建设“公平与效率相统一的资源节约型”医疗卫生事业的措施和方法

以建设“公平与效率相统一的资源节约型”医疗卫生事业为目标,结合国情,系统地提出了“诊疗就地区域化、转诊双向梯度化、服务基本适宜化”的原则和尽快制定《卫生法》、《初级卫生保健法》等8项相互关联、不可分割的具体措施。     

UK ward design: patient dependency, nursing workload, staffing and quality-an observational study

BACKGROUND: There are important relationships between ward design, patient welfare and staff activity in the literature but studies seem not to have tested all the variables. Whether ward designs influence nursing structures, processes and outcomes, therefore, has not been fully answered. While studies provide helpful guidance, nursing efficiency and effectiveness implications are speculative. OBJECTIVES: To improve nursing efficiency and effectiveness by capitalizing on the best ward design features. SETTING: A database consisting of 375 UK wards, constructed for other research and development purposes, was revisited and reconfigured for the present study. The database was updated between 2003 and 2004. PARTICIPANTS: Of 390 wards approached, 375 generated usable data. METHOD: Patient dependency, nursing activity, workload, nursing quality and staffing data in the original database were obtained using mainly non-participation observation methods. Later, wards were classified in eight ways and differences between ward types examined. RESULTS: Patient dependency did not stand out in any ward type but as the literature predicted, direct patient care was higher in Nightingale wards. Racetrack ward nursing activity was also close to idyllic. Bay wards, owing to their greater occupancy peaks and troughs, had a propensity to generate heavier workloads. Time-out and down-time were not excessive in any ward type, and it is likely that ward leadership may be compensating for some variables' negative effects. Racetrack wards were considerably less-well staffed and grade-mix dilute and consequently the cheapest. Quality scores were higher in Nightingale wards-nurses' greater observation capability was a significant factor. Wards' central-core configurations also influenced nursing efficiency and effectiveness. CONCLUSIONS: Racetrack wards have an edge over other ward designs. However, replicating Nightingale conditions by, for example, equalising occupancy, throughput and staffing and maximising nurses' substations, could engender similar outcomes elsewhere.     

丰田汽车公司实施精益管理对医疗行业的启示

介绍了丰田汽车公司实施精益管理的基本慨念、实际运用方法及当前状态价值流图的作用,举例说明了医疗行业引入精益管理的必要性及良好效果,阐述了精益管理从企业文化、流程优化、经营效率等方面带给医疗行业的启示.     

Automatic Extraction of Comprehensive Cardiac CT Angiography Parameters: A Novel Program with High Accuracy and Efficiency

We tested the accuracy and efficiency of a novel automated program capable of extracting 15 cardiac computed tomography angiography (CTA) parameters from clinical CTA reports. Five hundred cardiac CTA reports were retrospectively collected and processed. All reports were pre-populated with a structured template per guideline. The program extracted 15 parameters with high accuracy (97.3 %) and efficiency (84 s). This program may be used at other institutions with similar accuracy if its report format follows the Society of Cardiovascular Computed Tomography (SCCT) guideline recommendation.     

Obésité et irradiation : difficultés techniques,toxicité et efficacité

The number of obese patients has increased in France over the last two decades, which has had an impact on the incidence of numerous types of cancer. The treatment of cancer by radiotherapy is impacted by obesity as a result of the physical, technical and dosimetric constraints, the acute and late toxicity, local control and the survival of patients.     

土家医药半结构化数据的功效挖掘及可视化研究＊

目的 利用数据挖掘技术对半结构化数据的土家族医药进行品种规范和常用功效的可视化发现。方法 收集整理《中国民族药辞典》、《土家医方剂学》等土家族代表性医药文献，建立土家族医药原始数据库，包含药物拉丁学名、药用部位、性味、毒性、功效、主治疾病等。借助Visual FoxPro 9.0软件对土家族医药特性进行频次统计和品种规范，主要以法定标准收录；借助TCMISS (V2.5)、Cytoscape3.6.1、Gephi0.9.2等软件对土家药“药物-功效-主治”间的语义关系，进行功效挖掘和可视化展示。结果 筛选土家药共1453味，方剂共771首，其中土家药主要以“寒（凉）、平”性偏多，苦味药频次最高，其次是辛味药、甘味药；清热败毒、赶风除湿等功效出现频次最高；皮肤疮癣、妇科疾病等是关联程度较大的主治病症。结论 土家族医药的品种规范和“药性-药味-功效-主治”隐形关系可视化分析，可为完善土家药信息化研究奠定基础。     

A Web-Based Flexible Communication System in Radiology

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.