门诊分时段预约挂号流程再造

＂挂号难＂一直是各大医院致力解决的难题,医院在缓解患者挂号难的问题,继预约挂号之后,提出分时段预约挂号;着重介绍医院分时段预约挂号实践探索及其产生的社会意义。     

分时段预约挂号的流程优化与实践

实行门诊分时段预约挂号[1],病人可根据自己的时间预约就诊的确切时间,届时只要按照约定的时间点提前30 分钟到门诊相应的分诊台确认候诊即可;分时段预约挂号就诊流程十分便捷,大大缩短了候诊时间,在一定程度上缓解了"看病难、看病烦"的问题;我院每天门诊量约7 千人次,笔者结合医院近年来对专家预约挂号的推广实施情况,认为门诊分时段预约挂号是合理分流门诊病人就诊最有效方法之一;通过不断优化流程和实践,证明分时段预约挂号已逐渐被广大患者所接受.     

分时段预约挂号就诊在医院管理中的应用

目的分析在医院的管理与实践中应用分时段预约挂号就诊的效果。方法分别调查分时段预约挂号实施前后在我院就诊的患者,在实施前调查120人,在实施分时段预约挂号四个月以后,调查150人,同时调查25名护士与25名坐诊医生,分析分时段预约挂号实施情况。结果患者管理的难度改善效果、患者配合的程度改善情况较患者对于医护人员的压力改善情况好,差异明显(P<0.05),存在统计学意义;实施后的就诊等待时间与满意度评分明显比实施前好,差异明显(P<0.05),存在统计学意义;预约患者的就诊等待时间与满意度评分明显比非预约患者的好,差异明显(P<0.05),存在统计学意义。结论应用新型预约挂号体系,可以方便患者就诊,同时能够缓解大型医院的门诊挂号难问题。     

分时段预约挂号的实现与应用

我院依托医院信息化平台,在创新预约挂号模式,预约号源管理,改善预约挂号服务等方面进行了积极的尝试,尤其在预约挂号方式上,实行分时段预约就诊,推行专家门诊和普通门诊全预约诊疗,由患者自主选择就诊时间,最大程度满足广大群众就医需求,缓解门诊供需矛盾,使门诊医疗活动更加文明有序,缓解患者看病难的突出问题.     

大型综合性医院分时段预约的实践

目的：缩短患者挂号及候诊时间,提高患者满意度,提高医疗资源利用率。方法将实施分时段预约后与实施之前患者挂号及候诊时间、满意度等进行比较。结果开展分时段预约后,患者挂号、候诊时间明显缩短（P ＜0．01）,患者满意度明显提高（P ＜0．01）。结论分时段预约可缩短患者挂号、候诊时间,提高患者满意度,提高医疗资源利用率,提升医院的品质。     

专家门诊预约挂号的实践效果及体会

目的通过调查某大型三甲综合性医院专家门诊预约挂号推进情况,分析实施过程中的不足,为完善专家门诊预约挂号管理与全面推进门诊实名制预约挂号提供一些可行性的建议。方法采用回顾性调查方法,对医院2011—2013年的专家门诊预约挂号情况及影响因素进行总结分析。结果门急诊部采取加大医患双方的宣传力度、整合预约平台、健全服务措施后,专家门诊预约挂号比例明显上升,优化了患者的就医体验,但仍需完善后续服务,控制失约率。结论预约挂号的完善和发展需要医患双方的共同努力,医院应进一步细化分时段预约,改变传统的就医习惯,引导患者合理就诊,使有限的医疗资源最大限度地发挥。     

预约诊疗服务新模式——分时段就诊

利用信息化手段开展门诊预约诊疗服务,可优化门诊诊疗服务流程,节省患者排除挂号、交费及候诊时间,方便患者就医。苏州大学附属第一医院结合医院门诊的实际,启用分时段预约模式,采用多通道终端载体的预约挂号技术,实现医院门诊流程的优化,提高了工作效率。     

实行门诊预约挂号分时段就诊服务的体会

我院门诊于2009年11月开始提供全面的实名制预约挂号和分时段就诊服务,有效地分流了挂号病人,减少了病人就诊排队时间.为患者提供了"优质、优价、便捷"的人性化服务.     

我院推进“预约诊疗服务”的做法与成效

门诊预约挂号服务是患者就诊前通过各种方式提前预约就诊的专家和就诊的时间,按规定时间到医院就诊的挂号方式[1],是缓解“挂号难”、“看病繁”的有效举措.我院从2012年开始启用预约挂号,经过4年的推广使用,预约挂号形式不断丰富,服务也日趋完善,患者的接受和使用程度在不断提高.通过分时段就诊,明显减少了患者现场排队等候时间,满足了不同层次患者的需求,有效地提高了医疗资源的利用效率.     

门诊预约挂号存在的问题与对策

为了提高门诊预约挂号的预约率,建立分时段预约挂号系统。通过对预约现状的分析总结,采取分时段预约系统软件开发、加大宣传和增加预约号源等对策,提高了预约人次,缩短患者等候时间,合理利用医疗资源。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.