Exploration and thinking on promoting the innovational and transformational ability of an outstanding discipline in a grade A tertiary hospital / 中华医学科研管理杂志

Objective:The paper aims to take the Department of Nephrology of Peking University First Hospital as an example to explore the practice of promoting innovation and transformation of an outstanding discipline.Methods:A descriptive analysis was carried out on the research basis, research output, and the status quo of disciplinary innovation and transformation of the nephrology department.Results:The main result showed that through the strategic layout of research direction from the characteristics of the discipline, transformation of traditional consciousness, enhancement of the capacity of innovation subject, policy guidance and incentive, promotion of collaborative innovation of medical enterprises and research institutes, the effect of enhancement of innovation and transformation had been shown.Conclusions:In order to do a good job in the innovation and transformation of an outstanding discipline, clinical hospitals need to support clinical medical research based on clinical problems and resource coordination, strengthen the whole process management and service of intellectual property protection, implement performance evaluation related to innovation and transformation, and introduce and cultivate complex talents for innovation and transformation.

Emotional distress symptoms and their determinants: screening of non-clinical hospital staff in an Egyptian University hospital.

BACKGROUND: Non-clinical hospital staff were rarely studied despite their potential exposure to workplace stressors. We aimed to measure the prevalence of depression, anxiety, and stress (emotional distress symptoms) and determine their association with perceived job stress level and socioeconomic factors among non-clinical hospital staff. METHODS: This cross-sectional study was conducted in Ain-Shams University Hospitals from March to May 2019. Tools were the Arabic Depression, Anxiety, and Stress Scale-21, Workplace Stress Scale, and Socioeconomic status scale. Independent correlates were determined using multivariable ordinal regression. RESULTS: Out of 462 participants, 72.5% reported receiving insufficient income and 54.8% showed Effort-reward imbalance. Job stress was scored as severe/potentially dangerous by 30.1%. The prevalence of depression, anxiety, and stress were 67.5, 69.0, and 51.7%; and the severe/extremely severe levels were 20.8, 34.6, and 17.6% respectively. Across all the severity levels, the likelihood of depression, anxiety, and stress were progressively higher with more serious levels of income insufficiency [in debt versus able to save, OR:5.82 (95%CI:2.35-14.43), OR:3.84 (95%CI:1.66-8.91), and OR:3.01 (95%CI:1.20-7.55) respectively] and with higher job stress levels. Specifically, the likelihood of depression, anxiety, and stress increased by 74, 56, and 53% respectively with feelings of unpleasant/unsafe work conditions and by 64, 38, and 62% respectively with the presence of work-life conflict; while the likelihood of depression and stress increased by 32 and 33% respectively when there was difficult communication with superiors; and only the likelihood of depression increased by 23% with underutilization of skills. CONCLUSION: Non-clinical hospital staff were commonly affected by emotional distress symptoms with high rates of severe/very severe levels, and they often considered their workplace stress as severe/potentially dangerous. Workplace stress and income insufficiency were strong correlates with emotional distress symptoms. Decreasing work-life conflict, enhancing leadership skills, and mitigation of the economic hardship are needed.

Arquitectura de información para indicaciones médicas de signos vitales y ventilación

Introducción: La Historia Clínica es el documento principal en el sistema de información hospitalaria, imprescindible en sus vertientes asistencial y administrativa. Las nuevas tecnologías de la Informática y las comunicaciones han permitido informatizar todos los procesos del sistema de salud. Desde el punto de vista técnico, la informatización de los registros médicos, debe tener en cuenta la correcta descripción de las indicaciones médicas, más aún en los pacientes hospitalizados en las unidades de cuidados intensivos, por su estado de gravedad. Objetivo: desarrollar el prototipo de la aplicación informática que permitirá la gestión de la información del registro de las indicaciones médicas de signos vitales y ventilación de las historias clínicas en el Hospital Clínico-Quirúrgico Docente León Cuervo Rubio de la provincia de Pinar del Río. Métodos: la investigación que se describe obedeció a un estudio de desarrollo tecnológico, para su desarrollo se emplearon métodos teóricos y empíricos. Resultados: la investigación permite a los programadores desarrollar la aplicación informática para el registro de las indicaciones médicas de signos vitales y ventilación en la historia clínica tradicional, por una solución informatizada, a partir de la descripción del negocio, sus requisitos e interacciones. Conclusiones: se alcanzó un gran impacto social en nuestro sistema de salud tanto a nivel provincial como nacional, ya que no existe este sitema y beneficiaria tanto al paciente, como a los profesionales y a la misma institución al abaratar los costos.

Introduction: The Clinical History is the main document in the hospital information system, essential in its care and administrative aspects. The new information technology and communications have made it possible to computerize all the processes of the health system. From a technical point of view, the computerization of medical records must take into account the correct description of medical indications, especially in patients hospitalized in intensive care units, due to their state of seriousness. Objective: to develop the prototype of the computer application that will allow the management of the information of the registry of the medical indications of vital signs and ventilation of the medical records at the León Cuervo Rubio Teaching Clinical-Surgical Hospital in the province of Pinar del Río. Methods: the research that is described obeyed a study of technological development, for its development theoretical and empirical methods were used. Results: the research allows the programmers to develop the computer application for the registration of the medical indications of vital signs and ventilation in the traditional clinical history, by a computerized solution, based on the description of the business, its requirements and interactions. Conclusions: a great social impact was achieved in our health system both at the provincial and national level, since this system does not exist and it would benefit patient, professional and the institution itself by reducing costs.

The construction of an organized hospital scientific research platform under the background of organized scientific research in hospital / 中华医学科研管理杂志

Objective:To explore the paths and goals of organized construction for scientific research platforms in large-scale hospitals under the background of organized scientific research in China.Methods:By reviewing the relevant literature, and analyzing the construction of existing international and domestic research platforms for organized scientific research, this article elaborated on the importance and necessity of building a research platform for clinical hospitals under the background of organized scientific research and made suggestions for the platform construction.Results:Organized scientific research requires the organized construction of scientific research platforms. The construction of organized scientific research platforms should always focus on the major national needs, serve major scientific plans, carry out organized talent training, and internal efficient and orderly organization and operation, under the principle of interdisciplinary and multi-level collaborative innovation and development.Conclusions:In response to the strategic needs of national science and technology in the 14-Five Year Plan, the hospital scientific research platforms should be upgraded, integrated, expanded, and improved in an organized way, to form a multi-disciplinary and cross-dimensional platform structure to ensure the smooth development of organized scientific research.

Practice and reflection on international technology transfer in clinical hospitals: Take Peking University Third Hospital as an example / 中华医学科研管理杂志

Objective:To identify the problems and explore the possible approaches for improving the internationalization of technology transfer in hospitals of China.Methods:We make the attempt to summarize the concepts and characteristics of international technology transfer, discussed existing problems and dealing strategies of boosting the internationalization of technology innovation and transformation in hospitals in combination with daily practice.Results:Of the international technology transfer in clinical hospitals in China is at the early stage, there are also a lot of space for improvement, for instance, the training of professional personnel, well-developed innovation and application ecology and the comprehensive regulatory support system.Conclusions:Clinical hospitals should enhance the transformation of scientific and technological achievements at global level. It is important to empower the technology transfer team-building, enhance the infrastructure and professional service, as well as call for more support from the national level to strengthen related policy-making.

Preliminary study on the pathway of scientific and technological achievements of clinical hospitals transferred by medical device enterprises in the Yangtze River Delta / 中华医学科研管理杂志

Objective:To provide references for promoting clinical hospital technology transfer, through on-site investigations of medical device manufacturers and sorting out the situation of the participation of enterprises in technology transfer.Methods:Purposive sampling and questionnaire are used; the study analyzed the collected data by quantitative and qualitative research on the selected 5 enterprises in the Yangtze River Delta, and introduced the procedures of enterprises purchasing scientific payoffs.Results:It shows that the medical device enterprises have strong demand for the technology innovation, and the cooperation between enterprises and researchers at an earlier stage are conducive to technology transfer. At present, the overall technology readiness level for the hospitals is generally not high. The commercialization of scientific and research findings could achieve the win-win situation for both the hospitals and enterprises.Conclusions:To further promote the transformation of scientific and technological achievements in China, We should establish a more diversified achievement promotion platform to push forward the hospital-enterprise cooperation to improve the technology readiness level, and meanwhile, accelerate the application-oriented clinical scientific research.

[Translational Research Focused on Hospital-prepared Drugs in Japan: Developing and Accessing an Approach Using an Evidence Database].

Hospital-prepared drugs, as one form of off-label use, are prepared by pharmacists in individual Japanese hospitals. More than 20 originally hospital-prepared drugs have become commercially available in Japan, although the number reaching the commercialization stage has decreased recently. In this study, we show our recent approach to developing hospital preparations into commercially available drugs. Our first endpoint was to start phase 2 clinical trials of hospital-prepared drugs. The second endpoint was to determine whether the drugs could continue to phase 3 trials. We have developed an evidence database on 107 hospital-prepared drugs by performing a literature survey on each drug for references to the words "stability", "efficacy", and "safety". If evidence is lacking, in vitro study results are compiled in the database, which will be needed when initiating clinical trials. So far, a phase 2 clinical trial of one hospital-prepared drug has been completed, and we have started stability testing of some drugs for which evidence of stability is lacking. This paper presents our recent approach to developing hospital preparations into commercially available drugs.

[Survey of Literature on the Development of an Evidence Database for Hospital-prepared Drugs in Japan].

　Hospital-prepared drugs (HP), known as In'Naiseizai in Japan, are custom-prepared formulations which offer medical professionals an alternative administration pathway by changing the formulation of existing drugs according to a patients' needs. Preparing the HP is one of several roles of pharmacists in providing personalized medicine at hospitals in Japan. In 2012, the Japanese Society of Hospital Pharmacists provided guidelines for the appropriate use of "Hospital-prepared drugs". The following information was included in this guide: 1) documentation of the proper procedures, materials, prescription practices, etc., 2) required approval from the institutional review board of each HP on the risk-based classifications, and 3) to assess the stability, efficacy, and safety of each HP. However, several problems persist for pharmacists trying to prepare or use HP appropriately; the most common is insufficient manpower to both assess and prepare these drugs during routine hospital work. To resolve this problem, we are developing an evidence database for HP based on surveys of the current literature. This database has been developed for 109 drugs to date. Data-driven assessment of the stability of HP showed that 52 out of 109 drugs examined (47.7%). Notably, only 6 of the 109 HP (5.5%) in the database had all three characteristics of "stability", "safety", and "efficacy". In conclusion, the application of this database will save manpower hours for hospital pharmacists in the preparation of HP. In the near future, we will make this database available to the wider medical community via the web or through literature.

Study on the association between general surgeon volume, professional skill and surgery outcome / Монголын Анагаах Ухаан

Background: Several researchers had been previously done the health professional workload study,however, because of the lack of studies of the relationship between physicians’ volume and outcome, wedid not have enough evidence of the resource allocation, the surgery outcome and quality improvementin our country.Goal: The study was aimed to study general surgeon volume and surgery outcome.Materials and Methods: We randomly selected 1147 patients diagnosed with gallbladder disease whounderwent laparoscopic cholecystectomy (LC) and acute appendicitis from 2012-2013 at the First andThird Clinical hospital and Khovd province Regional Diagnostic and Treatment Center were included.Patient demographics and clinical information, such as drug cost, duration of surgery, and name ofsurgeons were derived from patient medical records. Surgeons’ information, such as age, gender,professional and academic degree, and work experience were derived from hospital human resourcedepartment and correlation analysis was performed to examine the association between surgeryduration, surgeon experience and drug cost.Results: Hospitals LC was done 51,3±32,8 minutes with 24900,70 tugriks, appendectomy was done52,7±31,4 minutes with 18361,00 tugriks of drug cost. The Third Clinical hospital surgeons operatedhigher costs (28631,34±16985,86tugriks) and shorter time (39,86±39,54 ìèí) of an appendectomy. Butthe First Clinical hospital surgeons incurred lower cost (8460,82±13231,40 tugriks) of appendectomy.However, there were no significant differences in operation time and drug average cost in appendectomyin terms of positive and weak correlation(r0.05). Conclusion: General surgeon volume was notassociated with surgery outcome.

Mean Problems and Measures in clinical hospital / 中华医学科研管理杂志

Less consciousness for science research,lower level of research work,shortage of research team,lack of research institution and so on are the mean problems in clinical hospitals.In recent years,we take the measures of carrying out research training,perfecting research equipment,strengthening the research team,establishing encourage and punish rules.these measures promote the research work of our hospital,change the research sense of hospital staff therefor we get notable progress in research work.

Evaluation on implementing postgraduate psychological mentor scheme in clinical hospitals of ;colleges and universities / 中华医学教育探索杂志

Objective To analyze the psychological condition of postgraduates in clinical hos-pitals of colleges and universities before and after the implementation of psychological mentor scheme so as to evaluate the effect. Methods Quantitative questionnaire (SCL-90 scale) and qualitative fo-cus interview were used to compare psychological condition of postgraduates. Totally 182 copies of questionnaires were sent to two hospitals (A and B) respectively. Then, psychological mentor scheme was carried out in A hospital. Afterwards, 206 and 140 copies of questionnaires were sent again to the hospitals respectively to compare the results. Eight student psychological consultants, 12 postgraduates and 5 postgraduate management staff were enrolled in qualitative focus interview. Excell2003 software was adopted to establish the database and SPSS 11.0 software was used for statistical analysis. Descrip-tive analysis, frequency analysis, t test, chi-square test and variance analysis were adopted for data analysis. P<0.05 signifies for statistically significant difference. Results Mental health status of both groups was better than the national level before the implementation (total SCL score: A hospital=118 . 08 ±36.20; B hospital =100.33 ±22.90). However, SCL-90 score of A hospital was decreased (total SCL score: 102.58 ±25.23) and that of B hospital (total SCL score:134.01 ±38.92) was in-creased (part of items higher than the adult national norm) at one year after conducting psychological mentor scheme. Conclusions Psychological mentor scheme can effectively relieve stress and interper-sonal stress so as to reduce the general psychological problems and can help to improve mental health of the students.

O desejo de partir: um estudo a respeito da tentativa de suicídio / The desire to leave: a study about attempted suicide / El deseo de partir: un estudio sobre intentos de suicidio

O objetivo deste trabalho foi refletir, à luz de uma revisão de literatura, sobre a experiência vivenciada no atendimento psicológico aos pacientes internados em um hospital-geral por tentativa de suicídio, dentro do Programa de Residência em Saúde, área Psicologia Hospitalar. Não foi apresentado nenhum caso em específico, tampouco os pacientes foram abordados como participantes deste estudo. A experiência da autora serviu como pano de fundo para tais reflexões, assim como pode ser considerada como um elemento motivador para a realização de uma pesquisa bibliográfica sobre o tema em questão. As considerações apontaram para a relevância da discussão do tema entre a equipe, visando a um atendimento integrado, uma atenção global ao paciente e à prevenção de novas tentativas de suicídio.(AU)

The objective of this study was to reflect, based upon a review of the available literature, upon the experience obtained while carrying out psychological treatment of patients hospitalized because of attempted suicide during a Residency in a Psychology Hospital. No specific cases were discussed, nor were the patients approached as participants in this study. The author's experience served as a backdrop for such reflections, which can be seen as a motivating factor for conducting a review of literature on the topic in question. The considerations pointed to the relevance of the topic of discussion among the team seeking an integrated service, global attention to the patient and the prevention of further suicide attempts.(AU)

El objetivo de este estudio fue el de reflexionar, partiendo de una revisión de la literatura existente, sobre la experiencia vivida durante las consultas psicológicas con los pacientes internados en un hospital general por intento de suicidio a través del Programa de Residencia en Salud - área: Psicología Hospitalaria. No se trató ningún caso en concreto, ni fueron abordados los pacientes como participantes en este estudio. La experiencia del autor sirvió como telón de fondo de estas reflexiones, y se puede considerar como factor motivador para la realización de una revisión de la bibliografía sobre el tema en cuestión. Las consideraciones indicaron la relevancia del estudio del tema entre el equipo, buscando un servicio integrado, atención global al paciente y prevención de nuevos intentos de suicidio.(AU)

Discussion on information system construction for postgraduate administration in affiliated clinical hospital / 中华医学教育探索杂志

Postgraduate administration is faced with new challenge in the affiliated clinical hospital because of the increasing quantity of postgraduates.The paper analyzed the characteristics of postgraduate administration and the status quo of information system construction in the affiliated clinical hospital and proposed the ideas of constructing information system for postgraduate administration from three aspects including system-frame,system-function and system-management.The purpose of the study was to provide reference for improving quality of postgraduate administration.

“Clinical hospital management” study result / Монголын Анагаах Ухаан

Goal: To outline possible approaches in improving clinical hospital management upon reviewing of its current setting Materials and Methods: The study was conducted by qualitative method and data was collected through applying discussions and participatory approaches. In total, 155 participants were enrolled in the study, from which 72 were covered by the Focus Group Discussions, and the remained 83 were studied for Organizational Diagnostic Analysis. Conclusions: 1. Advantages and Disadvantages of the Clinical hospital management levels, although they vary, management aspects are reasonably unsatisfactory. If to view in a isolation by each key role and direction of the management functions, organization, planning, quality assurance, monitoring and evaluation management encompass comparatively predominant advantages whereas human resources, information, finance, motivation, and decision making management enclose prevailing disadvantages. In terms of marketing management, it is extremely poor. 2. Healthcare Organizations’ strategic planning is advantageous focusing on essential skills and tools needed to enhance quality and accessibility of health care as new models of care delivery. Nevertheless, it is weak in operational processes resembling of introduction of technology initiatives and improving of health care targeted to vulnerable groups of the population. 3. Human resources management surrounds in a large amount of disadvantages, particularly, career development of personnel, workforce selection and research capability are inadequate. 4. Although management decisions made are usually accepted by working groups and are enforced their implementations, issues associated with any decisions to involve representaitives of community, regular dialogue of managers with staaf and clients and provision of supervision are fairly poor. 5. By and large, leading skills of managers are quite pleasing and the orders given by managers are executed on a timely manner. Conversely, awarding, incentives and motivation of personnel is highly problematic. 6. The following actions were in good shape, e.g monitoring and evaluation is performed according to the given guidelines, and performance evaluation is recognized by employees followed by inclusion of the findings in planning design. Notably, issues linked with cooperation with other agencies, ensuring quality assurances at the all levels and transparency to inform the cases for not being accountable and for poor performamce of the commands are in low morale. 7. Application of internal information network and provision of transparency and responsiveness has considerably been improved, while predominant mono communicative management, availability of electronic health security data, proper information utilization and time management is deficient. 8. Marketing and its management for High-Performance Healthcare Organizations are underprivileged and absolutely disadvantegious. 9. Even though financial management aspect has gained an introduction of software applications compatable with the Internationally Accepted Standards and Requirements and the projected resources have well mobilized, the necessary investment required for introduction of new technology, the budget for hospital expansion, the insufficient resources for risk management, mobilization of additional assets are limited. 10. International cooperation and collaboration is subject to the legal environment, economic, financial factors, inflation and other technical dynamics. Moreover, partnership with other sectors, private entities, civil society, and the public is scarce, and even, there is no adequate mechanism to gain supports of diverse aspects and to work effectively together.

The Evaliution of Outpatient Health Service in Achtan-elite Clinical Hospital / Монголын Анагаах Ухаан

Introduction: Outpatients health care service or ambulatory care is can support the most (80-85% of all) health services except the admission and emergency and intensive care of severe patients. WHO is offering the health care services provided to patients on an ambulatory basis, rather by admission to a hospital or other health care facility in developing countries. The outpatient health services quality may be diminished in my country since 1990 and also outpatient health care services did not expanded because of too much concerning about hospital admission. Goal of study: To evaluate the Achtan Elite Clinical Hospitals outpatient- policlinic health service in 2006-2007 years and to improve the outpatient- inpatient services correlation and management. Objectives: 1. To make analyses outpatient-policlinic health service result. 2. To find out outpatient areas workloads. Methodology of study: We prepared special questionnaire and tried to evaluate a daily normal workloads. We used Statistical SPSS-12 program is used for statistical analyses. Results of study: Achtan Clinical hospital served 3899-4364 inpatients for admition in hospital, 38327-39675 outpatients in 2006-2007 years. The most 30308- 35959 outpatients were for diagnostic visit for doctors and rest people visited for preventive care. If compare our workloads with state clinical hospitals, we provide 11.9%-14.3% health service of state hospitals workloads. Gastroenterology, cardiology and neurology cabinets workloads are always higher than other cabinets in 108% -124%. In contrast traditional medicine, pediatric, neurosurgery and psychiatrist cabinets did not perform (55-75%) their normal workloads. Discussion: According to ambulatory-outpatient health, services study shows that necessity of opening the family doctor centered local outpatient care in big cities like Ulaanbaatar. There will need 10-15 family doctors and 8-10 specialized doctors to serve 20000-25000 residencies or 4000-5000 families. Laboratory, rehabilitations, dispensary, health education department of preventing most infectious diseases including tuberculosis, psychiatric and traumatic disorders preventing programs will be able to maintain. When we change the policy of administration and management of outpatient health services than community, based prevention will be able to follow. Conclusion: 1. There is a necessity of expanding and management of renewing out and inpatient clinic. Which provide 80-85% of all the medical help and service. 2. The relationship of out and inpatient clinic and their activity risk and resource are need to determine. All these mentioned fi nding show that health administrative has to perform well-targeted study. 3. To fi nd out normal working load is main problem of health management. In our predictive study-shows in internal and neurological cabinets load can be 25 people per day, 15-20 for surgical and ophthalmological, 10-15 for urology and gynecology cabinets.