Many of the personnel who take up the central role in the implementation of medical safety measures in various departments are nurses. Medical safety measures involve a wide range of sometimes unclearly defined duties and it is assumed that the nurses responsible for these duties have a variety of opinions regarding them. As such, this study investigated the factors affecting the work motivation of nurses engaged in medical safety duties. A total of 429 national, public, and private university hospitals around the country, as well as facilities with at least 200 beds in Tokyo area, were asked to participate in the study. Approval was granted from 103 facilities and from these, 141 nurses, who were engaged in medical safety duties full-time or part-time, were the participants. Responses were received from 126 of the 141 participants, and most of them were engaged in medical safety duties in full-time managerial positions at facilities with at least 200 beds. A multiple regression analysis showed the following positive factors that influenced work motivation：that they could decide independently on how to undertake their work, that they could exhibit leadership while performing their duties, and, that they could improve themselves through their medical safety duties. A chosen negative factor was that insufficient numbers of staff were assigned to their departments. This negative factor was supported by data from the Japanese Central Social Insurance Medical Council that showed a lack of personnel within safety management departments.

More and more hospitals are introducing Hospital Information System (HIS) to deal with more complex medical conditions, and the demand for higher quality healthcare and patient-centered care. The role of HIS within management may change according to the duration from introduction, the level of information integration and the level of satisfaction felt by staff, and that the introduction purpose may also be altered relevantly.

In this study, we conducted questionnaire surveys in 2008 and 2010 to investigate the change of integration level of information, level of satisfaction, purposes of introducing HIS, and roles of HIS in hospital management. All hospitals that had incorporated HIS in 2006 were asked to answer the questionnaires.

The response rates were 31.1% (488/1,567) in 2010 and 20.3% (328/1,616) in 2008. The results of this study suggested that the integration level had improved and more hospitals were using paperless HIS in 2010 as compared with 2008, and the staff satisfaction level of HIS was influenced by the integration level rather than the duration after the introduction of HIS. Service and quality improvements of healthcare were the most often cited purposes of introducing HIS. Hospitals with paperless HIS were likely to evaluated their achievement higher than those with parallel paper-based HIS.

The integration levels were influenced by the purpose of introduction, and were classified into three groups：(1) the role in hospital management became more pivotal and achievement level improved, (2) the role in hospital management remained similar but achievement level improved due to higher operational efficiency, and (3) both the role in hospital management and achievement level remained similar.

In 2012, coordinated critical path for the treatment of dementia was established in the Kojima district of Kurashiki City, Okayama Prefecture. This article is a review of this critical path. Association of Kojima Neurological Disease Alliances was established mostly from the Department of Neurology, Kawasaki Medical School and the Kojima Medical Association. A working group for the coordinated critical path treatment of dementia was subsequently selected. The working group meetings were held at the Hall of the Kojima Medical Association. Academic meetings have been held on a regular basis for physicians and medical staff in the region to improve their education. In May 2012, we officially started using the critical path for the treatment of dementia and it has yielded several excellent results. Our path uses a file format, which is inherently more versatile than the booklet format. We believe that our path represents an ideal model for coordinated critical path treatment in a super ageing society.

This study was to investigate the amount of rehabilitation services provided by physical therapists by examining the daily reports in department of acute rehabilitation. Physical therapists worked an average of 9.8 hours and spent 6.0 hours for the treatment of the patients a day. Amount of indirect work (medical recording, patients transfer, reports preparation) was 21% of total rehabilitation services. A significant negative correlation was observed between amount of indirect work and exercise units of medical service fee per patient. This result indicated that the increase of exercise units of medical service fee per patient will decrease amount of indirect work and will lead to improvement of work efficiency in acute rehabilitation.

This study aims to longitudinally observe changes in the first-year nurses' occupational stress levels to determine periods during which they experience stress that affects their communication skill scale. The subjects were 35 first-year nurses. A questionnaire survey was conducted using the first-year nurses' occupational stress scale and a communication skill scale three times a year at 3, 6, and 11 months after employment. Changes in both scales were compared in three aspects using the Friedman test. The Spearman rank test correlation was used to determine the association between both scales. Although occupational stress tended to increase gradually, there was no change in communication skills. Occupational stress was associated with smoothness of communication skills and assertiveness. The findings suggested that occupational stress in nurses tended to increase gradually through their first year, the experience might eventually become usable to converse smoothly and provide assertive responses to questions.