临床路径在疗养院医疗质量管理中的应用

总结临床路径的内涵、特点及发展现状,分析了4 450例疗养员的医护质量、疗养费用支出,论证了临床路径在军队疗养院实施的可行性。高血压、糖尿病、冠心病实施临床路径后,达到了合理使用经费,有效提高医护理质量及疗养员满意度。实施临床路径是军队疗养院高效节流,提高疗养、护理质量的可行性管理方法之一。     

论临床路径理论、实施及其意义

临床路径在医院管理中被广泛应用,它促进了医院管理机制的转变和有效地提升医疗质量.本文通过临床路径的背景、定义、目的,介绍临床路径实施的现状、目标、具体方法,同时对临床路径的变异进行了详细分析.实施临床路径管理,非常符合我国目前医疗行业的实际以及社会对医疗机构的要求,在我国医院管理中将具有很好的应用前景.     

临床路径应用研究与体会

临床路径管理是我国现阶段深化医药卫生体制改革的必然选择。简要阐述临床路径实施过程,并应用指标评价体系分析了临床路径的成效,为临床路径的推广提供实践依据。     

临床路径在医疗质量管理中的应用与思考

就临床路径的发展和概念进行了描述,阐明了临床路径的实施步骤,讨论了临床路径在医院医疗质量管理中的作用,同时对其未得到普及的原因和在我国的发展前景进行了分析。     

腹腔镜胆囊切除的临床路径

本文阐述了实施临床路径的重要意义,通过对临床路径在我院的应用现状进行分析,探讨了其在应用中存在及注意的问题,认为对提高医疗质量有实际意义,临床路径在医院管理中具有良好的应用前景。     

医院质量管理的临床路径分析

本文阐述了实施临床路径的重要意义、实施步骤:①计划准备阶段;②CP制定阶段;③实施检查阶段;④评价改进阶段,并介绍了应用现状和存在问题,以及临床路径应用中要注意的问题,认为CP对在我国的推广应用具有一定的借鉴意义。     

临床路径管理与电子病历结合应用研究

目的：论述新型电子病历实现以患者为中心的临床路径管理思路和具体措施，探讨新型电子病历对临床路径管理的促进作用。方法：实施电子病历，结合质量管理措施，围绕临床路径管理，研究新型电子病历和临床路径管理之间的关系。结果：采用半结构化的新型电子病历有利于促进临床路径管理，提高临床管理质量，提升医院竞争力。结论：未来医院临床路径管理应努力结合电子病历的监控和管理，大力发展以患者为中心的新型半结构化电子病历。     

临床护理路径实施中的质量管理

目的探讨实施有效的临床护理路径(Clinical Nursing Pathway,CNP)质量管理体系的方法.方法建立临床护理路径质量管理体系,并有效运行.结果实施临床护理路径质量管理体系之后12个月比之前12个月在护理质量、护士行为测评、病人满意率上均有显著提高,而平均住院天数和医疗费用明显减少.结论实施有效的临床护理路径质量管理体系,对健全护理管理机制,有效推进科学化、系统化、制度化的护理质量管理工作,提高医院的内在效益和外在效益都起到了重要的作用.     

解困临床路径

案例背景2010年11月10日,某省一家三甲医院召开了临床路径实施动员大会,院长王建在会上作了专题动员报告。他强调:实施临床路径就是要将疾病的治疗阳光化、透明     

浅谈运用PDCA循环模式促进临床路径的实施

临床路径作为一种标准化诊疗方法,逐渐受到人们的关注。文中介绍了临床路径的产生背景和内涵,以及PDCA循环模式的相关知识,主要讨论了如何运用PDCA循环理论指导临床路径的制定和实施,旨在为临床路径的科学管理提供依据,从而促进临床路径在我国的推广。     

神经病学双语教学科学化、现代化、标准化的实践与研究

通过采用神经病学专科理论、临床实践与双语教学相结合的临床实习模式,使医学生能较熟练地运用医学英语进行神经内科知识的学习与交流,改进临床实习方法,从而提高教学质量,增强学生综合素质.在临床实习过程中引入双语教学模式对培养学生临床能力和专业英语水平有重要意义,值得推广.     

临床微生物实习教学工作的实践与思考

医学微生物学与临床药物学和感染性疾病密切相关,是检验医学中必须掌握的一门课程。培养高素质的临床微生物学人才,必须有合适临床实习教学方法。该文结合临床工作实际,从强化临床基本能力训练、改进临床实习教学方法、加强师资培训、强化实习效果评估等方面入手,对如何做好临床微生物实习教学工作,为临床培养高素质微生物工作者的方法与途径进行了有益的探讨。     

No exit: an evaluation of measures of physician attrition

OBJECTIVE: To validate physicians' self-reported intentions to leave clinical practice and the American Medical Association (AMA) Masterfile practice status variable as measures of physician attrition, and to determine predictors of intention to leave, and actual departure from, clinical practice. DATA SOURCES: Survey of specialist physicians in urban California (1998); the AMA Physician Masterfile (2001); and direct ascertainment of physician practice status (2001). STUDY DESIGN: Physicians' intention to leave clinical practice by 2001 (self-reported in 1998) was tested as a measure of each physician's actual practice status in 2001 (directly ascertained). Physician practice status according to the 2001 AMA Masterfile was also tested as a measure of physicians' actual practice status in 2001. Multivariate regression was used to predict both physicians' intentions to leave clinical practice and their actual departure. DATA COLLECTION/EXTRACTION METHODS: AMA Masterfile data on 2001 practice status were obtained for 967 of 968 physician respondents to the 1998 survey. Actual practice status for 2001 was directly ascertained for 957. PRINCIPAL FINDINGS: The sensitivity of Masterfile practice status as a measure of actual departure from clinical practice was 9.0 percent, and the positive predictive value was 52.9 percent. Allowing for a two-year reporting lag did not change this substantially. Self-reported intention to leave clinical practice had a sensitivity of 73.3 percent and a positive predictive value of 35.4 percent as a measure of actual departure from practice. The strongest predictor of both intention to leave clinical practice and actual departure from practice was older age. Physician dissatisfaction had a strong association (OR=5.6) with intention to leave clinical practice, but was not associated with actual departure from practice. CONCLUSIONS: Our findings call into question the accuracy of both AMA Masterfile data and physicians' self-reported intentions to leave as measures of physician attrition from clinical practice. Research using these measures should be interpreted with caution. Self-reported intention to leave practice may be more of a proxy for dissatisfaction than an accurate predictor of actual behavior.     

高等医学院校临床实践教学管理存在的问题与对策

临床实践教学在高等医学教育教学活动中占有特殊地位,临床实践教学管理对临床实践教学过程顺利进行至关重要。阐述了临床实践教学管理的内涵,分析了当前高等医学院校在临床实践教学管理中存在的问题,并针对临床实践教学管理工作中存在的薄弱环节提出了解决的对策。     

Clinical applications of computer-based health information

Competitive health care systems are improving their clinical and cost efficiency by performing clinical practice analyses. Large numbers of severity-adjusted cases provide the most objective data for making clinical efficiency decisions. The most cost-effective way to perform these analyses is to utilize well-coded, computer-based health information. This requires consistent coding of patients' comorbidities and complications as well as an interactive working relationship between coders and clinicians providing the clinical practice analysis. The article describes one hospital's evolving clinical efficiency information needs, how its health information system met them, the clinical practice analysis procedure, and the outcomes of this clinical practice analysis.     

The effects of clinical decision making on nurse practitioners' clinical productivity

The degree of clinical decision making and clinical productivity among nurse practitioners (NPs) is of great interest to policy makers and planners involved in providing appropriate outpatient primary care services. The authors performed a statewide mailed survey of all NPs practicing either full-time or part-time in Wisconsin (response rate of 72.1%) to address the following research questions: Do the demographic characteristics, practice attributes, and primary practice settings of NPs impact their level of clinical decision making (e.g., the autonomy to order laboratory and radiological tests or to refer a patient to a physician specialist other than their collaborating physician)? Do NPs' levels of clinical decision making correlate with their outpatient clinical productivity, adjusting for demographic characteristics, practice attributes, and primary practice settings? The multiple linear regression results indicated that having more years in practice as an NP, practicing in the family specialty area (vs. a combined other category, which included pediatrics, acute care, geriatrics, neonatal, and school), treating patients according to clinical guidelines, practicing in settings with a fewer number of physicians, and practicing in a multispecialty group practice versus a single-specialty group practice were associated with greater levels of clinical decision making. However, NPs who primarily practiced in a hospital/facility-based practice, as compared with a single-specialty group practice, had lower levels of clinical decision making. After adjusting for demographic characteristics, practice attributes, and primary practice settings, NPs with greater clinical decision-making authority had greater outpatient clinical productivity. The conclusions discuss the policy implications of the findings.     

常见病原菌少见表型在临床微生物检验实习教学中的应用

目的探讨常见病原菌少见表型在临床微生物检验实习教学中的应用效果。 方法将常见病原菌少见表型相关知识进行总结，引入到临床微生物学检验实习教学过程中。 结果常见病原菌少见表型丰富了教学内容，调动了学生能动性与积极性，提高临床微生物检验实习教学的质量。 结论把常见病原菌少见表型引入到临床微生物检验实习教学取得较好的效果，是对常规实习教学的有益补充。     

高职院校护理专职教师临床实践相关问题之探讨

探讨我国高职院校护理专职教师临床实践的发展路径,研究者结合临床实践的切身体会,提出了当前亟需解决护理专职教师临床实践"学什么"和"如何学"以及怎样保证临床实践路径畅通等问题,并阐述了解决问题的若干具体措施和方法,为高职院校进一步开展护理专职教师临床实践活动,促进高职护理教育发展提供了理论及实践支持。     

PBL法在儿童口腔医学临床实习中的应用

为提高儿童口腔医学临床实习效果,引入以问题为基础的教学法(problem-based learning,PBL)。本文介绍了PBL法在儿童口腔临床实习中的实施方法及流程。在学习中发现PBL法对学生自学能力,科研能力,临床技能的提高等方面有很大帮助,是传统教学法的重要补充。     

临床医学专业课间见习模式改革的实践与探索

目的：改革临床医学专业课间见习模式、增加临床见习课时,达到提高教学效果的目的。方法：临床医学专业在学习两年半基础医学课程后,随机抽取一个班,按照学校新的培养方案进行临床医学专业课教学,并与其他传统的临床教学模式教学点的学生进行比较。结果：教改班的病历分析成绩排第2名,明显高于其他几个班级。其他成绩无明显差异。结论：新的课间见习模式,使学生早接触临床、患者,使得理论学习与临床实践阶段相结合,又能够培养实践工作能力和锻炼临床思维能力。