对现代医学模式下中医药人才培养目标的几点思考

生物医学模式向生物-心理-社会医学模式转变,引发社会对中医药人才的素质及中医药学教育提出了新的要求。文章分析了传统中医药人才培养存在的不足,提出现代医学模式下中医药人才培养应重视人文科学和传统文化教育,强调综合素质教育与专业教育的统一,继承的基础上强调创新,重视医学道德教育,注重学生的知识、能力、素质的协同发展。     

医院文化建设与职工满意度关系探讨

医院文化被认为是医院发展的强力引擎。优质的医院文化更能够凝聚人心、促进创新,培育高素质的管理者与医务人员,从而提升医院的服务质量和服务效率。提高医院职工满意度,注重对员工期望的文化建设,有利于强化医院文化的内涵建设,促进医院可持续发展。     

在医学专业本科生中开展病原生物学研究型实验的探索

实验教学是高等教育的重要组成部分,是理论与实践相结合的过程,对于学生的综合素质和创新能力的培养,起着理论和其他教学环节不可替代的作用.研究型实验在提高学生综合素质、培养学生创新性思维和独立科研能力上有着其他实验教学方法所无法比拟的优势.本文选取10名临床医学专业的本科生进行了病原生物学专业的研究型实验教学的尝试,总结了...     

坚持科学发展 着力打造医院综合服务能力

文章分析了当前医院管理工作存在的一些主要问题，探索性提出医院管理新模式，强调坚持科学发展，打造医院综合服务能力的几点设想：人才队伍培养、医院管理信息化、强化医疗质量建设、正确处理医疗纠纷，以及构建以创新为核心的医院文化。     

物联网模式下医院文化新体系的构建

随着物联网医院雏形的逐步显现,医院文化的被感知度必然越来越高,由此更加迫切地呼唤医院要高度重视文化建设的创新,破解新形势下的新问题,增添新环境中的文化生机。而从当前医院的现实情况分析,管理文化、质量文化、安全文化、中医文化、和谐文化、服务文化,正是医院文化中最需要被感知的文化元素。借助物联网感知体系,在感知点上采取科学的文化感知方式．获得理想的文化创新结果。将更好地消除患者与医院之间的不和谐因素,使医院文化建设符合时代特征与现代节拍．有效发挥文化建设这一软实力对促进医院发展的正向作用。     

Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC)

Background  

Patient safety is a critical component to the quality of health care. As health care organizations endeavour to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. In this research, the authors use the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire to assess the culture of patient safety in Taiwan and attempt to provide an explanation for some of the phenomena that are unique in Taiwan.     

我院医院文化建设现状及对策分析

目的了解医院文化建设现状,对文化建设过程中存在的问题进行分析,探讨改进对策及建议。方法2011年11月至2012年2月在全院范围内发放了207份问卷对医院文化建设进行了调查,问卷内容包括：物质文化、行为文化、制度文化和精神文化建设。结果调查发现医院文化建设较好的方面有：1、医院组织具有较强的凝聚力,形成了以病人为中心的价值观和经营理念。2、医院重视对人才的培养,鼓励开展医疗新技术与科研创新。3、医院重视树立并弘扬先进模范典型。4、全院职工以良好的精神面貌为病人服务。5、职工清楚医院的质量方针、质量目标、医院精神。需要改进的部分：1、医院环境建设需要加强。2、医院各种信息反馈渠道还不够畅通。3、需要加强执行力,提高工作效率。结论先进的医院文化能够增强医院的发展活力,促进医院在激烈的市场竞争中产生强大的竞争力、生存力和发展力。只有加强医院文化建设,增强全院职工的向心力和凝聚力,才能提高医院的整体效益,使医院稳定发展。     

加强医院文化价值管理体系建设

在激烈的医疗市场竞争中，围绕社会主义核心价值体系和先进文化的基本要求，加强医院文化价值管理体系建设，提升医院管理水平和队伍素质，有利于促进医院发展观念的转变，推动医院发展模式的创新，促使医院发展质量的提高。     

医疗技术创新管理的实践与体会

作介绍了拓宽医疗技术创新的源泉;积极推广科研成果、大胆进行技术改造、花大力气引进技术、依托高精尖设备开展技术创新;提出了确保医疗技术创新的因素;探讨了如何处理好创新的关系,以提高医疗技术创新的质量。     

In pursuit of an improving National Health Service

The British National Health Service (NHS) before its 1990s internal-market reforms was a gridlock of perverse incentives. The internal market, an attempt to introduce some market incentives, stimulated much innovation in primary care commissioning and practice improvement and led to increased efficiency. However, its effects were quite limited, because the essential conditions for a market to operate were not fulfilled. There now exists a crisis of confidence in the quality of care in the NHS. It is doubtful whether a culture of innovation, efficiency, and good customer service is possible in a public-sector monopoly whose services are in excess demand and whose units do not get more resources for caring for more patients. It also is doubtful whether the NHS can modernize without consumer choice, competition, and more resources.     

医疗质量管理发展现状及展望

当前医疗质量管理的发展现状包括医疗质量实时控制、持续质量改进、IS09000质量体系认证、循证医学、临床路径等。未来医疗质量管理发屉应以超严质量要求为目标，数字化管理为基础，持续质量改进和质量管理创新为手段，科学管理和“化管理”的有机结合为根本。立足发展现状，展望医疗质量管理的未来，21世纪将是“质量的世纪”。无论对于工业产品抑或医疗产品，其超严质量要求就是“零缺陷”；其管理方式就是“零缺陷管理”。同时，将人的质量作为质量管理的核心也是一种新的管理思路，它要求医院管理更多地去关注和研究医疗行为和就医行为。     

知识经济时代医院文化创新的思考

随着知识经济时代的来临，医院文化对医院的发展所发挥的作用日益显现。在知识经济时代，医院文化是医院管理的重要手段、核心竞争力和发展的巨大推动力。知识经济时代医院文化创新的特征表现为时代性、软管理性、价值导向性和塑造形象性。创新的主要内容是确立正确的办院理念；建立优秀的医院精神；培育高尚的价值；培养良好的解体行为。     

试论医院文化力

医院文化力是柔性的精神生产力。它能够全面提升团队素质和全员思想境界,将文化内容贯透到组织结构的各个层面,确保员工按质按量完成工作任务;促使人们对医院总体目标产生认同感、使命感和自豪感,提高个人和组织的主动性和积极性,从制度上和思想上实现自我控制、自我管理;创造员工终身学习的环境,提高员工的创新意识、创新能力和医院创新体系,使医院核心价值观产生持久的精神支撑力;促使患者联想到医院与众不同的服务形象,创立独具特色的服务文化,增强患者对医院的信任度。     

Innovative health service delivery models in low and middle income countries - what can we learn from the private sector?

Background  

The poor in low and middle income countries have limited access to health services due to limited purchasing power, residence in underserved areas, and inadequate health literacy. This produces significant gaps in health care delivery among a population that has a disproportionately large burden of disease. They frequently use the private health sector, due to perceived or actual gaps in public services. A subset of private health organizations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor through innovative health service delivery models. This study aims to characterize these models and identify areas of innovation that have led to effective provision of care for the poor.     

军队医院跨越式发展构想

本文从优化为兵服务内涵、加强人才梯队建设、开拓科技创新、深化质量效益和塑造医院文化五个方面,介绍加强医院内涵建设的做法和经验,为医院内涵建设发展提供参考和借鉴。     

SWOT分析法在医院科研管理中的应用

运用SWOT法分析了医院临床科研工作积累的整体优势,认识到当前医院存在创新能力不足是面临的主要劣势,剖析了医院科研创新发展的大好机遇和医院体制调整所带来一些威胁,提出了培养高素质复合型创新人才、强调基础研究与临床创新相结合、不断完善科研创新机制的发展策略。     

WHO cooperative studies on the phage-typing of mycobacteria. 1. Phage lysis of Czechoslovak and Italian strains of Mycobacterium tuberculosis

Although phage-typing of some pathogenic microbes—e.g., Escherichia coli and the genera Salmonella, Staphylococcus, and Streptomyces—is in routine use, little progress has yet been made in the phage-typing of mycobacteria, chiefly because mycobacteriophages possess a polyvalence that prevents the reliable identification of individual species of mycobacterium. Furthermore, laboratories cannot compare their results because they employ different methods and culture media and also because the phages used cannot be accurately identified. It has been shown that internationally reproducible results can be obtained for M. tuberculosis by selecting suitable mycobacteriophages and sensitive culture media, and by using a standardized technique of phage-typing. Under these conditions, phage lysis may be utilized to classify strains of M. tuberculosis.     

Cure for increasing health care costs: The Bernhoven case as driver of new standards of appropriate care

Containing costs is a major challenge in health care. Cost and quality are often seen as trade-offs, but high quality and low costs can go hand-in-hand as waste exists in unnecessary and unfounded care. In the Netherlands, two healthcare insurers and a hospital collaborate to improve quality of care and decrease healthcare costs. Their aim is to reduce unnecessary care by shifting the business model and culture from a focus on volume to a focus on quality. Key drivers to support this are taking time for integrated diagnosis (‘first time right’), the right care at the right place and shared decision making between doctor and patient. Conditions to realize this are 1) contract innovation between the hospital and insurers to move away from fee-for-service reimbursement, 2) a culture change within the organization with emphasis on collaboration and empowerment of medical leadership and physicians to change daily practice, and 3) a reorganization of the hospital organization structure from a large number of medical departments to four business units related to the fundamental underlying patient need (acute care, solution shop, intervention unit and chronic care). Results from this whole-system-approach experiment show it is possible to provide better care (as experienced by patients) with lower volumes (16% lower DRG claims after 3 years) and provides valuable lessons for further healthcare reform.     

Public Accountability and Sunshine Healthcare Regulation

The lack of economic sustainability of most healthcare systems and a higher demand for quality and safety has contributed to the development of regulation as a decisive factor for modernisation, innovation and competitiveness in the health sector. The aim of this paper is to determine the importance of the principle of public accountability in healthcare regulation, stressing the fact that sunshine regulation—as a direct and transparent control over health activities—is vital for an effective regulatory activity, for an appropriate supervision of the different agents, to avoid quality shading problems and for healthy competition in this sector. Methodologically, the authors depart from Kieran Walshe’s regulatory theory that foresees healthcare regulation as an instrument of performance improvement and they articulate this theory with the different regulatory strategies. The authors conclude that sunshine regulation takes on a special relevance as, by promoting publicity of the performance indicators, it contributes directly and indirectly to an overall improvement of the healthcare services, namely in countries were citizens are more critical with regard to the overall performance of the system. Indeed, sunshine regulation contributes to the achievement of high levels of transparency, which are fundamental to overcoming some of the market failures that are inevitable in the transformation of a vertical and integrated public system into a decentralised network where entrepreneurialism appears to be the predominant culture.     

Science-based health innovation in Tanzania: bednets and a base for invention

Background

Tanzania is East Africa’s largest country. Although it is socially diverse, it has experienced general political stability since independence in 1964. Despite gradual economic development and Tanzania’s status as one of the biggest recipients of aid in Africa, health status remains poor. This paper explores Tanzania’s science-based health innovation system, and highlights areas which can be strengthened.

Methods

Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents, and through open-ended, face-to-face interviews with 52 people from across the science-based health innovation system over two visits to Tanzania from July to October 2007.

Results and discussion

Tanzania has a rich but complex S&;T governance landscape, with the public sector driving the innovation agenda through a series of different bodies which are not well-coordinated. It has some of the leading health research on the continent at the University of Dar es Salaam, Muhimbili University of Health and Applied Sciences, the National Institute for Medical Research and the Ifakara Medical Institute, with strong donor support. Tanzania has found developing an entrepreneurial culture difficult; nevertheless projects such as the clusters initiative at the University of Dar es Salaam are encouraging low-tech innovation and overcoming knowledge-sharing barriers. In the private sector, one generics company has developed a South-South collaboration to enable technology transfer and hence the local production of anti-retrovirals. Local textile company A to Z Textiles is now manufacturing 30 million insecticide impregnated bednets a year.

Conclusions

To have a coherent vision for innovation, Tanzania may wish to address some key issues: coordination across stakeholders involved with health research, increasing graduates in health-related disciplines, and building capabilities in biological testing, preclinical testing, formulation and standardization, and related areas important to moving from basic research to applications. The private sector can be encouraged to innovate through improved access to financing, and incentives for R&;D. The diaspora community represents an untapped source for partnerships and access to other developing world markets and technology. The government may wish to set up mechanisms to encourage south-south collaborations, and to bring the public and private sector together around specific projects to help realize the country’s innovation potential.