RESUMO
Objective: To design a hospital management information system based on attitude and perceived behavior control, and to explore the influence of the application of hospital management information system on the work performance of medical personnel. Methods: Through constructed hospital management information system and applied the work performance model of medical personnel to design questionnaire from three points of view included attitude, habits, subjective norm and perceived behavior control. And then the internal consistency and validity of the scale of measurement indexes of the questionnaire were tested, and the methods of statistical modeling and parameter estimation were adopted to carry out path analysis. Results: The results of primary estimation for the change situation of main medical indexes of application information system in earlier, middle and later stage indicated that the reliability of variates that were selected in this research was higher, and the consistency of interior of various variates was higher. At the three stages, earlier, middle and later stage, that information system was implemented, the person-time of leaving hospital, the number of inpatient surgery and the outpatient amount of expert displayed rising trend. And the drug proportion, average stay time decreased 9.45%, 3.36% and 16.16% and 4.27% respectively. Conclusion: Whether the hospital information system can be applied, the personal subjective factors of medical personnel play an important role.
RESUMO
Objective To study the clinical nurses and nursing students' cognition of clinical nurse specialist (CNS) and provide the basis for promoting the development of CNS.Methods Quantitative and qualitative research were adopted in this study.One hundred and ninety clinical nurses and nursing students were investigated with a questionnaire about the cognition of CNS,and the qualitative research was conducted on 9 clinical nurses selected by purposive sampling method.Results Most participants realized the importance of CNS and 78.4％ of them wished to be an excellent CNS.The cognition was different between the two groups,especially in terms of ability,working performance and status.Conclusions We should improve the clinical nurses and nursing students' cognition of CNS,and cultivate them with the core competence of CNS.Meanwhile,improving the status and confirming the role must be done to promote the development of CNS in China.
RESUMO
La calidad de un servicio de salud depende, en primer orden de la competencia del capital humano que en él labora. En Cuba, actualmente no existe ningún mecanismo ni procedimiento establecido para evaluar el desempeño de los médicos, como está establecido para otros profesionales y técnicos del país. El autor ha venido investigando esta problemática durante veinte años y los estudios efectuados se estructuraron en tres periodos. El primero de ellos (1986-1992) estuvo dirigido al estudio, análisis y crear consenso sobre las bases teóricas y metodológicas que fundamentaran el diseño de un modelo de desempeño profesional en nuestro Sistema Nacional de Salud (SNS). En el segundo periodo (1993-1996) se logró estructurar una propuesta metodológica y su operacionalización, lo que contó con la voluntad política del Ministerio de Salud Pública para su ejecución. El tercer periodo (1997-2006) posibilitó su aplicación, ganar experiencia, y se crearon las condiciones propicias para estructurar una nueva propuesta. La estrategia que se propone como producto final de nuestra investigación, permite interrelacionar la evaluación del desempeño laboral del médico, la superación profesional permanente, los créditos académicos posgraduales y la certificación profesional a nivel de estándares internacionales. Se hacen conclusiones, así como recomendaciones para iniciar su puesta en marcha.
The quality in a health service depends in first order on the competence of human staff supplying it. In Cuba, nowadays there is neither mechanism nor established procedure to assess the physician's performance as in the case of other professionals and technicians of our country. The author has been research on this problem for twenty years and the studies conducted were structured in three periods. The first one (1986-1992) was directed to study, analysis and consensus on the theoretical and methodological bases supporting the design of a professional performance model in our National Health System (NHS). In the second period (1993-1996) it was possible to structure a methodological proposal and its functional qualities supported by the Public Health Ministry political will for its execution. The third period (1997-2006) allowed its application, an increased experience and the creation of suitable conditions to structure a new proposal. The strategy suggesting as an end-product of our research, allows to interrelate the assessment of the physician's working performance, its permanent professional overcoming, the postgraduate academic credits and the professional certification at international standards level. We reach conclusions and made recommendations to start its implementation.