浅谈医院门诊对病人信息公开和保护政策

根据卫生部关于全面推行医院院务公开的指导意见,结合中国医院门诊对病人信息如何公开提出一点建议和看法,以树立医院门诊的形象和维护病人的隐私权与知情权,希望能有效地协调医院门诊信息公开与病人隐私权保护之间的冲突。     

医疗信息公开与医疗服务监管的DADS模式

医院作为福利性的社会公益机构,其内部运作的神秘性和信息的不透明性,以及监管职能的弱化与困难,使公众的信任和利益受到严重的损害。“披露—分析—发布—惩罚”解决方案(DADS模式)对完善我国医疗信息公开政策、加强医疗服务监管,恢复公众对医院及医疗服务人员的信任具有重要的指导意义。     

科技期刊对自主科技创新成果的传播策略研究

运用传播学原理研究了科技期刊对自主科技创新成果的传播策略。提出科技期刊要搞好自主科技创新成果的传播应当瞄准学科发展前沿,定位创新成果目标;挖掘稿件科技创新价值,发挥期刊创新品牌效应;培养企业创办期刊,推动创新成果转化。     

肺癌伴上腔静脉阻塞综合征患者的护理体会

目的:探讨上腔静脉阻塞综合征患者的护理措施,以期达到最佳的治疗效果。方法:报道8例肺癌伴上腔静脉阻塞综合征患者的临床治疗经过,并对护理措施进行总结分析。结果:8例患者经实施完整而系统的护理措施,配合放疗或静脉化疗,上腔静脉阻塞综合征的临床症状得到缓解。结论:积极系统的临床护理是上腔静脉阻塞综合征患者症状缓解不可缺少的重要措施。     

Development of claims‐based measures of unplanned acute care with superior power for assessing the effectiveness of interventions following acute care

ObjectiveTo develop outcome measures that are more sensitive than current measures for evaluating primary or transitional care after hospitalizations, emergency department (ED) visits, or observation stays.Data SourcesMedicare claims data from January 1, 2015, to October 31, 2017, for 1 261 707 Medicare fee‐for‐service beneficiaries served by (a) primary care practices participating in Track 1 of the Comprehensive Primary Care Plus (CPC+) initiative, and (b) their matched comparison practices.Study DesignGiven the poor statistical power in many studies to detect effects on readmissions, we developed two novel claims‐based measures of unplanned acute care (UAC) following an index acute care event. The first measure assesses the proportion of hospitalizations followed by an unplanned readmission, ED visit, or observation stay within 30 days of discharge; the second assesses the proportion of ED visits and observation stays followed by a hospitalization, ED visit, or observation stay within 30 days. We calculate minimum detectable effects (MDEs) for both measures and for a conventional measure of 30‐day unplanned readmissions, using CPC+ data.Principal FindingsRepeat UAC events are common among Medicare beneficiaries served by the CPC+ practices. In 2017, 22% of discharges and 21% of ED visits and observation stays had a UAC event within 30 days. Readmissions were the most common UAC event following discharge, whereas ED visits were most common following index ED visits or observation stays. MDEs are 25%‐40% lower for the new measures than for the standard 30‐day readmissions measure, indicating better statistical power to detect impacts of primary or transitional care interventions.ConclusionsThis study introduces two new claims‐based measures to assess quality of care during a patient''s vulnerable period following acute care. The new measures complement existing measures, covering a broader range of UAC events than the standard 30‐day readmissions measure, and yielding greater statistical power.     

Symbols were superior to numbers for presenting strength of recommendations to health care consumers: a randomized trial

OBJECTIVE: To compare health care consumers' understanding, evaluations, and preferences for symbols vs. numbers and letters for the representation of strength of recommendations (SOR) and quality of evidence (QOE). STUDY DESIGN AND SETTING: Questionnaire study in a randomized controlled design in the setting of a community health education program. RESULTS: Eighty-four participants completed the questionnaire. For the presentation of the SOR, participants had better objective understanding of symbols than numbers (74% vs. 14%, P<0.001). They also scored symbols positively, and numbers negatively for ease of understanding (mean difference [md]=1.5, P=0.001), clearness and conciseness (md=1.5, P<0.001), and conveyance of the degree of uncertainty (md=0.7, P=0.092). About half (48%) preferred symbols over numbers. For the presentation of the QOE, objective understanding of symbols and letters was similar (91% vs. 95%, P=0.509). Participants scored both symbols and letters positively; the scores for symbols were however lower for ease of understanding (md=-0.7, P=0.019), clearness and conciseness (md=-0.6, P=0.051), and conveyance of the QOE (md=-0.4, P=0.24). CONCLUSION: Symbols were superior to numbers for the presentation of the SOR. Objective understanding was high for both symbols and letters for the presentation of the QOE, but letters conveyed the QOE better than symbols.     

和上司一起跳槽后

跳槽,跳槽,越跳越高,更何况,你还是有幸和你的上司一起跳槽。这不仅意味着你们的才智备受上司的器重,更意味着你的职场生涯在上司的提携下上了一个台阶,让你觉得事业更有了奔头和发展。可是,当你摩拳擦掌,雄心勃勃准备再接再厉大干一场时,新的公司里各种意想不到的问题,特别是错综复杂的人际关系,如巨石般挡住了你前进的步伐,打击了你火热的激情,让你迷惑和痛苦。 于是,我们需要上一堂关于和上司一起跳槽后的职场心理课——     

扬"八荣"弃"八耻"构建和谐医患关系

随着我国经济和社会的发展,当前医疗卫生行业存在着一些不健康的、不文明的现象,一些人思想观念混乱,道德滑坡;医患矛盾突出。笔者从分析“八荣八耻”的实质和哲学内涵出发,提出牢固树立以“八荣八耻”为内容的社会主义荣辱观,对于维持群众切身利益、构建和谐医患关系、促进卫生事业发展的重大意义,并指出贯彻落实“八荣八耻”的有效途径。     

做一个比上司还"聪明"的人

人在职场，我们都逃不过要面对上司，因此，与上司相处就是每个在职者的必修课。这个学问深无止境，让你有无限深造的可能。没有什么不可能，只要你掌握了以下秘笈，一定会成为比上司还“聪明”的人。     

上腔静脉置管后皮下埋藏导管药盒与普通上腔静脉置管方法的临床对比观察

目的对比上腔静脉置管后皮下埋藏导管药盒（Port-Cath）与普通上腔静脉置管方法的方便性和并发症的临床观察。方法选择40例病人分为两组,A组病人经锁骨下静脉穿刺上腔静脉置管后皮下埋藏带导管药盒（Port－Cath）,B组病人经锁骨下静脉穿刺上腔静脉置双腔导管。结果Port－Cath组患者发生皮下血肿2例（占10％）,导管堵塞4例（占20％）,导管与Por连接处脱开1例（占5％）。B组患者发生导管堵塞1例（占5％）,导管移位1例（占5％）,两组无感染并发症发生。A组保留时间在30～790天（平均166天）,B组置管保留时间在15～90天（平均22天）,两组之间有统计学上显著性差异（P＜0．05）。两组均无气、血胸并发症发生。结论传统上腔静脉置管方法操作简便、并发症少,适用于需中心静脉置管2周至3个月的患者使用,而Port－Cath具有放置时间长,不影响日常生活等特点,更适合于需中心静脉置管3～6个月以上的晚期肿瘤患者化疗及输液治疗使用。