持续质量改进提高护理管理水平

随着社会的发展和医学模式地转变,病人对护理服务质量提出了更高的要求,高新技术的应用,使护理工作的难度和风险增高[1]。持续质量改进的护理管理正是为了适应时代的需求、病人的要求、质量的提高而开展的一种切实有效的管理方法。持续质量改进的主要原则:一是过程改进,质量改进的根本是过程的质量改进,质量改进通过改进过程而实现。二是持续改进,是以现有质量过程为基础,对病人不满意的问题,进行分析,寻找原因,解决问题,提高质量。三是预防性改进,质量改进的重点在于预防问题的发生,而不仅仅是事后的检查和补救,只有事前质量控制,才能达到…     

Purchasing population health: aligning financial incentives to improve health outcomes

OBJECTIVE: To review the concept of population health, including its definition, measurement, and determinants, and to suggest an approach for aligning financial incentives toward this goal. DATA SOURCE, STUDY DESIGN, DATA EXTRACTION: Literature review, policy analysis PRINCIPAL FINDINGS: The article presents the argument that a major reason for our slow progress toward health outcome improvement is that there is no operational definition of population health and that financial incentives are not aligned to this goal. Current attempts at process measures as indicators of quality or outcome are not adequate for the task. It is suggested that some measure of health-adjusted life expectancy be adopted for this purpose, and that integrated delivery systems and other agents responsible for nonmedical determinants be rewarded for improvement in this measure. This will require the development of an investment portfolio across the determinants of health based on relative marginal return to health, with horizontal integration strategies across sectoral boundaries. A 20-year three-phase development strategy is proposed, including components of research and acceptance, integrated health system implementation, and cross-sectoral integration. CONCLUSIONS: The U.S. health care system is a $1 trillion industry without a definition of its product. Until population outcome measures are developed and rewarded for, we will not solve the twenty-first century challenge of maximizing health outcome improvement for the resources available.     

优化门诊导医流程实现服务质量零缺陷

为了提高门诊导医服务质量,实现服务质量零缺陷,分析原导医流程中易造成病人不满意的环节,并进行流程再造与优化,把病人满意作为衡量服务质量的重要标准,在实施中不断地改进完善,使导医工作规范有序,就医时间缩短,向服务零缺陷目标迈近.提出及时科学地进行导医流程再造,是提高服务质量、实现服务质量零缺陷的有效途径.     

加强护士长管理提高护理服务质量

护理管理是一门艺术,也是一门科学,它是医院管理的重要组成部分.近年来,社会的发展和医疗市场激烈的竞争对护理工作提出了更高的要求,护理管理的效应也越来越重要[1].     

关注病人满意度 持续改进护理服务质量

目的 研究护理服务满意度调查在持续改进护理服务质量中的作用.方法 采用我院自行设计的护理服务满意度调查量表进行护理服务满意度调查,针对病人反馈,有的放矢地改进护理工作.结果 收集2005～2007年病人满意度调查数据,病人满意度明显提高.结论 关注病人满意度测评,改进措施到位,对提高护理服务质量具有非常现实的意义.     

Barriers to quality health care for the transgender population

The transgender community is arguably the most marginalized and underserved population in medicine. A special issue focusing on men's health would be incomplete without mention of this vulnerable population, which includes those transitioning to and from the male gender. Transgender patients face many barriers in their access to healthcare including historical stigmatization, both structural and financial barriers, and even a lack of healthcare provider experience in treating this unique population. Historical stigmatization fosters a reluctance to disclose gender identity, which can have dire consequences for long-term outcomes due to a lack of appropriate medical history including transition-related care. Even if a patient is willing to disclose their gender identity and transition history, structural barriers in current healthcare settings lack the mechanisms necessary to collect and track this information. Moreover, healthcare providers acknowledge that information is lacking regarding the unique needs and long-term outcomes for transgender patients, which contributes to the inability to provide appropriate care. All of these barriers must be recognized and addressed in order to elevate the quality of healthcare delivered to the transgender community to a level commensurate with the general population. Overcoming these barriers will require redefinition of our current system such that the care a patient receives is not exclusively linked to their sex but also considers gender identity.     

突出护理专业特色提高课堂实习质量

随着卫生教育改革工作的不断深入，实用型人才的培养越来越受到人们的普遍重视，各临床专业学科在知识领域、技能领域、态度领域全面发展的基础上，技能的培养更是被摆在了突出的位置。《护理学基础》作为护理专业开设的一门重要的专业基础课，是一门技能性、实践性和应用性均很强的学科。现代护理教育的指导思想要求“融传授知识、培养能力和提高素质为一体，贯穿于在校教育的全过程”。为了适应培养实用型护理人才的要求，适应市场经济对护理人才的需要，护理教师在教学过程中更应突出和重视实践教学这一环节，应将教学重点放在加强学生操作技能的训练和职业素质的培养上。     

突出护理专业特色提高课堂实习质量

随着卫生教育改革工作的不断深入,实用型人才的培养越来越受到人们的普遍重视,各临床专业学科在知识领域、技能领域、态度领域全面发展的基础上,技能的培养更是被摆在了突出的位置。《护理学基础》作为护理专业开设的一门重要的专业基础课,是一门技能性、实践性和应用性均很强的学科。现代护理教育的指导思想要求“融传授知识、培养能力和提高素质为一体,贯穿于在校教育的全过程”。为了适应培养实用型护理人才的要求,适应市场经济对护理人才的需要,护理教师在教学过程中更应突出和重视实践教学这一环节,应将教学重点放在加强学生操作技能的…     

改进护士长夜查房制度提高护理质量

护理总值班夜查房制度是医院夜间医疗护理质量管理的一项重要措施[1]。为了强化对夜间护理工作监督,更好地发挥夜值班护士长的职能,我院从2004年7月开始,对夜值班查房工作进行了改进,减少了差错事故的发生,提高了护理质量。1方法1.1人员组成查房人员由全院护士长组成,由原来的每天1人查房改为每天2人查房,内科与外科、年轻的与年长的、辅助科室与临床科室护士长搭配,由护理部统一排班,并设有3名机动护士长替班。1.2查房时间以往查房时间为20:00~22:00,现改为不定时查房,即夜值班人员随机抽查各病区的值班人员完成工作情况。1.3查房内容及记…