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Este trabalho visa problematizar a noção de singularidade na psicanálise lacaniana. Embora não seja propriamente um conceito, tampouco um termo recorrente na obra de Freud, ganha destaque especial em Jacques Lacan e em seus comentadores. Foi o que pudemos verificar quando focalizando o tema da direção do tratamento, realizamos uma leitura crítica do uso dessa noção tanto na obra de Lacan como na de seus seguidores de diversas escolas. Escolhemos circunscrever nossa reflexão ao campo da direção do tratamento que se articula intimamente ao tema da ética da clínica lacaniana. Isso não significa que abandonamos discussões epistemológicas da singularidade, pois sabemos que é necessário manter um tensionamento entre clínica e epistemologia. Lacan importou da matemática e da filosofia suporte teórico para pensar a singularidade em psicanálise, portanto, acompanharemos algumas dessas importações, nos debruçando fundamentalmente em suas consequências para a clínica psicanalítica. Como não há explicitamente uma teoria da singularidade em Lacan, tentamos extrair na rede conceitual de sua obra uma abordagem possível do termo, prevenidos de que, ao fazermos um emprego idealizado e impreciso da noção de singularidade na direção do tratamento psicanalítico, poderíamos incorrer em um problema ético. Há duas tendências mais comuns que nos levam a esse problema: a imaginarização da noção de singularidade e a negativização do termo. Assim, para afastarmos o risco de tomar a singularidade como um ideal psicanalítico (e cientes de que há um forte empuxo nesse sentido), não podemos essencializar essa noção nem descontextualizar o que nomeamos como singular. O que é singular se inscreve num tempo, num espaço e, portanto, num laço social. A singularidade nega e ao mesmo tempo faz existir o universal e o particular, por isso está em permanente articulação com estes. A ideia da singularidade como um jogo de forças que opera durante todo o tratamento, nos parece mais interessante do que a aposta na singularidade como critério de cura. Tal jogo é instaurado pela evanescência do inconsciente que emerge como pulsação na passagem entre os significantes ou nos lapsos de sentido. A singularidade seria uma expressão para se referir ao movimento de tensionamento entre o discurso coerente do paciente e a emergência do inconsciente. Dessa forma, pode se presentificar durante todo o processo do tratamento e não apenas no seu final. Pode ser uma experiência de curta duração, embora seus efeitos também possam ser duradouros. Há várias noções usadas por Lacan para falar da emergência do inconsciente na clínica: equívoco, ato falho, o encontro faltoso (tique), entre outras. No dia-a-dia de nossa atividade clínica, presenciamos como cada paciente subjetiva seu mal-estar ou ainda como cada um faz para lidar com sua divisão subjetiva e com suas contradições. Se estamos nessa esfera, sobre como cada um se vira com o próprio mal-estar, não falamos de singularidade e sim de subjetivações particulares. Assim, se seguirmos a proposta lacaniana de distinguir o singular do particular, circunscreveremos as diversas possibilidades subjetivas de resposta à castração, a uma ordem de particularidade. A nosso ver, a diversidade subjetiva não é menos importante que a emergência do singular num tratamento. É o que um sujeito pode fazer em termos de experiência subjetiva. O papel da singularidade é desencadear o jogo entre particular (articulações significantes e modalidades de subjetivação específicas) e universal (ordem simbólica como um sistema aberto) / This work aims to discuss the idea of uniqueness in Lacanian psychoanalysis. While not exactly a concept, either a recurring term in Freuds work, uniqueness earns special emphasis on Jacques Lacan and his commentators. Thats what we saw when, focusing on the theme of the direction of the treatment, we conducted a critical analysis of the use of this idea both in Lacans work as in his followers from different schools. We chose to circumscribe our thinking to the field of direction of the treatment, which is linked closely to the issue of ethics of Lacanian clinic. This does not mean that we abandoned epistemological discussions of the uniqueness because we know that it is necessary to maintain a tensioning between clinical and epistemology. Lacan imported from mathematics and philosophy a theoretical support to think the uniqueness in psychoanalysis, therefore, we will follow some of these imports addressing fundamentally its consequences for the psychoanalytic clinic. As there is not explicitly a theory of uniqueness in Lacan, we tried to pull from the conceptual network of his work a possible approach of the term, warned that when doing an idealized and inaccurate use of the idea of uniqueness in the direction of psychoanalytic treatment, we could incur in an ethical issue. There are two common trends that could lead us to this problem: the imaginarization of the idea of uniqueness and the negativation of the term. So, to move away from the risk of taking the uniqueness as a psychoanalytic ideal (and aware that there is a strong thrust in that direction), we can not essentialize this idea or decontextualize what we name as unique. What is unique is inscribed in time, in space and, therefore, a social bond. The uniqueness denies and at the same time makes real the universal and the particular, therefore it is in permanent liaison with these concepts. The idea of uniqueness as a game of forces that works throughout the treatment seems more interesting than the emphasis on the uniqueness as a criteria for cure. This game is set up by the evanescence of the unconscious, emerging as pulsation in the passage between the signifiers or in the lapses of sense. The uniqueness would be an expression to refer to the movement of tensioning between the patients coherent speech and the emergence of the unconscious. Thus, the uniqueness can be present throughout all the treatment process, not just at its end. It may be a short-term experience, although its effects can also be long lasting. There are several concepts used by Lacan to speak of the emergence of the unconscious in the clinic: mistake, parapraxis, the lacking encounter (tiquê), among others. In our daily clinical activity, we witness how each patient subjective its malaise or yet how each one deals with his subjective division and his contradictions. If we are in this sphere, talking about how each one deals with their own malaise, we do not speak of uniqueness, but of particular subjectivities. So, if we follow Lacans proposal to distinguish the uniqueness from the particular, we will circumscribe the several subjective possibilities of response to castration, to a particular order. In our view, the subjective diversity is not less important than the emergence of the uniqueness on a treatment. Its what a man can do in terms of subjective experience. The role of uniqueness is to trigger the game between particular (significant joints and specific modalities of subjectivation) and universal (symbolic order as an open system)

Nossa pesquisa tem origem no amplo campo da relação da psicanálise com a universidade. A partir do reconhecimento que essa relação é marcada por impasses, mas também por potencialidades, restringimos o foco da nossa pesquisa para as possibilidades de pesquisa clínica em psicanálise. O momento seguinte foi dedicado a fazer um levantamento das metodologias de escrita a partir de material clínico, resultando em encontrar cinco. A construção do caso de Pierre Fédida, a construção do caso de Carlo Viganò, a escrita da clínica de Simone Rickes, o traço do caso de Dumézil e o fato clínico de Czermak. Decidimos aprofundar nossa investigação nas duas últimas metodologias citadas por sua potencialidade teórica e de formação na psicanálise, mas curiosamente apresentando uma escassez de publicações. Logo, apresentamos exemplos de casos clínicos escritos a partir dessas metodologias e comentamos suas similaridades, diferenças, limites e potencialidades. Finalmente destacamos o modo de fazer operar a clínica com a teoria. Sublinhamos como a noção de ficção como operador a partir do real que é a clínica se oferece como suporte para fazer os conceitos como ferramentas. A partir da clínica, podemos construir um caso, escrever fazendo contorno no real, apreender um traço, propor um fato clínico. Consideramos que são essas ferramentas teóricas que permitem que operemos no campo abstrato, trabalhando hipóteses para tocar o que é de certa forma inacessível na clínica e assim produzimos e colhemos os efeitos da psicanálise. / Our research has its origin in the broad field of psychoanalysis's relationship with the university. From the recognition that this relationship is marked by impasses, but also by potentialities, we restrict the focus of our research to the possibilities of clinical research in psychoanalysis. The next moment was dedicated to make a survey of the writing methodologies with clinical material, resulting in finding five. The construction of the case of Pierre Fédida, the construction of the case of Carlo Viganò, the writing of the clinic of Simone Rickes, the trait of the case of Dumézil and the clinical fact of Czermak. We decided to deepen our research in the last two methodologies cited for their theoretical potential and formation in psychoanalysis, but curiously they presented a shortage of publications. Therefore, we present examples of clinical cases written from these methodologies and comments on their similarities, differences, limits and potentialities. Finally we highlighted the way of making operate the clinic with theory. We emphasized how the notion of fiction as an operator of the Real that is a support for the use of concepts as tools. With the clinic, we can build a case, we can write as making the counter of the Real, apprehend a trait, and also propose a clinical fact. We believe that it is these theoretical tools that allow us to operate in the abstract field, working hypotheses to touch what is in some way inaccessible in the clinic and thus we produce and reap the effects of psychoanalysis.

Ninguém envelhece da mesma maneira e as alterações causadas pelo envelhecimento desenvolvem-se num ritmo diferente para cada pessoa. O objetivo deste trabalho é realizar uma investigação exploratória do potencial psicoterapêutico do instrumento Caixa Lúdica para Idosos (CLI) oferecendo possibilidades de utilização em diferentes contextos, abarcando assim, um grande número de idosos, em variadas condições de saúde. Utilizou-se a metodologia qualitativa de enfoque psicanalítico. Participaram da pesquisa quarenta e cinco idosos, distribuídos da seguinte forma: quinze idosos provenientes de um Hospital Escola da zona oeste da cidade de São Paulo, quinze idosos provenientes de uma Universidade Aberta à Terceira Idade da zona oeste da cidade de São Paulo e quinze idosos provenientes de uma Instituição de Longa Permanência para Idosos da zona oeste da cidade de São Paulo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos do Instituto de Psicologia da Universidade de São Paulo (CEPH-IPUSP). Foram utilizados os seguintes instrumentos: Entrevista Preventiva Semi-dirigida, Mini-Exame do Estado Mental (MMSE), Escala Diagnóstica Adaptativa Operacionalizada (EDAO), Psicoterapia Breve Operacionalizada (PBO) e a Caixa Lúdica para Idosos (CLI). Foram realizadas duas entrevistas utilizando-se a Escala Diagnóstica Adaptativa Operacionalizada (EDAO) e seis encontros utilizando-se a Psicoterapia Breve (PBO) e a Caixa Lúdica para Idosos (CLI), uma vez por semana, com duração de até uma hora, durante um total de oito semanas com cada participante. A Caixa Lúdica para Idosos facilitou o vínculo emocional no atendimento clínico, permitindo que significativa quantidade de material emergisse, facilitando o manejo de angústias básicas, desejos inconscientes, conflitos e principais mecanismos de defesa em função do caráter lúdico e projetivo do instrumento. A utilização deste procedimento clínico permitiu a manifestação das múltiplas expressões do mundo interno, fator decisivo para a compreensão dos idosos, possibilitando insights sobre novos sentidos para a história de vida, novas significações e a livre expressão de fantasias inconscientes, contribuindo assim para ampliar a compreensão psicodinâmica do idoso bem como permitindo o acesso a aspectos preventivos, e em decorrência, propiciando ações eficazes seja para a conquista, manutenção ou melhoria das condições de saúde, bem estar e qualidade de vida da população idosa / Nobody grows old the same way and the aging changes develop at a different pace for each person. The objective of this study is to perform an exploratory investigation of the psychotherapeutic potential. The Playful Box for Seniors instrument (CLI) offering possibilities of use in different contexts, thus covering a large number of elderly in various health conditions. For both a theoretical foundation was organized in order to cover the main elements related to the elderly, then it conducted a survey of the techniques used with the elderly in Brazil and other countries to know the other existing instruments, with special emphasis on the differences of Playful Box for Seniors . We used the qualitative methodology of psychoanalytic approach, the stage of data collection involved fifteen elderly of each institution: University Hospital of USP (HUUSP), Long Term Care Institutions for the elderly (LTCF), and the Open University of the Third Age USP. After signing the consent form, the Mini Mental State Examination (MMSE) was used, it has been two preventive clinical interviews with the use of Adaptive Operational Diagnostic Scale (EDAO) and six meetings using the Brief Psychotherapy Operationalized (PBO) and Playful Box for the Elderly (CLI) with each of the elderly, once a week, The Playful Box for Seniors facilitated the emotional bond, allowing significant amount of clinical material emerged, facilitating the management of basic anxieties, unconscious desires, conflicts and major defense mechanisms due to the playful and projective character of the instrument. Use of this clinical procedure allowed the demonstration of the multiple expressions of the inner world, a decisive factor for understanding the elderly, providing insights into new directions for the story of life, new meanings and the free expression of unconscious fantasies, thus raise understanding the old psychodynamic as well as allowing access to preventive aspects, and as a result, enabling effective action is to conquer, maintenance or improvement of health, well-being and quality of life of the elderly population

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-02-16T19:28:46Z No. of bitstreams: 1 Sabrina Batista Andrade.pdf: 2313506 bytes, checksum: dc17a3a07a4e0916bff5e2d5258328ff (MD5) / Made available in DSpace on 2018-02-16T19:28:46Z (GMT). No. of bitstreams: 1 Sabrina Batista Andrade.pdf: 2313506 bytes, checksum: dc17a3a07a4e0916bff5e2d5258328ff (MD5) Previous issue date: 2018-02-07 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This research focus on the investigative experimentation of the clinic and performative action as both may be substantiated in self displacement in face of occurring events. It aim a conversation with the produced sense of neoliberal ethos in the current moment which we live in, keeping alert on the risks of collapse that these senses might suffer due to the occurrence of desires being captured and solidified, giving way to habitual and untraceable microfascism. It proposes a clinic that disorganizes this micro-fascism by means of creating and opening a space for liberation and transfer of desires to events that account for new perceptions of reality while creating other forms of presence in the world. By introducing performance to clinic and life, its spaces and behaviors, it may produce alternatives to numbness and normopathy experienced in our bodies / Esta pesquisa passa pela experimentação investigativa da ação clínica enquanto ação performática, pois ambas podem ser constituintes de deslocamentos de si em devires e acontecimentos. Procura-se uma conversa com os sentidos produzidos pelo ethos neoliberal do atual momento em que vivemos. E atente aos riscos destes sentidos sofrerem uma queda para afetos produzidos por desejos capturados e tendencialmente cristalizados, dando passagem a corriqueiros e imperceptíveis microfascismos. A construção de uma clínica que desoriente estes micro-fascismos quer abrir margens a lugares de liberação e passagem do desejo para acontecimentos que se constituam enquanto novas apreensões da realidade e criem outras formas de presença no mundo. Performatizar a clínica e a vida, seus espaços, sua conduta, tangencia alternativas ao que é vivido nos corpos enquanto anestesiamento e normopatia

Ninguém envelhece da mesma maneira e as alterações causadas pelo envelhecimento desenvolvem-se num ritmo diferente para cada pessoa. O objetivo deste trabalho é realizar uma investigação exploratória do potencial psicoterapêutico do instrumento Caixa Lúdica para Idosos (CLI) oferecendo possibilidades de utilização em diferentes contextos, abarcando assim, um grande número de idosos, em variadas condições de saúde. Utilizou-se a metodologia qualitativa de enfoque psicanalítico. Participaram da pesquisa quarenta e cinco idosos, distribuídos da seguinte forma: quinze idosos provenientes de um Hospital Escola da zona oeste da cidade de São Paulo, quinze idosos provenientes de uma Universidade Aberta à Terceira Idade da zona oeste da cidade de São Paulo e quinze idosos provenientes de uma Instituição de Longa Permanência para Idosos da zona oeste da cidade de São Paulo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos do Instituto de Psicologia da Universidade de São Paulo (CEPH-IPUSP). Foram utilizados os seguintes instrumentos: Entrevista Preventiva Semi-dirigida, Mini-Exame do Estado Mental (MMSE), Escala Diagnóstica Adaptativa Operacionalizada (EDAO), Psicoterapia Breve Operacionalizada (PBO) e a Caixa Lúdica para Idosos (CLI). Foram realizadas duas entrevistas utilizando-se a Escala Diagnóstica Adaptativa Operacionalizada (EDAO) e seis encontros utilizando-se a Psicoterapia Breve (PBO) e a Caixa Lúdica para Idosos (CLI), uma vez por semana, com duração de até uma hora, durante um total de oito semanas com cada participante. A Caixa Lúdica para Idosos facilitou o vínculo emocional no atendimento clínico, permitindo que significativa quantidade de material emergisse, facilitando o manejo de angústias básicas, desejos inconscientes, conflitos e principais mecanismos de defesa em função do caráter lúdico e projetivo do instrumento. A utilização deste procedimento clínico permitiu a manifestação das múltiplas expressões do mundo interno, fator decisivo para a compreensão dos idosos, possibilitando insights sobre novos sentidos para a história de vida, novas significações e a livre expressão de fantasias inconscientes, contribuindo assim para ampliar a compreensão psicodinâmica do idoso bem como permitindo o acesso a aspectos preventivos, e em decorrência, propiciando ações eficazes seja para a conquista, manutenção ou melhoria das condições de saúde, bem estar e qualidade de vida da população idosa / Nobody grows old the same way and the aging changes develop at a different pace for each person. The objective of this study is to perform an exploratory investigation of the psychotherapeutic potential. The Playful Box for Seniors instrument (CLI) offering possibilities of use in different contexts, thus covering a large number of elderly in various health conditions. For both a theoretical foundation was organized in order to cover the main elements related to the elderly, then it conducted a survey of the techniques used with the elderly in Brazil and other countries to know the other existing instruments, with special emphasis on the differences of Playful Box for Seniors . We used the qualitative methodology of psychoanalytic approach, the stage of data collection involved fifteen elderly of each institution: University Hospital of USP (HUUSP), Long Term Care Institutions for the elderly (LTCF), and the Open University of the Third Age USP. After signing the consent form, the Mini Mental State Examination (MMSE) was used, it has been two preventive clinical interviews with the use of Adaptive Operational Diagnostic Scale (EDAO) and six meetings using the Brief Psychotherapy Operationalized (PBO) and Playful Box for the Elderly (CLI) with each of the elderly, once a week, The Playful Box for Seniors facilitated the emotional bond, allowing significant amount of clinical material emerged, facilitating the management of basic anxieties, unconscious desires, conflicts and major defense mechanisms due to the playful and projective character of the instrument. Use of this clinical procedure allowed the demonstration of the multiple expressions of the inner world, a decisive factor for understanding the elderly, providing insights into new directions for the story of life, new meanings and the free expression of unconscious fantasies, thus raise understanding the old psychodynamic as well as allowing access to preventive aspects, and as a result, enabling effective action is to conquer, maintenance or improvement of health, well-being and quality of life of the elderly population

Founded by George Cavender in 1971, the Big Ten Band Directors Association is one of the oldest associations of its kind. With a membership consisting of each institution’s Director of Bands, Athletic Band Director, and all other band faculty, the stature of its members, both past and current, is clear. These band directors are leaders in the profession and have helped the field develop into what it has become today through their positions at their respective flagship institutions of the Big Ten Athletic Conference. The BTBDA meets each year at the Midwest International Band and Orchestra Clinic in Chicago, IL, and its investment in sponsoring quality sessions at the clinic is well documented. The association has sponsored twenty-one sessions since 1986, featuring prominent composers such as Michael Colgrass, Karel Husa, Warren Benson, Gunther Schuller, and Frank Ticheli. Additionally, the association has shown its dedication to the advancement of the band repertoire through commissioning seven new works from 1986-2014, four of which were born out of a commissioning contest that spanned from 1998-2005. This study is the first of its kind to document a band association formed of members bound by a specific athletic conference. Research of the Big Ten Band Directors Association shows numerous examples of how a band conference association can contribute to different facets of the field (e.g. commissioning, clinic session sponsorship, etc.). The profession’s knowledge of the BTBDA is important as it highlights how these associations are contributing to the landscape of the field.

<p>The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively.</p>

Abstract Dental implants can be a breakthrough in dental treatment. It has become an important index of the operation performance for the dental clinics. Patients¡¦ knowledge of dental implant medical quality is different from dentists¡¦ due to asymmetric information. This study sample consists of two major groups: 200 patients and 20 dentists, recruited from 15 dental clinics providing services of dental implants in Kaohsiung city. The data was collected by a questionnaire and try to investigate the relationship between the baseline data , the knowledge and attitude of patients about dental implants. The purposes of this study is to identify the difference between patients and dentists about dental implant medical quality . Providing information for patients seeking dental implant care, and for dental implant marketing of dental clinics. The results show that the willingness to accept dental implants is higher in patients well-educated and good oral hygiene . The most popular resources of getting dental implant information are from TV and their dentists. 74% of patients do not know the brand of their dental implants. 84.2% of patients would like to recommend dental implants with the reasons of their dental experiences and the trust of the dentists. The satisfaction rate of dental implant exceeds 70%. As for selecting dentists, medical skills, medical ethics, medical equipments and public praise are the more important factors. Male and young patients are more affected by objective factors; female patients take more consideration of their own feelings. However old patients more concern about interpersonal relationship. Highly-educated patients attach more importance of profession; Lowly-educated patients more care about the environment of the clinics. About medical quality, the most important factors in dentists are medical skills and sterilization, followed by dentist-patients relationship. The first three in patients are medical skills, sterilization and specialist certification. Of all six common factors in patients and dentists, the most different factor is dentist-patient relationship. It shows obviously high in dentists, and it maybe due to the elevation of consumer¡¦s awareness in Taiwan. Key word: dental implant, dental service quality , dental clinic choice, factor analysis

Recently, the health care services in Taiwan have rocket booming both in scale and in quantity. The competition among these health care service organizations are forging these facilities into cost effective systems through, promoting various quality control programs, elevating clinic & treatment capabilities, and improving quality of health care services. This study is to investigate how the medical staffs¡¦ recognitions are, and at what priority to initiate proper actions, while promoting Taiwan Quality Indicator Project in a medical center in southern Taiwan and its relative influences in clinic quality. The method is to conduct a survey of four hundred and twenty eight (428) clinic personnel from six (6) departments ¡V Emergency Dept., Surgery Dept., Intensive Care Unit, Obstetric & Gynecology Dept., Nursing Dept. and, Psychlogical Dept. - of the sampled medical center. A total of 428 copies of inquires were released to the sampled clinic personnel on April 1st, 2007; and those were collected back with a returning rate of 86.9%, on April 30th, 2007. Software package SPSS is applied to analyze the distribution of this survey. And methods of chi-square test, ANOVA are used to investigate the influence to health care quality caused by various different personnel characteristics. Conclusions are as follows: 1.The results demonstrate that 52.4% clinic personnel do not fully understand about TQIP. And among them, Nurses, Resident Doctors and, Chief Doctors are the most. While the clinic personnel completely understand TQIP are mostly Registered Nurses and, Attending Physicians. Obvious differences of understanding about TQIP exist, apparently, per different job titles. 2.The importance of TQIP given by the sampled persons is 4.08, categorized as ¡¥important¡¦. Without discrimination, same importance is indicated by all clinic personnel of different job titles. 3.The index/indicators of TQIP are accepted as capable to evaluate health care quality of their unit/department by 64.1% of the sampled personnel. Thus, the index/indicator chosen are adequate and proper. 4.69.4% of sampled clinic personnel agree that quality improvement policies are prepared and are realized in their unit/department. The results of TQIP in those units/departments illustrate positive quality improvements of health care service. 5.On the whole, after participating TQIP, the sampled hospital finds quality improvement in health care. The positive influences in health care are, sequentially from more to less, elevating concept of quality control, understanding quality status of the hospital, assessing quality problem of clinic service unit/department, improving health care service quality, improving capabilities in problem solving, improving operation processes & procedures, improving in methods of data collection, better team work, accelerating information computerization in the hospital, better communication and coordination among unit/department. 6.The sampled hospital standardized the ¡§Monitoring & Testing Procedures of Health Care Quality Index/Indicators¡¨. The details of operation procedures are posted on the intra-net for unit/department¡¦s inquiring and following. Annual data of index/indicators collected are to be introduced in the hopistal¡¦s MIS System for top managements¡¦ inquiry and references. Five (5) recommendations after analyses: 1.The sampled hospital is graded as medical center hospital holding the responsibilities in education. The education in quality control shall be promoted and continuously initiate improving programs in health care quality, due to in depth knowledge affects the attitude and behavior in health care quality performed. 2.Clinic personnel have heavy work loads. Computerized Index/Indicator related information should be easy to access on the information system. Thus, the programmer/engineer of the information center shall simplify the procedures/ processes as year planning even the resources are limited. 3.Unit/department requires specific person to handling index /indicator. Thus, the department management can lead daily jobs down to the ground, actively involving in quality improvement programs within the unit/department. 4.One of the opinions of ¡¥not important¡¦ category is that ¡¥no solid benefit for doctors following up index/indicators. The suggestion to top management is to elevate the morale by rewarding the participants with monetary efficiency bonus instead of just merits. 5.It is very complicated about how to increase knowledge and consensus in health care quality. Besides sufficient communication with clinic personnel, man-power integration, and continuous education and on job training, problem solving and quality improvement programs are necessary. Learning from the successful experience of other health care facilities, within the country or from foreign countries, is also an efficient method.