导入ISO9000理念加强医学信息服务质量管理

对ISO9000标准导入医学信息服务质量管理的重要性进行了论述,对建立符合 ISO9000标准的医学信息服务质量管理体系的工作步骤和建立体系的几点体会进行探讨。     

上海市医患纠纷人民调解中的专家咨询制度

在医患纠纷人民调解工作中,上海市实行了专家咨询指导工作,并建立了900余名专家库、建立了专家咨询工作标准,规定了专家咨询的工作程序,形成了一整套的专家咨询制度.在专家咨询形式上作出了有益的探索和思考.     

我国医疗器械标准体系基础数据库的建立与思考

通过对医疗器械标准体系基础数据库建立工作研究分析,发现医疗器械标准体系建设工作中存在的问题并提出建议,为医疗器械标准化管理工作提供参考。     

医院信息系统与医院信息标准化

医院信息标准化是建立医院信息系统的重要基础。我们介绍了医院信息系统中一些重要的编码标准，并讨论了信息标准化过程中的几个问题：①标准化工作的效益；②标准化工作应走在医院信息系统的前面；③建立标准要以实用、科学为原则；④标准的实施要宣传教育与法规相结合；⑤标准要长期维护、及时更新；⑥计算机应为标准的使用提供方便手段。     

建立妇幼卫生信息标准研究与评估机制的价值与意义

从理论角度论述了及时建立国家级常规的妇幼卫生信息标准研究与评估指导组织体系和工作机制的必要性,并提出有关工作规划和具体措施.     

急诊预检分诊服务标准化管理

本文分析了急诊预检分诊服务中存在的问题,提出建立标准化工作流程的方法和内容,包括建立急诊分诊护士的准入标准,分诊护士服务标准以及制定量化的分诊标准和分诊流程标准,认为急诊预检分诊服务标准化管理可提高急诊分诊的准确率,缩短病人等候时间,降低医疗风险,提高患者满意度,对塑造医院窗口形象有重要意义。     

芜湖市2011～2012年市级疾病预防控制工作绩效评估分析

自国家全面启动疾病预防控制工作绩效评估以来,经5年的探索实践和广泛征求意见,原国家卫生部对2008年印发的《疾病预防控制工作绩效评估标准》[1]进行了修订和完善,建立了更加成熟的疾病预防控制工作绩效评估体系。现根据新修订的《疾病预防控制工作绩效评估标准（2012年     

加强新生儿疾病筛查规范化管理保证新生儿疾病筛查质量

为保证新生儿疾病筛查的质量,建立了新生儿疾病筛查工作质量管理模式。从制定新生儿疾病筛查管理规范、血片采集、递送、实验室操作等工作规范,建立各级筛查部门、人员工作职责,加强信息科学化管理,定期业务培训,建立监测标准,深入指导监测等方面加强管理,保证了筛查、检验、诊治的规范化、标准化,达到了开展新生儿疾病筛查的目的。     

构建医学媒介生物国境卫生检疫行业标准体系的探讨

为了适应新形势下对国境口岸媒介生物监控工作的新要求,探索建立一个比较科学的医学媒介生物国境卫生检疫行业标准体系,为检验检疫部门制定相关行业标准提供参考.作者结合我国病媒生物控制标准体系和国境卫生检疫工作的具体实际,并参照现行的国境卫生检疫行业标准体系框架,建立了基于医学媒介生物控制过程要素、检疫对象类型要素和医学媒介生物类别要素的三维标准框架,为制、修订医学媒介生物国境卫生检疫行业标准的工作提供了有益参考.     

JCI标准运用于控制深静脉置管相关性感染的临床护理研究

目的探讨JCI标准运用于控制老年病房深静脉置管相关感染中的实施效果。方法运用JCI标准的先进管理理念,建立一套完整的、系统的、持续改进的护理工作流程,并进行护理质量监测。结果通过将JCI标准导入深静脉置管护理之中,建立以JCI为标准的护理操作流程,降低了相关感染的发生率;延长了导管留置时间;降低了医疗护理成本;增加了医患满意率。结论 JCI标准运用深静脉置管护理之中,是一种安全、有效、持续改进的科学方法。     

Effects of lifting frequency and technique on physical fatigue with special reference to psychophysical methodology and metabolic rate

A laboratory study was conducted (1) to evaluate the effects of lifting frequency and technique on maximum acceptable work loads using psychophysical measurement technique, and (2) to compare the physiological fatigue criteria of 5 Kcal/min with the psychophysical fatigue criteria by measuring the metabolic rates at maximum acceptable work loads determined by subjective estimates of physical fatigue. Six male college students were required to lift from the floor to a 0.5 m height for 40 minutes. Four levels of lifting frequency (3, 6, 9 and 12 lifts/min) and three different lifting techniques (free sytle, stooped back and straight-back, bent-knee) were employed. Oxygen consumption rates were measured at maximum acceptable work loads (and were reduced to STPD). Statistical analysis showed that the maximum work loads acceptable to the workers were significantly affected by both lifting frequency and technique. Maximum acceptable work loads increased with an increase in lifting frequency. Both the subjective estimates of physical fatigue and the metabolic energy expenditure rate favored the free style lifting technique. The measured metabolic rates were in agreement with the physiological fatigue criteria of 5 Kcal/min only for six of the twelve combinations of lifting frequency and technique. Use of the physiological fatigue criteria will result in more liberal standards of work load at low work paces, especially for the stooped back and the free style lifting techniques.     

中国饮用水源水中藻类卫生标准的研究

为制定饮用水源中藻类限值 ,结合国内外文献调查研究毒理学试验和现场生态学调查资料 ,根据世界卫生组织 (WHO)和卫生部推荐的饮用水中微囊藻毒素MC -LR的限值、藻类生物量和MC -LR浓度关系以及毒理学实验所得到的藻类的无作用浓度而制定饮用水源中藻类限值。结果显示 ,推荐饮用水源中藻类三级限值分别为 :安全限值 :1.0× 10 4个 升 ;警戒限值 :2 .1× 10 5个 升 ;危险限值 :1.2× 10 6 个 升。提示饮用水源中藻类限值在日常工作中有显著意义和可行性     

Chronic fatigue syndrome-like caseness as a predictor of work status in fatigued employees on sick leave: four year follow up study

Objective

To assess whether CFS‐like caseness (meeting the criteria for chronic fatigue syndrome (CFS)) predicts work status in the long term.

Methods

Prospective study in a sample of fatigued employees absent from work. Data were collected at baseline and four years later, and included CFS‐like caseness and work status (inactive work status and full work incapacity).

Results

CFS‐like cases at baseline were three times more likely to be unable to work at follow up than fatigued employees who did not meet CFS criteria at baseline (ORs 3–3.3). These associations grew even stronger when demographic and clinical confounders were controlled for (ORs 3.4–4.4).

Conclusion

A CFS‐like status (compared to non‐CFS fatigue) proved to be a strong predictor of an inactive work status and full work incapacity in the long term. Since little is known about effective interventions that prevent absenteeism and work incapacity or facilitate return to work in subjects with chronic fatigue, there is a great need for powerful early interventions that restore or preserve the ability to work, especially for workers who meet criteria for CFS.     

民族地区妇幼卫生工作绩效考核标准研究

目的:制定适合民族地区的妇幼卫生工作绩效考核评估标准,推动民族地区妇幼卫生工作绩效考核工作。方法:通过文献回顾、现场调研、专家咨询、专家研讨等多种方法,制定民族地区的妇幼卫生工作绩效考核评估标准。结果:研究产出民族地区妇幼卫生工作绩效考核标准,包括一级指标5个,二级指标14个,三级指标38个,并在民族地区开展绩效考核工作。结论:通过绩效考核提高当地政府对妇幼卫生工作重要性的认识,促进当地妇幼卫生体系建设与发展,规范妇幼卫生服务的实施,提高少数民族妇幼卫生服务的可及性,促进妇幼卫生服务均等化。     

军队机动心理救援分队建设方案设计

本文从心理救援分队建设的需求出发,阐述心理救援分队的任务、抽组来源、人员编配、人员职责、选拔标准、展开布局及工作流程,为我军战役层次机动心理救援分队的建设提供依据。     

Enhancing credibility of chemical safety studies: emerging consensus on key assessment criteria

Objectives

We examined the extent to which consensus exists on the criteria that should be used for assessing the credibility of a scientific work, regardless of its funding source, and explored how these criteria might be implemented.

Data sources

Three publications, all presented at a session of the 2009 annual meeting of the Society for Risk Analysis, have proposed a range of criteria for evaluating the credibility of scientific studies. At least two other similar sets of criteria have recently been proposed elsewhere.

Data extraction/synthesis

In this article we review these criteria, highlight the commonalities among them, and integrate them into a list of 10 criteria. We also discuss issues inherent in any attempt to implement the criteria systematically.

Conclusions

Recommendations by many scientists and policy experts converge on a finite list of criteria for assessing the credibility of a scientific study without regard to funding source. These criteria should be formalized through a consensus process or a governmental initiative that includes discussion and pilot application of a system for reproducibly implementing them. Formal establishment of such a system should enable the debate regarding chemical studies to move beyond funding issues and focus on scientific merit.     

建设全军重症监护示范基地的实践与体会

目的：探索建设管理规范、技术先进的重症监护示范基地的举措。方法：通过确立指导思想,成立专项工作领导小组,制订明确工作计划,动员全员积极参与,深入现场考察检查,广泛开展人员培训等一系列措施,加强了监护室软硬件等全面建设。结果：建成了一支合格的重症监护技术队伍,建立了先进的重症监护工作平台,全面提升了重症监护技术水平,取得示范基地建设工作良好成效。结论：重症监护示范基地建设是一个大的系统工程,加强组织领导、制定清晰标准、做好周密部署、调动全员参与是保证建设工作取得成效的基本途径。     

Twenty years of research on the quality of medical care: 1964-1984.

Since 1964 we have built on earlier work, with some refinements, particularly in the formulation of explicit criteria of process and outcome; the detailed standardization of case mix when outcomes signify quality; the prespecification of outcomes for follow-up, when adverse outcomes are only the occasion for later assessment of process; a greater emphasis on more subtle organizational characteristics in the study of structure; and the identification of the separate effects of structural attributes by multivariate analysis. We have also paid more systematic attention to questions of measurement, including the veracity and completeness of the record; the procedures of criteria formulation; and the reliability, validity, and screening efficiency of the criteria. A notable advance is the use of decision analysis to identify optimal strategies of care, including the introduction of patient preferences and monetary cost in the specification of such strategies, and the use of decisional algorithms to portray the criteria of quality.     

Multiprofessional healthcare team: concept and typology

This paper introduces concept and typology to teamwork as well as criteria to identify types of teams. The concept and the typology were developed based on the literature and research on multi-professional work in healthcare, based in the theory of studies on work process in healthcare and in the theory of communicative action. According to this theoretical proposition, teamwork is a form of collective work characterized by a reciprocal relationship between technical interventions and the interaction of agents. The proposed typology refers to two forms of teams: integrated teams as opposed to groups of people. The criteria to identify the types of team are related to communication among work agents; technical differences and inequality in social recognition of specialized works; formulation of a common care program; specificity of each professional area; flexibility of work division; and technical autonomy.     

Criteria and methods used for the assessment of fitness for work: a systematic review

The main findings from reports published in scientific journals on the criteria and methods used to assess fitness for work were reviewed. Systematic searches were made using internet engine searches (1966-2005) with related keywords. 39 reports were identified, mostly from the US and western Europe. Assessment of fitness for work is defined by most as the evaluation of a worker's capacity to work without risk to their own or others' health and safety. It is mainly assessed at recruitment (pre-offer or post-offer), and when changes of work or health conditions occur. Five main criteria used by occupational doctors to evaluate fitness for work were identified: the determination of worker's capacity and worker's risk in relation to his or her workplace, as well as ethical, economic and legal criteria. Most authors agreed that assessment tools used need to be specific and cost-effective, and probably none gives unequivocal answers. Outcomes from fitness for work assessments range from "fit" to "unfit", with other possible intermediate categories such as "fit subject to work modifications", "fit with restrictions" or "conditionally fit (temporarily, permanently)". Workplace modifications to improve or adjust working conditions must always be considered. There is confusion about the decision-making process to be used to judge about fitness for work. There is very scarce scientific evidence based on empirical data, probably because there are no standard or valid methodologies for all professions and circumstances.