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Sample records for hospital planning

  1. Planned hospital birth versus planned home birth

    PubMed Central

    Olsen, Ole; Clausen, Jette A

    2014-01-01

    Background Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998. Objectives To assess the effects of planned hospital birth compared with planned home birth in selected low-risk women, assisted by an experienced midwife with collaborative medical back up in case transfer should be necessary. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 March 2012) and contacted editors and authors involved with possible trials. Selection criteria Randomised controlled trials comparing planned hospital birth with planned home birth in low-risk women as described in the objectives. Data collection and analysis The two review authors as independently as possible assessed trial quality and extracted data. We contacted study authors for additional information. Main results Two trials met the inclusion criteria but only one trial involving 11 women provided some outcome data and was included. The evidence from this trial was of moderate quality and too small to allow conclusions to be drawn. Authors’ conclusions There is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low-risk pregnant women. However, the trials show that women living in areas where they are not well informed about home birth may welcome ethically well-designed trials that would ensure an informed choice. As the quality of evidence in favour of home birth from observational studies seems to be steadily increasing, it might be as important to prepare a regularly updated systematic review including observational studies as described in the Cochrane Handbook for Systematic Reviews of Interventions as to attempt to set up new randomised controlled trials. PMID:22972043

  2. Leaving the hospital - your discharge plan

    MedlinePlus

    ... patientinstructions/000867.htm Leaving the hospital - your discharge plan To use the sharing features on this page, ... once you leave. This is called a discharge plan. Your health care providers at the hospital will ...

  3. Developing a strategic marketing plan for hospitals.

    PubMed

    Dychtwald, K; Zitter, M

    1988-09-01

    The initial stages of developing a strategic marketing plan for hospitals are explored in this excerpt from the book, The Role of the Hospital in an Aging Society: A Blueprint for Action. The elderly have unique perceptual, cognitive, social, and psychological needs and preferences, and a marketing strategy for eldercare services must reflect these factors, as well as the financial role of third-party payers and the decision-making influence of families and physicians. Among the elements the hospital must address when developing a marketing strategy are market selection and segmentation, targeting markets with specific services, pricing, and positioning the hospital for a maximum share of the eldercare market. PMID:10302744

  4. Management strategies in hospitals: scenario planning

    PubMed Central

    Ghanem, Mohamed; Schnoor, Jörg; Heyde, Christoph-Eckhard; Kuwatsch, Sandra; Bohn, Marco; Josten, Christoph

    2015-01-01

    Background: Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Methodology: Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a “Stakeholder Feedback”. Results: Two key uncertainties were identified and considered in this study: the development of workload for the medical staff the profit oriented performance of the medical staff. According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Conclusion: Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and “blind spots”. This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management. PMID:26504735

  5. Family Planning in the Hospital Setting

    PubMed Central

    Russell, Keith P.; Meier, Gitta

    1969-01-01

    Although the availability of oral contraceptives and the development of improved intrauterine contraceptive devices have greatly increased the general utilization of family planning services, there are still great segments of our population which are not yet reached, especially in the economically deprived areas. Since over 98 percent of all obstetrical deliveries now occur in hospitals, it seems logical that it is on hospital maternity services that these deficiencies might often be best overcome. Although this is primarily a medical problem, the use of paramedical personnel can greatly augment the physician's practice in these areas. Family planning services should be an integral part of comprehensive maternity care, not alone in the physician's office but also in the hospital setting. PMID:5784113

  6. COLOR PLANNING FOR HOSPITALS AND SCHOOLS.

    ERIC Educational Resources Information Center

    Mobil Finishes Co., Inc., Chicago, IL.

    THE AIM OF THIS MANUAL PREPARED FOR ARCHITECTS AND BUILDERS IS TO PROVIDE FOR COLOR PLANNING IN HOSPITALS AND SCHOOLS AND ALTHOUGH APPROPRIATE FOR THE SELECTION OF ALL INTERIOR SURFACE MATERIALS IN NEW CONSTRUCTION. IN SCHOOL, AND INDIVIDUAL'S EXPOSURE TO DECORATION IS REPEATED DAILY FOR BOTH STUDENTS AND STAFF ATTEND AT LEAST FOR THE SCHOOL…

  7. Culinary Arts Hospitality Symposium Planning Guide.

    ERIC Educational Resources Information Center

    Borgie, Karen; Wang, Yeimei

    This guide was developed as part of a project to standardize California's statewide culinary arts curriculum based on industry guidelines and standards. It details a process that California community colleges can use to plan a hospitality symposium that will accomplish the following objectives: provide students with a forum to demonstrate their…

  8. Hospital Bioterrorism Planning and Burn Surge

    PubMed Central

    Myers, Brent; Cairns, Charles B.; Rich, Preston B.; Hultman, C. Scott; Charles, Anthony G.; Jones, Samuel W.; Schmits, Grace L.; Skarote, Mary Beth; Holmes, James H.; Cairns, Bruce A.

    2014-01-01

    On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity. PMID:24527874

  9. Hospital bioterrorism planning and burn surge.

    PubMed

    Kearns, Randy D; Myers, Brent; Cairns, Charles B; Rich, Preston B; Hultman, C Scott; Charles, Anthony G; Jones, Samuel W; Schmits, Grace L; Skarote, Mary Beth; Holmes, James H; Cairns, Bruce A

    2014-01-01

    On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity. PMID:24527874

  10. Planned Out-of-Hospital Birth and Birth Outcomes

    PubMed Central

    Snowden, Jonathan M.; Tilden, Ellen L.; Snyder, Janice; Quigley, Brian; Caughey, Aaron B.; Cheng, Yvonne W.

    2016-01-01

    Background The frequency of planned out-of-hospital birth in the United States has increased in recent years. The value of studies assessing the perinatal risks of planned out-of-hospital birth versus hospital birth has been limited by cases in which transfer to a hospital is required and a birth that was initially planned as an out-of-hospital birth is misclassified as a hospital birth. Methods We performed a population-based, retrospective cohort study of all births that occurred in Oregon during 2012 and 2013 using data from newly revised Oregon birth certificates that allowed for the disaggregation of hospital births into the categories of planned in-hospital births and planned out-of-hospital births that took place in the hospital after a woman’s intrapartum transfer to the hospital. We assessed perinatal morbidity and mortality, maternal morbidity, and obstetrical procedures according to the planned birth setting (out of hospital vs. hospital). Results Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P = 0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth. Planned out-of-hospital birth was also strongly associated with unassisted vaginal delivery (93.8%, vs. 71.9% with planned in-hospital births; P<0.001) and with decreased odds for obstetrical procedures. Conclusions Perinatal mortality was higher with planned out-of-hospital birth than with planned in-hospital birth, but the absolute risk of death was low in both settings. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human

  11. Hospital planning for weapons of mass destruction incidents.

    PubMed

    Perry, R W; Lindell, M K

    2006-01-01

    As terrorists attacks increase in frequency, hospital disaster plans need to be scrutinized to ensure that they take into account issues unique to weapons of mass destruction. This paper reports a review of the literature addressing hospital experiences with such incidents and the planning lessons thus learned. Construction of hospital disaster plans is examined as an ongoing process guided by the disaster planning committee. Hospitals are conceived as one of the components of a larger community disaster planning efforts, with specific attention devoted to defining important linkages among response organizations. This includes the public health authorities, political authorities, prehospital care agencies, and emergency management agencies. A review is completed of six special elements of weapons of mass destruction incidents that should be addressed in hospital disaster plans: incident command, hospital security, patient surge, decontamination, mental health consequences, and communications. The paper closes with a discussion of the importance of training and exercises in maintaining and improving the disaster plan. PMID:16679675

  12. Hospital development plans: a new tool to break ground for strategic thinking in Tanzanian hospitals.

    PubMed

    Flessa, Steffen

    2005-12-01

    Tanzanian hospitals suffer from underfunding and poor management. In particular, planning and strategic thinking need improvement. Cultural values such as subordination, risk aversion, and high time preference, together with a long history of socialist government, result in lack of responsibility, accountability, and planning. This has been addressed by the health sector reform with its focus on decentralization, strengthened by the introduction of basket funding facilitated by the Comprehensive Council Health Plans. As a consequence of this the next logical step is to improve the authority of regional and district hospitals in the use of their resources by introducing hospital development plans. These strategic plans were introduced as tools of strategic planning in 2001 by the Kreditanstalt für Wiederaufbau in close collaboration with the Tanzanian Ministry of Health, binding the release of rehabilitation funds to presentation of a strategic hospital plan. This study examines the rationale and content of hospital development plans. Initial experiences are discussed. The quality of presented plans has steadily improved, but there is a tendency for hospitals with a close connection to development partners to present well prepared reports while other hospitals have severe problems fulfilling the requirements. For many hospitals it is in fact the first time that they have had to define their functions and future role, thus breaking ground for strategic thinking. PMID:16267658

  13. Hospital planning for weapons of mass destruction incidents.

    PubMed

    Perry, Ronald W; Lindell, Michael K

    2007-01-01

    As terrorist attacks increase in fre-quency, hospital disaster plans need to be scrutinized to ensure that they take into account issues unique to weapons of mass destruction. This paper reports a review of the literature addressing hospital experiences with such incidents and the planning lessons thus learned. Construction of hos-pital disaster plans is examined as an ongoing process guided by the disaster planning committee. A review is completed of six special elements of weapons of mass destruction incidents that should be addressed in hospital disaster plans. The paper closes with a dis-cussion of the importance of train-ing and exercises in maintaining and improving the disaster plan. PMID:17970447

  14. HOSPITAL GENERATED WASTE: A PLAN FOR ITS PROPER MANAGEMENT

    PubMed Central

    Aljabre, Salih H.M.

    2002-01-01

    Hospitals are important sites for the generation of hazardous waste. Each hospital has its own profile for the generation and transportion of waste according to its location. It is extremely important to manage hospital generated waste properly in order to avoid health and environmental risks. This article reports the plan designed and used by the hospital waste management committee in King Fahad Hospital of the University , Alhkobar, Saudi Arabia, for the safe management of hospital generated waste starting from the collection areas to the final disposal procedure. The plan was in four stages: background information, identification of problems, intervention and monitoring. The possible solutions for problems encountered are suggested. This plan which was efficient and cost effective can be used in other medical establishments. PMID:23008674

  15. Business continuity planning: the hospital's insurance policy.

    PubMed

    Luecke, R W; Hoopingarner, C

    1993-04-01

    A comprehensive business continuity plan can prepare an organization for unforeseen circumstances that would otherwise totally disrupt the delivery of healthcare services. Properly planning for such an event can build confidence in the organization and safeguard the assets of the institution. In this article, the authors present a step-by-step plan for creating a business continuity plan. PMID:10145789

  16. Incorporating efficiency in hospital-capacity planning in Germany.

    PubMed

    Kuntz, Ludwig; Scholtes, Stefan; Vera, Antonio

    2007-09-01

    Hospital occupancy is a key metric in hospital-capacity planning in Germany, even though this metric neglects important drivers of economic efficiency, for example treatment costs and case mix. We suggest an alternative metric, which incorporates economic efficiency explicitly, and illustrate how this metric can be used in the hospital-capacity planning cycle. The practical setting of this study is the hospital capacity planning process in the German federal state of Rheinland-Pfalz. The planning process involves all 92 acute-care hospitals of this federal state. The study is based on standard hospital data, including annual costs, number of cases--disaggregated by medical departments and ICD codes, respectively--length-of-stay, certified beds, and occupancy rates. Using the developed metric, we identified 18 of the 92 hospitals as inefficient and targets for over-proportional capacity cuts. On the upside, we identified 15 efficient hospitals. The developed model and analysis has affected the federal state's most recent medium term planning cycle. PMID:17216425

  17. Does health plan generosity enhance hospital market power?

    PubMed

    Baker, Laurence C; Bundorf, M Kate; Kessler, Daniel P

    2015-12-01

    We test whether the generosity of employer-sponsored health insurance facilitates the exercise of market power by hospitals. We construct indices of health plan generosity and the price and volume of hospital services using data from Truven MarketScan for 601 counties from 2001 to 2007. We use variation in the industry and union status of covered workers within a county over time to identify the causal effects of generosity. Although OLS estimates fail to reject the hypothesis that generosity facilitates the exercise of hospital market power, IV estimates show a statistically significant and economically important positive effect of plan generosity on hospital prices in uncompetitive markets, but not in competitive markets. Our results suggest that most of the aggregate effect of hospital market structure on prices found in previous work may be coming from areas with generous plans. PMID:26402570

  18. Pre-hospital discharge planning: empowering elderly patients through choice.

    PubMed

    Merriman, Mary L

    2008-01-01

    Reductions in the length of stay for acute hospitalization have occurred as a result of Medicare cost containment strategies during the past 20 years. Thus, innovative approaches to the treatment of patients in the acute care hospital setting are necessary, particularly in the practice of discharge planning. The medical literature typically identifies the first day of admission as the time to begin discharge planning in order to minimize the patient's length of stay in the acute care hospital. This strategy has its limitations as elderly patients are often confused by unfamiliar surroundings, surgical anesthesia, postoperative pain, and the rapid pace of hospital recovery typically expected today. Consequently, options for discharge may be limited to the most expedient plan that will ensure safety and continued recovery. This article presents an alternative plan that begins with outpatient education preceding admission and follows the patient throughout the continuum of care including postdischarge. PMID:18316937

  19. Succession planning: perspectives of chief executive officers in US hospitals.

    PubMed

    Collins, Sandra K

    2009-01-01

    A study was conducted to explore the perceptions of chief executive officers in US hospitals regarding the origins of leadership and how they felt about internally developed successors versus externally recruited successors. Furthermore, the study examined how this group of executives utilizes the succession planning process, what factors impact successor identification, what positions are applicable for succession planning activities, and who is ultimately held responsible for leadership continuity within the hospital industry. PMID:19668068

  20. Hospital planning in France and the Federal Republic of Germany.

    PubMed

    Altenstetter, C

    1980-01-01

    This article on hospital planning programs in France and North-Rhine Westfalia (a state in the Federal Republic of Germany), assembles information on the formal building blocks of inter-organizational relations in the formulation and implementation process. Because these planning programs are embedded in past social policy developments and institution-building, it is necessary to first compare the two countries' compulsory health insurance schemes. This is followed by a general profile of each health care system. A third section examines the formulation and implementation of the countries' hospital planning programs and participation patterns. Based on this comparison, inferences are drawn that are relevant to policy and research. The analysis yields three major conclusions. First, despite abundant legal and administrative controls at the disposal of central health bureaucracies, the capability of the national leadership to influence the hospital system through innovative planning is limited by jurisdictional, institutional, functional and territorial fragmentation, and differentiation of control and public responsibility in health. However, the diverse goal orientations of participants may provide the necessary tension to allow for some change in otherwise highly structured political and administrative systems. Second, despite differences in historical, political and administrative developments, the decision making systems for health care policies in France and the Federal Republic, with the exception of health insurance, are strikingly similar to the fragmented decision making system in the United States. Third, the effect of government-mandated participation is empirically uncertain. Opening up the circle of participants seems to have reinforced alliances between public bureaucracies and corporate vested interests. Hospital planning continues to be carried out for rather than with the consumer and citizen. Hospital planning which is a mixture of goal and process

  1. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital...: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for inpatient mental hospital services. (a) The State plan must provide that each mental hospital...

  2. 42 CFR 456.101 - UR plan required for inpatient hospital services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient hospital services...: Hospitals Utilization Review (ur) Plan: General Requirement § 456.101 UR plan required for inpatient hospital services. (a) A State plan must provide that each hospital furnishing inpatient services under...

  3. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false UR plan required for inpatient mental hospital...: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for inpatient mental hospital services. (a) The State plan must provide that each mental hospital...

  4. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false UR plan required for inpatient mental hospital...: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for inpatient mental hospital services. (a) The State plan must provide that each mental hospital...

  5. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false UR plan required for inpatient mental hospital...: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for inpatient mental hospital services. (a) The State plan must provide that each mental hospital...

  6. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false UR plan required for inpatient mental hospital...: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for inpatient mental hospital services. (a) The State plan must provide that each mental hospital...

  7. 1. 1943 Plan View of 'Fort Lewis Station Hospital, Section ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. 1943 Plan View of 'Fort Lewis Station Hospital, Section No. 5.' Drawn by V. Steinbrueck for J.C. Boespflug Construction Co. July 23, 1943. HABS 8x10' negative was made from an 8.5 x 11' copy on card stock in the collection of the Community Library, Madigan Army Medical Center, Fort Lewis, WA. - Madigan Hospital, Bounded by Wilson & McKinley Avenues & Garfield & Lincoln Streets, DuPont, Pierce County, WA

  8. Pharmacy Leader’s Role in Hospital Emergency Preparedness Planning

    PubMed Central

    Bell, Christopher; Daniel, Sarah

    2014-01-01

    The Director’s Forum column is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. Environmental disasters and terrorist attacks demonstrate that it is imperative for both a hospital and community to have an emergency preparedness plan. The goal of this article is to provide health-system pharmacy leaders with a practical approach in developing an emergency operations plan (EOP) that can be activated in the event of a disaster. Pharmacy leaders should (1) review government and community disaster responses and understand the movement of drug supply for each response, (2) create a pharmacy disaster plan, (3) list the essential medications and determine their inventory levels, and (4) establish a staff training program to enhance understanding and implementation of the EOP. If successfully developed and executed, a hospital pharmacy department’s EOP has a high rating of success in meeting patient-centered needs in the unforeseen event of a disaster PMID:24958947

  9. Resource Requirements Planning for Hospitals Treating Serious Infectious Disease Cases.

    SciTech Connect

    Vugrin, Eric D.; Verzi, Stephen Joseph; Finley, Patrick D.; Turnquist, Mark A.; Wyte-Lake, Tamar; Griffin, Ann R.; Ricci, Karen J.; Plotinsky, Rachel

    2015-02-01

    This report presents a mathematical model of the way in which a hospital uses a variety of resources, utilities and consumables to provide care to a set of in-patients, and how that hospital might adapt to provide treatment to a few patients with a serious infectious disease, like the Ebola virus. The intended purpose of the model is to support requirements planning studies, so that hospitals may be better prepared for situations that are likely to strain their available resources. The current model is a prototype designed to present the basic structural elements of a requirements planning analysis. Some simple illustrati ve experiments establish the mo del's general capabilities. With additional inve stment in model enhancement a nd calibration, this prototype could be developed into a useful planning tool for ho spital administrators and health care policy makers.

  10. Hospital capacity planning: from measuring stocks to modelling flows.

    PubMed

    Rechel, Bernd; Wright, Stephen; Barlow, James; McKee, Martin

    2010-08-01

    The metric of "bed numbers" is commonly used in hospital planning, but it fails to capture key aspects of how hospital services are delivered. Drawing on a study of innovative hospital projects in Europe, we argue that hospital capacity planning should not be based on beds, but rather on the ability to deliver processes. We propose using approaches that are based on manufacturing theory such as "lean thinking" that focuses on the value that different processes add for the primary customer, i.e. the patient. We argue that it is beneficial to look at the hospital, not from the perspective of beds or specialties, but rather from the path taken by the patients who are treated in them, the respective processes delivered by health professionals and the facilities appropriate to those processes. Systematized care pathways seem to offer one avenue for achieving these goals. However, they need to be underpinned by a better understanding of the flows of patients, work and goods within a hospital, the bottlenecks that occur, and translation of this understanding into new capacity planning tools. PMID:20680129

  11. Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays.

    PubMed

    Baker, Laurence C; Bundorf, M Kate; Devlin, Aileen M; Kessler, Daniel P

    2016-08-01

    There is ongoing debate about how prices paid to providers by Medicare Advantage plans compare to prices paid by fee-for-service Medicare. We used data from Medicare and the Health Care Cost Institute to identify the prices paid for hospital services by fee-for-service (FFS) Medicare, Medicare Advantage plans, and commercial insurers in 2009 and 2012. We calculated the average price per admission, and its trend over time, in each of the three types of insurance for fixed baskets of hospital admissions across metropolitan areas. After accounting for differences in hospital networks, geographic areas, and case-mix between Medicare Advantage and FFS Medicare, we found that Medicare Advantage plans paid 5.6 percent less for hospital services than FFS Medicare did. Without taking into account the narrower networks of Medicare Advantage, the program paid 8.0 percent less than FFS Medicare. We also found that the rates paid by commercial plans were much higher than those of either Medicare Advantage or FFS Medicare, and growing. At least some of this difference comes from the much higher prices that commercial plans pay for profitable service lines. PMID:27503970

  12. Evaluation of hospital inpatient complications: a planning approach

    PubMed Central

    2010-01-01

    Background Hospital inpatient complications are one of a number of adverse health care outcomes. Reducing complications has been identified as an approach to improving care and saving resources as part of the health care reform efforts in the United States. An objective of this study was to describe the Potentially Preventable Complications software developed as a tool for evaluating hospital inpatient outcomes. Additional objectives included demonstration of the use of this software to evaluate the connection between health care outcomes and expenses in United States administrative data at the state and local levels and the use of the software to plan and implement interventions to reduce hospital complications in one U.S. metropolitan area. Methods The study described the Potentially Preventable Complications software as a tool for evaluating these inpatient hospital outcomes. Through administrative hospital charge data from California and Maryland and through cost data from three hospitals in Syracuse, New York, expenses for patients with and without complications were compared. These comparisons were based on patients in the same All Patients Refined Diagnosis Related Groups and severity of illness categories. This analysis included tests of statistical significance. In addition, the study included a planning process for use of the Potentially Preventable Complications software in three Syracuse hospitals to plan and implement reductions in hospital inpatient complications. The use of the PPC software in cost comparisons and reduction of complications included tests of statistical significance. Results The study demonstrated that Potentially Preventable Complications were associated with significantly increased cost in administrative data from the United States in California and Maryland and in actual cost data from the hospitals of Syracuse, New York. The implementation of interventions in the Syracuse hospitals was associated with the reduction of

  13. Development of a statewide hospital plan for radiologic emergencies

    SciTech Connect

    Dainiak, Nicholas . E-mail: pndain@bpthosp.org; Delli Carpini, Domenico; Bohan, Michael; Werdmann, Michael; Wilds, Edward; Barlow, Agnus; Beck, Charles; Cheng, David; Daly, Nancy; Glazer, Peter; Mas, Peter; Nath, Ravinder; Piontek, Gregory; Price, Kenneth; Albanese, Joseph; Roberts, Kenneth; Salner, Andrew L.; Rockwell, Sara

    2006-05-01

    Although general guidelines have been developed for triage of victims in the field and for hospitals to plan for a radiologic event, specific information for clinicians and administrators is not available for guidance in efficient management of radiation victims during their early encounter in the hospital. A consensus document was developed by staff members of four Connecticut hospitals, two institutions of higher learning, and the State of Connecticut Department of Environmental Protection and Office of Emergency Preparedness, with assistance of the American Society for Therapeutic Radiology and Oncology. The objective was to write a practical manual for clinicians (including radiation oncologists, emergency room physicians, and nursing staff), hospital administrators, radiation safety officers, and other individuals knowledgeable in radiation monitoring that would be useful for evaluation and management of radiation injury. The rationale for and process by which the radiation response plan was developed and implemented in the State of Connecticut are reviewed. Hospital admission pathways are described, based on classification of victims as exposed, contaminated, and/or physically injured. This manual will be of value to those involved in planning the health care response to a radiologic event.

  14. Transfer to hospital in planned home births: a systematic review

    PubMed Central

    2014-01-01

    Background There is concern about the safety of homebirths, especially in women transferred to hospital during or after labour. The scope of transfer in planned home births has not been assessed in a systematic review. This review aimed to describe the proportions and indications for transfer from home to hospital during or after labour in planned home births. Methods The databases Pubmed, Embase, Cinahl, Svemed+, and the Cochrane Library were searched using the MeSH term “home childbirth”. Inclusion criteria were as follows: the study population was women who chose planned home birth at the onset of labour; the studies were from Western countries; the birth attendant was an authorised midwife or medical doctor; the studies were published in 1985 or later, with data not older than from 1980; and data on transfer from home to hospital were described. Of the 3366 titles identified, 83 full text articles were screened, and 15 met the inclusion criteria. Two of the authors independently extracted the data. Because of the heterogeneity and lack of robustness across the studies, there were considerable risks for bias if performing meta-analyses. A descriptive presentation of the findings was chosen. Results Fifteen studies were eligible for inclusion, containing data from 215,257 women. The total proportion of transfer from home to hospital varied from 9.9% to 31.9% across the studies. The most common indication for transfer was labour dystocia, occurring in 5.1% to 9.8% of all women planning for home births. Transfer for indication for foetal distress varied from 1.0% to 3.6%, postpartum haemorrhage from 0% to 0.2% and respiratory problems in the infant from 0.3% to 1.4%. The proportion of emergency transfers varied from 0% to 5.4%. Conclusion Future studies should report indications for transfer from home to hospital and provide clear definitions of emergency transfers. PMID:24886482

  15. Discharge Planning in Acute Care Hospitals in Israel: Services Planned and Levels of Implementation and Adequacy

    ERIC Educational Resources Information Center

    Auslander, Gail K.; Soskolne, Varda; Stanger, Varda; Ben-Shahar, Ilana; Kaplan, Giora

    2008-01-01

    This study aimed to examine the implementation, adequacy, and outcomes of discharge planning. The authors carried out a prospective study of 1,426 adult patients discharged from 11 acute care hospitals in Israel. Social workers provided detailed discharge plans on each patient. Telephone interviews were conducted two weeks post-discharge. Findings…

  16. Hospital-based expert model for health technology procurement planning in hospitals.

    PubMed

    Miniati, R; Cecconi, G; Frosini, F; Dori, F; Regolini, J; Iadanza, E; Biffi Gentili, G

    2014-01-01

    Although in the last years technology innovation in healthcare brought big improvements in care level and patient quality of life, hospital complexity and management cost became higher. For this reason, necessity of planning for medical equipment procurement within hospitals is getting more and more important in order to sustainable provide appropriate technology for both routine activity and innovative procedures. In order to support hospital decision makers for technology procurement planning, an expert model was designed as reported in the following paper. It combines the most widely used approaches for technology evaluation by taking into consideration Health Technology Assessment (HTA) and Medical Equipment Replacement Model (MERM). The designing phases include a first definition of prioritization algorithms, then the weighting process through experts' interviews and a final step for the model validation that included both statistical testing and comparison with real decisions. In conclusion, the designed model was able to provide a semi-automated tool that through the use of multidisciplinary information is able to prioritize different requests of technology acquisition in hospitals. Validation outcomes improved the model accuracy and created different "user profiles" according to the specific needs of decision makers. PMID:25570746

  17. A hospital system's wellness program linked to health plan enrollment cut hospitalizations but not overall costs.

    PubMed

    Gowrisankaran, Gautam; Norberg, Karen; Kymes, Steven; Chernew, Michael E; Stwalley, Dustin; Kemper, Leah; Peck, William

    2013-03-01

    Many policy makers believe that health status would be improved and health care spending reduced if people managed their health better. This study examined the effectiveness of a program put in place by BJC HealthCare, a hospital system based in St. Louis, Missouri, that tied employees' eligibility to participate in the system's most generous health plan with participation in a wellness program. The intervention, which began in 2005, was associated with a 41 percent decrease, relative to a comparison group, in hospitalizations for conditions targeted by the wellness program but with no significant decrease in other hospitalizations. We found reductions in inpatient costs but similar increases in non-inpatient costs. Therefore, we conclude that although the program did cut some hospitalizations, it did not save money for the employer in the short term. This finding underscores that wellness program incentives under the Affordable Care Act are unlikely to greatly reduce health care spending over the short run. PMID:23459726

  18. Central Portion of Third Floor Plan U.S. Veterans Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Central Portion of Third Floor Plan - U.S. Veterans Hospital, Jefferson Barracks, Main Hospital, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  19. Central Portion of Second Floor Plan U.S. Veterans Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Central Portion of Second Floor Plan - U.S. Veterans Hospital, Jefferson Barracks, Main Hospital, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  20. Social Work Discharge Planning in Acute Care Hospitals in Israel: Clients' Evaluation of the Discharge Planning Process and Adequacy

    ERIC Educational Resources Information Center

    Soskolne, Varda; Kaplan, Giora; Ben-Shahar, Ilana; Stanger, Varda; Auslander, Gail. K.

    2010-01-01

    Objective: To examine the associations of patients' characteristics, hospitalization factors, and the patients' or family assessment of the discharge planning process, with their evaluation of adequacy of the discharge plan. Method: A prospective study. Social workers from 11 acute care hospitals in Israel provided data on 1426 discharged…

  1. Hospital to Home: Plan for a Smooth Transition

    MedlinePlus

    ... be in the hospital? HOSPITAL TEAM – Maintain regular communication with your “hospital team” – this group can include doctors, nurses, social workers, your caregiver( s) and other health professionals at ...

  2. Nursing workforce planning: insights from seven Malaysian hospitals.

    PubMed

    Drake, Robert

    In 2010, the Royal College of Nursing asked: 'What is the optimal level and mix of nurses required to deliver quality care as cost-effectively as possible?' This question implies there is a relationship between staffing levels, quality of care and financial efficiency. This paper examines the relationship between the staff budget, the number of staff required to achieve a target level of care and the actual number of staff employed in seven hospitals in Malaysia. It seeks to critically evaluate local challenges arising from staff budgeting/planning procedures, identify general issues that apply beyond Malaysian healthcare institutions and, finally, to propose a model that combines finance, staffing and level of care. PMID:23587892

  3. Long-range hospital capital requirements planning: the state of the art, a proposal for change.

    PubMed

    Hogan, A J

    1984-01-01

    A Hospital Capital Requirements Planning System is proposed to channel competition through the use of a regional planning model. This model would help to reduce the social deadweight loss arising from competition-induced uncertainty. The system would increase the internal long-range planning capacity of hospitals and improve the quality of the applications presented for Certificate of Need review. Both health systems planners and investment bankers should have better information with which to evaluate hospital capital investment proposals. PMID:10269910

  4. Landscape Plan U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Landscape Plan - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  5. First Floor Plan U.S. Veterans Hospital, Jefferson Barracks, Therapeutic ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  6. HCA Richmond Hospitals' new marketing strategy a winning plan.

    PubMed

    Rees, Tom

    2003-01-01

    HCA Richmond Hospitals, a five-hospital system in Richmond, Va., is positioning itself as a winner in a highly competitive, healthcare-saturated market since overhauling is marketing strategy a little over a year ago. The marketing strategy enables individual hospital to target their own unique constituencies. "Understanding the intricate marketing dynamics of hospital systems is today of critical importance and equal complexity," said Tony Bejamin, principal of Oxygen Advertising Inc., New York, the agency that remodeled HCA Richmond Hospitals' marketing strategy. PMID:12545900

  7. Strategic Planning, Implementation, and Evaluation Processes in Hospital Systems: A Survey From Iran

    PubMed Central

    Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

    2015-01-01

    Aim & Background: Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. Methods: The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. Results: All the investigated hospitals had a strategic plan. The obtained percentages for the items “the rate of the compliance to requirements” and “the quantity of planning facilitators” (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). Conclusion: According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved. PMID:25716385

  8. Hospitals Negotiating Leverage with Health Plans: How and Why Has It Changed?

    PubMed Central

    Devers, Kelly J; Casalino, Lawrence P; Rudell, Liza S; Stoddard, Jeffrey J; Brewster, Linda R; Lake, Timothy K

    2003-01-01

    Objective To describe how hospitals' negotiating leverage with managed care plans changed from 1996 to 2001 and to identify factors that explain any changes. Data Sources Primary semistructured interviews, and secondary qualitative (e.g., newspaper articles) and quantitative (i.e., InterStudy, American Hospital Association) data. Study Design The Community Tracking Study site visits to a nationally representative sample of 12 communities with more than 200,000 people. These 12 markets have been studied since 1996 using a variety of primary and secondary data sources. Data Collection Methods Semistructured interviews were conducted with a purposive sample of individuals from hospitals, health plans, and knowledgeable market observers. Secondary quantitative data on the 12 markets was also obtained. Principal Findings Our findings suggest that many hospitals' negotiating leverage significantly increased after years of decline. Today, many hospitals are viewed as having the greatest leverage in local markets. Changes in three areas—the policy and purchasing context, managed care plan market, and hospital market—appear to explain why hospitals' leverage increased, particularly over the last two years (2000–2001). Conclusions Hospitals' increased negotiating leverage contributed to higher payment rates, which in turn are likely to increase managed care plan premiums. This trend raises challenging issues for policymakers, purchasers, plans, and consumers. PMID:12650374

  9. Strategic information management plans: the basis for systematic information management in hospitals.

    PubMed

    Winter, A F; Ammenwerth, E; Bott, O J; Brigl, B; Buchauer, A; Gräber, S; Grant, A; Häber, A; Hasselbring, W; Haux, R; Heinrich, A; Janssen, H; Kock, I; Penger, O S; Prokosch, H U; Terstappen, A; Winter, A

    2001-12-01

    Information management in hospitals is a complex task. In order to reduce complexity, we distinguish strategic, tactical, and operational information management. This is essential, because each of these information management levels views hospital information systems from different perspectives, and therefore uses other methods and tools. Since all these management activities deal only in part with computers, but mainly with human beings and their social behavior, we define a hospital information system as a sociotechnical subsystem of a hospital. Without proper strategic planning it would be a matter of chance, if a hospital information system would fulfil the information strategies goals. In order to support strategic planning and to reduce efforts for creating strategic plans, we propose a practicable structure. PMID:11734379

  10. Hospital Discharge Planning: A Guide for Families and Caregivers

    MedlinePlus

    ... soft foods only? Certain foods not allowed?) Personal Hygiene Grooming Toileting Transfer (moving from bed to chair) ... for Healthcare Research and Quality, Patient Safety Network "Studies Suggest Ways to Improve the Hospital Discharge Process ...

  11. Ground Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Ground Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  12. First Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  13. First Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  14. Second Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Second Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  15. Ground Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Ground Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  16. Second Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Second Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  17. Floor Plans and Stair Section U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Floor Plans and Stair Section - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  18. Hospital-based discharge planning: the beginning of home care for many.

    PubMed

    Luken, P C

    1991-01-01

    Discharge planning can be viewed as the first step in home care for many individuals. This article examines the process through the discussion of the stages of discharge planning, and a study of discharge planning in an acute-care hospital. Several recommendations are made that would strengthen the role of home care providers in the process, who are encouraged to work for a more active role in discharge planning. PMID:10109300

  19. Developing a master plan for hospital solid waste management: a case study.

    PubMed

    Karamouz, Mohammad; Zahraie, Banafsheh; Kerachian, Reza; Jaafarzadeh, Nemat; Mahjouri, Najmeh

    2007-01-01

    Disposal of about 1750tons of solid wastes per day is the result of a rapid population growth in the province of Khuzestan in the south west of Iran. Most of these wastes, especially hospital solid wastes which have contributed to the pollution of the environment in the study area, are not properly managed considering environmental standards and regulations. In this paper, the framework of a master plan for managing hospital solid wastes is proposed considering different criteria which are usually used for evaluating the pollution of hospital solid waste loads. The effectiveness of the management schemes is also evaluated. In order to rank the hospitals and determine the share of each hospital in the total hospital solid waste pollution load, a multiple criteria decision making technique, namely analytical hierarchy process (AHP), is used. A set of projects are proposed for solid waste pollution control and reduction in the proposed framework. It is partially applied for hospital solid waste management in the province of Khuzestan, Iran. The results have shown that the hospitals located near the capital city of the province, Ahvaz, produce more than 43% of the total hospital solid waste pollution load of the province. The results have also shown the importance of improving management techniques rather than building new facilities. The proposed methodology is used to formulate a master plan for hospital solid waste management. PMID:16806885

  20. Brave new world: integrating electronics into a hospital security plan.

    PubMed

    Van Vlack, Bill; York, Tony

    2007-01-01

    Although approximately 90% of cameras that are currently installed in hospitals are analog-based, the trend is to switch to IP network-based digital cameras. How IT, security, and other departments can work together to successfully implement the new systems is explained in this article. PMID:17970444

  1. Organization of a hospital-based victim decontamination plan using the incident command structure.

    PubMed

    Powers, Robert

    2007-01-01

    Hospitals are required to have the capability of performing patient decontamination. Incorporating the incident command structure provided by the National Incident Management System and the Hospital Incident Command System into their decontamination plans will enable hospitals to be better organized and efficient in managing events producing contaminated patients. HAZMAT Branch incident command includes the leadership positions of a HAZMAT Branch director and a Victim Decontamination Unit leader, as well as managers for each zone, logistics, triage, medical monitoring, and support roles. Coupling a well-developed decontamination command structure with staff practice in their roles will help to ensure an organized response. This article describes the specific roles and responsibilities included in an incident command system-based hospital decontamination plan than has been used successfully in a multi-hospital system. PMID:17996656

  2. Clinical and human resource planning for the downsizing of psychiatric hospitals: the British Columbia experience.

    PubMed

    Macfarlane, D; Fortin, P; Fox, J; Gundry, S; Oshry, J; Warren, E

    1997-01-01

    Riverview Hospital, B.C.'s only and Canada's largest remaining provincial psychiatric hospital began a formal planned "downsizing" process in 1992. This initiative was an important element in the Province's strategic plan to shift to a more community-focused mental health system and to bring tertiary psychiatric services "closer to home" by redeveloping Riverview Hospital on three sites. The paper summarizes the literature pertaining to the "downsizing" of psychiatric hospital services in relation both to clinical and human resource planning. It describes the mental health system in B.C. and the service system context in which this exercise is occurring. It is based on the first three years of experience in identifying the major challenges and the strategies developed to meet these challenges. It draws some conclusions about the effectiveness of these strategies and it speculates about the likely future challenges as the "downsizing" process continues. PMID:9021839

  3. Succession planning in hospitals and the association with organizational performance.

    PubMed

    Kim, Tae Hyun

    2012-01-01

    Effective succession planning is the heart of leadership development and an essential business strategy because it enhances the ability to achieve orderly transitions and maintain productivity levels. The results of this study are consistent with previous studies that exhibit a positive association of previous years' performance with internal succession planning. The key to successful succession planning lies in building a solid foundation of profitability. Having successors ready to fill key vacancies helps improve operational condition and the bottom line, and thus, gives a competitive edge in the market. Preparing successors for leadership may determine which organizations simply survive and which thrive and lead their markets down the road. PMID:22479959

  4. Teaching hospital planning: a case study and the need for reform.

    PubMed

    Davis, Christopher K; Smith, Harry

    2010-08-16

    Academic teaching hospitals and their networks can best serve patients and other stakeholders by achieving critical mass and scope of clinical services, teaching and research. Successful hospital reconfigurations are associated with a convincing case and majority clinician buy-in. The inscrutable political decision to relocate services away from a major teaching hospital campus and into a merged Queensland Children's Hospital was determined without broad stakeholder consultation or a transparent and accountable business case. This compromised process poses a significant and enduring risk to patient care and Queensland's paediatric, perinatal, adolescent and obstetric academic teaching hospital services. As the proposed major stakeholder in Australia's public hospitals and medical workforce training, the federal government should review this decision using an effective methodology incorporating relevant criteria. National guidelines are needed to ensure best practice in the future planning and auditing of major health care projects. The medical profession is responsible for ensuring that health care policy complies with reliable evidence and good practice. PMID:20712545

  5. OCLC for the hospital library: the justification plan for hospital administration.

    PubMed

    Allen, C W; Branson, J R

    1982-07-01

    This paper delineates the necessary steps to provide hospital administrators with the information needed to evaluate an automated system, OCLC, for addition to the medical library. Based on experience at the Norton-Children's Hospitals, included are: (1) cost analyses of present technical processing systems and cost comparisons with OCLC; (2) delineation of start-up costs for installing OCLC; (3) budgetary requirements for 1981; (4) the impact of automation on library systems, personnel, and services; (5) potential as a shared service; and (6) preparation of the proposal for administrative review. PMID:7116018

  6. Impact of hospital discharge planning on meeting patient needs after returning home.

    PubMed

    Mamon, J; Steinwachs, D M; Fahey, M; Bone, L R; Oktay, J; Klein, L

    1992-06-01

    This study examines the contribution of hospital discharge planning in meeting the needs of patients for care after their return home. A random sample of 919 admissions (age 60 and over) to five hospitals was studied to obtain information on characteristics of discharge planning during the patients' hospital stay. Specifically, information was obtained on the involvement of a designated professional for managing and coordinating the discharge plan, and the extent to which the planning was interdisciplinary. Patient interviews conducted two weeks after discharge provided information on needs for care related to: (1) treatment, (2) activity limitations, and (3) other self-sufficiency limitations. Patients were asked about their need for care in these three areas and about whether or not these needs were being met. Overall, 97 percent reported one or more needs for care and 33 percent reported that at least one of these needs was not being met. Findings show that the involvement of a discharge planning case manager is related to a significant reduction in unmet treatment needs, but not to reductions in activity limitation, other self-sufficiency needs, or overall needs. No significant effects of interdisciplinary planning were identified. These findings suggest that treatment-related benefits result when a case manager has specific responsibility for the discharge planning of elderly patients returning home after hospitalization. These results provide insights into what is being achieved through current discharge planning practices. The meeting of specific patient needs through enhanced discharge planning may save future costs by reducing the rates of complications and hospital readmissions in an era of prospective payment, thus potentially offsetting the increased costs involved in planning and coordinating postdischarge care for older adults. PMID:1317367

  7. Financing and planning of public and private not-for-profit hospitals in the European Union.

    PubMed

    Thompson, Ceri R; McKee, Martin

    2004-03-01

    While much has been written about health care financing in Europe in recent years, discussion has almost entirely focused on revenue. In contrast, there has been remarkably little written on financing of capital investment in European health care systems. Yet major changes are underway in several countries, in particular involving new forms of public-private partnerships (PPP). At the same time, there is growing recognition of the way in which the inherited structure of the health care delivery system constrains the system's ability to adapt to changing circumstances. This paper reports the results of a survey undertaken among key informants in the member states of the European Union to begin to ascertain existing practices and future plans in relation to hospital planning and financing amongst public and private not-for-profit hospitals. The locus of hospital planning decisions reflect the constitutional framework of the country involved, and thus the emphasis on national or local plans. There has been an expansion of private sector involvement, with four basic models identified: private loans direct to the hospital; private loans to a regional health body; a PPP where the private sector's role is to build, design and operate the non-clinical functions of the hospital; and, finally, a PPP, where the private sector's involvement also includes management of the clinical functions of the hospital. It is too early to say whether these approaches will be more successful than the models they are replacing. PMID:15036816

  8. Auditing the health care enterprise. Evaluation research can improve strategic planning and implementation in hospitals.

    PubMed

    Woodside, A G; Montelepre, P

    1994-01-01

    Financial audits that focus on the recent past have been criticized for not answering questions concerning whether or not the enterprise will survive and thrive during the next few years. Strategic management/marketing audits (SMMAs) are designed to respond to these concerns. In conducting an SMMA for a long-term care hospital, the authors found critical differences in the beliefs held by key executives and staff members regarding the strategic goals, planning, and actions of the hospital. PMID:10154634

  9. Planning an open and IHE-compliant architecture for a filmless and paperless hospital

    NASA Astrophysics Data System (ADS)

    Ratib, Osman M.; McCoy, J. Michael; Kho, Hwa T.; Yu, Reba

    2001-08-01

    UCLA is in the process of building a new acute-care hospital due to open in 2005 with the intent to operate fully digitally. The strategic planning for this hospital is based on a set of new paradigms: wider and more efficient access to all information sources, enterprise-wide data repository, usage of thin-client technology and wide usage generic information-appliances and wireless devices allowing access to information from anywhere in the hospital. These new paradigms required significant changes from traditional information technology architecture in particular in workflow management of large quantities of imaging data.

  10. Don't shoot the messenter: master facilities planning for the hospital.

    PubMed

    Remen, S

    1995-01-01

    The acute care medical/surgical (somatic) hospital is among the most politicized, scrutinized, technically complex and increasingly expensive of building types within the infrastructure of civilized live. Unless well prepared, hospitals will generally continue to evolve haphazardly and expensively to become accretions of macro and micro renovations and additions. companion and servant to a hospital's overall Strategic Plan, a Master Facilities Plan should be an eminently accessible ongoing document for charging a hospital's facilities policy. It should be designed to assure continuity so that facilities responses to short term and term goals will remain compatible, complimentary and inherently flexible over time. The techniques employed in master planning for hospitals will vary with the planners, the clients and the agendas of governmental regulators. Although some unfavourable information concerning the condition of existing facilities is surely to be anticipated, especially for older buildings, how clearly that information is presented and then creatively resolved is often at the core of fine Master Facilities Planning. PMID:10156424

  11. Development of a nurse case management service: a proposed business plan for rural hospitals.

    PubMed

    Adams, Marsha Howell; Crow, Carolyn S

    2005-01-01

    The nurse case management service (NCMS) for rural hospitals is an entrepreneurial endeavor designed to provide rural patients with quality, cost-effective healthcare. This article describes the development of an NCMS. A detailed marketing and financial plan, a review of industry trends, and the legal structure and risks associated with the development of the venture are presented. The financial plan projects a minimum savings of 223,200 dollars for rural institutions annually. To improve quality and reduce cost for rural hospitals, the authors recommend implementation of an NCMS. PMID:15931047

  12. Succession planning: trends regarding the perspectives of Chief Executive Officers in US hospitals.

    PubMed

    Collins, Sandra K; McKinnies, Richard C; Matthews, Eric; Collins, Kevin S

    2013-01-01

    A study was conducted to revisit the perceptions of chief executive officers in US hospitals regarding the origin of leadership and how they felt about internally developed successors versus externally recruited successors. Furthermore, the study sought to develop understanding of how this group of executives utilizes the succession planning process, what factors impact successor identification, what positions are applicable for succession planning activities, and who is ultimately held responsible for leadership continuity within the hospital industry. The results of this 2012 study were compared with a previous study conducted in 2007 to determine if the perceptions had changed over time. PMID:23903939

  13. The need for strategic tax planning among nonprofit hospitals.

    PubMed

    Smith, Pamela C

    2005-01-01

    Strategic tax planning issues are important to the nonprofit health care sector, despite its philanthropic mission. The consolidation of the industry has led management to fight for resources and develop alternative strategies for raising money. When management evaluates alternative collaborative structures to increase efficiency, the impact on governance structures must also be considered. The increased governmental scrutiny of joint ventures within the health care sector warrants management's attention as well. The financial incentives must be considered, along with the various tax policy implications of cross-sector collaborations. PMID:18973000

  14. Effectiveness of asthma education with and without a self-management plan in hospitalized children.

    PubMed

    Espinoza-Palma, Tatiana; Zamorano, Alejandra; Arancibia, Francisca; Bustos, María-Francisca; Silva, Maria José; Cardenas, Consuelo; De La Barra, Pedro; Puente, Victoria; Cerda, Jaime; Castro-Rodriguez, José A; Prado, Francisco

    2009-11-01

    Background. Formal education in primary care can reduce asthma exacerbations. However, there are few studies in hospitalized children, with none originating in Latin America. Methods. A prospective randomized study was designed to evaluate whether a full education with self-management plan (ESM) was more effective than an education without self-management plan (E) in reducing asthma hospitalization. Children (5 to 15 years of age) who were hospitalized for an asthma attack were divided in two groups. Children in the E group received general instructions based on a booklet. Those in the ESM group received the same booklet plus a self-management guide and a puzzle game that reinforces the lessons learned in the booklet. Patients were interviewed every 3 months, by telephone, for one year. Interviewers recording the number of hospitalizations, exacerbations, and emergency visits for asthma and oral steroid burst uses. Results. From 88 children who met the inclusion criteria, 77 (86%) completed one year of follow-up (41 from E and 36 from ESM group). Overall, after one year, the hospitalization decreased by 66% and the inhaled corticosteroids therapy increased from 36% to 79%. At the end of the study, there was no difference in exacerbations, emergency visits, oral steroid burst uses, or hospitalizations between the two groups. Conclusions. Asthma education with or without a self-management plan during asthma hospitalization were effective in reducing exacerbations, emergency visits, oral steroid burst uses, and future rehospitalizations. This evidence supports the importance of providing a complete asthma education plan in any patient who is admitted for asthma exacerbation. PMID:19905916

  15. [Building Process and Architectural Planning Characteristics of Daehan Hospital Main Building].

    PubMed

    Lee, Geauchul

    2016-04-01

    This paper explores the introduction process of Daehan Hospital from Japan as the modern medical facility in Korea, and the architectural planning characteristics as a medical facility through the detailed building process of Daehan Hospital main building. The most noticeable characteristic of Daehan Hospital is that it was designed and constructed not by Korean engineers but by Japanese engineers. Therefore, Daehan Hospital was influenced by Japanese early modern medical facility, and Japanese engineers modeled Daehan Hospital main building on Tokyo Medical School main building which was constructed in 1876 as the first national medical school and hospital. The architectural type of Tokyo Medical School main building was a typical school architecture in early Japanese modern period which had a middle corridor and a pseudo Western-style tower, but Tokyo Medical School main building became the model of a medical facility as the symbol of the medical department in Tokyo Imperial University. This was the introduction and transplantation process of Japanese modern 'model' like as other modern systems and technologies during the Korean modern transition period. However, unlike Tokyo Medical School main building, Daehan Hospital main building was constructed not as a wooden building but as a masonry building. Comparing with the function of Daehan Hospital main building, its architectural form and construction costs was excessive scale, which was because Japanese Resident-General of Korea had the intention of ostentation that Japanese modernity was superior to Korean Empire. PMID:27301854

  16. 78 FR 54766 - Federal Plan Requirements for Hospital/Medical/Infectious Waste Incinerators Constructed On or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 60 and 62 RIN 2060-AR-11 and RIN 2060-A004 Federal Plan Requirements for Hospital/Medical/Infectious Waste Incinerators Constructed On or Before December 1, 2008, and Standards...

  17. Mathematical methods to assist with hospital operation and planning.

    PubMed

    Gallivan, Steve

    2005-12-01

    Within health Operational Research, the use of 'computer package' methods such as simulation and system dynamics is becoming so prevalent that it feels somewhat old hat to use analytical methods to develop explicit mathematical formulae or even to explore the mathematical structure of problems. This paper will discuss the use of such 'back of the envelope' analysis illustrating its usefulness. It will be shown that not only does this approach yield considerable insight, but also that it can give rise to powerful and practical solution methods. Examples of this will be discussed in relation to issues such as bed needs estimation, admissions and facilities planning. The author is Director of the Clinical Operational Research Unit (CORU) which was established in 1983, receiving core funding from the UK Department of Health. The concept of a full time university-based research unit dedicated to applying expertise in Operational Research (OR) to problems in health care provides a relatively rare research resource. Yet, the scope for such research, applied to an increasing range of health care activity, is enormous. Issues such as treatment evaluation, performance measures, clinical governance, evidence based medicine and health service delivery are all amenable to OR. Further, OR often provides an immensely cost effective alternative to traditional methods of clinical research based on randomised controlled trials or large scale epidemiological studies. The nature of OR, and one of its main strengths, is that it encompasses a wide range of analytical and scientific methods. Mathematical modeling, statistics, computer-based methods, trial design and analysis all contribute to health OR and, under both of its Directors since 1983, a conscious effort has been made within CORU to foster a diversity of research methodologies. Particular emphasis is put on developing new mathematical methods and computer software. This is somewhat at odds with what seems to be a growing trend

  18. [Planned non-hospital births in industrialized countries: bureaucratic dream vs. professional responsibility].

    PubMed

    Arabin, B; Chervenak, F A; McCullough, L B

    2013-02-01

    This article addresses in how far planned non-hospital births should be an alternative to planned hospital births. Advocates of planned non-hospital deliveries have emphasised patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and have doubts that the information available for the pregnant women and the public is in accord with professional responsibility. We understand that the increasing rates of interventions and operative deliveries in hospital births demand an answer, but we doubt that planned home birth is the appropriate professional solution. Complications during non-hospital births inevitably demand a transport of mother and child to a perinatal centre. The time delay by itself is an unnecessary risk for both and this cannot be abolished by bureaucratic quality criteria as introduced for non-hospital births in Germany. Evidence-based studies have shown that modern knowledge of the course of delivery including ultrasound as well as intensive care during the delivery all reduce the rate of operative deliveries. Unfortunately, this is not well-known and only rarely considered during any delivery. All these facts, however, are the best arguments to find a cooperative model within perinatal centres to combine the art of midwifery with modern science, reduction of pain and perinatal care of the pregnant women before, during and after birth. We therefore call on obstetricians, midwifes and health-care providers as well as health politicians to carefully analyse the studies from Western countries showing increasing risks if the model of intention-to-treat is considered and accoordingly not to support planned non-hospital births nor to include these models into prospective trials. Alternatively, we recommend the introduction of a home-like climate within hospitals and perinatal centres, to avoid unnecessary invasive measures and to really care for the pregnant mother

  19. Revitalized commitment to community. A community benefit plan helps a hospital be a good neighbor.

    PubMed

    Brown, S

    1994-01-01

    Three years ago St. John Hospital and Medical Center, Detroit, made a commitment to strengthen its community relationships and reaffirm its mission of serving those in need by following the Catholic Health Association's Social Accountability Budget. While implementing the program, administrators were surprised to learn the hospital was already participating in many community programs for which it received little or no reimbursement. They also discovered that the hospital had no formal, written charity care policy even though St. John provided more than $14 million in uncompensated care annually. To learn what the needs of the surrounding community were, the hospital went to the clergy, who overwhelmingly identified the needs of the elderly as the number-one priority. A close second was supporting the basic family unit. Other concerns included basic family needs, safe neighborhoods and schools, and teen pregnancy. Although the hospital realized it could not do all that was needed, it felt obliged to be a leader in seeing that the needs were met and drew up a community benefit plan that documented the problems and the solutions. The hospital did what it could and worked with other organizations to address needs such as housing for the elderly, affordable and accessible healthcare, neighborhood improvement and safety, and family services. PMID:10131088

  20. Strategic competition: the application of business planning techniques to the hospital marketplace.

    PubMed

    Morris, D E; Rau, S E

    1985-01-01

    Survival in the increasingly turbulent and uncertain health care environment should raise the application of business planning and corporate strategy to the highest levels of institutional consciousness. With hospital mergers and networking arrangements expected to account for over 60% of the hospital beds in the nation by 1990, and with government and business cost containment efforts squeezing hospital margins, the survivors are going to be those institutions able to develop and maintain a sustainable economic advantage over the competition in the programs and services that comprise the major portion of their business. The successful players will be those that allow the institution to identify and exploit new opportunities and concentrate management and financial resources in those segments of the market where competitive advantages are real and attainable. PMID:10299812

  1. Planning for Hospital IT Implementation: A New Look at the Business Case

    PubMed Central

    Menachemi, Nir; Randeree, Ebrahim; Burke, Darrell E.; Ford, Eric W.

    2008-01-01

    Executive Summary Compared to organizations in other industries, hospitals are slow to adopt information technology (IT). Those planning for system implementation must understand the barriers to IT adoption which, in healthcare, include the relatively high acquisition and maintenance costs of sophisticated administrative and clinical information systems. Understanding the overall business case is particularly important for hospital IT planners. This paper describes the literature that examines benefits from using health IT. In addition, we focus on a series of studies conducted in Florida that provide generalizable evidence regarding the overall business case associated with hospital adoption for information systems. These studies focus broadly on the improved financial, operational, and clinical performance associated with IT. PMID:27429553

  2. Customer satisfaction planning and industrial engineering move hospital towards in-house stockless program.

    PubMed

    Burton, R; Mauk, D

    1993-03-01

    By integrating customer satisfaction planning and industrial engineering techniques when examining internal costs and efficiencies, materiel managers are able to better realize what concepts will best meet their customers' needs. Defining your customer(s), applying industrial engineering techniques, completing work sampling studies, itemizing recommendations and benefits to each alternative, performing feasibility and cost-analysis matrixes and utilizing resources through productivity monitoring will get you on the right path toward selecting concepts to use. This article reviews the above procedures as they applied to one hospital's decision-making process to determine whether to incorporate a stockless inventory program. Through an analysis of customer demand, the hospital realized that stockless was the way to go, but not by outsourcing the function--the hospital incorporated an in-house stockless inventory program. PMID:10124470

  3. Hospital and Health Plan Partnerships: The Affordable Care Act's Impact on Promoting Health and Wellness

    PubMed Central

    Vu, Michelle; White, Annesha; Kelley, Virginia P.; Hopper, Jennifer Kuca; Liu, Cathy

    2016-01-01

    Background The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care. Objective To examine the ACA's impact on the health and wellness programs that have resulted from the joint ventures of hospitals and health plans based on the published literature. Method We conducted a review of the literature to identify successful mergers and best practices of health and wellness programs. Articles published between January 2007 and January 2015 were compiled from various search engines, using the search terms “corporate,” “health and wellness program,” “health plan,” “insurance plan,” “hospital,” “joint venture,” and “vertical merger.” Publications that described consolidations or wellness programs not tied to health insurance plans were excluded. Noteworthy characteristics of these programs were summarized and tabulated. Results A total of 44 eligible articles were included in the analysis. The findings showed that despite rising healthcare costs, joint ventures prevent hospitals from trading-off quality and services for cost reductions. Administrators believed that partnering would allow the companies to meet ACA standards for improving clinical outcomes at reduced costs. Before the implementation of the ACA, some employers had wellness programs, but these were not standardized and did not need to produce measurable results. The ACA encouraged improvement of employee wellness programs by providing funding for expanded health services and by mandating quality care. Successful workplace health and wellness

  4. Planning and verification in radiotherapy: our experience in a filmless hospital

    NASA Astrophysics Data System (ADS)

    Torresin, A.; Carbonini, C.; Ferrari, M. B.; Asnaghi, D.; Botturi, M.

    2009-01-01

    In our hospital we have recently installed a new radiotherapy treatment planning and verification system. Our system allows to follow the normal clinical workflow: from patient identification to follow-up through the treatment delivery with the study of the best irradiation geometry. We designed a new technical solutions relating to the use of four linear accelerators, a Record and Verify system, a Treatment Planning System (TPS) and a clinical folder, completely paperless. All the procedures for treatment planning, setup and verification are integrated in our digital imaging long-term archive. The integration is based on the existing HL7 and DICOM standard protocols described in the International Committee and IHE RO Technical Framework, which is able to support the workflow. All the images used for planning and setup are stored in the Oncentra DICOM archive server for short-term archiving and then are sent to the Agfa DICOM long-term archive for legal and scientific purposes.

  5. A management plan for hospitals and medical centers facing radiation incidents

    PubMed Central

    Davari, Fereshteh; Zahed, Arash

    2015-01-01

    Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary. PMID:26759575

  6. Evaluation of standardized teaching plans for hospitalized pediatric patients: a performance improvement project.

    PubMed

    Blagojevic, Joanne; Stephens, Sigrid

    2008-01-01

    Discharge teaching in a pediatric hospital setting is difficult because the situation involves multiple learners, time constraints, and differing skill levels of nurse teachers. Shortened length of stay forces nurses to complete patient education efficiently. Unstructured education can lead to failed learning, as evidenced by readmissions and postdischarge feedback. A performance improvement project was conducted to evaluate the effectiveness of standardized teaching plans for diabetes mellitus and infant cardiopulmonary resuscitation. Preliminary data indicated a passing score of at least 90% on posttests by all learners, suggesting that standardized teaching plans may help nurses complete prescribed discharge teaching. PMID:18507236

  7. Effectiveness of early discharge planning in acutely ill or injured hospitalized older adults: a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Older age and higher acuity are associated with prolonged hospital stays and hospital readmissions. Early discharge planning may reduce lengths of hospital stay and hospital readmissions; however, its effectiveness with acutely admitted older adults is unclear. Methods In this systematic review, we compared the effectiveness of early discharge planning to usual care in reducing index length of hospital stay, hospital readmissions, readmission length of hospital stay, and mortality; and increasing satisfaction with discharge planning and quality of life for older adults admitted to hospital with an acute illness or injury. We searched the Cochrane Library, DARE, HTA, NHSEED, ACP, MEDLINE, EMBASE, CINAHL, Proquest Dissertations and Theses, PubMed, Web of Science, SciSearch, PEDro, Sigma Theta Tau International’s registry of nursing research, Joanna Briggs Institute, CRISP, OT Seeker, and several internet search engines. Hand-searching was conducted in four gerontological journals and references of all included studies and previous systematic reviews. Two reviewers independently extracted data and assessed risk of bias. Data were pooled using a random-effects meta-analysis. Where meta-analysis was not possible, narrative analysis was performed. Results Nine trials with a total of 1736 participants were included. Compared to usual care, early discharge planning was associated with fewer hospital readmissions within one to twelve months of index hospital discharge [risk ratio (RR) = 0.78, 95% CI = 0.69 − 0.90]; and lower readmission lengths of hospital stay within three to twelve months of index hospital discharge [weighted mean difference (WMD) = −2.47, 95% confidence intervals (CI) = −4.13 − −0.81)]. No differences were found in index length of hospital stay, mortality or satisfaction with discharge planning. Narrative analysis of four studies indicated that early discharge planning was associated with greater overall quality of life and the

  8. Benefits planning for advanced clinical information systems implementation at Allina hospitals and clinics.

    PubMed

    Thompson, Douglas Ivan; Henry, Sharon; Lockwood, Linda; Anderson, Brian; Atkinson, Susan

    2005-01-01

    Allina Hospitals and Clinics is implementing an enterprise-wide information system with inpatient and ambulatory clinical documentation and orders, clinical decision support, and revenue cycle applications. Allina has adopted a rigorous approach to planning for and realizing the expected clinical and financial benefits from this investment. Allina's strategies include: Forming a benefits realization team with formal responsibility for analysis, education, facilitation, and measurement; Studying system design to consider requirements for benefits realization; Integrating cultural, organizational and process change plans with system implementation plans; Measuring benefits using a measurement framework that matches organizational reporting, enables multi-level sequential analysis and adjusts for bias in quantifying benefits; Assigning accountability for achieving benefits by matching every benefit with an individual and an operational group; system executives, hospital executives, and department managers are held accountable for benefits within their scope of responsibility, and expected financial benefits are part of their yearly budgets. This article describes Allina's approach for benefits planning, contrasting it with the typical provider's approach to benefits realization. It argues that this approach may greatly increase the likelihood of realizing the value of investments in integrated clinical and business IT PMID:15682677

  9. Managing aggression in a psychiatric hospital using a behaviour plan: a case study.

    PubMed

    Bisconer, S W; Green, M; Mallon-Czajka, J; Johnson, J S

    2006-10-01

    This paper focuses on the critical role of nursing in implementing a behaviour plan in a psychiatric hospital. The plan was implemented with a 40-year-old man with a long history of aggression towards others and self. The study used a single-subject research design with baseline and intervention phases (AB Design). Data were collected on (1) frequency of incidents of aggression towards others and self; (2) use of restrictive interventions to manage aggression (i.e. restraints, pro re nata medication, 1:1 special observation); and (3) frequency of staff injury. The data show a decrease in frequency of aggression towards others and self, a concurrent reduction in the use of restrictive interventions to manage aggression, and a decrease in incidents of staff injury. The behaviour plan helped staff maintain a safe and therapeutic milieu. The behaviour plan has given the patient an opportunity to learn positive replacement behaviours and skills, and the opportunity eventually to leave the hospital to live in a less restrictive community home. PMID:16965469

  10. Technical and organisational aspects in enterprise resource planning systems implementation: lessons from a Spanish public hospital

    NASA Astrophysics Data System (ADS)

    Escobar-Rodriguez, Tomas; Escobar-Pérez, Bernabe; Monge-Lozano, Pedro

    2014-09-01

    Public resources should always be managed efficiently, more so in times of crisis. Due to the specific characteristics of the healthcare sector, there is a need for special attention, especially in regards to hospitals. Administrators need useful tools to be able to efficiently manage available resources, such as enterprise resource planning (ERP) systems. Therefore, an analysis of the effects of their implementation and use in hospitals is valuable. This study has two purposes. One is to analyse the role ERP systems play in aiding the integration of hospital data, with focus on user satisfaction as well as possible resistance to change. The other purpose is to analyse the effects of implanting and using ERP systems in the hospital environment and identifying how certain variables influence the process, especially the existence of different organisational cultures. Results indicate that clinical information has become notably more integrated, despite the lack of flow in the economic-financial area. The heterogeneous nature of the different groups, clinical (Medical, Nursing) and non-clinical (Economic-Financial, Accounting), had a negative influence on the implementation process, and limited the integration of information as well as the system's performance.

  11. A systems approach to the design and planning of hospitals in the Arab world.

    PubMed

    Mikho, E

    1994-01-01

    The aim of this paper is to propose a 'planning framework' which offers a contemporary methodology for the accomplishment of reasonable and virtually fail-safe goals for the design and construction of Arab hospitals. The methodology can serve where economic conditions vary, from the very wealthy Gulf States to the presently very poor economy of the Sudan. Hospital programmes, which reflect so closely the essential features of their respective culture, will have to be carefully adopted to the conditions prevailing in each country. The hospital design team must recognize the importance of the influence of its country's cultural heritage on the evolution of hospitals in the future. Two central topics have been discussed: the 'healthcare building' and the 'building process', both of which can be affected by how information is assembled and how it is presented. The presentation of information for clarity is an essential part of logically translating thought into constructive action. The process is enhanced by a 'systems approach', an integration of an orderly presentation of facts with an orderly presentation of design components, using an orderly time-sensitive methodology. PMID:10142970

  12. Designing HIGH-COST medicine: hospital surveys, health planning, and the paradox of progressive reform.

    PubMed

    Perkins, Barbara Bridgman

    2010-02-01

    Inspired by social medicine, some progressive US health reforms have paradoxically reinforced a business model of high-cost medical delivery that does not match social needs. In analyzing the financial status of their areas' hospitals, for example, city-wide hospital surveys of the 1910s through 1930s sought to direct capital investments and, in so doing, control competition and markets. The 2 national health planning programs that ran from the mid-1960s to the mid-1980s continued similar strategies of economic organization and management, as did the so-called market reforms that followed. Consequently, these reforms promoted large, extremely specialized, capital-intensive institutions and systems at the expense of less complex (and less costly) primary and chronic care. The current capital crisis may expose the lack of sustainability of such a model and open up new ideas and new ways to build health care designed to meet people's health needs. PMID:20019312

  13. Designing HIGH-COST Medicine Hospital Surveys, Health Planning, and the Paradox of Progressive Reform

    PubMed Central

    2010-01-01

    Inspired by social medicine, some progressive US health reforms have paradoxically reinforced a business model of high-cost medical delivery that does not match social needs. In analyzing the financial status of their areas’ hospitals, for example, city-wide hospital surveys of the 1910s through 1930s sought to direct capital investments and, in so doing, control competition and markets. The 2 national health planning programs that ran from the mid-1960s to the mid-1980s continued similar strategies of economic organization and management, as did the so-called market reforms that followed. Consequently, these reforms promoted large, extremely specialized, capital-intensive institutions and systems at the expense of less complex (and less costly) primary and chronic care. The current capital crisis may expose the lack of sustainability of such a model and open up new ideas and new ways to build health care designed to meet people's health needs. PMID:20019312

  14. Pediatric hospital medicine: a strategic planning roundtable to chart the future.

    PubMed

    Rauch, Daniel A; Lye, Patricia S; Carlson, Douglas; Daru, Jennifer A; Narang, Steve; Srivastava, Rajendu; Melzer, Sanford; Conway, Patrick H

    2012-04-01

    Given the growing field of Pediatric Hospital Medicine (PHM) and the need to define strategic direction, the Society of Hospital Medicine, the American Academy of Pediatrics, and the Academic Pediatric Association sponsored a roundtable to discuss the future of the field. Twenty-one leaders were invited plus a facilitator utilizing established health care strategic planning methods. A "vision statement" was developed. Specific initiatives in 4 domains (clinical practice, quality of care, research, and workforce) were identified that would advance PHM with a plan to complete each initiative. Review of the current issues demonstrated gaps between the current state of affairs and the full vision of the potential impact of PHM. Clinical initiatives were to develop an educational plan supporting the PHM Core Competencies and a clinical practice monitoring dashboard template. Quality initiatives included an environmental assessment of PHM participation on key committees, societies, and agencies to ensure appropriate PHM representation. Three QI collaboratives are underway. A Research Leadership Task Force was created and the Pediatric Research in Inpatient Settings (PRIS) network was refocused, defining a strategic framework for PRIS, and developing a funding strategy. Workforce initiatives were to develop a descriptive statement that can be used by any PHM physician, a communications tool describing "value added" of PHM; and a tool to assess career satisfaction among PHM physicians. We believe the Roundtable was successful in describing the current state of PHM and laying a course for the near future. PMID:21994159

  15. [Family planning and the health care team in the hospital setting].

    PubMed

    Nicole, N

    1982-12-01

    When family planning clinics opened in French-speaking Switzerland in the 1960s, their major function was provision of information on fertility regulation methods. Their functions have expanded over time to include a wider variety of counseling activities. 1 in-hospital family planning service operating in conjunction with the department of obstetrics and gynecology provides contraceptive information each week to 8-10 patients in group or individual settings with or without the partner. Discussions are held on demand about contraception, lactation, sterilization, sexuality, gynecological follow-up care, and sex education of children. The goal is to use the occasion of obstetrical or gynecological events affecting the identity of the woman or her partner for nondirected interviews based on listening and providing objective information. Women or couples are encouraged to express their fears and desires and to overcome taboos. In the gynecological service, individual interviews are held with women hospitalized for abortion, adnexitis or endometritis, miscarriage, intrauterine death, or hysterectomy. Collaboration between the family planning worker and other health workers is promoted through use of brief weekly reports and a monthly colloquium in which cases are presented and discussed. The public at large and other health workers still view family planning counselors solely as contraceptive technicians, but in fact these workers are obliged to take account of psychic, sexual, and relational issues that contraception invariably raises. To respond to these new demands, family counselors can provide information and education, or counseling and support, or they can refer clients to specialists such as sexologists, marriage counselors, or psychiatrists. A family planning service may, through its wide range of activities, prevent a useless psychiatrisation of problems. PMID:12281319

  16. [Effect of a Discharge Planning Educational Program in a University Hospital].

    PubMed

    Sakai, Shima; Ohori, Yoko; Tanaka, Yuko; Sato, Yukiko; Watanabe, Ami; Fujii, Junko

    2015-12-01

    The purpose of this study was to investigate the effect of a discharge planning educational program on multidisciplinary team staff in a community. We provided training to nurses of a university hospital. The training covered an introduction to discharge planning, decision-making support, home care medicine and home nursing care, the medical social welfare system, and case review meetings. It was conducted every year from September through February between 2012 and 2015. Before and after the training, the awareness of nurses was evaluated by using self-administered questionnaires and the Discharge Planning scale for Ward Nurses(DPWN), and discharge planning satisfaction was measured using a visual analogue scale (VAS). The study process was reviewed and approved by the Ethics Committee of Tokyo Women's Medical University. The questionnaires were distributed to 96 nurses; of these, responses of 72 nurses(pre- and post-training)were analyzed(response rate: 75.0%). The average number of years of nursing experience was 8.5± 7.7. The total score of the DPWN and its subscales, as well as the VAS, with regard to satisfaction level significantly increased after the training(p<0.01), indicating that training improved nurses' awareness of discharge planning practices. PMID:26809418

  17. Strategic planning and designing of a hospital disaster manual in a tertiary care, teaching, research and referral institute in India

    PubMed Central

    Talati, Shweta; Bhatia, Prateek; Kumar, Ashok; Gupta, A. K.; Ojha, Col. D

    2014-01-01

    BACKGROUND: As per the “Disaster Management Act, 2005” of India, it is mandatory for government hospitals in India to prepare a disaster plan. This study aimed to prepare a disaster manual of a 1 900 bed tertiary care hospital, in consultation and involvement of all concerned stakeholders. METHODS: A committee of members from hospital administration, clinical, diagnostic and supportive departments worked on an initial document prepared according to the Act and gave their inputs to frame a final disaster manual. RESULTS: The prepared departmental standard operating procedures involved 116 people (doctors and paramedical staff), and were then synchronized, in 12 committee meetings, to produce the final hospital disaster manual. CONCLUSIONS: The present disaster manual is one of the few comprehensive plans prepared by the stakeholders of a government hospital in India, who themselves form a part of the disaster response team. It also helped in co-ordinated conduction of mock drills. PMID:25215145

  18. Hospital organizational response to the nuclear accident at Three Mile Island: implications for future-oriented disaster planning.

    PubMed

    Maxwell, C

    1982-03-01

    The 1979 nuclear accident at Three Mile Island (TMI) near Harrisburg, Pennsylvania, caused severe organizational problems for neighboring health care institutions. Dauphin County, just north of TMI, contained four hospitals ranging in distance from 9.5 to 13.5 miles from the stricken plant. Crash plans put into effect within 48 hours of the initial incident successfully reduced hospital census to below 50 per cent of capacity, but retained bedridden and critically ill patients within the risk-zone. No plans existed for area-wide evacuation of hospitalized patients. Future-oriented disaster planning should include resource files of host institution bed capacity and transportation capabilities for the crash evacuation of hospitalized patients during non-traditional disasters. PMID:7058968

  19. Hospital organizational response to the nuclear accident at Three Mile Island: implications for future-oriented disaster planning.

    PubMed Central

    Maxwell, C

    1982-01-01

    The 1979 nuclear accident at Three Mile Island (TMI) near Harrisburg, Pennsylvania, caused severe organizational problems for neighboring health care institutions. Dauphin County, just north of TMI, contained four hospitals ranging in distance from 9.5 to 13.5 miles from the stricken plant. Crash plans put into effect within 48 hours of the initial incident successfully reduced hospital census to below 50 per cent of capacity, but retained bedridden and critically ill patients within the risk-zone. No plans existed for area-wide evacuation of hospitalized patients. Future-oriented disaster planning should include resource files of host institution bed capacity and transportation capabilities for the crash evacuation of hospitalized patients during non-traditional disasters. PMID:7058968

  20. Deconstructing housework: cuts to home support services and the implications for hospital discharge planning.

    PubMed

    Rockwell, Jasmyne

    2010-01-01

    Over the last decade, the home support resources in British Columbia have decreased. Specifically, nonmedical tasks such as housekeeping and meal preparation have been severely restricted and are no longer available for hospital discharge planning with elders who are returning to the community. This paper applies analytical deconstruction to three aspects of a case example of an elderly couple: the technical and bureaucratic aspects of who gets home support and what kind, the socially constructed aspects of gender roles and the performance of unpaid labor, and the personally informed aspects that involve an elder's life experiences, social supports, and personal values. The paper then employs a feminist poststructuralist framework to suggest discharge planning implications for social work, using the case as an example. PMID:20391148

  1. What's the Plan? Needing Assistance with Plan of Care Is Associated with In-Hospital Death for ICU Patients Referred for Palliative Care Consultation

    PubMed Central

    Kiyota, Ayano; Bell, Christina L; Masaki, Kamal

    2016-01-01

    To inform earlier identification of intensive care unit (ICU) patients needing palliative care, we examined factors associated with in-hospital death among ICU patients (N=260) receiving palliative care consultations at a 542-bed tertiary care hospital (2005–2009). High pre-consultation length of stay (LOS, ≥7 days) (adjusted odds ratio (aOR)=5.0, 95% confidence interval (95% CI)=2.5–9.9, P<.01) and consultations for assistance with plan of care (aOR=11.6, 95% CI=5.6–23.9, P<.01) were independently associated with in-hospital death. Patients with both consultation for plan of care and high pre-consult LOS had the highest odds of in-hospital death (aOR=36.3, 95% CI=14.9–88.5, P<.001), followed by patients with consultation for plan of care and shorter pre-consult LOS (aOR=9.8, 95% CI=4.3–22.1, P<.001), and patients with long pre-consult LOS but no consultation for plan of care (aOR=4.7, 95% CI=1.8–12.4, P=.002). Our findings suggest that ICU patients who require assistance with plan of care need to be identified early to optimize end-of-life care and avoid in-hospital death. PMID:27563500

  2. What's the Plan? Needing Assistance with Plan of Care Is Associated with In-Hospital Death for ICU Patients Referred for Palliative Care Consultation.

    PubMed

    Kiyota, Ayano; Bell, Christina L; Masaki, Kamal; Fischberg, Daniel J

    2016-08-01

    To inform earlier identification of intensive care unit (ICU) patients needing palliative care, we examined factors associated with in-hospital death among ICU patients (N=260) receiving palliative care consultations at a 542-bed tertiary care hospital (2005-2009). High pre-consultation length of stay (LOS, ≥7 days) (adjusted odds ratio (aOR)=5.0, 95% confidence interval (95% CI)=2.5-9.9, P<.01) and consultations for assistance with plan of care (aOR=11.6, 95% CI=5.6-23.9, P<.01) were independently associated with in-hospital death. Patients with both consultation for plan of care and high pre-consult LOS had the highest odds of in-hospital death (aOR=36.3, 95% CI=14.9-88.5, P<.001), followed by patients with consultation for plan of care and shorter pre-consult LOS (aOR=9.8, 95% CI=4.3-22.1, P<.001), and patients with long pre-consult LOS but no consultation for plan of care (aOR=4.7, 95% CI=1.8-12.4, P=.002). Our findings suggest that ICU patients who require assistance with plan of care need to be identified early to optimize end-of-life care and avoid in-hospital death. PMID:27563500

  3. Is a leveraged ESOP (employee stock ownership plan) a possibility for the voluntary hospital?

    PubMed

    Cleverley, W O

    1988-01-01

    One of the biggest news stories to hit the health care industry last year was the leveraged Employee Stock Ownership Plan (ESOP) sale of 104 Hospital Corporation of America (HCA) hospitals to a newly formed company, Health Trust, Inc. (HTI). Much skepticism regarding the benefits of this transaction was raised. To many individuals, HCA was the primary, if not exclusive, beneficiary. The management and employees of HTI were viewed by many as being "left out to dry." These initial opinions were almost always based on a total ignorance of the substantial benefits--primarily but not exclusively tax benefits--that are available in an ESOP transaction. My awareness of these benefits comes through my limited involvement as a consultant to the agent bank in the HCA-HTI transaction. This article will acquaint health care executives with the basic features and benefits of an ESOP alternative. EOPSs are a viable alternative for both voluntary and investor-owned health care firms. PMID:10288640

  4. Community health insurance as a catalyst for uptake of family planning and reproductive health services: the Obio Cottage Hospital experience.

    PubMed

    Fakunle, B; Okunlola, M A; Fajola, A; Ottih, U; Ilesanmi, A O

    2014-08-01

    Health service delivery in the Niger Delta region of Nigeria has suffered many setbacks. Community participation may help break the barriers limiting access to health services, especially those associated with family planning and reproductive health services. This is a two-year review of family planning and reproductive health services records offered by the Obio Cottage Hospital from the onset of the Community Insurance Scheme (2010-12). Since the inception of the Community Insurance Scheme, there has been an increase in the uptake of family planning methods of more than 50%; 1,274 women in 2011 vs 3,140 in 2012. An increase in number of women seeking reproductive health services was also observed. The Community Health Insurance Scheme (CHIS) at the Obio Cottage Hospital provides evidence for expansion, as seen in the improvement in patronage for family planning and reproductive health services. PMID:24725223

  5. Advance care planning knowledge and documentation in a hospitalized cancer population

    PubMed Central

    Barakat, Ayman; Barnes, Sunni A.; Casanova, Mark A.; Stone, Marvin J.; Shuey, Kathleen M.

    2013-01-01

    To have a better understanding of our patients’ knowledge of advance directive planning and execution, as well as communication with their oncologists regarding their wishes, we conducted a survey on our inpatient hematology-oncology services. A total of 68 unique hospitalized patients with a diagnosis of cancer completed surveys. Surveys were given to all oncology patients regardless of their reason for admission. Overall, 29% of the patients reported having had a discussion with their oncologist regarding their wishes if they became seriously ill or near death. Of those who did have this conversation, the majority said that they, rather than their physician, initiated it. Although the vast majority of patients (97%) knew what a living will was, only 54% had one in place. Twenty patients had a discussion with their oncologist, and 14 of them (70%) had a living will. This percentage was higher than in the group that did not have a conversation with their physician (48%; 23 of 48 patients), but the difference was not statistically significant. Most cancer patients admitted to an inpatient oncology unit either did not have or did not recall having a discussion with their oncologist regarding end-of-life issues. This study gives us a baseline of information in evaluating future interventions directed to improve the quality of patient-physician communication regarding end-of-life planning. PMID:24082411

  6. An Introduction to Emergency Medical Services (EMS). Pre-Hospital Phase. Emergency Medical Services Orientation, Lesson Plan No. 9.

    ERIC Educational Resources Information Center

    Young, Derrick P.

    Designed for use with interested students at high schools, community colleges, and four-year colleges, this lesson plan was developed to provide an introduction to the pre-hospital phase of Emergency Medical Services (EMS) and to serve as a recruitment tool for the EMS Program at Kapiolani Community College (KCC) in Hawaii. The objectives of the…

  7. Planning and development of the Better Bites program: a pricing manipulation strategy to improve healthy eating in a hospital cafeteria.

    PubMed

    Liebert, Mina L; Patsch, Amy J; Smith, Jennifer Howard; Behrens, Timothy K; Charles, Tami; Bailey, Taryn R

    2013-07-01

    The Better Bites program, a hospital cafeteria nutrition intervention strategy, was developed by combining evidence-based practices with hospital-specific formative research, including key informant interviews, the Nutrition Environment Measures Study in Restaurants, hospital employee surveys, and nutrition services staff surveys. The primary program components are pricing manipulation and marketing to promote delicious, affordable, and healthy foods to hospital employees and other cafeteria patrons. The pricing manipulation component includes decreasing the price of the healthy items and increasing the price of the unhealthy items using a 35% price differential. Point-of-purchase marketing highlights taste, cost, and health benefits of the healthy items. The program aims to increase purchases of healthy foods and decrease purchases of unhealthy foods, while maintaining revenue neutrality. This article addresses the formative research, planning, and development that informed the Better Bites program. PMID:23182861

  8. Study of Educational Hospital Employees’ Satisfaction with the Administration of the Health Reform Plan in Ghazvin, 2015

    PubMed Central

    Gholami, Soheyla; Oveisi, Sonia; Ghamari, Fatemeh; Etedal, Mahboobeh Ghorban; Rajaee, Roya

    2015-01-01

    Introduction Employee satisfaction is considered to be an important component in the promotion of service quality and increased efficiency and effectiveness in the reform plan for a healthcare system. Neglecting this issue could result in a lack of success in achieving the healthcare system’s objectives. The healthcare reform plan is being implemented to achieve the objectives of the healthcare system. Thus, given the key role of hospital employees in implementing the reform plan, the aim of this study was to determine the levels of hospital employees’ satisfaction with their jobs. Methods This was a qualitative study in 2015 that included thematic analysis, and 138 employees of the Kosar, Rajaii, and Ghods Hospitals participated. Data were collected using semi-structured interviews, and the data were analyzed using content analysis. Results After analyzing the data collected by interviewing the employees, 132 codes were identified. The codes were classified into five general concepts including opinions about 1) the reform plan and its administrative barriers, 2) changes in visits, 3) changes in working conditions, 4) changes in salaries and 5) General satisfaction of personnel. Conclusion Increasing workloads, stagnant salaries, and the shortage of personnel were the main factors that reduced the satisfaction of the hospitals’ employees with the administration of the healthcare reform plan. PMID:26767104

  9. Including Internet insurance as part of a hospital computer network security plan.

    PubMed

    Riccardi, Ken

    2002-01-01

    Cyber attacks on a hospital's computer network is a new crime to be reckoned with. Should your hospital consider internet insurance? The author explains this new phenomenon and presents a risk assessment for determining network vulnerabilities. PMID:11951384

  10. Implementation of a combined Cardiopulmonary Resuscitation and Treatment Escalation Plan document in a District General Hospital.

    PubMed

    Stockdale, Claire; Trivedi, Bhavi; Jerome, Ellen; Salih, Samir; Huntley, Christopher; Cooke, Eleanor; Massey, Yolanda; Mella, Sophie

    2014-01-01

    Documentation of appropriate escalation of treatment was identified as a problem for junior doctors and Critical Care Outreach Nurses at Musgrove Park Hospital. An audit of resuscitation and escalation documentation of all wards found that of the patients who were not for Cardiopulmonary resuscitation (and therefore not for full escalation of care), 78.4% had no documentation of the appropriate level of escalation of treatment should they deteriorate. The majority of junior doctors had experienced cases where they felt that inappropriate treatment had been given, where no escalation plan was documented. Using several Plan, Do, Study, Act (PDSA) cycles, drawing tools used in other trusts and departments, and the views of clinicians, we developed a treatment escalation plan (TEP) tool, to be included in the resuscitation form. This included consideration of referral to critical care, ward based non-invasive ventilation, and appropriate use of intravenous or oral antibiotics. This then prompted the responsible clinician to consider and document appropriate escalation of treatment. The CPR-TEP form was trialed using a quasi-experiment design allowing the aim to be tested using two groups - intervention and control. All patients in the intervention group were not for CPR and therefore had their TEP-CPR form filled in fully (n=68). The control group consisted of patients who were not for CPR but who did not have a TEP form filled in (n=36). The appropriateness of OOH (out of hours) treatment in those patients who experienced clinical deterioration was judged by questionnaire-based feedback from the in-hours team the following morning. Levels of inappropriate treatment between the two groups were compared to test the aim. At the end of the study period, questionnaire feedback indicated that 11.1% of patients in the group with the new CPR-TEP document had received inappropriate OOH care compared to 44.4% of patients in the group without the document. Using the TEP

  11. Leading quality through the development of a multi-year corporate quality plan: sharing The Ottawa Hospital experience.

    PubMed

    Hunter, Linda; Myles, Joanne; Worthington, James R; Lebrun, Monique

    2011-01-01

    This article discusses the background and process for developing a multi-year corporate quality plan. The Ottawa Hospital's goal is to be a top 10% performer in quality and patient safety in North America. In order to create long-term measurable and sustainable changes in the quality of patient care, The Ottawa Hospital embarked on the development of a three-year strategic corporate quality plan. This was accomplished by engaging the organization at all levels and defining quality frameworks, aligning with internal and external expectations, prioritizing strategic goals, articulating performance measurements and reporting to stakeholders while maintaining a transparent communication process. The plan was developed through an iterative process that engaged a broad base of health professionals, physicians, support staff, administration and senior management. A literature review of quality frameworks was undertaken, a Quality Plan Working Group was established, 25 key stakeholder interviews were conducted and 48 clinical and support staff consultations were held. The intent was to gather information on current quality initiatives and challenges encountered and to prioritize corporate goals and then create the quality plan. Goals were created and then prioritized through an affinity exercise. Action plans were developed for each goal and included objectives, tasks and activities, performance measures (structure, process and outcome), accountabilities and timelines. This collaborative methodology resulted in the development of a three-year quality plan. Six corporate goals were outlined by the tenets of the quality framework for The Ottawa Hospital: access to care, appropriate care (effective and efficient), safe care and satisfaction with care. Each of the six corporate goals identified objectives and supporting action plans with accountabilities outlining what would be accomplished in years one, two and three. The three-year quality plan was approved by senior

  12. Disaster planning: the past, present, and future concepts and principles of managing a surge of burn injured patients for those involved in hospital facility planning and preparedness.

    PubMed

    Kearns, Randy D; Holmes, James H; Alson, Roy L; Cairns, Bruce A

    2014-01-01

    The 9/11 attacks reframed the narrative regarding disaster medicine. Bypass strategies have been replaced with absorption strategies and are more specifically described as "surge capacity." In the succeeding years, a consensus has coalesced around stratifying the surge capacity into three distinct tiers: conventional, contingency, and crisis surge capacities. For the purpose of this work, these three distinct tiers were adapted specifically to burn surge for disaster planning activities at hospitals where burn centers are not located. A review was conducted involving published plans, other related academic works, and findings from actual disasters as well as modeling. The aim was to create burn-specific definitions for surge capacity for hospitals where a burn center is not located. The three-tier consensus description of surge capacity is delineated in their respective stratifications by what will hereinafter be referred to as the three "S's"; staff, space, and supplies (also referred to as supplies, pharmaceuticals, and equipment). This effort also included the creation of a checklist for nonburn center hospitals to assist in their development of a burn surge plan. Patients with serious burn injuries should always be moved to and managed at burn centers, but during a medical disaster with significant numbers of burn injured patients, there may be impediments to meeting this goal. It may be necessary for burn injured patients to remain for hours in an outlying hospital until being moved to a burn center. This work was aimed at aiding local and regional hospitals in developing an extemporizing measure until their burn injured patients can be moved to and managed at a burn center(s). PMID:23817001

  13. The Power of Advance Care Planning in Promoting Hospice and Out-of-Hospital Death in a Dialysis Unit

    PubMed Central

    Weaner, Barbara B.; Long, Dustin

    2015-01-01

    Abstract Background: Despite mortality rates that exceed those of most cancers, hospice remains underutilized in patients with end-stage renal disease (ESRD) on dialysis and nearly half of all dialysis patients die in the hospital. Objective: To review the impact of advance care planning on withdrawal from dialysis, use of hospice, and location of death. Design: Retrospective review. Setting: A rural outpatient dialysis unit. Participants: Former dialysis patients who died over a 5-year period. Exposure: Advance care planning, the use of physician orders for life-sustaining therapy program (POLST). Main Outcome and Measure: Use of hospice among patients withdrawing from dialysis, location of death. Results: Advance care planning was associated with a low incidence of in-hospital death and among those who withdrew, a high use of hospice. Conclusions and Relevance: Comprehensive and systematic advance care planning among patients with ESRD on dialysis promotes greater hospice utilization and may facilitate the chance that death will occur out of hospital. PMID:25006866

  14. Assessing the planning and implementation strategies for the ICD-10-CM/PCS coding transition in Alabama hospitals.

    PubMed

    Houser, Shannon H; Morgan, Darius; Clements, Kay; Hart-Hester, Susan

    2013-01-01

    Health information management (HIM) professionals play a significant role in transitioning from ICD-9-CM to ICD-10-CM/PCS. ICD-10-CM/PCS coding will impact many operational aspects of healthcare facilities, such as physicians' documentation in health records, coders' process for review of clinical information, the billing process, and the payers' reimbursement to the healthcare facilities. This article examines the level of readiness and planning for ICD-10-CM/PCS implementation among hospitals in Alabama, identifies training methods/approaches to be used by the hospitals, and discusses the challenges to the ICD-10-CM/PCS coding transition. A 16-question survey was distributed to 116 Alabama hospital HIM directors in December 2011 with follow-up through February 2012. Fifty-three percent of respondent hospitals began the planning process in 2011, and most facilities were halfway or less than halfway to completion of specific implementation tasks. Hospital coders will be or are being trained using in-house training, through seminars/webinars, or by consultants. The impact of ICD-10-CM/PCS implementation can be minimized by training coders in advance, hiring new coders, and adjusting coders' productivity measures. Three major challenges to the transition were identified: the need to interact with physicians and other providers more often to obtain information needed to code in ICD-10-CM/PCS systems, education and training of coders and other ICD-10-CM/PCS users, and dependence on vendors for major technology upgrades for ICD-10-CM/PCS systems. Survey results provide beneficial information for HIM professionals and other users of coded data to assist in establishing sound practice standards for ICD-10-CM/PCS coding implementation. Adequate planning and preparation will be essential to the successful implementation of ICD-10-CM/PCS. PMID:23805061

  15. Into the frying pan? Hospitals wary of plan to reform Medicare's contracting rules.

    PubMed

    Lovern, E

    2001-08-13

    Hospital executives have plenty of horror stories to share when the topic is their Medicare fiscal intermediaries. In fact, some facilities have lost millions because of errors by these private contractors. Nevertheless, hospitals remain wary of change. "Sometimes the devil you know is better than the one you don't," one billing consultant says. PMID:11521480

  16. A Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the Congo

    PubMed Central

    Sion, Melanie; Rajan, Dheepa; Kalambay, Hyppolite; Lokonga, Jean-Pierre; Bulakali, Joseph; Mossoko, Mathias; Kwete, Dieudonne; Schmets, Gerard; Kelley, Edward; Elongo, Tarcisse; Sambo, Luis; Cherian, Meena

    2015-01-01

    Abstract Background: The impact of surgical conditions on global health, particularly on vulnerable populations, is gaining recognition. However, only 3.5% of the 234.2 million cases per year of major surgery are performed in countries where the world's poorest third reside, such as the Democratic Republic of the Congo (DRC). Methods: Data on the availability of anesthesia and surgical services were gathered from 12 DRC district hospitals using the World Health Organization's (WHO's) Emergency and Essential Surgical Care Situation Analysis Tool. We complemented these data with an analysis of the costs of surgical services in a Congolese norms-based district hospital as well as in 2 of the 12 hospitals in which we conducted the situational analysis (Demba and Kabare District Hospitals). For the cost analysis, we used WHO's integrated Healthcare Technology Package tool. Results: Of the 32 surgical interventions surveyed, only 2 of the 12 hospitals provided all essential services. The deficits in procedures varied from no deficits to 17 services that could not be provided, with an average of 7 essential procedures unavailable. Many of the hospitals did not have basic infrastructure such as running water and electricity; 9 of 12 had no or interrupted water and 7 of 12 had no or interrupted electricity. On average, 21% of lifesaving surgical interventions were absent from the facilities, compared with the model normative hospital. According to the normative hospital, all surgical services would cost US$2.17 per inhabitant per year, representing 33.3% of the total patient caseload but only 18.3% of the total district hospital operating budget. At Demba Hospital, the operating budget required for surgical interventions was US$0.08 per inhabitant per year, and at Kabare Hospital, US$0.69 per inhabitant per year. Conclusion: A significant portion of the health problems addressed at Congolese district hospitals is surgical in nature, but there is a current inability to meet

  17. European hospital reforms in times of crisis: aligning cost containment needs with plans for structural redesign?

    PubMed

    Clemens, Timo; Michelsen, Kai; Commers, Matt; Garel, Pascal; Dowdeswell, Barrie; Brand, Helmut

    2014-07-01

    Hospitals have become a focal point for health care reform strategies in many European countries during the current financial crisis. It has been called for both, short-term reforms to reduce costs and long-term changes to improve the performance in the long run. On the basis of a literature and document analysis this study analyses how EU member states align short-term and long-term pressures for hospital reforms in times of the financial crisis and assesses the EU's influence on the national reform agenda. The results reveal that there has been an emphasis on cost containment measures rather than embarking on structural redesign of the hospital sector and its position within the broader health care system. The EU influences hospital reform efforts through its enhanced economic framework governance which determines key aspects of the financial context for hospitals in some countries. In addition, the EU health policy agenda which increasingly addresses health system questions stimulates the process of structural hospital reforms by knowledge generation, policy advice and financial incentives. We conclude that successful reforms in such a period would arguably need to address both the organisational and financing sides to hospital care. Moreover, critical to structural reform is a widely held acknowledgement of shortfalls in the current system and belief that new models of hospital care can deliver solutions to overcome these deficits. Advancing the structural redesign of the hospital sector while pressured to contain cost in the short-term is not an easy task and only slowly emerging in Europe. PMID:24703855

  18. Contracting with Medicare Advantage plans: a brief for critical access hospital administrators.

    PubMed

    Mason, Michelle; Fraser-Maginn, Roslyn; Mueller, Keith; King, Jennifer; Radford, Andrea; Slifkin, Rebecca; Lenardson, Jennifer; Silver, Lauren; Mueller, Curt

    2005-12-01

    This document summarizes the experience of CAH administrators with contracts offered by Medicare Advantage (MA) plans. Telephone surveys were conducted with CAH administrators across the country to learn about their experiences with MA plans. This brief includes information about the contract terms administrators have been offered, their experiences negotiating with MA plans, and their advice for others dealing with this issue. PMID:16397967

  19. [Problems in career planning for novice medical technologists in Japanese national hospitals].

    PubMed

    Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki

    2012-12-01

    Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs. PMID:23427696

  20. Advance Care Planning Norms May Contribute to Hospital Variation in End-of-life ICU Use: A Simulation Study

    PubMed Central

    Barnato, Amber E.; Mohan, Deepika; Lane, Rondall K.; Huang, Yue Ming; Angus, Derek C.; Farris, Coreen; Arnold, Robert M.

    2014-01-01

    Background There is wide variation in end-of-life (EOL) intensive care unit (ICU) use among academic medical centers (AMCs). Objective To develop hypotheses regarding medical decision-making factors underlying this variation. Design High-fidelity simulation experiment involving a critically and terminally ill elder, followed by a survey and debriefing cognitive interview and evaluated using triangulated quantitative-qualitative comparative analysis. Setting 2 AMCs in the same state and health care system with disparate EOL ICU use. Subjects Hospital-based physicians responsible for ICU admission decisions. Measurements Treatment plan, prognosis, diagnosis, qualitative case perceptions and clinical reasoning. Main Results Sixty-seven of 111 (60%) eligible physicians agreed to participate; 48 (72%) could be scheduled. There were no significant between-AMC differences in 3-month prognosis or treatment plan, but there were systematic differences in perceptions of the case. Case perceptions at the low-intensity AMC seemed to be influenced by the absence of a DNR order in the context of norms of universal code status discussion and documentation upon admission, whereas case perceptions at the high-intensity AMC seemed to be influenced by the patient’s known metastatic gastric cancer in the context of norms of oncologists’ avoiding code status discussions. Conclusions In this simulation study of 2 AMCs, hospital-based physicians had different perceptions of an identical case. We hypothesize that different advance care planning norms may have influenced their decision-making heuristics. PMID:24615275

  1. Psychiatrist Health Human Resource Planning - An Essential Component of a Hospital-Based Mental Healthcare System Transformation.

    PubMed

    Jarmain, Sarah

    2016-01-01

    The World Health Organization (WHO) defines health human resource planning as "the process of estimating the number of persons and the kinds of knowledge, skills, and attitudes they need to achieve predetermined health targets and ultimately health status objectives" (OHA 2015). Health human resource planning is a critical component of successful organizational and system transformation, and yet little has been written on how to do this for physicians at the local level. This paper will outline a framework for developing and managing key aspects of physician human resource planning related to both the quantity and quality of work within a hospital setting. Using the example of a complex multiphase hospital-based mental health transformation that involved both the reduction and divestment of beds and services, we will outline how we managed the physician human resource aspects to establish the number of psychiatrists needed and the desired attributes of those psychiatrists, and how we helped an existing workforce transition to meet the new expectations. The paper will describe a process for strategically aligning the selection and management of physicians to meet organizational vision and mandate. PMID:26854544

  2. Ketogenic Diet for Children with Epilepsy: A Practical Meal Plan in a Hospital.

    PubMed

    Lee, Eunjoo; Kang, Hoon-Chul; Kim, Heung Dong

    2016-01-01

    A ketogenic diet (KD) is a dietary approach to treat intractable epilepsy. The KD begins with hospitalization and the child and their parents can adapt to the KD for 1-2 weeks. Recently, various type of dietary intervention such as the modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) have been performed. Since 2010, we carried out the KD, MAD, and LGIT for total of 802 patients; 489 patients (61%) for the KD, 147 patients (18.3%) with the MAD, and 166 patients (20.7%) for the LGIT. In this report, application of these dietary practices in Severance Hospital is shared. PMID:26839878

  3. Ketogenic Diet for Children with Epilepsy: A Practical Meal Plan in a Hospital

    PubMed Central

    2016-01-01

    A ketogenic diet (KD) is a dietary approach to treat intractable epilepsy. The KD begins with hospitalization and the child and their parents can adapt to the KD for 1-2 weeks. Recently, various type of dietary intervention such as the modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) have been performed. Since 2010, we carried out the KD, MAD, and LGIT for total of 802 patients; 489 patients (61%) for the KD, 147 patients (18.3%) with the MAD, and 166 patients (20.7%) for the LGIT. In this report, application of these dietary practices in Severance Hospital is shared. PMID:26839878

  4. Effects of an Enhanced Discharge Planning Intervention for Hospitalized Older Adults: A Randomized Trial

    ERIC Educational Resources Information Center

    Altfeld, Susan J.; Shier, Gayle E.; Rooney, Madeleine; Johnson, Tricia J.; Golden, Robyn L.; Karavolos, Kelly; Avery, Elizabeth; Nandi, Vijay; Perry, Anthony J.

    2013-01-01

    Purpose of the Study: To identify needs encountered by older adult patients after hospital discharge and assess the impact of a telephone transitional care intervention on stress, health care utilization, readmissions, and mortality. Design and Methods: Older adult inpatients who met criteria for risk of post-discharge complications were…

  5. 77 FR 24271 - Federal Plan Requirements for Hospital/Medical/Infectious Waste Incinerators Constructed on or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... Emissions D. Emissions Limits E. Compliance Schedules F. Waste Management Plan Requirements G. Testing... limits? C. What are the proposed amendments to the waste management plan requirements? D. What are the..., commercial waste disposal companies, private universities. Federal Government 622110, 541710,...

  6. The new concept of hospital--the strategic plan of the "Policlinico A. Gemelli" and positioning of the reengineering project.

    PubMed

    Cicchetti, A

    1998-01-01

    The innovations introduced in the Italian Health Care System by the legislative decrees No. 502/92 and 517/93 are remarkable, drawing on managerial methods and organizational structure of hospitals. To face this kind of change, in 1995 the "Policlinico A. Gemelli" prepared a five-year Strategic Plan that gave strategical lines and targets to be pursued. This plan has isolated 3 main strategical projects to be implemented with the participation of all medical and managerial professionals operating in the "Policlinico". The most complex project is that of the reengineering of management processes, we expect to end during 1998. The main target is to check the fundamental factors involved with the aim of achieving patient satisfaction as well as a cost-effective management. PMID:9689846

  7. Hospital discharge data used as feedback in planning research and education for primary care.

    PubMed

    Smith, D M; Haupt, B J

    1983-01-01

    Are research and training programs in pediatrics, internal medicine, and obstetrics and gynecology (OB-GYN) comprehensive enough to give trainees proficiency in primary care? Controversy exists about which subject areas should be added to the training schema to make them more applicable in primary care. One approach to this controversy is to use the most frequent of serious patient problems that are outside these disciplines as feedback into the process of selecting areas for more comprehensive training. In this study, patients' serious problems were defined as those requiring hospitalization. Diagnoses from the National Hospital Discharge Survey were grouped into categories of morbidity by age and sex. The most frequent categories outside the three disciplines were identified. For pediatrics these problems were trauma, mental disorders, and unintended pregnancy; for internal medicine, trauma, mental and gynecologic disorders, and unintended pregnancy; for OB-GYN, trauma and mental, cardiovascular, pulmonary, gastrointestinal, and arthritic disorders. Since primary care is largely ambulatory care, the next step in the resolution of the controversy would be to define the competency level needed for the prevention, early recognition, and early management of these disorders in the ambulatory care setting. Once defined, competency levels can be examined among trainees in the three specialties, and areas where competency is found inadequate can be emphasized. Although hospitalization data are not the only logical criteria for choosing areas for emphasis, these feedback data offer a method of integrating patients' most frequent severe problems into the selection process. PMID:6414031

  8. Pre‐pandemic planning survey of healthcare workers at a tertiary care children’s hospital: ethical and workforce issues

    PubMed Central

    Cowden, Jessica; Crane, Lori; Lezotte, Dennis; Glover, Jacqueline; Nyquist, Ann‐Christine

    2010-01-01

    Please cite this paper as: Cowden et al. (2010). Pre‐pandemic planning survey of healthcare workers at a tertiary care children’s hospital: ethical and workforce issues. Influenza and Other Respiratory Viruses 4(4), 213–222. Background  Prior to the development of written policies and procedures for pandemic influenza, worker perceptions of ethical and workforce issues must be identified. Objective  To determine the relationship between healthcare worker (HCW) reporting willingness to work during a pandemic and perception of job importance, belief that one will be asked to work, and sense of professionalism and to assess HCW’s opinions regarding specific policy issues as well as barriers and motivators to work during a pandemic. Methods  A survey was conducted in HCWs at The Children’s Hospital in Denver, Colorado, from February to June 2007. Characteristics of workers reporting willingness to work during a pandemic were compared with those who were unwilling or unsure. Importance of barriers and motivators was compared by gender and willingness to work. Results Sixty percent of respondents reported willingness to work (overall response rate of 31%). Belief one will be asked to work (OR 4·6, P < 0·0001) and having a high level of professionalism (OR 8·6, P < 0·0001) were associated with reporting willingness to work. Hospital infrastructure support staffs were less likely to report willingness to work during a pandemic than clinical healthcare professionals (OR 0·39, P < 0·001). Concern for personal safety, concern for safety of family, family’s concern for safety, and childcare issues were all important barriers to coming to work. Conclusions  Educational programs should focus on professional responsibility and the importance of staying home when ill. Targeted programs toward hospital infrastructure support and patient and family support staff stressing the essential nature of these jobs may improve willingness to work. PMID

  9. 78 FR 28051 - Federal Plan Requirements for Hospital/Medical/Infectious Waste Incinerators Constructed On or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... emissions limits? C. What are the final amendments to the waste management plan requirements? D. What are... research laboratories, commercial waste disposal companies, private universities. 622310 ] 325411 325412... health care facilities, state/local waste disposal services, state universities. 562213 611310 *...

  10. Factors determining the choice of contraceptive methods at the Family Planning Clinic, University College Hospital, Ibadan, Nigeria.

    PubMed

    Konje, J C; Oladini, F; Otolorin, E O; Ladipo, O O

    1998-10-01

    In a study of 2000 women volunteers seeking contraceptive services at the Family Planning Clinic (FPC), University College Hospital, Ibadan, Nigeria, 66.2 per cent chose the intrauterine device (IUD) making it the most common method of contraception. Factors influencing choice of contraceptive methods were advice from friends and family members, intended duration of use and information from the media. Ignorance, fear and unfounded cultural beliefs were factors responsible for the delay in seeking contraceptive advice. The mass media was an important source of information for most of the women. We conclude that the IUD is the contraceptive of choice in our clinic because of the highly selective nature of our clients. In order to provide a service with a broader clientele, we suggest the incorporation of other priority reproductive health services such as cervical and breast cancer screening, prevention and treatment of reproductive tract infections and sexually transmitted diseases including HIV/AIDS. PMID:9855717

  11. Nursing Personnel Planning for Rural Hospitals in Burdwan District, West Bengal, India, Using Workload Indicators of Staffing Needs

    PubMed Central

    Roy, Rabindra Nath; Dasgupta, Samir; Bhattacharyya, Krishna Das; Misra, Raghu Nath; Roy, Sima; Saha, Indranil

    2014-01-01

    ABSTRACT Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO—Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199

  12. Nursing personnel planning for rural hospitals in Burdwan District, West Bengal, India, using workload indicators of staffing needs.

    PubMed

    Shivam, Swapnil; Roy, Rabindra Nath; Dasgupta, Samir; Das Bhattacharyya, Krishna; Misra, Raghu Nath; Roy, Sima; Indranil, Saha

    2014-12-01

    Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO-Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199

  13. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    PubMed

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program. PMID:23924224

  14. Planning, expectation, and image evaluation for PACS at the University of Iowa Hospitals and Clinics

    NASA Astrophysics Data System (ADS)

    Franken, E. A., Jr.; Smith, Wilbur L.; Berbaum, Kevin S.; Owen, David A.; Hilsenrath, Peter

    1990-08-01

    Our strategy in studying PACS is to evaluate its clinical implementation working with equipment supplied by an established manufacturer. Fiscal and personnel resources required to design and integrate the hardware components and operational software to develop a functional PACS precluded a bottom up development approach at our institution. Imaging equipment vendors possess more abundant design development resources for this task and therefore can support a more rapid development of the initial components of PACS. For this reason we have chosen to serve as a beta test site to study the viability of the basic PACS components in a clinical setting. Our efforts primarily focus on: (1) image quality; (2) cost effectiveness; (3) PACS/HIS/RIS integration; (4) equipment and software reliability; and (5) overall system performance. The results of our studies are shared with the vendor for future PACS development and refi nement. To attain our investigational goals we have formed an interdisciplinary team of Radiologists, Perceptual Psychologist, Economist, Electrical and Industrial Engineers, Hospital Information System personnel and key departmental administrative staff. For several reasons Pediatric Radiology was targeted as the initial area for our PACS study: a small area representative of the overall operation,tight operational controls and willingness of physicians. We used a step-wise approach, the first step being the installation of PACS exclusively within the physical confines of Pediatric Radiology.

  15. Can telemonitoring reduce hospitalization and cost of care? A health plan's experience in managing patients with heart failure.

    PubMed

    Maeng, Daniel D; Starr, Alison E; Tomcavage, Janet F; Sciandra, Joann; Salek, Doreen; Griffith, David

    2014-12-01

    Telemonitoring provides a potentially useful tool for disease and case management of those patients who are likely to benefit from frequent and regular monitoring by health care providers. Since 2008, Geisinger Health Plan (GHP) has implemented a telemonitoring program that specifically targets those members with heart failure. This study assesses the impact of this telemonitoring program by examining claims data of those GHP Medicare Advantage plan members who were enrolled in the program, measuring its impact in terms of all-cause hospital admission rates, readmission rates, and total cost of care. The results indicate significant reductions in probability of all-cause admission (odds ratio [OR] 0.77; P<0.01), 30-day and 90-day readmission (OR 0.56, 0.62; P<0.05), and cost of care (11.3%; P<0.05). The estimated return on investment was 3.3. These findings imply that telemonitoring can be an effective add-on tool for managing elderly patients with heart failure. PMID:24865986

  16. Planning and cost analysis of digital radiography services for a network of hospitals (the Veterans Integrated Service Network).

    PubMed

    Duerinckx, A J; Kenagy, J J; Grant, E G

    1998-01-01

    This study analysed the design and cost of a picture archiving and communications system (PACS), computerized radiography (CR) and a wide-area network for teleradiology. The Desert Pacific Healthcare Network comprises 10 facilities, including four tertiary medical centres and one small hospital. Data were collected on radiologists' workloads, and patient and image flow within and between these medical centres. These were used to estimate the size and cash flows associated with a system-wide implementation of PACS, CR and teleradiology services. A cost analysis model was used to estimate the potential cost savings in a filmless radiology environment. ATM technology was selected as the communications medium between the medical centres. A strategic plan and business plan were successfully developed. The cost model predicted the cost-effectiveness of the proposed PACS/CR configuration within four to six years, if the base costs were kept low. The experience gained in design and cost analysis of a PACS/teleradiology network will serve as a model for similar projects. PMID:10321046

  17. A Developmental Curriculum Plan To Achieve a Sequenced Curriculum between High School Courses in Food Preparation and the Mattatuck Community College Hospitality/Food Services Program. Final Report.

    ERIC Educational Resources Information Center

    Mattatuck Community Coll., Waterbury, CT.

    This document contains a developmental curriculum plan for an articulated curriculum in hospitality/food service for Connecticut's Mattatuck Community College and area high schools. The curriculum guide includes a course description, criteria for evaluation, attendance policy, objectives, a curriculum area outline, 17 content area objectives, a…

  18. 77 FR 24451 - Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan for Designated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-24

    ...EPA is proposing to approve, through direct final rulemaking, Illinois' revised State Plan to control air pollutants from Hazardous/ Medical/Infectious Waste Incinerators (HMIWI). The Illinois Environmental Protection Agency submitted the revised State Plan on November 8, 2011 and supplemented it on December 28, 2011, following the required public process. The revised State Plan is consistent......

  19. 77 FR 24451 - Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan for Designated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-24

    ...EPA is proposing to approve, through direct final rulemaking, Indiana's revised State Plan to control air pollutants from Hazardous/ Medical/Infectious Waste Incinerators (HMIWI). The Indiana Department of Environmental Management submitted the revised State Plan on December 19, 2011, following the required public process. The revised State Plan is consistent with Emission Guidelines......

  20. Planned delay of oral intake after esophagectomy reduces the cervical anastomotic leak rate and hospital length of stay.

    PubMed

    Bolton, John S; Conway, William C; Abbas, Abbas E

    2014-02-01

    Cervical anastomotic leak rates are high after esophagectomy. We examined the effect of a purposeful delay in institution of oral diet after esophagectomy on the leak rate and hospital length of stay. A retrospective analysis of 120 patients submitted to esophagectomy with cervical esophagogastric anastomosis was conducted. Eighty-seven resumed diet within 7 days of surgery (early eaters), and 33 had delayed diet until a mean of 12 days after surgery (late eaters). Mean age was 62.3 years; 98 patients were male. One hundred one resections were for cancer, and 49 % of cancer patients received neoadjuvant therapy. The overall leak rate was 17.5 %, and hospital length of stay was 10.9 days. Anastomotic leak rate was 3 % for late eaters versus 23 % for early eaters (OR of 9.57, p = 0.010). Hospital length of stay was 6 days for late eaters versus 11.8 days for early eaters (p < 0.001). Anastomotic leak was significantly associated with increased length of stay (p < 0.001), adding an average of 7.6 days to hospital stay. Respiratory complications (p < 0.001) and delayed gastric emptying (p = 0.014) were also independent predictors of increased length of stay, but early eater status was not. Delayed resumption of oral diet after esophagectomy significantly reduces cervical anastomotic leak rate and avoids the increased length of stay associated with leak. PMID:24002761

  1. Factors Affecting Nurse Staffing in Acute Care Hospitals: A Review and Critique of the Literature. Nurse Planning Information Series 17.

    ERIC Educational Resources Information Center

    Young, John P.; And Others

    A critical review of literature on factors affecting nurse staffing in acute care hospitals, with particular regard for the consequences of a movement from team nursing to primary nursing care, was conducted. The literature search revealed a need for more research on the philosophy of nursing and nursing goals and policy as they relate to nurse…

  2. Integrating an EMR-based Transition Planning Tool for CYSHCN at a Children's Hospital: A Quality Improvement Project to Increase Provider Use and Satisfaction

    PubMed Central

    Wiemann, Constance M.; Hergenroeder, Albert C.; Bartley, Krystle A.; Sanchez-Fournier, Blanca; Hilliard, Marisa E.; Warren, Laura J.; Graham, Sarah C.

    2016-01-01

    An electronic medical record (EMR)-based transition planning tool (TPT) designed to facilitate transition from pediatric to adult-based health care for youth (16–25 years) with special health care needs was introduced at a large children's hospital. Activities to increase provider use were implemented in five plan–do–study–act cycles. Overall, 22 of 25 (88%) consenting providers in four pediatric subspecialty services used the TPT during 303 patient encounters, with nurses and case-managers the top users and physicians the least likely users. Use was highest with intensive technical assistance and following the introduction of an upgraded tool. Provider satisfaction with the TPT and self-reported transition planning activities notably increased across the PDSA cycles. PMID:26209173

  3. International Symposium on Ion Therapy: Planning the First Hospital-Based Heavy Ion Therapy Center in the United States

    PubMed Central

    Laine, Aaron; Pompos, Arnold; Story, Michael; Jiang, Steve; Timmerman, Robert; Choy, Hak

    2015-01-01

    Investigation into the use of heavy ions for therapeutic purposes was initially pioneered at Lawrence Berkeley National Laboratory in the 1970s [1, 2]. More recently, however, significant advances in determining the safety and efficacy of using heavy ions in the hospital setting have been reported in Japan and Germany [3, 4]. These promising results have helped to resurrect interest in the establishment of hospital-based heavy ion therapy in the United States. In line with these efforts, world experts in the field of heavy ion therapy were invited to attend the first annual International Symposium on Ion Therapy, which was held at the University of Texas Southwestern Medical Center, Dallas, Texas, from November 12 to 14, 2014. A brief overview of the results and discussions that took place during the symposium are presented in this article. PMID:27110586

  4. Best practices of hospital security planning for patient surge--a comparative analysis of three national systems.

    PubMed

    Downey, Erin; Hebert, Anjanette

    2010-01-01

    This paper examines three international healthcare security systems as they relate to patient surge in Canada, Israel, and the United States. Its purpose is to compare the systems, to highlight unique characteristics that define those systems, and to initiate the development of best practices that transcend national boundaries. Several significant national characteristics of demographics, healthcare systems, and political climate, among others, present challenges to translating best practices among these three countries. However, we have found that best practice strategies exist in areas of communications, coordination, building design, space adaptability, and patient routing (both from the community to the hospital, as well as within the hospital) that can be shared and incorporated into the healthcare preparedness efforts in all three countries. PMID:20873500

  5. Financial management of hospitals.

    PubMed

    Speranzo, A J

    1984-05-01

    The effect of hospital reimbursement systems on the financial management of hospitals is briefly discussed, and the organization of hospital financial operations is reviewed. The implementation of Medicare prospective pricing will change the way in which hospital finances are managed. Health-care managers will be concerned with the profitability of product lines, or diagnosis-related groups, in future strategic planning efforts. The hospital's finance department consists of several traditional areas that exist in almost all financial organizations. The functions and interactions of these various areas are discussed in light of previous and current hospital reimbursement strategies. Staffing of the finance department and the duties of the hospital's chief financial officer are also described. The prospective pricing system of hospital reimbursement and increasing pressure from the business community to stem the rising costs of health care will produce changes in the medical and financial operations of the hospital industry over the next decade. PMID:6375357

  6. A vision of long-term care. To care for tomorrow's elderly, hospitals must plan now, not react later.

    PubMed

    Kodner, D L

    1989-12-01

    In the next two decades, rapid, fundamental changes will take place in the way we finance, organize, and provide long-term care services. Because the elderly make up such a large portion of the patient population, America's hospitals should be concerned--and involved. There are six keys to the future of long-term care: a sharp increase in elderly population, a new generation of elderly, restrained government role, intergenerational strains, growing corporate concern, and the rise of "gerotechnology." These trends and countertrends will result in a new look in the long-term care landscape. By the year 2010, changes will include a true public-private financing system, provider reimbursement on the basis of capitation and prospective payment, coordinated access to services, dominant alternative delivery systems, a different breed of nursing homes, fewer staffing problems, patient-centered care, a new importance in housing, and an emphasis on prevention. For hospitals, this future vision of long-term care means that significant opportunities will open up to meet the needs of the elderly-at-risk and to achieve a competitive position in the burgeoning elderly care industry. PMID:10313396

  7. Dosimetric Verification of the System of Planning Brainscan for Stereotactic Radiosurgery at Oncology Department of the General Hospital of Mexico

    SciTech Connect

    Alvarez R, J. T.; Salinas, B.; Tovar M, V. M.; Villasenor O, L. F.; Molero M, A. C.

    2006-09-08

    The verification consists on the planning and administration of stereotactic treatments by means of conformed static beams, several polyethylene capsules with powder TLD 100 (type IAEA) located inside the head of a phantom Alderson-Rando. Because the planning system corrects for no-homogeneity in the density from the tomographic information, it is assumed that the absorbed dose in the tumor volume (capsule) corresponds to the dose absorbed to LiF: DLiF. Applying different cavity theories, the percent deviations to the nominal dose are: -1.81%{<=}{delta}%{<=}0.71%, which are consistent with the order of the U%'s. The values of DW are calculated from two calibration curve: TL Response (nC) vs DW for the energy of the 60Co corrected for energy dependence to the accelerator photon beam quality D20/D10=0.57. Once curve for 0.5 to 5 Gy and other for 5 to 35 Gy. The traceability for the Dwater is obtained by means of a secondary standard ionization chamber Farmer PTW 30013 calibrated at the NRC.

  8. Education for Hospital Library Personnel, Continuation of Feasibility Study for Continuing Education of Medical Librarians; Hospital Library Planning Data for the Northeastern Ohio Regional Medical Program. Interim Report No. 3.

    ERIC Educational Resources Information Center

    Rees, Alan M.; And Others

    This document is a guide to hospital library resources in the Northeastern Ohio Regional Medical Program (NEORMP). This information is intended to provide a data base for establishment of a network of hospital libraries linked to the major resource libraries in the region. Data collected in a survey of the 73 hospitals involved in the NEORMP cover…

  9. Hospital diversification strategy.

    PubMed

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger. PMID:25223156

  10. Hospital Library Development. Hospital Library Handbooks No. 2.

    ERIC Educational Resources Information Center

    Cramer, Anne

    Addressed to the administrator of the hospital as well as the librarian, this handbook covers aspects of library service policy and long-range planning. While hospitals of all sizes are discussed, a special effort is made to cover problems of small hospitals (17 to 100 beds) in sparsely-settled regions. Contents: The library as a clinical service,…

  11. Impact of dose rate on accuracy of intensity modulated radiation therapy plan delivery using the pretreatment portal dosimetry quality assurance and setting up the workflow at hospital levels

    PubMed Central

    Kaviarasu, Karunakaran; Raj, N. Arunai Nambi; Murthy, K. Krishna; Babu, A. Ananda Giri; Prasad, Bhaskar Laxman Durga

    2015-01-01

    The aim of this study was to examine the impact of dose rate on accuracy of intensity modulated radiation therapy (IMRT) plan delivery by comparing the gamma agreement between the calculated and measured portal doses by pretreatment quality assurance (QA) using electronic portal imaging device dosimetry and creating a workflow for the pretreatment IMRT QA at hospital levels. As the improvement in gamma agreement leads to increase in the quality of IMRT treatment delivery, gamma evaluation was carried out for the calculated and the measured portal images for the criteria of 3% dose difference and 3 mm distance-to-agreement (DTA). Three gamma parameters: Maximum gamma, average gamma, and percentage of the field area with a gamma value>1.0 were analyzed. Three gamma index parameters were evaluated for 40 IMRT plans (315 IMRT fields) which were calculated for 400 monitor units (MU)/min dose rate and maximum multileaf collimator (MLC) speed of 2.5 cm/s. Gamma parameters for all 315 fields are within acceptable limits set at our center. Further, to improve the gamma results, we set an action level for this study using the mean and standard deviation (SD) values from the 315 fields studied. Forty out of 315 IMRT fields showed low gamma agreement (gamma parameters>2 SD as per action level of the study). The parameters were recalculated and reanalyzed for the dose rates of 300, 400 and 500 MU/min. Lowering the dose rate helped in getting an enhanced gamma agreement between the calculated and measured portal doses of complicated fields. This may be attributed to the less complex motion of MLC over time and the MU of the field/segment. An IMRT QA work flow was prepared which will help in improving the quality of IMRT delivery. PMID:26865759

  12. Preventable hospitalizations and socioeconomic status.

    PubMed

    Blustein, J; Hanson, K; Shea, S

    1998-01-01

    "Preventable" hospitalizations have been proposed as indicators of poor health plan performance. In this study of elderly Medicare beneficiaries, however, we found that preventable hospitalizations are also more common among elders of lower socioeconomic status (SES). The relationship persisted even when an up-to-date severity-of-illness adjustment system was used. To the extent that indicators of health plan "performance" reflect enrollees' characteristics, plans will be rewarded for marketing their services to wealthier, healthier, and better-educated patients. Further work is needed to clarify issues of accountability for preventable hospitalizations and other putative indices of health plan performance. PMID:9558796

  13. Norovirus - hospital

    MedlinePlus

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  14. Hospital successes and failures indicate change in hospital marketing.

    PubMed

    Krampf, R F; Miller, D W

    1993-01-01

    Marketing has become an essential management function for hospitals during the past decade. A number of changes have occurred in hospital marketing as they have progressed through the marketing adoption process. A survey of Hospital CEOs reporting hospital successes and failures in the area of marketing have recently placed emphasis on sales and advertising based upon marketing research programs thus indicating entrance into the "Integrated Tactical Marketing" phase. This study also indicates that a few hospitals have entered the "Strategic Marketing Orientation" phase while future plans reported by the CEOs provide evidence that this trend is likely to continue. PMID:10129242

  15. Future pension accounting changes: implications for hospitals.

    PubMed

    Weld, Tim; Klein, Gina

    2011-05-01

    Proposed rules in accounting for defined benefit plans may affect hospitals' statement of operations and affect the time, effort, and cost to comply with periodic financial reporting requirements. The new standard would require immediate recognition of the full amount of plan amendments in determining operating income. Hospitals should consider the role of pension plans in their compensation programs. PMID:21634266

  16. Mental hospitals in India.

    PubMed

    Krishnamurthy, K; Venugopal, D; Alimchandani, A K

    2000-04-01

    This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present statusThe earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals.Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses. PMID:21407925

  17. Hospitals focus on physician relations.

    PubMed

    Rubright, R

    1987-09-01

    Many hospital administrators are shifting their marketing focus from consumers and referral agents to the hospital's attending physicians. These new comprehensive physician relations or retention programs are much broader than those implemented in the past and are used to build mutual exchanges between hospitals and physicians, sharpen the physicians' awareness of the hospital's most appealing attributes, compete with nearby hospitals that develop their own aggressive physician relations programs, and ensure a more promising financial picture for both parties. "Cutting-edge" physician relations plans in Catholic hospitals include the following: Marketing plans for the medical staff alone or with key medical staff sections; A strong physician data base; A physician referral system; A director of medical affairs; Practice enhancement and business assistance services; A young physicians section; Continuing marketing auditing and research into physicians' opinions, attitudes, and behavior patterns; Physician inclusion in all major programs, services, policies, and events; Programs for physician office staff; Marketing committees consisting of physicians. PMID:10283486

  18. The hospital based staffing agency.

    PubMed

    Manion, J; Reid, S B

    1989-01-01

    Before a hospital considers creating an internal staffing agency, a detailed business plan must be developed. By addressing marketing and operational issues in advance, nurse executives can avoid unnecessary business problems. PMID:2586644

  19. Drug Plan Coverage Rules

    MedlinePlus

    ... works with other insurance Find health & drug plans Drug plan coverage rules Note Call your Medicare drug ... shingles vaccine) when medically necessary to prevent illness. Drugs you get in hospital outpatient settings In most ...

  20. From cottage to community hospitals: Watlington Cottage Hospital and its regional context, 1874-2000.

    PubMed

    Hall, John

    2012-01-01

    The appearance in England from the 1850s of 'cottage hospitals' in considerable numbers constituted a new and distinctive form of hospital provision. The historiography of hospital care has emphasised the role of the large teaching hospitals, to the neglect of the smaller and general practitioner hospitals. This article inverts that attention, by examining their history and shift in function to 'community hospitals'within their regional setting in the period up to 2000. As the planning of hospitals on a regional basis began from the 1920s, the impact of NHS organisational and planning mechanisms on smaller hospitals is explored through case studies at two levels. The strategy for community hospitals of the Oxford NHS Region--one of the first Regions to formulate such a strategy--and the impact of that strategy on one hospital, Watlington Cottage Hospital, is critically examined through its existence from 1874 to 2000. PMID:23057181

  1. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings - Guideline of the German Society for Hospital Hygiene (DGKH).

    PubMed

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section "Ventilation and air conditioning technology" attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care. PMID:26958457

  2. Philanthropy and hospital financing.

    PubMed Central

    Smith, D G; Clement, J P; Wheeler, J R

    1995-01-01

    OBJECTIVE. This study explores the relationships among donations to not-for-profit hospitals, the returns provided by these hospitals, and fund-raising efforts. It tests a model of hospital behavior and addresses an earlier debate regarding the supply price of donations. DATA SOURCES. The main data source is the California Office of Statewide Health Planning data tapes of hospital financial disclosure reports for fiscal years 1980/1981 through 1986/1987. Complete data were available for 160 hospitals. STUDY DESIGN. Three structural equations (donations, returns, and fund-raising) are estimated as a system using a fixed-effects, pooled cross-section, time-series least squares regression. PRINCIPAL FINDINGS. Estimation results reveal the expected positive relation between donations and returns. The reverse relation between returns and donations is insignificant. The estimated effect of fund-raising on donations is insignificantly different from zero, and the effect of donations on fund-raising is negative. Fund-raising and returns are negatively associated with one another. CONCLUSION. The empirical results presented here suggest a positive donations-returns relations and are consistent with a positive supply price for donations. Hospitals appear to view a trade-off between providing returns and soliciting donations, but donors do not respond equally to these two activities. Attempts to increase free cash flow through expansion of community returns or fund-raising activity, at least in the short run, are not likely to be highly successful financing strategies for many hospitals. PMID:8537223

  3. [Problems of collaboration between community and hospital pharmacists for cancer chemotherapy and proposed corrective measures: KJ method based identification and planning workshop].

    PubMed

    Satoh, Hiroki; Miki, Akiko; Maejima, Kazutoshi; Iizuka, Keiko; Yamaga, Shoichi; Sakashita, Kanako; Takano, Yoshihiro; Takahashi, Yoshinori; Tajiri, Kotaro; Takechi, Yoichiro; Shimada, Mitsuaki; Suzuki, Minoru; Sawada, Yasufumi

    2014-01-01

    We conducted a workshop that aimed to address the problems of collaboration between community and hospital pharmacists to provide safe outpatient chemotherapy and promote continuous collaboration. Thirty-nine pharmacists in Gunma were enrolled in the workshop and divided into five groups. Each group comprised similar number of community and hospital pharmacists in the neighboring area. Participants in these groups discussed using the KJ method and identified the following important and urgent problems; "lack of collaboration between hospitals and pharmacies" and "lack of exchanging patients' information, including regimen". To improve collaboration, the participants recommended a workshop or a study group and setting up a hotline, and to exchange patients' information, they proposed to utilize a medicine notebook and reconfirm how to use these notebook. Furthermore, usage of cloud storage as a means to exchange patients' information was discussed. Post-workshop questionnaire revealed that 97% participants acknowledged an increased awareness toward collaboration, and 90% participants were motivated to take more aggressive action for promoting collaboration; whereas, only 53% participants believed that they could summarize the problems and corrective measures in promoting collaboration. The workshop seemed to be productive in identifying the problems of collaboration and improving the awareness and motivation toward collaboration. However, it served only as a "trigger", and therefore it is important for valuable "results" to continuously collaborate face-to-face between community and hospital pharmacists. PMID:24694817

  4. Mother-baby friendly hospital.

    PubMed

    Aragon-choudhury, P

    1996-01-01

    In Manila, the Philippines, the Dr. Jose Fabella Memorial Hospital has been a maternity hospital for 75 years. It averages 90 deliveries a day. Its fees are P200-P500 for a normal delivery and P800-P2000 for a cesarean section. Patients pay what they can and pay the balance when they can. The hospital provides a safe motherhood package that encompasses teaching responsible parenthood, prenatal care, labor, delivery, postpartum care, breast feeding, family planning, and child survival. In 1986, the hospital introduced innovative policies and procedures that promote, protect, and support breast feeding. It has a rooming-in policy that has saved the hospital P6.5 million so far. In the prenatal stage, hospital staff inform pregnant women that colostrum protects the newborn against infections, that suckling stimulates milk production, and that there is no basis to the claim of having insufficient breast milk. Sales representatives of milk substitutes are banned from the hospital. Staff confiscate milk bottles or formula. A lactation management team demonstrates breast feeding procedures. Mothers also receive support on the correct way of breast feeding from hospital staff, volunteers from the Catholic Women's League, consumer groups, and women lawyers. The hospital's policy is no breast milk, no discharge. This encourages mothers to motivate each other to express milk immediately after birth. The hospital has received numerous awards for its breast feeding promotion efforts. UNICEF has designated Fabella Hospital as a model of the Baby-Friendly Hospital Initiative. The hospital serves as the National Lactation Management Education Training Center. People from other developing countries have received training in lactation management here. The First Lady of the Philippines, the First Lady of the US, and the Queen of Spain have all visited the hospital. The hospital has also integrated its existing services into a women's health care center. PMID:12347466

  5. Hospital mergers and market overlap.

    PubMed Central

    Brooks, G R; Jones, V G

    1997-01-01

    OBJECTIVE: To address two questions: What are the characteristics of hospitals that affect the likelihood of their being involved in a merger? What characteristics of particular pairs of hospitals affect the likelihood of the pair engaging in a merger? DATA SOURCES/STUDY SETTING: Hospitals in the 12 county region surrounding the San Francisco Bay during the period 1983 to 1992 were the focus of the study. Data were drawn from secondary sources, including the Lexis/Nexis database, the American Hospital Association, and the Office of Statewide Health Planning and Development of the State of California. STUDY DESIGN: Seventeen hospital mergers during the study period were identified. A random sample of pairs of hospitals that did not merge was drawn to establish a statistically efficient control set. Models constructed from hypotheses regarding hospital and market characteristics believed to be related to merger likelihood were tested using logistic regression analysis. DATA COLLECTION: See Data Sources/Study Setting. PRINCIPAL FINDINGS: The analysis shows that the likelihood of a merger between a particular pair of hospitals is positively related to the degree of market overlap that exists between them. Furthermore, market overlap and performance difference interact in their effect on merger likelihood. In an analysis of individual hospitals, conditions of rivalry, hospital market share, and hospital size were not found to influence the likelihood that a hospital will engage in a merger. CONCLUSIONS: Mergers between hospitals are not driven directly by considerations of market power or efficiency as much as by the existence of specific merger opportunities in the hospitals' local markets. Market overlap is a condition that enables a merger to occur, but other factors, such as the relative performance levels of the hospitals in question and their ownership and teaching status, also play a role in influencing the likelihood that a merger will in fact take place. PMID

  6. Hospital fundamentals.

    PubMed

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID

  7. Hospital Hints

    MedlinePlus

    ... Division of Geriatrics and Clinical Gerontology Division of Neuroscience FAQs Funding Opportunities Intramural Research Program Office of ... have to spend the night in the hospital. Learning more about what to expect and about people ...

  8. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

    It remains an open question whether hospital spending on fundraising efforts to garner philanthropy is a good use of funds. Research and industry reports provide conflicting results. We describe the accounting and data challenges in analysis of hospital philanthropy, which include measurement of donations, measurement of fundraising expenses, and finding the relationships among organizations where these cash flows occur. With these challenges, finding conflicting results is not a surprise. PMID:23614267

  9. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH)

    PubMed Central

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals” (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care. PMID:26958457

  10. No place like the hospital.

    PubMed

    Gillick, Muriel R; Sabin, James E

    2011-10-01

    The gold standard for end-of-life care is home hospice. A case is presented in which a patient dying of irreversible small bowel obstruction from metastatic cancer insisted on remaining in the acute care hospital for care when alternative sites of care, including a skilled nursing facility and residential hospice, were available to her and covered by her health insurance plan. The ethical issues raised by this case are discussed from the perspective of the patient, the clinical team, the hospital, and the insurance company. Over the past decade, hospital-based palliative care consultation and general inpatient hospice care have sought to improve the quality of dying in the hospital. To the extent that such efforts have been successful, they may result in increasing demand for the hospital as the site for terminal care in the future. PMID:21889294

  11. [Laennec Hospital].

    PubMed

    Dauphin, A; Mazin-Deslandes, C

    2000-01-01

    When the Laennec Hospital of Paris closed, after 366 years of activities for the patients, the articles about the circumstances of the foundation and the main stapes of the institution which became an very famous university hospital it present the available information of the history of the apothecaries, of the "gagnants-maitrise", pharmacists and the pharmacy's interns who succeeded themselves to create and dispense the medicaments necessary to the patients hospitalized or welcomed in ambulatory. It describes the evolution of the places, of the material, of forms, of the organization, of the medicaments and of the missions of what became the Pharmacy department after the recent individualization of the biological analysis in the biochemistry. PMID:11625687

  12. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened

  13. The Status of Hospital Information Systems in Iranian Hospitals

    PubMed Central

    Jahanbakhsh, Maryam; Sharifi, Mohammed; Ayat, Masar

    2014-01-01

    Background: The area of e-Health is broad and has an excellent growth potential. An increasing number of experts believe that e-Health will fuel the next breakthroughs in health system improvements throughout the world, but there is frequent evidence of unsustainable use of e-Health systems in medical centres, particularly hospitals, for different reasons in different countries. Iran is also a developing country which is presently adopting this promising technology for its traditional healthcare delivery but there is not much information about the use of e-Health systems in its hospitals, and the weakness and opportunities of utilization of such Hospital Information Systems (HIS). Methods: For this research, a number of Hospitals from Isfahan, Iran, are selected using convenient sampling. E-health research professionals went there to observe their HIS and collect required data as a qualitative survey. The design of interview questions was based on the researchers’ experiences and knowledge in this area along with elementary interviews with experts on HIS utilization in hospitals. Results: Efficient administration of e-health implementation improves the quality of healthcare, reduces costs and medical errors, makes healthcare resources available to rural areas, etc. However, there are numerous issues affecting the successful utilization of e-health in Hospitals, such as a lack of a perfect HIS implementation plan and well-defined strategy, inadequate IT-security for the protection of e-health-related data, improper training and educational issues, legal challenges, privacy concerns, improper documentation of lessons learned, resistance to the application of new technologies, and finally a lack of recovery plan and disaster management. These results along with some informative stories are extracted from interview sessions to uncover associated challenges of HIS utilization in Iranian hospitals. Conclusion: The utilization of e-health in Iranian hospitals

  14. Dosimetric Verification of the System of Planning Brainscan for Stereotactic Radiosurgery at Oncology Department of the General Hospital of México

    NASA Astrophysics Data System (ADS)

    Álvarez R., J. T.; Villaseñor O., L. F.; Molero M., A. C.; Salinas, B.; Tovar M., V. M.

    2006-09-01

    The verification consists on the planning and administration of stereotactic treatments by means of conformed static beams, several polyethylene capsules with powder TLD 100 (type IAEA) located inside the head of a phantom Alderson-Rando. Because the planning system corrects for no-homogeneity in the density from the tomographic information, it is assumed that the absorbed dose in the tumor volume (capsule) corresponds to the dose absorbed to LiF: DLiF. Applying different cavity theories, the percent deviations to the nominal dose are: -1.81%⩽Δ%⩽0.71%, which are consistent with the order of the U%'s. The values of DW are calculated from two calibration curve: TL Response (nC) vs DW for the energy of the 60Co corrected for energy dependence to the accelerator photon beam quality D20/D10=0.57. Once curve for 0.5 to 5 Gy and other for 5 to 35 Gy. The traceability for the Dwater is obtained by means of a secondary standard ionization chamber Farmer PTW 30013 calibrated at the NRC.

  15. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  16. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  17. [Change in number of residents who plan to specialize in cerebrovascular disease and neurointervention in the Department of Neurology of Kyushu University Hospital].

    PubMed

    Matsumoto, Shoji

    2014-01-01

    As an example of the Neurology Department of the University, I will report on the human resources education and changes in the number of young neurologists who want to specialize in cerebrovascular disease and neurointervention therapy in the Department of Neurology of Kyushu University. In our department, 12% (14/116) of residents planned to specialize in cerebrovascular diseases and 9% (11/116) of residents wanted to learn neurointerventional therapy. These rates are not high. However, in the past year, four out of seven residents want to specialize in cerebrovascular diseases and all want to learn neurointerventional therapy. It is possible that advances in neurointerventional therapy have influenced young neurologists. It is necessary to develop a system that encourages young neurologists to undertake these specializations in universities all over Japan. PMID:25672746

  18. Strategic management of Public Hospitals' medical services.

    PubMed

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction. PMID:27273960

  19. Standards for hospital libraries 2002.

    PubMed

    Gluck, Jeannine Cyr; Hassig, Robin Ackley; Balogh, Leeni; Bandy, Margaret; Doyle, Jacqueline Donaldson; Kronenfeld, Michael R; Lindner, Katherine Lois; Murray, Kathleen; Petersen, JoAn; Rand, Debra C

    2002-10-01

    The Medical Library Association's "Standards for Hospital Libraries 2002" have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plans, the promotion and publicity of the knowledge-based information services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs; patients; and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges. PMID:12398254

  20. [Flexibility and safety in hospitals].

    PubMed

    Fara, G M; Barni, M

    2011-01-01

    The paper explains the reasons according to which the newly-planned hospitals must adopt the concept of advanced flexibility (structural, technological, organizational, diagnostic and therapeutic), in order to avoid the risk of being already obsolete at the moment of their opening, and this due to the fact that too much time elapses in this Country between the moment of planning a new hospital and the moment of the start of its activity. Flexibility is needed at different levels: at low or medium levels for what concerns administrative spaces and also patient rooms (except, in this latter case, when differential intensity of care is adopted); at advanced levelfor what concerns diagnostic and therapeutic areas, which must be rapidly adaptable to new solutions offered by advances in technology and organization. From a different standpoint, flexibility applies also to the fact that hospital must increasingly become a node of a large net including territorial health services: the latter devoted to take care of chronicity, while hospitals should concentrate on acute pathology. Of course the territory surrounding the hospital, through its outpatient service and consultories, is in charge also for first level diagnosy and therapy, leaving the hospital to more sophisticated activities. PMID:21770227

  1. What is your hospitality quotient?

    PubMed

    DeSilets, Lyn

    2015-03-01

    In addition to the behind-the-scenes work involved with planning and implementing continuing nursing education activities, there are additional ways we can enhance the learner's experience. This article presents ideas on how to improve your hospitality quotient. PMID:25723328

  2. Determinants of hospital utilization in the Netherlands.

    PubMed

    van der Gaag, J; Rutten, F F; van Praag, B M

    1975-01-01

    Hospital use in the Netherlands is examined in a cross-section analysis of 1969 and 1971 data for 120 service regions. Elasticities of admissions with respect to bed supply and supply of general practitioners are calculated, and the substitutability of first level care (by general practitioners) for hospital care is considered. Substitution effects found indicate that the Dutch government's plan to reduce the ratio of hospital beds to population is feasible. PMID:1225868

  3. [General coordination of hospital activity].

    PubMed

    Rodríguez, Paz; Serra, José Antonio

    2005-03-01

    The present article describes the organizational and general coordination measures taken by the hospital management to attend the 325 victims who arrived at our hospital after the terrorist attack on the morning of 11 March. Firstly, we summarize the activity performed by the extra-hospital emergency services and the distribution of the victims in centers. Secondly, we describe in greater detail the interventions performed to initiate the External Emergency Action Plan in our hospital, the triage system and identification of patients who used it, as well as the resources in terms of beds, operating rooms and personnel that were used on that day. Lastly, by way of discussion, we provide a critical analysis of our interventions. PMID:15771833

  4. Hospital Organization, Administration and Wellness Programming.

    ERIC Educational Resources Information Center

    Fleming, Jeanne Hmura

    1984-01-01

    Hospital organization, administration and planning, and implementation program procedures are reviewed in this article. Hospitals and medical centers are changing their strategies in the area of wellness programming since they offer the appropriate facilities for these programs. Various types of wellness programs currently being promoted are…

  5. Promoting Regional Disaster Preparedness among Rural Hospitals

    ERIC Educational Resources Information Center

    Edwards, Janine C.; Kang, JungEun; Silenas, Rasa

    2008-01-01

    Context and Purpose: Rural communities face substantial risks of natural disasters but rural hospitals face multiple obstacles to preparedness. The objective was to create and implement a simple and effective training and planning exercise to assist individual rural hospitals to improve disaster preparedness, as well as to enhance regional…

  6. Customer satisfaction: a practical approach for hospitals.

    PubMed

    VanderVeen, L; Ritz, M

    1996-01-01

    A California hospital developed a program to better serve and satisfy its customers. This article details the hospital's plan to implement the program with the collection and use of data to measure success, promote staff accountability, and, ultimately, demonstrate improved customer satisfaction as measured by fewer complaints. The various activities initiated to promote staff education and recognize employees also are briefly addressed. PMID:10157248

  7. Alligators, hospital birth and other urban legends.

    PubMed

    Cohain, Judy Slome

    2012-05-01

    The belief that hospital birth for low risk pregnancies has better outcomes than planned, attended homebirth is an urban legend. The choice of low-risk women to deliver in hospital is a result of the dominant and irrational human propensities to gossip, to follow the crowd and to cling to irrational hope. Rational analysis shows that planned homebirth with experienced trained attendants has the best outcomes for both mother and newborn for low risk pregnancy. PMID:22550002

  8. 42 CFR 456.180 - Individual written plan of care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.180 Individual written plan of care. (a) Before admission to a mental hospital...

  9. 42 CFR 456.180 - Individual written plan of care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.180 Individual written plan of care. (a) Before admission to a mental hospital...

  10. 42 CFR 456.180 - Individual written plan of care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.180 Individual written plan of care. (a) Before admission to a mental hospital...

  11. Standards for hospital libraries 2002

    PubMed Central

    Gluck, Jeannine Cyr; Hassig, Robin Ackley; Balogh, Leeni; Bandy, Margaret; Doyle, Jacqueline Donaldson; Kronenfeld, Michael R.; Lindner, Katherine Lois; Murray, Kathleen; Petersen, JoAn; Rand, Debra C.

    2002-01-01

    The Medical Library Association's “Standards for Hospital Libraries 2002” have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plans, the promotion and publicity of the knowledge-based information services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs; patients; and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges. Editor's Note: The “Standards for Hospital Libraries 2002” were approved by the members of the Hospital Library Section during MLA '02 in Dallas, Texas. They were subsequently approved by Section Council and received final approval from the MLA Board of Directors in June 2002. They succeed the Standards for Hospital Libraries

  12. Hospitals for sale.

    PubMed

    Costello, Michael M; West, Daniel J; Ramirez, Bernardo

    2011-01-01

    The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve. PMID:21864058

  13. 37. Roof Plan, Ground Floor Plan, Sections,and Details. Addition to ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    37. Roof Plan, Ground Floor Plan, Sections,and Details. Addition to Bacteriology Laboratory at Letterman General Hospital, San Francisco, Cal. June 1915. BUILDING 1006. - Presidio of San Francisco, Letterman General Hospital, Building No. 27, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  14. Potential for Hospital Based Corneal Retreival in Hassan District Hospital

    PubMed Central

    Melsakkare, Suresh Ramappa; Manipur, Sahana R.; Acharya, Pavana; Ramamurthy, Lakshmi Bomalapura

    2015-01-01

    Context In developing countries, corneal diseases are the second leading cause of blindness. This corneal blindness can be treated through corneal transplantation. Though the present infrastructure is strong enough to increase keratoplasty numbers at a required rate, India has largest corneal blind population in the world. So a constant supply of high quality donor corneal tissue is the key factor for reduction of prevalence of corneal blindness. Considering the magnitude of corneal blindness and shortage of donor cornea, there is a huge gap in the demand and supply. Aim To study the potential for hospital based retrieval of donor corneal tissue in Hassan district hospital after analysing the indicated and contraindicated causes of deaths, so that hospital corneal retrieval program in Hassan district hospital can be planned. Materials and Methods The cross-sectional, retrospective and record-based study included all hospital deaths with age group more than two years occurred during one year period (January 2014 to December 2014). Data regarding demographic profile, cause of death, treatment given and presence of any systemic diseases were collected. The causes of deaths which are contraindicated for the retrieval of corneas were analysed and noted. The contraindications were based on the NPCB guidelines for standard of eye banking in India 2009. Results Out of 855 deaths, number of deaths in males (565) was greater than females (290). Numbers of deaths were highest between 41-60 years age group (343). Deaths due to HIV, septicaemia, meningitis, encephalitis, disseminated malignancies were contraindicated for corneal retrieval. Corneas could be retrieved from 736 deaths out of 855. Potential for corneal retrieval in a period of one year in Hassan District hospital was 86%. Conclusion Hospital corneal retrieval program has got a great potential to bridge the gap between the need for the cornea and actually collected corneas which will contribute enormously in

  15. 5. TERRACE AT HOSPITAL CORPS BARRACKS AND WALKS AND STEPS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. TERRACE AT HOSPITAL CORPS BARRACKS AND WALKS AND STEPS AT OFFICER'S QUARTERS; PLOT PLAN AND PLANS, SECTIONS, AND DETAILS, DRAWING NO. NH16/N4-2(7) - U.S. Naval Hospital, Corps Barracks, Park Boulevard, Balboa Park, San Diego, San Diego County, CA

  16. Managed care's price bargaining with hospitals.

    PubMed

    Wu, Vivian Y

    2009-03-01

    Research has shown that managed care (MC) slowed the rate of growth in health care spending in the 1990s, primarily via lower unit prices paid. However, the mechanism of MC's price bargaining has not been well studied. This article uses a unique panel dataset with actual hospital prices in Massachusetts between 1994 and 2000 to examine the sources of MC's bargaining power. I find two significant determinants of price discounts. First, plans with large memberships are able to extract volume discounts across hospitals. Second, health plans that are more successful at channeling patients can extract greater discounts. Patient channeling can add to the volume discount that plans negotiate. PMID:19108922

  17. Marketing strategy determinants in rural hospitals.

    PubMed

    Smith, H L; Haley, D; Piland, N F

    1993-01-01

    Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed. PMID:10135505

  18. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Secretary designates as requiring inpatient care. (o) Hospital outpatient services furnished to SNF... comprehensive care plan (and thus included under the SNF PPS) that are furnished by the hospital “under arrangements” but billable only by the SNF, regardless of whether or not the patient is in a Part A SNF...

  19. Can hospitals compete on quality? Hospital competition.

    PubMed

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples. PMID:25711185

  20. 42 CFR 456.501 - UR plans as a condition for FFP.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals § 456.501 UR plans as a condition for FFP. (a) Except... services furnished by a hospital or mental hospital unless the facility has in effect a UR plan that...

  1. Hospital-acquired pneumonia

    MedlinePlus

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  2. [Role of the hospital director: an interorganizational comparison].

    PubMed

    Stern, Z; Nirel, N

    1993-11-01

    This study analyzes the role of the medical director of general hospitals in Israel. 26 directors of general hospitals were interviewed, of whom 7 managed independent or nonprofit hospitals, and 19 government or Kupat Holim Clalit hospitals. In Israel, hospital directors deal mainly with issues referred to in the literature as the "production" of hospital outputs and spend less time adapting the hospital to its changing environment. Accordingly, hospital directors spend only one-fifth of their time outside the hospital negotiating with outside agencies, and half of their time in their offices. More than 2/3 of the directors expressed dissatisfaction with the way they allocated their time, and said they would prefer to spend more time on long-term planning, quality control, and professional development, and less on ongoing operation. The management style of directors of independent hospitals was less centralized and they perceived themselves as having more authority than did directors of hospitals which are part of large, public, multihospital organizations. The independence of hospitals and the creation of a more competitive hospital market may make adapting the hospital to its changing environment a central part of the hospital director's agenda. Moreover, as hospitals gain more independence, directors will be granted broader authority and will have to assume more responsibility. These changes will require directors to adopt a different managerial orientation than that indicated by the findings of this study. PMID:8253426

  3. Disaster preparedness: emergency planning in the NICU.

    PubMed

    Phillips, Pamela; Niedergesaess, Yvonne; Powers, Richard; Brandt, Roberta

    2012-01-01

    Hospital emergency management has evolved beyond satisfying regulatory requirements. Although tools and resources have been developed to support hospitals in emergency planning, there appears to be a scarcity of resources to guide hospital departments. To ensure that standards of care are maintained and to minimize the impact on the hospital and/ or a nursing unit, Good Samaritan Hospital has developed a mobile emergency system and an Emergency Operations Plan (EOP) template to assist other nursing units in their planning efforts. This article focuses on the development of emergency bedside backpacks, mobile disaster boxes, disaster documentation and forms go-kits, and guidelines for creating such a plan. The ongoing equipment testing, inventory rotation, staff training, and exercising response protocols are all crucial to test the effectiveness of the program in place. All these activities require a multidisciplinary approach to ensure integration with hospital-wide emergency planning efforts. PMID:22232036

  4. Participatory management at Boston's Beth Israel Hospital.

    PubMed

    Rabkin, M T; Avakian, L

    1992-05-01

    In the mid-1980s, the senior management of Boston's Beth Israel Hospital became concerned that continuous cost-cutting efforts could lower the quality of the hospital's services and the morale of its staff. This led them to investigate organizational approaches to "participatory management" to determine whether any of these might be of value to the hospital. They decided that an approach developed in the 1930s called the "Scanlon Plan" would be compatible with the workplace culture of Beth Israel, could help the hospital meet the ongoing problems of change, and could help the staff at all levels develop a sense that they owned the problems of quality, productivity, and efficiency, which would motivate them to address these problems constructively in the face of necessary budget constraints. This plan has two mechanisms to foster employees' positive participation: (1) a process to ensure that all members of the organization have the opportunity to improve productivity, primarily through an open suggestion system and a responsive committee structure, and (2) a means of providing equitable rewards for all members of the organization as productivity and quality improve. This essay describes in some detail the plan and why it was selected, explains how it was adapted, prepared for, and finally implemented in 1989, and reports its success, lessons learned, and future plans as of early 1992. The authors believe Beth Israel's experience with the Scanlon Plan is noteworthy as an example of a leading teaching hospital's taking a quality improvement program seriously and making it work. PMID:1575858

  5. How to choose a health plan

    MedlinePlus

    ... health services covered by the plan. Thanks to health care reform, most plans must now cover the same basic services. This includes preventive care, hospital care, maternity care, mental health care, lab tests, and prescription drugs. Some services ...

  6. 42 CFR 412.130 - Retroactive adjustments for incorrectly excluded hospitals and units.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the inpatient population the hospital planned to treat during that cost reporting period, if the inpatient population actually treated in the hospital during that cost reporting period did not meet the... under § 412.29(c) regarding the inpatient population the hospital planned to treat in that unit...

  7. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

    Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

    2004-01-01

    Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

  8. Hospital marketing revisited.

    PubMed

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

  9. Hospital Library Administration.

    ERIC Educational Resources Information Center

    Cramer, Anne

    The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

  10. [Remote radiation planning support system].

    PubMed

    Atsumi, Kazushige; Nakamura, Katsumasa; Yoshidome, Satoshi; Shioyama, Yoshiyuki; Sasaki, Tomonari; Ohga, Saiji; Yoshitake, Tadamasa; Shinoto, Makoto; Asai, Kaori; Sakamoto, Katsumi; Hirakawa, Masakazu; Honda, Hiroshi

    2012-08-01

    We constructed a remote radiation planning support system between Kyushu University Hospital (KUH) in Fukuoka and Kyushu University Beppu Hospital (KBH) in Oita. Between two institutions, radiology information system for radiotherapy division (RT-RIS) and radiation planning system (RTPS) were connected by virtual private network (VPN). This system enables the radiation oncologists at KUH to perform radiotherapy planning for the patients at KBH. The detail of the remote radiation planning support system in our institutions is as follows: The radiation oncologist at KBH performs radiotherapy planning and the data of the patients are sent anonymously to the radiation oncologists at KUH. The radiation oncologists at KUH receive the patient's data, access to RTPS at KBH, verify or change the radiation planning at KBH: Radiation therapy is performed at KBH according to the confirmed plan by the radiation oncologists at KUH. Our remote radiation planning system is useful for providing radiation therapy with safety and accuracy. PMID:23157128

  11. Using Performance Data to Identify Preferred Hospitals

    PubMed Central

    Rosenthal, Meredith B; Landrum, Mary Beth; Meara, Ellen; Huskamp, Haiden A; Conti, Rena M; Keating, Nancy L

    2007-01-01

    Objective To explore the implications of current approaches used by health plans and purchasers to identify preferred hospitals for tiered networks using cost and quality information. Data Sources/Study Setting 2002 secondary data from WebMD Quality Services on hospital quality and costs in five markets (Boston, Miami, Phoenix, Seattle, and Syracuse). Study Design We compared four alternative tiering strategies that combine information on quality and cost to designate “preferred” (defined as ranking in the top quartile) hospitals. Within each market we identified the sets of hospitals designated preferred according to each strategy and examined the overlap in these sets across strategies. Principal Findings Compared with identifying preferred hospitals based on quality scores only, we found little overlap with the sets of hospitals that would be preferred based on cost scores only, cost scores after applying minimal quality standards, and an equally weighted quality and cost measure. The last two approaches, commonly used and intuitively appealing strategies to identify high-value hospitals, led to substantially different results. Conclusions The lack of agreement among alternative strategies to combine cost and quality data for ranking hospitals suggests the need for clear prioritization by payers and the application of more rigorous methods to identify high-value hospitals. PMID:17995555

  12. Two years into the storm over pricing to and collecting from the uninsured--a hospital valuation expert examines the risk/return dynamics and asks: would fair pricing and fair medical debt repayment plans increase yields to hospitals and simultaneously mitigate these controversies?

    PubMed

    Unland, James J

    2005-01-01

    As the controversies over 501(c)(3) "charitable" hospitals' pricing, collections, and charity care practices that emerged in the winter and spring of 2003 continue unabated--now involving government officials from city councils and county boards to state attorneys general and Congress as well as numerous class action lawsuits--a hospital valuation expert and risk analyst looks at the fundamental economic and strategic issues, concluding that the risk/return dynamics are out of whack in that hospitals are facing mushrooming, multifaceted troubles over what has been a very low net yield patient population. After interviewing patient account representatives at hospitals and conducting other research, this analyst asks: Should attention have been focused at the national and state hospital association levels in 2003 to take steps to increase the net yield to hospitals from the uninsured population through more equitable pricing and better medical debt repayment terms, steps that might have mitigated these controversies? Many hospitals and hospital associations have been so intent on proving hospitals' legal right to charge "list price" to and sue the uninsured that they have overlooked a simple yet effective business premise that many hospital patient accounts representatives already fully know: Fair pricing and fair payment terms are actually good business. The author asserts that the controversies that emerged in 2003 actually represented a significant opportunity that, with a different approach, would likely have resulted in hospitals being able to collect significantly more money from the uninsured population while, at the same time, lessening or even avoiding the destructive ramifications that have occurred in the form of investigations, legislation, and lawsuits. To realize higher net yields from the uninsured, highly specific leadership steps need to be taken uniquely at national and state "association" levels in order to avoid the negative financial consequences

  13. The politics of local hospital reform: a case study of hospital reorganization following the 2002 Norwegian hospital reform

    PubMed Central

    2009-01-01

    Background The Norwegian hospital reform of 2002 was an attempt to make restructuring of hospitals easier by removing politicians from the decision-making processes. To facilitate changes seen as necessary but politically difficult, the central state took over ownership of the hospitals and stripped the county politicians of what had been their main responsibility for decades. This meant that decisions regarding hospital structure and organization were now being taken by professional administrators and not by politically elected representatives. The question raised here is whether this has had any effect on the speed of restructuring of the hospital sector. Method The empirical part is a case study of the restructuring process in Innlandet Hospital Trust (IHT), which was one of the largest enterprise established after the hospital reform and where the vision for restructuring was clearly set. Different sources of qualitative data are used in the analysis. These include interviews with key actors, observational data and document studies. Results The analysis demonstrates how the new professional leaders at first acted in accordance with the intentions of the hospital reform, but soon chose to avoid the more ambitious plans for restructuring the hospital structure and in fact reintroduced local politics into the decision-making process. The analysis further illustrates how local networks and engagement of political representatives from all levels of government complicated the decision-making process surrounding local structural reforms. Local political representatives teamed up with other actors and created powerful networks. At the same time, national politicians had incentives to involve themselves in the processes as supporters of the status quo. Conclusion Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate

  14. 5 CFR 890.905 - Limits on inpatient hospital and physician charges.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Limits on inpatient hospital and... Inpatient Hospital Charges, Physician Charges, and FEHB Benefit Payments § 890.905 Limits on inpatient hospital and physician charges. (a) Hospitals may not collect from FEHB plans and retired...

  15. Sterilization and contraceptive services in Catholic hospitals.

    PubMed

    O'Lane, J M

    1979-02-15

    Sterilization and contraceptive practices in United States Catholic hospitals were surveyed by anonymous mail questionnaires, obtaining a 57% response rate (340 of 598). Twenty per cent of the hospitals permitted medically indicated sterilization operations. Forty-seven per cent of those hospitals not allowing sterilization procedures reported that their medical staffs were interested in performing medically indicated sterilizations. The types of contraceptive services offered varied widely. The rhythm method was most frequently available, with oral contraceptives in second place; many hospitals did not provide any family-planning services; 13% utilized all types of contraception. The thesis is advanced that improvement in availability of sterilization and contraceptive services is a duty of hospital medical staffs. PMID:433994

  16. A managerial accounting analysis of hospital costs.

    PubMed

    Frank, W G

    1976-01-01

    Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed. PMID:965233

  17. Hospital response during the Red Dragon drill.

    PubMed

    Martz, Marcum D; Moulder, John E; Knight-Wiegert, Kimberly

    2011-05-01

    From March 2009 to June 2009, a series of drills involving a hypothetical radiological dispersal device (RDD) detonation were conducted in the metropolitan area of Milwaukee, Wisconsin. Named Red Dragon, the drill constituted the largest multi-agency RDD scenario attempted to date in the United States. Froedtert Hospital and the Children's Hospital of Wisconsin comprise the Level One trauma center that served as the site for triage, decontamination, and treatment of approximately 80 victims who participated in the exercise. Examined are hospital resources, plans, interaction with external agencies, communications, and lessons learned. PMID:21451308

  18. Leveraging hospital formularies for improved prescribing.

    PubMed

    Karas, Albert; Kuehl, Bonnie

    2014-01-01

    Hospital formularies, guided by the Pharmacy and Therapeutics Committee, exist to optimize medication use by identifying and designating drugs of choice to guide rational prescribing, ultimately reducing patient risk and costs and improving patient outcomes. Guidelines and a framework exist to guide critical evaluations of medications for formulary listing; however, there may be opportunities to improve and standardize how a formulary change could be instituted in Canadian hospitals. A formulary change at an Ontario hospital revealed that there are some key challenges to the formulary change process including the importance of a robust project plan, appropriate resources, healthcare staff education, and acceptance. PMID:25046967

  19. [Hospital comparison--status quo and prospects].

    PubMed

    Betzler, M; Haun, P

    1998-12-01

    Hospitals are competing with each other for the limited financial resources available in the health care sector. Comparison of hospitals is legally required (BPf1V section 5) to improve financial efficiency in the health care sector and make competition between hospitals keener, while also objectivizing it. If comparison of the hospitals is really to enhance profitability or efficiency, and not just to reduce the prices for hospital stays regardless of quality, it must extend to far more than the global figures in the compilation summarizing performance and calculation and the hospital statistics (no. of cases, days of care, length of stay, case lump sums and special fees). Documentation of particular features of the patient population, the potentials of the hospital and description of the treatment processes yield valuable information on capacity and performance level. With rising costs, the danger is growing that the quality and risk dimension of the actual medical treatment will not be promoted with the same enthusiasm by those offering the service. Hospital audit does not only allow a check on the hospital's own situation with regard to performance, quality, efficiency and patient satisfaction, but can also provide a basis of structural planning. The fact is that all efforts made and steps taken by the responsible persons in the hospital to improve the quality of structures, processes and results can only be successful if they are also perceived by the patients, the doctors who refer them and the visitors. If hospital audit is restricted to the bed occupancy and the invoicing data, it is only realistic to expect cuts in performance level. This would be bad for the patient and, in view of the consequent costs, also for the overall costs in the health care sector. Against the backdrop of a future performance-related system of remuneration instead of the principle of covering one's own costs that has been in place hitherto, openness about treatment results gains

  20. The impact of policy on hospital productivity: a time series analysis of Dutch hospitals.

    PubMed

    Blank, Jos L T; Eggink, Evelien

    2014-06-01

    The health care industry, in particular the hospital industry, is under an increasing degree of pressure, by an ageing population, advancing expensive medical technology a shrinking labor. The pressure on hospitals is further increased by the planned budget cuts in public spending by many current administrations as a result of the economic and financial crises. However, productivity increases may alleviate these problems. Therefore we study whether productivity in the hospital sector is growing, and whether this productivity growth can be influenced by government policy. Using an econometric time series analysis of the hospital sector in the Netherlands, productivity is estimated for the period 1972-2010. Then, productivity is linked to the different regulation regimes during that period, ranging from output funding in the 1970s to the current liberalized hospital market. The results indicate that the average productivity of the hospital sector in different periods differs and that these differences are related to the structure of regulation in those periods. PMID:24258183

  1. A new hospital library: a marketing opportunity.

    PubMed

    Walker, M E

    1995-07-01

    A new or remodeled library presents a unique marketing opportunity for the hospital librarian. Furthermore, a well-designed library markets itself through its convenience, attractiveness, and ease of use. A marketing approach to library planning takes into account needs of users and of library staff and considers the librarian's relations with the architect as well as with hospital employees. This paper describes ways to combine library planning with marketing techniques and specifies aspects of the library that contribute to its good image. PMID:7581190

  2. A Study of an Emerging Hospital Service

    PubMed Central

    Meier, Gitta; Eliot, Johan W.; Hoffman, Sybil

    1967-01-01

    This report presents the methodologic problems of a 1964 study of family planning assistance given in one midwestern metropolitan area in 20 hospitals that had obstetrics residencies; assesses the ability of administrators, obstetrics chiefs, and other staff members to estimate numbers and characteristics of patients served, in the absence of systematic records of family planning services; and discusses the nature, origin, and operation of policies on family planning assistance. The widespread lack of specific policies, other than negative policies in Catholic hospitals, resulted in great variety and unevenness in amount and type of, and indications for, family planning service. Staff members themselves suggested many needed improvements with respect to indications for family planning assistance and extent and type of service provided. Numerous correctable deficiencies remain. However, since 1964, some obstetrics departments have been able to implement some of these suggestions, and major new family planning programs, publicly and governmentally supported, are estimated to have doubled the number of women in low-income groups given family planning services in these hospitals. PMID:6081243

  3. Hospital Workers Disaster Management and Hospital Nonstructural: A Study in Bandar Abbas, Iran

    PubMed Central

    Lakbala, Parvin

    2016-01-01

    Introduction: A devastating earthquake is inevitable in the long term and likely in the near future in Iran. The objective of the study was to assess the knowledge of hospital staff to disaster management system in hospital and to determine nonstructural safety assessment in Shahid Mohammadi hospital in Bandar Abbas city of Iran. This hospital is the main referral hospital in Hormozgan province with a capacity of about 450 beds and the highest patient admissions. Methods: The cross-sectional study was conducted in 2013 on 200 healthcare workers at Shahid Mohammadi hospital, in the city of Bandar Abbas, Iran. This hospital is the main referral hospital in Hormozgan province and has a capacity of about 450 beds with highest numbers of patient admissions. Questionnaire and checklist used for assessing health workers knowledge and awareness towards disaster management and nonstructural safety this hospital. Results: This study found that knowledge, awareness, and disaster preparedness of hospital staff need continual reinforcement to improve self efficacy for disaster management. Equipping health care facilities at the time of natural disasters, especially earthquakes are of great importance all over the world, especially in Iran. This requires the national strategies and planning for all health facilities. Conclusion: It seems due to limitations of hospital beds, insufficient of personnel, and medical equipment, health care providers paid greater attention to this issue. Since this hospital is the only educational public hospital in the province, it is essential to pay much attention to the risk management not only to this hospital but at the national level to health facilities. PMID:26573039

  4. Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives.

    PubMed Central

    Boscarino, J A; Steiber, S R

    1995-01-01

    Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital's image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 and January 1993. The survey was part of an ongoing annual survey of hospitals and included questions about AIDS, health education, marketing, patient satisfaction, and hospital planning. Altogether, 12.4 percent of executives indicated their hospital had a reputation for treating AIDS patients. Among hospitals without an AIDS reputation, 34.1 percent believed developing one would be harmful to the hospital's image, in contrast to none in hospitals that had such a reputation (chi 2 = 11.676, df = 1, P = .0006). Although 16.6 percent did not know if large-scale HIV testing should be implemented, a near majority (47.7 percent) expressed some support. In addition, 15 percent reported that HIV-positive physicians on the hospital's medical staff should not be allowed to practice medicine, but 32.1 percent indicated that they should.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7638335

  5. 42 CFR 482.43 - Condition of participation: Discharge planning.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Discharge planning. 482... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Basic Hospital Functions § 482.43 Condition of participation: Discharge planning. The hospital must have...

  6. Hospital demand for physicians.

    PubMed

    Morrisey, M A; Jensen, G A

    1990-01-01

    This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

  7. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    ERIC Educational Resources Information Center

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  8. 36. Post Engineer Office, Presidio of San Francisco. Plot Plan, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    36. Post Engineer Office, Presidio of San Francisco. Plot Plan, Letterman Army Hospital, San Francisco, Calif. 1958. SHOWING LOCATION OF BUILDINGS 1006 AND 1049 IN LETTERMAN HOSPITAL COMPLEX IN 1958. - Presidio of San Francisco, Letterman General Hospital, Building No. 27, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  9. The application of hospitality elements in hospitals.

    PubMed

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

  10. Hospitals as health educators

    MedlinePlus

    ... than your local hospital. From health videos to yoga classes, many hospitals offer information families need to ... care and breastfeeding Parenting Baby sign language Baby yoga or massage Babysitting courses for teens Exercise classes ...

  11. Hospital-acquired pneumonia

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000146.htm Hospital-acquired pneumonia To use the sharing features on this page, please enable JavaScript. Hospital-acquired pneumonia is an infection of the lungs ...

  12. Surviving Your Child's Hospitalization.

    ERIC Educational Resources Information Center

    Cohen, David A.

    1988-01-01

    The parent of a young child who required major open heart surgery shares his suggestions for coping with a young child's hospitalization including parent visitation, relating to the hospital staff, getting answers to questions, and utilizing available services. (DB)

  13. Understanding your hospital bill

    MedlinePlus

    ... getting the help you need, consider hiring a medical-billing advocate. Advocates charge an hourly fee or a ... American Hospital Association. Hospital Billing and Collection ... 15, 2015. Family Doctor.org. Understanding your Medical Bills. ...

  14. 42 CFR 456.181 - Reports of evaluations and plans of care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.181 Reports of evaluations and plans of care. A written report of each evaluation... evaluation or plan. Utilization Review (UR) Plan: General Requirements...

  15. 42 CFR 456.181 - Reports of evaluations and plans of care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.181 Reports of evaluations and plans of care. A written report of each evaluation... evaluation or plan. Utilization Review (UR) Plan: General Requirements...

  16. 42 CFR 456.181 - Reports of evaluations and plans of care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.181 Reports of evaluations and plans of care. A written report of each evaluation... evaluation or plan. Utilization Review (UR) Plan: General Requirements...

  17. 42 CFR 456.181 - Reports of evaluations and plans of care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.181 Reports of evaluations and plans of care. A written report of each evaluation... evaluation or plan. Utilization Review (UR) Plan: General Requirements...

  18. 42 CFR 456.181 - Reports of evaluations and plans of care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Plan of Care § 456.181 Reports of evaluations and plans of care. A written report of each evaluation... evaluation or plan. Utilization Review (UR) Plan: General Requirements...

  19. A variable-radius measure of local hospital market structure.

    PubMed Central

    Phibbs, C S; Robinson, J C

    1993-01-01

    OBJECTIVE. To provide a radius measure of the structure of local hospital markets that varies with hospital characteristics and is available for all hospitals in the United States. DATA SOURCES. 1982 American Hospital Association (AHA) Survey of Hospitals, 1982 Area Resource File (ARF), and 1983 California Office of Statewide Health Planning and Development (OSHPD) discharge abstracts. STUDY DESIGN. The OSHPD data were used to measure the radii necessary to capture 75 percent and 90 percent of each hospital's admissions. These radii were used as the dependent variables in regression models in which the independent variables were from the AHA and ARF. To estimate predicted market radii, the estimated parameters from the California models were applied to all nonfederal, short-term, general hospitals in the continental United States. These radii were used to define each hospital's service area, and all other hospitals within the calculated radii were considered potential competitors. Using this definition, we calculated two measures of local market structure: the number of other hospitals within the radius and a Herfindahl-Hirschman Index based on the distribution of hospital bed shares in the market. DATA EXTRACTION METHODS. These measures were calculated for all nonfederal, short-term, acute care hospitals in the continental United States for whom complete data were available (N = 4,884). CONCLUSIONS. These measures are available from the authors on computer-readable diskette, matched to hospital identifiers. PMID:8344822

  20. Hospital infection prevention and control issues relevant to extensive floods.

    PubMed

    Apisarnthanarak, Anucha; Mundy, Linda M; Khawcharoenporn, Thana; Glen Mayhall, C

    2013-02-01

    The devastating clinical and economic implications of floods exemplify the need for effective global infection prevention and control (IPC) strategies for natural disasters. Reopening of hospitals after excessive flooding requires a balance between meeting the medical needs of the surrounding communities and restoration of a safe hospital environment. Postflood hospital preparedness plans are a key issue for infection control epidemiologists, healthcare providers, patients, and hospital administrators. We provide recent IPC experiences related to reopening of a hospital after extensive black-water floods necessitated hospital closures in Thailand and the United States. These experiences provide a foundation for the future design, execution, and analysis of black-water flood preparedness plans by IPC stakeholders. PMID:23295568

  1. North Carolina State Plan for Technical Assistance and Energy Conservation Measures: Grant Programs for Schools and Hospitals and for Buildings Owned by Units of Local Government and Public Care Institutions.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Commerce, Raleigh. Energy Div.

    State guidelines for grant applications that follow the regulations of the National Energy Conservation Policy Act of 1978 are presented for North Carolina institutions. Among the 17 procedures spelled out in detail are several that concern eligible institutions' involvement in the development of the state plan, notification of the plan, and…

  2. The child in hospital*

    PubMed Central

    1955-01-01

    In 1951 the WHO Regional Office for Europe as a part of its long-term activities in child health initiated plans for a meeting between paediatricians and child psychiatrists, at which they could discuss their respective roles and the co-ordination of their work. Early in 1953 an ad hoc committee was called together to discuss the possibility of holding a conference which would delineate the role of the paediatrician in the management of psychosomatic and behaviour disorders in young children. This committee, consisting of leading specialists in paediatrics and child psychiatry, under the chairmanship of Professor R. Debré (France), felt that any wider conference should be devoted to considering more fully the inter-relation of somatic and psychological processes in sick children, the respective roles of paediatricians and child psychiatrists in their treatment, and the working relations between the different disciplines responsible for the care of children. In order to avoid diffusion of effort, and to arrive as far as possible at practical conclusions, the study group that was subsequently convened in Stockholm concentrated on one important aspect of child care—the child in hospital. PMID:14364192

  3. 2. View northwest of main hospital building complex, hospital building ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. View northwest of main hospital building complex, hospital building (Building 90), administration and clinical hospital building (Building 88), and hospital building (Building 91) - National Home for Disabled Volunteer Soldiers Western Branch, 4101 South Fourth Street, Leavenworth, Leavenworth County, KS

  4. Central Portion of First Floor Plan and Interior Elevations ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Central Portion of First Floor Plan and Interior Elevations - U.S. Veterans Hospital, Jefferson Barracks, Main Hospital, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  5. [Out-of-hospital births].

    PubMed

    Fernández Domínguez, N; Leal Gómez, E; García Lavandeira, S; Vázquez Rodríguez, M

    2016-01-01

    Childbirth is a physiological process and, as such, there should be limited assistance for the woman to ensure that it follows its natural process, avoiding any possible complication and, if they do appear, attempting to resolve them. Health personnel should try to achieve a balance between safety and the least possible outside assistance. The out-of-hospital delivery is considered an emergency as it happens unexpectedly, that is, without being previously planned. Given that it has to be treated outside the ideal conditions of a maternity ward, it is considered as an emergency. PMID:26006314

  6. Hurricane Katrina's Impact on Tulane's Teaching Hospitals

    PubMed Central

    Taylor, Ian L.

    2007-01-01

    On Monday, August 29, 2005 Hurricane Katrina passed east of New Orleans causing minimal damage to Tulane's Medical Center. Later that day, levees that protected the city failed and several feet of water entered the hospitals and school buildings. Emergency generators provided power for 36 hours before running out of fuel. Temperatures in the hospitals soared into the upper 90's and conditions were made intolerable by 100% humidity and backed-up sewage. For several days, faculty, residents, nurses and hospital personnel performed heroically, caring for patients in appalling conditions, hand-ventilating critically ill patients in shifts. Approximately 200 patients, and 1500 additional personnel would be evacuated on Wednesday and Thursday from a makeshift heliport on Tulane's parking garage. Current disaster plans may be inadequate should facilities be inaccessible for months because of damage or contamination. Contingency plans also need to be made should outside disaster relief be markedly delayed as was the case with Katrina. PMID:18528490

  7. Getting your home ready - after the hospital

    MedlinePlus

    ... ready for your return. If your surgery is planned, prepare your home in advance. If your hospital stay was unplanned, have family or friends prepare your home for you. You may not need all of the changes listed below. But read carefully for some good ...

  8. Impact of Diagnosis Related Groups of Hospital Social Service Departments.

    ERIC Educational Resources Information Center

    Patchner, Michael A.; Wattenberg, Shirley H.

    1985-01-01

    Surveyed 19 hospital social service administrators to examine the impact of Diagnosis Related Groups (DRGs). Results indicated increased recognition and increased scrutiny, and changes in discharge planning procedures. (JAC)

  9. ERP implementation in hospitals: a case study.

    PubMed

    Agarwal, Divya; Garg, Poonam

    2012-01-01

    In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital. PMID:23079029

  10. Hospital design for better infection control

    PubMed Central

    Lateef, Fatimah

    2009-01-01

    The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges PMID:20009307