简介：AIM:Tocombinecommunityandhospitalservicesinordertoenableimprovementsinpatientmanagement,anintegratedgastroenterologyservice(IGS)wasestablished.METHODS:Referralpatternstospecialistclinicswereoptimized;openaccessrouteforendoscopicprocedures(includingesophago-gastro-duodenoscopy,sigmoidoscopyandcolonoscopy)wasestablished;familyphysicians’knowledgeandconfidencewereenhanced;directcommunicationlinesbetweenexpertsandprimarycarephysicianswereopened.Continuingeducation,guidelinesandagreedinstructionsforreferralwerepromotedbytheIGS.SixqualityindicatorsweredevelopedbytheDelphimethod,rigorouslydesignedandregularlymonitored.Improvementwasassessedbycomparing2010,2011and2012indicators.RESULTS:Anintegrateddeliverysysteminaspecificmedicalfieldmayprovideasolutiontoafragmentedhealthcaresystemimpairedbyalackofcoordination.InthispaperwedescribeanewintegratedgastroenterologyserviceestablishedinApril2010.Waitingtimeforproceduresdecreased:3moinApril30th2010to3wkinApril30th2011andstayedbetween1-3wktillDecember30th2012.Averagecostforpatient’svisitdecreasedfrom691to638NIS(adecreaseof7.6%).Sixhealthindicatorswereimprovedsignificantlycomparing2010to2012,2.5%to67.5%:Bonedensitometryforpatientswithinflammatoryboweldisease,preventivemedicationsforhighriskpatientsonaspirin/NSAIDs,colonoscopyfollowingpositivefecaloccultbloodtest,gastroscopyinBarrett’sesophagus,documentationoffamilyhistoryofcolorectalcancer,andcolonoscopyinpatientswithafamilyhistoryofcolorectalcancer.CONCLUSION:EstablishmentofanIGSwasfoundtoeffectivelyimprovequalityofcare,whilebeingcosteffective.

简介：急性重度有机磷农药中毒（AOPP）的病人多服毒量大，中毒症状重，如不及时抢救，会迅速出现呼吸衰竭、脑水肿、循环衰竭，甚至死亡。为此，我们积极开展了对该类病人的“120”院前急救措施，使病人得到及时而有效的处理，抢救成功率明显提高，现将该工作总结报告如下。

简介：人力资源开发，就是根据人力资源载体的生理和心理特点，运用科学的方法，充分挖掘人力资源的潜力，合理配置人力资源，实现劳动投入和经济投入的高效率。有著名经济学家认为：中国加入WTO后，如何面对人才重重危机，是医院人力资源管理必须接受的考验，国外人力资源开发比较注重以人为本(即人本管理)，突出理解人、尊重人，充分发挥人的主动性和积极性。目前，急救工作在现代社会已显示出其重要地位，由于急救工作特点，使得急救护理人员合理配置和培训成为护理管理难题，本文就本院院前急救护理人员的配制和培训管理进行探讨。