发挥三甲医院优势 探索省-区合作公立医院改革新模式

通过总结省级三甲医院合并区属医院的实践经验,探索省-区合作这种新的公立医院改革新模式。以"输出管理、输出人才、输出技术、输出理念"为重心,深入推进"管理、学科、人才"三方面融合,将省级大医院先进的管理理念、医疗技术、人文思想渗透并扎根于基层。让乡镇老百姓得到了实惠,在家门口享受到省级优质医疗服务;优化了区域医疗卫生资源;进一步改善投资环境,提高区域竞争力。     

Colorectal cancer diagnosis: Pitfalls and opportunities

Colorectal cancer (CRC) is a major health problem in the Western world. The diagnostic process is a challenge in all health systems for many reasons: There are often no specific symptoms; lower abdominal symptoms are very common and mostly related to non-neoplastic diseases, not CRC; diagnosis of CRC is mainly based on colonoscopy, an invasive procedure; and the resource for diagnosis is usually scarce. Furthermore, the available predictive models for CRC are based on the evaluation of symptoms, and their diagnostic accuracy is limited. Moreover, diagnosis is a complex process involving a sequence of events related to the patient, the initial consulting physician and the health system. Understanding this process is the first step in identifying avoidable factors and reducing the effects of diagnostic delay on the prognosis of CRC. In this article, we describe the predictive value of symptoms for CRC detection. We summarize the available evidence concerning the diagnostic process, as well as the factors implicated in its delay and the methods proposed to reduce it. We describe the different prioritization criteria and predictive models for CRC detection, specifically addressing the two-week wait referral guideline from the National Institute of Clinical Excellence in terms of efficacy, efficiency and diagnostic accuracy. Finally, we collected information on the usefulness of biomarkers, specifically the faecal immunochemical test, as non-invasive diagnostic tests for CRC detection in symptomatic patients.     

Beliefs about back pain: The confluence of client,clinician and community

Patient beliefs play an important role in the development of back pain and disability, as well as subsequent recovery. Community beliefs about the back and back pain which are inconsistent with current research evidence have been found in a number of developed countries. These beliefs negatively influence people's back-related behaviour in general, and these effects may be amplified when someone experiences an episode of back pain.In-depth qualitative research has helped to shed light on why people hold the beliefs which they do about the back, and how these have been influenced. Clinicians appear to have a strong influence on patients' beliefs. These data may be used by clinicians to inform exploration of unhelpful beliefs which patients hold, mitigate potential negative influences as a result of receiving health care, and subsequently influence beliefs in a positive manner.     

Learning about Practice from Practice: A Peer-based Methodology

A recommendation from the Social Work Task Force was that all employers of social workers should conduct a regular “health check” of the social work profession to learn from practice as part of a continuous cycle of improvement. This article documents how the London Borough of Tower Hamlets has gone about this. I describe the methodological and practical pathway we followed so that others can see what we did and why we did it. Like other busy social work offices, we had to set out a plan of methodological action in order that we achieved the learning from practice to inform our health check, and it is the planning work that is engaged with in this article. We have found that by involving and engaging our staff in the health check work, we have gained more than we had set out to find. An organisational commitment to act on what social workers have told us about practice is offering the senior management team new ideas about the best ways of delivering professional and reflective support mechanisms for staff. Learning from practice is now one of the core functions for the new Principal Social Worker.     

医德医风教育与建设之我见

医德医风,事关民生,事关医疗卫生行业形象,事关党和政府与人民群众的血肉联系。我院主要从建立组织管理,完善制度建设,拓展监督渠道,强化服务考核四个方面,不断深化医德医风教育与建设。有效地提高了患者满意度和社会信誉度,树立了医院的良好形象。     

Early Intensive Family Intervention and Evidence of Effectiveness: Lessons from the South West Autism Programme

Intervention strategies in autistic spectrum disorder (ASD) have emanated from a range of theoretical perspectives with a consensus view that the greatest impact on children's subsequent development is likely to occur when this work is early, intensive and focuses on young children in the context of the family. Controversies in ASD intervention have arisen in relation to claims for effectiveness, particularly for versions of Applied Behavioural Analysis. Taking account of user perspectives, the evidence base for ASD intervention is considered, distinguishing between experimental work that identifies a treatment effect and research that establishes ecological validity. In order to move practice forward, research is required to address which programme components are helpful for which children and which families in which contexts. Drawing on current intervention research (South West Autism Programme), this paper concludes by outlining some of the factors that need to be considered in shaping future ASD research and ASD service provision.