Analysis of the influence of Chinese health policy on the promotion process of ophthalmology day sur-gery and its specific practice / 现代医院

With the reform of the national medical and health system entering a new stage of high-quality development of public hospitals,the large-scale implementation of day surgery in hospitals is imminent in the face of increasing patient demand.In this paper,the medical administration management and medical insurance policies related to day surgery in China and their im-pacts were sorted out,and the example of large-scale implementation of day surgery by a specialized ophthalmic medical institu-tion through pre-hospitalization mode was used to illustrate how to use management tools to break through the bottleneck in the promotion process of day surgery,and the positive effect of large-scale development of day surgery on both doctors and patients was expounded.

Ferramentas da administração estratégica e tomada de decisão em empresas estatais / Herramientas de gestión estratégica y toma de decisiones en empresas estatales / Strategic management tools and decision-making in state-owned enterprises

Resumo Dada a necessidade de se compreender mais detalhadamente como as ferramentas da administração estratégica (FAE) contribuem para a tomada de decisão no contexto da administração pública, este artigo tem o objetivo de avaliar o uso das FAE e sua influência na tomada de decisão em um grupo de empresas estatais. O estudo foi realizado com três empresas selecionadas por acessibilidade. Uma análise do conteúdo das entrevistas com os gestores de cada empresa foi realizada, obtendo-se os seguintes resultados: decisões de longo prazo foram associadas, principalmente, àquelas necessárias ao cumprimento do planejamento estratégico, porém, pouca ênfase foi dada às decisões que envolvessem risco ou incerteza; o uso das FAE com foco no cumprimento de exigências legais tendia a minar a conscientização e o preparo dos usuários. Tais fatores, assim como a necessidade de acomodar alterações de natureza política às ferramentas, restringem os benefícios plenos do uso das FAE nas empresas estatais e sua capacidade de lidar com a complexidade do ambiente estratégico. O estudo contribui para maior compreensão dos aspectos específicos do uso de FAE, bem como seus benefícios e limitações em organizações públicas, particularmente, empresas estatais.

Resumen Dada la necesidad de entender con más detalle cómo las herramientas de gestión estratégica (HGE) contribuyen a la toma de decisiones en el contexto de la administración pública, este artículo tiene como objetivo evaluar el uso de HGE y su influencia en la toma de decisiones en un grupo de empresas estatales. El estudio se realizó con tres empresas seleccionadas por su accesibilidad. Se realizó un análisis de contenido de las entrevistas con los gerentes de cada empresa, obteniendo los siguientes resultados: las decisiones a largo plazo se asociaron principalmente a las necesarias para cumplir con la planificación estratégica, pero se dio poco énfasis a las decisiones que involucran riesgo o incertidumbre; el uso de HGE con un enfoque en el cumplimiento de los requisitos legales socava la conciencia y la preparación de los usuarios. Tales factores, así como la necesidad de acomodar los cambios de naturaleza política a las herramientas, restringen todos los beneficios del uso de HGE en las empresas estatales y su capacidad para hacer frente a la complejidad del entorno estratégico. El estudio contribuye a una mayor comprensión de aspectos específicos del uso de HGE, así como sus beneficios y limitaciones en organizaciones públicas, particularmente, empresas estatales.

Abstract Given the need to understand in more detail how strategic management tools (SMT) contribute to decision-making in the context of public management, this article aims to evaluate the use of SMTs and its influence on decision-making in a group of state-owned companies. The study was conducted with three companies selected by means of accessibility. A content analysis of transcripts from the interviews with managers of each company was performed, leading to the following results: long-term decisions were mainly associated with those necessary to comply with strategic planning, but little emphasis was placed on decisions involving risk or uncertainty; the use of SMTs with a focus on complying with legal requirements undermines the awareness and training of users. Such factors, as well as the need to accommodate changes of a political nature to the tools, undermine the full benefits of SMTs in state-owned companies and their ability to deal with the complexity of the strategic environment. The study contributes to a broader comprehension of specific aspects of the use of SMTs, as well as their benefits and limitations in public organizations, particularly, state-owned enterprises.

Modelo de Gestión del Conocimiento Ambiental en la Agroindustria. Caso Sector Panelero / Environmental Knowledge Management Model in Agribusiness. Case of Panelero Sector / Modelo de Gestão do Conhecimento Ambiental no Agronegócio. Caso do Setor Panelero

Resumen Introducción: el sector agroindustrial ha evolucionado debido a la necesidad de una producción diversificada, competitiva y con menores efectos negativos para el ambiente y las comunidades. Esto requiere que sus procesos se basen en la integración del conocimiento científico y tecnológico con los saberes y conocimientos locales. Objetivo: proponer un modelo de Gestión del Conocimiento (GC) ambiental en la agroindustria, para adquirir, transferir y utilizar conocimiento técnico y tradicional, útil en la toma de decisiones. Aportando a la mejora de su nivel tecnológico, económico, social y ambiental. Materiales y métodos: mediante una búsqueda sistemática de literatura, y el análisis de redes, se identifican y determinan los modelos de GC pertinentes a la agroindustria; posteriormente se analizan los actores del sector panelero mediante el método Recursos, Actividades, Resultados (RARe), identificando sus relaciones y necesidades de GC, finalmente se propone el modelo de gestión del conocimiento y sus procesos. Resultados: Los resultados inician con la definición de las relaciones entre objetivos de GC, los modelos, las herramientas y los procesos pertinentes a la agroindustria, segundo el mapeo de los actores, sus relaciones y necesidades de GC en el sector panelero, y tercero la propuesta del modelo de GC ambiental, implicaciones, acciones, facilitadores y potencializadores de la GC frente a mejorar las unidades productivas de panela desde el factor ambiental, tecnológico, social y político. Conclusiones: El modelo de Gestión del Conocimiento Ambiental propuesto se convierte una herramienta mediante el cual es posible articular la GC en el sector panelero permitiendo la socialización de conocimiento innovador entre los actores productores y los actores externos para poder llegar a tener potenciales beneficios y suplir las necesidades de gestionar conocimiento sobre el mejoramiento tecnológico y gestión ambiental.

Abstract Introduction: the agribusiness sector has evolved due to the need for diversified, competitive production with fewer negative effects on the environment and communities. This requires its processes to be based on the integration of scientific and technological knowledge with local knowledge. Objective: to propose an environmental Knowledge Management (KM) model in agribusiness, to acquire, transfer and use technical and traditional knowledge, useful in decision making. Contributing to the improvement of its technological, economic, social and environmental level. Materials and methods: through a systematic literature search and network analysis, KM models pertinent to agribusiness are identified and determined; then the actors of the panel sector are analyzed through the method Resources, Activities, Results (RARe), identifying their relationships and KM needs; finally, the knowledge management model and its processes are proposed. Results: The results begin with the definition of the relationships between KM objectives, models, tools and processes relevant to the agroindustry; second, the mapping of actors, their relationships and KM needs in the sugarcane sector; and third, the proposal of the environmental KM model, implications, actions, facilitators and potentiates of KM to improve sugarcane production units from the environmental, technological, social and political points of view. Conclusions: The proposed Environmental Knowledge Management model becomes a tool through which it is possible to articulate KM in the sugarcane sector, allowing the socialization of innovative knowledge between producers and external actors in order to reach potential benefits and meet the needs of managing knowledge on technological improvement and environmental management.

Resumo Introdução: o sector agroindustrial evoluiu devido à necessidade de uma produção diversificada e competitiva com menos efeitos negativos no ambiente e nas comunidades. Isto exige que os seus processos se baseiam na integração do conhecimento científico e tecnológico com o conhecimento local. Objetivo: propor um modelo de Gestão do Conhecimento (GC) ambiental na agroindústria, para adquirir, transferir e utilizar conhecimentos técnicos e tradicionais, úteis na tomada de decisões. Contribuir para a melhoria do seu nível tecnológico, económico, social e ambiental. Materiais e métodos: através de uma pesquisa sistemática na literatura e análise de redes, são identificados e determinados os modelos de GC pertinentes à agroindústria; em seguida, os atores do setor de painéis são analisados através do método Recursos, Atividades, Resultados (RARe), identificando suas relações e necessidades de GC, e finalmente o modelo de gestão do conhecimento e seus processos são propostos. Resultados: Os resultados começam com a definição das relações entre os objetivos, modelos, ferramentas e processos da CG relevantes para a agroindústria; segundo, o mapeamento dos actores, suas relações e necessidades da CG no sector da cana de açúcar; e terceiro, a proposta do modelo ambiental da CG, implicações, ações, facilitadores e potenciadores da CG para melhorar as unidades de produção de cana de açúcar dos pontos de vista ambiental, tecnológico, social e político. Conclusões: O modelo proposto de Gestão do Conhecimento Ambiental torna-se uma ferramenta através da qual é possível articular a KM no sector canavieiro, permitindo a socialização do conhecimento inovador entre produtores e actores externos, de modo a alcançar potenciais benefícios e satisfazer as necessidades de gestão do conhecimento sobre melhoramento tecnológico e gestão ambiental.

The current situation of quality control circle among nursing quality management in Shandong Province: Cross-sectional survey / 中国实用护理杂志

Objective To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems. Methods A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning.SPSS 23.0 software was used to analyze the data. Results Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures", accounting for only 6.7% . The"calculation of target value"was the best for 45.1%, the best which"QCC report and evaluation"was 32.1%(72/224) in the promotion and management of hospital- level QCC, and the worst which"standardization approval"was only 4.0% (9/224). The main obstacle factors include personnel, skills and in- hospital support.Conclusions Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.

The current situation of quality control circle among nursing quality management in Shandong Province: Cross-sectional survey / 中国实用护理杂志

Objective@#To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems.@*Methods@#A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning. SPSS 23.0 software was used to analyze the data.@*Results@#Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures" , accounting for only 6.7%. The "calculation of target value" was the best for 45.1%, the best which "QCC report and evaluation" was 32.1%(72/224) in the promotion and management of hospital-level QCC, and the worst which "standardization approval" was only 4.0%(9/224). The main obstacle factors include personnel, skills and in-hospital support.@*Conclusions@#Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.

Research on quality of care management system at modern hospitals / 中华医院管理杂志

Objective To learn the present hospital medical quality management,to explore and improve the quality of care management system.Methods Literature review analysis theory of medical quality management system,questionnaires analysis the present medical quality management,case and influencing factors.Results The literature review showed that the trend of quality management study increased year by year in recent 20 years,and is gradually becoming a hot topic in China.The management practices survey found the quality of care management systems mostly established,yet with rooms of improvement for the management content and details.Thanks to the three-stage introduction,operation and indepth study of international standards,hospitals have effectively promoted their quality management.Conclusions Key influencing factors for hospital quality management are the design of such quality management system itself,and lack of quality tools and resources.To build a better quality of care management system,efforts should be paid from both internal and external aspects,thus elevating such quality to a new level.

The safety factor analysis on ventilator application based on quality management tools / 中国医学装备

Objective:Along with general hospital assessment opportunity, we explore to optimize ventilator management processes to reduce security risks by using the advanced quality management tools. Methods:Based on the ventilator maintenance statistical data in year 2012, we applied Pareto chart, Pareto curves and fishbone diagrams etc. quality management tools, and conducted PDCA cycle analysis on safety factors of ventilator clinical application. At the end, we summarized the results and provide improvements recommendations. Results:The cumulative proportions fell from 23.6%to 80%range, the human operator, compressor inlet;pipeline leaks and consumables management are a major are major factors. Through fishbone diagram analysis, we categorized them into 4 aspects:personnel, operations, equipment and supplies management. We optimized existing systems and processes from three areas:the device management, supplies management and training. By implementing these improvements plans, the security risk caused by supplies management was basically solved, the effect is very obvious. Conclusion:By using quality management tools, the safety problems during clinical application of ventilator can be reflected directly and clearly, and protect ventilator safe and stability to next level, so that it helps medical equipment management be more scientific, effective and normative.

TAKING THE MACRO FINANCE IDEAS AS THE GUIDE TO BUILD A NEW NORMAL FOR HOSPITAL FINE MANAGEMENT / 现代医院

Financial departments of hospitals should widen their horizons .Workers responsible for financial affairs should transform their functions and make the transition from the traditional business accountants to the value managers.The idea of macro financeis proposed in this paper to penetrate the financial ideas into every economic and business activity, every element of the workflows and every member of the staff .In practice, fine management of hospitals can be done jointly by using information platforms , employing financial management tools and organizing ef-ficient financial teams .By doing this , both financial management and operation efficiency of hospitals can be im -proved continuously .

Research on the Classification of Deviations in Drug Production / 中国药房

OBJECTIVE:To study the classification of deviation in drug production. METHODS:From the perspective of dom-inant and hidden deviation,combining with the theory of risk management,risk of deviation was evaluated with different risk man-agement tools to define the severity of the deviation,and it was handled by different methods. RESULTS & CONCLUSIONS:Ac-cording to the identifiability of deviation in actual management,the deviation was divided into dominance and hidden deviation. The dominant deviation can be divided into deep and shallow level. Whether the causes of deviation could be cleared and the conse-quences could be estimates were judged after the shallow level classification,and the deviation was further divided into simple and complex deviation. As for deviation complex,it could be evaluated with the tools of risk management to define the deviation severi-ty. As for hidden deviation,it needed beforehand preventing with the tools of risk management directly to define deviation levels and provide reference for preventive measures. In the process of deviation management,key point is to relay on the scientific meth-od to identify and classify deviation,and divide the influence levels. Combining the theory of risk management to select and use risk tools is the effective way to solve the problem.

Pacto federativo e gestão de águas

Resultado de um dispositivo constitucional, o Sistema Nacional de Gerenciamento de Recursos Hídricos (Singreh), regulamentado pela Lei n.9.433 de 1997, considera a natureza federativa do país. Além disso, a legislação traz novos paradigmas de descentralização, utilização de instrumentos econômicos para a gestão e participação pública no processo de tomada de decisão. O presente artigo, portanto, além de tratar das disponibilidades e demandas de recursos hídricos nas 12 regiões hidrográficas e abordar o desenho institucional e o funcionamento do Singreh em termos dos arranjos legais e institucionais, apresenta, em linhas gerais, os desafios da gestão das águas por bacia hidrográfica no contexto federativo, e trata do processo de implementação dos instrumentos técnicos e institucionais de recursos hídricos na Bacia Hidrográfica do Rio Paraíba do Sul, primeira bacia brasileira a implantar a cobrança pelo uso da água e a operacionalizar uma Agência de Água.