实验室管理法制化是检验医学发展需要

《医疗机构临床实验室管理办法》的出台，标志着临床实验室法制化、规范化、标准化管理从此进入了一个新的阶段，其宗旨和目的是为了加强对临床实验室的管理，保证医疗质量和医疗安全。《医疗机构临床实验室管理办法》作为国家第一部专门针对临床实验室管理而制定的国家规章，既对医疗机构临床实验室质量管理提出了更高的要求，也对提高检验医学在临床的地位起到推动作用，使我国的实验室管理逐步与国际接轨。我们认真学习领会《办法》以指导工作，同时也遇到一些困惑。近年来，检验医学虽然发展很快，但由于实验室管理法规滞后，阻碍了检验医学的发展，实际操作中遇到一些问题希望通过法制化建设来解决。     

血站实验室生物安全管理的体会

血站实验室的生物安全对血站的质量管理和临床用血安全至关重要。对血站实验室严格把关，加强实验室的全面质量管理，避免实验室人员职业暴露是血站管理者的重要职责。笔者根据工作中的经验和体会，对血站实验室生物安全的管理进行了探讨。     

对检验科管理的几点看法

一、依照法律法规对临床实验室进行管理临床实验室的检验结果是面对着广大患者和群众，它的准确与否直接关系到患者的安危。由于化验结果的误差，不能对患者病情进行及时诊断及治疗或得以不必要的治疗，均会给患者及社会带来巨大的损失。目前随着我国医疗保险制度的实施，许多化验数据将是医疗保险具体实施的依据，加强临床实验室的管理已成为医疗机构面对的重要课题。国际上，有的国家对医院临床实验室的管理有专门的法律，如美国国会在１９６７年通过第一个专门对临床实验室管理的法律，即临床实验室改进法案（ＣｌｉｎｉｃａｌＬａｂｏｒ…     

临床实验室微机网络化管理探讨

临床实验室微机网络化管理探讨金亚平吴敏良顾人德我院对临床实验室微机网络软件经４年多时间的开发与应用，基本形成了现代实验室微机网络化管理的雏形。一、微机网络系统及硬件设置选用Ｎｏｖｅｌ网络环境，系统用Ｆｏｘｂａｓｅ关系型数据库语言编写，服务机用ＰＣ４８...     

医学院校临床实验室的规范化管理

分析高等医学院校临床实验室管理系统的构成，介绍高等医学院校临床实验室管理系统的模块化设计，说明高等医学院校实验室的计算机管理是实验室规范化管理的重要手段及评估指标。     

加强临床实验室管理 适应医疗体制改革

文章根据医疗改革和医疗市场竞争对医疗单位的影响。分析了临床检验实验室目前存在的问题及其应采取的应对措施。探讨了临床实验室的管理构想，其核心就是要做好质量控制和管理，实施的前提是要建立一个完整的质量保证体系。     

对临床实验室生物安全管理的建议

医学临床实验室生物安全是社会安全的一部分.本文简要介绍了医院临床实验室生物安全发展的现状,针对其特点阐述了常见的生物危害;结合国外相关的生物安全管理措施,就医院实验室的生物安全管理问题做了思考,并根据国家实验室安全管理的法律法规提出了加强临床实验室生物安伞管理的一些建议.     

临床医学实验室的建设和人才管理

医学实验室在医院进行科研、人才的培养中发挥着越来越重要的作用，但是传统的医院实验室模式严重影响了医院的发展，难以适应市场经济的发展和需要。我院通过对传统的实验室管理模式进行改革，取得了一些成功的经验与体会，即加大实验室管理，建立新的医学检测中心；规范实验室的管理模式，统一科研及临床检测的设备；建立一支高素质的专业实验技术人员队伍及临床型的专业队伍。     

综合性医院科研实验室整合资源提高效率的探讨

医院科研实验室是医疗、教学、科研水平的综合体现。通过对上海市某综合性医院科研实验室的现状分析发现，目前科研实验室存在管理缺乏统一规划，实验室建设追求小而全，实验研究人员整体素质不高等问题，导致科研实验室资源浪费，效益不高。因此建议综合性医院确立适合本院科研实验室发展的策略，加强统一管理，成立中心实验室，加强横向联系，整合社会资源，并及时将科研成果转化的临床检验项目。     

临床医学实验室管理与临床科研工作

医学科学的不断发展，临床医学研究与临床医学实验室的发展更加密切。临床科研的主要指标来自实验室。准确的结果是科研结论的可靠依据。实验室质量管理是准确结果的保证。     

Reorganizing a family practice center: strategy to save a residency program at a financially troubled hospital

The family health center of a family practice training program was eliminated from the county hospital budget following funding cuts, forcing the program faculty to create an independent nonprofit community clinic in which to train residents and provide care to established patients. A county audit of the new clinic after 2 years' operation showed substantial savings, particularly for administrative overhead. This report presents data showing the cost advantages to a small private clinic with faculty management compared with costs in a hospital-managed outpatient clinic; the savings were sufficient to assure continuation of the training program. Increased flexibility under faculty management provided a more realistic teaching environment and new research opportunities.     

医院中心实验室的建设及意义

结合实验室未来发展,提出了建立医院中心实验室的指导思想和实施办法;并总结了中心实验室运行一年多来取得的效果,为新形势下医院的建设和发展提供有益的经验。     

Networking services to reach rural outpatients

The outreach program Marquette General Hospital (Marquette, MI) set up provides rural residents with healthcare services close to home. To create the comprehensive network of healthcare services required establishing outlying clinics with facilities and equipment for visiting specialists and sophisticated, yet cost-effective, laboratory testing instruments. The administrators at Marquette General decided an in-house lab at Marquette Medical Clinic would be convenient for patients as well as physicians. In the future, this lab will be linked to a communications system that encompasses the hospital and all Marquette clinic labs.     

Merging lab, drug data boosts disease management

Merging lab and pharmacy data can benefit disease management. Integrating lab data with other data sets gave Blue Cross Blue Shield of Southeast Michigan a way to focus its diabetes disease management program, assess the effectiveness of therapy, and profile physicians. Learn how the plan's experience in data integration can apply to hospital systems and why pursuing a partner in such a project might be a wise move.     

A strategy for supply cost savings

A collaborative team effort and a new software program helped this hospital lab to come in $47,500 under budget on supply expenses.     

医疗制度改革中临床实验室资源的合理利用

医疗改革使临床实验室的地位，作用发生变化，要求实验室资源的合理利用。结合国内实际。借鉴国外经验，作者认为，要以资源考察和成本核算为基础，以病人结果最佳而费用最低为目标，通过提高工作效率，建立成本效果或效益分析，加强同医患的联系，制订采用适宜技术的诊疗技术规范，健全经营补偿机制和合理资源布局等手段，实现实验室资源的合理利用。     

Interdisciplinary Team-Based Management of Heart Failure

Multidisciplinary team disease management has evolved into consensus ‘best practice’ in the care of patients with chronic heart failure (CHF). The mission of disease management for patients with CHF is to shift care from the hospital to the clinic and to the home, optimize quality of care in concert with consensus guidelines, reduce admissions by 40% and improve functional status and quality of life. The Partners Heart Care program has been operational for 5 years and enrolled hundreds of patients throughout the Partners Health Care System in Boston, Massachusetts, USA. This program enrolls patients following hospital discharge in a physician-directed multidisciplinary interventional care program, run by nurse practitioners, which incorporates several levels of care dependent upon patient acuity. Following clinical stabilization and optimal titration of oral therapy in concert with consensus care guidelines, patients transition to a longitudinal care program. The primary responsibility for the clinical care of patients in all phases of the program resides with nurse practitioners and primary care physicians, with heart failure specialists serving as consultants on an as-needed basis. Data on pre-specified program outcomes such as quality of care, mortality, hospital admissions, functional status, procedure use and costs are collected prospectively and provide benchmarks for continuous quality improvement. The most critical lesson learned in development to date is the necessity of precise tailoring of the program to local patient and provider needs with local oversight and management.     

计算机信息技术在我院耗材管理系统中的应用

医用耗材是临床医疗必须的资源,其产品种类和数量繁多,并且呈逐年增加的趋势。耗材管理系统就成了医院信息管理系统的重要组成部分,是加强管理,提高工作效率,减轻劳动强度和降低出错率的重要手段。本文着重介绍了我院耗材管理系统的开发方案及其主要功能。     

The dissemination of a smoking cessation program to 23 antenatal clinics: the predictors of initial program adoption by managers

Objective: To investigate whether the method of dissemination, antenatal clinic practice norms for smoking intervention and subjective evaluation of the attributes of a new smoking cessation program are associated with a nurse unit manager's initial decision to adopt the new program.
Method: Twenty-three hospital clinics were randomly allocated to two groups which received the program either by simple or intensive dissemination methods. Simple dissemination involved a mailout of the 'Fresh Start' program and intensive dissemination involved a mailout which was enhanced by personal contact with midwifery facilitators who provided support and training for the program. It was hypothesised that intensive dissemination would improve program adoption compared to simple dissemination. It was also hypothesised that managers' perceptions of the program and clinic smoking intervention practice norms would predict program adoption. A hierarchical regression analysis was used to examine the association between these variables and the adoption of program components.
Results: The results indicated that the method of dissemination and the managers' perceptions of the program are significant predictors of program adoption.
Conclusions: Although clinic practice norm for smoking cessation education is not a significant predictor of program adoption, it appears to mediate managers' perceptions of the program.     

Developing integrated referral channels for cardiology services

The author describes development of a vertical integration model for building patient referrals and revenue through channel management. The University of Alabama Hospital and Medical Center developed a program in which a satellite clinic was established in cooperation with a rural hospital in Alabama. This type of channel management enabled the medical center and hospital to increase outpatient capacity without affecting on-campus clinics and provided needed increases in the volume of up-channel cardiac services for revenue expansion.