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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. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  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. 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

  12. 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

  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. 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

  1. 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

  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. 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

  6. 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

  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. 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

  11. 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.

  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 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

  19. 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

  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

    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

  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 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

  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. 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,...

  5. 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…

  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. 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

  11. 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

  12. 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

  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. 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

  16. 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

  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. 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

  1. 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

  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. 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.

  14. 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

  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. 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…

  5. 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

  6. 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…

  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. 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...

  18. 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

  19. 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...

  20. 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

  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. [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

  8. 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…

  9. 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…

  10. 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

  11. 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

  12. 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

  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. 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

  17. 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

  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. 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...

  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. 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

  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. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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 ...

  16. 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)

  17. 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. ...

  18. 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 ...

  19. 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…

  20. 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

  1. 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

  2. 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

  3. 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

  4. [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

  5. 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

  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

  11. The performance of Hospital Corporation of America and Healthtrust hospitals after leveraged buyouts.

    PubMed

    Clement, J P; McCue, M J

    1996-07-01

    The authors examine performance changes after two leveraged buyouts (LBOs) in the hospital industry, one an employee stock ownership plan (ESOP) and the other a managed buyout (MBO). The findings show that hospitals owned by HCA, the MBO firm, and Health Trust, the ESOP firm, did not increase revenues, decrease operating expenses, or improve profitability after the LBOs, relative to other hospitals in their local markets. Nor were the numbers or salaries of employees at these facilities decreased. Although performance incentives associated with LBOs did not change performance at the hospital level, incentives to meet debt payments did result in corporate changes. More specifically, the LBOs led to corporate downsizing through the sale of hospitals and subsidiaries. PMID:8676606

  12. [Hospital integrated maintenance management system design and application].

    PubMed

    Zeng, Li

    2011-03-01

    According to hospital medical equipment, information equipment and water, electricity and other equipment maintenance procedures, this paper planned and developed a comprehensive maintenance management system for hospitals. The system implements equipment maintenance, maintenance applications, maintenance registration, preventive maintenance, data quantitative analysis and other functions. PMID:21706796

  13. [University clinics in the competitive hospital market].

    PubMed

    Schmidt, C E; Möller, J; Hesslau, U; Bauer, M; Gabbert, T; Kremer, B

    2005-07-01

    In recent years Germany has faced a growing economization and competition among hospitals. To protect their interests hospitals have to operate similarly to other commercial businesses. Academic hospitals face difficult circumstances in this competition. They have to facilitate research and education activities which require additional financial and personnel resources but also provide maximum acute care treatment at all times. This causes additional disadvantages in terms of financial resources, compared to private hospital chains. Such examples of financial shortcomings have led to the privatization of academic research centres in Germany. An alternative strategy to privatization of academic acute care hospitals is the change of their legal status into a capital company or into a foundation, according to US experiences. Public private partnerships (PPPs) may also represent a potential alternative, as they have already produced a growing number of successful examples in the public sector in Germany. Academic acute care hospitals can also choose a strategic reorganization of their targets, similar to their privately held competitors in the market. Potential economies in scale may be achieved in areas such as medical treatment, research and personnel planning.However, it is vital that academic acute care hospitals start to act productively and also individually. This article provides a number of managerial pathways and options to maintain and strengthen operational competitiveness. PMID:15942750

  14. Hospital preparedness for chemical and radiological disasters.

    PubMed

    Moore, Brooks L; Geller, Robert J; Clark, Charlotte

    2015-02-01

    Hospital planning for chemical or radiological events is essential but all too often treated as a low priority. Although some other types of disasters like hurricanes and tornadoes may be more frequent, chemical and radiological emergencies have the potential for major disruptions to clinical care. Thorough planning can mitigate the impact of a chemical or radiological event. Planning needs to include all 4 phases of an event: mitigation (preplanning), preparation, response, and recovery. Mitigation activities should include the performance of a hazards vulnerability analysis and identification of local subject-matter experts and team leaders. PMID:25455661

  15. Hospital-MD joint ventures move forward despite hurdles.

    PubMed

    Hudson, T

    1991-05-01

    Although experts say joint ventures are not a financial cure-all for hospitals, hospital-physician partnerships continue to move forward on hospital agendas. Despite some of the regulatory and practical challenges facing would-be joint venturers, health care attorneys, hospital executives and consultants agree that well-planned joint ventures can reap significant rewards for all parties involved. From purchasing equipment together to arranging for joint ownership of an entire hospital, hospital administrators and physician groups are broadening the range of a business management tool with a successful track record. Says one hospital CEO involved in a joint venture with a competing institution, "What drives these things is what's in the best interest of the patients." Joint ventures, he concludes, are "going to be more and more a part of our future." PMID:2013467

  16. [Hospital and environment: waste disposal].

    PubMed

    Faure, P; Rizzo Padoin, N

    2003-11-01

    Like all production units, hospitals produce waste and are responsible for waste disposal. Hospital waste is particular due to the environmental risks involved, particularly concerning infection, effluents, and radionucleide contamination. Management plans are required to meet environmental, hygiene and regulatory obligations and to define reference waste products. The first step is to optimize waste sorting, with proper definition of the different categories, adequate containers (collection stations, color-coded sacks), waste circuits, intermediate then central storage areas, and finally transfer to an incineration unit. Volume and delay to elimination must be carefully controlled. Elimination of drugs and related products is a second aspect: packaging, perfusion pouches, tubing, radiopharmaceutic agents. These later products are managed with non-sealed sources whose elimination depends on the radioactive period, requiring selective sorting and specific holding areas while radioactivity declines. Elimination of urine and excreta containing anti-cancer drugs or intravesical drugs, particularly coming from protected rooms using radioactive iodine is another aspect. There is also a marginal flow of unused or expired drugs. For a health establishment, elimination of drugs is not included as part of waste disposal. This requires establishing a specific circuit with selective sorting and carefully applied safety regulations. Market orders for collecting and handling hospital wastes must be implemented in compliance with the rules of Public Health Tenders. PMID:14639187

  17. Disaster drill at a university hospital.

    PubMed

    Rehmani, Rifat

    2005-01-01

    The course of a disaster drill held on 23 October 2001 at Aga Khan University, Karachi is reported. The Hospital Emergency Plan was put to trial on that day. Volunteers were invited to become simulated casualties in the drill. Briefing seminars had been conducted with the key players of the hospital. The scenario was a man-made type disaster. A 747 jumbo jet with 200 passengers had crashed at the end of the runway at Quaid-e-Azam International Airport while taking off in a thunderstorm. Fifty casualties were sent to Emergency Room by ambulance. The Plan was activated and relevant units were mobilized according to the Plan. It took 2 hours to complete the disaster drill. Major difficulties were identified in the operations, communications, staff deployment, and emergency control center. Debriefing sessions reviewed difficulties encountered throughout the drill and the possible remedies. PMID:15816693

  18. What does free cash flow tell us about hospital efficiency? A stochastic frontier analysis of cost inefficiency in California hospitals.

    PubMed

    Pratt, William R

    2010-01-01

    Hospitals are facing substantial financial and economic pressure as a result of health plan payment restructuring, unfunded mandates, and other factors. This article analyzes the relationship between free cash flow (FCF) and hospital efficiency given these financial challenges. Data from 270 California hospitals were used to estimate a stochastic frontier model of hospital cost efficiency that explicitly takes into account outpatient heterogeneity. The findings indicate that hospital FCF is significantly linked to firm efficiency/inefficiency. The results indicate that higher positive cash flows are related to lower cost inefficiency, but higher negative cash flows are related to higher cost inefficiency. Thus, cash flows not only impact the ability of hospitals to meet current liabilities, they are also related to the ability of the hospitals to use resources effectively. PMID:20973372

  19. Measuring Hospital Productivity

    PubMed Central

    Ruchlin, Hirsch S.; Leveson, Irving

    1974-01-01

    This study presents a comprehensive method for quantifying hospital output and estimating hospital productivity. A number of less comprehensive productivity measures that can be quantified from data available from regional third-party payers and from the American Hospital Association are also developed and evaluated as proxies for the comprehensive measure, which is based on local area data. Methods are discussed for estimating the necessary variables on a regional or national level. PMID:4461703

  20. [Management of the patient with COPD: home case or hospitalization].

    PubMed

    Aubert, John-David

    2013-05-01

    Acute exacerbation of COPD is one of the most common causes of hospital admission in patients affected with this disease. In most cases, consideration of differential diagnoses and assessment of important comorbidities will allow to make the decision whether or not the patient needs to be hospitalized. A decision to hospitalize will be based on specific symptoms and signs, as well on the patient's history. Contrary to bronchial asthma, a systematic action plan strategy is lacking for COPD. However, a disease management plan involving all the health care providers may have the potential to improve the patient's well being and to decrease costs related to these exacerbations. PMID:23644245

  1. Central line infections - hospitals

    MedlinePlus

    ... infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired infection - central line infection; Patient safety - central ...

  2. Exploration on Construction of Hospital "Talent Tree" Project.

    PubMed

    Yi, Lihua; Wei, Lei; Hao, Aimin; Hu, Minmin; Xu, Xinzhou

    2015-05-01

    Talent is the core competitive force of a hospital's development. Wuxi No. 2 People's Hospital followed the characteristics that medical talents mature slowly and their growth requires a long period. The innovated "talent tree" project, trained classified talents corresponding to "base-trunk-crown" of a tree, formed an individualized professional training plan with different levels and at different periods. We carried out a relay of the "talent tree" to bring their initiative into play. In practice, we gradually found this as a unique way of the talent construction, which conforms to our hospital's condition. This guarantees sustained development and innovative force of the hospital. PMID:25413963

  3. Hospital readmission from a transitional care unit.

    PubMed

    Anderson, Mary Ann; Tyler, Denice; Helms, Lelia B; Hanson, Kathleen S; Sparbel, Kathleen J H

    2005-01-01

    The purpose of this project was to characterize patients readmitted to the hospital during a stay in a transitional care unit (TCUT). Typically, readmitted patients were females, widowed, with 8 medical diagnoses, and taking 12 different medications. Readmission from the TCU occurred within 7 days as a result of a newly developed problem. Most patients did not return home after readmission from the TCU. Understanding high-risk patients' characteristics that lead to costly hospital readmission during a stay in the TCU can assist clinicians and healthcare providers to plan and implement timely and effective interventions, and help facility personnel in fiscal and resource management issues. PMID:15686074

  4. Production flow analysis: a tool for designing a lean hospital.

    PubMed

    Karvonen, Sauli; Korvenranta, Heikki; Paatela, Mikael; Seppälä, Timo

    2007-01-01

    Production flow analysis (PFA) was used in the planning process for a new acute care hospital. The PFA demonstrated that functional organisation--for example, with centralised medical imaging-- generates a lot of back and forth patient transfers between functional units. This to-and-fro patient flow increases lead times of care processes and also exposes the patients to unnecessary complications. PFA produced an ideal patient flow model and layout model for the acute care hospital. Thus, PFA revealed information for use in proximity ranking of different units of the hospital; the planning team then decided which units should be placed next to each other. Medical imaging should be essentially ubiquitous, to achieve simple, high-velocity patient flow. Thus, a modern decentralized layout model for medical imaging was planned. Furthermore, PFA enables optimizing transfer routes for patients and also, e.g., lift capacity in the hospital. PMID:17621771

  5. Marketing strategies of hospital service organizations in Nigeria: a study of selected privately owned hospitals in Port Harcourt.

    PubMed

    Okwandu, Gabriel A

    2002-01-01

    This study was centered on the identification of the marketing strategies of hospitals and the factors that militate against their effective adoption and implementation. A total of 80 hospitals in Port Harcourt responded to a structured questionnaire administered on them. It was found, among other things, that many hospital organizations apply marketing strategies, and that hospitals that adopt effective marketing strategies perform better than those that do not. Some of the factors militating against the effective adoption and implementation of marketing strategies include lack of planning, lack of top management support, and non-utilization of all the promotional mix elements. PMID:12569994

  6. [The insigne and suntuoso Royal Hospital of Granada (I). Royal foundations and the hospital regrouping (1501-1526)].

    PubMed

    Valenzuela Candelario, José

    2003-01-01

    In the 1520s the local authorities planned to set up a new modern hospital in the city of Granada by combining two existing Royal Hospitals: Alhambra and Reyes. As a public institution and as a new building, the new hospital could develop the mandates of the original foundation and extend its care to become a general hospital. In this way it would strengthen its status as a charitable undertaking and legacy of the Catholic Monarchs and, secondly, as a great architectural monument. PMID:14626277

  7. Hospitality Occupations. Curriculum Guide.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  8. Library Services in Hospitals.

    ERIC Educational Resources Information Center

    Department of Health and Social Security, London (England).

    The memorandum gives guidance to the provision and organization of library services at hospitals both for staff and for patients. It also draws attention to the assistance available from outside sources towards the development and maintenance of these services so hospital authorities may make the most effective use of the available facilities.…

  9. Hospitality, Tourism, and Recreation.

    ERIC Educational Resources Information Center

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  10. Handbook on Hospital Television.

    ERIC Educational Resources Information Center

    Prynne, T. A.

    Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…

  11. [Music in the hospital].

    PubMed

    Bouteloup, Philippe

    2010-01-01

    Occasional events, regular workshops, concerts, shows, artists in residence, cultural outings...Hospital does not necessarily have to be a place of silence and sadness. But this situation has not always been so straightforward as on the face of it, nothing is more incompatible with a hospital environment than music, which, by definition, is festive and noisy. PMID:20684389

  12. Hospitality services generate revenue.

    PubMed

    Bizouati, S

    1993-01-01

    An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider. PMID:10127850

  13. Hospitality Services Reference Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  14. Hospitality Services. Curriculum Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  15. Discharge Planning in Chronic Conditions

    PubMed Central

    McMartin, K

    2013-01-01

    Background Chronically ill people experience frequent changes in health status accompanied by multiple transitions between care settings and care providers. Discharge planning provides support services, follow-up activities, and other interventions that span pre-hospital discharge to post-hospital settings. Objective To determine if discharge planning is effective at reducing health resource utilization and improving patient outcomes compared with standard care alone. Data Sources A standard systematic literature search was conducted for studies published from January 1, 2004, until December 13, 2011. Review Methods Reports, randomized controlled trials, systematic reviews, and meta-analyses with 1 month or more of follow-up and limited to specified chronic conditions were examined. Outcomes included mortality/survival, readmissions and emergency department (ED) visits, hospital length of stay (LOS), health-related quality of life (HRQOL), and patient satisfaction. Results One meta-analysis compared individualized discharge planning to usual care and found a significant reduction in readmissions favouring individualized discharge planning. A second meta-analysis compared comprehensive discharge planning with postdischarge support to usual care. There was a significant reduction in readmissions favouring discharge planning with postdischarge support. However, there was significant statistical heterogeneity. For both meta-analyses there was a nonsignificant reduction in mortality between the study arms. Limitations There was difficulty in distinguishing the relative contribution of each element within the terms “discharge planning” and “postdischarge support.” For most studies, “usual care” was not explicitly described. Conclusions Compared with usual care, there was moderate quality evidence that individualized discharge planning is more effective at reducing readmissions or hospital LOS but not mortality, and very low quality evidence that it is more

  16. Hospital efficiency and debt.

    PubMed

    Bernet, Patrick Michael; Rosko, Michael D; Valdmanis, Vivian G

    2008-01-01

    U.S. Hospitals rely heavily on debt financing to fund major capital investments. Hospital efficiency is at least partly determined by the amount and quality of plant and equipment it uses. As such, a hospital's access to debt and credit rating may be related to its efficiency. This study explores this relationship using a broad sample of hospitals and associated bond issuance histories. Employing stochastic frontier analysis (SFA), we measure cost inefficiency to gauge the impact of debt issuance and debt rating. We find that hospitals with recent bond issues were less inefficient. Although we do not find a perfectly linear relationship between debt rating and inefficiency, we have evidence that hints at such a relation. Finally, we find an increase in inefficiency in the years following bond issues, consistent with the possibility of a debt death spiral. PMID:21110482

  17. [Hospital medicine in Chile].

    PubMed

    Eymin, Gonzalo; Jaffer, Amir K

    2013-03-01

    After 15 years of development of Hospital Medicine in Chile, there are several benefits of this discipline. Among others, a reduction in the length of hospital stay, readmissions, costs, and improved medical teaching of students, residents and fellows have been observed. However, in South América there are only isolated groups dedicated to Hospital Medicine in Chile, Argentina and Brazil, with a rather slow growth. The unjustified fear of competition from sub specialists, and the fee for service system of payment in our environment may be important factors to understand this phenomenon. The aging of the population makes imperative to improve the safety of our patients and to optimize processes and resources within the hospital, to avoid squandering healthcare resources. The following is a detailed and evidence-based article, on how hospital medicine might benefit both the public and prívate healthcare systems in Chile. PMID:23900327

  18. Hospitality as an Environmental Metaphor.

    ERIC Educational Resources Information Center

    Horwood, Bert

    1991-01-01

    Compares stewardship and hospitality as they relate to the biosphere. Traces the origin of the word "hospitality," discusses cultural traditions of hospitality, and applies the concept of hospitality to the natural world. Considers forms of symbiosis in nature: commensals, mutualism, and parasitism. Hospitality promotes respect, humility, and…

  19. Residential therapy. Hospitals take on finding housing for homeless patients, hoping to reduce readmissions, lower costs.

    PubMed

    Evans, Melanie

    2012-09-24

    As they grapple with containing the cost of caring for patients who frequently return to the ER or hospital for care, some hospitals are trying a new route: housing. In San Francisco, plans are under way to house 50 homeless patients. "Hospitalization is a failure of the medical system. It means that the condition has gotten so out of control that someone is at risk of life or limb," says Dr. Kelly Pfeifer, left, of the San Francisco Health Plan. PMID:23163192

  20. Hospitals' Internal Accountability

    PubMed Central

    Kraetschmer, Nancy; Jass, Janak; Woodman, Cheryl; Koo, Irene; Kromm, Seija K.; Deber, Raisa B.

    2014-01-01

    This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. PMID:25305387

  1. Hospitals' internal accountability.

    PubMed

    Kraetschmer, Nancy; Jass, Janak; Woodman, Cheryl; Koo, Irene; Kromm, Seija K; Deber, Raisa B

    2014-09-01

    This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. PMID:25305387

  2. An enlightened age: building the naval hospitals.

    PubMed

    Buchanan, Emmakate MacQueen

    2005-01-01

    Summerson writes that, in the spirit of the Enlightenment, the notion of 'bienfaisance', literally meaning the desire to render society more reasonable and more humane, liberated the scope of both hospital and prison planning. Both types of institution housed people who were deprived of their freedom either by disability or by force of law; therefore, we find similarities in the disposition of space and in the degree of humanitarianism expressed in their outward appearance. This observation can be transferred to naval hospital design, where architecture was combined to fulfil a twofold purpose. The high walls, sturdy massing and pared-down details intimated a strict economy of means, but also a strong sense of gravitas and authority. This visual authoritarian character was fundamental to the identity of a naval hospital, for whilst the prime intention was to provide efficient medical care, an equally important consideration was to maintain discipline and prevent sailors from escaping. PMID:17462287

  3. Hospitalized Patients and Fungal Infections

    MedlinePlus

    ... but can also be caused by fungi. Hospital construction. Hospital staff do everything they can to prevent ... patients staying at hospitals where there is ongoing construction or renovation. 5 This is thought to be ...

  4. The health care market: can hospitals survive?

    PubMed

    Goldsmith, J C

    1980-01-01

    Does it sound familiar? Resources are scarce, competition is tough, and government regulations and a balanced budget are increasingly hard to meet at the same time. This is not the automobile or oil industry but the health care industry, and hospital managers are facing the same problems. And, maintains the author of this article, they must borrow some proven marketing techniques from business to survive in the new health care market. He first describes the features of the new market (the increasing economic power of physicians, new forms of health care delivery, prepaid health plans, and the changing regulatory environment) and then the possible marketing strategies for dealing with them (competing hard for physicians who control the patient flow and diversifying and promoting the mix of services). He also describes various planning solutions that make the most of a community's hospital facilities and affiliations. PMID:10247957

  5. Effects of hospital downsizing on surviving staff.

    PubMed

    Young, S; Brown, H N

    1998-01-01

    In 1993, 27% of 1,147 surveyed hospitals planned to decrease staff size in the next year. This study surveyed 48 vice presidents of nursing in North Carolina hospitals with an average inpatient census over 100 using a 13-item questionnaire in an effort to discover strategies that were helpful in effective downsizing endeavors. Of the 31 (48%) returned questionnaires, 11 (35%) of the VPs reported downsizing in the past 3 years, most of which required the closing of one or more units. The respondents ranked attrition as the most common strategy, followed by relocation, early retirement, a change in skill mix, and layoffs. The most important components in successful downsizing or reorganization efforts were: two-way communication and sufficient planning, as well as seeking and using input from a broad group of staff (using both individual meetings and group forums/discussions). PMID:9987324

  6. 38. Second Floor Plan, North Elevation, South Elevation and Details. ...

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

    38. Second Floor Plan, North Elevation, South Elevation and Details. Addition to Bacteriology Laboratory at Letterman General Hospital, San Francisco, Cal. January 1916. BUILDING 1006. - Presidio of San Francisco, Letterman General Hospital, Building No. 27, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  7. After 9/11: priority focus areas for bioterrorism preparedness in hospitals.

    PubMed

    Murphy, Jenifer K

    2004-01-01

    Following the terrorist attacks of September 11, 2001, bioterrorism preparedness was a priority in hospitals, but it did not remain a priority. As a result, hospitals are still unprepared to deal with the effects of a bioterrorist attack. The government has provided initial funding to state and local governments for bioterrorism preparedness; however, much of this money has yet to reach hospitals. With the inadequate funding available to hospitals, four initial measures must be focused on. These focus areas are community involvement, hospital staff education, information technology and disease surveillance improvement, and additional equipment and staff acquisition. Hospitals should also make bioterrorism-preparedness planning a regional effort. PMID:15328657

  8. Integrating COPD into Patient-Centered Hospital Readmissions Reduction Programs

    PubMed Central

    Krishnan, Jerry A.; Gussin, Hélène A.; Prieto-Centurion, Valentin; Sullivan, Jamie L.; Zaidi, Farhan; Thomashow, Byron M.

    2015-01-01

    About 1 in 5 patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD) in the United States are readmitted within 30 days. The U.S. Centers for Medicare and Medicaid Services has recently expanded its Hospital Readmissions Reduction Program to financially penalize hospitals with higher than expected all-cause 30-day readmission rates following a hospitalization for COPD exacerbation. In October 2013, the COPD Foundation convened a multi-stakeholder National COPD Readmissions Summit to summarize our understanding of how to reduce hospital readmissions in patients hospitalized for COPD exacerbations. Over 225 individuals participated in the Summit, including patients, clinicians, health service researchers, policy makers and representatives of academic health care centers, industry, and payers. Summit participants recommend that programs to reduce hospital readmissions: 1) Include specific recommendations about how to promote COPD self-management skills training for patients and their caregivers; 2) Adequately address co-existing disorders common to COPD in care plans during and after hospitalizations; 3) Include an evaluation of adverse events when implementing strategies to reduce hospital readmissions; and 4) Develop a strategy (e.g., a learning collaboratory) to connect groups who are engaged in developing, testing, and implementing programs to reduce hospital readmissions for COPD and other conditions. PMID:25927076

  9. Hospital-sponsored primary care: I. Organizational and financial effects.

    PubMed Central

    Shortell, S M; Wickizer, T M; Wheeler, J R

    1984-01-01

    Findings are presented from a seven-year (1976-83) evaluation of the Community Hospital Program (CHP), a national demonstration program sponsored by the Robert Wood Johnson Foundation to assist 54 community hospitals in improving the organization of access to primary care. Upon grant expiration, 66 per cent of hospital-sponsored group practices continued under some form of hospital sponsorship; over 90 per cent developed or were planning to develop spin-off programs; and new physicians were recruited and retained in the community. About 9 per cent of hospital admissions were accounted for by group physicians and grantee hospitals experienced a greater annual increase in their market share of admissions than competing hospitals in the area. While only three of the groups generated sufficient revenue to cover expenses during the grant period, 21 additional groups broke even during the first post-grant year. Productivity and cost per visit compared favorably with most other forms of care. Hospitalization rates from the hospital-sponsored practices were somewhat lower than those for other forms of care. Medical director leadership and involvement and the organization design of the practice were among several key factors associated with higher performing practices. The ability of such joint hospital-physician ventures to meet the needs of the poor and elderly in a time of Medicare and Medicaid cutbacks is discussed along with suggestions for targeting future initiatives in primary care. PMID:6742268

  10. [Family-centered rounds in hospital settings].

    PubMed

    Lecorguillé, M; Thébaud, V; Sizun, J

    2016-04-01

    Family-centered care is an approach to the planning, delivery, and evaluation of healthcare based on partnership between parents and professionals. Family-centered rounds (FCRs) are a practical application in hospital settings. They are multidisciplinary rounds with active participation of the parents in the decision-making process. FCRs appear to have a positive impact on parents' satisfaction, information provision, and comprehension of care plans. Three concerns have been underlined: time management, confidentiality, and teaching students. FCR implementation is a process that requires in-depth thinking on the philosophy of care, staff information and training, and a specific organizational change. PMID:26774896

  11. YACHIYO HOSPITAL; Center of SUPER CARE MIX--Comprehensive Care from Emergency to Home for the community.

    PubMed

    Matsumoto, Takatoshi; Iyomasa, Shinsuke; Fukatsu, Atsushi

    2016-01-01

    Anjo City has two general hospitals. Kosei Hospital, a central medical center for advanced care, and our Yachiyo Hospital for regional care. Recently, Kosei Hospital faced over-capacity problem because of overflow in emergency visits and congested wards due to shortage of post-acute beds. We planned a project to ease the congestion of the central hospital and manage post-acute patients. PMID:27180467

  12. 8 strategies for hospital borrowers in 2011.

    PubMed

    Blake, James W; Jordahl, Eric A; Majka, Andrew J

    2011-04-01

    Given the likelihood that volatility and unexpected events will continue to challenge the capital markets, healthcare borrowers should implement the following strategic responses: Protect the organization's credit rating. Identify and address organizationwide risk. Establish a global capital strategy for the hospital. Diversify debt and investments. Anticipate challenges in the banking market. Anticipate challenges in the municipal bond market. Fully integrate leasing into the organization's capital structure strategy. Ensure the solidity of the organization's financial plan and future strategies. PMID:21548431

  13. Uninterrupted service on the hospital menu.

    PubMed

    Vines, Lee

    2014-09-01

    Lee Vines, sales and marketing director at PKL Group, a leading supplier of temporary and permanent catering infrastructure, considers the challenges facing hospital caterers and estates managers in ensuring that catering equipment is kept up-to-date and fit-for-purpose. He also discusses the options available to make sure kitchen services are able to run without interruption during planned or unplanned periods of kitchen 'downtime'. PMID:25282991

  14. Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India

    PubMed Central

    Manar, Manish Kumar; Sahu, Krishna Kumar; Singh, Shivendra Kumar

    2014-01-01

    Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

  15. Hospital financing in Norway.

    PubMed

    Carlsen, F

    1994-05-01

    The Norwegian block grant reform of 1980 replaced state reimbursements to hospitals by block grants allocated to counties according to objective criteria. The reform was accompanied by a general decentralization of budget authority to local level. The reform aimed to promote primary care, equalize the supply of health care across regions and give counties incentives to improve hospital efficiency. A decade later, the reform was reversed. The government has imposed restrictions which reduce the budget discretion of the counties and part of the block grant has been made dependent on the performance of the hospitals in the counties. The government has also issued a 'waiting-list guarantee' which states that patients who suffer from a serious disease are entitled to medical treatment within six months. This paper provides an overview of hospital financing in Norway during the last two decades and discusses why the block grant system did not fulfil the expectations of its architects. PMID:10136059

  16. Surgery, Hospitals, and Medications

    MedlinePlus

    Patient Education Sheet Sjögren’s, Surgery, Hospitals, and Medications The SSF thanks Lynn Petruzzi, RN, MSN, for this Patient Education Sheet. Educate your healthcare givers! • Tell your surgeon, ...

  17. Critical Access Hospitals (CAH)

    MedlinePlus

    ... CAH Conditions of Participation . What are the location requirements for CAH status? Critical Access Hospitals must be ... clinic that does not meet the CAH distance requirements? As of January 1, 2008, all CAHs, including ...

  18. Understanding your hospital bill

    MedlinePlus

    ... to know whether your hospital charged a fair price. There are some web sites you can use ... zip code to find an average or estimated price in your area. www.healthcarebluebook.com www.fairhealth. ...

  19. Practice Hospital Bed Safety

    MedlinePlus

    ... Bed? Todd says that there is no standard definition for hospital beds, a fact that consumers shopping ... in retail stores that don’t meet the definition of medical devices under the law, but which ...

  20. Hospital free cash flow.

    PubMed

    Kauer, R T; Silvers, J B

    1991-01-01

    Hospital managers may find it difficult to admit their investments have been suboptimal, but such investments often lead to poor returns and less future cash. Inappropriate use of free cash flow produces large transaction costs of exit. The relative efficiency of investor-owned and tax-exempt hospitals in the product market for hospital services is examined as the free cash flow theory is used to explore capital-market conditions of hospitals. Hypotheses concerning the current competitive conditions in the industry are set forth, and the implications of free cash flow for risk, capital-market efficiency, and the cost of capital to tax-exempt institution is compared to capital-market norms. PMID:1743965

  1. [Ryazan hospital--80 years].

    PubMed

    Klimov, A S; Gromov, M F

    2012-02-01

    In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area. PMID:22558855

  2. ["Working together" at hospital?].

    PubMed

    Divay, Sophie

    2015-02-01

    Working well together at hospital depends on several factors, on the level of a team as well as that of the ministry in charge of health. How can we encourage and promote cooperation between caregivers? If the hospital is the reflection of society as a whole, an analysis of the functioning of this universe provides a better understanding of the challenges and the missions of each player for the benefit of the patient. PMID:26144821

  3. Fast tracking hospital construction.

    PubMed

    Quirk, Andrew

    2013-03-01

    Hospital leaders should consider four factors in determining whether to fast track a hospital construction project: Expectations of project length, quality, and cost. Whether decisions can be made quickly as issues arise. Their own time commitment to the project, as well as that of architects, engineers, construction managers, and others. The extent to which they are willing to share with the design and construction teams how and why decisions are being made. PMID:23513759

  4. Management of Feedyard Hospitals.

    PubMed

    Fox, J T

    2015-11-01

    There are many considerations when managing feedyard hospitals. The type of hospital system must fit the facility design, the type of cattle fed at the feedyard, the crew that is employed by the feedyard, and the protocol established by the veterinarian. Ensuring the animals are well-cared for and have their basic needs met should be the priority of the feedyard personnel and the veterinarian maintaining the veterinarian-client-patient relationship with the feedyard. PMID:26210766

  5. Hospital air is sick.

    PubMed

    Brownson, K

    2000-11-01

    Indoor air quality has deteriorated so much since the 1970s oil shortage and subsequent energy-efficient construction of buildings that people are becoming seriously ill by just breathing the indoor air. This is a problem with all industrial buildings and hospital staff are at particular risk. There are various things that hospital managers from different departments can do to make the air safe for staff and patients to breathe. PMID:11185833

  6. 42 CFR 456.523 - Revised UR plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.523 Revised... control over the utilization of services; and (2) Conducts reviews in a way that improves the quality...

  7. Certain Hospital Waste Management Practices in Isfahan, Iran

    PubMed Central

    Ferdowsi, Ali; Ferdosi, Masoud; Mehrani, Zeinab; Narenjkar, Parisa

    2012-01-01

    Objectives: Infected hospital wastes are among hazardous wastes, and special treatment methods are needed for their disposal. Having information about present status of medical waste management systems is of great importance in finding weak, and for future planning. Such studies have not been done for most of the hospitals in Iran. Methods: This paper reports the results of a study on the present status of medical waste management in Isfahan hospitals. A ten page researcher made questionnaire was used to collect data in terms of collection, transportation, segregation, treatment and disposal. For assessment of autoclaves, standard tests including TST (Time, Steam, and Temperature) strip test and spore tests were used. Samples were made of stack gases of incinerators. Quantity and composition of hospital wastes in Isfahan were also measured manually. Results: Of all wastes in selected hospitals, 40% were infected wastes (1.59 kg/day/bed), which is 15 to 20% higher than World Health Organization (WHO) standards. TST and Spore test results were negative in all samples. Stack gases analysis showed high concentration of CO in some samples. Besides, the combustion efficiency in some samples is less than 99.5%, which is the standard criterion in Iran. Conclusions: This study may create awareness regarding the magnitude of the problem of waste management in hospitals of Isfahan and may stimulate interests for systematic control efforts for hospital waste disposal. Hospital waste management cannot succeed without documented plans, certain equipment, defined staff trainings, and periodic evaluations. PMID:22826762

  8. Recurrent psychiatric hospitalization.

    PubMed Central

    Voineskos, G.; Denault, S.

    1978-01-01

    Undue emphasis has been placed on rising rates of readmission to psychiatric facilities. After a decade of preoccupation with discharge rates, readmission statistics have been singled out in the last 15 years as the key factor for assessing hospital effectiveness. A study of a group of patients at high risk for recurrent hospitalization revealed that these patients were characterized more by features relating to environmental supports than by diagnosis. The operational definition for recurrent hospitalization (five or more admissions during the 2-year period preceding the latest admission) was effective in identifying this group; this is the first reported instance in which the definition has specified a certain number of admissions within a time-limited period. The findings of this study, as well as of an analysis of case histories and consumer opinion, led to the design of a pilot program for persons undergoing recurrent hospitalization. Readmission statistics are useless or misleading as measures of hospital effectiveness and efficiency; what matters is the way the former patients function in the community after discharge. Rather than simply trying to reduce the readmission rate psychiatric facilities should be examining the types of persons who are hospitalized recurrently to develop programs aimed at improving the functioning of these people in the community. PMID:630483

  9. Hospital accreditation in Europe.

    PubMed

    Shaw, C

    1998-01-01

    Health service accreditation systems have explicit standards for organisation against which the participating hospital assesses itself before a structured visit by outside "surveyors". They submit a written report back to the hospital with commendations and recommendations for development prior to a follow-up survey. Accreditation may be awarded for a fixed term or may be with held by an independent assessment Board if the hospital does not meet a defined threshold of standards. In Europe, some government and medical organisations initially distanced themselves from the pilot hospital wide programmes, arguing that they would cost too much and undermine management, or that they were irrelevant to clinical practice. But gradually it became obvious that accreditation worked for hospitals; purchasers and insurers saw its potential for quality and resource management; and professional bodies recognised the links between clinical training, practice and outcome and the environment in which health care is provided. If nothing else, it offered a multi-professional bridge between the existing numerous fragmented systems such as inspecting (statutory safety), visiting (professional training), and monitoring (service contracts). The introduction of accreditation appears to benefit hospitals in many different countries and health systems and provides a vehicle for integrated quality management which is visible to funding agencies, government and the public. Interest is growing within Europe. PMID:10179643

  10. Financing hospital disaster preparedness.

    PubMed

    De Lorenzo, Robert A

    2007-01-01

    Disaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. Under current policy, virtually the entire funding stream for hospital preparedness comes from general tax revenues. Medical payers (e.g., Medicare, Medicaid, and private insurance) directly fund little, if any, of the current bill. Funding options to improve preparedness include increasing the current federal grants allocated to hospitals, using payer fees or a tax to subsidize preparedness, and financing other forms of expansion capability, such as mobile hospitals. Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of preparedness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk. PMID:18087914

  11. Hospital management principles applicable to the veterinary teaching hospital.

    PubMed

    Harris, Donna L; Lloyd, James W; Marrinan, Mike

    2004-01-01

    The Skills, Knowledge, Aptitude, and Attitude (SKA) Subcommittee of the National Commission on Veterinary Economic Issues (NCVEI) has identified the need for veterinary teaching hospitals (VTH) to be at the forefront of progressive business management to serve as a model for both students and practitioners to emulate. To provide a foundation for developing a model, this study reviewed pertinent literature applicable to the management of a VTH. Much of the literature relevant to VTH management relates to work completed for the human side of medicine (academic health centers, or AHCs) or to the private sector. This review explores management practices in strategic planning, financial management, human resource management, marketing, pricing, operations, and legal issues. It is concluded that strategic management is important to provide the foundation for success in the VTH. In addition, periodic financial reports are recommended, as are the development and use of benchmarks for financial management. Establishing positive, motivating human resource practices is also suggested, along with development of a marketing plan based on a clear understanding of VTH core competencies and the market's specific needs. PMID:15510343

  12. Screening for Depression in Hospitalized Pediatric Patients

    PubMed Central

    ESMAEELI, Mohammad-Reza; ERFANI SAYAR, Reza; SAGHEBI, Ali; ELMI, Saghi; RAHMANI, Shagheyegh; ELMI, Sam; RABBANI JAVADI, Akram

    2014-01-01

    who had been hospitalized more than 3 times in the previous year, experienced more severe levels of depression. We also found a significant correlation between pubertal age and severity of depression in patients with cancers and chronic renal failure. Conclusion Children who are hospitalized due to chronic conditions are at a higher risk for mood disorders in comparison with the ones with acute conditions. It is therefore advisable to consider more practical plans to improve the care for hospitalized children’s mental health. PMID:24665327

  13. Improved Planning Time and Plan Quality Through Multicriteria Optimization for Intensity-Modulated Radiotherapy

    SciTech Connect

    Craft, David L.; Hong, Theodore S.; Shih, Helen A.; Bortfeld, Thomas R.

    2012-01-01

    Purpose: To test whether multicriteria optimization (MCO) can reduce treatment planning time and improve plan quality in intensity-modulated radiotherapy (IMRT). Methods and Materials: Ten IMRT patients (5 with glioblastoma and 5 with locally advanced pancreatic cancers) were logged during the standard treatment planning procedure currently in use at Massachusetts General Hospital (MGH). Planning durations and other relevant planning information were recorded. In parallel, the patients were planned using an MCO planning system, and similar planning time data were collected. The patients were treated with the standard plan, but each MCO plan was also approved by the physicians. Plans were then blindly reviewed 3 weeks after planning by the treating physician. Results: In all cases, the treatment planning time was vastly shorter for the MCO planning (average MCO treatment planning time was 12 min; average standard planning time was 135 min). The physician involvement time in the planning process increased from an average of 4.8 min for the standard process to 8.6 min for the MCO process. In all cases, the MCO plan was blindly identified as the superior plan. Conclusions: This provides the first concrete evidence that MCO-based planning is superior in terms of both planning efficiency and dose distribution quality compared with the current trial and error-based IMRT planning approach.

  14. Job embeddedness as a nurse retention strategy for rural hospitals.

    PubMed

    Stroth, Chandra

    2010-01-01

    RN turnover is expensive and disruptive for rural hospitals, constraining finances, impacting patient care, and stressing remaining nurses. Recent investigations have described a promising new construct related to employee retention: job embeddedness. Leaders in nonhealthcare organizations have adopted a job-embeddedness model to guide retention strategies and experienced a subsequent reduction in turnover. The author explores job embeddedness as an effective retention plan strategy for rural hospitals. PMID:20010375

  15. Wiring a medical school and teaching hospital for telemedicine.

    PubMed

    Hjelm, N M; Lee, J C K; Cheng, D; Chui, C

    2002-06-01

    The planning and installation of a telemedicine system for communication within a teaching hospital and its academic and hospital units with a capacity for accommodation of up to 400 video-stations is described. The system is intended for improving the communication between patients and health professionals, and between the health professionals themselves. It also provides the basis for improving pre-graduate teaching, especially problem-based learning, and all aspects of postgraduate teaching. PMID:12052428

  16. Wiring a medical school and teaching hospital for telemedicine.

    PubMed

    Hjelm, N M; Lee, J C; Cheng, D; Chui, C

    2001-05-01

    The planning and installation of a telemedicine system for communication within a teaching hospital and its academic and hospital units with a capacity for accommodation of up to 400 video-stations is described. The system is intended for improving the communication between patients and health professionals, and between the health professionals themselves. It also provides the basis for improving pre-graduate teaching, especially problem-based learning, and all aspects of postgraduate teaching. PMID:11311677

  17. Hospital pharmacy in Canada.

    PubMed

    Bachynsky, J A

    1980-04-01

    The status of Canadian hospital pharmacy and the impact of national hospital insurance on its development are discussed. The provision of health care services for Canadians is shared by the federal and provincial governments. The federal government enacts protective and regulatory legislation, compiles health statistics, promotes research, and provides direct health care for those citizens for whom it is directly responsible. Each province is responsible for hospitals, the education and training of health care professionals, public health, and the financing and administration of health insurance for all its citizens. Largely because of line-item budget allocations and a bureaucratic tendency to equalize services for the whole population, funds for existing pharmaceutical services have been assured but the introduction of upgraded or innovative programs has been difficult to achieve. The result has been an even quality of health care services, including pharmacy, throughout the country and a deficiency in clinical pharmacy programs and the trained personnel to run them. The last decade has brought advances, however, as allocation methods have changed and both hospital and insurance administrators have recognized the patient benefits and cost effectiveness of many of the newer pharmacy programs. The main challenges facing Canadian hospital pharmacy are to upgrade clinical services and education and to improve managerial and bureaucratic competence among department directors. PMID:7377213

  18. Direct hospital marketing: an idea whose time has come.

    PubMed

    Dodson, D C; Dotson, M J; Cussimanio, L

    1990-01-01

    Health care marketing has arrived swiftly and with significant impact upon the hospital scene. From the early days of rejection and suspicion of only a few years ago, it has now taken its place with other hospital management functions. Still, however, hospitals have not yet reached the degree of expertise that exists in other sectors. One of the reasons why hospitals have not fully emerged to the level of marketing expertise as many of their traditional business counterparts is that many of the areas of both the science and art of marketing have not been fully developed. One such area is direct mail marketing. Presented here is an overview of the advantages and functions of hospital direct mail marketing. A variety of examples are given with a more thorough case example being provided by Lee's Summit Community Hospital in Lee's Summit, Missouri. The successful direct mail marketing campaign there should be both an inspiration and a model for success for other hospitals. Space limitations prevent the authors from some of the more exacting details of mail marketing and, of course, successful campaigns do not happen by magic. They take careful planning, strategy, and execution. They also require a coordinated organizational and human effort to be successful. But direct mail marketing does offer a potentially new arena of marketing for most hospitals. The expertise, skill, knowledge, and technology are in place. All that is really needed is the commitment on the part of the hospital leadership. PMID:10104552

  19. Children in hospital: a design question.

    PubMed

    Vavili, F

    2000-01-01

    Holistic medicine is the global trend in medical care. It involves not only the highest possible standard of diagnosis and treatment, but also designing the whole experience of being ill and that of hospitalization. In such a frame, planning and designing for children has to be considered in such a way that a child will be helped to withstand the effects of illness, the separation from home and family and the entrance into an unusual, unfamiliar and strange world. Although the wellbeing and happiness of children in hospital is the concern of the nursing staff and of the parents, many other factors have to be satisfied also. A young ill child who has to be treated in hospital has to adjust to a number of environmental and treatment conditions which may be upsetting and may have far-reaching effects. Because of all these, much effort has been made, over the last fifty years, to develop planning and design aspects, which will make a child's life in hospital less unnatural. Furthermore, it will reduce the unavoidable and inevitable discomfort, disease, pain and misery experienced by children. These aspects include avoidance of admission of children into hospital whenever possible, operations on a daily basis, unrestricted visits, encouraging of parents to visit or to stay with their children, the provision of suitable playing facilities, materials, equipment etc. This paper will seek to explore and develop: a change in philosophy in child care, its influence on the various types of facilities, the importance of the family, the psychological needs as design factors such as security, social contacts, personal space, movement, comfort, independence, outdoor spaces and others. Factors relating to design parameters and standards will also be explored. The meaning and importance of scale is highlighted since it is felt that children are not miniature adults, but individuals with their own particular capacities. PMID:11214456

  20. Hospitals as interpretation systems.

    PubMed Central

    Thomas, J B; McDaniel, R R; Anderson, R A

    1991-01-01

    In this study of 162 hospitals, it was found that the chief executive officer's (CEO's) interpretation of strategic issues is related to the existing hospital strategy and the hospital's information processing structure. Strategy was related to interpretation in terms of the extent to which a given strategic issue was perceived as controllable or uncontrollable. Structure was related to the extent to which an issue was defined as positive or negative, was labeled as controllable or uncontrollable, and was perceived as leading to a gain or a loss. Together, strategy and structure accounted for a significant part of the variance in CEO interpretations of strategic events. The theoretical and managerial implications of these findings are discussed. PMID:1991677

  1. Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems.

    PubMed

    Melnick, Glenn A; Fonkych, Katya

    2016-01-01

    A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission) across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113%) than prices paid to all other California hospitals (70%). Prices were similar in both groups at the start of the period (approximately $9200 per admission). By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country. PMID:27284126

  2. Function of nurses and other staff to minimize hospital waste in selected hospitals in Isfahan

    PubMed Central

    Maroufi, Maryam; Javadi, Marzieh; yaghoubi, Maryam; Karimi, Saied

    2012-01-01

    Context: Medical waste (MW) is all waste materials generated at health care facilities. MW naturally is hazardous for environment and subsequently for human. Waste minimization (WM) is the latest alternative for risk reduction. All hospital staff generally and nurses specially can play an active role through education and the implementation of measures to reduce medical wastage and their environmental effects. Aims: This study is aimed to compare nurses and other staff functions in selected hospitals in Isfahan about waste minimization strategies. Settings and Design: This is a descriptive analytical study. The study tool was a researcher -designed questionnaire in five area of waste minimization based on WHO recommendation. Materials and Methods: There were 90 nurses and other staff from randomized selected public and private hospitals of Isfahan as the sample of this research. This study was done in 2009. Statistical Analysis Used: Data were analyzed by t-test using SPSS16. Results: Nurses mean score of WM performance was 58.16 (12), and others was 58.56 (12.18) (of max 100). There was no significant difference between nurses and others mean score of WM performance according to t-test. There was not significant difference between WM performances of two studied groups in public and private hospitals based on t-test. Comparing between two studied groups mean scores by waste minimization areas indicated that nurses have done significantly better in source reduction area and other staffs have acted better in waste segregation (P < 0.05). Conclusions: All of hospital staff specially, nurses have an important role in qualified waste management practice of hospitals. Totally mean score of WM performance in hospitals (nurses and other) was average. With regard to other countries activities, this result is disappointing. So, it is necessary to plan educational programs for hospital staff, especially nurses. PMID:23922587

  3. Converting partial hospitals to community integrated recovery centers.

    PubMed

    Evans, Arthur; Okeke, Barnabas; Ali, Sade; Achara-Abrahams, Ijeoma; OHara, Tom; Stevenson, Tramaine; Warner, Nikena; Bolton, Cathy; Lim, Suet; Faith, Joe; King, Joan; Davidson, Larry; Poplawski, Paul; Rothbard, Aileen; Salzer, Mark

    2012-10-01

    This paper describes the conversion of partial hospitals into recovery-oriented programs as part of system transformation. Steps included: participatory planning with stakeholders; strength based assessment of resources and needs; technical assistance; and changing funding strategies. Over a period of 8 years, use of partial hospitals decreased as persons with serious mental illnesses were transitioned to community integrated recovery centers. Preliminary outcomes suggest that these programs are more effective in engaging people in the community activities of their choice, confirming previous findings that showed that partial hospitals can be converted to recovery-oriented programs that focus more directly on promoting community inclusion. PMID:22015957

  4. Marketing the hospital library.

    PubMed

    Bridges, Jane

    2005-01-01

    Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations. PMID:15982957

  5. Substance use treatment barriers for patients with frequent hospital admissions.

    PubMed

    Raven, Maria C; Carrier, Emily R; Lee, Joshua; Billings, John C; Marr, Mollie; Gourevitch, Marc N

    2010-01-01

    Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identified by a validated statistical algorithm as being at high-risk for frequent hospitalizations were interviewed at an urban public hospital. Patient drug/alcohol history, experiences with medical, psychiatric and addiction treatment, and social factors contributing to readmission were evaluated. Three themes related to SU and frequent hospitalizations emerged: (a) barriers during hospitalization to planning long-term treatment and follow-up, (b) use of the hospital as a temporary solution to housing/family problems, and (c) unsuccessful SU aftercare following discharge. These data indicate that homelessness, brief lengths of stay complicating discharge planning, patient ambivalence regarding long-term treatment, and inadequate detox-to-rehab transfer resources compromise substance-using patients' likelihood of avoiding repeat hospitalization. Intervention targets included supportive housing, detox-to-rehab transportation, and postdischarge patient support. PMID:19540700

  6. Information technology implementation in a rural hospital: a cautionary tale.

    PubMed

    Spetz, Joanne; Keane, Dennis

    2009-01-01

    An increasing number of hospitals are implementing electronic medical records and other information technology (IT), and national policy is focused on fostering expansion of these systems. In September 2004, a 100-bed acute care hospital in a rural community was awarded a grant to implement and evaluate an integrated hospital IT system. The evaluation used qualitative and quantitative methods, including examining data on patient outcomes, conducting surveys of staff, and interviewing leaders and staff about the implementation process. In the end, the hospital suffered a number of setbacks during the implementation that could provide lessons to other hospitals. The hospital was hindered by a lack of clinical leadership, staff skepticism, turnover in the executive team, an overly aggressive schedule, and a vendor whose products were not ready on time. The IT implementation was associated with a large increase in patient care errors, including medication errors, procedure errors, and patient falls. These patient errors might have been averted if the launch of the IT system had been better planned and implemented. The experience of this hospital exemplifies difficulties that can be encountered when implementing IT systems. IT implementation must have unbending support from the top level of management, strong clinical leadership, a proactive internal marketing campaign, a timeline and implementation approach that allow for learning and change, and a good IT partner. Careful planning and thoughtful perseverance are required to ensure a successful IT implementation that benefits patients. PMID:19831118

  7. A Comparison of Organizational Climate and Nurses’ Intention to Leave Among Excellence Awarded Hospitals and Other Hospitals in 2013

    PubMed Central

    Mohamadzadeh Nojehdehi, Maryam; Ashgholi Farahani, Mansoureh; Rafii, Forough; Bahrani, Nasser

    2015-01-01

    Background: Human resource is the most important factor of performance, success and better revelation of excellence goals of each organization. By performing excellence plan, healthcare organizations improve their organizational climate and play a valuable role in retaining nurses and improving the quality of their services to patients. Objectives: The aim of this study was to compare hospital organizational climate and intention to leave among working nurses in hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences. Patients and Methods: This was a cross-sectional descriptive comparison study. Its population included 248 nurses of the hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences in Iran selected by random sampling. The used instrument had three parts: the first part was related to personal characteristics, the second part was the Munn’s organizational climate questionnaire and the third part was Hinshaw’s questionnaire of “anticipated turnover scale”. Data was analyzed using SPSS software, version 17 and indices of descriptive statistics and inferential statistics. Results: The results of the mean and standard deviation for organizational climate and intention to leave in both performing and non-performing hospitals of the organizational excellence plan were respectively (65.28 ± 19.31 and 56.42 ± 21.36) and (33.64 ± 5.58 and 35.59 ± 4.94). Independent T test revealed a significant difference between the mean scores for organizational climate in both performing and non-performing hospitals, and also a significant difference between the mean scores for intention to leave in both performing and non-performing hospitals (P = 0.004). Moreover, Pearson Correlation test showed a reverse significant correlation between organizational climate and intention to leave in performing hospitals of the organizational excellence plan (r = -0.337) and non

  8. The influence of hospital integration on hospital financial performance.

    PubMed

    Kim, Yang K; Stoskopf, Carleen H; Glover, Saundra H; Park, Eun C

    2004-01-01

    A clinical and functional integration strategy has a positive influence on increasing hospital revenue, and a solely functional integration strategy has a negative influence on increasing hospital expenses. Functional integration and clinical/functional integration strategies have a positive influence on hospital profit and the overall operations of the hospital. The mechanism of influence differs, however, based on the strategy used. Clinical/functional strategy has an impact on increasing hospital revenue, while functional integration strategy has an impact on reducing hospital expenses. Overall, the study shows that a functional integration strategy is more profitable than a clinical/functional integration strategy. PMID:15816230

  9. ICT in nursing in Dutch hospitals.

    PubMed

    Hilderink, H G M; Epping, P; Goossen, W T F

    2002-01-01

    VIZI and its successor NICTIZ (National ICT Institute for Healthcare) carried out a study to assess the status of ICT use in hospitals. The statutory obligation for the retention of care records and instructions was highlighted by the professional nursing institutions. Literature was studied to find out more about the contribution of nursing records to the care provided. Nursing records are kept in all hospitals, and keeping a good record is essential to the care. Nevertheless not much evidence was found to support the idea that the traditional way of keeping of keeping a nursing record has substantial positive effect on the care provided. It became clear however that Clinical Pathways does indeed seem to be promising as a protocol for treating patients and putting demands on registration, and to provide a clear method by which the electronic nursing record could be built up as a part of the integrated electronic patient record. By means of two questionnaires, one applied to suppliers and one applied to hospitals, the status of ICT in hospitals was addressed. It transpired that several suppliers are active in this area, but usually with general EPR systems which have little dedicated functionality for nurses. The number of nurses in hospitals who are using computers on a regular basis is on the increase. It also transpired that most of the functions that are being used by nurses are general functions such as recording demographic patient data, roster planning, etc. Finally we asked the hospitals to send us information about their own projects. Some 20 projects where submitted, 10 of which were regarded as being significant. The best application was rewarded with a prize. PMID:15058418

  10. Moving into a new hospital: strategies for success.

    PubMed

    Ecoff, Laurie; Thomason, Tanna

    2009-12-01

    The work of moving into a new hospital does not end with construction. Planning a move must include preparing staff and physicians for the changes in their usual routines in care delivery. This bimonthly department expands nurse leaders' knowledge and competencies in health facility design and enables them to lead in transition planning for operations in a new setting. As editor of the Health Facility Design department, I asked the guest authors to describe their use of conceptual frameworks and change acceleration processes to ensure a successful transition to a new hospital tower. PMID:19955959

  11. Evaluation of Patient Safety Indicators in Semnan City Hospitals by Using the Patient Safety Friendly Hospital Initiative (PSFHI)

    PubMed Central

    Babamohamadi, Hassan; Nemati, Roghayeh Khabiri; Nobahar, Monir; Keighobady, Seifullah; Ghazavi, Soheila; Izadi-Sabet, Farideh; Najafpour, Zhila

    2016-01-01

    Background: Nowadays, patient safety issue is among one of the main concerns of the hospital policy worldwide. This study aimed to evaluate the patient safety status in hospitals affiliated to Semnan city, using the WHO model for Patient Safety Friendly Hospital Initiatives (PSFHI) in summer 2014. Methods: That was a cross sectional descriptive study that addressed patient safety, which explained the current status of safety in the Semnan hospitals using by instrument of Patient safety friendly initiative standards (PSFHI). Data was collected from 5 hospitals in Semnan city during four weeks in May 2014. Results: The finding of 5 areas examined showed that some components in critical standards had disadvantages. Critical standards of hospitals including areas of leadership and administration, patient and public involvement and safe evidence-based clinical practice, safe environment with and lifetime education in a safe and secure environment were analyzed. The domain of patient and public involvement obtained the lowest mean score and the domain of safe environment obtained the highest mean score in the surveyed hospitals. Conclusion: All the surveyed hospitals had a poor condition regarding standards based on patient safety. Further, the identified weak points are almost the same in the hospitals. Therefore, In order to achieve a good level of all aspects of the protocol, the goals should be considered in the level of strategic planning at hospitals. An effective execution of patient safety creatively may depend on the legal infrastructure and enforcement of standards by hospital management, organizational liability to expectation of patients, safety culture in hospitals. PMID:27045391

  12. Hospital structure and consumer satisfaction.

    PubMed Central

    Fleming, G V

    1981-01-01

    This study examines the relationship between hospital structural characteristics and patient satisfaction with hospital care. Teaching hospitals and private hospitals were expected to receive higher ratings of patient satisfaction than were nonteaching and government-controlled hospitals, because they generally are reputed to be technologically superior. Results show that, in general, most patients are satisfied with their hospital stays, but they are clearly more dissatisfied with their stays in teaching hospitals. Although a number of other correlates of patient satisfaction with the hospital stay are identified, no measure succeeds in reducing to insignificance the strong relationship between teaching status and dissatisfaction. Some suggestions are made as to why teaching hospital receive relatively poor evaluations from their patients. PMID:7228714

  13. Introduction to hospital information systems.

    PubMed

    Vegoda, P R

    1987-01-01

    The phrase, 'hospital information system', is frequently used in discussions about the flow of information throughout a hospital with the assumption that everybody has the same concept in mind. Closer examination shows that this is not necessarily the case. The author draws on his experience as the Chief Information Officer at University Hospital at Stony Brook to define a hospital information system in terms of the implementation at Stony Brook. The University Hospital Information System at University Hospital (UHIS), has received international acclaim and was recently selected by the IBM Quarterly of Australia as the world leader in hospital information systems. This paper answers four questions: What is a hospital information system? How does a hospital information system work? How do you implement a hospital information system? After the system is operational, where do you go, e.g., critical care data management, physician's office management? University Hospital at Stony Brook is located on eastern Long Island and is the tertiary care referral hospital for approximately 1.4 million people. Nothing in the hospital happens without computers. Doctors, nurses, administrators and staff at all levels rely on the system daily. The system operates 24 hours per day, seven days per week. Access to the system is through 300 terminals and 128 printers throughout the hospital. In addition to the UHIS terminals, the critical care management system which is called Patient Data Management System, (PDMS), is available at over 90 ICU beds and in the operating rooms. PMID:3585130

  14. [The founding of Zemun Hospital].

    PubMed

    Milanović, Jasmina; Milenković, Sanja; Pavlović, Momcilo; Stojanović, Dragos

    2014-01-01

    This year Zemun Hospital--Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia.The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the"Kontumac"--a quarantine established in 1730. Soon after, two more confessional hospitals were opened.The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall--the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time.The final, physical merging of these hospitals was completed in 1795. PMID:25233701

  15. Hospital restructuring and burnout.

    PubMed

    Greenglass, Esther R; Burke, Ronald J

    2002-01-01

    Increasingly, organizations are experiencing changes as a result of extensive downsizing, restructuring, and merging. In Canada, government-sponsored medicine has been affected as hospitals have merged or closed, reducing essential medical services and resulting in extensive job loss for hospital workers, particularly nurses. Hospital restructuring has also resulted in greater stress and job insecurity in nurses. The escalation of stressors has created burnout in nurses. This study examines predictors of burnout in nurses experiencing hospital restructuring using the MBI-General Survey which yields scores on three scales: Emotional exhaustion, Cynicism, and Professional efficacy. Multiple regressions were conducted where each burnout scale was the criterion and stressors (e.g., amount of work, use of generic workers to do nurses' work), restructuring effects, social support, and individual resources (e.g., control coping, self-efficacy, prior organizational commitment) were predictors. There were differences in the amount of variance accounted for in the burnout components by stressors and resources. Stressors contributed most to emotional exhaustion and least to professional efficacy. Individual resources were more likely to contribute to professional efficacy and least to emotional exhaustion. Stressors and resources accounted for approximately equal amounts of variance in cynicism. Three conclusions were drawn. First, present findings parallel others by showing that individual coping patterns contribute to professional efficacy. Second, emotional exhaustion was found to be the prototype of stress. Third, prior organizational commitment, self-efficacy, and control coping resulted in lower burnout. PMID:15137570

  16. Hospital Library Development.

    ERIC Educational Resources Information Center

    Cramer, Anne

    Although this handbook is addressed primarily to the hopital administrator, it contains material of interest to the librarian as well. Basic requirements for providing good library services to hospital staff are identified as: (1) well chosen and well trained manpower; (2) a current collection of information materials; and (3) appropriate space in…

  17. Responsible Hospitality. Prevention Updates

    ERIC Educational Resources Information Center

    Colthurst, Tom

    2004-01-01

    Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

  18. Cost characteristics of hospitals.

    PubMed

    Smet, Mike

    2002-09-01

    Modern hospitals are complex multi-product organisations. The analysis of a hospital's production and/or cost structure should therefore use the appropriate techniques. Flexible functional forms based on the neo-classical theory of the firm seem to be most suitable. Using neo-classical cost functions implicitly assumes minimisation of (variable) costs given that input prices and outputs are exogenous. Local and global properties of flexible functional forms and short-run versus long-run equilibrium are further issues that require thorough investigation. In order to put the results based on econometric estimations of cost functions in the right perspective, it is important to keep these considerations in mind when using flexible functional forms. The more recent studies seem to agree that hospitals generally do not operate in their long-run equilibrium (they tend to over-invest in capital (capacity and equipment)) and that it is therefore appropriate to estimate a short-run variable cost function. However, few studies explicitly take into account the implicit assumptions and restrictions embedded in the models they use. An alternative method to explain differences in costs uses management accounting techniques to identify the cost drivers of overhead costs. Related issues such as cost-shifting and cost-adjusting behaviour of hospitals and the influence of market structure on competition, prices and costs are also discussed shortly. PMID:12220092

  19. Mechanical engineering in hospitals.

    PubMed

    Wallington, J W

    1980-10-01

    The design of a modern hospital owes more to engineering than the layman may realize. In this context, many engineers are in the position of laymen, being unfamiliar with the multitude of services that lies behind the impressive facade of a modern hospital. In recent years medicine and surgery themselves have taken on many of the characteristics of a technology. This has required a matching development of the services both mechanical and electrical that are required in modern health care buildings. In medical terms, if the architectural features provide the 'skin' of the hospital, the mechanical and electrical engineering services provide the nerves and sinews. If we take as an example the recently completed Freeman Hospital, Newcastle upon Tyne, (Fig. 1), which cost 10 million pounds at current cost, the service network was responsible for about half the total cost. About 400 miles (643 km) of electrical wiring and more than 40 mile (64.5 km) of copper and steel piping were used to service 3000 separate rooms. This compares with percentages of between 18 and 25 per cent for other large buildings such as office blocks, hotels and sports complexes. PMID:10273268

  20. Peptic ulcer in hospital

    PubMed Central

    Johnson, H. Daintree

    1962-01-01

    This study corresponds to an estimated 142,250 admissions for peptic ulcer to the wards of National Health Service hospitals in England and Wales during the two years 1956 and 1957. It presents a picture of the incidence and mortality of complications and surgical treatment throughout England and Wales. PMID:14036965

  1. HOSPITAL FOOD NEEDS

    PubMed Central

    Hoskins, R. G.

    1919-01-01

    There are eight classes of men in the military hospital including attendants, and for each class there should be a different dietary. Major Hoskins explains this, tells clearly the common sources of waste of food, notes the amount, and suggests lines of conservation. Imagesp435-a PMID:18010115

  2. Transitions between School and Hospital for Students with Multiple Disabilities: A Survey of Causes, Educational Continuity, and Parental Perceptions.

    ERIC Educational Resources Information Center

    Borgioli, Jennifer A.; Kennedy, Craig H.

    2003-01-01

    A study investigated the causes, educational continuity, and parental perceptions associated with 19 students with multiple disabilities transitioning from school to hospital. Sixty-one percent of hospitalizations were for emergencies and only 1 in 46 hospitalizations had a transition plan to deliver educational services while students were absent…

  3. Participatory Planning.

    ERIC Educational Resources Information Center

    DeJong, William S.

    1980-01-01

    A synopsis of a Planning Assistance Kit designed by the Council of Educational Facility Planners (CEFP) and Educational Facilities Laboratories (EFL) to assist local communities in participatory planning. (MLF)

  4. Planning Diseases.

    ERIC Educational Resources Information Center

    Gabel, Medard

    1984-01-01

    To solve societal problems, both local and global, a global approach is needed. Serious diseases that are crippling present-day problem solving and planning are discussed, and the characteristics of a healthy, effective planning approach are described. (RM)

  5. Birth Plans

    MedlinePlus

    ... but your partner. previous continue More Birthing Options Atmosphere during labor and delivery. Many hospitals and birthing ... allow women to make some choices about the atmosphere in which they give birth. Do you want ...

  6. [Leadership in the hospital].

    PubMed

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments. PMID:19545081

  7. Radioactive Waste Management in A Hospital

    PubMed Central

    Khan, Shoukat; Syed, AT; Ahmad, Reyaz; Rather, Tanveer A.; Ajaz, M; Jan, FA

    2010-01-01

    Most of the tertiary care hospitals use radioisotopes for diagnostic and therapeutic applications. Safe disposal of the radioactive waste is a vital component of the overall management of the hospital waste. An important objective in radioactive waste management is to ensure that the radiation exposure to an individual (Public, Radiation worker, Patient) and the environment does not exceed the prescribed safe limits. Disposal of Radioactive waste in public domain is undertaken in accordance with the Atomic Energy (Safe disposal of radioactive waste) rules of 1987 promulgated by the Indian Central Government Atomic Energy Act 1962. Any prospective plan of a hospital that intends using radioisotopes for diagnostic and therapeutic procedures needs to have sufficient infrastructural and manpower resources to keep its ambient radiation levels within specified safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. Records should be maintained to identify the quality and quantity of radioactive waste generated and the mode of its disposal. Radiation Safety officer plays a key role in the waste disposal operations. PMID:21475524

  8. Hospitals in the year 2000: a scenario.

    PubMed

    Foster, J T

    1989-01-01

    Hospitals came into the twentieth century as creations of local, usually altruistic, interests and wrestled with accelerating change throughout the decades. Their success brought third-party financing, employee health plans, and government guarantees for charity care. Success seemed to breed success, and they raced ahead with capital investment in bricks, mortar, and high technology, only to find themselves in increasing trouble as 1990 approached. Writing from the precarious perch of the year 2000, the author views the worsening hospital situation and raises questions about the contradictions of federal interventions, the efforts to create "systems," the plight of small hospitals, and the love-hate role of medical staffs. Offered for consideration is a scenario of a health care crisis in the early 1990s comparable to the savings and loan crisis of 1988. However, this time the federal intervention is not simply in dollars, but, instead, brings on a "health for all" program with national financing and decentralized "district health" management. As in other nations of the world, hospitals become an integral part of the commitment to attack the root causes of ill health. PMID:10296999

  9. Poverty, race, and hospitalization for childhood asthma.

    PubMed Central

    Wissow, L S; Gittelsohn, A M; Szklo, M; Starfield, B; Mussman, M

    1988-01-01

    This study uses Maryland hospital discharge data for the period 1979-82 to determine whether Black children are more likely to be hospitalized for asthma and whether this difference persists after adjustment for poverty. The average annual asthma discharge rate was 1.95/1000 children aged 1-19; 3.75/1000 for Black children, and 1.25/1000 for White. Medicaid-enrolled children of both races had increased discharge rates for asthma compared to those whose care was paid for by other sources: 5.68/1000 vs 2.99/1000 for Blacks, and 3.10/1000 vs 1.11/1000 for Whites. When ecologic analyses were performed, populations of Black and White children had nearly equal asthma discharge rates after adjustment for poverty. The statewide adjusted rate was 2.70/1000 (95% CL = 1.93, 3.78) for Black children and 2.10/1000 (1.66, 2.66) for White children. Among Maryland counties and health planning districts, variation in asthma discharge rates was not associated with the supply of hospital beds or the population to primary-care physician ratio. We conclude that Black children are at increased risk of hospitalization for asthma, but that some or all of this increase is related to poverty rather than to race. PMID:3381951

  10. Radiation decontamination unit for the community hospital.

    PubMed

    Waldron, R L; Danielson, R A; Shultz, H E; Eckert, D E; Hendricks, K O

    1981-05-01

    "Freestanding" radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstruction. Because of the development of nuclear power plants in relatively remote areas and widespread transportation of radioactive materials it is important for hospitals and physicians to be prepared to handle radiation accident victims. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Ridge Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. It is important that the team leader be knowledgeable in radiation accident management and have personnel trained in radiation accident management as members of this team. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important. Periodic drills are necessary for this mobilization and the smooth operation of the unit. PMID:6784538

  11. Self-insured health plans

    PubMed Central

    McDonnell, Patricia; Guttenberg, Abbie; Greenberg, Leonard; Arnett, Ross H.

    1986-01-01

    Nationwide, 8 percent of all employment-related health plans were self-insured in 1984, which translates into more than 175,000 self-insured plans according to our latest study of independent health plans. The propensity of an organization to self-insure differs primarily by its size, with large establishments more likely to self-insure. In the overwhelming majority of cases, the self-insured benefit was hospital and/or medical. Among employers who self-insure, 23 percent self-administer, and the remaining 77 percent hire a commercial insurance company, Blue Cross/Blue Shield plan, or an independent third-party administrator to administer the health plan. PMID:10312008

  12. Comprehensive Planning.

    ERIC Educational Resources Information Center

    Pavlenko, Victor V.

    Comprehensive planning, defined as the work of those who engage in efforts, within a delimited geographic area, to identify and order the physical, social, and economic relationships of that area, is discussed in the four sections of this paper. Section I, Introduction, describes what "planning" and "comprehensive planning" are. In Section II, Why…

  13. Fire Plans

    ERIC Educational Resources Information Center

    Power, June

    2011-01-01

    Many libraries have disaster recovery plans, but not all have prevention and action plans to prepare for an emergency in advance. This article presents the author's review of the prevention and action plans of several libraries: (1) Evergreen State College; (2) Interlochen Public Library; (3) University of Maryland, Baltimore-Marshall Law Library;…

  14. Physician attitudes and family planning in Nigeria.

    PubMed

    Covington, D L; Otolorin, E O; Janowitz, B; Gates, D S; Lamptey, P; Ladipo, O A

    1986-01-01

    This study examines family planning attitudes and practices of 681 Nigerian physicians selected from cities in which large university teaching hospitals are located. About half of the physicians were practicing family planning; the method of choice was the IUD. Obstetrician/gynecologists and general practitioners were more likely to provide methods to their patients than were other types of physicians. The physicians were concerned about population growth and favored family planning, yet a substantial minority believed that family planning is foreign to the culture and that it promotes promiscuity. Physicians were reluctant to promote family planning on a wide scale; many disapproved of non-physicians providing oral contraceptives or IUDs. PMID:3750358

  15. Smart Information System for Gachon University Gil Hospital

    PubMed Central

    Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

    2012-01-01

    Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476

  16. Hospital marketing orientation and managed care processes: are they coordinated?

    PubMed

    White, K R; Thompson, J M; Patel, U B

    2001-01-01

    The hospital marketing function has been widely adopted as a way to learn about markets, attract sufficient resources, develop appropriate services, and communicate the availability of such goods to those who may be able to purchase such services. The structure, tasks, and effectiveness of the marketing function have been the subject of increased inquiry by researchers and practitioners alike. A specific understanding of hospital marketing in a growing managed care environment and the relationship between marketing and managed care processes in hospitals is a growing concern. Using Kotler and Clarke's framework for assessing marketing orientation, we examined the marketing orientation of hospitals in a single state at two points in time--1993 and 1999. Study findings show that the overall marketing orientation score decreased from 1993 to 1999 for the respondent hospitals. The five elements of the Kotler and Clarke definition of marketing orientation remained relatively stable, with slightly lower scores related to customer philosophy. In addition, we evaluated the degree to which selected managed care activities are carried out as part of its marketing function. A significant (p < .05) decrease in managed care processes coordinated with the formal marketing function was evident from 1993 to 1999. With increasing numbers of managed care plan enrollees, hospitals are likely focusing on organizational buyers as important customers. In order to appeal to organizational buyers, hospital executives may be focusing more on clinical quality and cost efficiency in the production of services, which will improve a hospital's position with organizational buyers. PMID:11570344

  17. Family planning in Singapore.

    PubMed

    Kanagaratnam, K

    1968-01-01

    Since the initial voluntary efforts of the Singapore Family Planning Association in 1949, family planning in Singapore has made important progress. This effort extended over the years until the end of 1965 when the government accepted full responsibility for family planning on a national scale. In September 1965, the government announced a 5-year National Family Planning Program with the goal of reducing the birthrate from 32/1000 in 1964 to below 20/1000 by 1970. This would result in a growth rate of not more than 1.5%. The government program aims at reaching 60% of married women in the reproductive age range of 15-45. It is estimated that out of 450,000 in this age range, some 300,000 are married. The target is 180,000 in 5 years. The Singapore Family Planning & Population Board was established by an Act of Parliament and charged with responsibility for the implementation of the 5-year plan. The national program offers a menu card of all family planning methods except abortion. Initial focus was on the IUD as the method of choice for 80%. Oral contraception (OC) was the preferred alternative for the remaining 20%. Other conventonal methods also were available. A few months after the plan began in 1966, the IUD became unacceptable to Singapore women. Its side effects of bleeding, cramps, perforation, and pregnancy were exaggerated by rumors. By the middle of 1966, attendance and acceptors in the national program had declined. Emphasis in the national program was changed to OCs, which now are the mainstay of family planning. Currently, nearly 65% of the acceptors use OCs. The program also demonstrates the importance, especially in urban areas, of the tremendous impact of a postpartum family planning service. Over 70% of the births in Singapore take place at the Kandang Kerbau Maternity Hospitals. Government midwives deliver another 5%. All these women are contacted by a team of family planning workers in the postpartum period and are offered family planning. Nearly

  18. Utilizing a microcomputer-based physician incentive compensation program to increase inpatient hospital utilization and improve cost management.

    PubMed

    Annis, R J; Holton, J W

    1987-08-01

    This paper will address the complex issues of effective cost management and declining inpatient volume. Utilizing a microcomputer-based physician incentive compensation program, it will show how a hospital developed a plan to increase inpatient hospital utilization and improve cost management. It will discuss the Internal Revenue, HCFA, and legal implications of the plan. PMID:3312460

  19. The general NFP hospital model.

    PubMed

    Al-Amin, Mona

    2012-01-01

    Throughout the past 30 years, there has been a lot of controversy surrounding the proliferation of new forms of health care delivery organizations that challenge and compete with general NFP community hospitals. Traditionally, the health care system in the United States has been dominated by general NFP (NFP) voluntary hospitals. With the number of for-profit general hospitals, physician-owned specialty hospitals, and ambulatory surgical centers increasing, a question arises: “Why is the general NFP community hospital the dominant model?” In order to address this question, this paper reexamines the history of the hospital industry. By understanding how the “general NFP hospital” model emerged and dominated, we attempt to explain the current dominance of general NFP hospitals in the ever changing hospital industry in the United States. PMID:22324062

  20. Guide to Choosing a Hospital

    MedlinePlus

    ... the following and more: • Find hospitals by name, city, county, state, or ZIP code. • Check the results ... by the hospital name, or by ZIP Code, City, State or Territory, or County. • Select General Search, ...

  1. Public-private settlement and hospital mortality per sources of payment

    PubMed Central

    Machado, Juliana Pires; Martins, Mônica; Leite, Iuri da Costa

    2016-01-01

    ABSTRACT OBJECTIVE To analyze if the adjusted hospital mortality varies according to source of payment of hospital admissions, legal nature, and financing settlement of hospitals. METHODS Cros-ssectional study with information source in administrative databases. Specific hospital admission reasons were selected considering the volume of hospital admissions and the list of quality indicators proposed by the North-American Agency for Healthcare Research and Quality (AHRQ). Were analyzed 852,864 hospital admissions of adults, occurred in 789 hospitals between 2008 and 2010, in Sao Paulo and Rio Grande do Sul, applying multilevel logistic regression. RESULTS At hospital admission level, showed higher chances of death male patients in more advanced age groups, with comorbidity, who used intensive care unit, and had the Brazilian Unified Health System as source of payment. At the level of hospitals, in those located in the mean of the distribution, the adjusted probability of death in hospital admissions financed by plan or private was 5.0%, against 9.0% when reimbursed by the Brazilian Unified Health System. This probability increased in hospital admissions financed by the Brazilian Unified Health System in hospitals to two standard deviations above the mean, reaching 29.0%. CONCLUSIONS In addition to structural characteristics of the hospitals and the profile of the patients, interventions aimed at improving care should also consider the coverage of the population by health plans, the network shared between beneficiaries of plans and users of the Brazilian Unified Health System, the standard of care to the various sources of payment by hospitals and, most importantly, how these factors influence the clinical performance. PMID:27463256

  2. How hospitals approach price transparency.

    PubMed

    Houk, Scott; Cleverley, James O

    2014-09-01

    A survey of finance leaders found that hospitals with lower charges were more likely than other hospitals to emphasize making prices defensible rather than simply transparent. Finance leaders of hospitals with higher charges were more likely to express concern that price transparency would cause a reduction in hospital revenue by forcing them to lower charges. Those respondents said commercial payers likely will have to agree to renegotiate contracts for price transparency to be a financially viable proposition. PMID:25647890

  3. Product lines in hospitals.

    PubMed

    Weber, J R

    1986-01-01

    The findings presented in the case study demonstrate that financial analysis is only as valid as the assumptions it is based upon. The single most important task is the definition of the clinical product. All other associated data is suspect and can lead to serious errors in business decisions if the product is poorly defined. A comprehensive case mix system, integrated with other financial systems with flexible reporting capabilities is required. The hospital and physicians must be willing to invest the time and expense necessary to ensure that the data is reliable. The hospital must be prudent in determining what cost finding approach they will elect to use. Although the RCC method has some fundamental problems, care must be taken not to develop a cost system that will require a significant amount of effort to maintain. PMID:10311387

  4. [Homicide crimes in hospitals].

    PubMed

    Dürwald, W

    1993-02-01

    Report of some cases of willful homicide in hospitals of the former GDR. In no case the patient has wished his death. Besides compassion the cause of the homicide was a large carefully expense and in two cases the attempt to prove the incapability of the competent doctor. The patients were only means to an end. All the cases are discovered by the great number of obscure death. PMID:8438538

  5. Hospitality in College Composition Courses

    ERIC Educational Resources Information Center

    Haswell, Janis; Haswell, Richard; Blalock, Glenn

    2009-01-01

    There has been little discussion of hospitality as a practice in college writing courses. Possible misuses of hospitality as an educational and ethical practice are explored, and three traditional and still tenable modes of hospitality are described and historicized: Homeric, Judeo-Christian, and nomadic. Application of these modes to…

  6. Before Hospitalization: A Preparation Program

    ERIC Educational Resources Information Center

    Johnson, Beverly H.

    1974-01-01

    A tour of the hospital, a puppet show, and a discussion period afterwards over lemonade and cookies are all part of one hospital's efforts to prepare children and their families for the hospitalization, surgery, or other experiences young patients must undergo. (Author/CS)

  7. Hospitality Studies: Escaping the Tyranny?

    ERIC Educational Resources Information Center

    Lashley, Conrad

    2015-01-01

    Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…

  8. Childrens Hospital Inservice Education Curriculum.

    ERIC Educational Resources Information Center

    Lutz, Joan

    A description is provided of a 15-month, in-service nursing education program at Childrens Hospital (Los Angeles, California). The first sections of the paper describe Childrens Hospital and provide a rationale for the hospital-based program. A listing of program goals and objectives is also provided, indicating that the curriculum is designed to…

  9. Library Hospitality: Some Preliminary Considerations

    ERIC Educational Resources Information Center

    Johnson, Eric D. M.; Kazmer, Michelle M.

    2011-01-01

    Library scholars and practitioners have frequently reflected on the various factors that in combination make up a hospitable library, but there has been little theoretical synthesis of the notion of the library as a place of hospitality. The hospitality industry provides a rich vein of theoretical material from which to draw definitions of…

  10. Hospitality Services. Student Activity Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…

  11. Measuring comparative hospital performance.

    PubMed

    Griffith, John R; Alexander, Jeffrey A; Jelinek, Richard C

    2002-01-01

    Leading healthcare provider organizations now use a "balanced scorecard" of performance measures, expanding information reviewed at the governance level to include financial, customer, and internal performance information, as well as providing an opportunity to learn and grow to provide better strategic guidance. The approach, successfully used by other industries, uses competitor data and benchmarks to identify opportunities for improved mission achievement. This article evaluates one set of nine multidimensional hospital performance measures derived from Medicare reports (cash flow, asset turnover, mortality, complications, length of inpatient stay, cost per case, occupancy, change in occupancy, and percent of revenue from outpatient care). The study examines the content validity, reliability and sensitivity, validity of comparison, and independence and concludes that seven of the nine measures (all but the two occupancy measures) represent a potentially useful set for evaluating most U.S. hospitals. This set reflects correctable differences in performance between hospitals serving similar populations, that is, the measures reflect relative performance and identify opportunities to make the organization more successful. PMID:11836965

  12. [The hospital ship Jutlandia].

    PubMed

    Winge, M

    1996-01-01

    The Danish contribution to the United Nations action during the Korean War (1950-52) was the hospital ship "Jutlandia". The motorvessel Jutlandia - 8.500 tons - was built by the Nakskov Shipyard in 1934, and was rebuilt in three months at the same shipyard to a modern hospital ship with 300 beds, 3 operating theatres, a dental clinic, an x-ray department etc. The crew and the hospital staff consisted approximately each of 100 persons. Jutlandia sailed for Korea on Jan. 23. 1951 and the expedition ended in Copenhagen on Oct. 16. 1953. On the first two cruises the ship was stationed at Pusan. During the first period mostly as an "evacuation sick-bay" and during the second period the ship was opened for Korean military and civil patients, and extensive help was given to the local population on shore. While in Denmark between the second and third cruise a helicopter deck was installed and the operating theatre for neuro-surgery was changed to an opthalmic clinic. This time the ship was stationed at the Bay of Ichon so close to the front, that the wounded could be admitted directly from the advanced dressing stations. On the return journeys to Europe patients were sailed to their home countries. Commodore Kai Hammerich was in charge of the expedition and captain Christen Kondrup was in charge of the ship, throughout the whole expedition. PMID:11625136

  13. 42 CFR 456.180 - Individual written plan of care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Individual written plan of care. 456.180 Section 456.180 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Plan of Care § 456.180 Individual written plan of care. (a) Before admission to a mental hospital...

  14. 10 CFR 455.20 - Contents of State Plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Contents of State Plan. 455.20 Section 455.20 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS State Plan Development and Approval § 455.20 Contents of State Plan. Each State shall...

  15. Standards for Hospital Libraries 2002 with 2004 revisions.

    PubMed

    2005-01-01

    The Medical Library Association's Standards for Hospital Libraries 2002 has 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 plan, the promotion and publicity of the KBI 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 together. PMID:15795962

  16. Abortion a business hurdle for nation's Catholic hospitals.

    PubMed

    Burda, D

    1989-08-25

    Abortion is the foremost moral issue for 626 Catholic hospitals nationwide since church teachings prohibit the performance of elective abortions. This and the fact that Catholic hospitals can not do voluntary sterilizations can hinder their ability to get managed care contracts. In some cases a hospital will not join a network because abortions and sterilizations are done in other hospitals in the network. In other cases they have been in plans where abortions are performed in other contract facilities; this does not violate the Catholic church policy since the abortions are not performed in their facility. When a Catholic and secular hospital plan a merger, Catholic ideals seem to take precedence. A Catholic hospital that went bankrupt in Philadelphia, was turned over to investors, and was under no obligation to follow the Catholic church's directives, but did not perform abortions anyway. In Washington state there are merger talks going on between a secular facility and the Franciscan Health System. The cessation of abortion and sterilization services appear to be outweighed by the financial benefits. Besides, these procedures can be performed through other providers in the area. In Michigan similar merger talks may fail because of the abortion issue. The government justice system is investigating and is likely to challenge any merger there. PMID:10294510

  17. Competition in hospital and health insurance markets: a review and research agenda.

    PubMed Central

    Morrisey, M A

    2001-01-01

    OBJECTIVES: To review the empirical literature on the effects of selective contracting and hospital competition on hospital prices, travel distance, services, and quality; to review the effects of managed care penetration and competition on health insurance premiums; and to identify areas for further research. PRINCIPAL FINDINGS: Selective contracting has allowed managed care plans to obtain lower prices from hospitals. This finding is generalizable beyond California and is stronger when there is more competition in the hospital market. Travel distances to hospitals of admission have not increased as a result of managed care. Evidence on the diffusion of technology in hospitals and the extent to which hospitals have specialized as a result of managed care is mixed. Little research on the effects on quality has been undertaken, but preliminary evidence suggests that hospital quality has not declined and may have improved. Actual mergers in the hospital market have not affected hospital prices. Much less research has been focused on managed care markets. Greater market penetration and greater competition among managed care plans are associated with lower managed care premiums. Greater HMO penetration appears to be much more effective than PPO penetration in leading to lower premiums. While workers are willing to change plans when faced with higher out-of-pocket premiums, there is little evidence of the willingness of employers to switch plan offerings. Preliminary evidence suggests that greater managed care penetration has led to lower overall employer premiums, but the results differ substantially between employers with and without a self-insured plan. CONCLUSIONS: Much more research is needed to examine all aspects of managed care markets. In hospital markets, particular attention should be focused on the effects on quality and technology diffusion. PMID:11327174

  18. Predictors of Emotional Well-Being in Elderly after Hospitalization.

    ERIC Educational Resources Information Center

    Lurie, Elinore; And Others

    In previous research, two major sets of variables have been identified as correlates of emotional well-being among the elderly: measures of physical health and of social support. To suggest variables predictive of in-hospital discharge planning, and of emotional well-being after a severe incident of ill health, the Posthospital Support Study…

  19. ESL for Hotel/Hospitality Industry. Level: Beginner.

    ERIC Educational Resources Information Center

    Western Suffolk County Board of Cooperative Educational Services, Northport, NY.

    This document contains eight lesson plans for a beginning course in work-related English for non-English or limited-English speaking entry-level employees in the hotel and hospitality industry. Course objectives include the following: helping participants understand and use job-specific vocabulary; receive and understand job-related instructions;…

  20. Hospital incident command system: tool for a TJC accreditation survey.

    PubMed

    Shaw, Kenneth A; Wilson, Karen D; Brown, Judy E

    2016-01-01

    The unannounced Joint Commission (TJC) accreditation survey can prove just as unpredictable and challenging as any other incident. In this article, the authors describe a plan developed by a hospital emergency response team that has proven successful in dealing with TJC and other surveys. PMID:26978959

  1. Planning ahead: Improving escalation plans before the weekend.

    PubMed

    Zarkali, Angeliki; Black, Duncan; Smee, Elizabeth; Deshraj, Anshul; Smallwood, Nicholas

    2014-01-01

    Handover is the system by which responsibility for patient care is transferred between healthcare professionals. A significant aspect of handover is the existence of an escalation plan for each patient in case of deterioration over the weekend. According to the Royal College of Physicians, all patients should have a clear escalation plan documented in the notes before a weekend, since parent medical teams (Consultant team in charge of care) are best placed to make these decisions. If left to on-call teams, at a time of deterioration over a weekend, they might not have all available information, the patient might be unable to be involved in the decisions, and the family might not be consulted. With this is mind, we decided to analyse the existing handover process in a medium sized district general hospital, with the aim of improving the process and the documentation of escalation plans. The results from our retrospective analysis of the system in place revealed a significant lack of documentation of escalation plans in the medical notes. Three sample wards were selected to analyse the current handover system and test proposed measures before hospital-wide implementation. After trialling of a physical handover meeting in addition to the existing intranet system and a proforma for the Friday ward round, the documentation of escalation plans in the patients' notes improved from 9.1% to 41.1%. Based on these results, as well as formal feedback from junior doctors and informal feedback from other staff, the physical handover meeting and Friday ward round proforma will be implemented throughout the Trust. Our interventions led to an improvement in the documentation of escalation plans in our hospital, thus saving precious time in the event of a patient's deterioration. This also ensures that families and patients are involved in the decision making process and kept informed, and reduces the burden for the weekend on-call teams. PMID:26734241

  2. [Hospital infection--ethical aspects].

    PubMed

    Hossne, W S

    1995-01-01

    The author focuses the question of hospital infection, analysing the background on which the control committees were created. The hospital infection is discussed under bioethical principles and the Medical Ethics Code, examining the aspects related to the government, the Hospital Directorship, the Committee and the Control Service of Hospital Infection, and the assisting physician. A closer integration between the activities of the Program of Control of Hospital Infections and those of the Medical Ethics Committee is proposed, aiming at the patient and at the community, "targets of total medical attention". PMID:7550409

  3. Georgia hospital hit by F3 tornado--all patients evacuated through the ED.

    PubMed

    2007-04-01

    When an F3 tornado severely damaged a hospital in Americus, GA, all patients had to be evacuated through the emergency department. Fifty-three patients were evacuated by area ambulances and a school bus to other hospitals in the region. The hospital advises others to have an internal evacuation plan as well as two-way radios, a megaphone to direct staff and volunteers, and additional security. A temporary treatment area was set up at a local church. PMID:17438990

  4. Design and implementation of picture archiving and communication system in Huadong Hospital

    NASA Astrophysics Data System (ADS)

    Zhang, Jianguo; Zhou, Zheng; Zhuang, Jun; Han, Ruolin; Zhang, Guozhen; Feng, Jie; Wang, Mingpeng; Wang, Chuanfu

    2001-08-01

    Huadong hospital in Shanghai with 700 beds provides health care services for inpatients and outpatients, as well as special senior and VIP patients. In order to move to digital imaging based radiology practice, and also provide better intra-hospital clinical services for senior and VIP patients, we started designing and planning PACS implementation from September of 1999. Based on the radiology service model and current workflow in Huadong hospital, we implemented PACS in three steps.

  5. Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy

    PubMed Central

    McHugh, Matthew D.

    2010-01-01

    Hospital restructuring policies and an impending nursing workforce shortage have threatened the nation’s emergency preparedness. Current emergency response plans rely on sources of nurses that are limited and overestimated. A national investment in nursing education and workforce infrastructure, as well as incentives for hospitals to efficiently maximize nurse staffing, are needed to ensure emergency preparedness in the United States. This review highlights the challenges of maintaining hospital nursing surge capacity and policy implications of a nursing shortage. PMID:20840714

  6. Hospital Acquisitions Before Healthcare Reform.

    PubMed

    McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun

    2015-01-01

    The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities. PMID:26554263

  7. Quality Management Systems Implementation Compared With Organizational Maturity in Hospital

    PubMed Central

    Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiyasvand, Hesam

    2016-01-01

    Background: A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders’ satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. Objectives: We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. Materials and Methods: This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. Results: According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Conclusions: Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be

  8. A Relational Approach to Measuring Competition Among Hospitals

    PubMed Central

    Sohn, Min-Woong

    2002-01-01

    Objective To present a new, relational approach to measuring competition in hospital markets and to compare this relational approach with alternative methods of measuring competition. Data Sources The California Office of Statewide Health Planning and Development patient discharge abstracts and financial disclosure files for 1991. Study Design Patient discharge abstracts for an entire year were used to derive patient flows, which were combined to calculate the extent of overlap in patient pools for each pair of hospitals. This produces a cross-sectional measure of market competition among hospitals. Principal Findings The relational approach produces measures of competition between each and every pair of hospitals in the study sample, allowing us to examine a much more “local” as well as dyadic effect of competition. Preliminary analyses show the following: (1) Hospital markets are smaller than thought. (2) For-profit hospitals received considerably more competition from their neighbors than either nonprofit or government hospitals. (3) The size of a hospital does not matter in the amount of competition received, but the larger hospitals generated significantly more competition than smaller ones. Comparisons of this method to the other methods show considerable differences in identifying competitors, indicating that these methods are not as comparable as previously thought. Conclusion The relational approach measures competition in a more detailed way and allows researchers to conduct more fine-grained analyses of market competition. This approach allows one to model market structure in a manner that goes far beyond the traditional categories of monopoly, oligopoly, and perfect competition. It also opens up an entirely new range of analytic possibilities in examining the effect of competition on hospital performance, price of medical care, changes in the market, technology acquisition, and many other phenomena in the health care field. PMID:12036003

  9. Limited Use of Price and Quality Advertising Among American Hospitals

    PubMed Central

    Wilks, Chrisanne E A; Richter, Jason P

    2013-01-01

    Background Consumer-directed policies, including health savings accounts, have been proposed and implemented to involve individuals more directly with the cost of their health care. The hope is this will ultimately encourage providers to compete for patients based on price or quality, resulting in lower health care costs and better health outcomes. Objective To evaluate American hospital websites to learn whether hospitals advertise directly to consumers using price or quality data. Methods Structured review of websites of 10% of American hospitals (N=474) to evaluate whether price or quality information is available to consumers and identify what hospitals advertise about to attract consumers. Results On their websites, 1.3% (6/474) of hospitals advertised about price and 19.0% (90/474) had some price information available; 5.7% (27/474) of hospitals advertised about quality outcomes information and 40.9% (194/474) had some quality outcome data available. Price and quality information that was available was limited and of minimal use to compare hospitals. Hospitals were more likely to advertise about service lines (56.5%, 268/474), access (49.6%, 235/474), awards (34.0%, 161/474), and amenities (30.8%, 146/474). Conclusions Insufficient information currently exists for consumers to choose hospitals on the basis of price or quality, making current consumer-directed policies unlikely to realize improved quality or lower costs. Consumers may be more interested in information not related to cost or clinical factors when choosing a hospital, so consumer-directed strategies may be better served before choosing a provider, such as when choosing a health plan. PMID:23988296

  10. Assessing key stakeholders: who matters to hospitals and why?

    PubMed

    Fottler, M D; Blair, J D; Whitehead, C J; Laus, M D; Savage, G T

    1989-01-01

    A key stakeholder perspective, informed by illustrative quantitative and qualitative data, is developed for hospital administrators. These data provide answers to the questions, Who matters to hospitals? and Why do they matter? A tool kit for assessing stakeholders also is presented to help hospital executives identify their institutions' key stakeholders, determine the power of these stakeholders and their core values, and define who within their institutions should be responsible for the routine management of different stakeholders. These tools facilitate the management of each key stakeholder, ensuring that each strategic decision is examined in terms of the likely reaction of key stakeholders and is supplemented with plans for gaining stakeholder acceptance. Managers should recognize that the answers to Who matters? and Why? will vary by type of hospital and by the specific issue being addressed. PMID:10295896

  11. [Success factors in hospital management].

    PubMed

    Heberer, M

    1998-12-01

    The hospital environment of most Western countries is currently undergoing dramatic changes. Competition among hospitals is increasing, and economic issues have become decisive factors for the allocation of medical care. Hospitals therefore require management tools to respond to these changes adequately. The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements, the needs of the customers, process development, and organizational learning. This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland. Strategic management, the focus of medical services, customer orientation, and integration of professional groups across the hospital value chain were identified as success factors for hospital management. PMID:10023551

  12. In-Hospital Ischemic Stroke

    PubMed Central

    2015-01-01

    Between 2.2% and 17% of all strokes have symptom onset during hospitalization in a patient originally admitted for another diagnosis or procedure. These in-hospital strokes represent a unique population with different risk factors, more mimics, and substantially worsened outcomes compared to community-onset strokes. The fact that these strokes manifest during the acute care hospitalization, in patients with higher rates of thrombolytic contraindications, creates distinct challenges for treatment. However, the best evidence suggests benefit to treating appropriately selected in-hospital ischemic strokes with thrombolysis. Evidence points toward a “quality gap” for in-hospital stroke with longer in-hospital delays to evaluation and treatment, lower rates of evaluation for etiology, and decreased adherence to consensus quality process measures of care. This quality gap for in-hospital stroke represents a focused opportunity for quality improvement. PMID:26288675

  13. Hospital to School Transitions for Children: A Multiple Case Study of Family Experiences

    ERIC Educational Resources Information Center

    Rager, Rhiannon Y.

    2013-01-01

    Children with emotional and behavioral disorders often present with significant impairments in social, emotional, and academic functioning. For those with the most severe impairments, hospitalization is an essential intervention. Prior to releasing children from the hospital, a discharge plan is typically created in order to facilitate successful…

  14. 42 CFR 412.130 - Retroactive adjustments for incorrectly excluded hospitals and units.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... part regarding 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... October 1, 1991, based on a certification under § 412.30(a) regarding the inpatient population...

  15. Saving it for later. Healthy hospitals turn to layoffs to bend own cost curve.

    PubMed

    Evans, Melanie

    2011-06-27

    When the credit crisis hit in 2008, many hospitals reacted by cutting staff. While credit access and the markets may have rebounded, hospital spending hasn't and some are still looking for cuts. Dennis Dahlen, of Banner Health, recently told the health system's investors that executives will "plan for the worst and work for the best." PMID:21853603

  16. Hospital capacity during an influenza pandemic-Buenos Aires, Argentina, 2009.

    PubMed

    Meites, Elissa; Farias, Daniel; Raffo, Lucrecia; Albalak, Rachel; Carlino, Oreste Luis; McDonald, L Clifford; Widdowson, Marc-Alain

    2011-01-01

    At a major referral hospital in the Southern Hemisphere, the 2009 influenza A (H1N1) pandemic brought increased critical care demand and more unscheduled nursing absences. Because of careful preparedness planning, including rapid expansion and redistribution of the numbers of available beds and staff, hospital surge capacity was not exceeded. PMID:21087127

  17. Hospital mission and cost differences.

    PubMed

    Sorrentino, E A

    1989-01-01

    The results show no significant differences on average length of stay, cost per patient day, or cost per admission among non-profit, government, and for-profit hospitals when controlling for bed capacities, occupancy rates, number of Medicare/Medicaid days, and hospitals without nurseries. For-profit hospital manhours per patient day were significantly lower than non-profit and government hospitals. This is an important finding because patient-care delivery is labor-intensive. A majority of for-profit hospitals do not have nurseries, which means that they should have more manhours per patient day. As indicated earlier, the manhours for hospitals with nurseries are higher than those for hospitals without nurseries. This indicates cost-cutting behavior on the part of a majority of for-profit hospitals. This method of limiting expenditures by decreasing labor costs associated with certain services is consistent with profit-maximization. The findings of this study with regard to cost differences among non-profit and for-profit hospitals contradict previous research. However, a recent study by Kralewski, Gifford and Porter (1988) noted that whereas ownership, when considered alone, differentiates hospitals, when evaluated within each community, most of the investor-owned and non-for-profit hospital differences disappear. Similar questions have been raised as to whether non-profit hospitals truly differ from for-profit hospitals (Pauly 1987). Caution needs to be exercised in attempting to extrapolate the findings of this study, because of the dynamic health care environment. Hospital ownership changes over time, reimbursement rules affect behavior, and internal factors in organizational operation affect outcomes. These should be considered in future studies exploring organizational mission and cost differences. PMID:10293600

  18. Predicting days in hospital using health insurance claims.

    PubMed

    Xie, Yang; Schreier, Gunter; Chang, David C W; Neubauer, Sandra; Liu, Ying; Redmond, Stephen J; Lovell, Nigel H

    2015-07-01

    Health-care administrators worldwide are striving to lower the cost of care while improving the quality of care given. Hospitalization is the largest component of health expenditure. Therefore, earlier identification of those at higher risk of being hospitalized would help health-care administrators and health insurers to develop better plans and strategies. In this paper, a method was developed, using large-scale health insurance claims data, to predict the number of hospitalization days in a population. We utilized a regression decision tree algorithm, along with insurance claim data from 242 075 individuals over three years, to provide predictions of number of days in hospital in the third year, based on hospital admissions and procedure claims data. The proposed method performs well in the general population as well as in subpopulations. Results indicate that the proposed model significantly improves predictions over two established baseline methods (predicting a constant number of days for each customer and using the number of days in hospital of the previous year as the forecast for the following year). A reasonable predictive accuracy (AUC =0.843) was achieved for the whole population. Analysis of two subpopulations-namely elderly persons aged 63 years or older in 2011 and patients hospitalized for at least one day in the previous year-revealed that the medical information (e.g., diagnosis codes) contributed more to predictions for these two subpopulations, in comparison to the population as a whole. PMID:25680222

  19. Modeling Evacuation of a Hospital without Electric Power.

    PubMed

    Vugrin, Eric D; Verzi, Stephen J; Finley, Patrick D; Turnquist, Mark A; Griffin, Anne R; Ricci, Karen A; Wyte-Lake, Tamar

    2015-06-01

    Hospital evacuations that occur during, or as a result of, infrastructure outages are complicated and demanding. Loss of infrastructure services can initiate a chain of events with corresponding management challenges. This report describes a modeling case study of the 2001 evacuation of the Memorial Hermann Hospital in Houston, Texas (USA). The study uses a model designed to track such cascading events following loss of infrastructure services and to identify the staff, resources, and operational adaptations required to sustain patient care and/or conduct an evacuation. The model is based on the assumption that a hospital's primary mission is to provide necessary medical care to all of its patients, even when critical infrastructure services to the hospital and surrounding areas are disrupted. Model logic evaluates the hospital's ability to provide an adequate level of care for all of its patients throughout a period of disruption. If hospital resources are insufficient to provide such care, the model recommends an evacuation. Model features also provide information to support evacuation and resource allocation decisions for optimizing care over the entire population of patients. This report documents the application of the model to a scenario designed to resemble the 2001 evacuation of the Memorial Hermann Hospital, demonstrating the model's ability to recreate the timeline of an actual evacuation. The model is also applied to scenarios demonstrating how its output can inform evacuation planning activities and timing. PMID:25868416

  20. Simulation in hospitals.

    PubMed

    Proctor, T

    1996-01-01

    Health care costs continue to rise because increased demand for services and limited budgets put pressure on resources, however efficiently they may be used. Proposes discrete event simulation as an effective tool in the search for more efficient health care systems. Looks at the application of a desktop computer simulation package to model part of a hospital subsystem. The simulation package shows how efficiency might be improved by moderating available resources and times taken to complete tasks. Maintains that the principles expounded here are applicable to many different aspects of health care management. PMID:10161783

  1. Hospital board extramural services.

    PubMed

    Wright-St Clair, R E

    1981-12-23

    A hospital board has an obligation to provide services in the community but it is essential that those extramural services act in collaboration with and not in competition with all other services in the community. In particular, it is essential that we maintain the primacy of general practice and in return the general practitioner must accept full responsibility for the care of his patients in their homes, rehabilitation and encouraging the maximum possible independence on the part of the patients and their families must be the constant theme of the extramural services. PMID:6950292

  2. Implementation of the totally integrated hospital information system (Humane) in Osaka University Hospital.

    PubMed

    Matsumura, Y; Takeda, H; Inoue, M

    1995-01-01

    On September 1, 1993, in the new Osaka University Hospital, we implemented a new hospital information system named "HUMANE" (Human oriented Universal Medical Assessment system by Network Environment). We had planned to organize a more effective and efficient medical care system in the new hospital and improve the medical services to patients. To succeed in constructing a totally integrated hospital information system, the original data must be entered. Most of it would be entered by doctors who are not accustomed to the operation of a computer system, thus the production of a good man-machine interface is indispensable. For this reason, we adopted a micro-medium-main frame link system for the system configuration. The interface program and the copy of the master data about each subsystem are located on the microframe. Although, all patient data is stored on the mainframe, most of the active patients' data is delivered to the mediumframe before the data is requested. This system design makes it possible to shorten the response time and to use a comfortable user interface. On the basis of this system configuration, we made subsystems that support hospital management, for example, an ordering system, a reporting system, a reservation system, a supporting system for hospitalization, a nurse supporting system, and so on. These systems promote automation control in each central service division; pharmacy, radiology, laboratory for clinical investigation and accounting section, resulting in man-power being saved. At the same time, medical service to patients is improved, because waiting time is shortened and redundant examinations or prescription are avoided. PMID:8591271

  3. Transition Planning

    ERIC Educational Resources Information Center

    Statfeld, Jenna L.

    2011-01-01

    Post-school transition is the movement of a child with disabilities from school to activities that occur after the completion of school. This paper provides information about: (1) post-school transition; (2) transition plan; (3) transition services; (4) transition planning; (5) vocational rehabilitation services; (6) services that are available…

  4. Planned orphanhood.

    PubMed

    Landau, R

    1999-07-01

    Medical technology, which today makes it possible to bear a child after death, enables planned orphanhood. The first part of this paper will discuss the medical innovations in human conception, the psycho-social aspects of the wish for children from the genes of someone who is no longer alive, and the ensuing orphanhood and its implications. The second part will discuss the ethical issues relating to planned orphanhood: Who are involved in the matter of planned orphanhood? Is the decision to produce a planned orphan a private or public matter? Whose responsibility is the birth and bringing up of the planned orphan? To whom does society have more responsibility - the children who already exist or future children? And can planned orphanhood be regarded as a justification for wrongful conception? The last part of the paper will examine the judicial aspects of planned orphanhood in Israel and elsewhere and discuss the application of the principles of human dignity, human welfare, and justice. The paper argues for discouraging planned orphanhood so as to avoid violating the principles of human dignity and liberty, human welfare, and human justice, from the perspectives of both those who are involved in the process in general and the orphan who is the target of the medical intervention in particular. Its aim is to encourage deep and comprehensive public discussion of this issue in all its aspects. PMID:10414828

  5. Expedition Planning.

    ERIC Educational Resources Information Center

    Ewert, Alan

    Planning an expedition, particularly an expedition to climb Mount McKinley, can appear monumental. Not only must the obvious items like food, equipment and personnel be carefully planned, but attention must also focus on "insignificant" items like applications and reservations which, if forgotten, could mean the difference between a successful or…

  6. Planning Matters

    ERIC Educational Resources Information Center

    Ira, Vanessa B.

    2012-01-01

    The reality is sobering. According to a report published on the online site of Children's Hospital Boston, about 57,000 babies weighing less than 1,500 grams (3 pounds, 4 ounces) are born annually in the United States. With medical advances, as of 2005, survival of these frail infants has increased from about 20 percent 15 years ago to nearly 90…

  7. Planning a Tech Prep Program in Hospitality. Final Report.

    ERIC Educational Resources Information Center

    Chicago City Colleges, IL. Chicago City-Wide Coll.

    A project conducted to establish tech prep articulation training agreements between City Colleges of Chicago and several public secondary schools is described in this report. Project activities were as follows: (1) developed a handbook to define the tech prep experience and guide committee members on how tech prep can be a valuable asset to…

  8. Redesigning nurse staffing plans for acute care hospitals.

    PubMed

    Niday, Patricia; Inman, Yolanda Otero; Smithgall, Lisa; Hilton, Shane; Grindstaff, Sharon; McInturff, Debbie

    2012-06-01

    Johnson City Medical Center's approach to maximizing staffing in nursing units, particularly in acute care settings, had four primary goals: Identify opportunities to maximize the effectiveness of nurse staffing based on a review of core staffing schedules. Reduce cost duplication and improve workflow. Decrease the use of contract labor (with the goal of eliminating the use of contract labor). Develop financial dashboards for staffing that could be used by nursing managers. PMID:22734326

  9. Succession Planning and Financial Performance: Does Competition Matter?

    PubMed

    Patidar, Nitish; Gupta, Shivani; Azbik, Ginger; Weech-Maldonado, Robert

    2016-01-01

    Succession planning has been defined as the process by which one or more successors are identified for key positions, development activities are planned for identified successors, or both. Limited research exists pertaining to the relationship between hospital succession planning and financial performance, particularly in the context of market competition. We used the resource-based view framework to analyze the differential effect of succession planning on hospitals' financial performance based on market competition. According to RBV, organizations can achieve higher performance by using their superior resources and capabilities. We used a panel design consisting of a national sample of hospitals in the United States for 2006-2010. We analyzed data using multivariate linear regression with facility random effects and year and state fixed effects. The sample included 22,717 hospital-year observations; more than one half of the hospitals (55.4%) had a succession planning program. The study found a positive relationship between the presence of succession planning and financial performance (β = 1.41, p < .01), which was stronger in competitive markets (β = 2.31, p = .03) than in monopolistic markets (β = 1.06, p = .01). Hospitals can use these results to make informed decisions about investing in succession planning programs on the basis of competition in their market. PMID:27356448

  10. [Family and psychiatric hospitalization in a general hospital].

    PubMed

    de Mello, Rita Mello; Schneider, Jacó Fernando

    2011-06-01

    This study aims to identify the reasons that lead relatives to hospitalize patients in a psychiatric unit of a general hospital. It is a qualitative study based on Alfred Schutz' phenomenological sociology. Fourteen relatives, each with one family member hospitalized, were interviewed from August to October 2009. The guiding question of the phenomenological interview was "What do you expect from psychiatric hospitalization in a general hospital?". Phenomenological sociology was used to understand and interpret the interviews. Statements showed three concrete categories, that lead to the reasons for: treatment guidelines and continuity; prospects for improvement; ideas about normality. This research shows the experiences of relatives, contributing with mental health professionals' reflection about their actions and about the involvement of families in a general hospital's psychiatric unit. PMID:21987981

  11. Electronic Cigarettes on Hospital Campuses

    PubMed Central

    Meernik, Clare; Baker, Hannah M.; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O.

    2015-01-01

    Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62%) completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors. PMID:26729142

  12. Rural hospital information technology implementation for safety and quality improvement: lessons learned.

    PubMed

    Tietze, Mari F; Williams, Josie; Galimbertti, Marisa

    2009-01-01

    This grant involved a hospital collaborative for excellence using information technology over 3-year period. The project activities focused on the improvement of patient care safety and quality in Southern rural and small community hospitals through the use of technology and education. The technology component of the design involved the implementation of a Web-based business analytic tool that allows hospitals to view data, create reports, and analyze their safety and quality data. Through a preimplementation and postimplementation comparative design, the focus of the implementation team was twofold: to recruit participant hospitals and to implement the technology at each of the 66 hospital sites. Rural hospitals were defined as acute care hospitals located in a county with a population of less than 100 000 or a state-administered Critical Access Hospital, making the total study population target 188 hospitals. Lessons learned during the information technology implementation of these hospitals are reflective of the unique culture, financial characteristics, organizational structure, and technology architecture of rural hospitals. Specific steps such as recruitment, information technology assessment, conference calls for project planning, data file extraction and transfer, technology training, use of e-mail, use of telephones, personnel management, and engaging information technology vendors were found to vary greatly among hospitals. PMID:19574745

  13. Design of paediatric hospitals.

    PubMed

    Lambert, Veronica

    2016-05-01

    The impact of healthcare environments on children and young people's (CYP) health and psychosocial wellbeing has attracted much attention in recent years. This sits within the realm of the political drive for enhanced awareness of the need to take account of the rights and voice of the child. Perhaps as a direct result of the United Nations Convention on the Rights of the Child, and recognition from evidence in adult population studies of the impact of healthcare environments on psychosocial healing, contemporary times have witnessed a discernible movement towards enhancing quality care by promoting child and adolescent-friendly hospital environments. The Council of Europe guidelines on child-friendly health care moved to place the rights and needs of children at the heart of health care. The Council acknowledges that the delivery of child-oriented services, which includes the notion of family-centred care, should be delivered in child and family friendly environments. However, knowledge about what constitutes a child-friendly healthcare environment from CYP's perspective is often lacking with hospital architectural blueprints predominantly designed around adult proxy-reported assumptions about the needs and desires of children. PMID:27214414

  14. The preparedness of hospital Health Information Services for system failures due to internal disasters.

    PubMed

    Lee, Cheens; Robinson, Kerin M; Wendt, Kate; Williamson, Dianne

    2009-01-01

    The unimpeded functioning of hospital Health Information Services (HIS) is essential for patient care, clinical governance, organisational performance measurement, funding and research. In an investigation of hospital Health Information Services' preparedness for internal disasters, all hospitals in the state of Victoria with the following characteristics were surveyed: they have a Health Information Service/ Department; there is a Manager of the Health Information Service/Department; and their inpatient capacity is greater than 80 beds. Fifty percent of the respondents have experienced an internal disaster within the past decade, the majority affecting the Health Information Service. The most commonly occurring internal disasters were computer system failure and floods. Two-thirds of the hospitals have internal disaster plans; the most frequently occurring scenarios provided for are computer system failure, power failure and fire. More large hospitals have established back-up systems than medium- and small-size hospitals. Fifty-three percent of hospitals have a recovery plan for internal disasters. Hospitals typically self-rate as having a 'medium' level of internal disaster preparedness. Overall, large hospitals are better prepared for internal disasters than medium and small hospitals, and preparation for disruption of computer systems and medical record services is relatively high on their agendas. PMID:19546484

  15. Organizational and market factors associated with leadership development programs in hospitals: a national study.

    PubMed

    Kim, Tae Hyun; Thompson, Jon M

    2012-01-01

    Effective leadership in hospitals is widely recognized as the key to organizational performance. Clinical, financial, and operational performance is increasingly being linked to the leadership practices of hospital managers. Moreover, effective leadership has been described as a means to achieve competitive advantage. Recent environmental forces, including reimbursement changes and increased competition, have prompted many hospitals to focus on building leadership competencies to successfully address these challenges. Using the resource dependence theory as our conceptual framework, we present results from a national study of hospitals examining the association of organizational and market factors with the provision of leadership development program activities, including the presence of a leadership development program, a diversity plan, a program for succession planning, and career development resources. The data are taken from the American Hospital Association's (AHA) 2008 Survey of Hospitals, the Area Resource File, and the Centers for Medicare & Medicaid Services. The results of multilevel logistic regressions of each leadership development program activity on organizational and market factors indicate that hospital size, system and network affiliation, and accreditation are significantly and positively associated with all leadership development program activities. The market factors significantly associated with all leadership development activities include a positive odds ratio for metropolitan statistical area location and a negative odds ratio for the percentage of the hospital's service area population that is female and minority. For-profit hospitals are less likely to provide leadership development program activities. Additional findings are presented, and the implications for hospital management are discussed. PMID:22530292

  16. Implementing successful strategic plans: a simple formula.

    PubMed

    Blondeau, Whitney; Blondeau, Benoit

    2015-01-01

    Strategic planning is a process. One way to think of strategic planning is to envision its development and design as a framework that will help your hospital navigate through internal and external changing environments over time. Although the process of strategic planning can feel daunting, following a simple formula involving five steps using the mnemonic B.E.G.I.N. (Begin, Evaluate, Goals & Objectives, Integration, and Next steps) will help the planning process feel more manageable, and lead you to greater success. PMID:26058285

  17. Housestaff coverage in a nonteaching community hospital.

    PubMed

    Conti, A

    1994-11-01

    In August 1992, a project team of senior medical and administrative personnel was formed (Housestaff Coverage Project Team) at the Park Ridge Health System, Rochester, N.Y.. The team was given a mandate to address housestaff coverage, primarily from an economic standpoint. Through total quality management (TQM), the project team sought to develop a house coverage plan that was sustainable, efficient, and effective. A plan was developed that includes three layers of service. A minimum "standard hospital coverage" would be available to all physicians and their patients and cover the basic needs of admission, crisis intervention, and issues of length of stay. A complete level of service would be available under the title of "case management" and would consist of total patient management, under the direction of the attending physician, from admission through discharge. The third level of service available to both "standard" and "case managed" patients would be a "consultative service." The latter would function as a traditional in-house medical service and would bill for its services. Park Ridge Hospital believes it has developed a system of housestaff coverage that is sustainable, efficient, and effective. An evaluation mechanism, primarily addressed at length of stay, will tell if we are correct in this assumption. PMID:10140893

  18. 40 CFR 62.3340 - Identification of plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Gases, Organic Compounds and Nitrogen Oxide Emissions from Existing Hospital / Medical Infectious Waste... enforceable mechanism for this plan is 35 Ill. Adm. Code 229. The rule was adopted by the Illinois...

  19. 40 CFR 62.3110 - Identification of plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., Organic Compounds, Particulates and Nitrogen Oxide Emissions from Existing Hospital/medical/infectious..., 1996, as described in 40 CFR part 60, subpart Ce. (This plan does not apply to facilities on...

  20. Union Density and Hospital Outcomes.

    PubMed

    Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha

    2015-01-01

    The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction. Union density is not related to healthcare quality as measured by the AMI mortality rate or to net income per bed. This implies that unions per se are not good or bad for hospitals. The authors suggest that it is better for hospital administrators to take a Balanced Scorecard approach and be concerned about employee satisfaction, patient satisfaction, healthcare quality, and net income. PMID:26652043

  1. Variation and Trends in Lower Extremity Amputation Rates in Los Angeles County Hospitals 2000-2010.

    PubMed

    Jindeel, Ayad; Gessert, Charles; Johnson, Brian P

    2016-09-01

    Lower extremity amputation (LEA) is a preventable complication of diabetes and peripheral vascular disease. Hospital-related factors associated with higher LEA are low hospital LEA revascularization volume, rural setting, and nonteaching status. In this study, we describe LEA rates in health care systems and hospitals in Los Angeles County from 2000 to 2010. Data on hospital discharges in Los Angeles County from 2000 to 2010 were obtained from the California Office of Statewide Health Planning and Development. LEA rates were adjusted for clinical and demographic variables including age, sex, race, source of health care payment, diabetes, and peripheral vascular disease. Adjusted LEA rates over the study period were analyzed by category of hospital (municipal, nonprofit/non-Kaiser, Kaiser, and private), and for changes in rates in each hospital over the study period. Over the 11-year study period the LEA rates increased for municipal hospitals, while decreasing for the other 3 categories of hospitals. Among the 84 hospitals included in the final analysis, 41 hospitals had higher than average relative risk for LEA in 2007-2010. Among these hospitals 12 had higher than average decline in LEA rate between 2000-2003 and 2007-2010. The other 29 hospitals had not lowered the LEA rate as much as the whole County over the study period. After adjusting for demographic and clinical variables, the relative risk for LEA among hospitals varied by 7.5-fold. Significant variability was found both within each of the 4 types of hospitals, and between the 4 types. Hospitals also varied in the degree that they lowered their LEA rates. This study demonstrated that health care systems and hospitals are associated with significant disparity in LEA rates among socioeconomic groups and geographical regions. PMID:27335119

  2. RFID solution benefits Cambridge hospital.

    PubMed

    James, Andrew

    2013-10-01

    Keeping track of thousands of pieces of equipment in a busy hospital environment is a considerable challenge, but, according to RFID tagging and asset tracking specialist, Harland Simon, RFID technology can make the task considerably simpler. Here Andrew James, the company's RFID sales manager, describes the positive benefits the technology has brought the Medical Equipment Library (MEL) at Addenbrooke's Hospital, one of the world's most famous teaching hospitals. PMID:24341115

  3. Cottage hospitals: an evident future.

    PubMed

    Davidson, N

    1980-05-23

    When Nick Davidson visited the Yeatman Cottage Hospital in Sherborne, Dorset, he found a beautiful country town with a history and a hospital with its roots in the past. It has grown to be not only part of the present, but a model for the future. As he toured Sherborne Abbey, in the process of restoration thanks to the public's generosity, he reflected on the town's other 'good cause'--the Yeatman Cottage Hospital. PMID:10297860

  4. IK Brunel's Crimean war hospital.

    PubMed

    Merridew, C G

    2014-07-01

    "Those wonderful huts…" (Florence Nightingale). This is the story of the British Civil Hospital, erected in 1855 at Renkioi on the south Dardanelles coast of Turkey. The spectacular hospital was a portable one designed by British engineer IK Brunel. It was his only health-related project, and it was known as a Civil Hospital because its staff were all civilians, despite its patients being military. PMID:25196954

  5. Lower Mortality in Magnet Hospitals

    PubMed Central

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2014-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082

  6. Lower Mortality in Magnet Hospitals

    PubMed Central

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2012-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence— Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared to non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet vs. non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor’s degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (OR 0.86, 95% CI 0.76-0.98, p=0.02) and 12% lower odds of failure-to-rescue (OR 0.88, 95% CI 0.77-1.01, p=0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions Magnet hospitals have lower mortality than is fully accounted for by measured characteristics of nursing. Magnet recognition likely both identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:23047129

  7. Wearing gloves in the hospital

    MedlinePlus

    Infection control - wearing gloves; Patient safety - wearing gloves; Personal protective equipment - wearing gloves; PPE - wearing gloves; Nosocomial infection - wearing gloves; Hospital acquired infection - wearing gloves

  8. Financial burden of emergency preparedness on an urban, academic hospital.

    PubMed

    Petinaux, Bruno

    2009-01-01

    This study assessed the direct human resource costs of a hospital's emergency preparedness planning (in 2005) by surveying participants retrospectively. Forty participants (74% of the identified population) were surveyed. Using the self-reported hourly salary of the participant, a direct salary cost was calculated for each participant. The population was 40% male and 60% female; 65% had a graduate degree or higher; 65% were administrators; 35% were clinicians; and 50% reported that their job description included a reference to emergency planning activities. All participants spent a combined total of 3,654.25 hours on emergency preparedness activities, including 20.1% on personal education/training; 11.6% on educating other people; 39.3% on paperwork or equipment maintenance; 22.2% on attendance at meetings; 5.6% on drill participation; and <1% on other activities. Considering the participants' hourly salary, direct personal costs spent on emergency preparedness activities at the institution totaled US$232,417.Ten percent, all of whom were physicians, reported no compensation for their emergency preparedness efforts at the hospital level. As much as these results illustrate the strong commitment of the institution to its community, they represent a heavy burden in light of the often unfunded mandate of emergency preparedness planning that a hospital may incur. Such responsibility is carried to some extent by all hospitals. PMID:20066636

  9. Hunger: a hospital survey.

    PubMed

    Rosenberg, E; Bernabo, L

    1992-01-01

    Patients at a New York City municipal hospital were surveyed in 1985 and 1989 to ascertain the extent of hunger and its possible correlates. Twenty-two percent (22%) of the 382 subjects in 1985 and 23% of the 332 subjects in 1989 experienced hunger. Hunger was related significantly to homelessness, social isolation and the physical inability to buy and/or prepare food. Between 1985 and 1989, there was a large increase in the use of institutional resources for food; a decline in reliance on Food Stamps; and an increase in household density. Inpatients were found to be poorer than outpatients, and to rely more heavily upon soup kitchens. Practice, policy and research implications are noted. PMID:1589827

  10. Practice and hospital economics.

    PubMed

    Senagore, Anthony J

    2006-08-01

    There has been a significant effort over the past 10 years to attempt to control the rate of increase in the cost of medical care. However, as is true of any economic system, there are multiple stakeholders involved and often competing motivations. The single largest source of medical inflation is the cost of pharmaceuticals; however, this topic is not directly discussed in this article Similarly, the cost of medical insurance products is not included as these issues cannot be directly addressed by physician behavior. The body of this discussion focuses on costs directly experienced by or potentially controlled by physicians. These areas include practice expense and margin and hospital direct costs and margin. It is essential for physicians to understand fully factors they can potentially control and areas they may be able to influence in this troubling era of cost containment. PMID:20011377

  11. Third Floor Plan, Second Floor Plan, First Floor Plan, Ground ...

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

    Third Floor Plan, Second Floor Plan, First Floor Plan, Ground Floor Plan, West Bunkhouse - Kennecott Copper Corporation, On Copper River & Northwestern Railroad, Kennicott, Valdez-Cordova Census Area, AK

  12. Southwest elevation, roof plan, site plan & main floor plan, ...

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

    Southwest elevation, roof plan, site plan & main floor plan, loft plan, section looking east, north window head detail - Richard Buckminster Fuller & Anne Hewlett Fuller Dome Home, 407 South Forest Avenue, Carbondale, Jackson County, IL

  13. Competing forces, collaborative solutions: a vision for hospital-physician relationships.

    PubMed

    Smith, Alison P

    2007-01-01

    At a time when hospitals and physicians are struggling to survive, one institution envisioned a new definition of community hospital care that was dependent upon more collaborative relationships with its physicians. Northwest Community Hospital (NCH) created the Northwest Community Hospital Physicians Cooperative, a unique membership group offering access to professional liability insurance, joint venture investment opportunities, and other physician practice support services. The "price" for membership is a cooperative relationship. The scope of this cooperation includes adherence to clinical best practice and safety guidelines, adoption of information technology for patient care management, collaboration with hospitalists, and service in leadership and planning activities for clinical programs. PMID:17974094

  14. Examining sustainability in a hospital setting: Case of smoking cessation

    PubMed Central

    2011-01-01

    Background The Ottawa Model of Smoking Cessation (OMSC) is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Methods Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up) were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Results Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Conclusions Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during implementation may provide insight

  15. Assessment of Hospital Pharmacy Preparedness for Mass Casualty Events

    PubMed Central

    Awad, Nadia I.; Cocchio, Craig

    2015-01-01

    Objectives: To assess the preparedness of hospital pharmacies in New Jersey to provide pharmaceutical services in mass casualty scenarios. Methods: An electronic cross-sectional survey was developed to assess the general knowledge of available resources and attitudes toward the preparedness of the pharmacy department. Results: Out of 60 invitations to participate, 18 surveys (30%) were completed. Respondents practiced at community hospitals (12, 66.6%) with no trauma center designation (11, 67.4%) that served more than 500 licensed beds (five, 29.4%). Six respondents (35.3%) indicated that 75,000 to 100,000 patients visited their emergency departments annually. Seventeen sites (94.4%) reported the existence of an institutional disaster preparedness protocol; 10 (55.5%) indicated that there is a specific plan for the pharmacy department. Most respondents (10, 55.5%) were unsure whether their hospitals had an adequate supply of analgesics, rapid sequence intubation agents, vasopressors, antiemetics, respiratory medications, ophthalmics, oral antimicrobials, and chemical-weapon-specific antidotes. Five (27.7%) agreed that the pharmacy disaster plan included processes to ensure care for patients already hospitalized, and four (22.2%) agreed that the quantity of medication was adequate to treat patients and hospital employees if necessary. Medication stock and quantities were determined based on national or international guidelines at three (16.6%) institutions surveyed. Conclusion: This survey demonstrates a lack of general consensus regarding hospital pharmacy preparedness for mass casualty scenarios despite individualized institutional protocols for disaster preparedness. Standardized recommendations from government and/or professional pharmacy organizations should be developed to guide the preparation of hospital pharmacy departments for mass casualty scenarios. PMID:25859121

  16. Proposal of benchmark to study hospital management sustainability.

    PubMed

    Nishida, Zaiken

    2008-07-01

    Well, regarding how I introduced this story today, I thought that I would have to add a new story due to the original request from Vice President Sato. There were other situations. The other day, Mr. Miyabayashi visited my office at the University of Shizuoka, he looked like lack of spirit. I asked him what was wrong. He told me that an incorporated foundation running a mental hospital consulted with him concerning rebuilding their mental hospital that was in practice in the town. It has been in business for a long time. When they opened business, the place was not a commercial center. However, the place is in the town now, so they would like to replace the old building with a new one. They have been running the hospital in the red for the last several years, so they were wondering how to rebuild the hospital under these conditions. Simply put, since the land price went up since the opening of business, they will sell the half of the land and rebuild a new building on the remaining land using the land money and loan from the bank. However, the top executives of the incorporated foundation have been replaced completely, and there are no people related to the owner family. Hired president and hired hospital director wished to rebuild with a gorgeous hospital. Then he sit up all night to write a draft of the down-to-earth hospital rebuilding plan because their future repayment would be deadlocked if they built such a gorgeous hospital. Then he brought the plan to them. However, his client became angry after reading it, and he was banned from the hospital. He felt depressed and visited me in Shizuoka. I have come to like the universal coverage health insurance system while studying hospital management sustainability. The universal coverage health insurance system in Japan is the envy of the world. It functions if there is a medical institution nearby when a citizen owning an insurance certificate becomes ill. Today, it is functioning, so citizens' satisfaction level

  17. Hospitals cannot afford to be without access to MRI.

    PubMed

    Dougherty, E; Hagin, D

    1989-05-01

    Although practicing state-of-the-art diagnostic medicine is impossible without access to magnetic resonance imaging, this high-ticket technology is a mixed blessing in an era of cost containment. The good news is that MRI's diagnostic capabilities continue to grow, and the prices for scanners are dropping. However, MRI services remain expensive, and reimbursement is declining. To get the maximum benefit from MRI, physicians must stay up to date with the latest advances, a task that hospitals can facilitate through educational programs. Hospitals need to plan carefully for the introduction or expansion of MRI services, but the end result will be better patient care. PMID:10293190

  18. Hospital technology management: the Tao of clinical engineering.

    PubMed

    Gordon, G J

    1990-01-01

    Planning a profession's future is a formidable task that must be based on both what the members want to become and what is natural to the marketplace. The hospital industry, however, will not wait for clinical engineering to establish its profession. Competition will arise and push aside the unprepared. Clinical engineering's leadership has not created a clear vision of their profession's role in improving healthcare, nor have they helped others to internalize a sincere professional purpose and to share the responsibility for change. This paper examines the profession and articulates action that only clinical engineers can take to increase their value in the hospital industry. PMID:10104536

  19. Evolution of the UCSF Distributed Hospital Information System

    PubMed Central

    Shafarman, Mark; Mapp, Tom; Yip, Rod

    1988-01-01

    The scope of this paper is the continued development of the local area network for application level data exchange in a distributed hospital data network. The need for a modular distributed hospital information system has been well articulated in the past [1]. UCSF Medical Center has been a seminal development center for the linking of separate clinical and administrative systems via a local area network. We discuss the successful project to replace the original prototypical fiber optic LAN [2], the improvements in LAN functionality, and future plans and options.

  20. Pain Assessment in Hospitalized Older Adults With Dementia and Delirium

    PubMed Central

    Paulson, Christina May; Monroe, Todd; Mion, Lorraine C.

    2015-01-01

    Pain can have negative effects leading to prolonged hospital stays. Determining the presence of uncontrolled and untreated pain in patients with cognitive impairments such as delirium, dementia, and delirium superimposed on dementia (DSD) is challenging. One tool commonly suggested for use in assessment of pain in older adults with cognitive impairment is the Pain Assessment In Advanced Dementia (PAINAD) scale. Proper use of the PAINAD scale as part of a comprehensive pain management plan can help reduce the likelihood of a patient experiencing unrecognized and untreated pain. Using an individual example, this article illustrates best practices in pain assessment and management for a woman experiencing DSD during an acute hospitalization. PMID:24800815

  1. Pre-hospital emergency medicine.

    PubMed

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E

    2015-12-19

    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care. PMID:26738719

  2. [Practical aspects of implementation quality management system ISO 9001:2000 by hospital infection control team].

    PubMed

    Kuziemski, Arkadiusz; Czerniak, Beata; Frankowska, Krystyna; Gonia, Ewa; Salińska, Teresa; Motuk, Andrzej; Sobociński, Zbigniew

    2009-01-01

    In 2006 the Board of the Jan Biziel Hospital in Bydgoszcz decided to include procedures of health services in the implementation process within the confines of ISO 9001:2000 certification. The hospital infection control team that has operated in the hospital since 1989 performed the analysis of the forms of activities to date and on that basis the team prepared original plan of quality management. In April 2007, this plan was successfully accepted by the certifying team. The aim of this study is to present the aforementioned plan which is the result of 18 years experience of the team. At the same time, I hope that this study will be very helpful for all professionals interested in hospital epidemiology, especially in the context of implementing quality management systems. PMID:19899608

  3. A case mix simulation decision support system model for negotiating hospital rates.

    PubMed

    Hatcher, M E; Connelly, C

    1988-12-01

    The institution of prospective payment systems by many health care insurers has drawn increased attention to case-based financial planning in hospitals. When hospital revenues are directly linked to patient diagnoses rather than to the types and quantities of services supplied to patients, managers must be aware of the financial implications of different case mixes and must be prepared to influence insurers' price structures. A case-based financial planning model is presented here for the purpose of assisting managerial decision making in the strategic areas of case mix planning and pricing. The computerized model characterizes hospitals as product manufacturers, the product being discharged patients. Diagnosis serves to differentiate the "products"; however, diagnoses are grouped by payor and similar treatment cost experiences to create a limited set of managerially meaningful case types. Diagnostic and treatment costs are also aggregated to facilitate the modeling of the hospital production process. The computerized model projects the number of patients of each case-type and total patient volume, based on estimated patient volume growth rates. The model also projects prices and contribution margins for each case-type, as well as total contribution to hospital overhead. Testing the model with a hypothetical example of a hospital strategic planning problem demonstrates the model's potential as a decision-making aid in case mix planning and case-type pricing. It also reveals several model shortcomings that require further developmental effort. PMID:3148679

  4. 40 CFR 62.14432 - When must my waste management plan be completed?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 9 2013-07-01 2013-07-01 false When must my waste management plan be... POLLUTANTS Federal Plan Requirements for Hospital/Medical/Infectious Waste Incinerators Constructed On Or Before December 1, 2008 Waste Management Plan § 62.14432 When must my waste management plan be...

  5. 42 CFR 456.142 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false UR plan requirements for medical care evaluation...: Hospitals Ur Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide...

  6. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false UR plan requirements for medical care evaluation...: Mental Hospitals Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide...

  7. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false UR plan requirements for medical care evaluation...: Mental Hospitals Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide...

  8. 42 CFR 456.242 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false UR plan requirements for medical care evaluation...: Mental Hospitals Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide...

  9. 42 CFR 456.142 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false UR plan requirements for medical care evaluation...: Hospitals Ur Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide...

  10. 42 CFR 456.142 - UR plan requirements for medical care evaluation studies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false UR plan requirements for medical care evaluation...: Hospitals Ur Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care... medical care evaluation studies under paragraph (b)(1) of this section. (b) The UR plan must provide...

  11. 78 FR 63937 - Approval and Promulgation of Implementation Plans; Approval and Promulgation of State Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... Emissions From Existing Hospital/ Medical/Infectious Waste Incinerator Units, Negative Declaration and 111(d... program and Clean Air Act (CAA) section 111(d) Plan. The purpose of these revisions is to make general... declaration and withdrawal of its section 111(d)/129 plan for Hospital Medical Infectious Waste...

  12. Family Planning Evaluation. Abortion Surveillance Report--Legal Abortions, United States, Annual Summary, 1970.

    ERIC Educational Resources Information Center

    Center for Disease Control (DHEW/PHS), Atlanta, GA.

    This report summarizes abortion information received by the Center for Disease Control from collaborators in state health departments, hospitals, and other pertinent sources. While it is intended primarily for use by the above sources, it may also interest those responsible for family planning evaluation and hospital abortion planning. Information…

  13. Collaboration Among Missouri Nonprofit Hospitals and Local Health Departments: Content Analysis of Community Health Needs Assessments

    PubMed Central

    Wilson, Kristin D.; Ciecior, Amanda; Stringer, Lisa

    2015-01-01

    Objectives. We identified the levels of joint action that led to collaboration between hospitals and local health departments (LHDs) using the hospital’s community health needs assessments (CHNAs). Methods. In 2014, we conducted a content analysis of Missouri nonprofit hospitals (n = 34) CHNAs, and identified hospitals based on previously reported collaboration with LHDs. We coded the content according to the level of joint action. A comparison sample (n = 50) of Missouri nonprofit hospitals provided the basic comparative information on hospital characteristics. Results. Among the hospitals identified by LHDs, 20.6% were “networking,” 20.6% were “coordinating,” 38.2% were “cooperating,” and 2.9% were “collaborating.” Almost 18% of study hospitals had no identifiable level of joint action with LHDs based on their CHNAs. In addition, comparison hospitals were more often part of a larger system (74%) compared with study hospitals (52.9%). Conclusions. The results of our study helped develop a better understanding of levels of joint action from a hospital perspective. Our results might assist hospitals and LHDs in making more informed decisions about efficient deployment of resources for assessment processes and implementation plans. PMID:25689184

  14. Implementing physician orders for life-sustaining treatment in California hospitals: factors associated with adoption.

    PubMed

    Sugiyama, Takehiro; Zingmond, David; Lorenz, Karl A; Diamant, Allison; O'Malley, Kate; Citko, Judy; Gonzalez, Victor; Wenger, Neil S

    2013-08-01

    Physician Orders for Life-Sustaining Treatment (POLST) is a tool to document and ensure continuity of end-of-life treatment decisions across healthcare settings that became a legal document in California in January 2009. Hospitals were surveyed to evaluate factors associated with uptake of this intervention and whether a grassroots community coalition intervention facilitated dissemination. A mail and telephone survey of all acute care hospitals in California was conducted between August 2011 and January 2012, and community coalition reports of interaction with hospitals and hospital characteristics from the California Office of Statewide Planning and Development and Census ZIP Code Tabulation Areas were analyzed. Of 349 hospitals, 286 (81.9%) responded to the survey. Sixty-five percent of hospitals had a policy about POLST, 87% had available blank POLST forms, 84% had educated staff, and 94% reported handling POLST properly in the emergency department and on admission. In multivariable analyses, hospitals in poor areas and for-profit (vs nonprofit) hospitals were less likely to stock blank POLST forms and to have educated staff, and hospitals with community coalition interaction and in wealthier areas were more likely to handle POLST forms correctly. Although POLST is widely used in California, a significant minority of hospitals remain unprepared 3 years after implementation. Efforts to improve implementation should emphasize dissemination in poorer areas and in for-profit hospitals. PMID:23865958

  15. [Bottlenecks in the provision of inpatient care--caused by the Hospital Funding Act].

    PubMed

    Jansen, Christoph

    2010-01-01

    The responsibility of the state for ensuring the provision of hospital care services to its citizens derives from the welfare state principle laid down in Sect. 20 para. 1 GG (Grundgesetz, i.e., the German constitutional law). The state fulfils this responsibility by means of planning and funding regulations in the Hospital Funding Act (KHG), the Hospital Remuneration Act (KHEntG), the National Ordinance on Hospital Rates (BPflV), the Hospital Laws of the German federal states and other supplementary legislation. The funding of hospitals is based on a dual funding system, meaning that hospital investment costs generally need to be borne by the German federal states as required, while operating costs will have to be funded through the remuneration for hospital treatments. Because of the tight budget situation of the German federal states a considerable backlog of investment has built up. After a transition period (between 2005 and 2009) operating costs are now funded on the basis of the so-called DRG system (DRG=Diagnosis Related Groups)--irrespective of the actual costs incurred by each individual hospital, which has led to a commodification of hospital care services. Whether this commodification avoids bottlenecks in the provision of health services to hospital patients or creates additional bottlenecks, is a controversial issue. PMID:20870488

  16. [The 442th military clnical hospital celebrates 180th anniversary].

    PubMed

    Lyutov, V V

    2015-07-01

    The Hospital made a great contribution to the development of national healthcare during its 180-years history. Outstanding medical scientists of XIX-XX centuries, such as Bekhterev, Sklifosovsky, Vreden, Kupriyanov, Petrov and many others stood not only behind the history of the Hospital, they represented scientific society of military medical science. The merit of the Hospital cannot be overestimated during the World War II period, when 82% of the wounded and sick soldiers were returned to duty. The Hospital is considered as one of the best hospitals in the medical service of the Western Military District of the Russian Federation. Despite the on-going reconstruction of the main building, the year of 2014 has been eventful--institutional personnel achieved positive progress in improving combat skills and field training in the sphere of medical support in the district. Nowadays the methods of tutoring seminars with all categories of personnel are actively being improved. Currently 442th Military clinical hospital of Russian Defense Ministry is in the process of acquisition of its modern appearance. Phased plan for reconstruction and capital construction of its main building is now successfully implementing. PMID:26821460

  17. How to help hospitals achieve their mission through good design.

    PubMed

    Rabner, Barry S

    2012-01-01

    In 2003, Princeton HealthCare System (PHCS) completed a strategic plan that called for replacing its 220-bed acute care hospital--a decision driven by the need to serve a growing and aging population and the demand for new programs, services, technologies, and clinical strategies. As hospitals nationwide undertake similar projects to replace aging facilities, they face many of the same challenges. Various factors must be considered when designing a new hospital. Two significant obstacles to great design exist: First, hospital executives understand the economic and clinical drivers that affect hospital care and financial performance but often lack an appreciation for how design decisions can impact these critical factors. Second, CEOs often delegate oversight to others in the organization. The CEO's direct participation is necessary to ensure that the project reflects the organization's values and strategic and operational objectives. Solutions to address this dilemma include increased use of evidence-based design and strategies such as tying payment for design services to long-term facility performance indicators. Effective partnerships among healthcare planners, facility designers, and hospital executives will result in a new facility whose design promotes improved clinical outcomes, greater patient satisfaction, and financial viability. PMID:23002564

  18. Faculty Internships for Hospitality Instructors

    ERIC Educational Resources Information Center

    Lynn, Christine; Hales, Jonathan A; Wiener, Paul

    2007-01-01

    Internships can help hospitality faculty build industry relationships while also ensuring the best and most current training for their students. Many hospitality organizations have structured faculty internships available or are willing to work with faculty to provide individualized internship opportunities. Career and technical educators in…

  19. Comparing Candidate Hospital Report Cards

    SciTech Connect

    Burr, T.L.; Rivenburgh, R.D.; Scovel, J.C.; White, J.M.

    1997-12-31

    We present graphical and analytical methods that focus on multivariate outlier detection applied to the hospital report cards data. No two methods agree which hospitals are unusually good or bad, so we also present ways to compare the agreement between two methods. We identify factors that have a significant impact on the scoring.

  20. Partners: group practices and hospitals.

    PubMed

    Schryver, D L

    1990-02-01

    Many hospital executives see the emergence of medical group practices as a threat to their autonomy. However, the degree of future success of hospitals and group practices may depend on their willingness and ability to develop common goals and strategies. PMID:10106349

  1. Latex in the Hospital Environment

    MedlinePlus

    LATEX in the Hospital Environment Updated Fall 2015 This list provides a guide to some of the most common objects containing latex and offers some ... remover–Sepha Pharm) 1 LATEX in the Hospital Environment (continued) Frequently contains LATEX OR/Infection Control masks, ...

  2. Management of the Hospital Environment

    ERIC Educational Resources Information Center

    Turner, Alvis G.

    1976-01-01

    Hospital studies indicate the need for an environmental/sanitarian specialist for control of nosocomial infection and maintenance of a quality environment. The author recommends these requirements for certification as a hospital environmentalist: academic studies including toxicology, epidemiology, hygiene, management, and an internship in…

  3. Hospitality Management Education and Training.

    ERIC Educational Resources Information Center

    Brotherton, Bob, Ed.; And Others

    1995-01-01

    Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

  4. Practicing Hospitality in the Classroom

    ERIC Educational Resources Information Center

    Burwell, Rebecca; Huyser, Mackenzi

    2013-01-01

    This article explores pedagogical approaches to teaching students how to practice hospitality toward the other. Using case examples from the college classroom, the authors discuss the roots of Christian hospitality and educational theory on transformative learning to explore how students experience engaging with others after they have…

  5. Segmentation in local hospital markets.

    PubMed

    Dranove, D; White, W D; Wu, L

    1993-01-01

    This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based on insurance coverage, particularly Medicaid, and race. Segmentation based on insurance and race is related to hospital characteristics, but not the characteristics of the hospital's community. Medicaid patients are more likely to go to hospitals with lower costs and fewer service offerings. Privately insured patients go to hospitals offering more services, although cost concerns are increasing. Hispanic patients also go to low-cost hospitals, ceteris paribus. Results indicate little evidence of segmentation based on medical condition in either 1983 or 1989, suggesting that "centers of excellence" have yet to play an important role in patient choice of hospital. The authors found that distance matters, and that patients prefer nearby hospitals, moreso for some medical conditions than others, in ways consistent with economic theories of consumer choice. PMID:8417270

  6. Improving the efficiency of district hospitals: is contracting an option?

    PubMed

    Mills, A; Hongoro, C; Broomberg, J

    1997-02-01

    cost. The nature of the contract between government and missions was implicit rather than explicit and of long standing. On the whole the mission organizations felt the informal nature of the agreement was advantageous, though the government plans to introduce service contracts at district level with all hospitals, both government and mission. The paper concludes by identifying concerns raised by the case-studies that are of relevance to other countries considering the introduction of explicit contractual arrangements for district hospital provision. PMID:9472296

  7. Gynaecological referrals to Baragwanath Hospital.

    PubMed

    Buchmann, E; Ephraim, G; Kathawaroo, S

    1994-04-01

    Three hundred and fifty-nine consecutive referral letters to Baragwanath Hospital's gynaecological outpatients' department were analysed. Letters from private doctors contained significantly less clinical information than those from clinics. Only 11% of referring private doctors mentioned what treatment they had given patients before sending them to hospital. Soweto clinic nurses tended to include more information in their letters than clinic doctors. There were no significant differences in the number of appropriate referrals and incorrect diagnoses from private doctors, clinic doctors and clinic nurses respectively. The poor communication, especially between general practitioners and the hospital, is probably the result of overwork and lack of time. Hospital doctors should reply to well-written referral letters, and liaison between clinics and the hospital ought to be improved and expanded. PMID:7974041

  8. [In-hospital emergency management].

    PubMed

    Jantzen, Tanja; Fischer, Matthias; Müller, Michael P; Seewald, Stephan; Wnent, Jan; Gräsner, Jan-Thorsten

    2013-06-01

    5-10% of in-hospital patients are affected by adverse events, 10% of these requiring CPR. Standardized in-hospital emergency management may improve results, including reduction of mortality, hospital stay and cost. Early warning scores and clinical care outreach teams may help to identify patients at risk and should be combined with standard operation procedure and consented alarm criteria. These teams of doctors and nurses should be called for all in hospital emergencies, providing high-end care and initiate ICU measures at bedside. In combination with standard means of documentation assessment and evaluation--including entry in specific registers--the quality of in-hospital emergency management and patient safety could be improved. PMID:23828085

  9. New directions in hospital governance.

    PubMed

    Shortell, S M

    1989-01-01

    This article suggests new directions for hospital governance to meet the demands of a rapidly changing health care environment. Board members must increasingly play roles as risk takers, strategic directors, experts, mentors, and evaluators. Lessons from other industries regarding risk taking, use of expertise, and streamlining decision making must be adapted to meet hospital needs. Recent data suggest that these needs may still differ by hospital ownership despite a convergence in investor-owned and not-for-profit corporate structures. The effectiveness of hospital boards in the future will depend on their ability to: (1) manage a diverse group of stakeholders; (2) involve physicians in the management and governance process; (3) meet the governance needs of multi-institutional systems and hospital restructuring; (4) meet the challenges of diversification and vertical integration; and (5) understand strategy formulation and implementation as interdependent and interrelated processes. PMID:10303235

  10. [Reasons for the construction of Bispebjerg Hospital--a hospital with light, air and freedom of nature].

    PubMed

    Permin, Henrik; Wagner, Peter

    2009-01-01

    Since the 1850ies the city of Copenhagen changed, ramparts were removed or remodelled as parks, industries were established. The new factories and wharfs expanded, labourers were needed; many country people moved into the city to find work and thus the population increased immensely. In Copenhagen a few hospitals only were present around 1850; The Royal Frederik Hospital (now the Museum of applied Arts) was the only hospital in the modern sense of the word. Other institutions with "hospital" as part of their name as e.g. General Hospital (Almindelig Hospital) or Ladegaarden were a mixture of hospital and workhouse and The Royal Maternity Hospital founded in 1750. The wealthy and the upper middle class citizens were nursed or cured at home. At the end of the nineteenth century medical doctors could successfully cure some diseases, and surgeons could after the introduction of the anesthetic and aseptic treatment carry out operations with diminished risks of complications. Copenhagen's first modern hospital, Municipal Hospital (Kommunehospitalet) opened 1863, but in a very short time it was permanently overcrowded. Although two small hospitals Blegdam Hospital (isolation hospital) and the Oresund Hospital (quarantine station) were established a large new hospital was needed. Although the financial situation of the city of Copenhagen was strained due to the expenditures caused by the rapidly growing population within the city itself and the villages incorporated into it, the first social democratic mayor Jens Jensen wanted to secure his voters the same care and treatment as citizens of better means. As this view was accepted by the majority of the city council a hospital in the then modern and functional pavilion system (ascribed to Florence Nightingale) with buildings surrounded by gardens was planned. The architect Martin Nyrop (1849-1921) who had just completed the monumental and beautiful Copenhagen City Hall along with the engineer AC Karsten (1857-1931) and

  11. Effects of payment mechanisms on hospital behaviours in Brazil: evidence from a multi-payer and multi-payment system.

    PubMed

    Couttolenc, Bernard F; Forgia, Gerard M

    2011-01-01

    A variety of provider payment mechanisms (PPMs) are used in Brazil to direct funds to hospitals. This article examines their effect on hospital efficiency, cost and quality. Public hospitals funded through the traditional line-item public budget are the best least efficient. Those funded through global budgets and other decentralized budget modalities perform on a par with private providers funded mainly by private prepaid health plans. Private hospitals that are dependent on government payments exhibit lower levels of quality. However, the overall effects of PPMs on performance are less than expected for some groups of hospitals. Factors compromising the impact of PPMs on performance are examined. PMID:22235724

  12. Beware of the biologicals--hospitals may die: the Rheumatism Foundation Hospital, Heinola, Finland (1951-2010).

    PubMed

    Kauppi, Markku J; Säilä, Hanna; Belt, Eero A; Hakala, Markku

    2012-08-01

    The first patient entered the Rheumatism Foundation Hospital, Heinola, Finland in July 1951. From that point on, the hospital helped patients suffering from rheumatic disorders. Specialists in the hospital actively developed treatments and published a large number of scientific articles in international journals. The hospital was well known internationally among people working in the field. Progress in the development of disease-modifying medication (biological agents in particular) has dramatically improved the life of patients with rheumatic diseases, but all effective treatments may also have adverse effects. In this article, we briefly review the history of the Rheumatism Foundation Hospital, which was closed permanently in March 2010 due to bankruptcy. The economical difficulties were caused primarily by the progress made in disease-modifying therapy, which decreased the need of rehabilitation and operative treatment of patients with rheumatic diseases. It seems that a great success in biological agents can carry "serious adverse effects", which may kill hospitals. This is an important primary observation, which should be noticed when the future of specialised institutes is planned. PMID:22644088

  13. Physicians and foundation hospitals.

    PubMed

    Cooper, John; Black, Carol

    2003-01-01

    Foundation NHS Trusts will be constituted in the same way as Mutual Societies, and local people and patients will be invited to become subscribers. Subscribers will elect a board of governors who will appoint the non-executive directors of the Trusts. Foundation Trusts will be outside the performance management system, but will be subject to a regulator and to inspection. Contracts with commissioners will be legally enforceable. Issues discussed in the article include: financial borrowing; whether competition is being reintroduced; poaching staff; fears of a two-tier health service; fragmentation of the NHS; the impact on research and teaching; and the impact on the current 'target culture'. Local communities and patient groups may welcome involvement with their local hospitals, but special interest groups could be a danger. Foundation Trusts may bring back some of the better features of NHS Trusts as originally conceived, and offer better opportunities for clinicians to influence local policies and priorities. Fears of yet another organisational change are an important issue. Only time will tell whether the outcome will justify the effort the changes will involve. PMID:14703035

  14. Changes in Hospital Competitive Strategy: A New Medical Arms Race?

    PubMed Central

    Devers, Kelly J; Brewster, Linda R; Casalino, Lawrence P

    2003-01-01

    Objective To describe changes in hospitals' competitive strategies, specifically the relative emphasis placed on strategies for competing along price and nonprice (i.e., service, amenities, perceived quality) dimensions, and the reasons for any observed shifts. Methods This study uses data gathered through the Community Tracking Study site visits, a longitudinal study of a nationally representative sample of 12 U.S. communities. Research teams visited each of these communities every two years since 1996 and conducted between 50 to 90 semistructured interviews. Additional information on hospital competition and strategy was gathered from secondary data. Principal Findings We found that hospitals' strategic emphasis changed significantly between 1996–1997 and 2000–2001. In the mid-1990s, hospitals primarily competed on price through “wholesale” strategies (i.e., providing services attractive to managed care plans). By 2000–2001, nonprice competition was becoming increasingly important and hospitals were reviving “retail” strategies (i.e., providing services attractive to individual physicians and the patients they serve). Three major factors explain this shift in hospital strategy: less than anticipated selective contracting and capitated payment; the freeing up of hospital resources previously devoted to horizontal and vertical integration strategies; and, the emergence and growth of new competitors. Conclusion Renewed emphasis on nonprice competition and retail strategies, and the service mimicking and one-upmanship that result, suggest that a new medical arms race is emerging. However, there are important differences between the medical arms race today and the one that occurred in the 1970s and early 1980s: the hospital market is more concentrated and price competition remains relatively important. The development of a new medical arms race has significant research and policy implications. PMID:12650375

  15. Turning around an ailing district hospital: a realist evaluation of strategic changes at Ho Municipal Hospital (Ghana)

    PubMed Central

    2010-01-01

    Background There is a growing consensus that linear approaches to improving the performance of health workers and health care organisations may only obtain short-term results. An alternative approach premised on the principle of human resource management described as a form of 'High commitment management', builds upon a bundles of balanced practices. This has been shown to contribute to better organisational performance. This paper illustrates an intervention and outcome of high commitment management (HiCom) at an urban hospital in Ghana. Few studies have shown how HiCom management might contribute to better performance of health services and in particular of hospitals in low and middle-income settings. Methods A realist case study design was used to analyse how specific management practices might contribute to improving the performance of an urban district hospital in Ho, Volta Region, in Ghana. Mixed methods were used to collect data, including document review, in-depth interviews, group discussions, observations and a review of routine health information. Results At Ho Municipal Hospital, the management team dealt with the crisis engulfing the ailing urban district hospital by building an alliance between hospital staff to generate a sense of ownership with a focus around participative problem analysis. The creation of an alliance led to improving staff morale and attitude, and contributed also to improvements in the infrastructure and equipment. This in turn had a positive impact on the revenue generating capacity of the hospital. The quick turn around in the state of this hospital showed that change was indeed possible, a factor that greatly motivated the staff. In a second step, the management team initiated the development of a strategic plan for the hospital to maintain the dynamics of change. This was undertaken through participative methods and sustained earlier staff involvement, empowerment and feelings of reciprocity. We found that these factors acted

  16. Bourdieu at the bedside: briefing parents in a pediatric hospital.

    PubMed

    LeGrow, Karen; Hodnett, Ellen; Stremler, Robyn; McKeever, Patricia; Cohen, Eyal

    2014-12-01

    The philosophy of family-centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision-making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting. PMID:24467272

  17. Strategies for Managing Mobile Devices for Use by Hospitalized Inpatients.

    PubMed

    Dykes, Patricia C; Stade, Diana; Dalal, Anuj; Clements, Marsha; Collins, Sarah; Chang, Frank; Fladger, Anne; Getty, George; Hanna, John; Kandala, Ravali; Lehmann, Lisa S; Leone, Kathleen; Massaro, Anthony F; Mlaver, Eli; McNally, Kelly; Ravindran, Sucheta; Schnock, Kumiko; Bates, David W

    2015-01-01

    Despite the potential advantages, implementation of mobile devices and ongoing management pose challenges in the hospital environment. Our team implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork among nurses, physicians, patients and to engage patients and care partners in their plan of care. In this paper, we describe the device-related decisions and challenges faced including device and accessory selection, integration, information and device security, infection control, user access, and ongoing operation and maintenance. We relate the strategies that we used for managing mobile devices and lessons learned based on our experiences. PMID:26958185

  18. Transfusion monitoring: care practice analysis in a public teaching hospital

    PubMed Central

    dos Reis, Valesca Nunes; Paixão, Isabella Bertolin; Perrone, Ana Carolina Amaral de São José; Monteiro, Maria Inês; dos Santos, Kelli Borges

    2016-01-01

    ABSTRACT Objective To analyze the process of recording transfusion monitoring at a public teaching hospital. Methods A descriptive and retrospective study with a quantitative approach, analyzing the instruments to record transfusion monitoring at a public hospital in a city in the State of Minas Gerais (MG). Data were collected on the correct completion of the instrument, time elapsed from transfusions, records of vital signs, type of blood component more frequently transfused, and hospital unit where transfusion was performed. Results A total of 1,012 records were analyzed, and 53.4% of them had errors in filling in the instruments, 6% of transfusions started after the recommended time, and 9.3% of patients had no vital signs registered. Conclusion Failures were identified in the process of recording transfusion monitoring, and they could result in more adverse events related to the administration of blood components. Planning and implementing strategies to enhance recording and to improve care delivered are challenging. PMID:27074233

  19. Strategies for Managing Mobile Devices for Use by Hospitalized Inpatients

    PubMed Central

    Dykes, Patricia C.; Stade, Diana; Dalal, Anuj; Clements, Marsha; Collins, Sarah; Chang, Frank; Fladger, Anne; Getty, George; Hanna, John; Kandala, Ravali; Lehmann, Lisa S.; Leone, Kathleen; Massaro, Anthony F.; Mlaver, Eli; McNally, Kelly; Ravindran, Sucheta; Schnock, Kumiko; Bates, David W.

    2015-01-01

    Despite the potential advantages, implementation of mobile devices and ongoing management pose challenges in the hospital environment. Our team implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women’s Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork among nurses, physicians, patients and to engage patients and care partners in their plan of care. In this paper, we describe the device-related decisions and challenges faced including device and accessory selection, integration, information and device security, infection control, user access, and ongoing operation and maintenance. We relate the strategies that we used for managing mobile devices and lessons learned based on our experiences. PMID:26958185

  20. The impact of the America's Cup on Fremantle Hospital.

    PubMed Central

    Galvin, G M; Jelinek, G A

    1989-01-01

    The first defence of the America's Cup outside of the USA took place off Fremantle, Western Australia, between October, 1986 and February, 1987. Fremantle Hospital, the nearest hospital to the marinas, was involved in the planning for disasters and for the provision of clinical services to the syndicates involved and the projected crowds of tourists and spectators. The impact of this unique sporting event on the hospital was measured by collecting data from all patients whose presence in Fremantle was related to the yachting. The America's Cup resulted in only 654 attendances and 31 admissions over the 5 months of the event. The figures fell far short of those predicted. A number of conclusions have been drawn. PMID:2610801

  1. Nursing Home Resident Symptomatology Triggering Transfer: Avoiding Unnecessary Hospitalizations

    PubMed Central

    Ashcraft, Alyce S.; Champion, Jane Dimmitt

    2012-01-01

    The purpose of this study was to describe nursing home resident symptomatology and medical diagnoses associated with nursing home to hospital transfers. A retrospective chart review of documented transfers was conducted at a 120-bed, nonprofit urban Continuing Care Retirement Center nursing home facility located in the southwestern United States. The transferred residents (n = 101) had seventy different medical diagnoses prior to hospital transfer with hypertension, coronary artery disease, and congestive heart failure most frequently reported. Most frequently reported symptomatology included fatigue, lethargy or weakness, shortness of breath, and change in level of consciousness. Multiple symptomatology was indicative of a wide variety of medical diagnoses. The diagnoses and symptomatology recorded in this paper identify the importance of strategic planning concerning assessment and communication of common nursing home resident symptomatology and the importance of basic nursing and diagnostic procedures for prevention of potentially avoidable hospitalizations. PMID:23091714

  2. Information Architecture for Quality Management Support in Hospitals.

    PubMed

    Rocha, Álvaro; Freixo, Jorge

    2015-10-01

    Quality Management occupies a strategic role in organizations, and the adoption of computer tools within an aligned information architecture facilitates the challenge of making more with less, promoting the development of a competitive edge and sustainability. A formal Information Architecture (IA) lends organizations an enhanced knowledge but, above all, favours management. This simplifies the reinvention of processes, the reformulation of procedures, bridging and the cooperation amongst the multiple actors of an organization. In the present investigation work we planned the IA for the Quality Management System (QMS) of a Hospital, which allowed us to develop and implement the QUALITUS (QUALITUS, name of the computer application developed to support Quality Management in a Hospital Unit) computer application. This solution translated itself in significant gains for the Hospital Unit under study, accelerating the quality management process and reducing the tasks, the number of documents, the information to be filled in and information errors, amongst others. PMID:26306878

  3. Addressing diversity and moving toward equity in hospital care.

    PubMed

    Cordova, Richard D; Beaudin, Christy L; Iwanabe, Kelly E

    2010-01-01

    Healthcare disparities are a major challenge for hospital and healthcare system leadership. Leaders must possess vision, visibility, and ability to drive organizational change toward an environment that fosters diversity and cultural competence. As challenging economic conditions force management to make difficult budgetary decisions, the integration of equity into the organization's core mission and strategic process is essential for sustainability. Building organizational capacity requires systematic actions including workforce composition, training and development, and policy advocacy. This article offers perspectives on the current state of diversity in hospitals, exemplars from pediatric hospitals, and considerations for the future. Healthcare leaders are influential in shaping the future of the organization through strategic planning and resource allocation to those efforts that enhance services, programs, and processes that support a culture of diversity and equity. PMID:20364641

  4. Segmentation of hospital markets: where do HMO enrollees get care?

    PubMed

    Escarce, J J; Shea, J A; Chen, W

    1997-01-01

    Commercially insured and Medicare patients who are not in health maintenance organizations (HMOs) tend to use different hospitals than HMO patients use. This phenomenon, called market segmentation, raises important questions about how hospitals that treat many HMO patients differ from those that treat few HMO patients, especially with regard to quality of care. This study of patients undergoing coronary artery bypass graft surgery found no evidence that HMOs in southeast Florida systematically channel their patients to high-volume or low-mortality hospitals. These findings are consistent with other evidence that in many areas of the country, incentives for managed care plans to reduce costs may outweigh incentives to improve quality. PMID:9444826

  5. Insurance type and choice of hospital for coronary artery bypass graft surgery.

    PubMed Central

    Chernew, M; Scanlon, D; Hayward, R

    1998-01-01

    OBJECTIVE: To examine the effect of insurance type on the relationship between hospital attributes and patient flows, with particular attention to whether HMO enrollees are more or less likely than other patients to receive care at high-quality hospitals and whether HMO enrollees travel farther to receive care. DATA SOURCES/STUDY SETTING: Data on patient flows, taken from discharge abstracts compiled by the California Office of Statewide Health Planning and Development. Our sample consists of patients undergoing coronary artery bypass graft surgery (CABG) in 1991 who resided in three California markets. Only patients under the age of 65 and insured by HMOs, Blue Cross/Blue Shield, or other commercial insurance were included. Hospital quality is based on hospital-specific measures of excess mortality from CABG. Other hospital attributes were taken from American Hospital Association survey data. STUDY DESIGN: Conditional-choice models were used to estimate the probability that patients would receive care at any given hospital as a function of their insurance type and the hospital's attributes. PRINCIPAL FINDINGS: Patients were more likely to receive care from hospitals closer to their residence. However, HMO patient flows were less sensitive to proximity. In general, the likelihood that an HMO enrollee received care at a given hospital was positively related to hospital quality. Moreover, quality had a greater effect on patient flows for HMO enrollees than for non-HMO enrollees. However, the evidence suggests that the effect of quality on patient flows is neither uniform across markets nor across HMOs. CONCLUSIONS: HMOs do not appear to direct patients to low-quality hospitals. However, heterogeneity among HMOs and across markets suggests that buyers must recognize that choosing an HMO involves greater scrutiny than simply picking a plan labeled "HMO." PMID:9685117

  6. Appropriateness of hospital admissions in general hospitals in Egypt.

    PubMed

    Al-Tehewy, M; Shehad, E; Al Gaafary, M; Al-Houssiny, M; Nabih, D; Salem, B

    2009-01-01

    We measured the rate of inappropriate admissions, and associated factors, in 3 general hospitals in Egypt. A total of 1191 admissions were reviewed using the Appropriateness Evaluation Protocol for adult patients and the Pediatric Appropriateness Evaluation Protocol for paediatric patients. Inappropriate admissions were 66.3% and 78.9% of admissions in the surgery departments of 2 hospitals compared with 1.9% in the 3rd hospital that followed a specific admission protocol for elective surgery. The paediatrics department had the lowest rates of inappropriate admissions in all hospitals (0%, 1.0% and 1.9%). On logistic regression analysis, the route of admission was the only factor significantly associated with inappropriate admissions in the departments of surgery, obstetrics/gynaecology and internal medicine. PMID:20214126

  7. Strategic Planning.

    ERIC Educational Resources Information Center

    Vivelo, Frank Robert

    1992-01-01

    Describes the future environment facing community colleges, addressing the service population, demands for accountability and quality, and the need for currency. Identifies seven areas a strategic plan should address (e.g., mission, student success, instructional quality, resource development, diversity, operational efficiency, and community…

  8. Motor Planning.

    PubMed

    Wong, Aaron L; Haith, Adrian M; Krakauer, John W

    2015-08-01

    Motor planning colloquially refers to any process related to the preparation of a movement that occurs during the reaction time prior to movement onset. However, this broad definition encompasses processes that are not strictly motor-related, such as decision-making about the identity of task-relevant stimuli in the environment. Furthermore, the assumption that all motor-planning processes require processing time, and can therefore be studied behaviorally by measuring changes in the reaction time, needs to be reexamined. In this review, we take a critical look at the processes leading from perception to action and suggest a definition of motor planning that encompasses only those processes necessary for a movement to be executed-that is, processes that are strictly movement related. These processes resolve the ambiguity inherent in an abstract goal by defining a specific movement to achieve it. We propose that the majority of processes that meet this definition can be completed nearly instantaneously, which means that motor planning itself in fact consumes only a small fraction of the reaction time. PMID:24981338

  9. Planning Facilities.

    ERIC Educational Resources Information Center

    Flynn, Richard B., Ed.; And Others

    1983-01-01

    Nine articles give information to help make professionals in health, physical education, recreation, dance, and athletics more knowledgeable about planning facilities. Design of natatoriums, physical fitness laboratories, fitness trails, gymnasium lighting, homemade play equipment, indoor soccer arenas, and dance floors is considered. A…

  10. Strategic Planning.

    ERIC Educational Resources Information Center

    Groff, Warren H.

    1983-01-01

    Reviews the strategic elements of an institutional plan: assessment of the external environment, auditing of institutional strengths and weaknesses, and matching of institutional strengths with external opportunities through the process of strategic goal setting. Urges community colleges to take action-oriented, dynamic, purposeful steps to shape…

  11. CDC Vital Signs: Hospital Actions Affect Breastfeeding

    MedlinePlus

    ... Read the MMWR Science Clips Hospital Actions Affect Breastfeeding Language: English Español (Spanish) Recommend on Facebook Tweet ... in many US hospitals do not fully support breastfeeding. Some of the Ten Steps on which hospitals ...

  12. Energy audits at 48 hospitals

    NASA Astrophysics Data System (ADS)

    Hirst, E.

    1981-11-01

    Staff at the Oak Ridge Associated Universities (ORAU) conducted energy audits at 48 hospitals in four states (New York, Pennsylvania, Virginia, Tennessee) between 1978 and 1980. Staff at the Oak Ridge National Laboratory (ORNL) and ORAU developed and organized a computerized data base containing information from these audits. This paper describes the ORAU audit process; summarizes the data collected from these audits on hospital characteristics annual energy use, and the audit recommendations; and analyzes the audit data in terms of cost effectiveness, type of recommendations, and the relationship between potential energy saving and characteristics of the individual hospital.

  13. Hospital-based neuropsychological services.

    PubMed

    Sciara, A D

    1986-01-01

    Hospital-based neuropsychological services may provide the hospital with a new means of interfacing with the general medical community, especially neurologists and neurosurgeons. This could produce increased census through the evaluation and treatment of patients who may not have been referred to the psychiatric hospital previously. Additionally, it is a service that can be marketed to the legal community. The establishment of neuropsychological services is a relatively inexpensive project that requires little in the way of physical plant and personnel needs other than a qualified technician and neuropsychologist. PMID:10279536

  14. The Efficiency and Budgeting of Public Hospitals: Case Study of Iran

    PubMed Central

    Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

    2013-01-01

    Background Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. Objective The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. Materials and Methods This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. Results The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Conclusions Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance

  15. Hospital incident command system (HICS) performance in Iran; decision making during disasters

    PubMed Central

    2012-01-01

    Background Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used. Results None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). Conclusions The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with

  16. Impact of Nurse Staffing Mandates on Safety-Net Hospitals: Lessons from California

    PubMed Central

    McHugh, Matthew D; Brooks Carthon, Margo; Sloane, Douglas M; Wu, Evan; Kelly, Lesly; Aiken, Linda H

    2012-01-01

    Context California is the first and only state to implement a patient-to-nurse ratio mandate for hospitals. Increasing nurse staffing is an important organizational intervention for improving patient outcomes. Evidence suggests that staffing improved in California hospitals after the mandate was enacted, but the outcome for hospitals bearing a disproportionate share of uncompensated care—safety-net hospitals—remains unclear. One concern was that California's mandate would burden safety-net hospitals without improving staffing or that hospitals would reduce their skill mix, that is, the proportion of registered nurses of all nursing staff. We examined the differential effect of California's staffing mandate on safety-net and non-safety-net hospitals. Methods We used a time-series design with Annual Hospital Disclosure data files from the California Office of Statewide Health Planning and Development (OSHPD) for the years 1998 to 2007 to assess differences in the effect of California's mandate on staffing outcomes in safety-net and non-safety-net hospitals. Findings The mandate resulted in significant staffing improvements, on average nearly a full patient per nurse fewer (−0.98) for all California hospitals. The greatest effect was in those hospitals with the lowest staffing levels at the outset, both safety-net and non-safety-net hospitals, as the legislation intended. The mandate led to significantly improved staffing levels for safety-net hospitals, although there was a small but significant difference in the effect on staffing levels of safety-net and non-safety-net hospitals. Regarding skill mix, a marginally higher proportion of registered nurses was seen in non-safety-net hospitals following the mandate, while the skill mix remained essentially unchanged for safety-net hospitals. The difference between the two groups of hospitals was not significant. Conclusions California's mandate improved staffing for all hospitals, including safety-net hospitals

  17. Reducing hospital acquired pressure ulcers in intensive care

    PubMed Central

    Cullen Gill, Emma

    2015-01-01

    Pressure ulcers are a definite problem in our health care system and are growing in numbers. Unfortunately, it is usually the most weak and vulnerable of our culture that faces these complications, causing the patient and their families discomfort, anguish, and economic hardship due to their expensive treatment. Data collected by the tissue viability department showed high incidence of hospital acquire pressure ulcers in the intensive care unit in March 2013. An action plan was initiated and implemented by the tissue viability team, senior nursing management, pressure ulcer prevention (PUP) team and respiratory therapists (RT's) within the ICU. Our objective was to reduce hospital acquired pressure ulcers in the intensive care unit using the plan, do, check, act quality improvement process. PMID:26734370

  18. Illinois hospital using Web to build database for relationship marketing.

    PubMed

    Rees, T

    2000-01-01

    Silver Cross Hospital and Medical Centers, Joliet, Ill., is promoting its Web site as a tool for gathering health information about patients and prospective patients in order to build a relationship marketing database. The database will enable the hospital to identify health care needs of consumers in Joliet, Will County and many southwestern suburbs of Chicago. The Web site is promoted in a multimedia advertising campaign that invites residents to participate in a Healthy Living Quiz that rewards respondents with free health screenings. The effort is part of a growing planning and marketing strategy in the health care industry called customer relationship management (CRM). Not only does a total CRM plan offer health care organizations the chance to discover the potential for meeting consumers' needs; it also helps find any marketplace gaps that may exist. PMID:11184485

  19. Validation of a framework for measuring hospital disaster resilience using factor analysis.

    PubMed

    Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

    2014-06-01

    Hospital disaster resilience can be defined as "the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one." This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies. PMID:24945190

  20. Variation in charges for 10 common blood tests in California hospitals: a cross-sectional analysis

    PubMed Central

    Hsia, Renee Y; Akosa Antwi, Yaa; Nath, Julia P

    2014-01-01

    Objectives To determine the variation in charges for 10 common blood tests across California hospitals in 2011, and to analyse the hospital and market-level factors that may explain any observed variation. Design, setting and participants We conducted a cross-sectional analysis of the degree of charge variation between hospitals for 10 common blood tests using charge data reported by all non-federal California hospitals to the California Office of Statewide Health Planning and Development in 2011. Outcome measures Charges for 10 common blood tests at California hospitals during 2011. Results We found that charges for blood tests varied significantly between California hospitals. For example, charges for a lipid panel ranged from US$10 to US$10 169, a thousand-fold difference. Although government hospitals and teaching hospitals were found to charge significantly less than their counterparts for many blood tests, few other hospital characteristics and no market-level predictors significantly predicted charges for blood tests. Our models explained, at most, 21% of the variation between hospitals in charges for the blood test in question. Conclusions These findings demonstrate the seemingly arbitrary nature of the charge setting process, making it difficult for patients to act as true consumers in this era of ‘consumer-directed healthcare.’ PMID:25127708