How to improve performance and prevent burnout in safety representatives

Background:The present work is part of a greater research project, aimed to examine Safety Representatives’ (SRs) role, twenty years after the appointment of this figure.Objectives:The study aims to investigate the role of some personal and organizational dimensions in the promotion of SRs’ well-being, in terms of reducing burnout and improving performance.Methods:The study involved 455 SRs operating in North East Italy. They completed a self-report questionnaire, regarding conflicts with co-workers, ethical conflict, training satisfaction, work engagement, performance, and burnout.Results:Structural equation models show that work engagement partially mediates (γ=-0.52, p<0.001; β=0.23, p<0.01) the relationship between conflict with co-workers and performance (γ=-0.26; p<0.01), as well as partially mediating (γ=0.14, p<0.05; β=0.23; p<0.01) the relationship between training satisfaction and performance (γ=0.21, p<0.001). Moreover, it totally mediates the relationship between conflict with co-workers and burnout (γ=-0.52, p<0.001; β=-0.40, p<0.001), as well as totally mediating the relationship between training satisfaction and burnout (γ=0.14, p<0.05; β=-0.40, p<0.001). Finally, ethical conflict is positively associated with burnout (γ=0.047, p<0.001).Conclusions:This study provides useful information about the improvement of SRs’ well-being, highlighting the importance of their involvement in this role.Key words: Safety representatives, conflict, training, work engagement, performance, burnout     

如何做好介入材料的规范化管理

医院对介入材料实行招标采购的形式,增加了院务的透明度,降低了医疗成本,加强了医院的廉政建设.对介人材料从招标采购至入库使用采取科学规范化的管理,收效十分显著,对医院医疗发展和管理建设有重要的意义.     

Quality assurance in radiotherapy. How to improve the effectiveness and completeness of an electronic patient's chart

A checking form was introduced in order to test the completeness of electronic and paper patient's charts in a radiotherapy department which had introduced record-and-verify system (RVS) and to improve tha staff performance. The chosen items for the electronic chart were 9 and 5 for paper chart. 223 patients were reviewed in two phases. The data analysis was based on a scoring method, attributing a positive score (+1) to the operator's good behaviour, a negative score (-1) to the lack of data input and a neutral score (0) to the inapplicable situation. The average global score increased from 0.4 to 0.7: in A (lowest complexity) category from 0.37 to 0.64, in B category from 0.4 to 0.89, in C category from 0.48 to 0.61.     

浅谈如何创新农保管理 提高医院经济效益

探讨创新农保管理,以提高医院经济效益。就当前农保管理中存在的问题进行分析,提出相应的对策新农保解决了农民看病难看病贵问题,避免农民因为看病导致贫困现象,缓解医患冲突,创建了和谐有序的医疗环境。从新农村合作医疗推行之后主要受益群体和一环关系两个方面来研究新农保的管理问题,期许为提高医院绩效提供有价值的参考。     

How to report and monitor the performance of waiting list management

OBJECTIVES: Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management. METHODS: There were 1,774 waiting list patients for hallux valgus or varicose vein surgery or sterilization. The waiting time distributions of patients receiving surgery and of patients still waiting for an operation are presented in column charts. The charts are compared with two model charts. One model chart presents a high queue discipline (first in-first out) and another a poor queue discipline (random) queue. RESULTS: There were significant differences in waiting list management across hospitals and patient categories. Examples of a poor queue discipline were found in queues for hallux valgus and varicose vein operations. CONCLUSIONS: A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.     

Reducing burnout and stress: the effectiveness of clinical supervision

Health visitors and school nurses have been identified as a particularly vulnerable group to stress given the complex, frontline clinical work that they are involved in. Recent high-profile reviews of safeguarding practices have brought an increased pressure on the profession. This paper provides evidence of the effectiveness of a model of clinical supervision that reduced burnout and stress for health visitor and school nurse Leaders. Commissioned by NHS West Midlands, the project delivered supervision to health visitors and school nurses with a safeguarding leadership responsibility within their organisation.     

How to improve patient education

There are a variety of ways to improve patient education. Healthcare managers should investigate the best practices used by the most successful providers and adapt the best ideas for use in their own organizations. Healthcare providers are increasingly recognizing that developing an effective system of patient education is one of the most cost-effective ways to maintain the health status of chronically ill patients. In an era of capitated payment and competition, the provider who can successfully partner with its patients to manage their health will be the one to survive.     

教你提高免疫力

我们中有些人在流感袭来时很容易就传染上了，而另一些人对任何感染都有较强的抵抗力。我们通常用免疫系统的强弱来解释这种现象。在谈到如何提高免疫力的问题时，让我们首先——     

How to improve hospital-physician relationships

For healthcare organizations (HCOs), successfully partnering with physicians is the strategic imperative. A number of misperceptions and limiting beliefs compromise partnering initiatives. To pursue a more successful approach to partnering, it is important to understand some of the forces that are affecting the healthcare industry. The accelerating pace of change demands that healthcare leaders serve as change agents, evoking resentment from the majority of healthcare stakeholders. Demands for measured accountability and the shift of control from provider to consumer threaten the physician perception as "captain of the ship." Cultural differences between the expert culture of physicians and the affiliative culture of the HCO perpetuate feelings of distrust and compromise efforts to actualize interdependencies. Economic pressures and an unwillingness to make time to engage in dialog prevent the provider community from serving as a creative force in shaping its own future and restrict the ability to build the mutual trust that is necessary for the establishment of successful relationships. Measures that would enhance the likelihood of forming successful and lasting relationships include the following. Adopting an orchestration model would allow a flexible way to bring services to a community. It may be the only way to simultaneously integrate and specialize. Budgeting to reflect service-line functioning would allow the systematic integration of patient care throughput and provide a necessary metric for assessing clinical and operational performance. Segmenting the medical staff would allow the establishment of pluralistic relationships based on shared goals and values and allow change agents to lead to critical mass rather than consensus. Focusing on the customer would ensure relevance in the changing medical marketplace. Adopting a complexity science metaphor rather than continuing in a command-and-control, top-down organizational structure would enhance adaptability and help maximize human capital. Most importantly, forming relationships that center around shared purpose and values will lay the foundation for excellence and sustainability while restoring a sense of meaning, pride, and joy to the healthcare professions.     

食品监管存在的问题与建议

随着阜阳奶粉事件曝光，食品的监管问题再次被引入社会视线，央视的每周质检也经常涉及食品问题，上至中央．领导，下到平民百姓都非常关注，食品卫生安全成为今年两会期间的重要话题。国务院为此专门下发了《关于进一步加强食品安全工作的决定》，将食品的管理部门由原来的1家增至5家。     

Using performance indicators to improve performance.

The recent introduction of performance assessment within the UK NHS, incorporating numerous performance indicators (PIs) and league tables, has led to health care organisations facing large numbers of targets and a star rating system with associated rewards and penalties. However, there is considerable evidence that using PIs for judgement rather than learning provides perverse incentives and can prove counterproductive. Drawing on earlier PI systems which, supplemented by expert systems, were designed to promote learning and exploration particularly by encouraging analysis of interactions between different indicators, a series of 'mini case studies' is presented. These reveal interesting relationships and suggest explanations for variations in performance, areas worth exploring further and possible approaches to improving performance -- approaches not apparent from individual indicators and league tables. It is concluded that presentation of PIs in a format that encourages exploration and analysis could greatly enhance the potential of the current PIs to improve NHS performance.     

Change of heart. How a team of North Kirklees primary care trust clinicians used performance management principles to improve coronary heart disease services

PURPOSE: North Kirklees, an urban area in the East of England, known to have a 6.8 percent incidence of Coronary Heart Disease (CHD), embarked on a nurse-led CHD primary prevention service in order to improve residents' health. This paper seeks to investigate this serice. DESIGN/METHODOLOGY/APPROACH: Keen to utilise the principles of performance management, the team applied the European Foundation for Quality Management (EFQM) Excellence Model RADAR logic believing that it would strengthen their "results orientation". This paper investigates the results. FINDINGS: Using RADAR, the team identified baseline data for CHD health indicators. The teams were then equipped to set targets for continuous improvement, thereby increasing their potential to progress local residents' health. The case-study findings enable others to adopt a similar approach in their pursuit of excellence. RESEARCH LIMITATIONS/IMPLICATIONS: The CHD Primary Prevention team focused only on performance results in the first instance and did not look at other EFQM Excellence Model results areas. ORIGINALITY/VALUE: The paper describes an original case study into how nurses applied RADAR, which gives insight into the team's experiences during their 18-month journey.     

加强对口岸供机食品监管有效性的探讨

目的通过该案例流行病学调查分析,加强对供机食品监管的有效性。方法对温州航空食品实业公司的供机食品:正餐冷荤、正餐水果和点心面包,进行卫生监督检验。结果两份供机食品样品检测大肠菌群严重超过卫生标准。结论检验检疫机关应当加强对航空供机食品卫生监督,改善食品加工场所,作业流程,提高员工个人卫生意识,防止病源微生物污染供机食品,保证食品卫生安全。     

定点医疗机构的监督与管理

将定点医疗机构的监督管理置于基本医疗保险的核心部位、中心环节来抓，能有效制止不规范服务行为，确保参保人员基本医疗权益。逐步建立医疗保险经办机构、定点医疗机构和参保人员相互影响、相互作用、相互监督的关系，才能不断提高医疗保险管理服务能力和水平，实现对定点医疗机构监督管理的最优效果。     

公共卫生监督管理工作规范的探讨

近年来，为适应公共卫生执法工作的需要，我县在逐步调整充实相应监督科室和卫生监督管理人员的基础上，先后制定了卫生监督人员道德规范和卫生监督工作差错责任追究等一系列制度，有力地促进和规范了全县公共卫生监督工作的开展，保障了人民身体健康。但是，在卫生监督管理工作中，仍存在执法不严、违法不究等严重影响公共卫生监督管理职能发挥和有损卫生部门声誉的不良现象，这是降低卫生部门和公共卫生法规权威的一个重要原因。