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61.
A web-based system for rapid multidirectional communication has been created in the Radiology department at San Francisco
General Hospital. The system allows messaging among radiology attendings, residents, and technologists, as well as other members
of the hospital community, such as Emergency Department physicians and nurses. Instead of being tied to a particular workflow,
this system provides a flexible communication infrastructure which can be easily adapted for different functions and user
roles. The system has so far been configured to successfully support the standard “wet reading” workflow, to support marking
and tracking of critical results, as well as multiple educational and quality improvement workflows. In the 19 months of operation,
the system has gained over 1,800 users (virtually all providers at our institution), it has been accessed by radiologists
over 39,000 times and by non-radiologists over 34,000 times. It has become an integral part of the radiology department operations
and non-radiology clinical workflows. Unlike most existing softwares, our system is not a task-specific application, but a
multipurpose communication system. It is able to effectively accommodate multiple workflows and user roles through configuration
(without additional programming). This flexibility has helped this system to be rapidly and widely adopted within our enterprise.
The extended reach of the system enables improved monitoring and documentation of workflows, helping with management decision
making, and quality assurance. We report a successful radiology communication system based on the principles of flexibility
and inclusiveness of users inside and outside the radiology department. 相似文献
62.
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64.
We use a formal model to examine the implications of endogenous managerial effort for the interpretation and estimation of efficiency in health care organisations. The model is applied to investigate the doubling of the cost of administering primary care in England in real terms between 1989/1990 and 1994/1995. The main cost determinant was the number of general practitioners (GPs), and there were economies of scale but not of scope. Fund-holding had a positive but small effect on administrative costs, so that the recent abolition of fund-holding may do little to reduce primary care administrative costs. After allowing for changes in the numbers of primary care practitioners, the quality of primary care and the extent of fund-holding, most of the increase in costs was unexplained, and may reflect additional but unmeasured increases in the administrative burden associated with the 1990 reforms. There was little variation in relative efficiency across areas. 相似文献
65.
Berta Otov Radka Vclavíkov Vlasta Danielov Jaroslava Holubov Marie Ehrlichov Stanislav Horský Pavel Sou
ek Petr imek Ivan Gut 《European journal of pharmaceutical sciences》2006,29(5):442-450
We investigated, whether the effects on paclitaxel, docetaxel or their combinations on T-cell lymphomas in Sprague-Dawley/Cub rats were mainly caused by their different efficiency or combination of different mechanism of action, or limited by metabolic inactivation by P450 enzymes or drug efflux caused by P-glycoprotein (P-gp). Docetaxel most effectively prolonged the survival of rats and the time of lymphoma appearance, inhibited their intravital size and weight after sacrifice. Paclitaxel was poorly effective and combined administration had intermediate effects. Blood levels of both drugs were similar. Repeated administration of paclitaxel, but not docetaxel, decreased its area under concentration, but the effect disappeared 6h after dosing and was not sufficient to explain lower effects of paclitaxel. The faster metabolism of docetaxel than paclitaxel in vitro did not limit its higher efficiency and repeated administration of paclitaxel did not induce its metabolism to decrease its blood levels sufficiently. Likewise, undetectable expression of P-gp protein in tumours could not explain lower effects of paclitaxel, which is a better substrate of P-gp. Docetaxel was three-fold more effective than paclitaxel against P388D1 lymphoma cell line, used as a model of the T-cell lymphoma and combined action was dominated by the effects of docetaxel. Thus, docetaxel was effective against T-cell lymphomas and may be a potential anticancer drug in similar indications. 相似文献
66.
目的了解教师职业倦怠的状况,为教师心理卫生提供基础研究。方法采用自行设计的教师职业倦怠问卷对167份来自徐州地区的教师进行自我效能感、情绪倦怠、去个性化三个维度的调查。结果数据显示43%的教师存在着职业倦怠。贮检验结果表明各类教师的职业倦怠程度的差异有显著意义,中小学教师较幼儿园教师更为严重,此外城乡差异有显著意义。结论教师群体职业倦怠状况不容乐观。 相似文献
67.
医疗行业政府管制的改进 总被引:11,自引:4,他引:11
李彤宇 《中华医院管理杂志》2005,21(7):433-436
医疗行业具有政府公共产业的属性及市场属性,且存在着政府和医疗机构之间以及医患之间的信息不对称,单纯依靠市场机制无法健康发展,因此需要引入政府管制。作者通过介绍政府管制的内涵及发展历史,分析了我国医疗行业政府管制的状况,提出引入激励性管制,建立并完善医疗收费体系、医疗质量评估体系和医疗法律体系,才能保证有效控制医疗成本,兼顾医疗的公平和有效,使医疗行业高效、公平、有序地发展。 相似文献
68.
H. Stolecke 《European journal of pediatrics》1971,111(1):21-28
Zusammenfassung In der vorliegenden Untersuchung werden die Wirksamkeit, die Dosisrelation und der Depoteffekt eines synthetischen depot-1–24-tetracosactide (Cortrophine-S-Deport Organon®) und eines nach herkömmlicher Weise hergestellten Depot-ACTH-Präparates (Cortrophine-Z Organon®) verglichen. Als Parameter gilt die Ausscheidung des freien Cortisols im Harn. Bei einer angenommenen Relation von 100 IE Cortrophine-Z gleich 1 mg Cortrosyn-Depot zeigt das synthetische Präparat bei vollwertiger adrenocorticotroper Wirkung einen Gesamtstimulationseffekt von 70,2% desjenigen des herkömmlichen Präparates. Dabei ist der Initialphaseneffekt bei beiden Präparaten gleich. In der sogenannten Stimulationserhaltungsphase und in der Abklingphase des Depoteffektes zeigen sich Unterschiede zugunsten des herkömmlichen Präparates. Es errechnet sich eine Dosisrelation von 100 IE Cortrophine-Z gleich 1,42 mg Cortrosyn-Depot, wobei diskutiert wird, ob es sich hier in der Tat um ein Dosisproblem oder um ein Problem der Depotstabilität handelt.
Efficiency, dose relation and depot effect of a depot-1–24-tetracosactide
This paper reports on a comparative study on a synthetic depot-1–24-tetracosactide (Cortrophine-S-Depot Organon®) and an extractive ACTH-depotpreparation (Cortrophine-Z Organon®); the factors studied were efficiency, dose relation, and depot effect. The parameter used was the excretion of free cortisol in the urine. Assuming a dose relation of 100 I.U. of extractive ACTH equal to 1 mg of the synthetic preparation, our results show, that the synthetic preparation evokes a stimulative effect which equals 70.2% of that of the extractive ACTH. The difference was especially observed in the decreasing phase of the depot effect. The true dose relation calculated with regard to the parameter used, was 100 I.U. extractive ACTH to 1.42 mg of the synthetic tetracosactide. However, it has to be considered whether the difference between the two preparations regarding the effect of stimulation is in fact a question of unequal doses or a question of the stability of the depot itself.
Die Untersuchung wurde im Rahmen einer Beihilfe der Deutschen Forschungsgemeinschaft, Bad Godesberg, durchgeführt (Sto 45/8) 相似文献
69.
Sara Jo Nixon Robert Paul Mary Phillips 《Alcoholism, clinical and experimental research》1998,22(7):1414-1420
Previous studies have found alcoholics to be impaired on tests of cognitive efficiency. However, it is unclear to what extent individuals who abuse drugs in addition to alcohol exhibit similar deficits. To answer this question, 63 healthy control subjects were compared with 40 individuals who abused alcohol only, 24 individuals who abused alcohol and stimulants, 16 individuals who abused alcohol and marijuana, and 41 individuals who abused alcohol and depres-sants/narcotics, or alcohol and two or more other drugs. All subjects were administered tests of Short-term memory, spatial orientation, visual-spatial perception, and problem-solving. Results from the study indicated that control subjects and individuals who abused both alcohol and marijuana performed significantly better than the other groups on most tests. These results were not attributable to differences on measures of affect or chronicity of alcohol consumption. 相似文献
70.
Adequacy and efficiency of nursing staff in a child-welfare-clinic at Umtata General Hospital, South Africa 总被引:1,自引:1,他引:0 下载免费PDF全文
Meel BL 《African health sciences》2003,3(3):127-130