聚焦研究型肿瘤医院建设议题,以北京市某三级甲等肿瘤专科医院为例,采用SWOT-PEST模型,深入分析肿瘤专科医院的自身优势和劣势,并从政治、经济、社会和技术等4个维度梳理其向研究型医院转型发展的外部机遇与威胁,针对性提出应对策略建议,以期为我国研究型肿瘤医院建设发展的提供决策参考.

Objective To explore the improvement of the administrative ward rounds model and provide a reference path for promoting the refined management of public hospitals.Methods To improve the administrative ward rounds model in 4 aspects, including work subject,content index, process design, and object selection, and to analyze the actual ward rounds conducted by applying the model. Results From January 2016 to December 2021, Beijing Cancer Hospital applied the model to perform administrative ward rounds for 10 departments and supervised 67 items under optimized element allocation. Among them, the fine management issues（25 items）were the most concerned, and the overall completion rate of the supervised matters was 95.5%. The needs for high-quality development of the departments were better met, and the indicators were significantly improved. Conclusions Administrative ward rounds can optimize the allocation of elements and enhance the fine management of departments and hospitals.

Objective:To explore the external factors of the development of cancer hospitals under normalized epidemic prevention and control, and to propose targeted strategies in accordance with existing practice.Methods:PEST model was used to analyze the political, economic, social and technological environment of specialized cancer hospitals, with an overall strategy proposed based on the specific analysis of a cancer hospital.Results:In the era of normalized epidemic prevention and control, cancer hospitals were facing a new environment that was common or unique to other types of medical institutions. In response, the case hospital had adopted such strategies as integrating prevention and control with medical services, integrating offline with online services, and integrating internal and external resources to promote its recovery and development.Conclusions:Cancer hospitals and government should fully leverage the environmental changes incurred by the normalization of prevention and control, and formulate a more integrated development strategy covering short, medium up to long term conditions, based on the two major objectives of epidemic prevention and control and cancer prevention and medical services.

整合医学被视为重塑全球和各国卫生体系的关键.结合北京某三甲肿瘤专科医院的管理实践,探讨在整合医学模式下运用具体策略和管理措施,提高医疗服务质量和患者健康收益的可能方案.实践表明,医疗机构可以从学科建设、医院管理和社会服务3个维度进行整体设计,通过多学科综合诊疗等一系列管理措施,突破医、教、研、防的传统管理架构和思维模式,推动医院实现整合型发展.

研究型医院建设是各医疗机构尤其是三级医院建设发展的重要目标.近年来北京大学肿瘤医院运用卓越绩效管理模式,统筹领导、战略、市场、人才、运营等关键要素,持续推进研究型医院建设.医院围绕患者需求、自身优势,确立临床研究、转化医学和癌症高发区肿瘤防治作为研究型医院建设的三驾马车,并将其纳入“十三五”规划和综合改革方案中的关键指标及具体行动计划.医院实行卓越绩效管理后在医疗、科研、肿瘤预防方面取得了积极进展,产出、运营、人员和公益性等关键指标得以有效提升.

目的 分析北京市某肿瘤专科医院接收的上级转办信访件的现状及特点,讨论信访问题的成因,完善处理信访问题的对策,为医院信访工作的开展提供依据,促使患者的满意度以及医疗服务水平明显提升.方法 采用回顾性研究方法,对2017—2019年某医院党院办公室统一负责的由12320转来的356件信访件进行统计,通过分析信访事件随时间变化的趋势、信访事件的性质及信访事件的处理结果,对信访问题的成因进行讨论,为制定有效的对策提供良好依据.结果 2017年、2018年、2019年信访事件发生率分别为22.47％、34.83％、42.70％,呈现逐年升高的趋势,差异有统计学意义(P<0.05);诉求方式为投诉、建议和咨询,发生率分别为25.00％、13.20％、61.80％,对比差异有统计学意义(P<0.05);反映最多的五类问题依次是医疗质量、管理流程、服务态度、后勤保障、财务收费,占比分别为29.21％、21.91％、18.82％、15.73％、14.33％;3年间信访满意率分别为80.00％、91.94％、98.68％,呈现逐年升高的趋势,差异有统计学意义(P<0.05).结论 通过分析医院信访工作中存在的问题,制定针对性的整改措施,促使医疗服务质量明显提升,为医院健康、稳步、可持续的发展提供良好保障.

Value-based healthcare emphasizes the importance of taking patients′ needs and experiences into full consideration during the entire diagnosis and treatment process and providing patient-centered medical services, so as to improve population health and medical outcomes with manageable medical costs.From this perspective, it is particularly important to investigate how patients could take full advantage of their subjective value and central role to engage in healthcare-related activities. This article aims to summarize the concepts and specific pathways relevant to patient engagement in the entire healthcare process, and provide specific suggestions and recommendations on promoting participation in health self-monitoring, access to disease and consultation information, shared decision-making(SDM)between doctors and patients, patients for patient safety(PFPS), patient-reported outcomes(PROs), participation in self-management, and participation in patient organizations, etc. This article provided valuable reference and evidence on implementation of relevant medical practices and policies.

目的 加强疫情期间信访管理,提升医院治理水平,保障人民健康.方法 在信访形势分析的基础上,运用"识别-化解-反馈"机制,加强诉求识别,突出主体责任,创新化解渠道,及时分析反馈.结果 信访数量迅速回落,答复效率明显提升(48小时内答复率76％),并对解决患者健康需求、提高信访满意率产生积极作用.结论 疫情期间医疗机构信访管理的重要性、紧迫性较日常时期更加突出,应充分发挥信访管理作用,保障人民生命安全,提升治理水平,为疫情防控做出贡献.

Background Limited information is available regarding the patient safety culture in Chinese hospitals. This study aims to assess the patient safety culture in Peking University Cancer Hospital and to identify opportunities for improving the organization’s safety culture. Methods A cross-sectional study was conducted in April 2018 and 2019, respectively. Data on patient safety culture were collected from clinical and administrative staffs using the Hospital Survey on Patient Safety Culture (HSOPSC). Results Twelve composite dimension variables were hierarchically clustered. Three highest positive response dimensions include ‘Organizational Learning and continuous improvement’ (92.9%), ‘Teamwork within units’ (89.7%), and ‘Hospital management support for patient safety’ (83.7%), while 3 lowest positive response dimensions included ‘Frequency of events reported’ (43.9%), ‘Non-punitive response to error’ (51.1%), ‘Communication openness’ (52.2%), and ‘Staffing’ (53.7%). Compared to the average scores of the United States, the scores of the Peking University Cancer Hospital was significantly lower on ‘Communication openness’ and ‘Frequency of events reported’. After targeted continuous improvement based on results in 2018, all 12 dimensions surprisingly increased in the safety culture conducted in 2019. Conclusion Inadequate feedback and communications about error and lack of communication openness are key challenges for patient safety in the delivery of care in this hospital. Results of this baseline survey indicate the need for a modified approach and attention to context when designing interventions aimed at improving the safety culture in this organization.

The study is to establish the administrative ward round system and its effect evaluation system under the modern hospital management conditions, and explore the formation of a standardized, scientific and replicable standard mode of Administrative Ward round. According to the annual ward rounds plan, clinical departments and administrative departments were organized to decide the major issues of a department according to the procedures of " hearing-evaluation-discussion-decision " , and to ensure the implementation of management. Since 2016, administrative ward round has been carried out in 9 departments, and the medical quality and operational efficiency have been improved significantly. The closed-loop administrative ward rounds mode can effectively promote the modernization of hospital management system through the joint decision-making of clinical departments and functional departments.

In the process of promoting modern hospital management system, the two basic issues repeatedly thought and constantly researched are: what kind of modern hospital management system will be established and how to establish modern hospital management system. Seen from current status, modern hospital management system is arranged by public hospital system making modern hospital and management system match socialist market economic system, meanwhile, modern hospital management mode is also the target mode Chinese public hospitals constantly reform. Three comparatively outstanding features and requirements of modern hospital management are systematic power release, effective governance and scientific management. The features can be specified, that is to say, in the aspect of organization form, modern hospital management system belongs to one special public legal person system, power release of systematism is made by this system; From the aspect of system equipment, modern hospital management system includes one series of interrelated governance mechanism to conduct effective governance; From the aspect of management behavior, modern hospital management system means scientific, refined and professional management of public hospitals to realize the feature of scientific management.

目的:通过问卷调查,分析行政管理部门对于法律顾问的工作模式及法律服务的具体需求,以加强医院法律顾问制度建设.方法:对某公立医院22个行政管理部门进行问卷调查,并对5个重点部门进行了无结构深度访谈.结果:聘请专职律师、外聘律师需具有医院法律顾问工作经历、签订三年及以上的服务期限,是较好的法律顾问的工作模式;服务需求方面,最希望律师提供的前三位服务包括“起草、审阅、修改合同等法律文件”、“日常法律事务咨询”、“协助起草、审阅、修改单位规章制度”,不要求法律顾问进驻医院,但所提需求应在3个工作日内予以响应.结论:问卷调查结果,为建立适合医院的标准化法律顾问制度、流程、内容提供了建议与方向.

目的 通过调查某肿瘤专科医院国际交流现状,分析面临的挑战,提出应对措施,为医院更好地开展外事工作提供参考.方法 全面调查某肿瘤医院2015年至2017年在编职工因公出访和外宾来访情况并进行统计分析.结果 2015年至2017年,肿瘤医院在编职工因公临时出国(境)602人次,因公长期出国(境)55人次;2016年至2017年,医院累计接待外宾来访129人次.国际交流以消化道肿瘤、胸部肿瘤、乳腺癌、淋巴瘤、黑色素瘤等医院重点学科为主.结论 该肿瘤医院国际交流不断发展,但面临资源配置不均衡、合作转化率低、成果分享不足、政策知晓度有待提高等挑战,医院将通过加强整体规划、优化外事管理、扩大政策宣传等措施综合应对.

应用案例研究法与深度访谈法,对案例医院2014-2016年的法律事务数量、需求部门及类型等进行统计分析;并通过与行政管理部门负责人无结构的深度访谈,挖掘现行法律事务实践中的问题与趋势.发现在对外合作、知识产权保护等领域服务需求增加,以及法务咨询需求亦有增长趋势;存在的问题主要在于:缺乏法务主管部门与专职人员;缺乏统一的合同管理制度,以及缺乏广泛的范本合同.完善医院法律事务工作已成为依法管理医院以及建立健全现代医院管理制度的迫切需求.完善合同管理制度、制作医院的范本合同、更多关注对外合作、知识产权保护等新兴领域的法务需求,是完善医院法律事务实践的有效措施.

建设国际一流的肿瘤治疗中心,除了先进的治疗理念、精密的检测仪器、技艺精湛的医疗团队,还需要什么?季加孚院长这样说—— "坚持正确导向,打造积极、先进、开放的医院文化,以先进的医院文化引领医院发展,为医院发展保驾护航."

S100A6 is involved in regulating the progression of cancer. S100A6 can regulate the dynamics of cytoskeletal constituents, cell growth and differentiation by interacting with binding or target proteins. The present study investigated whether S100A6 affects cell proliferation in gastric cancer cells by stimulating several downstream factors. Firstly, the expression and localization of S100A6 were investigated using immunohistochemical staining, an immunoelectron microscopy and laser confocal scanning. A ChIP-Chip assay was performed to determine the downstream factors of S100A6 using promoter Chip analysis, including approximately the -800 to +200 regions around the transcription starting point. Polymerase chain reaction analysis was performed to confirm this. It was found that the intensity of S100A6 staining was markedly higher in the cytoplasm and nucleus, and its expression level correlated with that of the Ki67 protein. The overexpression of S100A6 also promoted cell proliferation in AGS and BGC823 cell lines, detected using a Cell Counting-Kit 8 assay. In cells overexpressing S100A6, the expression levels of interleukin (IL)-8, cyclin-dependent kinase (CDK)5, CDK4, minichromosome maintenance complex component 7 (MCM7) and B-cell lymphoma 2 (Bcl2) were noticeably increased. In conclusion, the increased expression of S100A6 promoted cell proliferation by regulating the expression levels of IL-8, CDK5, CDK4, MCM7 and Bcl2 in gastric cancer cells.

To explore the value of digital office management model on the administrative value of hospital.Through the communication and communication functions,business management functions,personal office functions and system supervision functions of the implementation of digital office management mode,the establishment of information exchange platform to achieve resource sharing.In the digital office management mode,can effectively achieve the exchange platform and a complete information query,effectively shorten the distance between space and time,to promote the increase in information disclosure,sharing of resource data,and then monitor and optimize the workflow,reduce office supplies,Improve the effectiveness.In the hospital implementation of digital office management model can promote the hospital organizational structure flat,standardized management work,to promote the level of management and work efficiency.

公立医院绩效考核体系中，行政管理部门的绩效考核是医院绩效考核体系的难点。检索以往文献［1‐4］，公立医院行政管理部门绩效考核体系存在着考核指标难以统一评价；考核内容过于笼统、易受主观随意性的影响；考核结果无法准确反映各部门人员之间的水平与差距；考核结果与奖惩挂钩不到位等诸多问题。这些都会造成行政管理部门对考核重视程度低、参与积极性不高、绩效考核拘泥于形式，无法真正达到绩效管理的目的。本研究以院长办公室为例，建立以目标管理为原则、以平衡积分卡为维度、以关键业绩指标（key performarce indicator ，KPI）为技术、以360度测评分为考评方式的绩效考核指标体系，以期为各公立医院行政管理部门的绩效考核提供参考。

本文梳理了医院评审评价制度的相关理论,对制度运行的特点以及评审中出现的问题进行了归纳总结,最后从评审的理念与评审标准的建立、评审方式与评审程序的完善、评审结果的应用,以及评审主体这四方面探讨了完善我国医院评审评价制度的对策建议.

Objective To study employee satisfaction in the hospital so as to provide evidence for hospital decision-making.Methods The anonymous questionnaires were issued to 1310 employees to carry out statistical analysis.Results The largest differences in satisfaction scores between managers and grass-roots staff lay in occupation loyalty and management mechanism. Staffs had the lowest satisfaction scores in the system of rewards and penalties (2.35 scores), job responsibilities (2.54 scores), income level (2.76 scores). Middle-aged staff with 11-15 working years had the lowest scores in cohesion and willingness to work.Conclusion The suggestions were brought forward according to the results, such as promoting the hospital transparency, paying more attention to the middle-aged staff, building learning platform, transforming the staff's marketing mentality, motivating employees to participate in the project management and optimizing the organizational structure.