高校附属医院兼具医疗服务、人才培养、科学研究、社会服务等多重职能,监督难点多、协同难度大、形成合力难.本文以笔者所在医院为例,剖析高校附属医院监督工作形势,统筹监督主体、监督重点、监督制度,积极构建以党内监督为主导的协同监督体系,复盘协同监督实践中的有益经验和做法,总结协同监督实践工作中的经验体会,为高校附属医院协同监督体系建设提供有意义的借鉴.
在国家加强公立医院运营管理背景下,作为临床诊疗技术的重要物质基础以及现代医院经济投入重要方面的医疗设备,其管理水平仍亟待提升以适应医院新发展要求.当前,医疗设备"重采购、轻管理"现象依然存在,面临采购流程监督、运行效率提升、使用质量控制、绩效评价数据有效获取等多方面难题.本文以苏州大学附属第一医院实践为例,通过落实党委领导、服务医院发展定位、对照大型公立医院绩效考核标准、加强信息支撑和注重人才培养等,促进医疗设备总量管理、科学配置和高效利用,提升医疗设备的社会效益和经济效益,实现"降本、提质、增效".
目的:探讨"远程模拟"线上考核在内科住院医师规范化培训(简称"住培")临床技能结业考核中的应用效果.方法:将178名参加S市2022年内科住培临床技能结业考核的考生分成线上组和线下组,参与两组考核的考官和问诊标准化病人(SP)均为研究者所在住培基地聘请的相同批次老师,线上组考生于所在地临床技能中心通过腾讯会议平台远程视频进行,线下组在研究者住培基地临床技能中心实地考核.分析两组考生考试成绩、考官及考生对考核形式认可度、SP对考生表现反馈.结果:线上及线下内科住培考生临床技能结业考核合格率均为100％.线上考生临床思维1、临床思维2考站得分及总分显著低于线下考生(P＜0.05),其余考站得分差异无统计学意义.线上与线下组考官和考生对考核形式的评价无统计学差异.线下考生识别SP情绪变化的比例显著高于线上考生(P=0.045).结论:"远程模拟"线上考核方式应用于内科住培临床技能结业考核具有一定的可行性;线上医患沟通时,考生识别SP情绪变化的意识和能力尚待提高.
Using theoretical analysis and case data research, under the guidance of system theory, the path of building geriatricfriendly medical institutions in Grade Ⅲ general hospitals is explored by analyzing the system environment, system and system elements, and integrating the functional orientation of Grade Ⅲ general hospitals with the construction of geriatric-friendly medical institutions. It is pointed out that the construction of geriatric-friendly medical institutions in tertiary general hospitals is influenced by many external environmental and internal system elements. There are still some problems between external environmental factors,internal system elements, and internal and external. It is proposed that three aspects of the external environment aging trend, policy requirements, and evaluation system and four elements of the internal system hospital management, geriatrics department construction,multi-disciplinary specialty synergy, and multi-departmental cooperation provide suggestions for the practice work, and finally achieve the optimal system effect.
Objective:To study the demand willingness and its influencing factors of the elderly in rural areas for Chinese medicine treatment services,and to provide a reference for promoting the reform of Chinese medicine services at the grass-roots level.Methods:A multi-stage sampling method was used to select 720 elderly people in rural areas of Jiangxi Province to conduct questionnaire surveys,and the influencing factors were analyzed by chi-square test and logistic regression.Results:A total of the 609 valid questionnaires collected,39.9％of the elderly were willing to receive Chinese medicine treatment services.Logistic regression results show that chronic diseases,trust in traditional Chinese medicine services,perceived health,setting of traditional Chinese medicine bulletin boards,and expenditure on traditional Chinese medicine services have a significant impact on the elderly willingness to demand Chinese medicine treatment services.Conclusion:The overall demand for Chinese medicine treatment services for the elderly in rural areas of Jiangxi Province is low.It is suggested to broaden the dissemination of health knowledge of Chinese medicine,innovate the health service model of Chinese medicine in grassroots areas,and improve the price of Chinese medicine and medical insurance policies so that Chinese medicine health services can play a key role in rural areas.
Objective:To construct a comprehensive evaluation system of the service capability of cleaning companies in medical institutions.Methods:Using relevant standards,norms,and literature to summarize evaluation indicators,using the expert consultation method to screen the indicators by importance and realizability,and designing the specialized requirements for each indicator.Results:The evaluation system included a total of 11 evaluation indexes in 4 categories:"basic operation","safety management","human resource management"and"service quality",and each index contained 1-4 specialized requirements.The internal consistency reliability Cronbach's alpha coefficient for the expert questionnaire consultation was 0.853,the overall content validity index(S-CVI)was 0.86,and the item content validity(I-CVI)ranged from 0.83 to 1.Conclusion:The comprehensive evaluation system of the service capability of cleaning companies constructed in this study provides a management tool for medical institutions to select and evaluate the service quality and ability of cleaning companies,and to clarify the focus and direction of the assessment of the quality of cleaning work in medical institutions.This tool was conducive to the improvement of the comprehensive service ability of cleaning companies.
Objective:To analyze the current situation of Internet hospital service use in a Grade Ⅲ Level A public hospital,discuss the role of Internet hospitals before and after the COVID-19 pandemic,and put forward suggestions for the sustainable development of Internet hospitals.Methods:Descriptive statistics were used to analyze the use of Internet hospital services from 2018 to 2022.By comparing the changes in the usage of Internet hospitals before and after the outbreak of the COVID-19 pandemic,the effect of Internet hospitals on relieving the pressure of offline medical treatment under the background of the COVID-19 pandemic was tested.Results:The number of people using the Internet hospital increased from 20,241 before the COVID-19 pandemic to 169,987 after the COVID-19 pandemic.The number of people using the Internet hospital increased exponentially compared with that before the outbreak.Conclusion:Internet hospitals developed rapidly during the COVID-19 epidemic and played a role in sharing offline medical traffic,avoiding cross-infection,flexibly deploying resources,and meeting patients'diversified needs during the COVID-19,etc.In the future,they should continue to give full play to the advantages of Internet hospitals in the scheduling of resources,provide continuous and closed-loop health management services,and promote the synergy of supply,demand,and management in order to realize their sustainable development.
As the main body of emergency disposal and medical treatment in public health emergencies,their emergency system construction and emergency capacity level are directly related to the effectiveness and efficiency of emergency response.The party committee of Beijing Ditan Hospital combined with 77 years of emergency management practice,established an emergency management system based on the six-box model,this system has been well applied in the emergency management of COVID-19 pneumonia.At the same time,this paper puts forward concrete suggestions for continuously optimizing the six-box model of the hospital Party committee emergency management system.
In order to promote the high-quality development of work injury rehabilitation hospitals in the new period,and better protect the life and health of occupational workers,the author focuses on the development status quo,industry characteristics,policies,and regulations of the domestic work injury rehabilitation medical institutions to carry out research,and conducts an empirical analysis on the most representative of the rehabilitation healthcare industry,with the city's total number of beds of 75％of the city's total work injury rehabilitation of a Grade Ⅲ Level A rehabilitation hospital in Beijing,for example.Through empirical data analysis and policy research,it is pointed out that there are still bottlenecks in the current development of work injury rehabilitation hospitals,such as weak awareness of work injury rehabilitation,lagging behind of relevant policies,lack of medical scale,unscientific project settings,and imperfect billing system,etc.,and targeted countermeasures and suggestions for improvement are put forward,i.e.,in the new period of time,work injury rehabilitation hospitals should increase the publicity of policies,standardize the standards of work injury,update the catalog scientifically,and strengthen the construction of institutions,It also puts forward targeted countermeasures and suggestions for improvement,i.e.increasing policy publicity,standardizing work injury standards,scientifically updating catalogs,strengthening institutional construction,improving information systems,etc.,so as to make scientific and useful discussions for the country to further improve the policy and mechanism related to rehabilitation hospitals for work injuries and to enhance the efficiency of work injury rehabilitation medical resources.
Medical insurance fund regulatory policies are of great significance for maintaining fund security,improving fund efficiency and promoting equity.This paper analyzes the development and current situation of China's medical security fund supervision policy during the last ten years in three aspects:policy system,policy process stage and policy tool type,and it also analyzes the public cognition of medical insurance supervision from the perspective of the medical staff.China's medical insurance fund supervision system has been gradually established,improved and implemented,including the establishment of rules and regulations,the establishment of standards,the establishment of reward and punishment mechanisms and enforcement systems.It integrated the use of regulatory,economic,information,and social tools,etc.The analysis from the perspective of medical staff showed that the importance of supervision tools recognized by medical staff was mass supervision,credit rating management,supervision by public opinion,etc.In the future,improving laws and regulations,strengthening training and learning,innovating medical insurance supervision methods and means,and strengthening the coordination of interest subjects are the key links to improve the efficiency of supervision.
The issuance of the series of high-quality development documents marks that public hospitals have entered a new development cycle and urgently need to shift from scale expansion to quality-benefit,and refined operation management is its important support.A large Grade Ⅲ Level A general hospital in Hubei Province has carried out a series of operation and management innovation measures through management mechanism innovation,detailed research,and analysis,performance model optimization,special key improvement,etc.The concept of fine management has been deeply rooted in the hearts of the people,and the key indicators of the hospital continue to improve.This article introduces the innovative mode and specific implementation path of the hospital's operation and management,in order to provide a reference for the operation and management of large public hospitals.
This study starts from exploring the practical path of high-quality development of a municipal-level Grade Ⅲ Level A public hospital.Taking the performance appraisal of public hospitals and the reform of medical insurance payment methods as the starting point,it carries out relevant research on strengthening disciplines,emphasizing talents,grasping management,laying foundation and cultivating culture.Useful exploratory research has been carried out in practice.On this basis,combined with the functional positioning of prefecture-level public hospitals,suggestions are put forward:clarify the goal positioning and highlight the hospital's discipline construction;adhere to the people-oriented approach and strengthen the construction of the hospital's talent team;adhere to operational guarantees and promote the sustainable development of the hospital;strengthen information support,Accelerate the construction of smart hospitals.
Drawing on the institutional management style of the Italian research,hospitalization and health care institute(IRCCS)to provide suggestions for the management of research hospitals.Utilizing the literature research method and the current situation of the construction of domestic research hospitals,we put forward suggestions to improve the medical science and technology innovation system,formulate key research directions,and regularly evaluate research performance on a rolling basis,so as to promote the development of research hospitals.
Objective:Analyze the policy documents for the reform of the TCM medical insurance payment system,and identify the core content and weak parts of the policy.This study aims to provide a basis and reference for optimizing the TCM medical insurance payment system reform policy in the future.Methods:Text mining was conducted on 28 policy documents,and a PMC index model was constructed to quantitatively evaluate 13 representative policies from 2017 to 2023.Results:The mean PMC score for the 13 policies was 6.52,indicating that the policies and systems were generally good.Of the 13 policies,9 were considered good policies,while 4 were considered passing policies.Conclusion:The policy reform on payment methods for TCM under the medical insurance system still requires further improvement.In the future,the reform scope should be expanded continuously,and a diversified and composite pricing mechanism should be established,accompanied by improved supervisory and guarantee measures.When formulating policies,it is necessary to distinguish TCM from Western medicine and fully reflect the characteristics of TCM and policy support.
Objective:To construct a nursing quality evaluation index system applicable to the anesthesia preparation room,and to provide a basis for monitoring the nursing quality in the anesthesia preparation room.Methods:Based on literature research,a preliminary framework for evaluating the nursing quality of anesthesia preparation rooms was constructed,and a semi-structured interview method was used to construct the indicator system.The nursing quality evaluation indicator system was determined through two rounds of Delphi expert consultation.Results:Two rounds of expert correspondence were carried out,and the effective recovery rate of the questionnaires reached 100％,with an expert authority coefficient of 0.945 and Kendall harmony coefficients of 0.252 and 0.260,respectively;3 primary indicators,11 secondary indicators,and 66 tertiary indicators were ultimately established to form the quality of anesthesia preparation room nursing care evaluation index system.Conclusion:The construction of nursing quality indicators for anesthesia preparation rooms is scientific and reliable,highlighting the characteristics of nursing work in preparation rooms,and providing continuous improvement evaluation methods for the nursing quality of anesthesia preparation rooms.
The reform of medical insurance payment mode is an important part of the medical insurance reform.In recent years,China has been faced with severe pressure of medical insurance fund expenditure,and the original medical insurance payment mode will cause a certain waste of medical resources,so the implementation of the DRG payment mode has become the main development direction.The article on the implementation of the DRG payment model connotation points out that DRG payment model hospital operation management faces many challenges,such as operational risk increases,reversed transmission hospitals take the initiative to reduce costs,etc.,so the hospital must combine their own actual situation,take effective countermeasures,ensure the DRG payment mode of the hospital operation and management of scientific and rationality,reduce the hospital operation risk and cost,promote the sustainable development of the hospital.
Objective:To analyze and evaluate the status quo of human resource allocation and input-output efficiency of a public hospital,to measure the human resource demand of various disciplines in the hospital,and to provide a decision-making basis for the scientific and accurate allocation of human resources in public hospitals.Methods:The development data of 32 disciplines in a large public hospital in Suzhou were collected in 2022,and four-dimensional indicators,namely,medical service,talent team,scientific research level and teaching ability,were selected to evaluate the efficiency of human resource allocation in each discipline by using the DEA and RSR methods.Results:The mean values of comprehensive efficiency,pure technical efficiency,and scale efficiency of human resource allocation in a large public hospital in Suzhou are 0.924,0.913,and 0.847,respectively,with 16 overall effective disciplines,5 weakly effective,and 11 ineffective disciplines.The RSR method divides the efficiency of human resource allocation in each discipline of the sample hospital into 4 grades,with 2 weak disciplines,14 general disciplines,13 dominant disciplines,and 3 branded disciplines.Conclusion:The investigation and calculation of the development status of the talent team and the future demand for human resources of various disciplines in hospitals,the precise positioning of superior disciplines,common disciplines,and weak disciplines,and timely planning of future human resources for each discipline are an important way to promoting discipline construction and high-quality development of hospitals.
Objective:To analyze the regional gap and evolution trend of health resource allocation in China from 2017 to 2021,and to provide a reference for further improving the equity of health resource allocation.Methods:From the three dimensions of population,geographical area,and population density,the Dagum Gini coefficient decomposition method was used to study the regional gap.Results:From 2017 to 2021,the Gini coefficient values of various health resources decreased and the regional gap narrowed,but the Gini coefficient values of health resources distributed by geographical area and population density distribution exceeded the international warning line by 0.4,the overall regional gap in the allocation level of health resources is mainly caused by the intra-regional gap,and the contribution rate of hypervariable density is low.Conclusion:The allocation of health resources in China is unbalanced,and the population distribution is better than the population density distribution than the geographical area distribution,so it is necessary to further balance the allocation of health resources and improve fairness and accessibility.
The construction of National Regional Centres(NRCs)is an important initiative to promote the expansion and sinking of high-quality medical resources and a balanced regional layout.The paper firstly reviews the background of the trustees and co-constructing NRCs by Beijing Children's Hospital(BCH)as National Centre for Children's Health,proposes a'BCH co-constructing NRCs Model',describes the main initiatives for the construction of the 4 NRCs,summarizes the current achievements,ponders on the next step of the construction work and puts forward relevant suggestions,so as to provide examples for the in-depth advancement of the construction of the NRCs.
Under the high-quality development of public hospitals,in addition to requiring the environment,equipment,and technology to reach a high level,the hospital also needs to build a professional and technical team with excellent skills and first-class services.The construction of high-level health professional talent teams occupies an important position in the medical and health field.Especially in terms of talent introduction,high-level talents are the core force supporting the development and construction of hospitals.Doing a good job in introducing high-level talents and building a high-quality first-class talent team will improve the hospital's medical quality and drive the coordinated,stable,and sustainable development of the hospital.The author introduces the practice and exploration of high-level talent introduction in a Grade Ⅲ Level A hospital in Deyang,providing a reference for the high-quality development of public hospitals.
