医院实施ISO9001质量管理体系内部审核的探讨

医疗机构实施ISO9001,其目的是为了提高医疗服务质量,满足病人一切明确和隐含的需求。那么,内审是否发挥作用,直接关系管理体系的有效性。文章对此进行了初步的探讨,即:①明确内审的目的是检查体系满足标准要求的程度;②建立正规的内审机构,要选拔责任心强、综合素质高的人担任内审员;③编制合理且有特色的内审计划,是内审有效性的关键;④适当增加专题审核;⑤医院最高管理者应重视内审结果。     

ECS produced disruption or facilitation of discriminated active avoidance performance in rats

Two experiments investigated the effect of electroconvulsive shock on the performance of a one-way active avoidance response. In the first experiment it was found that if the response was learned under scopolamine, ECS given prior to relearning failed to produce a deficit. The second experiment demonstrated that ECS facilitated relearning of a response trained to a low criterion level while it disrupted performance of a response trained to a strict criterion. These results support other indications that Deutsch's memory model has predictive value for proactive effects of ECS on relearning (retrieval).     

Applying international organization for standards 9001 to create an effective surgical quality committee

BackgroundEfforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes.MethodsA surgical quality committee was created using ISO 9001:2015 standards. Quality objectives were assessed to understand how any suggested changes will be impacted due to risks and opportunities inherent in the system.ResultsThe initial quality focus was on surgical site infections in 5 services. Change in surgical infection ratio from 2018 to 2019 showed significant improvement: coronary bypass 1.288 vs. 0.901; Colon 1.359 vs. 0.589; Hysterectomy 2.119 vs. 1.022; Knee 1.391 vs. 0.306; Hip 0 vs. 0.302.ConclusionsThis is one of the first studies using ISO 9001 to improve surgical quality. The results indicate both acceptance and success of applying continual improvement strategies.     

面向行业需求的中医药标准：发展现状与建设思考

在科学技术蓬勃发展的现代社会,标准建设在各行各业的必要性和重要性不断彰显,中医药标准建设则是推进中医药事业发展、促进中医药更好服务于人类健康的关键所在。伴随着国家政策支持及更多研究人员的关注,中医药标准建设工作已取得显著成效。紧跟标准改革的步伐,同时面向行业的需求,梳理了当前中医药行业标准研究与制定的概况,解析新时期下标准建设所面临的机遇与挑战及其不足,旨在为中医药标准引领行业高质量发展提供参考。     

System weaknesses as contributing causes of accidents in health care.

OBJECTIVE: Accidents in health care, resulting in injury or death to the patient, are a matter of considerable concern. The aim of this study is to examine whether system weaknesses can contribute to these accidents, and if so, how. DESIGN: Eight consecutive accidents reported to the Health Authority in Sweden were analysed using MTO (Man-Technique-Organization) analysis. SETTING: Emergency care hospitals in Sweden. RESULTS: All cases that involved the system supported the assumption that system weaknesses are a contributing factor to accidents. In this study two types of latent failure could be identified: process control latent failures and interactional latent failures. The time span from activation of process control latent failures to operator error was very short, and the study demonstrates the simple relationship between situational factors and operator errors. Interactional latent failures exert system influence in a more indistinct manner. Latent failures, as seen in this study, act not only by creating opportunities for operator errors but also by hindering error detection in the time window available. Safety barriers, which might have prevented the accidents, could be proposed in seven out of eight cases. CONCLUSION: System weaknesses seem to play an important role in accident evolution. Consequently, certain measures can be suggested in order to improve patient safety: (i) sufficient resources should be allocated for research and development at both medical schools and hospitals in order to establish competence and procedures for systematic analyses of processes; and (ii) authorities handling accident cases should have adequate competence in system analysis.     

结合国际标准做好医院人力资源管理工作

在医院人力资源管理中运用ISO9001标准和JCI标准,并将两个标准结合起来是切实可行的方法。注重能力、意识和培训三个重要方面,在能力中明确岗位职责并以此定位任用的员工,同时要求员工的知识和技能与患者的要求一致;制定专门工作程序,寻找符合岗位能力要求的人员;合理定位,定期评估员工完成岗位任务的能力;建立一套有效的收集、验证和评价个人资料的程序,确保其有与医院任务、资源和患者需要相符合的资质和能力;加强对员工的培训和教育,保持或改进其能力,强化主动为患者服务的意识,有针对性地提高员工满足患者需要的能力。     

利用ISO9000族质量控制体系改造一次性医疗用品管理流程

一次性医疗用品的管理是一个多部门协作、多环节连续的过程。其管理模式存在着管理环节的不连贯性、管理制度的非标准性、工作方式的随意性、个人责任的不明确性和实施记录的非系统性等5个缺陷特征。针对这些问题引入了ISO9000动态的、具备防错与纠错功能的、保证质量管理水平螺旋式不断上升的体系。通过系统性的溯源。找出原因，并实施有效的纠正，防止差错的重复发生。新的管理流程重点突出了对过程管理的特点。确定一次性医疗用品管理的整体预期目标，实施预期目标的分段管理。重点加强对流程各个环节实施过程的管理，实现整个流程的优化和持续改进。强调质量记录，保持和实现流程过程各个环节的可追溯性。     

建立实验室ISO15189质量管理体系

实施有效的质量管理是确保实验室管理水平和技术水平的重要手段,而质量管理体系的核心是检测结果的可靠性。笔者总结了本检验科建立ISO15189质量管理体系的经验,从体系文件的编写、人员积极性的调动、人员素质的提高、检验全过程(检验前、中、后)的质量控制、室间质评及管理评审等方面阐述了ISO15189质量管理体系建立的具体措施必须体现在保证检验质量的各个环节,而且只有结合自身实际,求真务实,不断探索,持续改进,才有可能在检验科中建立行之有效的质量管理体系。     

ISO9001：2000在医院药剂科质量管理体系中的应用

目的:探索医院药学服务与国际质量标准接轨的方式。方法:依据ISO9001:2000,运用科学的管理理念,结合医院药剂科工作的特点,制定规范化管理文件,建立医院药学部门质量管理体系。结果:确立了新型的医院药剂科管理模式。结论:ISO9001:2000标准适用于医院药剂科质量管理。     

基于PDCA循环的质量管理体系在我科ISO9001贯标中的应用

目的:在药剂科推行ISO9001标准质量管理体系。方法:将PDCA循环(策划-实施-检查-改进)的程序和方法应用于我科ISO9001质量认证贯标工作中。结果:基于PDCA循环的ISO9001标准在我科贯标中的应用获得成功。结论:遵循PDCA循环进行ISO9001质量认证行之有效。