Work-based learning: a leadership development example from an action research study of shared governance implementation

AIM: An empowering action research study was undertaken to evaluate and strengthen the implementation of shared governance. One aim was to identify factors that acted as aids or barriers to effective decision-making by clinical leaders. As a work-based learning approach, action research was expected to lead to integration of learning into practice by researcher and participants alike. BACKGROUND: Shared governance replaces traditional hierarchies and requires and develops clinical leaders. Strategies are needed to maximize learning from introduction of such initiatives at the individual, group and organizational level. METHODS: Participant-observations and interviews were undertaken with shared governance council members from one model in north-west England. RESULTS: Leadership skills and knowledge and shared governance practices were significantly enhanced. Preparation for council roles was considered inadequate. Increased structured time for reflection and action planning was indicated. CONCLUSIONS: Implementation of shared governance has succeeded in developing leadership capacity. Evaluation findings have led to improvements in the overall shared governance model. Action research has been found to have great utility at optimizing work-based learning. Nurse Managers need to develop their coaching and facilitating skills and recognize there is no "quick fix" for developing clinical leaders. Implications include the need to support learners in identifying and implementing changes arising from work-based learning activities, the significant resource implications and the need to optimize the organizational climate if work-based learning approaches to leadership and management development are to succeed.     

七个经合组织国家全球卫生战略比较研究

全球化对健康产生了广泛而深刻的影响,挑战了原有的国际卫生体系,推动了全球卫生概念的提出,开拓了全球卫生治理的新局面。经济合作与发展组织中的七个国家已经发布并实施了国家全球卫生战略。本文比较研究了这些国家出台全球卫生战略的背景、目标利益,指导价值理念、重点领域及战略的制定过程等,并对七国战略的共同点及不同特色进行了总结提炼,发现尊重和维护健康权、积极承担国际责任并发展合作伙伴的能力是共同的价值理念;维护和改善本国人民的健康并为改善全球健康做出贡献、促进国家利益的实现是共同的目标;基于本国比较优势满足发展中国家卫生合作的需求是确定重点领域的关键;加强全球卫生治理、影响健康的全球治理,以及影响全球的卫生治理的思想贯穿战略的始终;多部门和全社会参与战略制订的过程。在借鉴上述国家全球卫生战略核心思想和经验的基础上,提出对中国制订国家全球卫生战略的建议。     

我国区域整合型医疗健康服务体系的治理逻辑与路径分析——基于多中心治理视角

治理机制是构建区域整合型医疗健康服务体系的核心机制之一,从单中心治理向多中心治理转变,是推动卫生健康领域治理体系与治理能力现代化的重要途径.本文基于多中心治理理论,探索构建区域整合型医疗健康服务体系多中心协同治理框架,提出多元主体协同治理结构以及实现制度有效嵌入的核心机制;针对实践中的现实困境,提出在构建区域整合型医疗...     

新型冠状病毒肺炎疫情下骨关节结核外科的管理规范

2019年12月以来,我国武汉市出现了新型冠状病毒感染引起的肺炎(简称"新冠肺炎")疫情,并逐渐向全国其他地区及境外蔓延,医护人员也出现了感染情况。疫情的不断传播,除对呼吸科、结核科、胸外科产生巨大影响外,对骨关节结核外科也带来了较大困难。疫情期间须严格做好门诊筛查防控与鉴别诊断,严格控制入院标准,尽可能选择居家治疗;门诊就诊,严格执行"一人一诊一室"原则;严格把握手术指征,一般不进行择期手术或暂缓推迟择期手术;拟行手术患者,需隔离至少2周以上且核酸检测2次阴性后,方可安排手术;拟行抢救脊髓功能及出现危及生命的并发症而需急诊手术患者,术前必须进行核酸检测,不论阳性或阴性,按照"以疑从有"原则,术中按三级防护处理,建议在负压手术室进行,严格执行手术的消毒隔离措施。对于术后患者,要积极进行新冠肺炎相似症状的鉴别处理,排查并发新冠肺炎的患者,确保不出现交叉感染。     

完善公共卫生治理体系与治理机制的思考与建议

反思新型冠状病毒肺炎疫情防控下我国公共卫生治理体系与治理机制,要坚持以习近平新时代中国特色社会主义思想为指导,贯彻落实新时代党的卫生与健康工作方针。坚持实事求是,立足我国基本卫生国情,总结经验、汲取教训,提出完善公共卫生治理体系和治理机制的建议。同时,明确提出要防止两个“认识误区”。     

健康服务业的发展特征与未来趋势分析

第五次科技革命浪潮中,“信息技术是第一生产力”对医疗服务的供给和需求产生了很大影响。互联网医疗广义上等同于信息技术加持下的医疗健康产业。“健康中国”战略作为我国的“优先发展战略”,强调把健康融入所有政策,坚持健康公平公正原则,以共建共享为基本路径。互联网医疗在实施“健康中国”战略中的重要作用在于以互联互通、数据、人工智能3大工具促进医疗服务生产要素的流动性,提高整体医疗健康体系的运行效率,从而优化医疗资源配置。互联网医疗的未来发展遵循技术与政策共同驱动的双螺旋模式,政策决定了产业的发展边界。在确保医疗安全的基础上,进一步探索互联网诊疗的可能性空间,在提高效率的同时注重资源配置的公平性,从而实现医疗健康服务的共建共享,仍任重而道远。     

How to reduce processing times for site-specific assessments from 29 to 5 days using a common-sense approach: it does not have to be that hard

Researchers have reported limitations with research governance processes across Australia. This study aimed to streamline research governance processes across a local health district. Four basic principles were applied to remove non-value-adding and non-risk-mitigating processes. Average processing times were reduced from 29 to 5 days and end-user satisfaction was improved, all within the same staffing levels.     

健康治理视角下我国居家社区医养结合服务治理功能的实现

基于健康治理的视角,从政策指导与愿景、系统设计、协同合作、监管能力、问责制与透明度、信息收集与监测六个方面对我国居家社区医养结合的治理功能进行了分析。研究发现,当前我国居家社区医养结合的治理功能主要面临长期发展计划与目标缺乏、政府多部门协同效率欠佳、非政府力量参与治理作用有限、监管体系不完善以及后续问责制与透明度不明晰等问题。未来应从完善相关发展计划与目标的制定、持续深化部门间协同合作力度、重视多中心治理能力的发挥以及强化监管与问责机制等方面进行改善。