某院芦山地震医学救援实践

2013年4月20日,四川省芦山县发生7.0级强烈地震后,本院快速抽组医疗队赶赴灾区,开展3种形式的医学救援行动;医疗队在救援过程中表现出经验丰富、预案完善、科学施救的特点。结合参加地震医学救援的实践经验,在今后的灾害医学救援工作中,为了进一步提高医疗救援的效能,还应在健全军地协作机制、提升救援活动的信息化水平、规范医学信息统计分析工作,加强医疗人员综合保障防护措施等方面不断完善和提高。     

武警某部医院遂行“4·25”尼泊尔地震医学救援实践与启示

"4·25"尼泊尔地震发生后,武警某部医院紧急抽组医疗队赶赴灾区进行医学救援。通过分析此次医疗救援的特点和关键做法,总结经验启示,以期为部队医院提高卫勤保障能力提供借鉴。     

姜潮：我就是连长

地震刚刚发生，正在北京开会的辽宁省卫生厅姜潮厅长便抓起电话，要求辽宁省内所有大型医院马上组建医疗队，随时准备赶赴灾区。5月14日，120名医疗队员登上了飞往灾区的飞机。15日，医疗队分成4组分别进驻绵阳市中心医院、绵阳市中医院、绵阳市人民医院和北川受灾群众临时避难所九洲体育场。一场争分夺秒的紧急医疗救援战役就此打响。     

非军人护士应急医疗救援中的培训

目的 探讨军队医院非军人护士应急医疗救援培训的护理组织与管理.方法 配备合理的人力资源,明确应急医疗救援工作职责,制定科学的轮训制度,通过训练及严格的组织管理,做好应急医疗救援的准备工作.结果 非军人护士的考核成绩由75.26分升至85.23分;提高应急医疗队的快速反应能力,准备阶段的时间由25分钟缩短至15分钟,提高工作效率.结论 科学高效的组织管理是圆满完成应急医疗救援任务的关键.     

“5．12”抗震救灾军队医院医疗队救援实践

本文结合军队医院医疗队参加汶川地震医疗救援的实践，探讨医院派出医疗队实施医疗救援时应做的八项工作，以发挥医疗队的最大作用，提高部队医院应急医疗保障能力。     

海上医疗队执行抗震救灾任务的卫勤管理

本文介绍了某海上医疗队在地震灾区执行医疗救援的管理实践。得益于多年军事斗争训练准备,该医疗队在执行抗震救灾任务中,正确理解上级指示,科学管理队伍,适应灾区实际,始终掌握救灾工作主动。作者从救灾实践中体会到,训练和管理水平是卫勤分队胜任多样化任务的关键。     

山东医疗队员积极投身于抗震救灾工作

5月12日，山东省卫生厅得到四川省汶川县发生强烈地震消息后，厅领导高度重视，立即指示厅应急办密切关注灾情，做好医疗救援准备，并立即组建了20人的救灾防病队伍和28名医护人员组成的2支医疗队，于13日早10时乘飞机赶赴灾区参加医疗救援和救灾防病工作。     

强化应急机动训练 提高卫勤保障水平

机动卫勤分队建设是军队医院义不容辞的责任和义务，同时还担负着各种突发事件应急医学救援任务。解放军第八十八医院充分认清了应急能力和机动能力在机动卫勤分队建设中的重要作用，重点加强了这方面的工作。特别是在汶川大地震发生后，医院根据上级命令紧急抽组了一支防疫医疗队，由于有充分的准备和预案，防疫医疗队以最快的速度到达灾区执行任务，做到了“忙而不乱、快而不散”，得到各级领导的一致好评。     

某部医疗队地震灾害紧急医疗救援的特点及体会

目的 探讨地震紧急医疗救援实施的有效措施.方法 总结某部医疗队汶川地震紧急医疗救援的特点,分析救援的难点,寻找解决问题的有效办法.结果 医疗队在第一时间赶到救援现场,完成平武县南坝镇灾区紧急救援任务,实现了安全高效救援目标.结论 地震紧急救援应把握的重点:行动迅速,技术全面,任务目标明确,救援指挥有力,救援力量配置合理,救援灵活机动,志愿者作用发挥充分.     

中国医疗队情暖菲律宾

<正>2013年11月8日,菲律宾遭受台风"海燕"袭击,造成重大人员伤亡,中国政府决定派遣医疗队赴菲律宾提供紧急医疗救援。国家卫生计生委依托国家紧急医疗救援队浙江队组建了一支50人的中国政府应急医疗队,在得到菲律宾政府应允后,于11月21日启程。这是国家紧急医疗救援队组建以来首次出国执行救援任务。     

The contribution of work characteristics,home characteristics and gender to burnout in medical residents

Burnout is highly prevalent in medical residents. In order to prevent or reduce burnout in medical residents, we should gain a better understanding of contributing and protective factors of burnout. Therefore we examined the associations of job demands and resources, home demands and resources, and work–home interferences with burnout in male and female medical residents. This study was conducted on a nation-wide sample of medical residents. In 2005, all Dutch medical residents (n = 5245) received a self-report questionnaire on burnout, job and home demands and resources and work–home interference. Path analysis was used to examine the associations between job and home characteristics and work–home interference and burnout in both males and females. In total, 2115 (41.1 %) residents completed the questionnaire. In both sexes emotional demands at work and the interference between work and home were important contributors to burnout, especially when work interferes with home life. Opportunities for job development appeared to be an important protective factor. Other contributing and protective factors were different for male and female residents. In females, social support from family or partner seemed protective against burnout. In males, social support from colleagues and participation in decision-making at work seemed important. Effectively handling emotional demands at work, dealing with the interference between work and home, and having opportunities for job development are the most essential factors which should be addressed. However it is important to take gender differences into consideration when implementing preventive or therapeutic interventions for burnout in medical residents.     

利用DRGS（诊断相关分组）平台建立双向转诊下转模式探索

目的 依靠DRGS平台的病案大数据,研究双向转诊的下转标准制定,将病人从三级医院分流到二级医院与社区,实现分级诊疗。方法 通过DRGS软件平台,分析2015年1月 - 2016年12月2年的病案大数据,建立下转标准并实施。通过对2017上半年病案数据的监测,检查下转标准实施的合理性及效果。结果 分析DRGS平台的病案大数据,将“权重（CW）小于0.5且平均住院天数小于6 d”的DRGS组作为向下转诊的标准,调控2017年1 - 6月的患者,由三级医院转诊至二级医院或社区。结论 通过DRGS平台权重指数制定下转标准,合理分流患者,为分级诊疗的落实提供借鉴与参考。     

医师临床工作个体化评价系统的研究

目的：科学评价临床医师医疗工作质量，为医院人力资源管理提供依据。方法：依托医院“军卫一号”工程和医师工作评价模型，自主开发评价软件，评价数据采取系统自动化采集和手工录入相结合的方法。结果：本系统由工作质量、工作效率、经济效益、质量检查、综合评价和帮助6个菜单构成。结论：该系统实用性强、易操作，能够比较科学的评价临床医师医疗工作质量。     

精细化管理在医院人力资源管理中的应用效果研究

目的分析医院人力资源管理现状,提出提高人力资源管理效率的措施。方法该次研究所选择的研究对象为该院医护人员164名,研究时间为2018年1月—2019年12月,其中,2018年1—12月,该院采用常规方式进行人力资源管理,2019年1—12月采用精细化管理方式进行人力资源管理,通过问卷调查法和对比分析法,分析两个年度该院医护人员的工作态度达标率以及医护人员对于人力资源管理部门工作的投诉率。结果2018年度,该院医护人员对人力资源管理工作开展的投诉率为29.27%,而在2019年度,相关指标下降至12.80%,医护人员对于人力资源管理部门工作的投诉率有了较大幅度的下降。从本质上讲,医护人员的工作态度是对医院整体管理质量的反映,通常情况下,医护人员对医院相关管理方式的认可度越高,他们工作态度的积极程度也越高。由于人力资源管理工作涉及的很多项目都与医护人员的利益密切相关,因此对于医护人员来说,人力资源管理工作也是十分敏感的一项工作。结论医院在开展人力资源管理工作的过程中,要想切实提升人力资源管理工作开展的整体效率,采用精细化管理的方式进行管理有着十分积极的现实意义。     

Autonomy and work in medicine

We discuss autonomy in medical work as resulting from two basic moments: as social work consuming and producing goods and services, reproducing the dominant mode of production and its ethical foundations; and as a service in which autonomy, limited as social work, expresses some attributes acquired by medical work (technical independence and self-regulation) as a result of the monopoly in the use of science to deal with individually perceived health-related needs. These moments are expressed in the doctor-patient relationship, which makes uncertainties surrounding that relationship more evident. From this understanding about medical work and its autonomous condition, we discuss some theoretical concepts related to the study of labor and/or services in contemporary society and which provide us with an epistemological basis for more adequate approaches to scientific research concerning that object.     

论医院医务社工在医疗纠纷中的职责

目的：医疗纠纷逐渐增多,使得医患关系日趋紧张,成为社会关注的焦点,有学者提出医院中的医务社工应该介入医疗纠纷,本文就医院医务社工在医疗纠纷中的职责进行探讨。方法通过文献回顾的方法,了解我国医务社工的职责以及在医疗纠纷中发挥的作用。结果在医疗行为进行过程中,医务社工的职责主要体现在,针对医患之间信息不对称的情况,通过调查、谈话等活动,弥补双方的信息不对称,预防可能发生的矛盾冲突,缓解医患关系。结论医务社工在医疗纠纷处理过程中,从专业的角度,运用个案工作、小组工作、社区工作等工作方法,在中间起到的是调和、缓冲的作用。医务社工坚持价值中立原则,理清自身的角色,明确自己的立场,从第三方的角度出发,不介入医学专业问题,使纠纷能得到合理合法的解决。     

For public service or money: understanding geographical imbalances in the health workforce

Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, and especially in developing countries. In this paper we investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analysing data obtained from contingent valuation questions for final year students from three medical schools and eight nursing schools, we find that there is substantial heterogeneity in the willingness to serve in rural areas. Using both ordinary least squares and maximum likelihood regression analysis, we find that household consumption and the student's motivation to help the poor are the main determinants of willingness to work in a rural area. We carry out a simulation on how much it would cost to get a target proportion of health workers to take up a rural post.     

Transforming general practice: the redistribution of medical work in primary care

The paper focuses on the redistribution of medical work within primary health care teams. It reports the results of the analysis of interviews with general practitioners, practice nurses and managers, undertaken as part of an ethnographic study of primary care organisation and practice during a period of rapid organisational change. By examining the ways in which the respondents account for how work is being redefined and redistributed, we explore how current government policy and professional discourses combine to reconfigure both the identities of those who work in primary care and the nature of patienthood. In particular, we show how general practitioners are being reconfigured as medical specialists or consultants in ways that seem to depart radically from earlier claims that general practice is a distinctive field of social or biographical medicine. Within this new discourse medical work is distributed between doctors, nurses and unqualified staff in ways which make explicit the reduction of general practice work to sets of biomedical problems or tasks. At the same time, the devolution of much general practice work to less qualified and cheaper personnel is justified by drawing on a discourse of person-centred medicine.     

Why are some medical specialists working part-time, while others work full-time?

Although medical specialists primarily work full-time, part-time work is on the increase, a trend that can be found worldwide. This article seeks to answer the question why some medical specialists work part-time, while others do not although they are willing to work part-time. Two approaches are used. First, we studied reported reasons and as a second approach we used a theoretical model, based on goal-directed behavior and restrictions. A questionnaire was sent to all internists (N=817), surgeons (N=693) and radiologists (N=621) working in general hospitals in The Netherlands. Questions were asked about personal traits, characteristics of the work situation, and motives for working full-time or part-time. Frequencies were reported for the reasons given, and multilevel analysis was used to test the theoretical model. The results show that the reported reasons for working part-time and being willing to work part-time are the same: the importance of family and leisure pursuits. The second approach showed that medical specialists working part-time tend to be female, older, and have children below the age of five. Surgeons are least likely to work part-time. A willingness to work part-time is purely individual and not related to any of the explanatory variables. We conclude that working part-time is related to both professional and personal circumstances. Policy should be aimed at removing the organizational difficulties that obstruct the realization of part-time work. Alternatively, perhaps there should be a change in working hours for all medical specialists. As the majority of all full-time working medical specialists are willing to work part-time, this might indicate that most medical specialists actually prefer "normal" working hours.     

Social work at the Chinese Medicine system in Hong Kong: opportunities and challenges

Dealing with health and disease is an area of concern for social workers. The establishment of medical social service in a health setting has more than 100 years of history in the USA and more than 60 years in Hong Kong. Despite the increasing popularity of Chinese Medicine (CM) used by the Hong Kong people, there has been no medical social service presence in the CM system. A pilot project demonstrated a successful interdisciplinary collaboration model between social work and CM irrespective of different social work methods, that is, individual work, groupwork, and community-based services. In this article, we will relate the opportunities and difficulties that we encountered in setting up the first medical social service in the CM system. Drawing on our experience, we found that both professions benefited from the interdisciplinary collaboration. CM was able to expand its scope of service to increase the service quality and promote primary health care in the community with the support of social work. Conversely, social workers found that CM is a good resource for providing innovative services to meet the various needs of the people in the community. There was also a ripple effect of incorporating CM elements into social service. The interface between the disciplines of social work and CM can widen the scope of their contributions on health. Implications for CM social service in social work will also be examined.