新医改环境下创新医院图书馆服务模式的思考

阐述了医院图书馆服务模式转变是社会发展、医院改革和读者需求的客观必然。并以新医改政策为契机,打破区域和行政隶属的限制,对现有的医院图书馆资源进行有效的整合,改革医院图书馆的管理和运行机制,构建现代医学信息体系,创新医院图书馆服务模式。     

高校保健体育课与心理健康教育的研究

通过查阅了大量文献资料,发现就目前高校保健体育的开课现状调查分析,趋势不容乐观,保健体育课教学在一部分高校中没有得到应有的重视.为此,笔者从对高校保健体育课与心理健康教育的必要性、保健体育课程与<学生体质健康标准>内容的编制等几方面提出了一点思考,为完善高校保健体育课教学提供参考.     

具有提前期的三级和二级药品库存模型比较

根据总成本最小原则,在考虑需求提前期影响的情况下,建立了基于随机提前期的三级药品库存优化模型和基于常值提前期的二级药品库存优化模型.运用Matlab软件研究了提前期与库存成本的关系,说明了提前期的变化对药品库存系统有着重要的影响.通过数据实例借助Lingo软件对2个模型进行了仿真计算和比较,结果表明,在保证服务水平的前提下,具有提前期的二级药品库存的总成本比三级药品库存的总成本有明显降低.     

保健运动误区的生物学因素分析

因人而异、科学合理的保健运动对促进人体身体健康非常重要。然而人们在保健运动中常存在一些误区,如对有氧运动与无氧运动、适宜运动量的错误认识;运动减肥上的认识误区;中、老年人锻炼肌力必要性的认识不足;女性经期运动认识误区;锻炼时间选择上的误区,等等。该文从生物学角度对以上误区进行分析探讨,从而达到纠正人们认识偏差的目的,为进一步指导人们科学合理地进行保健运动、促进身体健康提供一些有益的帮助。     

Innovating for a cause: the work and learning required to create a new approach to healthcare for homeless people

Innovation occupies a pivotal place in our understanding of knowledge-based economies, and this is raising questions about sources of innovation, how it originates, and the role played by employees, work practices and learning. This paper explores these issues through case study research into a new approach to providing healthcare for homeless people in England, and by bringing together conceptual insights from the employee-driven innovation literature, and more broadly from social and practice-based learning theory and organisational theory. Applying these perspectives to our case enables illumination of the innovation as a process – not an event – and as an ongoing set of organisational practices that transcend their origins. Through our analysis we argue that the notion of ‘a cause’ is helpful in elucidating the impetus and the commitment to making the innovation happen (and go on happening). Our findings are presented under three themes: ‘establishing a cause’, ‘organising for innovation’, and ‘innovative capability in practice’. Building on these, we have identified five key inter-related dimensions which help conceptualise the work and learning that it took to create and (re-)enact the innovation and that we suggest may have relevance for understanding and characterising other employee-led innovations in and perhaps beyond healthcare.     

公立医院医务人员薪酬管理体系改革探讨

公立医院医务人员是医疗服务体系的主体,但是存在收入分配不合理,医务人员职业责任和风险高,工作量大等问题.在医改进程中,保障并提高非营利性公立医院医务人员的薪酬标准,建立新的公立医院薪酬分配体系,是医疗改革问题的根源,也将保障医改顺利进行.     

Digital health eco-systems: An epochal review of practice-oriented research

This article describes an epochal review of research literature on practice-oriented digital health ecosystems that have emerged during the period between 1998 and 2018. Practice-orientation refers to efforts that have resulted in positive impact and transformations in the delivery of healthcare. The review is epochal in the sense that there have been 3 major stages of innovation and diffusion in digital health that are identified. The year 1998 was deemed a significant starting point for the literature search because it marked the introduction of the term e-health. The main objective of this review is to track the evolution of digital health and the conspicuous developments in the field - crucial steps to get a grasp of the key issues involving the delivery of healthcare. The article includes a general discussion of these various key issues and sensitizing concepts. The sense-making thus shed some light on the areas of enquiry, which are central to identifying the direction in which the practice of healthcare is headed. These areas of enquiry often referred to as ‘substantive areas’ in qualitative research terminology, were identified as ‘electronic medical records’, ‘health cloud’, ‘data analytics’, ‘Internet-enabled devices’, and other ‘emerging information technologies’. The article concludes with a synthesis of key inferences drawn from the epochal review. The digital disruption of healthcare has created necessary conditions for its offering as a global, interoperable service.     

Teaching root cause analysis in healthcare management with Grey's Anatomy

Over the past 20 years, root cause analysis (RCA) has become one of the most widely used retrospective methods for detecting safety hazards in medicine and healthcare. Despite its wide use in management practice and growing popularity in academic research, there is currently a dearth of coverage of RCA in popular healthcare management textbooks and pedagogical publications. This paper addresses this gap by presenting innovative instructional materials and recommendations for teaching RCA in healthcare management. Using an episode of Grey's Anatomy TV show, this experiential learning exercise takes students through the steps of RCA and makes use of a range of RCA tools, including high-level flowchart, fishbone diagram, “five whys”, corrective action plan, and others. The exercise, which was classroom tested and received positive student feedback, can be adapted to a range of healthcare management classes. Because RCA can have widespread, lifesaving consequences, healthcare management courses can significantly benefit from integrating this exercise into classroom pedagogies.     

Mapping experiences of pathological demand avoidance in Ireland

Pathological demand avoidance (PDA) is contended to be a distinct presentation within autism characterised by extreme levels of anxiety in response to the demands of everyday life, manifested in excessive levels of demand avoidance. This results in complex interactions with service providers in education and health settings, impacting on outcomes for individuals and their families. This national study sought to gather the viewpoints of individuals who experience PDA, families, and practitioners, with the intention of determining levels of knowledge, recognition and understanding of PDA; exploring current pathways to assessment and diagnosis; capturing experiences of access to education and healthcare services; identifying effective intervention and support strategies; and illuminating education and health outcomes for individuals and families. This mixed-method study collates survey responses from N = 264 parents, N = 9 life partners, N = 6 individuals experiencing PDA and N = 54 practitioners, and in-depth individual and focus group interviews from these cohorts. Findings suggest that a flexible, informed and individualised approach to assessment and service provision for individuals presenting with a PDA profile is essential. Practitioners universally referred to the necessity for a streamlined, integrated and multi-disciplinary approach. The reported disconnect between education and health systems indicates a need for access to services on an equitable basis.     

Ethical Challenges for Student Design Projects in Health Care Settings in New Zealand

Student‐led design projects undertaken within healthcare settings raise considerable ethical challenges, primarily resulting from collaboration with service users. This article emerged out of the experiences of design from a New Zealand university undertaking real world projects in acute health care contexts. A human‐centred approach to design is underpinned by a requirement for students to immerse themselves in the user context to optimise design outcomes. Several issues exist in relation to the management of the ethical complexities arising from these projects. Multiple formal ethical review processes were triggered when students’ projects were defined as research. These processes were perceived as onerous and disproportionate to the scale of the projects, and students were ill equipped to identify ethical issues and engage with formal review processes. This resulted in either abandoned projects or the use of compromised methods. A review of codes of practice and design industry approaches identifies a gap in guidance for both students and qualified designers. Some designers describe their projects as service improvement, and not subject to formal ethical review. This article argues for embedding consideration of ethics in all design projects to enhance the process, to be true to the underpinning philosophy of human centred design and to produce ethically aware graduates. To achieve this, a multi‐pronged pedagogical approach which encompasses both hypothetical, class‐based and real‐world learning experiences is described, with the ultimate goal of normalising the consideration and development of ethical standards for students and best practice across the industry.