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双语推荐：诊疗流程

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目的探索临床营养诊疗流程(NCPM)在国内应用的可行性。方法通过检索文献,了解美国营养诊疗流程的内容、世界各国使用情况,开发适合中国国情的临床营养诊疗流程(MK-NCPM)并尝试与多家医院合作进行临床实践。结果美国、加拿大、韩国、澳大利亚、台湾等多个国家和地区成功引入NCPM,并取得了不同程度的发展;我国的临床实践已经在十余家医院陆续开展。结论 NCPM为临床营养工作者提供了系统的营养诊疗方法,初步实践证实可行,有利于我国临床营养科的建设与发展。
Objective We mainly explore the feasibility of Nutrition Care Process and Model (NCPM)in the domestic application. Methods Through searching the literature,understanding the content and application of NCPM,we establish MaiKang-Nutrition Care Process and Model (MK -NCPM)that is suitable for China''s national conditions and try to achieve clini-cal practice and exploration in cooperation with several hospitals. Results The United States,Canada,South Korea,Austral-ia,Taiwan and other countries or regions have successfully introduced NCPM and made a further development;More than ten hospitals in our country have been carried out the clinical practice. Conclusion NCPMprovides a system methods of clinical nutrition intervention,it is also advantageous to the construction and development of clinical nutrition in our country.

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针对患者预约服务及候诊排队拥挤的问题,讨论了基于手机短信的院外候诊服务流程和基于专家问诊时间的分时就诊流程。首先介绍了预约诊疗的几种模式,并讨论了预约就诊数据交换流程,然后阐述了基于手机短信的院外候诊服务流程和基于专家问诊时间的分时就诊流程,完全改变了传统取号后直接候诊的就医流程。主要从院外候诊、分时就诊以及服务质量评价几个方面对预约诊疗服务流程进行优化,对有效解决医院"三长一短"问题,缓解医院拥挤的现状,减少患者感染几率具有非常重要作用。
Queuing congestion problem, based mobile phone text messages outside the hospital waiting service processes and timeshare treatment process based on expert interrogation time for patients booking service and waiting. First introduced several models of the clinic appointment and discuss the process of appointment data exchange, and then based mobile phone text messages outside the hospital waiting service processes and time-sharing treatment process based on expert interrogation time, completely changed the traditional take a number direct the process of waiting for medical treatment. From outside the hospital waiting time-treatment and the evaluation of the quality of service aspects clinic appointment service process optimization is very important to have an effective solution to the hospital"three long and one short"to ease the hospital crowded the status quo, to reduce the risk of infection in patients with role.

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先诊疗后结算是精简诊疗环节、缩短病人就诊时间的有效举措。该文具体介绍了医院推行基于自助的先诊疗后结算流程,包括协议签约、自助挂号、选择预付费用、就诊、直接检查检验、离院结算、取药等环节。同时,提出先诊疗后结算应从综合、系统的角度推行,要便捷、易操作,并要加强与病人沟通。
Treatment before bill settlement is an effective measure of simplifying the treatment procedure and shortening patients''treatment time .This article expounds on the flow of treatment before bill settlement based on self-service, which includes signing agreement , self-registering, choosing prepaid expenses , receiving treatment , receiving examination and test directly , paying upon discharge from the hospital , and getting the medicine . The article also points out that the project should be made comprehensive and systematic as well as convenient and easy to operate , and that it is necessary to make sufficient communication with patients .

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目的通过门诊流程的再造提升门诊诊疗、服务水平,节约患者候诊时间。方法采用问卷调查法,对流程再造前后的内分泌科就诊患者进行调查,比较再造措施实施前后患者的就诊用时及就诊满意度。结果门诊流程再造前内分泌患者就诊平均用时为105.66 min,再造后平均用时为56.48 min,有效节约49 min,满意度由原来的78.14%上升至90.67%。结论门诊流程再造可很好的提高门诊运营效率,缩短患者候诊时间,提高患者满意度,规范门诊管理,进一步提高诊疗、服务水平,提升医院文化品质。
Objective This article introduces our experience in reengineering outpatient service process that aiming at improving the levels of outpatient diagnosis and treatment as well as services and saving patients time of waiting to see a doctor . Methods Questionnaires were used to survey the endocrinology patients, before and after the implementation of reengineering outpatient ser-vice flow in endocrinology department. And then, the patients’ visit time and patients’ satisfaction before and after the implemen-tation of the reengineering measures were compared. Results The patients’ visit time was reduced from 105.66 minutes to 56.48 minutes; the patients’ satisfaction was raised from 78.14% to 90.67%. Conclusion Reengineering outpatient service process can greatly improve the outpatient operational efficiency, save the patients’ visit time, raise the patients’ satisfaction,standardize the outpatient management and improve diagnosis and treatment level persistently. Also, it

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近年来，在新医改的助推下，为满足患者不断增长的就医需求，缓解日益凸显的看病难问题，预约诊疗在国内应运而生。预约诊疗在全国范围内的开展，有效地提高了患者就医可及性和便利性。目前国内预约诊疗大部分还停留在预约挂号阶段，尚未实现就医全流程预约管理。“301模式便民就医一卡通”信息系统，响应国家开展预约诊疗的号召，为开展多种形式的预约诊疗服务提供了可借鉴的成功案例。
In recent years, under the new healthcare reform, in order to match the growing medical demand and smooth the unavailability of medical treatment, reservation medical service is introduced to China. With its extendedness to all China, reservation highly improves the convenience and accessibility of medical treatment. But most of reservation medical service just includes reservation registration. The convenience medical card information system developed by 301 hospital provides successful case of various reservation medical service.

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目的：建立门诊“健康指导、预防治疗、追踪治疗”的颈椎病“治未病”诊疗流程，探讨“治未病”诊疗流程对颈椎病高危人群的影响。方法：将100例非脊髓型颈椎病患者随机分为干预组（50例）和对照组（50例），干预组每隔2周进行最少1次电话随访进行功能锻炼及生活习惯指导；对照组则每隔2周进行最少1次电话随访，了解病情发展情况，但不进行指导干预。6个月后进行问卷调查，观察两组效果。结果：干预组颈椎功能障碍评分显著低于对照组（P<0.01）。结论：经“治未病”防治诊疗流程干预后能明显提高患者的治愈率、降低复发率，以及提高生活质量。
Objective:To establish a diagnosis and treatment process of"health guidance, prevention and treatment, tracking treatment"that based on"preventive treatment of disease"concept at outpatient department for cervical spondylosis, and investigate the influence of the process on cervical spondylosis high-risk groups. Methods: 100 cases of patients with non cervical spondylotic myelopathy were randomly divided into intervention group (50 cases) and control group (50 cases), the intervention group was followed-up by telephone at least one time every 2 weeks to guide function-al exercise and living habits;while control group was followed-up by telephone at least one time every 2 weeks to track the development of disease, but no guidance or intervention. At the sixth month after that, observed the effectiveness of two groups by questionnaire survey. Results:The cervical dysfunction score of intervention group was significantly lower than that of control group (P<0.01). Conclusion:Inte

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目前多数医院采用传统付费方式，成为老百姓“看病难”主要原因之一。为合理解决此问题，优化服务流程，提高服务质量和效率，我院提出“以患者为中心”创新服务理念，采用信息化、网络化运作模式，利用多种渠道、多种方式为患者提供安全、有效、便捷的诊疗服务。同时采用银行投资，医院HIS开发，医院设计流程等方式，建设以社保卡为载体的“先诊疗后结算”银医一卡通服务平台。
At present, most hospitals use traditional payment methods, which is one of the primary causes resulting in public''s difficulty with seeing doctors. In order to solve the problem, to optimize service process and to improve service quality and efficiency, our hospital proposed the"patient-centered"idea. The hospital employed an informationized, webified running model, multiple channels and methods so as to provide the patients with safe, efficient, and convenient medical services. Meanwhile approaches such as bank investment, hospital HIS development, and workflow design were used to build a bank-hospital one-card platform that can offer social security care-based"treatment before payment"services.

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目的：对内镜诊疗患者常见的护理安全隐患进行原因分析和流程改进，减少护理安全风险事件发生，保障患者诊疗安全。方法：根据质量管理讨论会的记录，采用鱼骨图分析法，归纳并总结存在的安全隐患，分析关键因素和根本原因，并制定可行的护理防范措施。结果：分析出了内镜诊疗发生护理安全隐患的原因，落实了护理评估，采取了有效的护理防范措施，优化改进了信息系统自动识别功能，强化了安全核查。结论：紧抓安全风险防范关键环节，强化安全防范意识，优化流程并制定有效措施，有效地杜绝了护理安全风险的发生，保障了患者检查期间的安全。
Objective:To reduce potential endoscopy safety risks and safeguard patients by analyzing reasons and improving nursing processes. Methods:Fishbone analysis was adopted to ifgure out key risks during endoscopy examinations and their main reasons. We took detailed and speciifc precautions to prevent safety accidents. Results:Based on the causal analysis, solutions included enhancing nursing assessment, enhancing safety precautions, optimizing information system and so on. Conclusions:Safety risk control not only could prevent safety accidents, but also could safeguard patients during endoscopy examinations.

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现有的就诊流程需多次排队、流程繁琐，普遍存在看病“三长一短”的现象。为了解决这个难题，并结合新医改政策要求，为患者提供“先诊疗，后结算”服务。医院一卡通信息系统就是把诊疗卡、医保卡、银行卡“三卡合一”，在诊疗过程中实现自助挂号、缴费、报告单自助打印等功能。“一卡通”可达到的成效：缩短看病时间，提高医疗服务质量；减少人工作业，杜绝收费漏洞，避免差错；实行无纸化、无现金数据传输办公，提高工作效率，降低医疗运营成本；实现未来的区域医疗信息共享，为全民医疗改革信息共享奠定了基础。
The existing treatment process needs multiple queue, process cumbersome, widespread doctor "three long and one short" phenomenon, in order to solve this problem, combined with the new medical reform policy requirements: to provide "first diagnosis and treatment for the patient, after the settlement" service, hospital card information system is to diagnosis and treatment card, insurance card, bank card "three card one", realize the self-help registration, payment,report self-help printing function in the process of diagnosis and treatment. "One card" can achieve results: 1, see a doctor time shorten, improve the quality of medical service;2, reduce manual work, stop charging vulnerability, avoid errors; 3, implementation of paperless office, no cash data transmission, improve work efficiency, reduce the medical operation cost; 4, to realize the regional medical information sharing in the future, lay the foundation for universal health care information sharing.

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文章运用根本原因分析法对2例患者身份识别的医疗信息不良事件展开分析，经过团队组成与资料收集，梳理流程并还原事件，辨识直接原因和分析根本原因，找出现有流程设计上的缺陷，针对性提出修复潜在性失误的流程改造方案。通过案例分析验证根本原因分析法是推动信息系统持续改进的有效方法；对于医疗信息不良事件，应以流程为主线展开分析，关注诊疗流程信息化后新流程各环节的安全权重分配和数据源的准确性。
Two cases of patients identification with adverse events were reported and analyzed with the root cause analysis method.To streamline the process and reconstruct the events by collecting materials,to explore the defects of the existing process design by analyzing the proximate and root causes,to propose a process improvement plan.This paper suggests that RCA be an effective methods to continuously improve the hospital information system,RCA be applied in process analysis,the new safety weight distribution in the diagnosis and treatment processes informationized and the accuracy of the data source should be attached importance to.

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