“一院两区”医疗质量管理信息平台的研制与应用

医疗质量同质化是“一院多区”医院管理工作中的难点。同济大学附属东方医院通过搭建“一院两区”医疗质量管理信息平台,充分借助信息化手段,实现医疗质量管理委员会、医疗质量管理部门、临床科室三级联动的闭环管理模式,助力提升院区间医疗质量同质化水平。     

两种DRGs指标体系的绩效评价效果比较研究

目的应用传统与新型DRGs指标体系进行绩效评价效果比较研究,探讨新型DRGs指标体系应用价值。方法基于某省大数据平台的31家三级综合公立医院DRGs资料,分别采用传统与新型DRGs指标体系对之进行综合绩效评价,采用Pearson检验对医院排名进行相关性分析,通过专家咨询法论证两种指标体系。结果31家医院排名均发生了变化,超过一半的医院排名变化幅度超过10名。两种DRGs指标体系的医院排名不存在显著相关性（相关系数为-0.348,P=0.057）,即在实际评价效果上存在较大差异。新型DRGs评价指标体系的应用价值优于传统型。结论相较于传统DRGs指标体系,新型DRGs指标体系严格把控区域医疗质量指标,通过强化学科评价与费用控制,重视患者医疗质量,使评价更为科学、全面。     

应用移动管理平台提高危急值管理水平

基于移动管理平台,对传统危急值管理进行改进,使手机移动端具备危急值管理功能,实现在手机移动端查看、提醒和监控危急值。平台应用后,临床科室在5 min内、10 min内、20 min内、30 min内危急值平均处置效率分别为31.43%、58.32%、70.05%、80.76%。运用移动管理平台,可提高对危急值处置和监管的及时性,提升危急值闭环管理能力,进一步保障患者安全。     

Applications of platform technologies in veterinary vaccinology and the benefits for one health

The animal-human interface has played a central role in advances made in vaccinology for the past two centuries. Many traditional veterinary vaccines were developed by growing, attenuating, inactivating and fractioning the pathogen of interest. While such approaches have been very successful, we have reached a point where they have largely been exhausted and alternative approaches are required. Furthermore, although subunit vaccines have enhanced safety profiles and created opportunities for combined discrimination between vaccinated and infected animal (DIVA) approaches, their functionality has largely been limited to diseases that can be controlled by humoral immunity until very recently. We now have a new generation of adjuvants and delivery systems that can elicit CD4 + T cells and/or CD8 +  T cell responses in addition to high-titre antibody responses. We review the current vaccine platform technologies, describe their roles in veterinary vaccinology and discuss how knowledge of their mode of action allows informed decisions on their deployment with wider benefits for One Health.     

An improved technique for the extraction of stochastic parameters from stabilograms

An improved characterization of the dynamics of postural sway can provide a better understanding about the functional organization of the postural control system as well as a more robust tool for postural pattern recognition. To this aim, a novel parameterization was applied to the stabilogram diffusion analysis formerly proposed by Collins and De Luca [Collins JJ, De Luca CJ. Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories. Exp Brain Res 1993;95:308–18] that considered the act of maintaining posture as a stochastic process. The main purpose of the present technique was to overcome some drawbacks of the model presented by Collins and De Luca that may restrain its potential application in clinical practice. The approach uses a unique non-linear model to describe the center of pressure (COP) dynamics that reduces the number of parameters and decreases their intra-subject variability; consequently, fewer trials are required to perform reliable estimates of stochastic parameters and this is of particular importance for subjects that cannot afford many repeated measurements because of age or pathology. Four new statistical mechanics parameters (NSMP) were computed on the log–log stabilogram diffusion plots and their estimates were compared in terms of reliability and sensitivity to the visual conditions with: (1) a minimal set of four summary statistic scores (SSS); and (2) the six statistical mechanics parameters (SMP) proposed by Collins and De Luca. All four NSMP showed at least a fair-to-good reliability (intraclass correlation coefficient, ICC>0.49) while SMP (ICC>0.20) showed some poor reliability. A better overall reliability was also observed with respect to SSS. Moreover, only NSMP had a similar score for eyes open and eyes closed conditions. Three out of four NSMP were also significantly sensitive to eyes open or closed conditions (P<0.001) while only three out of six SMP were sensitive to operating conditions (P<0.01).     

区级卫生监督机构绩效评估指标体系研究

作者通过文献查阅、焦点小组访谈和专家咨询论证方法研制区级卫生监督机构绩效评估指标体系。研究所得绩效评估指标体系包括要素系统、指标系统和操作系统三个部分。其中,要素系统包括投入、产出、结果、效率和解释变量五个部分,指标系统包括39个一般指标,12个关键指标,操作系统给出了每个指标的概念、作用、统计口径和数据搜集方法。     

县级卫生执法监督机构面临的困境和对策研究

目的探讨县级卫生执法监督机构建设。方法系统分析县级卫生执法监督机构存在的执法主体与执法队伍相分离、卫生监督力量薄弱、职责职能不明确等主要问题和产生的原因。结果对进一步加强基层卫生执法监督工作提出了相应的建议和对策。     

2003～2004年苍山县部分蔬菜农药残留量检测分析

[目的]了解苍山县蔬菜农药残留有关情况,为有效控制蔬菜农药残留,提供科学依据.[方法]2003～2004年对苍山县部分蔬菜批发市场、种植基地及零散摊点进行随机抽样检测,用农药速测卡结合色谱法测定其中的有机磷类农药.[结果]共检测各种蔬菜827份,农药残留阳性的98份,阳性率为11.85%.[结论]我县蔬菜农药残留问题比较严重,应进一步加强监督管理.     

深圳市宝安区2004-2005年医疗机构的消毒效果

目的了解2004—2005年深圳市宝安区医疗机构消毒效果质量,促进医疗机构消毒工作,减少医院感染的发生率。方法对68家医疗机构按国家有关标准进行6次监测,共采集3 436份样品。结果室内(手术室、产房)空气、物体表面、手、紫外线、灭菌器、一次性使用医疗器械、医疗机构污水、胃镜、使用中消毒剂检测合格率分别为96.44%、98.93%、97.84%、98.81%、100%、100%、95.05%、90.11%、99.00%。结论该区医疗机构的消毒质量较高,但还要继续加强规范医疗机构消毒工作。