党的十九大首次提出"高质量发展"的概念,原本是指经济的高质量发展,后来这一概念逐渐成为各领域发展的指导原则.2021年6月国务院办公厅出台了《关于推动公立医院高质量发展的意见》,明确了公立医院要朝着高质量发展的方向持续推进.公立医院实行的是党委领导下的院长负责制,要实现党对高质量发展的有效领导,需要明晰高质量党建与高质量发展的关系,从各自的内容、运行特点和结果中完善对其关系的认识,从而在工作中正确处理二者的关系,以高质量的政治建设引领医院高质量发展方向,以高质量的组织建设保障医院高质量发展实践,以高质量的作风建设营造医院高质量发展环境.

Objective:To understand the current situation and problems in the construction of research wards in Beijing municipal hospitals, and put forward corresponding strategies and suggestions to explore the path for the construction of research hospitals.Methods:From March 2020 to May 2021, through the method of questionnaire and expert interview, the bed and personnel allocation, projects undertaken, review efficiency and problems faced by the research wards of 22 Beijing municipal hospitals were analyzed in depth.Results:82%(18/22)of the municipal hospitals explored the construction of research wards, and 27%(6/22) were Beijing Demonstration research wards construction units. In 2020, the overall performance of the construction of research ward was as follows: the investment of clinical research resources was increased, the ability of clinical research was enhanced, the ability to serve enterprises in Beijing was improved, the efficiency of examination was improved, but the enrollment rate of clinical research(including clinical trials) was reduced. At present, the main problems were focused on investment, personnel and informatization.Conclusions:The construction of research wards in Beijing municipal hospitals is developing steadily, but there are still some problems, such as lack of clinical research talents, performance incentive and guarantee to be strengthened. In the future, we should strengthen the training of clinical research talents, improve the incentive and guarantee mechanism, promote the integration of industry, university and research, accelerate the construction of clinical research information system, further improve the hospital′s clinical research ability and level, and accumulate experience for the construction of research hospitals.

结合去中心化临床试验特点及北京自由贸易试验区政策优势,梳理在京开展去中心化临床试验存在的优势、机遇及挑战,从完善相关法规体系、营造政策环境、提高落地效率与质量等方面提出建议,为北京市各相关部门及在京医疗机构开展去中心化临床试验提供决策参考.

健康医疗逐渐成为大数据应用最活跃的领域之一.为了更有效地推动健康医疗行业数据整合、存储、共享、管理和保护,文章从医疗行业数据安全发展的现状、面临的挑战进行研究,对安全保护策略进行探讨,完善健康医疗行业数据安全体制机制,为健康医疗行业数据的发展保驾护航.

伦理审查作为规范研究行为、控制研究风险的重要手段,在医院科研课题临床研究增多和精细化管理面前,遭遇一定的问题与挑战.本文针对首都医科大学附属北京胸科医院科研课题伦理审查中遇到的伦理知识知晓、审查方式选择、样本库伦理及跟踪审查等问题的影响因素和原因进行深入分析,并提出加强委员准入、考核和培训,丰富伦理审查形式,强化与学术审查协同,规范样本库泛知情签署流程,推进伦理追踪审查等相应的解决对策.本文认为准确把握科研课题实施和遵循伦理间的平衡点,确保临床科研健康规范地发展,对提高医院科研课题临床研究的伦理审查质量,完善伦理审查体系,有较强的实用价值.在未来,要结合国际国内及医院的相关标准和实际情况,制定对于临床科研课题的伦理审查规范将是我们下一步的工作重点,并为其他医院开展科研课题伦理审查提供借鉴.

Collaborative development among medical practice, education and research is a strategic decision of the country in disciplinary development guided by the innovation-driven strategy. In October 2017, Beijing Hospitals Authority organized 18 tertiary hospitals with pediatrics discipline and founded a collaborative development center for pediatrics. This center operated in a model featuring both leadership of due authorities and autonomous administration. Two of the specialized pediatrics hospitals work as leading units, and existing high quality pediatrics resources of the member hospitals were pooled to establish an academics committee and an executive committee. A development system was established with disciplinary construction as the focus, collaborative development as the goal and horizontal collaboration as the means. It was designed to explore a new model featuring overall planning and standardized management of the discipline, building of a shared platform for clinical capacity development, joint development of continued medical education and talent cultivation, as well as diversified and multi-centered research and platform resources sharing. This model can effectively promote the overall development level of pediatrics in Beijing municipal hospitals.

Objective:Construct a set of evaluation system of scientific and technological innovation index of Beijing municipal hospitals, so as to lay a foundation for the systematic evaluation of scientific and technological innovation capacities of such hospitals.Methods:By using the methods of literature review and expert consultation, the composition and weight of scientific and technological innovation index of Beijing municipal hospitals are determined.Results:The evaluation system includes 5 first-level indexes, 13 second-level indexes and 17 third-level indexes, which including innovation resource index, talent development index, academic contribution index, development vitality index and industry support index.Conclusions:The evaluation system of scientific and technological innovation index of Beijing municipal hospitals pays attention to the talent development and high-quality output, innovation introduces development vitality index and industrial support index, which is a useful exploration for the " collectivization" horizontal quantitative evaluation of scientific and technological innovation capacity.

健康医疗大数据是国家重要的基础性战略资源,建立国家健康医疗大数据平台是深入实施创新驱动发展"健康中国"战略的重要环节.临床研究产生的数据是健康医疗大数据的重要组成部分,依托国家临床医学研究中心开展基于临床研究的国家级健康医疗大数据平台建设是目前较为成熟和可行的一种模式,在实施过程中要统一数据标准,使用高效的数据采集技术并严格控制数据质量,重点保障数据安全,最终实现数据的挖掘共享和经营管理,产生巨大社会价值.

Objective:To analyze the application for and funding for individual key clinical specialties under the Youth Program at the approved hospital groups, for suggestions on future development of hospitals.Methods:Based on the Youth Program data of the applications and approval as summarized by Beijing Hospitals Authority from year 2015 through 2018, 22 municipal hospitals were classified into three groups with more, less and none key clinical specialties respectively(the more group, the less group and the non group for short). The categories were made according to the number of state key clinical specialties approved by National Health Commission and key specialties approved by the National Administration of Traditional Chinese Medicine. χ2 test was used to compare the baseline situation, the approval rate of project applications, and the categories of approved project among the three hospital groups. Results:During 2015—2018 period, the number of applicants for Youth Program was 1 128 persons/cases. The groups with more, less, and none key clinical specialties were 7, 10, 5 respectively. In the more specialties group, the applicants of seniority less than five years accounted for 40.93%, who had higher than those of the other two groups( χ2=13.794, P=0.032), and higher doctoral degree applicants(80.31%) as well. The difference was statistically significant( χ2=116.611, P<0.001). The approval rate of the Youth Program in 2015—2018 in the group with key clinical specialties vs. the group with none key clinical specialties was 36.09%(166/460) rersus. 29.04%(194/668) with significant difference( χ2=6.222, P=0.013). The approval rate of the departments with more key clinical specialties was 37.82%, higher than those of less and none key clinical specialties(approval rate at 31.82% and 21.50%, respectively), with significant difference( χ2=16.897, P<0.001). However, there was no significant difference between the approval rates of key specialties group and non-key specialties in each hospital group( P>0.05). Of the three groups, the proportion of clinical medical projects in each group was all higher than such other types as scientific research, medical technology, hospital administration and nursing. Conclusions:The applications and approval rate of key specialties under the Youth Program were higher than the rest, reflecting the discipline advantage. At the same time, it can play an important leading role in the construction of research-oriented hospitals. It is necessary to further strengthen the showcase role of specialties, for encouraging innovative talents cultivation of other specialties, in the hope for promoting the construction of research-oriented hospitals in their clinical, scientific research, medical technology, management and nursing comprehensively.

2017年4月,北京市医院管理局(以下简称医管局)下发《医学学科协同发展中心试点工作实施方案》,选择在儿科和消化内科等学科具有全国领先优势的两家市属医院试点医学学科协同发展中心(以下简称协同中心)建设,辐射带动其他市属医院儿科和消化内科的整体发展水平,初步建立适合市属医院的协同发展体系,进一步提高管理水平、创新工作模式、完善运行机制以及绩效产出、建立质量评估和持续改进体系.协同中心定位于区域协同发展,又不同于传统的分级诊疗体系和区域医学中心,是医管局在充分梳理市属医院学科发展特点,并结合自身集团化管理优势的基础上提出的一种有机协同、全面发展且相对紧密的协同创新体系,对提高市属医院整体学科水平有重要意义,报告如下.

目的 2017年度中国医院科技影响力排行(综合排名)得分、指标体系和相应数据中,选取前100的北京市属三级医院为研究对象,分析科技影响力发展现状,为市属医院提升科技影响力提出策略性建议.方法 通过描述性分析等方法,分析北京市属医院的投入、产出、影响力及科研效率,并与在京央属医院相关指标进行比较.结果 进入2017年全国影响力前100强医院中,北京市属三级医院有8家,其近年来整体科技实力不断提升,但与在京央属医院相比,在国家自然科学基金项目数、高影响因子论著、科研效率等方面还有待进一步提升.结论 需要综合科技投入、科技产出、影响力等多个指标来制定相应的策略与措施,提高科研效率,加大对纵向科研项目特别是国家自然科学基金项目的储备,提高论文质量和专利产出,以期提升市属医院的科技影响力.

目的 探索建立行之有效的医院科技成果的经济效益评估方法体系.方法 向北京市属医院征集重点产业转化类成果,利用“风险修正型现值收益法”模型(risk-adjusted net present value,rNPV)进行估值研究.结果 共征集来自8家市属医院的14项成果,涉及化学药品、中药等5个产品领域,估值结果显示,各成果估值均符合当下技术市场行情相匹配的价值区间要求,因技术成熟度存在差异,其中1项成果偏向价值区间上限,5项偏下限,8项位于中线水平.结论 rNPV模型能够综合考量成果各项风险要素对估值结果的影响力,可以相对准确地对医院科技成果进行估值,具有较强的实践意义.

Discipline development is the core power of hospital development,which is highly emphasized by Beijing Municipal Administration of Hospitals.To meet the demands of public hospitals reform and requirements of municipal hospitals development,performance evaluation is used as a tool for municipal hospitals in their fine management.This paper introduced the research performance evaluation system and index design of Beijing’s municipal hospitals,with a summary and analysis the operating and practices.

近年来，交叉学科快速发展，以疾病诊疗或科研项目等任务为中心的学科群建设的重要性日益明显，甚至成为衡量医院整体办院水平和学术地位的重要标志，培养和巩固医院的优势学科群体系成为当前医院管理和宏观政策的重要目标之一。北京市医院管理局（简称医管局）的成立是北京市政府全面推行公立医院改革的创新举措，具体承担北京市属21家三级医院的运行管理职能。为了解医管局所属医院（简称市属医院）学科群建设情况，我们采用SWOT 分析方法[优势（strengths）、劣势（weakness-es）、发展机会（opportunities）和威胁（threats）]进行学科群建设的分析，为提升市属医院学科群优势，增强核心竞争力提供借鉴和参考。

目的 探讨北京21家市属医院科技成果转化的现状和存在的问题,探索医院科技成果转化和产业化创新举措.方法 通过问卷形式对北京市医院管理局所属21家市属医院的科研工作者进行调查,了解科技成果转化情况 结果 2000年1月1日至2013年12月31日21家市属医院共有科技成果587项,已转化进入市场57项,转化率9.7％;外科、内科等为北京市属医院的成果高产学科;产业转化类成果估计市值大部分集中在100万～500万元;近5年市属医院科研投入人民币5亿元,其中政府投入占76.6％,医院自有经费占20.8％.结论 市属医院科技成果转化主要存在转化资金不足、转化比例小、价值不高,成果产出依赖优势专业等特点,可从增加投入、加强院企合作、培训宣讲、人才培养等方面探索解决问题的措施.

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