英国医疗服务创新模式分析——以NHS西北创新中心TrusTECH为例

英国医疗服务创新成果显著,值得借鉴.首先简要介绍了英国国家医疗服务体系(NHS)及其创新系统的主要情况,接着以NHS的西北创新中心TrusTECH为例,介绍了它的两种创新模式--商业化创新和服务创新计划,然后通过三个案例(生理学追踪和触发系统、信息管理工作手册和戒烟服务)深入分析了TrusTECH的服务创新流程和特点.最后总结了英国医疗服务创新模式的理论启示,以及对我国医疗服务创新的实践启示,包括培养医护人员创新意识和能力,建立系统化的创新平台,实现平台上的知识共享,以及重视非商业化创新等.     

Forward view: advancing health library and knowledge services in England

This article is the fourth in a series on New Directions. The National Health Service is under pressure, challenged to meet the needs of an ageing population, whilst striving to improve standards and ensure decision making is underpinned by evidence. Health Education England is steering a new course for NHS library and knowledge services in England to ensure access to knowledge and evidence for all decision makers. Knowledge for Healthcare calls for service transformation, role redesign, greater coordination and collaboration. To meet user expectations, health libraries must achieve sustainable, affordable access to digital content. Traditional tasks will progressively become mechanised. Alongside supporting learners, NHS librarians and knowledge specialists will take a greater role as knowledge brokers, delivering business critical services. They will support the NHS workforce to signpost patients and the public to high‐quality information. There is a need for greater efficiency and effectiveness through greater co‐operation and service mergers. Evaluation of service quality will focus more on outcomes, less on counting. These changes require an agile workforce, fit for the future. There is a bright future in which librarians’ expertise is used to mobilise evidence, manage and share knowledge, support patients, carers and families, optimise technology and social media and provide a keystone for improved patient care and safety.     

A safe place to stay sharp: action learning meets cooperative inquiry in the service of NHS OD capacity building

This is an account of practice. It explores the meeting point between action learning and action research, as a way of doing capacity building in organisational development (OD) in the NHS in the UK. The authors were part of a short cooperative inquiry (Heron, J. 1996. Co-operative Inquiry: Research into the Human Condition. London: Sage). The research found that it was vital in such challenging environments as the current NHS scene to have a ‘safe place to stay sharp.' They outline here what the qualities of such a space might be for themselves, and, following the notion of parallel process (what we experience may be symptomatic of the wider system), for other OD practitioners in the NHS.     

全外显子组测序发现一个中国Nance-Horan综合征家系NItS基因的新突变

研究目的：通过对一个中国Nance-Horan综合征家系的临床表型及基因突变分析,揭示本家系的致病遗传机制。研究方法：对该Nance—Horan综合征家系的一个男性患者进行全外显子组测序,结合此家系临床表型及遗传方式分析,选定x染色体上NHS基凶上的一个无义突变c．322G〉T（E108x）为可疑致病突变。通过聚合酶链式反应（PCR）和Sanger测序,对该家系内其他成员进行NHS基因突变分析,同时对50名健康对照者的NHS基因的突变检测结果进行对比。另外,将该突变的位点第108位氨基酸残基进行多物种NHS蛋白内序列比对。最后,对该家系成员眼部及全身的临床特点进行全面检查和分析。重要结论：全外显子组测序结合Sanger测序发现NHS基因第一个外显子上的c．322G〉T（E108X）突变为引起该家系临床病变的突变位点;多物种NHS蛋白内序列比对发现该突变位点第108位氨基酸残基位于高度保守区;临床表型分析发现该家系内存在表型异质性。此家系为国内首次报道的无义突变引起的Nance-Horan综合征家系。     

Knowledge for Healthcare: the future of health librarianship

Many people are still not receiving the right care. It is imperative for health care librarians to come together around a common vision to achieve Knowledge for Healthcare so that the right knowledge and evidence is used at the right time in the right place. The authors describe five workstreams within a modernisation programme: Service Transformation, Workforce Planning and Development, Quality and Impact, Resource Discovery and Optimising Investment. Communications, engagement and partnership working are central to success. The development framework sets out principles on which to base decisions, and design criteria for transforming services.     

An investigation into the move towards electronic journals: a case study of NHS libraries in Kent,Surrey and Sussex

Electronic journals are so embedded into practice in academic libraries that it is easy to forget that this is not the case everywhere. In NHS libraries, for example, the staff face a particular set of issues. This article is based on Rebecca England's dissertation on this topic, completed as part of the MSc Econ course in Information and Library studies at Aberystwyth University. Rebecca is E‐resources Librarian at the Maidstone and Tunbridge Wells NHS Trust. She investigated the momentum towards electronic journals in NHS libraries in the Kent, Surrey and Sussex region and the potential for a regional purchasing consortium. AM