delays by companies providing operative devices, poor coordination of assistants, and slow movements of instrument nurses. Intraoperative irritability was found to be significantly correlated with burnout, especially in emotional exhaustion. Residents were the population having the least opportunities to lose temper in operation.Conclusion
Burnout is highly prevalent in Chinese adult reconstructive surgeons, and it had some correlations with irritability. Further research is needed to determine more risk factors and reduce intraoperative irritability-related incidences. 相似文献75.
76.
Elizabeth A. Mauldin Debra Crumrine Margret L. Casal Sekyoo Jeong Lukáš Opálka Katerina Vavrova Yoshikazu Uchida Kyungho Park Brittany Craiglow Keith A. Choate Kyong-Oh Shin Yong-Moon Lee Gary L. Grove Joan S. Wakefield Denis Khnykin Peter M. Elias 《The American journal of pathology》2018,188(6):1419-1429
77.
JK Dickson A Davies S Rahman C Sethu JRO Smith A Orlando D Ayers 《Annals of the Royal College of Surgeons of England》2015,97(1):52-55
IntroductionDissection of regional lymph nodes (RLNs) can lead to significant morbidity and a high prevalence of complications. Published guidance states that these procedures should be carried out by surgeons who are members of a specialist skin multidisciplinary team who carry out a combined minimum of 15 axillary/groin dissections per year. However, there is little evidence to guide this minimum figure of procedures. We report on the burden of service provision and prevalence of complications across the South West of England and Wales.MethodsA 12-month review of dissections of RLNs for skin cancer was undertaken covering five Plastic Surgery Units with a collective catchment of 8.4 million people. Detailed data were collected on patient demographics, pathology, timing of surgery, and prevalence of complications.ResultsA total of 163 dissections were carried out. Forty-three per cent of patients experienced one or more complication. In that 12-month period, an average of 8 axillary/groin dissections was carried out per surgeon. A funnel plot demonstrated that the prevalence of complications for individual surgeons was within the limit of the plot but, in many cases, this was based only on a relatively small number of procedures per consultant. If surgeons carried out 10 procedures per year, the upper and lower limits on the plot were 73% and 11%, respectively.ConclusionsFunnel plots can provide a useful guide as to whether the prevalence of complications for procedures for individual surgeons lies within acceptable limits. Based on these results, 10 procedures per consultant per year should be sufficient to enable meaningful assessment of the prevalence of complications. 相似文献
78.
Eliane Roseli Winkelmann Fernanda Dallazen Angela Beerbaum Steinke Bronzatti Juliara Cristina Werner Lorenzoni Pollyana Windm?ller 《Brazilian Journal Of Cardiovascular Surgery》2015,30(1):40-48
Objective
To analyze a cardiac rehabilitation adapted protocol in physical therapy during the postoperative hospital phase of cardiac surgery in a service of high complexity, in aspects regarded to complications and mortality prevalence and hospitalization days.Methods
This is an observational cross-sectional, retrospective and analytical study performed by investigating 99 patients who underwent cardiac surgery for coronary artery bypass graft, heart valve replacement or a combination of both. Step program adapted for rehabilitation after cardiac surgery was analyzed under the command of the physiotherapy professional team.Results
In average, a patient stays for two days in the Intensive Care Unit and three to four days in the hospital room, totalizing six days of hospitalization. Fatalities occurred in a higher percentage during hospitalization (5.1%) and up to two years period (8.6%) when compared to 30 days after hospital discharge (1.1%). Among the postoperative complications, the hemodynamic (63.4%) and respiratory (42.6%) were the most prevalent. 36-42% of complications occurred between the immediate postoperative period and the second postoperative day. The hospital discharge started from the fifth postoperative day. We can observe that in each following day, the patients are evolving in achieving the Steps, where Step 3 was the most used during the rehabilitation phase I.Conclusion
This evolution program by steps can to guide the physical rehabilitation at the hospital in patients after cardiac surgery. 相似文献79.
目的 了解高年资专科护士自我超越的促进因素。方法 对15名高年资专科护士就自我超越的动力因素进行深入访谈,对访谈资料采用内容分析法进行归纳和提炼。结果 归纳出2个主题和9个副主题,包括内在驱动力(思维结构改变、个性特征、目标导向、反馈寻求行为、反思与自我激励)和外在驱动力(团队支持、领导授权、外源性压力和社会认可)。结论 促进高年资专科护士自我超越的因素是多方面的,建议护理管理者采取相应措施,重视发挥专科护士的内在动力,优化外力支持环境,以促进专科护理队伍建设。 相似文献
80.