« 医学メモ090412 | メイン | 090611 »

埼玉医科大学国際医療センター開設から学んだもの

●埼玉医科大学国際医療センター開設から学んだもの

Patient oriented
Ordemade

エントランスホール
統合型手術室
  患者のベッドを動かすことで、モードを手術・血管・CTと切り替える
  はめ込み方無影灯
  ディスプレイを折りたためる

カフェ

患者図書室

120人入れる総合医局

各病棟に薬剤師がいる

日本人の3大疾患(がん、心臓病、救急救命(含 脳卒中センター))をまとめて引き受ける
 腫瘍学
 心臓病学(MI、小児)
 総合救急+脳卒中

…基本的に満床
  朝の仕事は 入院患者のカンファと、退院と

患者を「引き受けるけれど引き取ってもらう」

救急入り口近くに、
 定時の心臓血管造営
 脳血管造営

プロジェクトに必要なもの
・明確な方向性、コンセプト
・リーダー
・情報の共有
・現場スタッフの積極的参加

反省
・新しい病院で誰が働くのかわかっていないとだめ
 「現場で働く人間を早く決める。その人らが中心になってアイデアをだす」

・今までこうやっていた、と今までにこだわる人が必ずいる。だが、何かを切り捨てないと新しいものはできない。埼玉医大は閉鎖空間だった。「大きな病院だけれど比較の対象がない」→あそこでやっていることがすべて。外からの人間は「やったことない」
「みたことない」「やったひといない」ばかり。→一つひとつ説得してまわった

自分たちは
何が強くて、どこが弱いのか
それをはっきりさせることが大切。
今までにこだわると、それが足かせになる

「既得権」 これをなしにしないと新しいものが生まれない

埼玉医大は理事長がトップダウンだったのが、よかった

救急は人手がいるし、リスクが高い
 限られたマンパワーと設備でどうするか
最終的にははっきり区別した。
 この病院ではこれを診ない。これは全部診る。
 …それが浸透するのに2年かかった

・働いているひとが満足できないと、長続きしない。患者はハッピーにならない
 憩える場所、など、働きやすくしないといけない

・患者を回転させないと、経営成り立たない。連携がカギ
 オープン前にやっておくことが大切
 資本投資したらまわさないと

・外科は手術中心 〜例: 手術室30
 内科は外来中心 〜例: ゆとりのあるきれいな外来
   土曜日は全部日帰り手術

・建築業者との打ち合わせは必ず議事録を
  建築業界はいい加減… 「言った言わない」
   いろいろなことがごまかされないように…


・患者さんが望むもの
 「安心感」
 この病院大丈夫?
 この先生大丈夫?
 ここの看護婦さん大丈夫?
 ここの技師さんほんとうに病気のことわかっている?

問題!!
 慣れない状況で、ヒヤリハットがたくさん
 効率のいい回転
 請求漏れが多いこと

スタッフ・コメディカルも専門家でなければいけない

実際に起きた事件
 ・私はよくわかりません事件
 ・アンギオとエンボリ知りません事件
   患者から看護師に質問されたときに答えた言葉


必要なのは、Passion!
 【われわれは、患者さんのために】


・苦労
予算は??
 埼玉医大は買い物上手。叩いている
 購買部がものすごくよく勉強している
 なるべく早めに決めないことが重要。決めると、下がらない
  向こうに「勘弁してください」といわれるほどでないと、だめ
 いまは、初期はやすくメンテナンスでお金をとられる


●感想

高度医療
「医療が、何をやりたいのか」
「専門家に頼る」「病気をなおしたい」
    (病気: 医療者の物差し。そこでの仕事)
  利用者は、専門家
  専門家が具体的なアイデアを練り上げる

…しかし、専門家が往診に行きたい、佐久


地域医療
「医療は何をやらせていただきたいのか」
「地域・住民に頼る」「あなたに元気になっていただきたい」
    (元気: 住民の物差し。そこでの仕事)
  利用者は、患者・住民
  住民が具体的なアイデアを練り上げる
    地域の専門家は、住民(状況設定、根回し、etc)
『高度医療センターが集中できるように、つくり上げる必要あり』


…どちらも、利用者とのコミュニケーションが必要
 働く人間が積極的に動く環境が必要


・新病院は、1次はやらない、と決めるべき


トラックバック

このエントリーのトラックバックURL:
http://dream-hosp.net/cgi/mt/mt-tb.cgi/2766

コメント

I loved as much as you will receive carried out right here. The sketch is tasteful, your authored material stylish. nonetheless, you command get bought an impatience over that you wish be delivering the following. unwell unquestionably come more formerly again since exactly the same nearly very often inside case you shield this increase.

What a lovely day for a 1322458! SCK was here

There is perceptibly a bunch to know about this. I feel you made certain good points in features also.

What a lovely day for a 3157715! SCK was here

Thanks for an idea, you sparked at idea from a concept I hadn't thought of before . Now lets see if I can do something productive with it.

you have got an amazing blog here! would you like to make some invite posts on my weblog?

love the blog, thanks for sharing your thoughts

I'm still learning from you, while I'm making my way to the top as well. I absolutely liked reading everything that is posted on your website.Keep the posts coming. I liked it!

love the blog, thanks for sharing your thoughts

Thanks on your marvelous posting! I genuinely enjoyed reading it, you could be a great author.I will be sure to bookmark your blog and will often come back in the foreseeable future. I want to encourage one to continue your great writing, have a nice afternoon!

I this site is really great. I'm glad that i found a place to get such important information. Keep up the good work! juicer machineinfo.

I'm so happy to read this. This is the kind of manual that needs to be given and not the random misinformation that's at the other blogs. Appreciate your sharing this best doc.

I have a problem with the overall premise of your post but I still think its really informative. I still really like your writing style. Keep up the good work.

Would you be involved in exchanging hyperlinks?

I was wondering if you ever considered changing the layout of your blog? Its very well written; I love what youve got to say. But maybe you could a little more in the way of content so people could connect with it better. Youve got an awful lot of text for only having one or two images. Maybe you could space it out better?

I am continuously invstigating online for posts that can assist me. Thank you!

I wanted to put you this very little observation in order to give thanks as before for your personal gorgeous ideas you have contributed in this article. It was certainly shockingly generous with you to allow extensively just what many people would've made available as an electronic book in order to make some dough for themselves, notably now that you could have done it in the event you decided. Those inspiring ideas additionally worked to become a easy way to fully grasp many people have similar zeal really like my personal own to know somewhat more with reference to this problem. Certainly there are lots of more enjoyable sessions in the future for individuals that scan through your website.

What a lovely day for a 1322009! SCK was here

I am so happy to read this. This is the kind of manual that needs to be given and not the random misinformation that's at the other blogs. Appreciate your sharing this best doc.

As I site possessor I believe the content matter here is rattling fantastic , appreciate it for your efforts. You should keep it up forever! Good Luck.

I do not even know how I ended up here, but I thought this post was great. I don't know who you are but certainly you're going to a famous blogger if you aren't already ;) Cheers!

Just want to say your article is as surprising. The clarity in your post is just cool and i can assume you are an expert on this subject. Well with your permission allow me to grab your RSS feed to keep up to date with forthcoming post. Thanks a million and please continue the enjoyable work.

Thank you for the advice. I窶况e found your first point to be most effective.

I couldn窶冲 resist commenting. :)

What窶冱 Happening i'm new to this, I stumbled upon this I've found It positively useful and it has helped me out loads. I hope to contribute & assist other users like its aided me. Good job.

An impressive share, I simply given this onto a colleague who was doing a little bit analysis on this. And he in reality purchased me breakfast as a result of I found it for him.. smile. So let me reword that: Thnx for the deal with! But yeah Thnkx for spending the time to debate this, I really feel strongly about it and love studying more on this topic. If doable, as you grow to be experience, would you mind updating your blog with more particulars? It's extremely useful for me. Big thumb up for this blog submit!

very nice post, i actually love this web site, carry on it

Excellent beat ! I would like to apprentice while you amend your web site, how can i subscribe for a blog web site? The account helped me a acceptable deal. I had been a little bit acquainted of this your broadcast offered bright clear idea

I am constantly browsing online for posts that can help me. Thx!

I really appreciate this post. I have been looking all over for this! Thank goodness I found it on Bing. You have made my day! Thanks again

Simply want to say your article is as surprising. The clarity in your post is simply nice and i could assume you're an expert on this subject. Fine with your permission allow me to grab your RSS feed to keep up to date with forthcoming post. Thanks a million and please carry on the enjoyable work.

It窶冱 exhausting to search out educated folks on this topic, however you sound like you know what you窶决e speaking about! Thanks

As i gotta disclose that posting is going to be outstanding that will make my family mastered plenty of important things headlines. I bought enough proposal in my mind at this instant. Appreciate this. I think you'll can continue running and therefore sustain display additional facts which we are not aware of and yet.

I do not even know how I ended up here, but I thought this post was good. I do not know who you are but certainly you're going to a famous blogger if you are not already ;) Cheers!

Since i really admit that this post is truly good that leave my lifestyle trained a number of tasks thing. I acquired a great amount of view in my mind next. Nice this valuable. I hope you can continue running and therefore hold talk about recent guidance i always do not however.

excellent post. i really like it. keep it up.

I was just seeking this information for some time. After six hours of continuous Googleing, finally I got it in your website. I wonder what's the lack of Google strategy that don't rank this type of informative websites in top of the list. Generally the top web sites are full of garbage.

It窶冱 actually a cool and helpful piece of info. I am glad that you shared this helpful information with us. Please keep us up to date like this. Thanks for sharing.

コメントを投稿