以医院管理内容为基础构建医院管理专业课程体系的构想

医院管理的对象包括人、财、物、信息、技术等,因此医院管理的内容包括组织、人力资源、财务与经济、物流、信息、业务与质量管理以及环境分析等,以此为基础本文提出:紧密结合医院管理本身的管理对象和内容,建立本科医院管理专业合理的学科体系,即把医院管理专业课程分为国家规定的公共课、基础课(主要是医院管理的方法、工具性课程,如运筹学、统计学、流行病学等)和专业课(包括组织管理、人力资源管理、经济管理、物流管理、信息管理、业务及其质量管理、环境分析等内容)。     

浅论“人本管理”思想在现代医院管理中的意义

医院管理就是按照医院管理的客观规律,运用管理理论和方法,对医院的人、财、物和信息等资源进行计划、组织、协调和控制,充分发挥整体运行功能,取得最佳效益的管理活动过程。在以往的管理中,人们往往强调对事和物的管理,而不重视对人的管理。人本管理强调的就是以人为本的管理,强调把人作为管理的核心要素,在满足、理解、尊重人的基础上,通过充分发挥人的积极性和主动性来实现管理者的目的,从而达到管理者和被管理者效益的双赢。现代医院的发展越来越离不开人的作用的充分发挥,医院的生存与发展、效益和声誉的好坏与医院所拥有的人才数量、…     

公立医院人文管理模式实践研究

人文管理作为新型的医院管理模式,受到人们的广泛关注,并被运用到现代医院管理中。专家学者对于人文管理的内涵、重要性和必要性、内容和作用等进行了大量的研究和实践探索,本文就此方面的理论、实践研究进行综述,以期启示广大医院管理者更好地服务于医院的建设与发展。1医院人文管理的内涵医院人文管理是医院管理的一种新模式和新趋势,它是一系列以人为中心的管理理论与管理实践的总称。这种管理理念就是把人作为管理活动的核心,着重研究和思考如何发挥和应用人的作用,并采用多种途径充分开发和利用人文资源,力图创造出极大的群体合力,从而实现组织意愿和成员个人的奋斗目标。“人文型”医院,是指建立在医院人文精神之上,以患者为中心,以人文关怀为主要管理手段,在医院内部形成良好的人文环境,激发员工的人文道德关爱,以解除患者痛苦为最高宗旨的一种医院组织形式。“人文型”医院以追求“真、善、美”等崇高的价值理想为核心,以促进人的自身自由和全面发展为终极目标,塑造独具特色的人文氛围,力求人和医院各项事业的完美结合。实现医院救死扶伤,全心全意为患者服务的根本宗旨。“人文型医院”的本质在于利用系统的人文管理理论来构建全新的医院管理平台,人文管理和人文服务分别是...     

浅谈医院文化建设在21世纪医院管理中的地位与作用

随着医药卫生体制改革的进行 ,各级医院都在进一步摸索医院在今后竞争中发展的新思路与新办法 ,特别是医院管理如何适应 2 1世纪的新形势 ,其中对医院文化建设的探索也越来越多的引起了医院管理工作者及医务人员的重视。本文试图通过对当前医院文化建设在医院管理中作用的阐述 ,探索医院管理的新思路。1　医院管理与医院文化建设的关系管理是计划、组织、用人、指导及控制组织机构的目的。管理工作也可看成是包括决策、协调及资源运用三种主要形式的工作。医院管理同企业一样 ,其主要内容实质就是人、财、物的管理。近年来对医院文化建设的…     

首届全国医院门诊管理学术会议在广州召开

经中华医院管理学会批准,首届全国医院门诊管理学术会议于2000年11月5日～7日在广州召开。全国医院门诊管理专业委员会委员及论文作者共126人参加了会议。会议除进行了专题讲座,讨论通过了《中华医院管理学会门诊管理专业委员会组织管理办法》外,与会代表还就我国医药卫生体制改革的深化和医院建设发展、社区服     

“全国医院相关法律知识培训班”及“全国医院管理组织行为学培训班”在深圳举办

中华医院管理学会于2001年4月13-17日、4月21-25日在深圳医学培训中心分别举办了“全国医院相关法律知识培训班”及“全国医院管理组织行为学培训班”。两班学员近200人,讲课教师来自国务院法制办、中国政法大学、中华医院管理学会维权部     

以人为本管理理念在医院政治思想工作中的应用

医院是服务群众和服务社会的特殊社会组织,兼具经济性和社会性。医院的思想政治管理工作占据极其重要的地位。当前,随着形势的发展与医疗改革的不断深入,医院的政治思想工作应紧随时代发展,关注当前医疗从业人员的思想状态和心理特点,使医院思想政治工作更具针对性和实效性,调动从业人员的积极性和自主性。以人为本的管理是现代管理方式之一,它以人为中心,从人的需求和利益出发,尊重人的主体地位。在医院政治思想工作当中贯彻落实以人为本管理理念有着重大的作用与意义。本文主要探讨以人为本管理理念在医院政治思想工作中的意义、目标,进而探讨在医院思想政治工作中如何践行以人为本的管理理念,以此推动医院的健康和可持续发展。     

"以人为本"在医院管理中的重要作用

在医院的组织、经营、管理中,"以人为本"既是医院组织行为学的重要体现,也是基层管理者领导工作的艺术之一.随着医学科学的飞速发展和医疗体制的不断变革,医疗服务市场的竞争日趋激烈,一些医院的优秀医学人才不断流失,严重影响和制约医院的发展.一个医院要想在竞争中立于不败之地,必须强化人本意识,把"以人为本"的管理概念融入医疗服务的全过程中,突出体现人的智慧、技术、道德、精神在管理中的重要作用.用现代化、科学化、规范化的管理模式进行管理,并要增强医院的竞争力,关键在于增强医院的核心竞争力,即所谓的实行人本管理,从而提高工作效率,提高医院效益.只有强化人本意识,才能提高医院管理水平.     

医院资产内部控制五要素

案例折射出的公立医院资产管理问题,令人深思。医院资产管理,涉及人、财、物及组织、制度等众多方面,但内部控制中的控     

组织文化与医院组织文化

今天我讲的主题是组织文化。什么叫文化,为什么要讲文化,我今天着重从管理的角度来讲一讲,并结合医院实际,讲一讲文化与医院的关系,文化对医院管理的功能,以及怎样来塑造医院文化。 一、组织文化的意义 组织文化的英语叫Organization Culture。首先文化普遍存在而且视为当然的做人做事的方式。不同的人和不同的企事业机构有不同的待人接物的方式,有的热情,有的冷淡,这也     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.