利用"军字一号”工程加强信息资源的有效应用

为探讨“军字一号”工程的信息资源的有效应用。本阐述了“军字一号”工程建设对信息资源利用的影响以及医院信息资源利用在医疗和管理中的作用与价值,提出了加强医院信息资源有效应用的方法和措施。     

"军字一号”工程的建设与应用

目的：为探讨“军字一号”工程建设与应用中存在的问题和解决的办法。方法：调查部分正在运行和准备运行“军字一号”工程的医院。结果：在“军字一号”工程的建设与应用方面,虽然已取得了很大的成绩和许多成功的经验;但也存在一些共性问题。结论：提高主管领导的认识,建立平稳运行的系统,搞好建管用的衔接,达到管理模式的转变,对在全军医院用好“军字一号”工程,发挥现代医院管理效益,提高管理水平是必要的。     

“军字一号”工程与兰州市医疗保险接口方案

通过对医院HIS系统和地方医保系统优缺点对比分析,结合医院“军字一号”工程的应用实际提出了医院“军字一号”工程与驻地医疗保险接口方案。     

“军字一号”工程的实用研究

为探讨“军字一号”工程在医院实施过程中的应用情况,对“军字一号”工程的特点与功能,安全性与稳定性,组织技术与管理等问题进行了阐述;为保证网络畅通,正确指导操作人员严格操作规程,使“军字一号”工程保持良好的运行状态。     

利用"军字一号"工程和PACS提高远程会诊水平

目的：为提高会诊信息的准确性和医学影像质量，减轻远程会诊工作量。方法：医院建立“军字一号”工程和PACS，并把远程会诊系统“军字一号”和PACS融合。结果与结论：会诊病人的临床信息直接人“军字一号”采集，医学影像从PACS采集，既减轻了工作量，又提高了远程会诊水平。     

医院数字化建设的现状与发展思考

南京军区福州总医院以推广应用“军字一号”工程为龙头，按照数字化医院要求，大力推进医院信息系统建设，使卫生资源的利用水平、服务质量、管理水平均得到了提高，促进了医院全面建设。本从战略角度提出数字化医院建设发展方向：向深层次数据利用发展；向临床应用深入发展；向因特网应用发展。指出建设数字化医院应立足中国国情，应选适合与“军字一号”工程融合的设备与技术，开发应用中力求节省高效，不盲目追求高标准，必须高度重视信息安全问题。     

军队医院经费核算系统的设计

为更有效地利用和发挥“军字一号”所拥有信息资源,我们设计了《军队医院经费核算归口软件》。该软件通过提取“军字一号”数据库中的数据,自动生成“军队会计账务管理系统”所需数据,实现了“军字一号”和“军队会计账务管理系统”的对接,达到了信息资源共享,财务归口管理的目的。     

"军字一号”工程在管理决策中的应用

本根据新时期管理在管理决策过程中对信息资源的迫切需求，结合医院管理实际，介绍了应用“军字一号”工程的查询功能在具体工作中产生的作用和效果。     

利用条码技术实现野战医疗中药品的管理

本文从我院野战医疗的实际情况来论证我单位在野战医疗药品管理中采用条形码技术的必要性，体现信息技术的优势、提高药品在整个医院中统一管理和合理应用，做到野战医疗药品和“军字一号”系统中药品管理的统一性。     

应用IC卡技术为社区病人服务

“军字一号”工程已在我院顺利启动，提高了我院医疗信息管理工作的智能化和网络化水平，有效降低了医务工作者的劳动强度，增强了医院的整体实力。针对我院长期就诊的社区病人多的特点，我们对这部分病人的门诊就医也采用了IC卡管理，方便了病人，提高了效率，收到了良好的社会效果。１系统概述“军字一号”工程运行后，我院工作人员及其家属子女的用药，已实行了IC卡管理，提高了这部分病人的门诊划价速度，规范了管理，提高了效率。通过调查分析，我们将“军字一号”工程向外扩展应用，对长期在我院门诊就医的社区病人也实行IC卡管理…     

金卫“军字一号”工程临床诊疗项目字典的初始化和更新维护

金卫“军字一号”工程在全军和地方医院中已陆续投入使用,其对推动我国卫生事业发展起到了很大的作用。做好诊疗项目字典初始化和更新维护,不仅是医院信息系统能否顺利开展应用的重点和难点,而且还是系统能否正常运行的关键工作,本文就有关临床诊疗项目字典的初始化及如何更新维护等方面内容做了探讨。     

医院消耗性器材“零库存”管理方案的建立与实施

目的 完善合理利用资金,理性指导医院消耗性器材库房的管理。方法 通过对医院消耗性器材订货,入库,贮存,出库诸因素运行流程分析。设计出有关允许缺货存贮管理,不允许缺货存贮管理,仓库清理的“零库存”管理数学模型方案,并付诸实施,结果 有效地使消耗性器材既满足临床诊疗需求,又降低了器材积压,资金浪费。结论 它的应用,推广将使医院消耗性器材管理更加规范,合理,有效。     

Establishing a group practice "without walls"

The group practice "without walls" has become a health care delivery system that is preferred by an increasing number of physicians. This article traces the experience of Premier Medical Group, PC, a "second generation" clinic without walls in the Denver Metropolitan area, to highlight the potential benefits and the key issues related to the development and implementation of a group practice-without-walls model of health-care delivery. The model promises to address physician business and professional needs by building on the best aspects of a traditional group practice, in an overall organizational structure that maximizes each physician's autonomy, individual practice style, and practice identity. The successful implementation of a group practice without walls depends upon physician leadership and impetus, clear goals-and-objectives, competent professional staff, and legal-and-financial guidance.     

基于“军字一号”工程的门诊医嘱管理系统构建

针对现有"军字一号"门诊医生站对门诊医嘱支持不完善的问题,拟设计开发一套门诊医嘱管理系统。该系统能将门诊处方智能转换为门诊医嘱,自动生成门诊医嘱单、执行单等,并加强对门诊医嘱的管理,增强门诊治疗数据的可追溯性。使用该系统后门诊医护人员的工作效率将得到较大提高,为部队保障的能力得到增强。     

在医院层面缓解看病难看病贵的“五建立”创新模式

看病难、看病贵是当今社会关注的焦点。高州市人民医院“在医院层面缓解群众看病难、看病贵”课题组,运用建立政府、医院、患者“利益共同体”,建立优势学科群体,建立资源节约型医院运行机制,建立以荣耻观为核心医院文化的优秀团队,建立市、镇、村三级辐射网络的区域卫生防治体系创新模式,取得了减轻政府财政负担、加快医院发展步伐、提高患者满意度、铸就优秀医院品牌的显著成效,医院不断获得殊荣,成为同类医院学习的典范。     

"This clinic is number one": a qualitative study of factors that contribute toward "successful" care at a South African Pediatric HIV/AIDS clinic

HIV/AIDS has significantly affected health care practices. The need for high adherence and regular clinic visits places pressure on health care providers and patients. Poor quality of care has been described in many contexts, but some clinics have achieved excellent treatment results. Using a success case approach, this study aimed to understand factors which contribute to successful care at a South African pediatric HIV/AIDS clinic with documented high patient adherence and follow-up rates. Data included over 50 hours of ethnographic observations and interviews with a total of 35 clinic staff and caregivers. Thematic analysis highlighted strong congruence between caregiver and staff perceptions. Factors which seemed to contribute to successful care included organizational routines, staff-patient relationships, communication, teamwork, leadership, job commitment, caregivers' negative experiences at other clinics, and faith in the "life-saving" care at this clinic. Results suggest the need for all factors to be present in order to promote quality of care. Recommendations for other clinic settings are discussed.     

Implementation of an innovative health service a "real-world" diffusion study

BACKGROUND: Although reporting on the healthcare-setting level of continuance or discontinuance of an intervention once a trial is completed has been recommended, such "real-world" diffusion studies are rare. The present example was made possible by funding to explore opportunities for post-trial implementation of an innovative health counseling intervention for cardiovascular prevention in The Netherlands. METHODS: Between 2001 and 2004, in a longitudinal case study, we compared two healthcare settings: a cardiology outpatient clinic and general practices. Rogers' diffusion of innovations theory served as the theoretical background. Information was extracted from minutes of meetings and informal conversations with health counselors, and checked by the project manager. Additional data were collected from physicians with a short questionnaire. RESULTS: Implementation of the health counseling intervention was successful in the cardiology outpatient clinic, but was unsuccessful in the general practices. Success was related to a centralized diffusion system, stronger "change agent" efforts, avoidance of post-trial interruption of service delivery, easily achievable "reinventions," and positive physician perceptions of the service (i.e., not complex and compatible with current practice routines). Support came from changes in the organization of care that created opportunities for, instead of competition with, the innovative service. However, coincidental events may also have played a part. CONCLUSIONS: Our findings confirm the importance of most theoretically predicted individual and organizational diffusion variables. This implies that the implementation of innovative healthcare services requires attention at both levels.     

The "doctor-customer" relationship: Hippocrates in the modern marketplace

We performed a consecutive survey of 100 people presenting to a hospital injury clinic to ascertain their attitude to terminology currently used to describe them in our own institution and in the international literature. The results of this demonstrated that the subjects significantly preferred the traditional assignation "patient" rather than terms such as client or customer. This finding reflects the need to remember peoples' attitudes and expectations from their consultation with their doctor. Although business models undoubtedly help in the provision of an efficient health care service, remaining at the centre of this encounter is a doctor-patient relationship that involves a more complex interaction than simply a market transaction.     

“QC”小组在医院节能降耗工作中的应用研究

介绍了内蒙古某医院将“QC”小组应用于医院节能降耗工作的具体实施过程及方案;对应用效果进行了评价;对实施过程中存在的问题进行了总结,并提出了针对性的优化策略。     

Cluster randomized trial of a guideline-based open access urological investigation service

BACKGROUND: Out-patient services are trying to achieve effective and efficient health care in overcrowded, busy clinic settings. "One stop" and "open access" clinics have been advocated as a way of improving out-patient services. OBJECTIVES: Our aim was to evaluate the effectiveness and efficiency of a guideline-based open access urological investigation service. METHODS: General practices were randomized to receive either referral guidelines and access to the investigation service for lower urinary tract symptoms (LUTS) or referral guidelines and access to the investigation service for microscopic haematuria (MH). The study population comprised 66 general practices in the Grampian region of Scotland referring 959 patients. The outcome measures were compliance with guidelines (number of recommended investigations completed), number of general practice consultations, the number and case mix of referrals, waiting time to initial hospital appointment, and the number of patients with a management decision reached at initial appointment and discharged by 12 months after referral. RESULTS: GPs' compliance with referral guidelines increased (difference in means 0.5; 95% confidence interval 0.2-0.8, P < 0.001). Approximately 50% of eligible patients were referred through the new system. The number and case mix of referrals were similar. The intervention reduced the waiting time from referral to initial out-patient appointment (ratio of means 0.7; 0.5-0.9, patients with LUTS only) and increased the number of patients who had a management decision reached at initial appointment (odds ratio 5.8; 2.9-11.5, P < 0.00001, both conditions). Patients were more likely to be discharged within 12 months (odds ratio 1.7; 0.9-3.3, P = 0.11). There were no significant changes detected in patient outcomes. Overall the new service was probably cost saving to the NHS. CONCLUSIONS: The guideline-based open access investigation service streamlined the process of out-patient referral, resulting in a more efficient service with reduced out-patient waiting times, fewer out-patient and investigation appointments and release of specialist and clinic time.