3种模式下医院与社区医生信息沟通现状分析

目的了解不同互动模式下,大型医院与社区卫生服务中心医务人员信息互动情况,为改善两者互动关系提供建议。方法采取典型性抽样方法,调查了武汉市、恩施市、深圳市和南昌市的医院临床医生。结果院管院办模式下的医院医生与社区医生的沟通状况相对更好。互动模式、性别、职称、医院对本院是否开展双向转诊认知、医生是否知晓对口社区卫生服务中心名称、医生认为是否有必要与社区医生进行病人家族史等信息的沟通均对医生对社区基本情况了解程度有影响。结论医院医生对与社区医生的沟通预期不高,同时沟通意识尚未建立。行政部门可督促医院加强对女性医生,中、低职称医生的宣传教育,同时督促社区卫生服务机构提高自身服务水平和服务能力。     

医生绩效考核模型的建立及应用

质量管理作为医院管理的核心和永恒主题，已成为国内外医院管理工作者的共识。医生是医疗服务的提供者，如何使用计算机系统评价医生的医疗行为的质量．公平、公正地考核医生的绩效，是医院绩效管理中的一个重要课题。因此，有效地地运用现代科学绩效管理理论、技术和方法，针对医疗结构质量、环节质量和终末质量进行有效地监控，建立适合我国医院体制下的医生绩效考核系统。     

基于医务人员沟通视角的城市医院与社区卫生服务机构信息互动状况调查研究

目的:为了解大型医院与社区卫生服务中心医务人员信息互动情况,为改善两者互动关系提供建议。方法:采取典型性抽样方法调查了城市医院和社区卫生服务中心临床医生。结果:两类机构临床医生均对双向转诊可行性认知较好,但是50%的受访社区医生不了解上级医院情况。两类机构均有超过一半的医生从未与对方机构医生联系。受访临床医生均对信息沟通现状评价差,但医院医生与社区医生评价差异有统计学意义。结论:目前,大型医院与社区卫生服务机构尚未建立稳定、和谐的信息互动机制。沟通渠道不畅通、资金匮乏、工作量大没有时间是造成沟通不良的主要原因。     

门诊医生站、“一卡通”联合使用效果初探

目的提高医院门、急诊的服务质量、工作效率。方法以门诊医生站和"一卡通"为载体,加强就诊信息共享,优化工作流程。结论门诊医生站和"一卡通"在医院的使用,为患者提供方便、快捷的门急诊就医服务,提高工作人员的工作效率,推进医院现代化管理进程。     

关于征集优秀医学论文的启事

为了鼓励作者撰写高质量的论文,并进一步提高《中国实用乡村医生杂志》的质量,更好地为全国广大基层医务工作者及乡村医生服务,《中国实用乡村医生杂志》编辑委员会根据本刊"读者问卷调查"的反馈信息,决定面向全国各级医院临床工     

互联网医院医疗服务模式及趋势分析

随着"互联网+医疗"的深入发展,以"互联网医院"为代表的新型医疗服务模式逐渐兴起。通过阐述我国互联网医院发展现状,探讨互联网医院医疗服务模式及功能,最后从平台、医生、患者和资源方面对互联网医院的发展趋势作出展望。     

给医生松绑 还须让其飞翔

正"医生集团医疗有限公司"的出现,意味着"医疗服务"可以作为"产品"单独进行工商注册,生产者是医生团体,而不是医疗机构,这是中国工商管理注册的一个重大突破。如何理解医生执业与医生集团服务呢?医生与医院签约是一种用工合同,医生集团与医院签约则是服务合同——提供有价值的服务。对于老百姓看病治疗来说,同样是一件大好事。比如号贩子炒号,由于民众只知道"好医生"在大医院里,至于谁是"好医生",很多民众并不十分清楚,     

产科医护人员接受及给予人性化服务的状况研究

目的 了解产科医护人员接受及给予人性化服务的状况,为改善医护人员服务状态提供依据.方法 在北京、上海、深圳6个综合医院和妇幼保健院进行定性和定量调查,对30名门诊早上9点进入医院接受产前检查的孕妇和58名产科医护人员进行访谈,对120名门诊孕晚期孕妇进行问卷调查.结果 门诊医生每3～6分钟接诊1名就诊者,对就诊者想了解的病情解释少.大多数门诊出诊医生没有时间上厕所及喝水,中午没有时间休息,大多数医院没有为出诊医生提供饮水和工作餐等便捷服务.从孕妇的角度分析,医生对孕妇的微笑次数多于咨询台、分诊台、挂号室、收款台的工作人员,差异有显著性(t=3.426,P<0.05);孕妇对医生服务态度的满意度得分(3.93±0.64)比对护士和前台工作人员(3.43±0.77)高,t=2.730,P=0.01.但孕妇对"医生看病时是否称呼您的名字"、"看病时是否告诉您相关的保健知识"、"看病所用时间"较为不满意;认为医生的接诊量过大.结论 医生能够热情的为就诊者服务,但是医生接诊量大,自身得到的人性化服务不足,就诊者对接诊量、看病时间和获取知识方面不满意.医院过多注意对就诊者的人性化服务,疏忽了对医护人员的人文关怀服务,呼吁加强对医疗人才的保护.     

医疗服务信息系统在当今医疗市场的应用

<正>医疗服务信息化是国际发展的趋势。随着信息技术的快速发展,国内越来越多的医院正加速实施基本信息平台及医疗服务信息系统的整体建设,以提高医院的服务水平与核心竞争力。"十二五"是深化医药卫生体制改革,实现"为群众提供安全、有效、方便、价廉的医疗卫生服务"总体目标的关键时期,全面提升医生的工作效率,使医生有更多的时间为患者服务,提高患者 更多还原     

声音

正"卫生计生系统要加快推进职能转变和机构改革,建立城市医生下基层的长效机制,有效提升县医院和社区卫生机构的服务能力,适当提高基层医疗卫生机构奖励性绩效工资比例,积极落实乡村医生养老政策。"近日,国家卫生计生委主任李斌在海南省调研卫生计生工作时提出,要以县级公立医院综合改革为突破口,加快推     

我院对首例艾滋病住院患者的护理体会

目的:探讨护理人员消除对艾滋病人的恐惧心理,对患者做好心理护理、药物治疗观察和饮食指导等措施和方法.方法:介绍对首例艾滋病住院患者的护理体会.结果:患者及亲属对病情有了正确认识,患者病情好转出院.结论:护理人员消除对艾滋病人的恐惧心理,是做好艾滋病住院病人护理工作的前提.     

患者体验评价研究与进展

本文评述了患者体验相关内容和国内外患者体验的研究现状与进展,对患者体验及患者满意度进行了比较.文章建议加强对患者体验理论和测评方法及患者体验分析方法等方面的研究,制定符合中国国情的患者体验调查与评价规范,从而建立更为科学有效、符合我国国情的患者体验评价体系.     

Defining Patient Engagement in Research: Results of a Systematic Review and Analysis: Report of the ISPOR Patient-Centered Special Interest Group

ObjectivesLack of clarity on the definition of “patient engagement” has been highlighted as a barrier to fully implementing patient engagement in research. This study identified themes within existing definitions related to patient engagement and proposes a consensus definition of “patient engagement in research.”MethodsA systematic review was conducted to identify definitions of patient engagement and related terms in published literature (2006-2018). Definitions were extracted and qualitatively analyzed to identify themes and characteristics. A multistakeholder approach, including academia, industry, and patient representation, was taken at all stages. A proposed definition is offered based on a synthesis of the findings.ResultsOf 1821 abstracts identified and screened for eligibility, 317 were selected for full-text review. Of these, 169 articles met inclusion criteria, from which 244 distinct definitions were extracted for analysis. The most frequently defined terms were: “patient-centered” (30.5%), “patient engagement” (15.5%), and “patient participation” (13.4%). The majority of definitions were specific to the healthcare delivery setting (70.5%); 11.9% were specific to research. Among the definitions of “patient engagement,” the most common themes were “active process,” “patient involvement,” and “patient as participant.” In the research setting, the top themes were “patient as partner,” “patient involvement,” and “active process”; these did not appear in the top 3 themes of nonresearch definitions.ConclusionDistinct themes are associated with the term “patient engagement” and with engagement in the “research” setting. Based on an analysis of existing literature and review by patient, industry, and academic stakeholders, we propose a scalable consensus definition of “patient engagement in research.”     

Does the concordance between medical records and patient self-report vary with patient characteristics?

Few studies of the concordance between patient self-report and medical record data have examined how concordance varies with patient characteristics, and results of such studies have been mixed. Given discrepancies in the quality of care received across patient cohorts, it is important to understand the degree to which concordance metrics are robust across patient characteristics.We hypothesized that concordance between ambulatory medical record and patient survey data varies by patient demographic characteristics, especially education, income, and race/ethnicity. We present the results of bivariate and multivariate analyses including data from 1,270 patients with at least one of: diabetes, ischemic heart disease, asthma or COPD, or low back pain sampled from 39 West Coast medical organizations.We present total agreement, kappa, and survey sensitivity and specificity, stratified by patient demographic and health status characteristics. We conducted logistic regressions to test the impact of patient demographic characteristics, domain of medical care, and health status on these three measures of concordance. Survey sensitivity varied significantly by race/ethnicity in bivariate analyses, but this effect was erased in multivariate analyses. Our findings do not support the hypothesis that patient education, income, or race/ethnicity have an independent effect on concordance when controlling for other factors. However, concordance varied significantly by patient health status. The medical record and patient self-report do not measure quality comparably across patient cohorts. We recommend continued efforts to improve survey data collection across different patient populations and to improve the quality of clinical data.     

The (dis)appearance of the dying patient in generalist hospital and care home nurses' talk about the patient

Abstract This article explores interview data from a study of 50 Norwegian generalist nurses' focus group accounts of caring for dying patients in the hospital and care home. An eclectic discourse analytic approach was applied to nurses' accounts of the patient and three discursive contexts of reference to the patient were identified: the ‘taken as read’ patient, the patient paired with particular characteristics and the patient as psychologically present. Talk about the patient falls mainly into the first two contexts, which position the patient in relation to three closely related discursive processes: individualization, anonymization and objectification. The third context presents the patient as a person with a particular identity. The analysis is discussed in a broader philosophical and sociological context in which we return to some of the theoretical work on death and dying of the 1990s and the topic of sequestration. We suggest that nurses' talk about the patient can be heard to participate in a continuing sequestration of the dying patient in healthcare institutions focused on ‘result‐oriented’ care.     

患者价值差异模型的构建及启示

患者价值是顾客价值理论在医疗领域的延伸,由于医疗行业的特殊性,患者和医生在不同的角度对患者价值的理解具有差异。通过剖析患者价值维度,构建了患者价值差异模型,探索医疗服务提供方与患者在患者价值方面存在的差异。根据模型启示,提出将患者价值纳入患者满意度评价范畴,注重患者情感需要来提高患者感知价值,以及将患者价值纳入制度化建设从而实现患者价值与医疗机构价值的统一。     

Patients' informed consent requires understanding of treatment risks

The need for patient consent to medical treatment derives from the idea that the patient is morally obligated to take ordinary means to preserve his or her life. The physician has only that right over the patient which the patient gives him. To ensure that patient treatment decisions are responsible, consent must be both free and informed. Free consent generally implies that the patient is under no pressure to choose a particular course of action. Informed consent suggests that the physician has a duty to give the patient sufficient information about a proposed procedure's significant risks and benefits. The patient need not receive comprehensive knowledge of the treatment, however, since overdisclosure can interfere with the freedom to decide by playing on patient fears. Though some patients simply disregard treatment information or rely on other factors in their decision making, physicians should not abandon attempts to attain patient understanding. They must develop communication skills and exercise patience in their efforts to explain treatments and obtain consent. Proxies and patient advocates also may be requested, and physicians may consult with their colleagues to guarantee that the patient's best interests are met.     

Do electric patient beds reduce the risk of lower back disorders in nurses?

The aim of this study was to compare the probability estimates of lower back disorder (LBD) for a nurse performing a range of simulated patient care activities involving manual and electric patient beds. Studies of simulated patient care involving patient beds were undertaken using electrically powered and manually operated patient beds. The estimated probabilities of back injury, as calculated by the Lumbar Motion Monitor (LMM), between the two beds were compared statistically. A statistically significant reduction in LBD probability was observed in those functions that were completely achieved by the electrical mechanism. No significant difference in risk was observed in the patient care activities involving manipulating the patient in and around the bed that are more typical of 'heavy' orthopaedic nursing care in a busy acute ward environment. A potential for increased patient independence was observed during this trial. The LMM recorded no real risk reduction between situations involving electric or manual patient beds in those actions typically required of nurses in an acute orthopaedic ward caring for a disabled patient.     

患者安全文化建设实践研究

基于艾德希恩三层次文化理论,通过培养医务人员患者安全意识,促进患者安全行动,构建多元素患者安全文化,并以患者安全文化建设为基础,进一步拓展患者安全文化外延,向患者家属、家庭、基层医疗机构、社区、社会延伸,广泛传播患者安全文化。该项目降低了不良事件发生率,提升了医护人员职业认同感,形成了一系列患者安全文化成果转化。通过患者安全文化建设和传播,对推动全民健康覆盖率,建设健康中国具有重要意义。     

国内外医患纠纷调处模式比较研究

面对日益增多的医患纠纷,各级政府和卫生行政部门正在积极探索调处纠纷的有效途径。文章通过分析现行医患纠纷调处模式,指出第三方调处医患纠纷应该成为调处医患纠纷的发展方向。