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Sample records for administration medical centers

  1. Retaining medical directors in community health centers. The importance of administrative relationships.

    PubMed

    Cochran, Christopher; Peltier, James W

    2003-01-01

    Physician retention has become a critical issue for maintaining the success of today's health care organizations. With many external factors--increasing malpractice premiums, lower reimbursement rates, and managed care controls--driving physicians out of the practice, it is imperative to understand how the internal functions of the organization can help maintain satisfaction in the workplace and prevent physicians from leaving (Reece, 2000; Taylor, 2002). This is especially important in Community and Migrant Health Centers (C/MHCs), federally supported health clinics providing care to low-income and uninsured patients in medically underserved communities and neighborhoods. In this study, we examine the medical directors' roles and responsibilities, their relationships with the C/MHC administrators, and whether these impact satisfaction and, ultimately retention in the centers. PMID:12856504

  2. Implementing a patient centered medical home in the Veterans health administration: Perspectives of primary care providers.

    PubMed

    Solimeo, Samantha L; Stewart, Kenda R; Stewart, Gregory L; Rosenthal, Gary

    2014-12-01

    Implementation of a patient centered medical home challenges primary care providers to change their scheduling practices to enhance patient access to care as well as to learn how to use performance metrics as part of a self-reflective practice redesign culture. As medical homes become more commonplace, health care administrators and primary care providers alike are eager to identify barriers to implementation. The objective of this study was to identify non-technological barriers to medical home implementation from the perspective of primary care providers. We conducted qualitative interviews with providers implementing the medical home model in Department of Veterans Affairs clinics-the most comprehensive rollout to date. Primary care providers reported favorable attitudes towards the model but discussed the importance of data infrastructure for practice redesign and panel management. Respondents emphasized the need for administrative leadership to support practice redesign by facilitating time for panel management and recognizing providers who utilize non-face-to-face ways of delivering clinical care. Health care systems considering adoption of the medical home model should ensure that they support both technological capacities and vertically aligned expectations for provider performance. PMID:26250631

  3. Energy-efficient management of lighting in a Veterans Administration medical center

    SciTech Connect

    Verderber, R.R.; Arthur, A.; Morse, O.; Rubinstein, F.

    1981-03-01

    More thn 200 solid-state fluorescent ballasts were installed in representative areas of the Veterans Administration Medical Center in Long Beach, California, to determine the cost-effectiveness of the installation and to measure levels of conducted and radiated electromagnetic interference (EMI). The power, illumination, and EMI levels were measured first as the test sites initially existed, then after the fixtures were cleaned and relamped with energy-saving fluorescent lamps, and finally after the core-coil ballasts were replaced with solid-state ballasts. The annual energy savings for the complete retrofit was measured as 34%. In the director's suite natural daylight was used to supplement the electrical illumination, saving an additional 20 to 25% in energy. Thus, in that area, the total annual energy savings amounted to 51%. EMI levels were measured in general areas (lobby and director's suite), in diagnostic examination areas, and in a coronary care ward. The EMI levels, compared to existing levels, were not considered excessive. All of the above data are analyzed on the basis of life-cycle costing. The analysis is presented on sets of curves relating the cost-effective price of a ballast to the cost of electrical energy.

  4. Health Hazard Evaluation Report HETA 91-395-2244, Veterans Administration Medical Center, Los Angeles, California

    SciTech Connect

    Kelly, J.E.; Miller, A.

    1992-08-01

    In response to a request from an employee of the Veterans Administration Medical Center (SIC-8062), Los Angeles, California, an investigation was undertaken of exposures to chemicals in the laboratory department, excessive heat and humidity in the kitchen area of the dietetics department, and carbon-monoxide (630080) exposures inside the building. In three of five personal breathing zone samples taken in the histopathology laboratory, formaldehyde (50000) was detected at concentrations up to 0.17 part per million (ppm) and it was also present in all four of the area air samples at concentrations up to 1.1ppm. The predominant symptoms associated with work in the laboratory included occasional headaches and nose/throat irritation. Mild episodes of dermal irritation and rash were also reported. All carbon-monoxide levels were less than 5ppm. In the kitchens, relative humidity levels were below the recommended range. Temperatures were above the range of temperatures recommended for a medium level of work. The authors conclude that a potential carcinogenic risk existed for workers in laboratories which use formaldehyde. The authors recommend specific measures to lower the risk of formaldehyde exposures in the laboratory.

  5. Instructional Design Process for a Course on Time Management for Head Nurses and Supervisors at a Veterans Administration Medical Center.

    ERIC Educational Resources Information Center

    Geering, Adrian D.

    This paper develops an instructional design process for teaching a time management course to head nurses and supervisors. (The course was conducted at the Veterans' Administration Medical Center, Lincoln, Nebraska, and was based on "A New Instructional Design Development Process for Instructors of Adults," by Mary Jane Even.) The paper covers…

  6. Prevalence of nosocomial infection in long-term-care Veterans Administration medical centers.

    PubMed

    Steinmiller, A M; Robb, S S; Muder, R R

    1991-06-01

    Prevention and control of nosocomial infections are major goals of institutional risk-management programs. However, variations in criteria and denominator parameters make comparison of rates across settings difficult. This study addressed those problems by reporting criteria used to identify infections and applying the same denominator across long-term-care facilities. Findings demonstrated a 9.8% prevalence rate for nosocomial infections in four long-term-care VA facilities. Most of the identified infections were consistent with Centers for Disease Control definitions of nosocomial infections. The most frequent indicators of nosocomial infections that did not fully meet those definitions were (1) documented symptoms, (2) antibiotic therapy, and (3) physician diagnosis. PMID:1907438

  7. Writing Centers: Theory and Administration.

    ERIC Educational Resources Information Center

    Olson, Gary A., Ed.

    Prepared by writing center directors, the articles in this book examine the pedagogical theories of tutorial services and relate them to actual center practices. The 19 articles are arranged into three categories: writing center theory, writing center administration, and special concerns. Specific topics discussed in the articles include the…

  8. Computerized medication administration records decrease medication occurrences.

    PubMed

    Wilson, A L; Hill, J J; Wilson, R G; Nipper, K; Kwon, I W

    1997-04-01

    Studies have demonstrated that medication errors occur at a number of locations in the continuum between ordering of drug therapy and administration of the medication. Computer management of patient medication profiles offers the opportunity to enhance communication between pharmacists and nurses, and to decrease medication errors and delays in delivery of therapy. A number of authors have postulated that computerization of medication profiles would enhance medication delivery accuracy and timeliness, but no study has demonstrated this improvement. We report the results of a retrospective analysis undertaken to assess the improvements resulting from sharing a computerized medication record. We used a broader definition of medication occurrences that includes the more traditional definition, and averted errors, delays in delivery of medications and information, and disagreements between pharmacy and nursing medication profiles. We compared medication occurrences reported through an existing internal system between two periods; the first when separate pharmacy and nursing medication records were used, and the second period when a shared medication record was used by pharmacy and nursing. Average medication occurrences per admission decreased from 0.1084 to 0.0658 (p < 0.01). Medication occurrences per dose decreased from 0.0005 to 0.0003 (p < 0.01). The use of a shared medication record by pharmacy and nursing led to a statistically significant decrease in medication occurrences. Information shared between the two professions allowed timely resolution of discrepancies in medication orders, leading to better execution of drug therapy, decreased medication occurrences, and increased efficiency. PMID:10166241

  9. 2. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 1) ...

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

    2. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING SW. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

  10. 4. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 ...

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

    4. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 & BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING NE. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

  11. 3. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 ...

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

    3. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 & BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING NW. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

  12. Enrolled nurse medication administration.

    PubMed

    Kimberley, Anne; Myers, Helen; Davis, Sue; Keogh, Penny; Twigg, Di

    2004-01-01

    This paper describes an initiative undertaken at Sir Charles Gairdner Hospital in Perth, Western Australia to enhance the professional development of enrolled nurses to allow them to administer medications without the direct supervision of a registered nurse. This practice change proved to be a positive step for the hospital and for enrolled nurses. Benefits for patients were identified as greater continuity of care and increased timeliness of medication admiuistrqtion. The benefits for enrolled nurses were increased job satisfaction, improved morale and self esteem while the main benefit for registered nurses was decreased stres and workload. PMID:17929736

  13. Satellite medical centers project

    NASA Astrophysics Data System (ADS)

    Aggarwal, Arvind

    2002-08-01

    World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

  14. Using intervention mapping to develop and adapt a secondary stroke prevention program in Veterans Health Administration medical centers

    PubMed Central

    2010-01-01

    Secondary stroke prevention is championed by the stroke guidelines; however, it is rarely systematically delivered. We sought to develop a locally tailored, evidence-based secondary stroke prevention program. The purpose of this paper was to apply intervention mapping (IM) to develop our locally tailored stroke prevention program and implementation plan. We completed a needs assessment and the five Steps of IM. The needs assessment included semi-structured interviews of 45 providers; 26 in Indianapolis and 19 in Houston. We queried frontline clinical providers of stroke care using structured interviews on the following topics: current provider practices in secondary stroke risk factor management; barriers and needs to support risk factor management; and suggestions on how to enhance secondary stroke risk factor management throughout the continuum of care. We then describe how we incorporated each of the five Steps of IM to develop locally tailored programs at two sites that will be evaluated through surveys for patient outcomes, and medical records chart abstraction for processes of care. PMID:21159171

  15. Patient Experience in Health Center Medical Homes.

    PubMed

    Cook, Nicole; Hollar, Lucas; Isaac, Emmanuel; Paul, Ludmilla; Amofah, Anthony; Shi, Leiyu

    2015-12-01

    The Human Resource and Services Administration, Bureau of Primary Health Care Health Center program was developed to provide comprehensive, community-based quality primary care services, with an emphasis on meeting the needs of medically underserved populations. Health Centers have been leaders in adopting innovative approaches to improve quality care delivery, including the patient centered medical home (PCMH) model. Engaging patients through patient experience assessment is an important component of PCMH evaluation and a vital activity that can help drive patient-centered quality improvement initiatives. A total of 488 patients from five Health Center PCMHs in south Florida were surveyed in order to improve understanding of patient experience in Health Center PCMHs and to identify quality improvement opportunities. Overall patients reported very positive experience with patient-centeredness including being treated with courtesy and respect (85 % responded "always") and communication with their provider in a way that was easy to understand (87.7 % responded "always"). Opportunities for improvement included patient goal setting, referrals for patients with health conditions to workshops or educational programs, contact with the Health Center via phone and appointment availability. After adjusting for patient characteristics, results suggest that some patient experience components may be modified by educational attainment, years of care and race/ethnicity of patients. Findings are useful for informing quality improvement initiatives that, in conjunction with other patient engagement strategies, support Health Centers' ongoing transformation as PCMHs. PMID:26026275

  16. Assessing the Academic Medical Center as a Supportive Learning Community

    ERIC Educational Resources Information Center

    Gannon, Sam C.

    2011-01-01

    Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…

  17. Medication Administration Practices of School Nurses.

    ERIC Educational Resources Information Center

    McCarthy, Ann Marie; Kelly, Michael W.; Reed, David

    2000-01-01

    Assessed medication administration practices among school nurses, surveying members of the National Association of School Nurses. Respondents were extremely concerned about medication administration. Errors in administering medications were reported by 48.5 percent of respondents, with missed doses the most common error. Most nurses followed…

  18. The need of community health centers for international medical graduates.

    PubMed Central

    Baer, L D; Konrad, T R; Miller, J S

    1999-01-01

    OBJECTIVES: This study sought to determine whether community health centers need international medical graduates to fill staff positions. METHODS: The authors surveyed 100 community health center administrators to learn about their perceptions of international medical graduates. RESULTS: Nationally, about one quarter of community health centers depend on international medical graduates to fill physician vacancies; most of these centers foresee unfilled positions in the event of a cutback. CONCLUSIONS: Policies calling for a national reduction in the supply of international medical graduates need to be balanced by an understanding of these individuals' role in reducing local physician shortages. PMID:10511843

  19. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), north side. - Fitzsimons General Hospital, Administration Building, Southeast Corner of West McAfee Avenue & South Eighth Street, Aurora, Adams County, CO

  20. Kennedy Space Center Medical Operations and Medical Kit

    NASA Technical Reports Server (NTRS)

    Scarpa, Philip

    2011-01-01

    This slide presentation reviews the emergency medical operations at Kennedy Space center, the KSC launch and landing contingency modes, the triage site, the medical kit, and the medications available.

  1. Patient-Centered Medical Homes in 2016.

    PubMed

    Tayloe, David T

    2016-01-01

    There is much information in the medical literature concerning the medical home concept. Each medical practice must utilize that literature to devise a system of care-a patient-centered medical home-that best meets the needs of patients, families, and practice staff. This article is Goldsboro Pediatrics' attempt to describe its system of care, its patient-centered medical home. PMID:27422953

  2. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    PubMed Central

    Wang, Hua-fen; Jin, Jing-fen; Feng, Xiu-qin; Huang, Xin; Zhu, Ling-ling; Zhao, Xiao-ying; Zhou, Quan

    2015-01-01

    Background Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs) are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI) advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014). Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results The number of MAEs continuously decreased from 143 (first half-year of 2012) to 64 (first half-year of 2014), with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05). The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011) to 16 (the first half-year of 2014), with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05). Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases). Intravenous administration error was the top type of error regarding administration route, but it continuously decreased from 64 (first half-year of 2012) to 27 (first half-year of 2014). More experienced registered nurses made fewer medication errors. The number of MAEs in surgical wards was twice that in medicinal wards. Compared with non-intensive care units, the intensive care units exhibited higher occurrence rates of MAEs

  3. Applying airline safety practices to medication administration.

    PubMed

    Pape, Theresa M

    2003-04-01

    Medication administration errors (MAE) continue as major problems for health care institutions, nurses, and patients. However, MAEs are often the result of system failures leading to patient injury, increased hospital costs, and blaming. Costs include those related to increased hospital length of stay and legal expenses. Contributing factors include distractions, lack of focus, poor communication, and failure to follow standard protocols during medication administration. PMID:12736927

  4. Medication Administration Technician. Update. Teacher Edition.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This teacher's edition contains curriculum materials for an upgrading course for medication administration technicians who have completed initial training. The course consists of six units of instruction that cover the following: (1) controlling infection; (2) administering medication; (3) obtaining vital signs; (4) discussing legal issues and…

  5. School Nurses' Experiences with Medication Administration

    ERIC Educational Resources Information Center

    Kelly, Michael W.; McCarthy, Ann Marie; Mordhorst, Matthew J.

    2003-01-01

    This article reports school nurses' experiences with medication administration through qualitative analyses of a written survey and focus groups. From a random sample of 1,000 members of the National Association of School Nurses, 649 (64.9%) school nurses completed the survey. The quantitative data from the survey were presented previously.…

  6. Study of nurse workarounds in a hospital using bar code medication administration system.

    PubMed

    Rack, Laurie L; Dudjak, Linda A; Wolf, Gail A

    2012-01-01

    This study analyzed registered nurse workarounds in an academic medical center using bar code medication administration technology. Nurse focus groups and a survey were used to determine the frequency and potential causes of workarounds. More than half of the nurses surveyed indicated that they administered medications without scanning the patient or medications during the last shift worked. Benefits of this study include considerations when implementing bar code medication administration technology that may minimize the development of these workarounds in practice. PMID:22202186

  7. Women's Centers and Women Administrators: Breaking the Glass Slipper Together.

    ERIC Educational Resources Information Center

    Mellow, Gail O.

    1988-01-01

    Focuses on benefits of mutually supportive relationships between female administrators and women's center directors. Identifies specific roles that female administrators can play (guardian angel, mentor). Also discusses benefits that administrators derive from closer ties with center directors. (NB)

  8. Reengineering Academic Medical Centers: Reengineering Academic Values?

    ERIC Educational Resources Information Center

    Korn, David

    1996-01-01

    Discussion of academic medical centers (AMCs) looks at: change due to heavy federal funding in recent decades; adverse consequences, including deemphasis on education in favor of research and clinical service delivery, and discrepancies between AMC internal and external labor markets; and challenges to medical education in research, education, and…

  9. Skylab Medical Data Center and Archives

    NASA Technical Reports Server (NTRS)

    Spross, F. R.

    1974-01-01

    The founding of the Skylab medical data center and archives as a central area to house medical data from space flights is described. Skylab program strip charts, various daily reports and summaries, experiment reports and logs, status report on Skylab data quality, raw data digital tapes, processed data microfilm, and other Skylab documents are housed in the data center. In addition, this memorandum describes how the data center acted as a central point for the coordination of preflight and postflight baseline data and how it served as coordinator for all data processing through computation and analysis. Also described is a catalog identifying Skylab medical experiments and all related data currently archived in the data center.

  10. 78 FR 16679 - Center for Drug Evaluation and Research Medical Policy Council; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... HUMAN SERVICES Food and Drug Administration Center for Drug Evaluation and Research Medical Policy... interested organizations, on medical policy issues that may be considered by the CDER Medical Policy Council (Council) in FDA's Center for Drug Evaluation and Research (CDER). These comments will help the...

  11. Case study: a data warehouse for an academic medical center.

    PubMed

    Einbinder, J S; Scully, K W; Pates, R D; Schubart, J R; Reynolds, R E

    2001-01-01

    The clinical data repository (CDR) is a frequently updated relational data warehouse that provides users with direct access to detailed, flexible, and rapid retrospective views of clinical, administrative, and financial patient data for the University of Virginia Health System. This article presents a case study of the CDR, detailing its five-year history and focusing on the unique role of data warehousing in an academic medical center. Specifically, the CDR must support multiple missions, including research and education, in addition to administration and management. Users include not only analysts and administrators but clinicians, researchers, and students. PMID:11452578

  12. Developing physician leaders in academic medical centers.

    PubMed

    Bachrach, D J

    1997-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.* PMID:10164266

  13. The Manned Spacecraft Center and medical technology

    NASA Technical Reports Server (NTRS)

    Johnston, R. S.; Pool, S. L.

    1974-01-01

    A number of medically oriented research and hardware development programs in support of manned space flights have been sponsored by NASA. Blood pressure measuring systems for use in spacecraft are considered. In some cases, complete new bioinstrumentation systems were necessary to accomplish a specific physiological study. Plans for medical research during the Skylab program are discussed along with general questions regarding space-borne health service systems and details concerning the Health Services Support Control Center.

  14. Intravenous Medication Administration in Intensive Care: Opportunities for Technological Solutions

    PubMed Central

    Moss, Jacqueline; Berner, Eta; Bothe, Olaf; Rymarchuk, Irina

    2008-01-01

    Medication administration errors have been shown to be frequent and serious. Error is particularly prevalent in highly technical specialties such as critical care. The purpose of this study was to describe the characteristics of intravenous medication administration in five intensive care units. These data were used within the context of a larger study to design information system decision support to decrease medication administration errors in these settings. Nurses were observed during the course of their work and their intravenous medication administration process, medication order source, references used, calculation method, number of medications prepared simultaneously, and any interruptions occurring during the preparation and delivery phases of the administration event were recorded. In addition, chart reviews of medication administration records were completed and nurses were asked to complete an anonymous drop-box questionnaire regarding their experiences with medication administration error. The results of this study are discussed in terms of potential informatics solutions for reducing medication administration error. PMID:18998790

  15. Survey: Federal Aviation Administration National Communication Center

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The National Communication (NATCOM) Center (commonly known as the FAA Weather Message Switching Center), is a Federal Aviation Administration (FAA) facility with responsibility for providing communication switching services to the National Weather Service (NWS), the FAA, commercial and private flight organizations under the auspices of the FAA, and DoD. Data handled by NATCOM include weather data, flight plans, and Notices to Airmen (NOTAMS) on both national and international networks. The communications and data management functions are handled through four computer-controlled communication networks designated as WMSC, AFTN, A-BDIS, and NASNET. The functions of these networks are discussed with emphasis on those networks that support the different elements of the NWS. The primary network of concern to NASA, the WMSC (Weather Message Switching Center) network, performs approximately 60 percent of its work for the NWS, 20 percent for the State Department, and 20 percent for the FAA. This document discusses the current and future systems capabilities and workload of NATCOM in terms of new roles.

  16. The Biomedical Engineer in the Medical Center

    ERIC Educational Resources Information Center

    Furst, Emanuel

    1973-01-01

    Discusses the roles of engineers in medical centers, including technical support, instrument control and safety for the hospital, and teaching and research tasks. Indicates that engineering education should take responsibilities to prepare them to understand the human relations and organizational characteristics of their environment through course…

  17. Medical Center Farmers Markets: A Strategic Partner in the Patient-Centered Medical Home

    PubMed Central

    Rovniak, Liza S.; Kraschnewski, Jennifer L.; Morrison, Kathy J.; Dillon, Judith F.; Bates, Beth Y.

    2013-01-01

    Background The number of medical center–based farmers markets has increased in the past decade, but little is known about how such organizations contribute to the preventive health goals of the patient-centered medical home. Community Context In 2010, we started a seasonal farmers market at Penn State Hershey Medical Center to help support the institution’s commitment to the medical home. Methods We obtained descriptive data on the farmers market from hospital and market records and tracking information on the market’s Facebook and Twitter sites. We computed summary measures to characterize how the market has begun to meet the 6 standards of the 2011 National Committee for Quality Assurance’s report on the medical home. Outcome During the 2010 and 2011 seasons, 146 medical center volunteers from 40 departments formed 23 interprofessional teams that spent an average of 551 volunteer hours per season at the market, providing health screenings (n = 695) and speaking to customers (n = 636) about preventive health. Fifty-five nonmedical community health partners provided 208 hours of service at the market alongside medical center staff. Market programming contributed to 5 regional preventive health partnerships and created opportunities for interprofessional mentoring, student leadership, data management, development of social media skills, and grant-writing experience. The market contributed to all 6 medical home standards outlined by the National Committee for Quality Assurance. Interpretation Medical center markets can support medical home standards. With systematic tracking of the health effects and integration with electronic medical health records, markets hold potential to contribute to comprehensive patient-centered care. PMID:23906327

  18. The changes involved in patient-centered medical home transformation.

    PubMed

    Wagner, Edward H; Coleman, Katie; Reid, Robert J; Phillips, Kathryn; Abrams, Melinda K; Sugarman, Jonathan R

    2012-06-01

    In 2007, the major primary care professional societies collaboratively introduced a new model of primary care: the patient-centered medical home (PCMH). The published document outlines the basic attributes and expectations of a PCMH but not with the specificity needed to help interested clinicians and administrators make the necessary changes to their practice. To identify the specific changes required to become a medical home, the authors reviewed literature and sought the opinions of two multi-stakeholder groups. This article describes the eight consensus change concepts and 32 key changes that emerged from this process, and the evidence supporting their inclusion. PMID:22608865

  19. [Medical education centers: strategies and purpose].

    PubMed

    Binetti, P

    1999-01-01

    The introduction of new didactic guidelines, for the graduate degrees in medicine and allied disciplines, is secondary to the new needs of the National Health Care System, and in part to the significant developments of science. It is not easy to meet this challenge. It is likewise not easy to channel coherently the required changes, with respect to the scientific, clinical and didactic goals. Paradoxically the same institutions that are in such great need of transformation, are also a significant part of the existing problem. In many countries, schools of medicine have developed centers for medical education that are geared toward the development and growth of students, teachers-tutors, and patients alike. Medical education has become more global, in an attempt to meet much needed communication needs, from both ends, teachers and students, as well as the recipients of care, patients. One major goal of such centers is the introduction of innovative didactic activities. There is indeed a new tendency toward the development of methodological tracks aiming at the acquisition and consolidation of a deeper and broader cultural knowledge. Amongst these initiatives there is the introduction of an evaluation of the teaching delivered, as well as the development of a multidisciplinary approach to didactics. The latter, is a prerequisite of an effective training directed toward the development of the concept of "team approach", whose ultimate goal is patient care. In Italy, at the Università Campus Biomedico, in Rome, one of the first of such centers of medical education has been developed. Its goal is to be both a learning organization, as well as a center for both research and clinical services. PMID:10687267

  20. Development of the Family Caregiver Medication Administration Hassles Scale

    ERIC Educational Resources Information Center

    Travis, Shirley S.; Bernard, Marie A.; McAuley, William J.; Thornton, Megan; Kole, Tristen

    2003-01-01

    Purpose: "Medication administration hassles" are the minor daily irritants that family caregivers experience when they assist a dependent family member with medication regimens. This study was designed to develop and test a multidimensional measure of the hassles in family caregiver medication administration. Design and Method: The authors…

  1. Guidelines for Medication Administration in Schools.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Health and Mental Hygiene, Baltimore.

    These guidelines present standards for administering medication in Maryland schools, both prescribed and over-the-counter medications. In general, medication during school hours is discouraged unless necessary. The guidelines recommend that, whenever possible, children administer their own medication under appropriate supervision. Specifically,…

  2. Filmless radiology at Brooke Army Medical Center

    NASA Astrophysics Data System (ADS)

    Wilson, Dennis L.

    1997-05-01

    The hospital at Brooke Army Medical Center in San Antonio, Texas has an essentially filmless radiology department. Mammography is one of the few services still using film. The radiology department at Brooke takes advantage of a very capable Lockheed Martin PACS to achieve the filmless operation. The old hospital has been replaced by a new hospital, the new Brooke Army Medical Center. As a basis for predictions of activity at new Brooke, the activities at the old Brooke Army Medical Center were examined. The heart of the PACS at Brooke is the image server with an associated database. The image server has the performance required to keep the radiologist from returning to film for diagnosis. A directly connected workstation can present a full screen of images in less than two seconds, even during the busiest hour of the day for this large hospital. In addition the database is used to organize the workflow for the radiology examinations through the hospital. Information about the activity at the new Brooke hospital is used to predict the utilization of the short term storage and the long term storage. In particular, the time that an examination will be retained on the new Brooke short term storage is measured. The Brooke medical complex generates 384.8 exams per day on a typical weekday. The number of exams on a weekend is 40 percent of the exams on the weekday. The storage required is 18.3 gigabytes per day in the short term storage of the Image Storage Unit (ISU) and 9.7 gigabytes per day in the archive. The 256 gigabytes of the ISU will hold 11.7 weeks or about 2.5 months of exams. The archive will hold four years of exams in tow jukeboxes. A working year will have an effective 300 days of equivalent weekday radiology load. By ten years from now the hospital complex can be expected to handle to load that is estimated to be about 160 percent of the current load. With the changes in the storage of disks and archive media that will have occurred by that time, the

  3. Measuring physicians' productivity in a Veterans' Affairs Medical Center.

    PubMed

    Coleman, David L; Moran, Eileen; Serfilippi, Delchi; Mulinski, Paul; Rosenthal, Ronnie; Gordon, Bruce; Mogielnicki, R Peter

    2003-07-01

    The mission of the Department of Veterans Affairs includes patient care, education, research, and backup to the Department of Defense. Because the measurement of physicians' productivity must reflect both institutional goals and market forces, the authors designed a productivity model that uses measures of clinical workload and academic activities commensurate with the VA's investments in these activities. The productivity model evaluates four domains of physicians' activity: clinical work, education, research, and administration. Examples of the application of the productivity model in the evaluation of VA-paid physician-staff and in the composition of contracts for clinical services are provided. The proposed model is a relatively simple strategy for measuring a broad range of the work of academic physicians in VA medical centers. The model provides incentives for documentation of resident supervision and participation in administrative activities required for effective and efficient clinical care. In addition, the model can aid in determining resource distribution among clinical services and permits comparison with non-VA health care systems. A strategy for modifying the model to incorporate measures of quality of clinical care, research, education, and administration is proposed. The model has been a useful part of the process to ensure the optimum use of resources and to meet clinical and academic institutional goals. The activities and accomplishments used to define physician productivity will have a substantial influence on the character of the medical profession, the vitality of medical education and research, and the cost and quality of health care. PMID:12857686

  4. NASA Johnson Space Center Medical Licensing Opportunities

    NASA Technical Reports Server (NTRS)

    Hernandez-Moya, Sonia

    2009-01-01

    This presentation reviews patented medical items that are available for licensing in the areas of Laboratory Technologies, Medical Devices, Medical Equipment and other technologies that are of interest to the medical community.

  5. Geriatric education centers address medication issues affecting older adults.

    PubMed Central

    Kahl, A; Blandford, D H; Krueger, K; Zwick, D I

    1992-01-01

    Serious problems have been identified in the prescribing of medications for elderly patients and use of prescription and nonprescription drugs by older persons. Overuse, underuse, and inappropriate use of drugs by the elderly have been widely documented, and the harmful consequences have been described. This paper reviews information concerning the need for action to improve health professionals' knowledge and skills with respect to drugs and the elderly and activities being undertaken by geriatric education centers (GECs) to enhance these capacities. Grant support for the centers from the Health Resources and Services Administration, a Public Health Service component agency, began in 1983. In fiscal year 1992 there are 31 centers operating in 26 States. The centers are multi-institutional and conduct four types of educational activities. These include review of pharmacological issues for multidisciplinary groups, specialized training for pharmacists, discipline-specific programs focusing on medication issues, and activities aimed at educating the public. Examples of the GECs' educational activities are given. PMID:1738807

  6. Medication Administration in the School Setting. Position Statement. Amended

    ERIC Educational Resources Information Center

    Zacharski, Susan; Kain, Carole A.; Fleming, Robin; Pontius, Deborah

    2012-01-01

    It is the position of the National Association of School Nurses (NASN) that school districts develop written medication administration policies and procedures that focus on safe and efficient medication administration at school by a registered professional school nurse (hereinafter referred to as school nurse). Policies should include prescription…

  7. Person-Centered Management in Project Administration.

    ERIC Educational Resources Information Center

    Caraway, James E.

    The theories of several contemporary management theorists are examined in order to demonstrate that their administrative stance is that of a person-intensive approach to management. After exploring leadership theory and the positions of Douglas McGregor, John J. Morse, Jay W. Lorsch, Rensis Likert, Bernard M. Bass, William Reddin, George H. Rice,…

  8. [Patient-centered medicine for tuberculosis medical services].

    PubMed

    Fujita, Akira; Narita, Tomoyo

    2012-12-01

    The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other

  9. Jackson Park Hospital Green Building Medical Center

    SciTech Connect

    William Dorsey; Nelson Vasquez

    2010-03-31

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work. The new green building houses the hospital's Family Medicine Residency Program and Specialty Medical Offices. The residency program has been vital in attracting new, young physicians to this medically underserved area. The new outpatient center will also help to allure needed medical providers to the community. The facility also has areas designated to women's health and community education. The Community Education Conference Room will provide learning opportunities to area residents. Emphasis will be placed on conserving resources and protecting our environment, as well as providing information on healthcare access and preventive medicine. The new Medical Office Building was constructed with numerous energy saving features. The exterior cladding of the building is an innovative, locally-manufactured precast concrete panel system with integral insulation that achieves an R-value in excess of building code requirements. The roof is a 'green roof' covered by native plantings, lessening the impact solar heat gain on the building, and reducing air conditioning requirements. The windows are low-E, tinted, and insulated to reduce cooling requirements in summer and heating requirements in winter. The main entrance has an air lock to prevent unconditioned air from entering the building and impacting interior air temperatures. Since much of the traffic in and out of the office building comes from the adjacent Jackson Park Hospital, a pedestrian bridge connects the two buildings, further

  10. Replacing the academic medical center's teaching hospital.

    PubMed

    Reves, J G; Smith, Stuart; Greenberg, Ray; Johnson, Donald

    2005-11-01

    Addressing the need for updated teaching hospital facilities is one of the most significant issues that an academic medical center faces. The authors describe the process they underwent in deciding to build a new facility at the Medical University of South Carolina (MUSC). Initial issues included whether or not the teaching hospital would continue to play a role in clinical education and whether to replace or renovate the existing facility. Once the decision to build was reached, MUSC had to choose between an on-campus or distant site for the new hospital and determine what the function of the old hospital would be. The authors examine these questions and discuss the factors involved in different stages of decision making, in order to provide the academic medicine community guidance in negotiating similar situations. Open communication within MUSC and with the greater community was a key component of the success of the enterprise to date. The authors argue that decisions concerning site, size, and focus of the hospital must be made by developing university-wide and community consensus among many different constituencies. The most important elements in the success at MUSC were having unified leadership, incorporating constituent input, engaging an external consultant, remaining unfazed by unanticipated challenges, and adhering to a realistic, aggressive timetable. The authors share their strategies for identifying and successfully managing these complex and potentially divisive aspects of building a new teaching hospital. PMID:16249296

  11. Medication Administration Practices in Pennsylvania Schools

    ERIC Educational Resources Information Center

    Ficca, Michelle; Welk, Dorette

    2006-01-01

    As a result of various health concerns, children are receiving an increased number of medications while at school. In Pennsylvania, the School Code mandates a ratio of 1 certified school nurse to 1,500 students, which may mean that 1 school nurse is covering 3-5 buildings. This implies that unlicensed personnel are administering medications, a…

  12. IAIMS at Columbia-Presbyterian Medical Center: accomplishments and challenges.

    PubMed Central

    Roderer, N K; Clayton, P D

    1992-01-01

    The concept of "one-stop information shopping" is becoming a reality at Columbia-Presbyterian Medical Center. Our goal is to provide access from a single workstation to clinical, research, and library resources; university and hospital administrative systems; and utility functions such as word processing and mail. We have created new organizational units and installed a network of workstations that can access a variety of resources and systems on any of seventy-two different host computers/servers. In November 1991, 2,600 different individuals used the clinical information system, 700 different individuals used the library resources, and 900 different individuals used hospital administrative systems via the network. Over the past four years, our efforts have cost the equivalent of $23 million or approximately 0.5% of the total medical center budget. Even small improvements in productivity and in the quality of work of individuals who use the system could justify these expenditures. The challenges we still face include the provision of additional easy-to-use applications and development of equitable methods for financial support. PMID:1326368

  13. Emergency Medical Services Program Administration Prototype Curriculum: Curriculum Guide.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    The curriculum guide was developed for training administrators (new entrants and incumbents), at the college level, in Emergency Medical Services (EMS) program administration. It is designed to be comprehensive and to include all knowledge and skills needed to perform the functions and tasks involved in EMS administration and management. The brief…

  14. Dealing with the flood crisis of 1993. A medical center's account.

    PubMed

    Ramsey, D S

    1994-01-01

    On Saturday, 10 July 1993, Iowans were assaulted by the greatest natural disaster in the state's history when virtually all rain-swollen rivers and creeks in the Midwest spilled over their banks. In Des Moines, the Iowa Methodist Medical Center was suddenly surrounded by flood waters and stripped of power, water, computer, and telephone communication. Striving to deliver quality patient care in the face of the crisis, medical staff, administrators, and employees at the center achieved recovery in record time. PMID:10134872

  15. Using simulations to identify nursing student behaviors: a longitudinal study of medication administration.

    PubMed

    Schneidereith, Tonya A

    2014-02-01

    The Centers for Disease Control and Prevention recognizes adverse drug events as a serious public health problem. Nurses routinely administer patient medications and must be safe when delivering care. Typically, students are taught the traditional rights method (RM) of safe medication administration in the skills laboratory and through the use of high-fidelity simulation scenarios. The RM includes measures of ensuring the right patient, right medication, right dose, right time, and right route. This pilot study demonstrates changes in verification of the rights among junior and senior nursing students in four simulation scenarios over the course of one academic year. The findings suggest that students become more neglectful in verification of the rights prior to medication administration as they progress through the curriculum. This study should help educators identify significant focus areas for clinical supervisors, including the importance of increased verification of the rights of safe medication administration in the clinical setting. PMID:24444012

  16. A sustainable medical center in Texas

    SciTech Connect

    Pfeiffer, P.L.; Miller, B.

    1999-07-01

    The purpose of this presentation is to demonstrate how one can successfully integrate many sustainable features into the construction and operation of a mid-sized medical clinic located in the hot/humid piney woods of east Texas for a moderate increase over normal construction costs. The subject project, known as The Texas Specialist Center, has enjoyed the predicted energy and green building results. It is a 6,300 square foot stand alone clinic located in Lufkin, Texas for a client with multiple chemical sensitivities. Green features include passive solar design for heating and cooling, enhanced natural ventilation (including the use of natural thermal siphons within the building), cool communities site planning (to reduce the urban heat island effect), extensive use of daylighting and energy-efficient artificial lighting, photovoltaics to provide security system and computer operations back-up, careful attention to material selections for low toxicity and high indoor air quality, use of regionally appropriate building materials and systems, an extensive rainwater collection system, and xeriscape landscaping principals. It was constructed in 1996 and has been under full operation for two years. Actual energy consumption data will be presented and the above Green design strategies will be elaborated upon.

  17. 1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' ...

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

    1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' WITH HILLMAN HOSPITAL, THE FIVE-STORY BUILDING (CENTER RIGHT AT 20TH STREET AND SIXTH AVENUE SOUTH), JEFFERSON TOWER (CENTER LEFT AT 20TH STREET AND SEVENTH AVENUE SOUTH, AND THE MANY HOSPITALS AND TEACHING FACILITIES OF THE UNIVERSITY OF ALABAMA AT BIRMINGHAM MEDICAL CENTER. - Hillman Hospital, 600 Block Westside Twentieth Street South, Birmingham, Jefferson County, AL

  18. 75 FR 22438 - Proposed Information Collection (Health Resource Center Medical Center Payment Form) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... medical care copayment online. DATES: Written comments and recommendations on the proposed collection of... 10-0505 will be used to allow claimants with medical care copayment debts to pay online with a credit... AFFAIRS Proposed Information Collection (Health Resource Center Medical Center Payment Form)...

  19. Review of Medical School Administrative Staff Salaries, 1976-1977.

    ERIC Educational Resources Information Center

    Association of American Medical Colleges, Washington, DC.

    Results of the most recent Administrative Salary Survey of the Association of American Medical Colleges are analyzed. The data represent 94 U.S. medical schools, with the number of applicable staff positions ranging from two to 52 per institution. The positions considered included those in which at least 20 percent of the time was spent in…

  20. Children's Medications: A Guide for Schools and Day Care Centers.

    ERIC Educational Resources Information Center

    Bates, Richard D.; Nahata, Milap C.

    Noting the lack of reference sources available on the use of medications in schools and day care centers, this book was created to help school and day care center personnel become more aware of the medicine being given to children at home and at school. Using detailed medication charts, the book answers questions about how to administer medicines…

  1. An Artist in the University Medical Center. Review.

    ERIC Educational Resources Information Center

    James, A. Everette, Jr.

    1991-01-01

    Reviews "An Artist in the University Medical Center" (M. Lesser, New Orleans: Tulane University Press, 1989), in which the artist captures the human side of the complex Tulane Medical Center in New Orleans (Louisiana). The interplay of drawings, etchings, watercolors, and prose conveys traditions of nurturing in the hospital. (SLD)

  2. The new reality: academic medical centers partner with the community.

    PubMed

    Scott, K

    1996-11-01

    As academic medical centers face a price-sensitive market dominated by managed care, their survival, says Association of American Medical Colleges' Robert Dickler, will depend on the combination of strategies they use in response. HSL looks at three centers' solution--building alliances to secure patient bases, focusing on expanding primary care capabilities, and downsizing and reorganizing for greater cost savings. PMID:10162189

  3. The Stanford University Medical Center and the Federal Government.

    ERIC Educational Resources Information Center

    Rosenzweig, Robert M.; And Others

    The Stanford University Medical Center consists of three main units: a medical school, a set of outpatient clinics, and a hospital. Financing of the center's functions cannot be carried out without federal support, and a network of relationships with government agencies has emerged. The impact of these relationships was discussed with key…

  4. Introduction of Ambulatory Medical Training in a Veterans Administration Hospital.

    ERIC Educational Resources Information Center

    Casciato, Dennis A.

    1979-01-01

    The implementation of a continuity of a care clinic in a highly subspecialized Veterans Administration internal medicine training program for postgraduate medical students is described, with focus on resolving problems created by the idiosyncratic administrative features and resource limitations of the hospital. (Author/JMD)

  5. An analytics approach to designing patient centered medical homes.

    PubMed

    Ajorlou, Saeede; Shams, Issac; Yang, Kai

    2015-03-01

    Recently the patient centered medical home (PCMH) model has become a popular team based approach focused on delivering more streamlined care to patients. In current practices of medical homes, a clinical based prediction frame is recommended because it can help match the portfolio capacity of PCMH teams with the actual load generated by a set of patients. Without such balances in clinical supply and demand, issues such as excessive under and over utilization of physicians, long waiting time for receiving the appropriate treatment, and non-continuity of care will eliminate many advantages of the medical home strategy. In this paper, by using the hierarchical generalized linear model with multivariate responses, we develop a clinical workload prediction model for care portfolio demands in a Bayesian framework. The model allows for heterogeneous variances and unstructured covariance matrices for nested random effects that arise through complex hierarchical care systems. We show that using a multivariate approach substantially enhances the precision of workload predictions at both primary and non primary care levels. We also demonstrate that care demands depend not only on patient demographics but also on other utilization factors, such as length of stay. Our analyses of a recent data from Veteran Health Administration further indicate that risk adjustment for patient health conditions can considerably improve the prediction power of the model. PMID:24942633

  6. Developing an Academic Administration Clerkship for Upper-Division Medical Students.

    ERIC Educational Resources Information Center

    Hejna, William F.; Lerner, Wayne M.

    1978-01-01

    A course at Rush-Presbyterian-St. Luke's Medical Center in Chicago provides students with an understanding of the administrative responsibilities inherent in academic management positions. A practicum, thesis project, and seminars cover such topics as legislative trends and effects of health care institutions, manpower planning and recruitment,…

  7. The Impact of Bar Code Medication Administration Technology on Reported Medication Errors

    ERIC Educational Resources Information Center

    Holecek, Andrea

    2011-01-01

    The use of bar-code medication administration technology is on the rise in acute care facilities in the United States. The technology is purported to decrease medication errors that occur at the point of administration. How significantly this technology affects actual rate and severity of error is unknown. This descriptive, longitudinal research…

  8. Lessons learned: mobile device encryption in the academic medical center.

    PubMed

    Kusche, Kristopher P

    2009-01-01

    The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs. PMID:19382736

  9. Building Faculty Community: Fellowship in Graduate Medical Education Administration

    PubMed Central

    Edler, Alice A.; Dohn, Ann; Davidson, Heather A.; Grewal, Daisy; Behravesh, Bardia; Piro, Nancy

    2009-01-01

    Introduction The Department of Graduate Medical Education at Stanford Hospital and Clinics has developed a professional training program for program directors. This paper outlines the goals, structure, and expected outcomes for the one-year Fellowship in Graduate Medical Education Administration program. Background The skills necessary for leading a successful Accreditation Council for Graduate Medical Education (ACGME) training program require an increased level of curricular and administrative expertise. To meet the ACGME Outcome Project goals, program directors must demonstrate not only sophisticated understanding of curricular design but also competency-based performance assessment, resource management, and employment law. Few faculty-development efforts adequately address the complexities of educational administration. As part of an institutional-needs assessment, 41% of Stanford program directors indicated that they wanted more training from the Department of Graduate Medical Education. Intervention To address this need, the Fellowship in Graduate Medical Education Administration program will provide a curriculum that includes (1) readings and discussions in 9 topic areas, (2) regular mentoring by the director of Graduate Medical Education (GME), (3) completion of a service project that helps improve GME across the institution, and (4) completion of an individual scholarly project that focuses on education. Results The first fellow was accepted during the 2008–2009 academic year. Outcomes for the project include presentation of a project at a national meeting, internal workshops geared towards disseminating learning to peer program directors, and the completion of a GME service project. The paper also discusses lessons learned for improving the program. PMID:21975722

  10. [SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

    PubMed

    Davidson, Ehud; Sheiner, Eyal

    2016-02-01

    Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research. PMID:27215117

  11. Research support in an academic medical center.

    PubMed

    Cheek, Fern M

    2010-01-01

    In 2003, the Prior Health Sciences Library (Prior Library) at The Ohio State University (OSU) explored the possibility of providing specialized support to biomedical, nursing, and allied health researchers by adding a research librarian position. The decision came about after the Medical Library Association (MLA) investigated how libraries could provide enhanced support to medical researchers. This article describes how the research librarian position was developed and how it continues to evolve. PMID:20391163

  12. Johnson Space Center Health and Medical Technical Authority

    NASA Technical Reports Server (NTRS)

    Fogarty, Jennifer A.

    2010-01-01

    1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

  13. Medication Errors Involving the Intravenous Administration Route: Characteristics of Voluntarily Reported Medication Errors.

    PubMed

    Wolf, Zane Robinson

    2016-01-01

    Characteristics of medication errors involving the intravenous (IV) route of administration were analyzed in reports from 1995 to 2013. This was accomplished through a voluntary medication error reporting program. A retrospective case study design analyzed reports by practitioners or consumers on IV-associated medication errors (N = 975) affecting patients. Patterns in error accounts reflected cultural changes in health care organizations. Equipment, labeling, incorrect route of administration, types of errors, patient outcomes, and causal agents represented major codes. Results point to health care provider and consumer knowledge, the need for ongoing education of nursing staff, and interdisciplinary strategies for preventing IV-associated medication errors. PMID:27379682

  14. Medical Informatics in Academic Health Science Centers.

    ERIC Educational Resources Information Center

    Frisse, Mark E.

    1992-01-01

    An analysis of the state of medical informatics, the application of computer and information technology to biomedicine, looks at trends and concerns, including integration of traditionally distinct enterprises (clinical information systems, financial information, scholarly support activities, infrastructures); informatics career choice and…

  15. Photocopy of print in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of print in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south side. - Fitzsimons General Hospital, Female Dormitory, Southeast Corner of West McCloskey Avenue & North Seventh Street, Aurora, Adams County, CO

  16. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Infirmary, Northwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  17. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Tubercular Ward, Southeast Corner of East Harlow Avenue & South Page Street, Aurora, Adams County, CO

  18. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Tubercular Ward, Southwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  19. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south side. - Fitzsimons General Hospital, Officers' Garage, West Pennington Avenue, West of Building 129, Aurora, Adams County, CO

  20. Photocopy of photograph from Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph from Fitzsimons Army Medical Center real property book (green cloth cover), south and west sides. - Fitzsimons General Hospital, Gymnasium, Northeast Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  1. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), showing east side and north sides. - Fitzsimons General Hospital, Transformer House, North Page Street, immediately North of Building No. 217, Aurora, Adams County, CO

  2. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south and east sides. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

  3. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Storage Sheds, Northeast Corner of West Pennington Avenue & North Eighth Street, Aurora, Adams County, CO

  4. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover) south and east sides. - Fitzsimons General Hospital, Nurses' Garage, East of Building No. 121, Aurora, Adams County, CO

  5. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south side. - Fitzsimons General Hospital, Laboratory Annex, Northwest Corner of East McCloskey Avenue & North Twelfth Street, Aurora, Adams County, CO

  6. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), west and north sides of the southern wing. - Fitzsimons General Hospital, Laundry, Southeast corner of East Harlow Avenue & South Twelfth Street, Aurora, Adams County, CO

  7. Photocopy of print from the Fitzsimons Army Medical Center Real ...

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

    Photocopy of print from the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Tool House, West Pennington Avenue, North of Building No. 140, Aurora, Adams County, CO

  8. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south and west sides. - Fitzsimons General Hospital, Power House, Northwest Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  9. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing southwest corner of building 732. - Fitzsimons General Hospital, Storehouses, Northwest Corner of East Harlow Avenue & North Thirteenth Street, Aurora, Adams County, CO

  10. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Ambulent Tubercular Ward, Southeast Corner of East Bushnell Avenue & South Hickey Street, Aurora, Adams County, CO

  11. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Artesian Well, East McCloskey Avenue, East of Building No. 231, Aurora, Adams County, CO

  12. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), probably southwest side. - Fitzsimons General Hospital, Operating Pavilion, West McAfee Avenue, East of Building No. 507, Aurora, Adams County, CO

  13. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Post Exchange Garage, North Eighth Street, North of Building No. 143, Aurora, Adams County, CO

  14. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides. - Fitzsimons General Hospital, Workshop Building, East Harlow Avenue, immediately East of Building No. 529, Aurora, Adams County, CO

  15. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), probably south and west sides. - Fitzsimons General Hospital, Nurses' Quarters, Southeast Corner of West McAfee Avenue & South Hickey Street, Aurora, Adams County, CO

  16. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south sides. - Fitzsimons General Hospital, Officer Recreation Building, West Harlow Avenue, immediately East of Building 118, Aurora, Adams County, CO

  17. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), looking east. - Fitzsimons General Hospital, Tennis Courts, Northeast Corner of East McCloskey Avenue & North Hickey Street, Aurora, Adams County, CO

  18. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south and west sides. - Fitzsimons General Hospital, Utilities Storeroom, West Pennington Avenue, East of Building No. 145, Aurora, Adams County, CO

  19. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Post Exchange Garage, Northwest Corner of West Pennington Avenue & North Eighth Street, Aurora, Adams County, CO

  20. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), showing west side. - Fitzsimons General Hospital, Fire Equipment House, North Page Street, North of Building No. 228, Aurora, Adams County, CO

  1. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Nurses' Quarters, Southwest Corner of West Harlow Avenue, & South Eighth Street, Aurora, Adams County, CO

  2. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south side. - Fitzsimons General Hospital, Office Building, Northwest Corner of West McCloskey Avenue & North Tenth Street, Aurora, Adams County, CO

  3. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), showing east side. - Fitzsimons General Hospital, Transformer House, North Page Street, immediately North of Building No. 216, Aurora, Adams County, CO

  4. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), showing south and west sides. - Fitzsimons General Hospital, Salvage Building, Northeast Corner of East I Avenue & North Page Street, Aurora, Adams County, CO

  5. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth clover), west side. - Fitzsimons General Hospital, Motor Transport Dispatcher's Office, Northeast Corner of East Harlow Avenue & North Tenth Street, Aurora, Adams County, CO

  6. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Storehouse, East Harlow Avenue, immediately South of Building 201, Aurora, Adams County, CO

  7. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover) - Fitzsimons General Hospital, Quartermaster Store House, Northwest Corner of East I Avenue & North Twelfth Street, Aurora, Adams County, CO

  8. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides. - Fitzsimons General Hospital, Pharmacy & Prophylactic Station, Northwest Corner of West McAfee Avenue & South Eighth Street, Aurora, Adams County, CO

  9. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), east side. - Fitzsimons General Hospital, Shops Building, Northwest Corner of West Pennington Avenue, & North Tenth Street, Aurora, Adams County, CO

  10. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and north sides. - Fitzsimons General Hospital, Wagon Shed with Office, Southeast Corner of East J Avenue & North Tenth Street, Aurora, Adams County, CO

  11. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Turbercular Ward, Northwest Corner of Charlie Kelly Boulevard & South Hickey Street, Aurora, Adams County, CO

  12. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Nurses Quarters No. 3, Northwest Corner of West Harlow Avenue & North Seventh Street, Aurora, Adams County, CO

  13. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Greenhouse, West Pennington Avenue, East of Building No. 139, Aurora, Adams County, CO

  14. Prevalence of medication administration errors in two medical units with automated prescription and dispensing

    PubMed Central

    Herranz-Alonso, Ana; Martin-Barbero, Maria Luisa; Duran-Garcia, Esther; Durango-Limarquez, Maria Isabel; Hernández-Sampelayo, Paloma; Sanjurjo-Saez, Maria

    2011-01-01

    Objective To identify the frequency of medication administration errors and their potential risk factors in units using a computerized prescription order entry program and profiled automated dispensing cabinets. Design Prospective observational study conducted within two clinical units of the Gastroenterology Department in a 1537-bed tertiary teaching hospital in Madrid (Spain). Measurements Medication errors were measured using the disguised observation technique. Types of medication errors and their potential severity were described. The correlation between potential risk factors and medication errors was studied to identify potential causes. Results In total, 2314 medication administrations to 73 patients were observed: 509 errors were recorded (22.0%)—68 (13.4%) in preparation and 441 (86.6%) in administration. The most frequent errors were use of wrong administration techniques (especially concerning food intake (13.9%)), wrong reconstitution/dilution (1.7%), omission (1.4%), and wrong infusion speed (1.2%). Errors were classified as no damage (95.7%), no damage but monitoring required (2.3%), and temporary damage (0.4%). Potential clinical severity could not be assessed in 1.6% of cases. The potential risk factors morning shift, evening shift, Anatomical Therapeutic Chemical medication class antacids, prokinetics, antibiotics and immunosuppressants, oral administration, and intravenous administration were associated with a higher risk of administration errors. No association was found with variables related to understaffing or nurse's experience. Conclusions Medication administration errors persist in units with automated prescription and dispensing. We identified a need to improve nurses' working procedures and to implement a Clinical Decision Support tool that generates recommendations about scheduling according to dietary restrictions, preparation of medication before parenteral administration, and adequate infusion rates. PMID:21890872

  15. Characterizing customers at medical center farmers’ markets1

    PubMed Central

    Kraschnewski, Jennifer L.; George, Daniel R.; Rovniak, Liza S.; Monroe, Diana L.; Fiordalis, Elizabeth; Bates, Erica

    2014-01-01

    Approximately 100 farmers’ markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010-October 2011 at three medical centers in different geographic regions of the US: Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center were conducted. Markets reported serving 180–2000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n=585) across markets were similar in sociodemographic characteristics – most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers’ markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers’ markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health. PMID:24421001

  16. DOE Center of Excellence in Medical Laser Applications. Final report

    SciTech Connect

    Jacques, S.L. )

    1998-01-01

    An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland, OR, Houston, TX, and Galveston, TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulation of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

  17. Jackson Park Hospital Green Building Medical Center

    SciTech Connect

    Dorsey, William; Vasquez, Nelson

    2010-05-01

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work.

  18. [The training of administration personnel for private medical organizations].

    PubMed

    2012-01-01

    The training of administration personnel for medical institutions is an integral part of the restructuring of health care. The authors proposed a system approach during the development of business-competences needed for modem medicine to provide the corresponding level of activity in the conditions of market economy and modernization of health care system. PMID:23033577

  19. Chronic Disease Medication Administration Rates in a Public School System

    ERIC Educational Resources Information Center

    Weller, Lawrence; Fredrickson, Doren D.; Burbach, Cindy; Molgaard, Craig A.; Ngong, Lolem

    2004-01-01

    Anecdotal reports suggest school nurses and staff treat increasing numbers of public school students with chronic diseases. However, professionals know little about actual disease burden in schools. This study measured prevalence of chronic disease medication administration rates in a large, urban midwestern school district. Data from daily…

  20. Consolidating medical staff and administrative requirements eliminates potential problems.

    PubMed

    Hershey, N

    1980-11-01

    If policies and procedures relative to a single function are scattered among hospital documents, the potential for conflict and inconsistency between administration and medical staff is enhanced. Incorporation in one reference source can help clarify responsibilities and facilitate conformity. PMID:10248580

  1. PASTE: patient-centered SMS text tagging in a medication management system

    PubMed Central

    Johnson, Kevin B; Denny, Joshua C

    2011-01-01

    Objective To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Design Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. Measurements A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Results Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Conclusion Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages. PMID:21984605

  2. Benefits of Student-Centered Tandem Teaching in Medical English.

    PubMed

    Antić, Zorica

    2015-01-01

    This paper addresses some of the key notions about English for special purposes with special regard to English for medical purposes. The content was determined by observations and based on authors' professional experience. The starting point of a medical English course is a thorough analysis of students' needs, which is then used in course design and definition of appropriate learning goals. The student is at the center of learning and it is necessary to establish a positive cooperation between students and teachers. As medical English course is highly context-based, the inclusion of medical teachers can offer many opportunities for a successful learning process. PMID:26506766

  3. Appropriateness of administration of nasogastric medication and preliminary intervention

    PubMed Central

    Zhu, Ling-Ling; Xu, Ling-Cheng; Wang, Hui-Qin; Jin, Jing-Fen; Wang, Hua-Fen; Zhou, Quan

    2012-01-01

    A utilization study was performed in a 2200-bed tertiary care teaching hospital. Data mining was performed on all nasogastric medication prescriptions for patients hospitalized in 2011. Nurses were interviewed by questionnaire. A PDCA (Plan-Do-Check-Act) cycle was used for continuous quality improvement. The proportion of patients with nasogastric tubes (NGT) was 3.2%. A large number of medical orders (n = 6261) involved nasogastric medications with a package insert particularly noting that they should not be crushed or opened (group 1) or medications without a specific formulation recommendation in the package insert but having evidence discouraging NGT dosing (group 2). Of the nasogastrically administered sustained-release or controlled-release formulations, a sustained-release sodium valproate tablet formulation was the most prescribed drug and a sustained-release 2.5 mg felodipine tablet was prescribed with the highest proportion of NGT dosing [NGT/(NGT + oral) = 12.3%]. Among the nasogastrically administered enteric-coated formulations, a myrtol-standardized enteric-coated capsule formulation was the most prescribed drug and a pantoprazole tablet formulation was prescribed with the highest proportion of NGT dosing [NGT/(NGT + oral) = 19.3%]. Proportions of NGT dosing for amiodarone and carbamazepine (group 2) were 4.8% and 6.3%, respectively. The percentage of nurses with adequate knowledge about pharmaceutical dosage formulations was 60%. The rate of answering correctly as to whether medications in group 1 could be crushed or opened was only 30%. Awareness of evidence discouraging NGT dosing of medications in group 2 was zero. Most nurses (90%) left physicians and pharmacists with the entire responsibility for knowledge and decision-making concerning route of drug administration. After a 3-month preliminary intervention, irrational medical orders involving nasogastric administration of medications in group 1 were successfully abolished. The rate of answering

  4. National Disaster Medical System; medical manpower component establishment--Health Resources and Services Administration, HHS. Notice.

    PubMed

    1988-04-20

    This notice announces the creation of the medical manpower component within the Health Resources and Services Administration (HRSA), Department of Health and Human Services/Public Health Service (HHS/PHS) as a part of the National Disaster Medical System (NDMS). The NDMS is an organized resource that may be activated to serve national needs in the event of disasters or other major emergencies requiring extraordinary medical services. The manpower component will contain volunteer medical response personnel and technical staff that will be made available in situations requiring substantial medical services from outside the area affected by the disaster or emergency. The manpower component of NDMS is being established by HRSA/HHS/PHS in cooperation with the Department of Defense (DoD), Federal Emergency Management Agency (FEMA), and the Veterans Administration (VA). PMID:10287019

  5. The Center for Healthy Weight: an academic medical center response to childhood obesity

    PubMed Central

    Robinson, T N; Kemby, K M

    2012-01-01

    Childhood obesity represents a worldwide medical and public health challenge. Academic medical centers cannot avoid the effects of the obesity epidemic, and must adopt strategies for their academic, clinical and public policy responses to childhood obesity. The Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford provides an example and model of one such strategy. The design provides both breadth and depth through six cores: Research, Patient Care, Community Programs, Advocating for Public Policy Change, Training and Professional Education, and the Healthy Hospital Initiative. The Center and its cores are designed to facilitate interdisciplinary collaboration across the university, medical school, children's hospital and surrounding community. The foci of these cores are likely to be relevant to almost any academic medical center's mission and functions. PMID:25089192

  6. The Six Sigma initiative at Mount Sinai Medical Center.

    PubMed

    Chassin, Robert

    2008-01-01

    Lean Six Sigma, in various forms, has been used widely in many Fortune 500 companies. Motorola, General Electric, Sony, American Express, and Bechtel all use Six Sigma to improve quality and performance. While the impact of this methodology has been documented extensively by the press in manufacturing and transactional settings, less evidence is available regarding its utility in health care environments. Mount Sinai Medical Center initiated a Six Sigma program in 2000 to determine its applicability and value in a large academic medical center. This article discusses Mount Sinai Medical Center's experience adapting this methodology to improve both patient care and business processes and outcomes. We present an overview of Six Sigma, and offer examples of projects undertaken using this data-driven approach to performance improvement. Lastly, the article provides insights and lessons learned regarding this organization-wide experience. PMID:18306249

  7. STOR: From Pilot Project to Medical Center Implementation

    PubMed Central

    Henke, J.; Whiting-O'Keefe, Q.E.; Whiting, A.; Schaffner, R.; Schnake, R.; Goldstein, R.; Abrego, J.

    1988-01-01

    Summary Time Oriented Record (STOR) is a clinical information system operating at the University of California San Francisco Medical Center (UCSF). It provides two major services: on-line display of clinical information in the hospitals and clinics and an ambulatory medical record that partially replaces the traditional paper medical record for outpatient patient visits. In 1985 STOR was approved for clinic-wide implementation in the UCSF ambulatory care clinics. The implementation will be completed in September 1989. STOR captures clinical data directly from clinicians via hand written notations and ancillary data from other UCSF computers via a local area network. Development on STOR is continuing in order to meet the changing and diversified environment of inpatient and outpatient practices found in a university medical center.

  8. Medication error report: Intrathecal administration of labetalol during obstetric anesthesia

    PubMed Central

    Laha, Baisakhi; Hazra, Avijit

    2015-01-01

    Labetalol, a combined alfa and beta-adrenergic receptor antagonist, is used as an antihypertensive drug. We report a case of an acute rise in blood pressure and lower limb pain due to the inadvertent intrathecal administration of labetalol, mistaking it for bupivacaine, during obstetric anesthesia. The situation was rescued by converting to general anesthesia. The cesarean delivery was uneventful, and mother as well as newborn child showed no ill-effect. This particular medication error was attributable to a failure on the part of the doctors administering the injection to read and cross-check medication labels and the practice of keeping multiple injections together. In the absence of an organized medication error reporting system and action on that basis, such events may recur in future. PMID:26288484

  9. Student perceptions of a patient- centered medical training curriculum

    PubMed Central

    Gallentine, Ashley; Salinas-Miranda, Abraham A.; Shaffer-Hudkins, Emily; Hinojosa, Sara; Monroe, Alicia

    2014-01-01

    Objectives To evaluate a patient-centered medical training curriculum, the SELECT program, through perceptions of the inaugural student cohort. Methods Data were collected from two focus groups conducted in the university setting, comprised of fifteen first-year medical students who participated in the SELECT program during its inaugural year. A questioning protocol was used to guide the focus group discussion, which was transcribed and hand-coded through thematic analyses. Results Various themes related to patient-centered care were identified. Students noted changes in their attitudes towards interacting with patients in an empowering and educative manner as a result of communication and motivational interviewing exercises. Additionally, they recognized certain external, structural barriers as well as internal conflict between pragmatism and emotional intelligence that could potentially hinder patient-centered care. The impact of family dynamics and social support on quality of life and health outcomes was acknowledged. Students also emphasized the value of collaborating with multiple health professionals. Lastly, students provided suggestions for program improvement, namely additional simulations, more education regarding other healthcare professionals’ roles, more standardized experiences, and application of principles to acute and primary care. Conclusions Upon completion of the first year of the SELECT program, students gained an appreciation for patient-centered care and various factors and skills that facilitate such care. Additionally, they experienced a dissonance between didactic concepts from the curriculum and observed medical practices. This study highlights the educational benefits of a patient-centered medical curriculum and provides suggestions for future improvement. PMID:25341218

  10. An Unsuccessful Experience with Computerized Medical Records in an Academic Medical Center.

    ERIC Educational Resources Information Center

    Dambro, Mark R.; And Others

    1988-01-01

    Experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center is reported. Use of the system was terminated because clinic revenues could not cover operating costs. (Author/MLW)

  11. Effectively implementing FDA medication alerts utilizing patient centered medical home clinical pharmacists.

    PubMed

    Arenz, Barbara J; Diez, Heidi L; Bostwick, Jolene R; Kales, Helen C; Zivin, Kara; Dalack, Gregory W; Fluent, Tom E; Standiford, Connie J; Stano, Claire; Mi Choe, Hae

    2016-03-01

    FDA medication alerts can be successfully implemented within patient centered medical home (PCMH) clinics utilizing clinical pharmacists. Targeted selection of high-risk patients from an electronic database allows PCMH pharmacists to prioritize assessments. Trusting relationships between PCMH clinical pharmacists and primary care providers facilitates high response rates to pharmacist recommendations. This health system approach led by PCMH pharmacists provides a framework for proactive responses to FDA safety alerts and medication related quality measure improvement. PMID:27001101

  12. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept. 29, 1934 when the revised Real Property form on building 257 was completed. - Fitzsimons General Hospital, Building 257, North side of East O'Neill Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  13. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept 29, 1934 when the revised Real Property form on building 255 was completed. - Fitzsimons General Hopital, Building 255, North side of East O'Niell Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  14. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept. 29, 1934 when the revised Real Property form on building 256 was completed. - Fitzsimons General Hospital, Building 256, North side of East O'Niell Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  15. Photocopy of postcard from Fitzsimons Army Medical Center public affairs ...

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

    Photocopy of postcard from Fitzsimons Army Medical Center public affairs office, building 120, showing building 215 in the 1940's before the top of the smokestack blew off. Photograph shows north side and corner of west side. - Fitzsimons General Hospital, Power House, Northwest Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  16. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides of building no. 715, now the south wing of building no. 508. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

  17. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and west sides of buildings no. 719, now the north wing of building no. 508. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

  18. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), probably west and north sides. - Fitzsimons General Hospital, Officer Patient's Mess & Kitchen, Northeast Corner of West McAfee Avenue & South Hickey Street, Aurora, Adams County, CO

  19. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), north and east sides of the east/west wing. - Fitzsimons General Hospital, General Mess & Kitchen, Southwest Corner of East McAfee Avenue & South Twelfth Street, Aurora, Adams County, CO

  20. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing part of east side and most of north side. - Fitzsimons General Hospital, Quartermaster's Storehouse, Southwest Corner of East I Avenue & North Twelfth Street, Aurora, Adams County, CO

  1. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Red Cross Building, South Eighth Street Bounded by West McAfee Avenue on South & West Harlow Avenue on North, Aurora, Adams County, CO

  2. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph of south side before perpendicular wing added. - Fitzsimons General Hospital, Carpenter Shop Building, Southwest Corner of West I Avenue, & North Tenth Street, Aurora, Adams County, CO

  3. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and north sides. - Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of Building No. 516, East of corridor connecting Building No. 511 to Building No. 515, Aurora, Adams County, CO

  4. Claretian Medical Center Task Analysis. Worker Education Program.

    ERIC Educational Resources Information Center

    Union of Needletrades, Industrial and Textile Employees.

    This task analysis for positions at the Claretian Medical Center in southeast Chicago was developed to improve communication and customer service in the workplace. The task analysis was prepared through clinic tours, employee interviews, and supervisor questionnaires. It is used for the purpose of curriculum development for onsite instruction in…

  5. Photocopy of post card from Fitzsimons Army Medical Center Public ...

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

    Photocopy of post card from Fitzsimons Army Medical Center Public Affairs Office, building 120. Photograph by Rocky Mountain photo. CO was no copyrighted and is , therefore, in the public domain. - Fitzsimons General Hospital, Memorial Tablet, West McAfee, South of Building No. 524, Aurora, Adams County, CO

  6. The 'Adventist advantage'. Glendale Adventist Medical Center distinguishes itself.

    PubMed

    Botvin, Judith D

    2002-01-01

    Glendale Adventist Medical Center, Glendale, Calif., adopted an image-building campaign to differentiate the 450-bed hospital from its neighbors. This included the headline "Adventist Advantage," used in a series of sophisticated ads, printed in gold. In all their efforts, marketers consider the sensibilities of the sizable Armenian, Korean, Hispanic and Chinese populations. PMID:12134406

  7. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property book (green cloth cover), showing east and most of south sides. - Fitzsimons General Hospital, Assembly Hall School, Northeast Corner of West McCloskey Avenue & North Tenth Street, Aurora, Adams County, CO

  8. [An analysis of the medical administration pattern of the Yuan Dynasty as interpreted from the Guan yi ti ju si (Department of Official Medical Administration)].

    PubMed

    Han, Xiaowen; Yu, Hong; Zhang, Qicheng

    2015-07-01

    The Imperial Academy of Medicine of the Yuan Dynasty established an institution called Guan yi ti ju si (Department of Official Medical Administration). Through its central to local network, the Department carried out its medical administration throughout the nation. The responsibilities of Guan yi ti ju si included 5 aspects, viz., the selection of local medical professionals and talents; the dispatch of prison doctors; the examination and administration of local medical workers; the revision and publication of medical works and the inspection and identification of local herbs. Guan yi ti ju si played an important role in medical education and the publication of medical books which were generally considered as the work of Yi xue ti ju si (Department of General Medical Administration ). In terms of administrative pattern, there were two specialties, the government focused its work on the rational allocation and governing of local medical professionals and resources, with medical administration and medical education belonged to two separate systems, which, at the same time, supervised and controlled mutually. These noticeable features of medical administration of the Yuan Dynasty are still revealing its reference value today. PMID:26815020

  9. Barcode Medication Administration: Supporting Transitions in Articulation Work

    PubMed Central

    Novak, Laurie L.; Lorenzi, Nancy M.

    2008-01-01

    Articulation work is that which enables coordinated activity among colleagues distributed in time and space. Despite its important role in clinical settings, this work remains largely invisible in process flowcharts. When process-oriented information systems are implemented, the informal, flexible, contingent activities of participants that enable coordinated work are suddenly placed in a new context. Articulation work must adapt to new contexts of automation, and there are opportunities for clinical systems to better support coordination activities. This research explores the articulation work involved in medication administration, how it is affected by the implementation of barcoding, and strategies for support and problem resolution in this arena. PMID:18999121

  10. Challenges implementing bar-coded medication administration in the emergency room in comparison to medical surgical units.

    PubMed

    Glover, Nancy

    2013-03-01

    Bar-coded medication administration has been successfully implemented and utilized to decrease medication errors at a number of hospitals in recent years. The purpose of this article was to discuss the varying success in utilization of bar-coded medication administration on medical-surgical units and in the emergency department. Utilization reports were analyzed to better understand the challenges between the units. Many factors negatively impacted utilization in the emergency department, including the inability to use bar-coded medication administration for verbal orders or to document medications distributed by the prescribing providers, unique aspects of emergency department nursing workflow, additional steps to chart when using bar-coded medication administration, and alert fatigue. Hardware problems affected all users. Bar-coded medication administration in its current form is more suitable for use on medical-surgical floors than in the emergency department. New solutions should be developed for bar-coded medication administration in the emergency department, keeping in mind requirements to chart medications when there is no order in the system, document medications distributed by prescribing providers, adapt to unpredictable nursing workflow, minimize steps to chart with bar-coded medication administration, limit alerts to those that are clinically meaningful, and choose reliable hardware with adequate bar-code scanning capability. PMID:23321481

  11. The impact of the IRB on medical centers.

    PubMed

    Lee, A S; Thompson, J H

    1981-01-01

    The role of the IRB in a Medical Center is presented with respect to investigations of medical device safety and effectiveness involving human subjects. The prime points presented and discussed are: the reasons (governmental, social, economic, legal-liability, scientific and moral) for the existence of an IRB; the analytical and descriptive documentation which should always precede experimentation; the concepts governing an application to a "typical" IRB; a practical, detailed outline of some special facts and circumstances typically most important to an IRB; and, the question of confidentiality of trade secrets. PMID:10251107

  12. Three-Year Experience of an Academic Medical Center Ombuds Office

    PubMed Central

    Layde, Peter M.

    2016-01-01

    An ombuds is an individual who informally helps people or groups (visitors) resolve disputes and/or interpersonal conflicts as an alternative to formal dispute resolution mechanisms within an organization. Ombuds are nearly ubiquitous in many governmental, business, and educational settings but only recently have gained visibility at medical schools. Medical schools in the United States are increasingly establishing ombuds offices as part of comprehensive conflict management systems to address concerns of faculty, staff, students, and others. As of 2015, more than 35 medical schools in the United States have active ombuds Web pages. Despite the growing number of medical schools with ombuds offices, the literature on medical school ombuds offices is scant. In this article, the authors review the first three years of experience of the ombuds office at the Medical College of Wisconsin, a freestanding medical and graduate school with a large physician practice. The article is written from the perspective of the inaugural ombuds and the president who initiated the office. The authors discuss the rationale for, costs of, potential advantages of, and initial reactions of faculty, staff, and administration to having an ombuds office in an academic medical center. Important questions relevant to medical schools that are considering an ombuds office are discussed. The authors conclude that an ombuds office can be a useful complement to traditional approaches for conflict management, regulatory compliance, and identification of systemic issues. PMID:26675192

  13. Three-Year Experience of an Academic Medical Center Ombuds Office.

    PubMed

    Raymond, John R; Layde, Peter M

    2016-03-01

    An ombuds is an individual who informally helps people or groups (visitors) resolve disputes and/or interpersonal conflicts as an alternative to formal dispute resolution mechanisms within an organization. Ombuds are nearly ubiquitous in many governmental, business, and educational settings but only recently have gained visibility at medical schools. Medical schools in the United States are increasingly establishing ombuds offices as part of comprehensive conflict management systems to address concerns of faculty, staff, students, and others. As of 2015, more than 35 medical schools in the United States have active ombuds Web pages. Despite the growing number of medical schools with ombuds offices, the literature on medical school ombuds offices is scant. In this article, the authors review the first three years of experience of the ombuds office at the Medical College of Wisconsin, a freestanding medical and graduate school with a large physician practice. The article is written from the perspective of the inaugural ombuds and the president who initiated the office. The authors discuss the rationale for, costs of, potential advantages of, and initial reactions of faculty, staff, and administration to having an ombuds office in an academic medical center. Important questions relevant to medical schools that are considering an ombuds office are discussed. The authors conclude that an ombuds office can be a useful complement to traditional approaches for conflict management, regulatory compliance, and identification of systemic issues. PMID:26675192

  14. Indiana Health Occupations Education: Student Modules for Administration of Medications for Unlicensed Nursing Personnel. Revised Edition.

    ERIC Educational Resources Information Center

    Bilger, Phyllis; And Others

    These learning modules are designed to provide health care workers involved with medications with basic information about the nature and administration of medications. The 30 modules are organized into six units. An overview of preparation and administration of medicines, principles of medication therapy, and medication fundamentals are presented…

  15. Computer Assisted Multi-Center Creation of Medical Knowledge Bases

    PubMed Central

    Giuse, Nunzia Bettinsoli; Giuse, Dario A.; Miller, Randolph A.

    1988-01-01

    Computer programs which support different aspects of medical care have been developed in recent years. Their capabilities range from diagnosis to medical imaging, and include hospital management systems and therapy prescription. In spite of their diversity these systems have one commonality: their reliance on a large body of medical knowledge in computer-readable form. This knowledge enables such programs to draw inferences, validate hypotheses, and in general to perform their intended task. As has been clear to developers of such systems, however, the creation and maintenance of medical knowledge bases are very expensive. Practical and economical difficulties encountered during this long-term process have discouraged most attempts. This paper discusses knowledge base creation and maintenance, with special emphasis on medical applications. We first describe the methods currently used and their limitations. We then present our recent work on developing tools and methodologies which will assist in the process of creating a medical knowledge base. We focus, in particular, on the possibility of multi-center creation of the knowledge base.

  16. Energy use baselining study for the National Naval Medical Center

    SciTech Connect

    Parker, G.B.; Halverson, M.A.

    1992-04-01

    This report provides an energy consumption profile for fourteen buildings at the National Naval Medical Center (NNMC) in Bethesda, Maryland. Recommendations are also made for viable energy efficiency projects funded with assistance from the servicing utility (Potomic Electric Power Company) in the form of rebates and incentives available in their Demand Side Management (DSM) program and through Shared Energy Savings (SES) projects. This report also provides estimates of costs and potential energy savings of the recommended projects.

  17. Photocopy of photograph from Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph from Fitzsimons Army Medical Center real property book (green cloth cover), showing building 225's west and a north sides. This photograph is included because it shows how the west side of building 221 looked before the corridor between buildings 220 and 221 was added and because building 225 was built to the same plan as building 221. - Fitzsimons General Hospital, Hospital Corps Barracks, East Harlow Street, East of Building No. 220, Aurora, Adams County, CO

  18. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), apparently showing west side of building 732. In 1921, buildings 732 and 733 were combined and it is assumed that this photograph, which was taken after 1921, shows the section added to make buildings 732 and 733 once continuous building. - Fitzsimons General Hospital, Storehouses, Northwest Corner of East Harlow Avenue & North Thirteenth Street, Aurora, Adams County, CO

  19. Best practice in unbilled account management: one medical center's story.

    PubMed

    Menaker, Debra; Miller, Joshua

    2016-02-01

    After implementing its new electronic health record, a large metropolitan academic medical center (AMC) decided to optimize its supporting business systems, beginning with billing. By identifying problems and taking the following corrective actions immediately, the AMC significantly reduced the number and average age of its unbilled accounts: Realigning system automation to improve routing efficiency. Facilitating interdisciplinary collaboration to better identify and correct the root causes of issues. Ensuring transparent data reporting by setting up different ways of viewing the underlying information. PMID:26999975

  20. Efficiency and Usability of a Near Field Communication-Enabled Tablet for Medication Administration

    PubMed Central

    Neri, Pamela M; Robertson, Alexandra; McEvoy, Dustin; Dinsmore, Michael; Sweet, Micheal; Bane, Anne; Takhar, Sukhjit S; Miles, Stephen

    2014-01-01

    Background Barcode-based technology coupled with the electronic medication administration record (e-MAR) reduces medication errors and potential adverse drug events (ADEs). However, many current barcode-enabled medication administration (BCMA) systems are difficult to maneuver and often require multiple barcode scans. We developed a prototype, next generation near field communication-enabled medication administration (NFCMA) system using a tablet. Objective We compared the efficiency and usability of the prototype NFCMA system with the traditional BCMA system. Methods We used a mixed-methods design using a randomized observational cross-over study, a survey, and one-on-one interviews to compare the prototype NFCMA system with a traditional BCMA system. The study took place at an academic medical simulation center. Twenty nurses with BCMA experience participated in two simulated patient medication administration scenarios: one using the BCMA system, and the other using the prototype NFCMA system. We collected overall scenario completion time and number of medication scanning attempts per scenario, and compared those using paired t tests. We also collected participant feedback on the prototype NFCMA system using the modified International Business Machines (IBM) Post-Study System Usability Questionnaire (PSSUQ) and a semistructured interview. We performed descriptive statistics on participant characteristics and responses to the IBM PSSUQ. Interview data was analyzed using content analysis with a qualitative description approach to review and categorize feedback from participants. Results Mean total time to complete the scenarios using the NFCMA and the BCMA systems was 202 seconds and 182 seconds, respectively (P=.09). Mean scan attempts with the NFCMA was 7.6 attempts compared with 6.5 attempts with the BCMA system (P=.12). In the usability survey, 95% (19/20) of participants agreed that the prototype NFCMA system was easy to use and easy to learn, with a pleasant

  1. Understanding and improving inpatient mortality in academic medical centers.

    PubMed

    Behal, Raj; Finn, Jeannine

    2009-12-01

    The purpose of this article is to describe factors contributing to potentially preventable mortality in academic medical centers and the organizational characteristics associated with success in reducing mortality. Sixteen U.S. academic medical centers that wished to improve risk-adjusted inpatient mortality rates requested a consultation that included interviews with physicians, nurses, and hospital leaders; review of medical records; and evaluation of systems and processes of care. The assessments took place on-site; they identified key factors contributing to preventable mortality, and each hospital received specific recommendations. Changes in observed mortality and in the ratio of observed to expected mortality were measured from 2002 to final follow-up in 2007. Evaluations determined each hospital's success factors and key barriers to improvement. The key factors contributing to preventable mortality were delays in responding to deteriorating patients, suboptimal critical care, hospital-acquired infections, postoperative complications, medical errors, and community issues such as the availability of hospice care. Of the 16 hospitals, 12 were able to reduce their mortality index. The five hospitals that had the greatest improvement in mortality were the only hospitals with a broad level of engagement among hospital and physician leaders, including the department chairs. In the hospitals whose performance did not improve, the department chairs were not engaged in the process. The academic medical centers that focused on mortality reduction and had engagement of physicians, especially department chairs, were able to achieve meaningful reductions in hospital mortality. The necessary ingredients for achieving meaningful improvement in clinical outcomes included good data, a sound method for change, and physician leadership. PMID:19940569

  2. Succession planning in an academic medical center nursing service.

    PubMed

    Barginere, Cynthia; Franco, Samantha; Wallace, Lynne

    2013-01-01

    Succession planning is of strategic importance in any industry. It ensures the smooth transition from leader to leader and the ability of the organization to maintain the forward momentum as well as meet its operational and financial goals. Health care and nursing are no exception. In the complex and challenging world of health care today, leadership is critical to an organization's success and leadership succession is a key strategy used to ensure continuity of leadership and development of talent from within the organization. At Rush University Medical Center, a 667-bed academic medical center providing tertiary care to adults and children, the need for a focus on succession planning for the nursing leadership team is apparent as key leaders come to the end of their careers and consider retirement. It has become apparent that to secure the legacy and continue the extraordinary history of nursing excellence, care must be taken to grow talent from within and take the opportunity to leverage the mentoring opportunities before the retirement of many key leaders. To ensure a smooth leadership transition, nursing leadership and human resources partner at Rush University Medical Center to implement a systematic approach to leadership succession planning. PMID:23222756

  3. Use of Electronic Medication Administration Records to Reduce Perceived Stress and Risk of Medication Errors in Nursing Homes.

    PubMed

    Alenius, Malin; Graf, Peter

    2016-07-01

    Concerns have been raised about the effects of current medication administration processes on the safety of many of the aspects of medication administration. Keeping electronic medication administration records could decrease many of these problems. Unfortunately, there has not been much research on this topic, especially in nursing homes. A prospective case-control survey was consequently performed at two nursing homes; the electronic record system was introduced in one, whereas the other continued to use paper records. The personnel were asked to fill in a questionnaire of their perceptions of stress and risk of medication errors at baseline (n = 66) and 20 weeks after the intervention group had started recording medication administration electronically (n = 59). There were statistically significant decreases in the perceived risk of omitting a medication, of medication errors occurring because of communication problems, and of medication errors occurring because of inaccurate medication administration records in the intervention group (all P < .01 vs the control group). The perceived overall daily stress levels were also reduced in the intervention group (P < .05). These results indicate that the utilization of electronic medication administration records will reduce many of the concerns regarding the medication administration process. PMID:27270628

  4. Serving two masters? Recent legal developments regarding the professional obligations of medical administrators in Australia.

    PubMed

    Bradfield, Owen

    2011-03-01

    Medical administration is a recognised medical specialty in Australia. Historically, medical administrators have rarely been subjected to litigation or disciplinary hearings relating specifically to their administrative functions. However, the legal landscape for medical administrators in Australia appears to be shifting. In 2009, the Queensland Health Practitioners Tribunal heard two separate cases involving the professional conduct of medical administrators who were implicated in the scandal surrounding Dr. Jayant Patel at Bundaberg Hospital. In September 2010, judgment in one of those cases was delivered. This article reviews the tribunal's decision through the lens of relevant United Kingdom authorities and recent legislative changes in Australia regulating the health professions. PMID:21528739

  5. School-Based Health Centers and the Patient-Centered Medical Home. Position Statement

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2010

    2010-01-01

    The patient-centered medical home (PCMH) is an innovative care delivery model designed to provide comprehensive primary care services to people of all ages by fostering partnerships between patients, families, health care providers and the community. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies that…

  6. An academic medical center under prolonged rocket attack--organizational, medical, and financial considerations.

    PubMed

    Bar-El, Yaron; Michaelson, Moshe; Hyames, Gila; Skorecki, Karl; Reisner, Shimon A; Beyar, Rafael

    2009-09-01

    The Rambam Medical Center, the major academic health center in northern Israel, serving a population of two million and providing specialized tertiary care, was exposed to an unprecedented experience during the Second Lebanon War in the summer of 2006. For more than one month, it was subjected to continuous rocket attacks, but it continued to provide emergency and routine medical services to the civilian population and also served the military personnel who were evacuated from the battlefront. To accomplish the goals of serving the population while itself being under fire, the Rambam Medical Center had to undertake major organizational decisions, which included maximizing safety within the hospital by shifting patients and departments, ensuring that the hospital was properly fortified, managing the health professional teams' work schedules, and providing needed services for the families of employees. The Rambam Medical Center's Level I trauma center expertise included multidisciplinary teams and extensive collaborations; modern imaging modalities usually reserved for peacetime medical practice were frequently used. The function of the hospital teams during the war was efficient and smooth, based on the long-term actions taken to prepare for disasters and wartime conditions. Routine hospital services continued, although at 60% of normal occupancy. Financial losses incurred were primarily due to the decrease in revenue-generating activity. The two most important components of managing the hospital under these conditions are (1) the ability to arrive at prompt and meaningful decisions with respect to the organizational and medical hospital operations and (2) the leadership and management of the professional staff and teams. PMID:19707058

  7. Interpersonal Communications Curriculum. Claretian Medical Center for the Worker Education Program of Northeastern Illinois University, Chicago Teacher's Center.

    ERIC Educational Resources Information Center

    Estes, Florence S.

    This teaching guide contains the materials required to teach a 6-week course in interpersonal communications that was developed for the workers of a Chicago medical center through a partnership involving the medical center, its employees, their union, and Northeastern Illinois University. Based on the student-centered philosophy of teaching, the…

  8. The Prescribed Pediatric Center: A Medical Day Treatment Program for Children with Complex Medical Conditions.

    ERIC Educational Resources Information Center

    Ruppert, Elizabeth S.; Karst, Thomas O.; Brogan, Mark G.

    1998-01-01

    The Prescribed Pediatric Center (Toledo, Ohio) is a community-based, multidisciplinary program for infants and children with chronic, complex medical conditions. This article describes program beginnings; the planning process; and the program's growth, development, and components. Initial program evaluation indicates positive effects on some…

  9. Design for Medical Education. The Development and Planning of a Medical College and Care Center.

    ERIC Educational Resources Information Center

    Peery, Thomas M.; Green, Alan C.

    Planning and design procedures which one medical education center employed in translating its educational objectives, philosophy and techniques into laboratory, classroom and clinic facilities are described. Basic planning considerations included--(1) determination of the curriculum, (2) facility utilization rate, (3) housing of research…

  10. Commentary: Institutes versus traditional administrative academic health center structures.

    PubMed

    Karpf, Michael; Lofgren, Richard

    2012-05-01

    In the Point-Counterpoint section of this issue, Kastor discusses the pros and cons of a new, institute-based administrative structure that was developed at the Cleveland Clinic in 2008, ostensibly to improve the quality and efficiency of patient care. The real issue underlying this organizational transformation is not whether the institute model is better than the traditional model; instead, the issue is whether the traditional academic health center (AHC) structure is viable or whether it must evolve. The traditional academic model, in which the department and chair retain a great deal of autonomy and authority, and in which decision-making processes are legislative in nature, is too tedious and laborious to effectively compete in today's health care market. The current health care market is demanding greater efficiencies, lower costs, and thus greater integration, as well as more transparency and accountability. Improvements in both quality and efficiency will demand coordination and integration. Focusing on quality and efficiency requires organizational structures that facilitate cohesion and teamwork, and traditional organizational models will not suffice. These new structures must and will replace the loose amalgamation of the traditional AHC to develop the focus and cohesion to address the pressures of an evolving health care system. Because these new structures should lead to more successful clinical enterprises, they will, in fact, support the traditional academic missions of research and education more successfully than traditional organizational models can. PMID:22531588

  11. University-Based Research Centers: Characteristics, Organization, and Administrative Implications

    ERIC Educational Resources Information Center

    Sa, Creso M.

    2008-01-01

    This paper examines the characteristics and organizational issues associated with university-based research centers. The first section sketches general characteristics and functions of centers. The second section examines major issues concerning the organization of centers, including funding and sustainability, center autonomy, and relations with…

  12. My personal experiences at the BEST Medical Center: A day in the clinic-the afternoon.

    PubMed

    Cohen, Philip R; Kurzrock, Razelle

    2016-01-01

    Dr. Ida Lystic is a gastroenterologist who recently began her new faculty position at the BEST (Byron Edwards and Samuel Thompson) Medical Center. After completing her MD degree at the prestigious Harvey Medical School (recently renamed the Harvey Provider School), she did her internal medicine residency and fellowship training at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center. Her morning in gastroenterology clinic was highlighted by: (1) being reprimanded by the clinic nurse manager for a patient who not only arrived early, before clinic had opened, but also neglected to schedule the anesthesiologist for his colonoscopy; (2) the continued challenges of LEGEND (also known as Lengthy and Excessively Graded Evaluation and Nomenclature for Diagnosis by her colleagues), the new electronic medical record system after the BEST discarded the SIMPLE (Succinct Input Making Patient's Lives Electronic) system; (3) a nurse's interruption of an office visit-once the egg timer on the examination room door ran out-because she had exceeded the allocated time for the appointment; and (4) her chairman's unanticipated arrival in the clinic to visit with the clinic nurse manager. In addition to seeing her patients, Dr. Lystic's afternoon is occupied by attending a LOST (Laboratory OverSight and Testing) Committee meeting and a visit from a wayfinding and signage specialist to depersonalize the doorpost plaques of the examination rooms. Her day ends with a demeaning email from her chairman regarding the poor results of the most recent patient satisfaction survey and being personally held accountable to develop solutions to improve not only her performance but also that of the clinic. Although Dr. Ida Lystic and the gastroenterology clinic at "the BEST Medical Center" are creations of the authors' imagination, the majority of the anecdotes mentioned in this essay are based on individual patients and their physicians, clinics in medical centers and their administration

  13. Undergoing Transformation to the Patient Centered Medical Home in Safety Net Health Centers: Perspectives from the Front Lines

    PubMed Central

    Quinn, Michael T.; Gunter, Kathryn E.; Nocon, Robert S.; Lewis, Sarah E.; Vable, Anusha M.; Tang, Hui; Park, Seo-Young; Casalino, Lawrence P.; Huang, Elbert S.; Birnberg, Jonathan; Burnet, Deborah L.; Summerfelt, W. Thomas; Chin, Marshall H.

    2013-01-01

    Objectives Safety Net Health Centers (SNHCs), which include Federally Qualified Health Centers (FQHCs) provide primary care for underserved, minority and low income patients. SNHCs across the country are in the process of adopting the Patient Centered Medical Home (PCMH) model, based on promising early implementation data from demonstration projects. However, previous demonstration projects have not focused on the safety net and we know little about PCMH transformation in SNHCs. Design This qualitative study characterizes early PCMH adoption experiences at SNHCs. Setting and Participants We interviewed 98 staff,(administrators, providers, and clinical staff) at 20 of 65 SNHCs, from five states, who were participating in the first of a five-year PCMH collaborative, the Safety Net Medical Home Initiative. Main Measures We conducted 30-45 minute, semi-structured telephone interviews. Interview questions addressed benefits anticipated, obstacles encountered, and lessons learned in transition to PCMH. Results Anticipated benefits for participating in the PCMH included improved staff satisfaction and patient care and outcomes. Obstacles included staff resistance and lack of financial support for PCMH functions. Lessons learned included involving a range of staff, anticipating resistance, and using data as frequent feedback. Conclusions SNHCs encounter unique challenges to PCMH implementation, including staff turnover and providing care for patients with complex needs. Staff resistance and turnover may be ameliorated through improved healthcare delivery strategies associated with the PCMH. Creating predictable and continuous funding streams may be more fundamental challenges to PCMH transformation. PMID:23914423

  14. Evaluation of Intravenous Medication Errors with Smart Infusion Pumps in an Academic Medical Center

    PubMed Central

    Ohashi, Kumiko; Dykes, Patricia; McIntosh, Kathleen; Buckley, Elizabeth; Wien, Matt; Bates, David W.

    2013-01-01

    While some published research indicates a fairly high frequency of Intravenous (IV) medication errors associated with the use of smart infusion pumps, the generalizability of these results are uncertain. Additionally, the lack of a standardized methodology for measuring these errors is an issue. In this study we iteratively developed a web-based data collection tool to capture IV medication errors using a participatory design approach with interdisciplinary experts. Using the developed tool, a prevalence study was then conducted in an academic medical center. The results showed that the tool was easy to use and effectively captured all IV medication errors. Through the prevalence study, violation errors of hospital policy were found that could potentially place patients at risk, but no critical errors known to contribute to patient harm were noted. PMID:24551395

  15. A cryptologic based trust center for medical images.

    PubMed Central

    Wong, S T

    1996-01-01

    OBJECTIVE: To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. DESIGN: The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. MEASUREMENTS: The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. RESULTS: The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. CONCLUSION: Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment. PMID:8930857

  16. Family Perceptions of Medication Administration at School: Errors, Risk Factors, and Consequences

    ERIC Educational Resources Information Center

    Clay, Daniel; Farris, Karen; McCarthy, Ann Marie; Kelly, Michael W.; Howarth, Robyn

    2008-01-01

    Medications are administered every day in schools across the country. Researchers and clinicians have studied school nurses' and educators' experiences with medication administration, but not the experiences of children or their parents. This study examined medication administration from the child and parent perspectives to (a) determine problems…

  17. Task Analysis of Medical Technology Administration and Supervision as a Foundation to a Curriculum Ladder.

    ERIC Educational Resources Information Center

    Becan-McBride, Kathleen Elizabeth

    The administrative and supervisory competencies that a medical technology student should acquire before graduation were investigated. Selected medical technology laboratory supervisors and administrative technologists in the Houston-Galveston, Texas area were surveyed to determine the tasks performed by the medical technology laboratory…

  18. Promoting cancer screening within the patient centered medical home.

    PubMed

    Sarfaty, Mona; Wender, Richard; Smith, Robert

    2011-01-01

    While consensus has grown that primary care is the essential access point in a high-performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the most promising approach to addressing the burden of chronic disease, improving health outcomes, and reducing health spending. However, the potential for the medical home to improve the delivery of cancer screening (and preventive services in general) has received limited attention in both conceptualization and practice. Medical home demonstrations to date have included few evidence-based preventive services in their outcome measures, and few have evaluated the effect of different payment models. Decreasing use of hospitals and emergency rooms and an emphasis on improving chronic care represent improvements in effective delivery of healthcare, but leave opportunities for reducing the burden of cancer untouched. Data confirm that what does or does not happen in the primary care setting has a substantial impact on cancer outcomes. Insofar as cancer is the leading cause of death before age 80, the PCMH model must prioritize adherence to cancer screening according to recommended guidelines, and systems, financial incentives, and reimbursements must be aligned to achieve that goal. This article explores capacities that are needed in the medical home model to facilitate the integration of cancer screening and other preventive services. These capacities include improved patient access and communication, health risk assessments, periodic preventive health exams, use of registries that store cancer risk information and screening history, ability to track and follow up on tests and referrals, feedback on performance, and payment models that reward cancer screening. PMID:22086728

  19. A suicide prevention advisory group at an academic medical center.

    PubMed

    Hough, D; Lewis, P

    2000-02-01

    During a 15-month period, there were seven suicides among patients who were in active treatment or who had been seen recently by providers in the Department of Psychiatry of Tripler Army Medical Center, Honolulu, Hawaii. As a result, a Suicide Prevention Advisory Group was formed to identify possible causes and make recommendations aimed at improving the identification and treatment of suicidal patients. The group made 11 specific recommendations. No known suicides occurred during the 22 months after the implementation of the Suicide Prevention Advisory Group's recommendations. PMID:10709368

  20. A suicide prevention advisory group at an academic medical center.

    PubMed

    Hough, David; Lewis, Philip

    2010-05-01

    During a 15-month period, there were seven suicides among patients who were in active treatment or who had been seen recently by providers in the Department of Psychiatry of Tripler Army Medical Center, Honolulu, Hawaii. As a result, a Suicide Prevention Advisory Group (SPAG) was formed to identify possible causes and make recommendations aimed at improving the identification and treatment of suicidal patients. The group made 11 specific recommendations. No known suicides occurred during the 22 months after the implementation of the Suicide Prevention Advisory Group's recommendations. PMID:20486507

  1. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

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

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover). In that book, this photograph appears for building 706 was renumbered 353 and subsequently 202. The building in the photograph resembles building 204 more than it does building 202, but all Fitzsimons Real Property records indicate that the building in the photograph, showing west side, is early photograph of building 202. - Fitzsimons General Hospital, Motor Transport Garage, Northwest Corner of East Harlow Avenue, & North Twelfth Street, Aurora, Adams County, CO

  2. Cancer Research Institute, Loma Linda University Medical Center

    SciTech Connect

    1994-08-01

    The Department of Energy (DOE) has prepared an Environmental Assessment (EA) DOE/EA-0975, evaluating the construction, equipping and operation of the Cancer Research Institute (CRI) at the Loma Linda University Medical Center (LLUMC) on its campus in Loma Linda, California. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act of 1969 (NEPA). Therefore, the preparation of an Environmental Impact Statement is not required. This document describes alternatives, the affected environment and environmental consequences of the proposed action.

  3. Forensic neuropsychological evaluations in an academic medical center.

    PubMed

    Schwarz, Lauren; Schrift, Michael; Pliskin, Neil

    2009-01-01

    Within the expanding field of clinical neuropsychology, the subspecialty of forensic neuropsychology has developed. Currently, there is considerable diversity within the discipline as to how practitioners approach test selection, reports, and number of hours billed. How individuals handle these issues is subject to debate, but what is clear is that there are no specific guidelines as to how to conduct these evaluations. The current study provides an introduction to the issues faced by clinical neuropsychologists completing forensic evaluations. In addition, the authors present how the relevant issues are addressed in one neuropsychology service housed within a university-affiliated academic medical center. PMID:19333065

  4. University Research Centers: Heuristic Categories, Issues, and Administrative Strategies

    ERIC Educational Resources Information Center

    Hall, Kelly

    2011-01-01

    University-based research centers can bring prestige and revenue to the institutions of higher education with which they are affiliated. Collaborating with corporations, units of government, and foundations, centers provide services to organizational leaders, policy makers, and communities. University research centers continue to increase in…

  5. An Integrated Model of Care: A Visit to The SPARK Center, a Program of Boston Medical Center

    ERIC Educational Resources Information Center

    Griest, Christa

    2010-01-01

    This article features The SPARK Center, a program of Boston Medical Center, located in Mattapan, Massachusetts. The Center has pioneered a whole-child approach to address the multi-dimensional needs of Boston's most at-risk children, recognizing that vulnerable children need more than educational supports to flourish. The Center's integrated model…

  6. 48 CFR 619.402 - Small Business Administration procurement center representatives.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Small Business... DEPARTMENT OF STATE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Cooperation with the Small Business Administration 619.402 Small Business Administration procurement center representatives....

  7. 48 CFR 619.402 - Small Business Administration procurement center representatives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Small Business... DEPARTMENT OF STATE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Cooperation with the Small Business Administration 619.402 Small Business Administration procurement center representatives....

  8. 78 FR 29699 - Transfer of Administrative Jurisdiction: Marine Corps Mountain Warfare Training Center...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Transfer of Administrative Jurisdiction: Marine Corps Mountain Warfare Training Center..., lying within the Marine Corps Mountain Warfare Training Center and the Humboldt-Toiyabe National...

  9. Photodynamic research at Baylor University Medical Center Dallas, Texas

    NASA Astrophysics Data System (ADS)

    Gulliya, Kirpal S.; Matthews, James Lester; Sogandares-Bernal, Franklin M.; Aronoff, Billie L.; Judy, Millard M.

    1993-03-01

    We received our first CO2 laser at Baylor University Medical Center in December 1974, following a trip to Israel in January of that year. Discussion with the customs office of the propriety of charging an 18% import tax lasted for nine months. We lost that argument. Baylor has been using lasers of many types for many procedures since that time. About ten years ago, through the kindness of Tom Dougherty and Roswell Park, we started working with photodynamic therapy, first with hematoporphyrin I and later with dihematoporphyrin ether (II). In February 1984, we were invited to a conference at Los Alamos, New Mexico, U.S.A. on medical applications of the free electron laser as part of the Star Wars Program. A grant application from Baylor was approved that November, but funding did not start for many months. This funding contributed to the development of a new research center as part of Baylor Research Institute. Many of the projects investigated at Baylor dealt with applications of the free electron laser (FEL), after it became available. A staff was assembled and many projects are still ongoing. I would like to outline those which are in some way related to photodynamic therapy.

  10. Confirming delivery: understanding the role of the hospitalized patient in medication administration safety.

    PubMed

    Macdonald, Marilyn T; Heilemann, MarySue V; MacKinnon, Neil J; Lang, Ariella; Gregory, David; Gurnham, Mary Ellen; Fillatre, Theresa

    2014-04-01

    The purpose of our study was to gain an understanding of current patient involvement in medication administration safety from the perspectives of both patients and nursing staff members. Administering medication is taken for granted and therefore suited to the development of theory to enhance its understanding. We conducted a constructivist, grounded theory study involving 24 patients and 26 nursing staff members and found that patients had the role of confirming delivery in the administration of medication. Confirming delivery was characterized by three interdependent subprocesses: engaging in the medication administration process, being "half out of it" (patient mental status), and perceiving time. We believe that ours is one of the first qualitative studies on the role of hospitalized patients in administering medication. Medication administration and nursing care systems, as well as patient mental status, impose limitations on patient involvement in safe medication administration. PMID:24598773

  11. Development and assessment of learning objects about intramuscular medication administration

    PubMed Central

    Tamashiro, Lilian Mayumi Chinen; Peres, Heloisa Helena Ciqueto

    2014-01-01

    OBJECTIVES: to develop and assess a learning object about intramuscular medication administration for nursing undergraduates and nurses. METHOD: a random, intentional and non-probabilistic sample was selected of nurses from a Brazilian social network of nursing and students from the Undergraduate Program at the University of São Paulo School of Nursing to serve as research subjects and assess the object. RESULTS: the participants, 8 nurses and 8 students, studied the object and answered an assessment instrument that included the following criteria: educational aspects (relevance of the theme, objectives and texts/hypertexts), interface of the environment (navigation, accessibility and screen design) and didactic resources (interactivity and presentation of resources). In total, 128 significant answers were obtained, 124 (97%) of which were positive, assessed as excellent and satisfactory, considered as a flexible, dynamic, objective resources that is appropriate to the nursing learning process. CONCLUSION: the educational technology shows a clear and easily understandable language and the teaching method could be applied in other themes, contributing to the education and training of nursing professionals, positively affecting nursing teaching, stimulating the knowledge, autonomous and independent learning, aligned with the new professional education requirements. PMID:25493665

  12. Publications in academic medical centers: technology-facilitated culture clash.

    PubMed

    Berner, Eta S

    2014-05-01

    Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed. PMID:24667517

  13. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience

    PubMed Central

    Palamaner Subash Shantha, Ghanshyam; Gollamudi, Lakshmi Rani; Sheth, Jignesh; Ebersole, Brian; Gardner, Katlyn J.; Nardella, Julie; Ruddy, Meaghan P.; Meade, Lauren

    2015-01-01

    Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents—12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents—began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents. PMID:25699213

  14. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience.

    PubMed

    Thomas-Hemak, Linda; Palamaner Subash Shantha, Ghanshyam; Gollamudi, Lakshmi Rani; Sheth, Jignesh; Ebersole, Brian; Gardner, Katlyn J; Nardella, Julie; Ruddy, Meaghan P; Meade, Lauren

    2015-01-01

    Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents' self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents-12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents-began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA's) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents. PMID:25699213

  15. Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home

    PubMed Central

    O’Donnell, Alison J.; Kellom, Katherine; Miller-Day, Michelle; McClintock, Heather F. de Vries; Kaye, Elise M.; Gabbay, Robert; Cronholm, Peter F.

    2016-01-01

    Introduction Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. Methods The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n = 47), medical assistants (n = 26), office administrators (n = 12), care managers (n = 11), front office staff (n = 7), patient educators (n = 4), nurses (n = 4), social workers (n = 4), and other administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. Results Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. Conclusion Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care. PMID:26916899

  16. Spectrum of tablet computer use by medical students and residents at an academic medical center

    PubMed Central

    2015-01-01

    Introduction. The value of tablet computer use in medical education is an area of considerable interest, with preliminary investigations showing that the majority of medical trainees feel that tablet computers added value to the curriculum. This study investigated potential differences in tablet computer use between medical students and resident physicians. Materials & Methods. Data collection for this survey was accomplished with an anonymous online questionnaire shared with the medical students and residents at Southern Illinois University School of Medicine (SIU-SOM) in July and August of 2012. Results. There were 76 medical student responses (26% response rate) and 66 resident/fellow responses to this survey (21% response rate). Residents/fellows were more likely to use tablet computers several times daily than medical students (32% vs. 20%, p = 0.035). The most common reported uses were for accessing medical reference applications (46%), e-Books (45%), and board study (32%). Residents were more likely than students to use a tablet computer to access an electronic medical record (41% vs. 21%, p = 0.010), review radiology images (27% vs. 12%, p = 0.019), and enter patient care orders (26% vs. 3%, p < 0.001). Discussion. This study shows a high prevalence and frequency of tablet computer use among physicians in training at this academic medical center. Most residents and students use tablet computers to access medical references, e-Books, and to study for board exams. Residents were more likely to use tablet computers to complete clinical tasks. Conclusions. Tablet computer use among medical students and resident physicians was common in this survey. All learners used tablet computers for point of care references and board study. Resident physicians were more likely to use tablet computers to access the EMR, enter patient care orders, and review radiology studies. This difference is likely due to the differing educational and professional demands placed on

  17. 75 FR 74063 - Supplemental Funding Under the Food and Drug Administration's Convener of Active Medical Product...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... HUMAN SERVICES Food and Drug Administration Supplemental Funding Under the Food and Drug Administration... Supplemental Application AGENCY: Food and Drug Administration, HHS. ACTION: Notice of intent. SUMMARY: The Food... Medical Policy, Food and Drug Administration, 10903 New Hampshire Ave, Bldg. 51, rm. 6360, Silver...

  18. The Administrative Assessment Center: An Opportunity for Service.

    ERIC Educational Resources Information Center

    Richardson, M. D.

    In 1988, the Department of Educational Leadership at Western Kentucky University (WKU) established the Western Kentucky Assessment Center, sponsored by the National Association of Secondary School Principals (NASSP). This document provides an overview of the history and methods of NASSP assessment centers, followed by a discussion of costs to…

  19. Reflecting on the ethical administration of computerized medical records

    NASA Astrophysics Data System (ADS)

    Collmann, Jeff R.

    1995-05-01

    This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing

  20. My personal experiences at the BEST Medical Center: A day in the clinic-the morning.

    PubMed

    Cohen, Philip R; Kurzrock, Razelle

    2016-01-01

    Dr. Ida Lystic is a gastroenterologist who trained at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center, after having completed her MD degree at the prestigious Harvey Medical School (recently renamed the Harvey Provider School). She accepted a faculty position at the BEST (Byron Edwards and Samuel Thompson) Medical Center. Dr. Lystic shares her experiences on a typical morning in gastroenterology clinic. Although her clinic start date was delayed by 2 months after becoming sick following a mandatory flu shot and having to complete more than 70 hours of compliance training modules, she is now familiar with the BEST system. Clinic scheduling priorities include ensuring that the staff can eat lunch together and depart at 5:00 pm. It is a continual challenge to find time to complete the electronic medical record after BEST changed from the SIMPLE (Succinct Input Making Patients Lives Electronic) system to LEGEND (referred to as Lengthy and Excessively Graded Evaluation and Nomenclature for Diagnosis by her colleagues). To maintain clinic punctuality, a compliance spreadsheet is e-mailed monthly to the Wait Time Committee. Their most recent corrective action plan for tardy physicians included placing egg timers on the doors and having nurses interrupt visits that exceed the allotted time. Administrative decisions have resulted in downsizing personnel. Patients are required to schedule their own tests and procedures and follow-up appointments-causing low patient satisfaction scores; however, the money saved lead to a large year-end bonus for the vice president of BEST Efficiency, who holds "providers" accountable for the poor patient experience. Although Dr. Ida Lystic and the gastroenterology clinic at "the BEST Medical Center" are creations of the authors' imagination, the majority of the anecdotes are based on actual events. PMID:27265082

  1. Psychologists in medical schools and academic medical centers: over 100 years of growth, influence, and partnership.

    PubMed

    Robiner, William N; Dixon, Kim E; Miner, Jacob L; Hong, Barry A

    2014-04-01

    Psychologists have served on the faculties of medical schools for over 100 years. Psychologists serve in a number of different roles and make substantive contributions to medical schools' tripartite mission of research, education, and clinical service. This article provides an overview of the history of psychologists' involvement in medical schools, including their growing presence in and integration with diverse departments over time. We also report findings from a survey of medical school psychologists that explored their efforts in nonclinical areas (i.e., research, education, administration) as well as clinical endeavors (i.e., assessment, psychotherapy, consultation). As understanding of the linkage between behavioral and psychological factors and health status and treatment outcomes increases, the roles of psychologists in health care are likely to expand beyond mental health. An increasing focus on accountability-related to treatment outcomes and interprofessional research, education, and models of care delivery-will likely provide additional opportunities for psychologists within health care and professional education. The well-established alignment of psychologists' expertise and skills with the mission and complex organizational needs of medical schools augurs a partnership on course to grow stronger. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24588315

  2. 47 CFR 54.637 - Off-site data centers and off-site administrative offices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... connections and network equipment associated with off-site data centers and off-site administrative offices... care provider's computer systems, associated components, and data, including (but not limited to... center and the public Internet or another network, (v) An off-site administrative office and the...

  3. 47 CFR 54.637 - Off-site data centers and off-site administrative offices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... connections and network equipment associated with off-site data centers and off-site administrative offices... care provider's computer systems, associated components, and data, including (but not limited to... center and the public Internet or another network, (v) An off-site administrative office and the...

  4. A special issue on the patient-centered medical home.

    PubMed

    Blount, Alexander

    2010-12-01

    This special issue on the Patient-Centered Medical Home (PCMH) reflects its times. At the present time, the PCMH is an aspirational model with a few pilots functioning well around the country. How long the current period of idealism, fueled by the energy of early adopters, the consensus of diverse stakeholders, and the dollars of the Affordable Care Act will continue is anybody's guess. Representing the thinking of some of the best minds in the field, the articles in this issue have an aspirational and idealistic tone as much as a descriptive and analytic one. A year ago the balance would have been tipped more toward idealism and model building and a year from now it would, in all likelihood, tip more toward model description and analysis. The authors in this volume have been personally responsible for helping to move behavioral health to a more central position in the PCMH model. PMID:21299276

  5. An academic medical center's response to widespread computer failure.

    PubMed

    Genes, Nicholas; Chary, Michael; Chason, Kevin W

    2013-01-01

    As hospitals incorporate information technology (IT), their operations become increasingly vulnerable to technological breakdowns and attacks. Proper emergency management and business continuity planning require an approach to identify, mitigate, and work through IT downtime. Hospitals can prepare for these disasters by reviewing case studies. This case study details the disruption of computer operations at Mount Sinai Medical Center (MSMC), an urban academic teaching hospital. The events, and MSMC's response, are narrated and the impact on hospital operations is analyzed. MSMC's disaster management strategy prevented computer failure from compromising patient care, although walkouts and time-to-disposition in the emergency department (ED) notably increased. This incident highlights the importance of disaster preparedness and mitigation. It also demonstrates the value of using operational data to evaluate hospital responses to disasters. Quantifying normal hospital functions, just as with a patient's vital signs, may help quantitatively evaluate and improve disaster management and business continuity planning. PMID:24352930

  6. Facilitators and Barriers to Safe Medication Administration to Hospital Inpatients: A Mixed Methods Study of Nurses’ Medication Administration Processes and Systems (the MAPS Study)

    PubMed Central

    McLeod, Monsey; Barber, Nicholas; Franklin, Bryony Dean

    2015-01-01

    Context Research has documented the problem of medication administration errors and their causes. However, little is known about how nurses administer medications safely or how existing systems facilitate or hinder medication administration; this represents a missed opportunity for implementation of practical, effective, and low-cost strategies to increase safety. Aim To identify system factors that facilitate and/or hinder successful medication administration focused on three inter-related areas: nurse practices and workarounds, workflow, and interruptions and distractions. Methods We used a mixed-methods ethnographic approach involving observational fieldwork, field notes, participant narratives, photographs, and spaghetti diagrams to identify system factors that facilitate and/or hinder successful medication administration in three inpatient wards, each from a different English NHS trust. We supplemented this with quantitative data on interruptions and distractions among other established medication safety measures. Findings Overall, 43 nurses on 56 drug rounds were observed. We identified a median of 5.5 interruptions and 9.6 distractions per hour. We identified three interlinked themes that facilitated successful medication administration in some situations but which also acted as barriers in others: (1) system configurations and features, (2) behaviour types among nurses, and (3) patient interactions. Some system configurations and features acted as a physical constraint for parts of the drug round, however some system effects were partly dependent on nurses’ inherent behaviour; we grouped these behaviours into ‘task focused’, and ‘patient-interaction focused’. The former contributed to a more streamlined workflow with fewer interruptions while the latter seemed to empower patients to act as a defence barrier against medication errors by being: (1) an active resource of information, (2) a passive information resource, and/or (3) a

  7. Putting patients first: a novel patient-centered model for medical enterprise success.

    PubMed

    Dhawan, Naveen

    2014-01-01

    This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises. The author introduces a model that directs all business activities toward the end consumer with an underlying guidance by patient needs. A business is advised to understand its customer, design a patient-directed vision, and focus on creating a unique customer experience. The article delineates key action items for physicians and administrators that will allow them to better meet their patient-customers' needs and develop loyalty. By practicing a patient-centered approach and following these guidelines, one may ensure greater success of the medical enterprise. PMID:25108980

  8. The Critical Role of Clerks in the Patient-Centered Medical Home.

    PubMed

    Solimeo, Samantha L; Stewart, Greg L; Rosenthal, Gary E

    2016-07-01

    Research evaluating the effectiveness, function, and implementation of patient-centered medical homes (PCMHs) has found major socioprofessional transformations and contributions of primary care physicians and, to a lesser degree, nurses. Our longitudinal ethnographic research with teams implementing PCMH in Veterans Health Administration (VHA) primary care identifies the important but largely underutilized contributions of clerks to PCMH outcomes. Although the relationship of high-performing clerical staff to patient satisfaction is widely acknowledged, PCMH can be further enhanced by enabling clerks to use administrative tasks as conduits for investing in long-term personalized relationships with patients that foster trust in the PCMH and the broader health care organization. Such relationships are engendered through the care-coordination activities clerks perform, which may be bolstered by organizational investment in clerks as skilled health care team members. PMID:27401428

  9. Medication administration errors for older people in long-term residential care

    PubMed Central

    2011-01-01

    Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing). Data on all medication administrations for a cohort of 345 older residents were recorded in real-time using a disguised observation technique. Every attempt by social care and nursing staff to administer medication over a 3-month observation period was analysed using BCMA records to determine the incidence and types of potential medication administration errors (MAEs) and whether errors were averted. Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Further analysis compared data for residential and nursing homes. In addition, staff were surveyed prior to BCMA system implementation to assess their awareness of administration errors. Results A total of 188,249 medication administration attempts were analysed using BCMA data. Typically each resident was receiving nine different drugs and was exposed to 206 medication administration episodes every month. During the observation period, 2,289 potential MAEs were recorded for the 345 residents; 90% of residents were exposed to at least one error. The most common (n = 1,021, 45% of errors) was attempting to give medication at the wrong time. Over the 3-month observation period, half (52%) of residents were exposed to a serious error such as attempting to give medication to the wrong resident. Error incidence rates were 1.43 as high (95% CI 1.32-1.56 p < 0.001) in nursing homes as in residential homes. The level of non-compliance with system alerts was very low in both settings (0.075% of administrations). The pre-study survey revealed that only 12

  10. Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center

    PubMed Central

    Rizer, Milisa K.; Kaufman, Beth; Sieck, Cynthia J.; Hefner, Jennifer L.; McAlearney, Ann Scheck

    2015-01-01

    Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation. PMID:26396558

  11. Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center.

    PubMed

    Rizer, Milisa K; Kaufman, Beth; Sieck, Cynthia J; Hefner, Jennifer L; McAlearney, Ann Scheck

    2015-01-01

    Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation. PMID:26396558

  12. The Design & Implementation of a Curriculum Ladder in Medical Record Administration 1970-1973.

    ERIC Educational Resources Information Center

    Waters, Kathleen A.; Hanken, Mary Alice

    Objectives of a 3-year articulation project were (1) to design and put into effect a curriculum for medical record personnel which would provide educational progression for associate arts degree medical record technicians to baccalaureate degree medical record administration programs, (2) to research, classify, and compare curriculum content of…

  13. Establishing Compliance with Liquid Medication Administration in a Child with Autism

    ERIC Educational Resources Information Center

    Schiff, Averil; Tarbox, Jonathan; Lanagan, Taira; Farag, Peter

    2011-01-01

    Children with autism often display difficulty with swallowing pills and liquid medications. In the current study, stimulus fading and positive reinforcement established compliance with liquid medication administration in a young boy with autism. The boy's mother eventually administered liquid medication on her own. (Contains 1 figure.)

  14. 78 FR 102 - Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-02

    ..., Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave., Bldg... CONTACT: Samie Allen, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New... HUMAN SERVICES Food and Drug Administration Guidance for Industry and......

  15. Conflict of interest issues pertinent to Veterans Affairs Medical Centers.

    PubMed

    Hanna, Jennifer; Simiele, Ernest; Lawson, D Curtis; Tyler, Douglas

    2011-09-01

    Conflicts of interest exist when an arrangement potentially exerts inappropriate influence on decision making or professional judgment, or is perceived to do so, and can thus damage the public trust and undermine the integrity of those decisions. Concerns regarding financial conflicts of interest in the medical arena have reached their height as of late, given that physicians now function in a milieu of complex and delicate relationships with pharmaceutical, biotechnology, and medical device industries. Even when such relationships do not correlate with actual compromise of judgment or patient care, it threatens the credibility of both the health care professional and the institution because of the social perception of the effect of these relationships. Although most institutions in the Western world set forth a code of ethics and conflict-of-interest policies to be followed under threat of termination, the Veterans Health Administration (VHA) presents itself as a unique environment in which conflicts of interest are subject to governmental laws, violation of which may not only result in employment-related discipline, but may be sanctioned by civil and criminal penalties. Moreover, these provisions are developed by a national authoritative organization rather than being institution-specific guidelines. Given that many academic physicians working within the VHA may also have a component of their practice in a University setting, it becomes important to understand the differences in policy between these contexts so as not to threaten the public trust in the veracity of decisions made and, therefore, maintain the integrity of the relationship between physician and patient. This article will review aspects of conflict-of-interest policies in the realm of research, financial relationships, foreign travel, and vendor contracting that are particular to the VHA and make it a unique environment to function in as a physician and scientist. PMID:21872117

  16. Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center

    PubMed Central

    Chandler, Paulette D.; Giovannucci, Edward L.; Williams, Michelle A.; LeBoff, Meryl S.; Bates, David W.; Hicks, LeRoi S.

    2014-01-01

    OBJECTIVE Assess racial/ethnic and sex differences in treatment of vitamin D deficiency with high dose ergocalciferol (‘vitamin D2’) or other forms of vitamin D in a northeastern U.S. ambulatory clinic of an academic urban medical center. STUDY DESIGN Cross-sectional observational review of electronic medication prescribing records of patients with 25-hydroxyvitamin D (25OHD) deficiency (25OHD < 20 ng/ml) from 2004–2008. METHODS Using multivariable logistic regression adjusting for patients’ demographics, and Elixhauser comorbidity score, we examined the association of sex and race/ethnicity with prescription for at least one dose of vitamin D. RESULTS Among 2,140 patients without renal disease and tested for 25OHD deficiency (25OHD < 20 ng/ml), 66.2% received no vitamin D prescription for vitamin D deficiency. Blacks and Hispanics received vitamin D prescriptions at a higher frequency than whites, 37.8% 38.4% and 30.9%, respectively, p=0.003. The vitamin D prescription rate for women versus men was 26.3% and 7.5%, respectively, p=0.04. In a fully adjusted model, no difference in prescription likelihood for blacks and whites [OR=1.18 95% CI, 0.88–1.58; p=0.29] or Hispanics and whites was noted [OR=1.01 95% CI, 0.70–1.45;p=0.73]. Similarly, fully adjusted model showed no difference in prescription likelihood for females and males [OR=1.23 95% CI, 0.93–1.63; p=0.12]. CONCLUSIONS Among primary care patients with vitamin D deficiency, vitamin D supplementation was low and white patients were less likely to receive vitamin D treatment than blacks or Hispanics. Interventions to correct the high prevalence of vitamin D deficiency should address the markedly low rate of vitamin D prescribing when 25OHD levels are measured. PMID:25328637

  17. 78 FR 59038 - Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    ... HUMAN SERVICES Food and Drug Administration Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice.... In the Federal Register of July 21, 2011 (76 FR 43689), FDA announced the availability of the...

  18. An integrated nursing-pharmacy approach to a computerized medication dispensing/administration system.

    PubMed

    Cook, A A

    1985-05-01

    This paper describes the collaborative efforts of the nursing and pharmacy departments to develop a nurse-generated/pharmacist-verified computerized medication administration record (MAR). The objectives were to improve accuracy in dispensing and administering medications and a avoid duplicate labor efforts created by separate records to dispense and to administer the medications. These efforts provided the nurses with an accurate record to administer the medication and the physicians with an informative record with which to review their patient's drug therapy. PMID:10271106

  19. Nonstandard Programs: the University of Pittsburgh Medical Center's next frontier in graduate medical education.

    PubMed

    Kroboth, Frank J; Zerega, W Dennis; Patel, Rita M; Barnes, Barbara E; Webster, Marshall W

    2011-02-01

    The University of Pittsburgh Medical Center has seen continuous growth in the number and types of graduate training programs not accredited by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Medical Specialties, or the American Osteopathic Association. For the purposes of ensuring best educational products and of controlling unrecognized competition with our accredited programs, a sequential process of centralized oversight of these nonstandard programs was undertaken. The first step involved programs whose fellows were hired and tracked like accredited fellows (i.e., not instructors). The basic process began with consensus among leadership, writing of policy with consultation as necessary, establishment of a registry of programs and graduates, and a committee to allow sharing of best practices and dissemination of policy. The second step applied the same process to instructor-level programs. Whereas the previous group of programs was made subject to ACGME regulations, more latitude in duty hours and progressive responsibility were allowed for instructor programs. The final step, in progress, is extending a similar but modified approach to short-duration clinical experiences and observerships. The outcomes of these efforts have been the creation of a centralized organizational structure, policies to guide this structure, an accurate registry of a surprising number of training programs, and a rolling record of all graduates from these programs. Included in the process is a mechanism that ensures that core program directors and department chairs specifically review the impact of new programs on core programs before allowing their creation. PMID:21169779

  20. Behavioral anchors: building a medical center on solid foundations.

    PubMed

    Doordan, Martin L; Stupak, Ronald J

    2005-01-01

    Construction of new facilities in the healthcare arena is an ongoing, almost daily, occurrence. The desire to build wisely and effectively is evidenced at the Anne Arundel Medical Center which has attracted healthcare executives from all over the country who come to view, analyze, and experience the beauty, utility and interdependencies of the buildings and facilities that constitute "the AAMC campus." However, too often these executive visitors and benchmarking experts tend to focus on the technical, architectural, engineering, concrete aspects of the hospital, while naively overlooking and/or giving short shrift to the more critical behavioral dynamics of the construction process. The ultimate success of any building project requires a clear understanding by the leadership of "where people are coming from," so that both the design and the development of the final product can be brought under the synthesizing umbrella of patient care, clinical excellence, individual safety, and community responsibility. Not only must the leadership determine and drive the strategic thrust toward the final outcome; in addition, they must make sure that they allow significant colleagues to be actively, operationally, and symbolically engaged in a process that ends up in a structural outcome that everyone is proud to own, to see, and to inhabit. PMID:16521615

  1. Public Health Potential of Farmers’ Markets on Medical Center Campuses: A Case Study From Penn State Milton S. Hershey Medical Center

    PubMed Central

    Kraschnewski, Jennifer L.; Rovniak, Liza S.

    2011-01-01

    There are currently 7175 farmers’ markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces. PMID:22021298

  2. Writing Effectively as Counseling Center Directors and Administrators: Lessons Learned from a 2-Minute Speech

    ERIC Educational Resources Information Center

    Sevig, Todd; Bogan, Yolanda; Dunkle, John; Gong-Guy, Elizabeth

    2015-01-01

    Administrative writing is a crucial skill needed for the counseling center professional to be able to transmit knowledge and values for the rest of the campus community. This article highlights both conceptual and technical aspects of effective writing.

  3. Accountable care organization readiness and academic medical centers.

    PubMed

    Berkowitz, Scott A; Pahira, Jennifer J

    2014-09-01

    As academic medical centers (AMCs) consider becoming accountable care organizations (ACOs) under Medicare, they must assess their readiness for this transition. Of the 253 Medicare ACOs prior to 2014, 51 (20%) are AMCs. Three critical components of ACO readiness are institutional and ACO structure, leadership, and governance; robust information technology and analytic systems; and care coordination and management to improve care delivery and health at the population level. All of these must be viewed through the lens of unique AMC mission-driven goals.There is clear benefit to developing and maintaining a centralized internal leadership when it comes to driving change within an ACO, yet there is also the need for broad stakeholder involvement. Other important structural features are an extensive primary care foundation; concomitant operation of a managed care plan or risk-bearing entity; or maintaining a close relationship with post-acute-care or skilled nursing facilities, which provide valuable expertise in coordinating care across the continuum. ACOs also require comprehensive and integrated data and analytic systems that provide meaningful population data to inform care teams in real time, promote quality improvement, and monitor spending trends. AMCs will require proven care coordination and management strategies within a population health framework and deployment of an innovative workforce.AMC core functions of providing high-quality subspecialty and primary care, generating new knowledge, and training future health care leaders can be well aligned with a transition to an ACO model. Further study of results from Medicare-related ACO programs and commercial ACOs will help define best practices. PMID:24979282

  4. Enriching Patient-Centered Medical Homes Through Peer Support

    PubMed Central

    Daaleman, Timothy P.; Fisher, Edwin B.

    2015-01-01

    Peer supporters are recognized by various designations—community health workers, promotores de salud, lay health advisers—and are community members who work for pay or as volunteers in association with health care systems or nonprofit community organizations and often share ethnicity, language, and socioeconomic status with the mentees that they serve. Although emerging evidence demonstrates the efficacy of peer support at the community level, the adoption and implementation of this resource into patient-centered medical homes (PCMHs) is still under development. To accelerate that integration, this article addresses three major elements of peer support interventions: the functions and features of peer support, a framework and programmatic strategies for implementation, and fiscal models that would support the sustained viability of peer support programs within PCMHs. Key functions of peer support include assistance in daily management of health-related behaviors, social and emotional support, linkage to clinical care, and longitudinal or ongoing support. An organizational model of innovation implementation provides a useful framework for determining how to implement and evaluate peer support programs in PCMHs. Programmatic strategies that can be useful in developing peer support programs within PCMHs include peer coaching or mentoring, group self-management training, and programs designed around the telephone and information technology. Fiscal models for peer support programs include linkages with hospital or health care systems, service- or community-based nonprofit organizations, and partnerships between health care systems and community groups. Peer support promises to enrich PCMHs by activating patients in their self-care, providing culturally sensitive outreach, and opening the way for partnerships with community-based organizations. PMID:26304975

  5. Energy savings through retrofits in a large medical center

    SciTech Connect

    Hutchins, P.F.

    1997-06-01

    A 600,000-square-foot medical center in the southeastern United States is presently undergoing major renovations which will result in savings of energy use and costs. The current project, funded for FY96 includes a number of modifications to the Heating and Cooling Plant and the hospital itself. These upgrades include: (1) High efficiency chillers, (2) Cooling tower replacement, (3) High efficiency condenser and chilled water pump motors, (4) New chilled water and condenser pumps and piping, (5) Condenser water reset controls, (6) Electricity demand reduction using gas-fired absorption chiller, (7) Secondary chilled water variable speed flow, (8) Boiler controls improvements, (9) Feedwater pump replacements, (10) Repair of air-side economizer HVAC system, (11) New 2x4 parabolic troffers with T-8 lamps and electronic ballasts, and (12) DDC controls. The current hospital energy use was modeled using Trane`s TRACE 600{reg_sign} computer simulation program to agree with recent historical energy use data. A second model was created implementing the energy conservation improvements listed above to quantify the associated energy and cost savings. Additional energy saving ideas were evaluated for cost effectiveness. These are: (1) New unattended boilers, (2) Boiler pressure reduction, (3) Boiler economizer, (4) Additional boiler controls, (5) Exhaust air heat recovery, (6) Domestic hot water decentralization, (7) Desiccant cooling, (8) Supply air reduction scheduling, (9) Compact fluorescents, (10) Variable air volume HVAC systems, and (11) Occupancy sensors. Another interesting aspect of this project was an evaluation of harmonic distortion due to electronic ballasts. Direct field measurements were made on similar lighting circuits to compare the harmonic currents generated by electronic and magnetic ballasts. A graphical as well as quantitative analysis is presented.

  6. Enriching Patient-Centered Medical Homes Through Peer Support.

    PubMed

    Daaleman, Timothy P; Fisher, Edwin B

    2015-08-01

    Peer supporters are recognized by various designations-community health workers, promotores de salud, lay health advisers-and are community members who work for pay or as volunteers in association with health care systems or nonprofit community organizations and often share ethnicity, language, and socioeconomic status with the mentees that they serve. Although emerging evidence demonstrates the efficacy of peer support at the community level, the adoption and implementation of this resource into patient-centered medical homes (PCMHs) is still under development. To accelerate that integration, this article addresses three major elements of peer support interventions: the functions and features of peer support, a framework and programmatic strategies for implementation, and fiscal models that would support the sustained viability of peer support programs within PCMHs. Key functions of peer support include assistance in daily management of health-related behaviors, social and emotional support, linkage to clinical care, and longitudinal or ongoing support. An organizational model of innovation implementation provides a useful framework for determining how to implement and evaluate peer support programs in PCMHs. Programmatic strategies that can be useful in developing peer support programs within PCMHs include peer coaching or mentoring, group self-management training, and programs designed around the telephone and information technology. Fiscal models for peer support programs include linkages with hospital or health care systems, service- or community-based nonprofit organizations, and partnerships between health care systems and community groups. Peer support promises to enrich PCMHs by activating patients in their self-care, providing culturally sensitive outreach, and opening the way for partnerships with community-based organizations. PMID:26304975

  7. Development Trends in Federal Library and Information Center Automation. Guides for Administrative and Technical Interviews.

    ERIC Educational Resources Information Center

    Information Dynamics Corp., Bethesda, MD.

    These two guides for interviews on trends in library automation in federal libraries and information centers cover administrative and technical interviews. The guide for administrative interviews is divided into five steps: (1) determining the details of the agency's mission and organizational structure, (2) establishing the administrative…

  8. 48 CFR 19.402 - Small Business Administration procurement center representatives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Small Business... FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Cooperation With the Small Business Administration 19.402 Small Business Administration procurement center representatives. (a)(1)...

  9. 48 CFR 19.402 - Small Business Administration procurement center representatives.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Small Business... FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Cooperation With the Small Business Administration 19.402 Small Business Administration procurement center representatives. (a)(1)...

  10. Medication administration in the domiciliary care setting: whose role?

    PubMed

    Bradford, Jennie

    2012-11-01

    Unqualified social care workers are increasingly delegated the responsibility of both assisting with and administering medication in the domiciliary care setting. This article discusses the considerations required before the delegation of these roles by both commissioners and nurses. In particular, variations in training, policies and provision are explored with reference to the Care Quality Commission guidance and Nursing and Midwifery Council standards. The levels of support and their definitions are clarified for use in policy documents, and the effectiveness of devices used to support self-care are critiqued within a legal framework. The importance of joint working to provide a seamless medication management service are highlighted using reflections on examples from practice. PMID:23124424

  11. Photographer: NASA Administrators Award for: 1. 'Turning Goals into Reality' presented to Center

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Photographer: NASA Administrators Award for: 1. 'Turning Goals into Reality' presented to Center TRACON Automation System Team, Langley Research Center October 9, 1998 2. 'Turning Goals into Reality 1998 Goal Award for Excetptional Progress toward Next-Generation Design Tools and Experimental Aircraft acrylic

  12. 34 CFR 668.152 - Administration of tests by assessment centers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... agreement between a test publisher or a State, as applicable, and an assessment center indicates otherwise... center scores the test, it must provide weekly to the test publisher or the State, as applicable— (i) All... the test and any identifier assigned to the test administrator by the test publisher or the State,...

  13. 34 CFR 668.152 - Administration of tests by assessment centers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... agreement between a test publisher or a State, as applicable, and an assessment center indicates otherwise... center scores the test, it must provide weekly to the test publisher or the State, as applicable— (i) All... the test and any identifier assigned to the test administrator by the test publisher or the State,...

  14. 34 CFR 668.152 - Administration of tests by assessment centers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... agreement between a test publisher or a State, as applicable, and an assessment center indicates otherwise... center scores the test, it must provide weekly to the test publisher or the State, as applicable— (i) All... the test and any identifier assigned to the test administrator by the test publisher or the State,...

  15. 34 CFR 668.152 - Administration of tests by assessment centers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... agreement between a test publisher or a State, as applicable, and an assessment center indicates otherwise... center scores the test, it must provide weekly to the test publisher or the State, as applicable— (i) All... the test and any identifier assigned to the test administrator by the test publisher or the State,...

  16. An Ounce of Prevention: An Administrative Guide for Day Care Center Directors.

    ERIC Educational Resources Information Center

    Gray, Norma; Hall, Don

    One of three training manuals developed for day care center staff, this administrative guide was written to assist day care center directors in developing policies and procedures aimed at improving all aspects of the day care program, and thus reducing the risk of child abuse. Four chapters focus on (1) selection of staff, including recruiting,…

  17. Searching for the Final Answer: Factors Contributing to Medication Administration Errors.

    ERIC Educational Resources Information Center

    Pape, Tess M.

    2001-01-01

    Causal factors contributing to errors in medication administration should be thoroughly investigated, focusing on systems rather than individual nurses. Unless systemic causes are addressed, many errors will go unreported for fear of reprisal. (Contains 42 references.) (SK)

  18. Scanning for safety: an integrated approach to improved bar-code medication administration.

    PubMed

    Early, Cynde; Riha, Chris; Martin, Jennifer; Lowdon, Karen W; Harvey, Ellen M

    2011-03-01

    This is a review of lessons learned in the postimplementation evaluation of a bar-code medication administration technology implemented at a major tertiary-care hospital in 2001. In 2006, with a bar-code medication administration scan compliance rate of 82%, a near-miss sentinel event prompted review of this technology as part of an institutional recommitment to a "culture of safety." Multifaceted problems with bar-code medication administration created an environment of circumventing safeguards as demonstrated by an increase in manual overrides to ensure timely medication administration. A multiprofessional team composed of nursing, pharmacy, human resources, quality, and technical services formalized. Each step in the bar-code medication administration process was reviewed. Technology, process, and educational solutions were identified and implemented systematically. Overall compliance with bar-code medication administration rose from 82% to 97%, which resulted in a calculated cost avoidance of more than $2.8 million during this time frame of the project. PMID:21099677

  19. The Patient-Centered Medical Neighborhood: Transformation of Specialty Care.

    PubMed

    Spatz, Christin; Bricker, Patricia; Gabbay, Robert

    2014-01-01

    The growing need for coordinated care of those with medically complex diseases is becoming more important in today's health care system, wherein reimbursement changes are driving methods to improve quality and cost. This article discusses the 6 key processes that, according to the American College of Physicians, define an effective medical neighborhood; the evidence supporting the need for this coordinated system; and pilot medical neighborhood strategies being implemented. PMID:23966551

  20. Characteristics of medication errors made by students during the administration phase: a descriptive study.

    PubMed

    Wolf, Zane Robinson; Hicks, Rodney; Serembus, Joanne Farley

    2006-01-01

    Faculty concentrate on teaching nursing students about safe medication administration practices and on challenging them to develop skills for calculating drug dose and intravenous flow rate problems. In spite of these efforts, students make medication errors and little is known about the attributes of these errors. Therefore, this descriptive, retrospective, secondary analysis study examined the characteristics of medication errors made by nursing students during the administration phase of the medication use process as reported to the MEDMARX, a database operated by the United States Pharmacopeia through the Patient Safety Program. Fewer than 3% of 1,305 student-made medication errors occurring in the administration process resulted in patient harm. Most were omission errors, followed by errors of giving the wrong dose (amount) of a drug. The most prevalent cause of the errors was students' performance deficits, whereas inexperience and distractions were leading contributing factors. The antimicrobial therapeutic class of drugs and the 10 subcategories within this class were the most commonly reported medications involved. Insulin was the highest-frequency single medication reported. Overall, this study shows that students' administration errors may be more frequent than suspected. Faculty might consider curriculum revisions that incorporate medication use safety throughout each course in nursing major courses. PMID:16459288

  1. Legal Issues in School Health Services and School Psychology: Guidelines for the Administration of Medication

    ERIC Educational Resources Information Center

    Mazur-Mosiewicz, Anna; Pierson, Eric E.; McIntosh, David E.

    2009-01-01

    The use of psychoactive medications to augment behavioral and psychosocial interventions in schools has significantly increased within the last few decades. Yet, advising, administrating, and supervising the dispensation of medication (including psychostimulants and psychoactive substances) tend to be some of the most risky tasks of school…

  2. Evaluation of Safe Medication Administration through the Use of Simulation in an Academic Setting

    ERIC Educational Resources Information Center

    Dover, Cheryl D.

    2013-01-01

    Nursing educational programs are struggling with how to educate students to safely and efficiently administer medications. There is no doubt education programs need to find a way to assist students to acquire the skill of medication administration and to also transfer the skill into practice. Knowledge, skills, and abilities are requirements for…

  3. Re-launch of the South African Society of Medical Managers (previously known as the Medical Administrators Group).

    PubMed

    Dudley, L; Selebano, T E; Nathan, R; Kirsten, R; Ciapparelli, P; Mutshekwane, M N; Basu, D

    2013-01-01

    Medical management is a recognised specialty in many developing and developed countries, including Australia, India, New Zealand, Pakistan and Sri Lanka. In South Africa it was recognised as a sub-specialty in the 1990s, but this is no longer the case. The South African Society of Medical Managers, in close collaboration with the Division of Medical Management of the College of Public Health Medicine of South Africa, has been working to re-establish the specialty of medical management in South Africa. Well-trained specialist medical managers would play a significant role in the effective and efficient implementation of National Health Insurance and primary healthcare re-engineering through the practice of evidence-based health care, clinical economics and administrative medicine. PMID:23237117

  4. Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.

    PubMed

    Nelson, Karin; Sun, Haili; Dolan, Emily; Maynard, Charles; Beste, Laruen; Bryson, Christopher; Schectman, Gordon; Fihn, Stephan D

    2014-01-01

    Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care. PMID:25180648

  5. 77 FR 10537 - Food and Drug Administration/Xavier University Global Medical Device Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-22

    ...: The public conference will be held on the campus of Xavier University, 3800 Victory Pkwy., Cincinnati... HUMAN SERVICES Food and Drug Administration Food and Drug Administration/Xavier University Global... University, is announcing a public conference entitled ``FDA/Xavier University Global Medical...

  6. 75 FR 15439 - Food and Drug Administration/Xavier University Global Medical Device Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... HUMAN SERVICES Food and Drug Administration Food and Drug Administration/Xavier University Global... University, is announcing a public conference entitled ``FDA/Xavier University Global Medical Device... public conference will be held on the campus of Xavier University, 3800 Victory Pkwy., Cincinnati,...

  7. 76 FR 15986 - Food and Drug Administration/Xavier University Global Medical Device Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... conference will be held on the campus of Xavier University, 3800 Victory Pkwy., ] Cincinnati, OH 45207, 513... HUMAN SERVICES Food and Drug Administration Food and Drug Administration/Xavier University Global... University, is announcing a public conference entitled ``FDA/Xavier University Global Medical...

  8. 78 FR 15957 - Food and Drug Administration/Xavier University Global Medical Device Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... public conference will be held on the campus of Xavier University, 3800 Victory Pkwy., Cincinnati, OH... HUMAN SERVICES Food and Drug Administration Food and Drug Administration/Xavier University Global... University, is announcing a public conference entitled ``FDA/Xavier University Global Medical...

  9. 77 FR 43846 - Food and Drug Administration Pediatric Medical Devices Workshop; Notice of Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ... Administration's (FDA) Office of Orphan Products Development is announcing the following workshop: FDA Pediatric... Office of Orphan Product Development and will include participants from the FDA's Center for Devices...

  10. The effect of a safe zone on nurse interruptions, distractions, and medication administration errors.

    PubMed

    Yoder, Mindy; Schadewald, Diane; Dietrich, Kim

    2015-01-01

    Patient safety is a health care priority. Yet medical errors are ranked the eighth leading cause of death. Medication administration errors (MAEs) often result from multiple environmental and individual factors. This quality improvement initiative adapted a protocol based on airline industry safety measures to decrease nurse distractions and interruptions during medication administration, with the goal of decreasing MAEs. Sources of distractions, interruptions, and MAEs were measured pre and post intervention. Patient satisfaction scores were measured concurrently. Results of this initiative differ from previous studies in which similar interventions reduced both distractions and MAEs. An unexpected finding was dramatically increased patient satisfaction. PMID:25723837

  11. Suggested Minimum Data Set for Speech Therapy Centers Affiliated to Tabriz University of Medical Sciences

    PubMed Central

    Damanabi, Shahla; Abdolnejad, Shawbo; Karimi, Gelavizh

    2015-01-01

    Background: The minimum data considered as a conceptual framework, based on the achievement of effectiveness indicators and it ensures to access of precise and clear health data. The aims of the present study were identified and proposed a data element set of speech therapy centers affiliated with Tabriz University of Medical Sciences. Material and Methods: This study that was cross – sectional type, performed in 9 speech therapy clinic from medical university in 2014. Firstly, the minimum data elements set evaluated using the check list in these centers. Using the findings from the first step and survey of internal and external documentation forms, designed a questionnaire containing a minimum data speech therapy files and it shared between 36 Speech therapy experts using 5 options of Likert scale. Validity of questionnaire was examined through its validity and reliability of content by retest. For data analysis, data processing was performed using descriptive statistics by SPSS21 software. Results: The minimum data set for speech therapy were divided into two categories: clinical and administrative data. The Name and surname, date of birth, gender, address, telephone number, date of admission and the number of treatments, the patient’s complaint, the time of occurrence of injury or disorder, reason and age of disease considered as the most important elements for management data and health history. For the most important elements of clinical information were selected Short-term and long-term aims and development of speech history. Conclusion: The design and implementation of suitable data collection of speech therapy for gathering of data, we recommended planning for the control and prevention of speech disorders to providing high quality and good care of patient in speech therapy centers. PMID:26483600

  12. Is technology the best medicine? Three practice theoretical perspectives on medication administration technologies in nursing.

    PubMed

    Boonen, Marcel Jmh; Vosman, Frans Jh; Niemeijer, Alistair R

    2016-06-01

    Even though it is often presumed that the use of technology like medication administration technology is both safer and more effective, the importance of nurses' know-how is not to be underestimated. In this article, we accordingly try to argue that nurses' labor, including their different forms of knowledge, must play a crucial role in the development, implementation and use of medication administration technology. Using three different theoretical perspectives ('heuristic lenses') and integrating this with our own ethnographic research, we will explore how nursing practices change through the use of medication technology. Ultimately, we will argue that ignoring (institutional) complexity and the various types of important knowledge that nurses have, will seriously complicate the implementation of medication administration technology. PMID:26491844

  13. Medical Bibliography and Medical Library Administration. LS 8497, 4 Quarter Hours: Course Information.

    ERIC Educational Resources Information Center

    Wayne State Univ., Detroit, MI. Dept. of Library Science.

    This publication outlines and presents a series of 27 learning modules for a course in medical librarianship intended to be conducted in an individualized instructional framework featuring lectures, small group discussions, talks by guest speakers from the medical profession, on-site observation of hospital libraries, on-line demonstrations of…

  14. Medical Automation System at the Marshall Space Flight Center

    NASA Technical Reports Server (NTRS)

    Spraul, J. H.

    1970-01-01

    A computer system is reported for scheduling and coordinating physical examinations for groups of people who work with chemicals, lasers, X-rays, isotopic sources, toxic fuels, adhesives, and exotic metals. Complete medical data on the examined population are continuously updated for a broad medical master file. Statistical methods are employed to project progressive changes in the health status of these employees for possible clinical interventions.

  15. [Administration of medication to use when needed and the care of psychiatric nursing].

    PubMed

    Estrela, Kelly da Silva Rocha; Loyola, Cristina Maria Douat

    2014-01-01

    This qualitative study aimed to analyze the clinical criteria used for the administration of prescribed medications for use when needed (SOS); and discuss the implication of the findings in this research to clinical psychiatric nursing. The records of female patients admitted to a psychiatric institution in the city of Rio de Janeiro, in the time frame from May to June 2009, were analyzed. In the 38 patient records, 16 prescriptions for medications SOS were found. The mean age of patients was around 45-55 years with a clinical diagnosis of Bipolar Mood Disorder. The medication category most prescribed as SOS was of benzodiazepines, followed by antipsychotics. It was noticed a tendency to not valuing the administration of medication in SOS notes. The study points out the importance to establish clinical criteria to indicate the need, or not, to administer prescribed SOS medications. PMID:25271580

  16. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital

    PubMed Central

    Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; de Andrade, Rayza Assis; Teleginski, Fernanda; da Rocha, Maria Dagmar

    2016-01-01

    Abstract Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r) program, and frequencies were calculated. Results: 786 errors were observed, 63.9% (502) in Phase 2, and 36.1% (284) in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes. PMID:27276019

  17. INTRAVENOUS MEDICATION ADMINISTRATION ERRORS AND THEIR CAUSES IN CARDIAC CRITICAL CARE UNITS IN IRAN

    PubMed Central

    Bagheri-Nesami, Masoumeh; Esmaeili, Ravanbakhsh; Tajari, Mojdeh

    2015-01-01

    Background and Objectives: The dangerous events caused by medication errors are one of the main challenges faced in critical care units. The present study was conducted to determine the frequency of intravenous medication administration errors and their causes in cardiac critical care units in Iran. Materials and Methods: The present descriptive study was conducted in the critical care units (CCUs and cardiac surgery intensive care units) of 12 teaching hospitals. Of the total of 240 nurses working in these departments, 190 participated in the present study. The data collection tools used in this study included the “nurses’ demographic data questionnaire”, the “patients’ medical and demographic data questionnaire” and the “nurses’ self-reporting questionnaire about the frequency of intravenous medication administration errors and their causes”. The data obtained were analyzed in SPSS-20 using descriptive statistics such as the absolute and relative frequency. Findings: During the 2 months in which this study was being conducted, 2542 patients were admitted to these departments and 20240 doses of intravenous medications were administered to these patients. The nurses reported 262 intravenous medication administration errors. The most common intravenous medication error pertained to administering the wrong medication (n=71 and 27.1%). As for the causes of intravenous medication administration errors, 51.5% of the errors were associated with work conditions, 24% with packaging, 13.4% with communication, 9.9% with transcription and 1.2% with pharmacies. Discussion and Conclusion: According to the results, strategies are recommended to be adopted for reducing or limiting medication errors, such as building a stronger pharmacology knowledge base in nurses and nursing students, improving work conditions and improving communication between the nurses and physicians. PMID:26889108

  18. Nursing administration of medication via enteral tubes in adults: a systematic review.

    PubMed

    Phillips, Nicole M; Nay, Rhonda

    2007-09-01

    Background  Enteral tubes are frequently inserted as part of medical treatment in a wide range of patient situations. Patients with an enteral tube are cared for by nurses in a variety of settings, including general and specialised acute care areas, aged care facilities and at home. Regardless of the setting, nurses have the primary responsibility for administering medication through enteral tubes. Medication administration via an enteral tube is a reasonably common nursing intervention that entails a number of skills, including preparing the medication, verifying the tube position, flushing the tube and assessing for potential complications. If medications are not given effectively through an enteral tube, harmful consequences may result leading to increased morbidity, for example, tube occlusion, diarrhoea and aspiration pneumonia. There are resultant costs for the health-care system related to possible increased length of stay and increased use of equipment. Presently what is considered to be best practice to give medications through enteral tubes is unknown. Objectives  The objective of this systematic review was to determine the best available evidence on which nursing interventions are effective in minimising the complications associated with the administration of medications via enteral tubes in adults. Nursing interventions and considerations related to medication administration included form of medication, verifying tube placement before administration, methods used to give medication, methods used to flush tubes, maintenance of tube patency and specific practices to prevent possible complications related to the administration of enteral medications. Search strategy  The following databases were searched for literature reported in English only: CINAHL, MEDLINE, The Cochrane Library, Current Contents/All Editions, EMBASE, Australasian Medical Index and PsychINFO. There was no date restriction applied. In addition, the reference lists of all included

  19. Errors of oral medication administration in a patient with enteral feeding tube.

    PubMed

    Emami, Shahram; Hamishehkar, Hadi; Mahmoodpoor, Ata; Mashayekhi, Simin; Asgharian, Parina

    2012-07-01

    Enteral feeding tube is employed for feeding of critically ill patients who are unable to eat. In the cases of oral medication administration to enterally fed patients, some potential errors could happen. We report a 53-year-old man who was admitted to intensive care unit (ICU) of a teaching hospital due to the post-CPR hypoxemic encephalopathy. The patient was intubated and underwent mechanical ventilation. A nasogastric (NG) tube was used as the enteral route for nutrition and administration of oral medications. Oral medications were crushed then dissolved in tap water and were given to the patient through NG tube. In present article we report several medication errors occurred during enterally drug administration, including errors in dosage form selection, methods of oral medication administration and drug interactions and incompatibility with nutrition formula. These errors could reduce the effects of drugs and lead to unsuccessful treatment of patient and also could increase the risk of potential adverse drug reactions. Potential leading causes of these errors include lack of drug knowledge among physicians, inadequate training of nurses and lack of pharmacists participation in medical settings. PMID:24991587

  20. Integration of footprints information systems in palliative care: the case of Medical Center of Central Georgia.

    PubMed

    Tsavatewa, Christopher; Musa, Philip F; Ramsingh, Isaac

    2012-06-01

    Healthcare in America continues to be of paramount importance, and one of the most highly debated public policy issues of our time. With annual expenditures already exceeding $2.4 trillion, and yielding less than optimal results, it stands to reason that we must turn to promising tools and solutions, such as information technology (IT), to improve service efficiency and quality of care. Presidential addresses in 2004 and 2008 laid out an agenda, framework, and timeline for national health information technology investment and development. A national initiative was long overdue. This report we show that advancements in both medical technologies and information systems can be capitalized upon, hence extending information systems usage beyond data collection to include administrative and decision support, care plan development, quality improvement, etc. In this paper we focus on healthcare services for palliative patients. We present the development and preliminary accounts of a successful initiative in the Medical Center of Central Georgia where footprints information technology was modified and integrated into the hospital's palliative care service and existing EMR systems. The project provides evidence that there are a plethora of areas in healthcare in which innovative application of information systems could significantly enhance the care delivered to loved ones, and improve operations at the same time.. PMID:21057887

  1. Nurses and Psychologists Advancing the Patient-Centered Medical Home Model.

    PubMed

    Corso, Kent A; Gage, Donna

    2016-01-01

    As America experiences the largest health care revolution of the past 50 years, clinicians and administrators are refocusing their attention on the goals of the Quadruple Aim. Motivation and capabilities among stakeholders vary as practical tools and an adequate workforce remain elusive. At the same time, the patient-centered medical home (PCMH) model is spreading rapidly but demonstrating variable results. Positive PCMH outcomes seem to reflect high-quality teamwork. A primary care physician shortage is looming, and increasing numbers of health professionals are being pushed into the PCMH, mandated to provide "integrated" care. Even now, the majority of our Graduate Medical Education programs do not train clinicians in team-based workflow models and interaction skills. Consequently, PCMH teams will only optimize and realize the model's true potential if they learn to coordinate, communicate, and collaborate effectively. This means all PCMH staff members achieve solid teamwork skills and work at the top of their license. The authors discuss resources for improving coordination, communication, and collaboration among members of PCMH teams, and strategies for including other professionals. PMID:27259123

  2. Teaching successful medication administration today: more than just knowing your 'rights'.

    PubMed

    Fothergill Bourbonnais, Frances; Caswell, Wenda

    2014-08-01

    Medication administration is an important skill taught in undergraduate nursing programs. Student learning for this activity includes not only how to prepare and administer medications, but also includes interventions such as patient and family teaching. Students also are taught a series of 'rights' in order to prevent medication errors. There are many factors, both personal and system related, which contribute to medication errors in the health care environment. The purpose of this article is to provide strategies for teaching students medication administration that encompass the multiple factors involved to ensure safe practice. This opinion paper is based on the authors' considerable years of teaching experience (35 years clinical setting and classroom teaching with senior students in final year of baccalaureate program for 1st author and 16 years total for co-author). Recommendations put forth by the authors are: a) leveling students' clinical experiences in administering medications to include understanding of system factors, b) structured scenarios and purposeful linking of theory to clinical courses to advance students' knowledge and skills related to medication administration as they progress through the program, 3) revisiting math skills. PMID:24857050

  3. Improving the Safety of Oral Chemotherapy at an Academic Medical Center

    PubMed Central

    Casella, Erica; Capozzi, Donna; McGettigan, Suzanne; Gangadhar, Tara C.; Schuchter, Lynn; Myers, Jennifer S.

    2016-01-01

    Purpose: Over the last decade, the use of oral chemotherapy (OC) for the treatment of cancer has dramatically increased. Despite their route of administration, OCs pose many of the same risks as intravenous agents. In this quality improvement project, we sought to examine our current process for the prescription of OC at the Abramson Cancer Center of the University of Pennsylvania and to improve on its safety. Methods: A multidisciplinary team that included oncologists, advanced-practice providers, and pharmacists was formed to analyze the current state of our OC practice. Using Lean Six Sigma quality improvement tools, we identified a lack of pharmacist review of the OC prescription as an area for improvement. To address these deficiencies, we used our electronic medical system to route OC orders placed by treating providers to an oncology-specific outpatient pharmacist at the Abramson Cancer Center for review. Results: Over 7 months, 63 orders for OC were placed for 45 individual patients. Of the 63 orders, all were reviewed by pharmacists, and, as a result, 22 interventions were made (35%). Types of interventions included dosage adjustment (one of 22), identification of an interacting drug (nine of 22), and recommendations for additional drug monitoring (12 of 22). Conclusion: OC poses many of the same risks as intravenous chemotherapy and should be prescribed and reviewed with the same oversight. At our institution, involvement of an oncology-trained pharmacist in the review of OC led to meaningful interventions in one third of the orders. PMID:26733627

  4. Smartphones in medicine: emerging practices in an academic medical center.

    PubMed

    Johnson, Angela C; El Hajj, Stephanie C; Perret, J Nelson; Caffery, Terrell S; Jones, Glenn N; Musso, Mandi W

    2015-01-01

    Advances in mobile phone technology now provide a myriad of resources to physicians' fingertips. However, the medical profession continues to struggle with potential for misuse of these devices. There is a need for better understanding of physicians' uses of smartphones in order to establish guidelines for appropriate and professional behavior. The purpose of the current study was to survey physicians' and medical students' practices concerning smartphone use in the healthcare setting. Physicians and medical students were asked to complete anonymous surveys regarding uses of smartphones within the past month in various healthcare settings. Overall, the participants reported distinctly different patterns in the uses they made of their phones in different settings (P<.001), with most individuals engaging in most behaviors while on break but few using their smartphones while with patients or during procedures. It appears that physicians and medical students make decisions about using their smartphones according to some combination of three considerations: degree of relevance to patient care, the appropriateness of the behavior in front of patients, and the issue of how disruptive that behavior may be. PMID:25526706

  5. Development of a Patient-Centered Antipsychotic Medication Adherence Intervention

    ERIC Educational Resources Information Center

    Pyne, Jeffrey M.; Fischer, Ellen P.; Gilmore, LaNissa; McSweeney, Jean C.; Stewart, Katharine E.; Mittal, Dinesh; Bost, James E.; Valenstein, Marcia

    2014-01-01

    Objective: A substantial gap exists between patients and their mental health providers about patient's perceived barriers, facilitators, and motivators (BFMs) for taking antipsychotic medications. This article describes how we used an intervention mapping (IM) framework coupled with qualitative and quantitative item-selection methods to…

  6. Medication Practices at Center Of Hospital and Nursing Home Proposals: Discharge and Pharmacy Requirements to Change.

    PubMed

    Barlas, Stephen

    2016-04-01

    Rules proposed by the Centers for Medicare and Medicaid Services would change discharge policies at hospitals and long-term care facilities and update conditions of participation with a focus on medication reconciliation and pharmacist responsibilities. PMID:27069341

  7. Fiscal strain and access to opiate substitution therapy at Department of Veterans Affairs Medical Centers.

    PubMed

    Rosenheck, Robert; Leslie, Douglas; Woody, George

    2003-01-01

    This study examines the relationship between institutional fiscal strain and the availability of opiate substitution therapy (eg, methadone maintenance), an effective but relatively expensive treatment for heroin addiction. An observational design was used to examine the association of changes in funding and changes in provision for treating opiate addiction at 29 VA Medical Centers (VAMCs). We hypothesized that VAMCs experiencing greater fiscal strain would show reduced availability of opiate substitution treatment. Administrative records from each of 29 VAMCs that provided opiate substitution therapy in both Fiscal Year (FY) 1995 and FY 1999 were used to measure changes in the availability of this service, ie, the percent change in total patients treated, annual visits per patient, and total services delivered. Institutional fiscal strain was measured by the percent decline in per capita funding at four levels at each VAMC: the entire medical center, all mental health programs, all substance abuse programs (inpatient and outpatient), and outpatient substance abuse programs alone. The total number of patients receiving opiate substitution increased from 5,549 in FY 1995 to 6,884 in FY 1999 (24%), annual visits per patient decreased by 16%, and the total number of units of services increased by 4%. There were no significant relationships between changes in the delivery of opiate substitution services and changes in per capita funding at any of the four institutional levels. No new programs were started during these years. Although no new programs were started, the availability of opiate substitution therapy at VA facilities with existing programs was maintained over a five-year period regardless of local funding changes, although at somewhat reduced intensity. PMID:12851018

  8. How do Interruptions Impact Nurses’ Visual Scanning Patterns When Using Barcode Medication Administration Systems?

    PubMed Central

    He, Ze; Marquard, Jenna L.; Henneman, Philip L.

    2014-01-01

    While barcode medication administration (BCMA) systems have the potential to reduce medication errors, they may introduce errors, side effects, and hazards into the medication administration process. Studies of BCMA systems should therefore consider the interrelated nature of health information technology (IT) use and sociotechnical systems. We aimed to understand how the introduction of interruptions into the BCMA process impacts nurses’ visual scanning patterns, a proxy for one component of cognitive processing. We used an eye tracker to record nurses’ visual scanning patterns while administering a medication using BCMA. Nurses either performed the BCMA process in a controlled setting with no interruptions (n=25) or in a real clinical setting with interruptions (n=21). By comparing the visual scanning patterns between the two groups, we found that nurses in the interruptive environment identified less task-related information in a given period of time, and engaged in more information searching than information processing. PMID:25954449

  9. Changing Economics of Health Care Are Devastating Academic Medical Centers.

    ERIC Educational Resources Information Center

    van der Werf, Martin

    1999-01-01

    Once a financially healthy part of American universities, many academic health centers are struggling to survive. Many are merging with for-profit chains or declaring bankruptcy. The advance of managed care and insurance companies focusing on reducing costs appears to be affecting teaching hospitals more than community hospitals. (MSE)

  10. The American Academy of Pediatrics Committee on School Health POLICY STATEMENT: Guidelines for the Administration of Medication in School

    ERIC Educational Resources Information Center

    Journal of School Nursing, 2004

    2004-01-01

    Many children who take medications require them during the school day. This policy statement is designed to guide prescribing physicians as well as school administrators and health staff on the administration of medications to children at school. The statement addresses over-the-counter products, herbal medications, experimental drugs that are…

  11. Advancing regulatory science to bring novel medical devices for use in emergency care to market: the role of the Food and Drug Administration.

    PubMed

    Scully, Christopher G; Forrest, Shawn; Galeotti, Loriano; Schwartz, Suzanne B; Strauss, David G

    2015-04-01

    The Food and Drug Administration (FDA) performs regulatory science to provide science-based medical product regulatory decisions. This article describes the types of scientific research the FDA's Center for Devices and Radiological Health performs and highlights specific projects related to medical devices for emergency medicine. In addition, this article discusses how results from regulatory science are used by the FDA to support the regulatory process as well as how the results are communicated to the public. Regulatory science supports the FDA's mission to assure safe, effective, and high-quality medical products are available to patients. PMID:25128009

  12. DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

    SciTech Connect

    Jacques, S.L.

    1998-01-01

    An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

  13. Trend of knowledge production of research centers in the field of medical sciences in iran.

    PubMed

    Falahat, K; Eftekhari, Mb; Habibi, E; Djalalinia, Sh; Peykari, N; Owlia, P; Malekafzali, H; Ghanei, M; Mojarrab, Sh

    2013-01-01

    Establishment of medical research centers at universities and health-related organizations and annually evaluation of their research activities was one of the strategic policies which followed by governmental organization in last decade in order to strengthening the connections between health research system and health system. The aim of this study is to scrutinize the role of medical research centers in medical science production in Iran. This study is a cross sectional which has been performed based on existing reports on national scientometrics and evaluation results of research performance of medical research centers between years 2001 to 2010. During last decade number of medical research centers increased from 53 in 2001 to 359 in 2010. Simultaneous scientific output of medical research centers has been increased especially articles indexed in ISI (web of science). Proper policy implementation in the field of health research system during last decades led to improving capacity building and growth knowledge production of medical science in recent years in Iran. The process embedding research into the health systems requires planning up until research products improves health outcomes and health equity in country. PMID:23865017

  14. Medical devices; laser fluorescence caries detection device. Food and Drug Administration, HHS. Final rule.

    PubMed

    2000-04-01

    The Food and Drug Administration (FDA) is classifying the laser fluorescence caries detection device into class II (special controls). The special controls that will apply to this device are set forth below. The agency is taking this action in response to a petition submitted under the Federal Food, Drug, and Cosmetic Act (the act) as amended by the Medical Device Amendments of 1976 (the amendments), the Safe Medical Devices Act of 1990, and the Food and Drug Administration Modernization Act of 1997. The agency is classifying this device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. PMID:11010622

  15. 49 CFR 1.64 - Delegations to the Director, Transportation Administrative Service Center.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Administrative Service Center. 1.64 Section 1.64 Transportation Office of the Secretary of Transportation ORGANIZATION AND DELEGATION OF POWERS AND DUTIES Delegations § 1.64 Delegations to the Director, Transportation... authority to operate the Working Capital Fund (49 U.S.C. 327)....

  16. Administrative Problem-Solving for Writing Programs and Writing Centers: Scenarios in Effective Program Management.

    ERIC Educational Resources Information Center

    Myers-Breslin, Linda

    Addressing the issues and problems faced by writing program administrators (WPAs) and writing center directors (WCDs), and how they can most effectively resolve the political, pedagogical, and financial questions that arise, this book presents essays from experienced WPAs and WCDs at a wide variety of institutions that offer scenarios and case…

  17. Developing a Typology of Branch Campuses: Findings from the NABCA Campus and Center Administrator Survey

    ERIC Educational Resources Information Center

    Bebko, Phyllis; Huffman, Dennis

    2011-01-01

    Relatively little is known about the presumably thousands of branch campuses and centers represented among U.S. higher education institutions. In an effort to fill this void, the research committee of the National Association of Branch Campus Administrators (NABCA) conducted a web-based survey targeting the leaders of branch campuses and…

  18. A Podiatric Medical Residency Program in an Academic Health Science Center

    ERIC Educational Resources Information Center

    Bogy, Louis T.; And Others

    1977-01-01

    The podiatric medical residency program in the Health Science Center at San Antonio provides an intensive exposure for the newly graduated podiatrist to practice in a multidisciplinary environment. Residents become more familiar with general medical and surgical diseases and disorders as well as podiatric pathology. (LBH)

  19. Medication Adherence among Adolescents in a School-Based Health Center

    ERIC Educational Resources Information Center

    Mears, Cynthia J.; Charlebois, Nicole M.; Holl, Jane L.

    2006-01-01

    School-based health centers are an integral part of the health care delivery system for low-income children. Medication adherence for these patients may be challenging because the student is often responsible for bringing home the prescription and receiving the instructions. This study assesses medication fill, initiation, and adherence rates…

  20. PROJECT HEAD START MEDICAL--A GUIDE FOR DIRECTION OF CHILD DEVELOPMENT CENTERS.

    ERIC Educational Resources Information Center

    Office of Economic Opportunity, Washington, DC.

    HEALTH SERVICES OF PROJECT HEAD START CHILD DEVELOPMENT CENTERS PROVIDE--A MEDICAL EVALUATION OF EACH CHILD INCLUDING MEDICAL HISTORY, DEVELOPMENTAL ASSESSMENT, AND PHYSICAL EXAMINATION, SCREENING TESTS FOR VISION, HEARING, SPEECH, AND TUBERCULOSIS, LABORATORY TESTS OF URINE FOR ALBUMIN AND TESTS OF SUGAR AND BLOOD FOR ANEMIA, DENTAL ASSESSMENT,…

  1. The University of New Mexico Medical Center Library's Health Information Services Outreach Program.

    ERIC Educational Resources Information Center

    Chamberlin, Susan B.; And Others

    Begun in 1980, the University of New Mexico Medical Center Library's statewide Outreach Program is a composite of many services and projects designed to meet the medical and health information needs of the state's diverse and scattered population. The only major biomedical library in New Mexico, the Library has built the program on existing…

  2. Developing a frenotomy policy at one medical center: a case study approach.

    PubMed

    Masaitis, N S; Kaempf, J W

    1996-09-01

    The objective of this study was to change procedures in our medical center regarding frenotomy for ankyloglossia (tongue-tie). The medical and breastfeeding outcomes of 36 fullterm infants who received frenotomies were studied. The information was used to develop frenotomy eligibility standards that would guide other physicians and insure timely treatment to avoid breastfeeding cessation. PMID:9025430

  3. The Medical Library and Media Center of Keio University in Tokyo: report on a visit.

    PubMed Central

    Accart, J P

    1995-01-01

    The Medical Library and Media Center at Keio University in Tokyo offers many facilities to its users: access to medical information within a large catalog of monographs and journals, online searching and CD-ROM databases, and a dynamic interlibrary loan service. This article is a report of a professional visit to the library on September 30, 1993. PMID:7703947

  4. Managing Information in the Academic Medical Center: Building an Integrated Information Environment.

    ERIC Educational Resources Information Center

    Fuller, Sherrilynne; And Others

    1995-01-01

    A program designed by the National Library of Medicine and the Association of American Medical Colleges to help academic medical centers develop appropriate information systems is described. The characteristics of such an integrated information environment, technical and organizational structures necessary for creating it, and the librarian's role…

  5. Nurse delegation of medication administration for older adults in assisted living.

    PubMed

    Reinhard, Susan C; Young, Heather M; Kane, Rosalie A; Quinn, Winifred V

    2006-01-01

    Assisted living (AL) is a relatively new form of long-term care that offers residents personal care services and more independence in a home-like environment. Introduced to the United States in the 1980s, AL is changing the conventional thinking about how to care for frail older adults. One important issue to explore is registered nurse (RN) delegation to unlicensed assistive personnel (UAP), particularly for medication administration. This study provides a national perspective on medication delivery in AL settings from the perspectives of state Board of Nursing (BON) executives. Qualitative interviews using semi-structured interview guides were conducted with BON executives to validate a legal summary of AL regulations and nurse practice acts, and to identify nursing issues pertaining to medication management in AL across the United States. In this study, there was considerable variation across states regarding medication administration and the role of both the RN and the UAP. BON executives displayed a range of knowledge about nursing practice issues in AL, with many reporting low familiarity with this setting. Mechanisms for systematic review of quality of delegation were not in place. Medication administration and nurse delegation were dynamic issues, with practice and policy evolving concurrently. This study highlights the limited articulation of policies between agencies and across states in the important and growing setting of assisted living. Nurses have the opportunity to shape this evolving practice arena and to enhance awareness of the professional and clinical issues inherent in working with UAP in medication delivery. PMID:16597525

  6. Information technology for medication administration: assessing bedside readiness among nurses in Lebanon.

    PubMed

    Marini, Sana Daya; Hasman, Arie; Huijer, Huda Abu-Saad

    2009-03-01

    Medication errors continue to be of great concern to hospitals. The use of Information technology (IT) for medication administration was recommended to assist nurses to administer medications safely, decrease the chance of medication errors, and contribute to patient safety. Such IT will be operational soon in some Lebanese hospitals. Users' readiness and acceptance to use such an IT application is crucial as it is a prerequisite for successful system implementation. This descriptive study used the Technology Acceptance Model to determine the level of nurses' readiness to use IT for medication administration in Lebanon. The sample included nurses working in three different major hospitals in Beirut. Data were collected on nurses' demographics, attitudes, perceived usefulness and ease of use of IT for medication administration. During the first 2 weeks of July, 2007, nurses manually or electronically were asked to voluntarily complete the questionnaire. Results showed that the users' attitude towards the use of the proposed IT is correlated with their perceptions on system usefulness and ease of use. Many showed a positive attitude towards system use and scored high on both perceptions. Yet around 20% of the nurses in the sample showed a negative attitude towards the use of the proposed system. PMID:21631846

  7. The Honolulu Liver Disease Cluster at the Medical Center: Its Mysteries and Challenges.

    PubMed

    Teschke, Rolf; Eickhoff, Axel

    2016-01-01

    In 2013, physicians at the Honolulu Queen's Medical Center (QMC) noticed that seven liver disease patients reported the use of OxyELITE Pro (OEP), a widely consumed dietary supplement (DS). Assuming a temporal association between OEP use and disease, they argued that OEP was the cause of this mysterious cluster. Subsequent reexamination, however, has revealed that this QMC cohort is heterogeneous and not a cluster with a single agent causing a single disease. It is heterogeneous because patients used multiple DS's and drugs and because patients appeared to have suffered from multiple liver diseases: liver cirrhosis, liver failure by acetaminophen, hepatotoxicity by non-steroidal antiinflammatory drugs (NSAIDs), resolving acute viral hepatitis by hepatitis B virus (HBV), herpes simplex virus (HSV), and varicella zoster virus (VZV), and suspected hepatitis E virus (HEV). Failing to exclude these confounders and to consider more viable diagnoses, the QMC physicians may have missed specific treatment options in some of their patients. The QMC physicians unjustifiably upgraded their Roussel Uclaf Causality Assessment Method (RUCAM) causality scores so that all patients would appear to be "probable" for OEP. However, subsequent RUCAM reassessments by our group demonstrated a lack of causality for OEP in the evaluated QMC cases. The QMC's questionable approaches explain the extraordinary accumulation of suspected OEP cases at the QMC in Hawaii as single place, whereas similar cohorts were not published by any larger US liver center, substantiating that the problem is with the QMC. In this review article, we present and discuss new case data and critically evaluate upcoming developments of problematic regulatory assessments by the US Centers for Disease Control and Prevention (CDC), the Hawaii Department of Health (HDOH), and the Food and Drug Administration (FDA), as based on invalid QMC conclusions, clarifying now also basic facts and facilitating constructive

  8. The Honolulu Liver Disease Cluster at the Medical Center: Its Mysteries and Challenges

    PubMed Central

    Teschke, Rolf; Eickhoff, Axel

    2016-01-01

    In 2013, physicians at the Honolulu Queen’s Medical Center (QMC) noticed that seven liver disease patients reported the use of OxyELITE Pro (OEP), a widely consumed dietary supplement (DS). Assuming a temporal association between OEP use and disease, they argued that OEP was the cause of this mysterious cluster. Subsequent reexamination, however, has revealed that this QMC cohort is heterogeneous and not a cluster with a single agent causing a single disease. It is heterogeneous because patients used multiple DS’s and drugs and because patients appeared to have suffered from multiple liver diseases: liver cirrhosis, liver failure by acetaminophen, hepatotoxicity by non-steroidal antiinflammatory drugs (NSAIDs), resolving acute viral hepatitis by hepatitis B virus (HBV), herpes simplex virus (HSV), and varicella zoster virus (VZV), and suspected hepatitis E virus (HEV). Failing to exclude these confounders and to consider more viable diagnoses, the QMC physicians may have missed specific treatment options in some of their patients. The QMC physicians unjustifiably upgraded their Roussel Uclaf Causality Assessment Method (RUCAM) causality scores so that all patients would appear to be “probable” for OEP. However, subsequent RUCAM reassessments by our group demonstrated a lack of causality for OEP in the evaluated QMC cases. The QMC’s questionable approaches explain the extraordinary accumulation of suspected OEP cases at the QMC in Hawaii as single place, whereas similar cohorts were not published by any larger US liver center, substantiating that the problem is with the QMC. In this review article, we present and discuss new case data and critically evaluate upcoming developments of problematic regulatory assessments by the US Centers for Disease Control and Prevention (CDC), the Hawaii Department of Health (HDOH), and the Food and Drug Administration (FDA), as based on invalid QMC conclusions, clarifying now also basic facts and facilitating constructive

  9. Professional or administrative value patterns? Clinical pathways in medical problem-solving processes.

    PubMed

    Holmberg, Leif

    2007-11-01

    A health-care organization simultaneously belongs to two different institutional value patterns: a professional and an administrative value pattern. At the administrative level, medical problem-solving processes are generally perceived as the efficient application of familiar chains of activities to well-defined problems; and a low task uncertainty is therefore assumed at the work-floor level. This assumption is further reinforced through clinical pathways and other administrative guidelines. However, studies have shown that in clinical practice such administrative guidelines are often considered inadequate and difficult to implement mainly because physicians generally perceive task uncertainty to be high and that the guidelines do not cover the scope of encountered deviations. The current administrative level guidelines impose uniform structural features that meet the requirement for low task uncertainty. Within these structural constraints, physicians must organize medical problem-solving processes to meet any task uncertainty that may be encountered. Medical problem-solving processes with low task uncertainty need to be organized independently of processes with high task uncertainty. Each process must be evaluated according to different performance standards and needs to have autonomous administrative guideline models. Although clinical pathways seem appropriate when there is low task uncertainty, other kinds of guidelines are required when the task uncertainty is high. PMID:17958969

  10. Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

    SciTech Connect

    Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

    2015-12-15

    Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

  11. Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

    NASA Astrophysics Data System (ADS)

    Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

    2015-12-01

    Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

  12. City of Faith Medical and Research Center, Tulsa, Oklahoma.

    PubMed

    1984-01-01

    The gold towers of the City of Faith command the viewer's attention as they soar into the Tulsa sky. Built by Evangelist Oral Roberts, the City of Faith combines a 60-story clinic and diagnostic center, a 30-story full-service hospital and a 20-story research center on one 80-acre site adjacent to the Oral Roberts University campus. Due in part to their futuristic architectural features, the campus and the City of Faith are one of the top tourist attractions in Oklahoma. Construction began in early 1978. The clinic, first opened in June 1981 with nine physicians, is now staffed with more than 80, all with faculty appointments to the Oral Roberts School of Medicine. The hospital accepted its first patient in November, 1981 and is currently certified for 294 beds (final plans call for a total of 777). The research center began operations last June and focuses on cancer, heart disease, arthritis, diabetes and geriatrics. Built entirely through contributions from followers of the Oral Roberts Ministries, the debt-free City of Faith is expected to cost more than $500 million when completed in 1988. PMID:10267423

  13. An initial assessment of the cost and utilization of the Integrated Academic Information System (IAIMS) at Columbia Presbyterian Medical Center.

    PubMed Central

    Clayton, P. D.; Anderson, R. K.; Hill, C.; McCormack, M.

    1991-01-01

    The concept of "one stop information shopping" is becoming a reality at Columbia Presbyterian Medical Center (CPMC). The goal of our effort is to provide access to university and hospital administrative systems as well as clinical and library applications from a single workstation, which also provides utility functions such as word processing and mail. Since June 1987, CPMC has invested the equivalent of $23 million dollars to install a digital communications network that encompasses 18 buildings at seven geographically separate sites and to develop clinical and library applications that are integrated with the existing hospital and university administrative and research computing facilities. During June 1991, 2425 different individuals used the clinical information system, 425 different individuals used the library applications, and 900 different individuals used the hospital administrative applications via network access. If we were to freeze the system in its current state, amortize the development and network installation costs, and add projected maintenance costs for the clinical and library applications, our integrated information system would cost $2.8 million on an annual basis. This cost is 0.3% of the medical center's annual budget. These expenditures could be justified by very small improvements in time savings for personnel and/or decreased length of hospital stay and/or more efficient use of resources. In addition to the direct benefits which we detail, a major benefit is the ease with which additional computer-based applications can be added incrementally at an extremely modest cost. PMID:1666966

  14. Dealing with the stress of an HIV-positive diagnosis at an Army medical center.

    PubMed

    Rothberg, J M; Bain, M W; Boggiano, W; Cline, W R; Grace, W C; Holloway, H C; Rock, N L

    1990-03-01

    Following mandatory military-wide testing for the human immunodeficiency virus (HIV), Army medical facilities have gained extensive experience with HIV-positive persons who undergo special stresses as a result of their affiliation with the military. The consequences of evacuation to medical centers for evaluation of HIV status are presented and the impact of this process on the medical center staff are considered. This paper is a description of one system designed to evaluate, treat, and support HIV-positive soldiers and their families. PMID:2107473

  15. Implementing a medication safety and poison prevention program at a senior center.

    PubMed

    Gershman, Jennifer A

    2013-10-01

    The Institute for Safe Medication Practices encourages pharmacists to assist in preventing medication misuse. The purpose of this article is to discuss a medication-safety education session conducted by a pharmacy professor, the faculty advisor to the American Society of Consultant Pharmacists university student chapter and students in a pharmacovigilance rotation, which was conducted at a local senior center. The author attended a train-the-trainer Webinar and then educated the pharmacy students. Participants at the senior center were taught about poison prevention, drug interactions, and appropriate drug disposal through an interactive format. We plan to continue the medication safety program at the senior center as a longitudinal project to promote patient safety. Pharmacists should be encouraged to play an active role in community outreach programs. PMID:24129222

  16. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    ERIC Educational Resources Information Center

    Huang, Yuan-Han

    2013-01-01

    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  17. A School Administrator's Guide to the Family and Medical Leave Act

    ERIC Educational Resources Information Center

    Bosland, Carl C.

    2007-01-01

    This book is a comprehensive, yet practical, reference for information and guidance to comply with the requirements of the Family and Medical Leave Act of 1993. It provides school administrators with the latest information to ensure that school policies and practices are up-to-date and it helps to manage leave and avoid costly legal violations.…

  18. The Relationship between Barcode Medication Administration Satisfaction and the Use of Workarounds among Registered Nurses

    ERIC Educational Resources Information Center

    Bennett, Sally F.

    2012-01-01

    Adverse drug events, resulting in preventable patient harm or death, are of great concern. To keep patients safe, hospitals have implemented barcode medication administration (BCMA) technology for RNs who have accepted this technology with varying levels of satisfaction. When nurses are dissatisfied with a BCMA system, they may find alternative…

  19. Administrative risk quantification of subcutaneous and intravenous therapies in Italian centers utilizing the Failure Mode and Effects Analysis approach

    PubMed Central

    Ponzetti, Clemente; Canciani, Monica; Farina, Massimo; Era, Sara; Walzer, Stefan

    2016-01-01

    Background In oncology, an important parameter of safety is the potential treatment error in hospitals. The analyzed hypothesis is that of subcutaneous therapies would provide a superior safety benefit over intravenous therapies through fixed-dose administrations, when analyzed with trastuzumab and rituximab. Methods For the calculation of risk levels, the Failure Mode and Effect Analysis approach was applied. Within this approach, the critical treatment path is followed and risk classification for each individual step is estimated. For oncology and hematology administration, 35 different risk steps were assessed. The study was executed in 17 hematology and 16 breast cancer centers in Italy. As intravenous and subcutaneous were the only injection routes in medical available for trastuzumab and rituximab in oncology at the time of the study, these two therapies were chosen. Results When the risk classes were calculated, eight high-risk areas were identified for the administration of an intravenous therapy in hematology or oncology; 13 areas would be defined as having a median-risk classification and 14 areas as having a low-risk classification (total risk areas: n=35). When the new subcutaneous formulation would be applied, 23 different risk levels could be completely eliminated (65% reduction). Important high-risk classes such as dose calculation, preparation and package labeling, preparation of the access to the vein, pump infusion preparation, and infusion monitoring were included in the eliminations. The overall risk level for the intravenous administration was estimated to be 756 (ex-ante) and could be reduced by 70% (ex-post). The potential harm compensation for errors related to pharmacy would be decreased from eight risk classes to only three risk classes. Conclusion The subcutaneous administration of trastuzumab (breast cancer) and rituximab (hematology) might lower the risk of administration and treatment errors for patients and could hence indirectly have

  20. HMO development in an academic medical center: the rise and fall of a prepaid health program in New York city.

    PubMed

    Bosch, S J; Deuschle, K W

    1993-08-01

    Through a documented case study the authors identify the critical factors that impede the introduction of prepaid medical care as part of education and practice within a prestigious and well established academic medical center. The inherent conflicts between individual fee-for-service practice and population-based prepaid practice and the resistance to innovations in medical care organization as they surfaced in that center, are presented. The need for a clear understanding of the complexities of HMO development and of an appreciation for the importance of a planning process in which all interested parties are involved, is emphasized. A clear commitment by policy makers, administrators and providers is highlighted as fundamental for the implementation of a system where practitioners are motivated to assume responsibility for the comprehensive care of a defined population that prepays for their services. The rewards as well as the difficulties for institutionalizing commitment to this form of health care delivery and impacting on medical education are discussed. PMID:8408749

  1. Factors associated with a patient-centered medical home among children with behavioral health conditions.

    PubMed

    Knapp, Caprice; Woodworth, Lindsey; Fernandez-Baca, Daniel; Baron-Lee, Jacqueline; Thompson, Lindsay; Hinojosa, Melanie

    2013-11-01

    At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities. PMID:23108741

  2. Predictors of early faculty attrition at one Academic Medical Center

    PubMed Central

    2014-01-01

    Background Faculty turnover threatens the research, teaching and clinical missions of medical schools. We measured early attrition among newly-hired medical school faculty and identified personal and institutional factors associated with early attrition. Methods This retrospective cohort study identified faculty hired during the 2005–2006 academic year at one school. Three-year attrition rates were measured. A 40-question electronic survey measured demographics, career satisfaction, faculty responsibilities, institutional/departmental support, and reasons for resignation. Odds ratios (ORs) and 95 percent confidence intervals (95% CI) identified variables associated with early attrition. Results Of 139 faculty, 34% (95% CI = 26-42%) resigned within three years of hire. Attrition was associated with: perceived failure of the Department Chair to foster a climate of teaching, research, and service (OR = 6.03; 95% CI: 1.84, 19.69), inclusiveness, respect, and open communication (OR = 3.21; 95% CI: 1.04, 9.98). Lack of professional development of the faculty member (OR = 3.84; 95% CI: 1.25, 11.81); institutional recognition and support for excellence in teaching (OR = 2.96; 95% CI: 0.78, 11.19) and clinical care (OR = 3.87; 95% CI: 1.04, 14.41); and >50% of professional time devoted to patient care (OR = 3.93; 95% CI: 1.29, 11.93) predicted attrition. Gender, race, ethnicity, academic degree, department type and tenure status did not predict early attrition. Of still-active faculty, an additional 27 (48.2%, 95% CI: 35.8, 61.0) reported considering resignation within the 5 years. Conclusions In this pilot study, one-third of new faculty resigned within 3 years of hire. Greater awareness of predictors of early attrition may help schools identify threats to faculty career satisfaction and retention. PMID:24512629

  3. 77 FR 63837 - Draft Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-17

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device Submissions; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability...

  4. 75 FR 18219 - Drug and Medical Device Forum on Food and Drug Administration Drug and Device Requirements and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-09

    ... HUMAN SERVICES Food and Drug Administration Drug and Medical Device Forum on Food and Drug Administration Drug and Device Requirements and Supplier Controls; Public Educational Forum AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public educational forum. SUMMARY: The Food and Drug Administration...

  5. Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers

    PubMed Central

    Chen, Ruijun; Desai, Nihar R; Ross, Joseph S; Zhang, Weiwei; Chau, Katherine H; Wayda, Brian; Murugiah, Karthik; Lu, Daniel Y; Mittal, Amit

    2016-01-01

    Objective To determine rates of publication and reporting of results within two years for all completed clinical trials registered in ClinicalTrials.gov across leading academic medical centers in the United States. Design Cross sectional analysis. Setting Academic medical centers in the United States. Participants Academic medical centers with 40 or more completed interventional trials registered on ClinicalTrials.gov. Methods Using the Aggregate Analysis of ClinicalTrials.gov database and manual review, we identified all interventional clinical trials registered on ClinicalTrials.gov with a primary completion date between October 2007 and September 2010 and with a lead investigator affiliated with an academic medical center. Main outcome measures The proportion of trials that disseminated results, defined as publication or reporting of results on ClinicalTrials.gov, overall and within 24 months of study completion. Results We identified 4347 interventional clinical trials across 51 academic medical centers. Among the trials, 1005 (23%) enrolled more than 100 patients, 1216 (28%) were double blind, and 2169 (50%) were phase II through IV. Overall, academic medical centers disseminated results for 2892 (66%) trials, with 1560 (35.9%) achieving this within 24 months of study completion. The proportion of clinical trials with results disseminated within 24 months of study completion ranged from 16.2% (6/37) to 55.3% (57/103) across academic medical centers. The proportion of clinical trials published within 24 months of study completion ranged from 10.8% (4/37) to 40.3% (31/77) across academic medical centers, whereas results reporting on ClinicalTrials.gov ranged from 1.6% (2/122) to 40.7% (72/177). Conclusions Despite the ethical mandate and expressed values and mission of academic institutions, there is poor performance and noticeable variation in the dissemination of clinical trial results across leading academic medical centers. PMID:26888209

  6. Underserved patients' perspectives on patient-centered primary care: does the patient-centered medical home model meet their needs?

    PubMed

    Mead, Holly; Andres, Ellie; Regenstein, Marsha

    2014-02-01

    The patient-centered medical home (PCMH) has gained significant interest as a delivery system model that can improve health care quality while reducing costs. This study uses focus groups to investigate underserved, chronically ill patients' preferences for care and develops a patient-centered framework of priorities. Seven major priorities were identified: (a) communication and partnership, (b) affordable care, (c) coordinated care, (d) personal responsibility, (e) accessible care, (f) education and support resources, and (g) the essential role of nonphysician providers in supporting their care. Using the framework, we analyzed the PCMH joint principals as developed by U.S. medical societies to identify where the PCMH model could be improved to better meet the needs of these patients. Four of the seven patient priorities were identified as not present in or supported by current PCMH joint principles. The study discusses how the PCMH model can better address the needs of low-income, disadvantaged patients. PMID:24288366

  7. Occupational exposure to formaldehyde in a medical center autopsy service

    SciTech Connect

    Coldiron, V.R.; Ward, J.B. Jr.; Trieff, N.M.; Janssen, H.E. Jr.; Smith, J.H.

    1983-07-01

    The formaldehyde exposures occurring in the autopsy service of a medical complex were evaluated as part of a study to detect genetically harmful effects of chemical exposures. Determination of time-weighted average (TWA) exposures and characterization of the patterns of exposure experienced by individuals with different work responsibilities in this occupational setting were sought. Both general area and breathing zone samples were evaluated. Estimated weekly time-weighted average exposures for pathologists, residents and technicians were determined to be between 0.61 and 1.32 parts per million with little difference between work roles. While the averages were similar, the patterns of exposure of technicians and physicians were different. Technicians were exposed to a baseline level of formaldehyde for a prolonged period of time. In contrast, physicians were exposed for shorter times but experienced higher levels during specific tasks, particularly tissue-sectioning and examination. Evaluations of work procedures and environmental conditions in autopsy services are recommended to reduce personnel exposure to formaldehyde vapor.

  8. What do clinicians want? Interest in integrative health services at a North Carolina academic medical center

    PubMed Central

    Kemper, Kathi J; Dirkse, Deborah; Eadie, Dee; Pennington, Melissa

    2007-01-01

    Background Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care. Methods We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future. Results Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%). Conclusion There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life. PMID:17291340

  9. Good Neighbors: Shared Challenges and Solutions Toward Increasing Value at Academic Medical Centers and Universities.

    PubMed

    Clancy, Gerard P

    2015-12-01

    Academic medical centers (AMCs) and universities are experiencing increasing pressure to enhance the value they offer at the same time that they are facing challenges related to outcomes, controlling costs, new competition, and government mandates. Yet, rarely do the leaders of these academic neighbors work cooperatively to enhance value. In this Perspective the author, a former university regional campus president with duties in an AMC as an academic physician, shares his insights into the shared challenges these academic neighbors face in improving the value of their services in complex environments. He describes the successes some AMCs have had in generating revenues from new clinical programs that reduce the overall cost of care for larger populations. He also describes how several universities have taken a comprehensive approach to reduce overhead and administrative costs. The author identifies six themes related to successful value improvement efforts and provides examples of successful strategies used by AMCs and their university neighbors to improve the overall value of their programs. He concludes by encouraging leaders of AMCs and universities to share information about their successes in value improvements with each other, to seek additional joint value enhancement efforts, and to market their value improvements to the public. PMID:26266460

  10. Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

    PubMed

    Johnson, Bill

    2014-01-01

    Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met. PMID:25807604

  11. Cancers in Eastern Libya: First results from Benghazi Medical Center

    PubMed Central

    Bodalal, Zuhir; Azzuz, Raouf; Bendardaf, Riyad

    2014-01-01

    AIM: To study the pattern of cancer incidence and determine the incidence rates in Eastern Libya (for the first time in a decade). METHODS: A hospital-based registry of cancer patients was formed using records from the primary oncology center in eastern Libya - focusing on those diagnosed in the year 2012. RESULTS: The most common malignancies in men were cancers of the colon (22.3%, n = 90), lung (20.3%, n = 82), prostate (16.1%, n = 65), pancreas (4.2%, n = 17) and liver (4.2%, n = 17). For women, they were found to be cancers of the breast (41.5%, n = 213), colon (16.4%, n = 84), uterus (8%, n = 41), ovary (5.5%, n = 28) and pancreas (3.1%, n = 16). Additionally age-standardized rates (ASR) were determined for Libya. The different cities and towns in eastern Libya were compared for any variation. The city of Beida in particular was found to have a remarkably high incidence of gastric cancer. The different findings were discussed and comparisons were made with past literature as well as the incidence rates for neighbouring countries. The incidence rates given for the eastern region showed differences from previously reported values (i.e., the rate of colon cancer was the highest in North Africa whereas other malignancies occurred less frequently). Potential explanations for the urban-rural difference as well as the difference in incidence rates were put forth. The significance of this study is that it establishes a baseline of cancer incidence which should be the backbone for any future national cancer plan in Libya. CONCLUSION: Proper surveillance programs need to be in place and healthcare policy should be adjusted to take into account the more prevalent and pressing cancers in society. PMID:24876750

  12. Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada.

    PubMed Central

    Himmelstein, D U; Lewontin, J P; Woolhandler, S

    1996-01-01

    OBJECTIVES. We compared US and Canadian health administration costs using national medical care employment data for both countries. METHODS. Data from census surveys on hospital, nursing home, and outpatient employment in the United States (1968 to 1993) and Canada (1971 and 1986) were analyzed. RESULTS. Between 1968 and 1993, US medical care employment grew from 3.976 to 10.308 million full-time equivalents. Administration grew from 0.719 to 2.792 million full-time equivalents, or from 18.1% to 27.1% of the total employment. In 1986, the United States deployed 33,666 health care full-time equivalent personnel per million population, and Canada deployed 31,529. The US excess was all administrative; Canada employed more clinical personnel, especially registered nurses. Between 1971 and 1986, hospital employment per capita grew 29% in the United States (mostly because of administrative growth) and fell 14% in Canada. In 1986, Canadian hospitals still employed more clinical staff per million. Outpatient employment was larger and grew faster in the United States. Per capita nursing home employment was substantially higher in Canada. CONCLUSIONS. If US hospitals and outpatient facilities adopted Canada's staffing patterns, 1,407,000 fewer managers and clerks would be necessary. Despite lower medical spending, Canadians receive slightly more nursing and other clinical care than Americans, as measured by labor inputs. PMID:8633732

  13. Improving Medication Knowledge among Older Adults with Heart Failure: A Patient-Centered Approach to Instruction Design

    ERIC Educational Resources Information Center

    Morrow, Daniel G.; Weiner, Michael; Young, James; Steinley, Douglas; Deer, Melissa; Murray, Michael D.

    2005-01-01

    Purpose: We investigated whether patient-centered instructions for chronic heart failure medications increase comprehension and memory for medication information in older adults diagnosed with chronic heart failure. Design and Methods: Patient-centered instructions for familiar and unfamiliar medications were compared with instructions for the…

  14. Managing information in the academic medical center: building an integrated information environment.

    PubMed

    Fuller, S; Braude, R M; Florance, V; Frisse, M E

    1995-10-01

    The strategic importance of integrated information systems and resources for academic medical centers should not be underestimated. Ten years ago, the National Library of Medicine in collaboration with the Association of Academic Medical Centers initiated the Integrated Advanced Information Management System (IAIMS) program to assist academic medical centers in defining a process for addressing deficiencies in their information environments. The authors give a brief history of the IAIMS program, and they describe both the characteristics of an integrated information environment and the technical and organizational structures necessary to create such an environment. Strategies some institutions have used to implement integrated information systems are also outlined. Finally, the authors discuss the role of librarians in integrated information system design. PMID:7575920

  15. Impact of a Regional Pharmacy Call Center on Telephone Access Metrics Within the Veterans Health Administration

    PubMed Central

    Jones, Marshall R.; Kuester, Melanie K.; Myers, Kelly L.; Schnarr, Barbara A.

    2015-01-01

    Purpose: To establish a cost-effective centralized pharmacy call center to serve the patients of Veterans Integrated Service Network (VISN) 11 that would meet established performance metrics. Methods: A pilot project began in August 2011 with the Indianapolis VA Medical Center (VAMC) and the Health Resource Center (HRC) in Topeka, Kansas. The Indianapolis VAMC used a first-call resolution business model consisting of pharmacy technicians receiving tier 1 phone calls that could be escalated to a tier 2 line that consisted of lead technicians and pharmacists, while the HRC utilized general telephone agents that would transfer unresolved calls to the primary facility. Pre- and post-VISN 11 Pharmacy Call Center performance metrics were compared for each of the 7 facilities in the network with the goals being monthly average abandoned call rate less than 5% and average speed to answer less than 30 seconds. Cost per call was also compared. Results: The average abandoned call rate for the network during the year prior to VISN 11 Pharmacy Call Center implementation (August 2010-July 2011) was 15.66% and decreased to 3% in July 2014. The average abandoned call rate decreased for each individual facility. In fiscal year 2014, the VISN 11 Pharmacy Call Center was operating at a cost of $4.35 per call while providing more services than the HRC, resulting in less workload being transferred back to the individual facilities. Conclusion: A centralized VISN pharmacy call center is a reasonable alternative to individual facility call centers or the HRC. PMID:26405322

  16. 77 FR 70166 - Provisions of the Food and Drug Administration Safety and Innovation Act Related to Medical Gases...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ...The Food and Drug Administration (FDA) is establishing a public docket for information pertaining to FDA's implementation of the provisions of the Food and Drug Administration Safety and Innovation Act (FDASIA) related to medical gases. This action is intended to ensure that information submitted to FDA on the implementation of the medical gas provisions of FDASIA is available to all......

  17. A Human-Centered Approach to Medical Informatics for Medical Students, Residents, and Practicing Clinicians.

    ERIC Educational Resources Information Center

    Stahlhut, Richard W.; Gosbee, John W.; Gardner-Bonneau, Daryle J.

    1997-01-01

    Describes development of a curriculum in medical information science that focuses on practical problems in clinical medicine rather than details of information technology. Design was guided by identification of six key clinical challenges that must be addressed by practitioners in the near future and by examination of past failures of informatics…

  18. Results of an Institutional LGBT Climate Survey at an Academic Medical Center.

    PubMed

    Chester, Sean D; Ehrenfeld, Jesse M; Eckstrand, Kristen L

    2014-12-01

    The purpose of this study was to characterize the climate and culture experienced by lesbian, gay, bisexual, and transgender (LGBT) employees and students at one large academic medical center. An anonymous, online institutional climate survey was used to assess the attitudes and experiences of LGBT employees and students. There were 42 LGBT and 14 non-LGBT survey participants. Results revealed that a surprisingly large percentage of LGBT individuals experienced pressure to remain "closeted" and were harassed despite medical center policies of non-discrimination. Continuing training, inclusive policies and practices, and the development of mechanisms to address LGBT-specific harassment are necessary for improving institutional climate. PMID:26789861

  19. Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

    PubMed

    Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

    2013-06-01

    Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination. PMID:23242811

  20. Design and implementation of web-based mobile electronic medication administration record.

    PubMed

    Hsieh, Sung-Huai; Hou, I-Ching; Cheng, Po-Hsun; Tan, Ching-Ting; Shen, Po-Chao; Hsu, Kai-Ping; Hsieh, Sheau-Ling; Lai, Feipei

    2010-10-01

    Patients' safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System (HIS) to facilitate patients' safety and to improve the quality of medical care. During the medical care processing, all the tasks are based upon physicians' orders. In National Taiwan University Hospital (NTUH), the Electronic Health Record committee proposed a standard of order flows. There are objectives of the standard: first, to enhance medical procedures and enforce hospital policies; secondly, to improve the quality of medical care; third, to collect sufficient, adequate data for EHR in the near future. Among the proposed procedures, NTUH decides to establish a web-based mobile electronic medication administration record (ME-MAR) system. The system, build based on the service-oriented architecture (SOA) as well as embedded the HL7/XML standard, is installed in the Mobile Nursing Carts. It also implement accompany with the advanced techniques like Asynchronous JavaScript and XML (Ajax) or Web services to enhance the system usability. According to researches, it indicates that medication errors are highly proportion to total medical faults. Therefore, we expect the ME-MAR system can reduce medication errors. In addition, we evaluate ME-MAR can assist nurses or healthcare practitioners to administer, manage medication properly. This successful experience of developing the NTUH ME-MAR system can be easily applied to other related system. Meanwhile, the SOA architecture of the system can also be seamless integrated to NTUH or other HIS system. PMID:20703613

  1. Transient and Sustained Changes in Operational Performance, Patient Evaluation, and Medication Administration During Electronic Health Record Implementation in the Emergency Department

    PubMed Central

    Ward, Michael J.; Froehle, Craig M.; Hart, Kimberly W.; Collins, Sean P.; Lindsell, Christopher J.

    2014-01-01

    Study objective Little is known about the transient and sustained operational effects of electronic health records on emergency department (ED) performance. We quantify how the implementation of a comprehensive electronic health record was associated with metrics of operational performance, test ordering, and medication administration at a single-center ED. Methods We performed a longitudinal analysis of electronic data from a single, suburban, academic ED during 28 weeks between May 2011 and November 2011. We assessed length of stay, use of diagnostic testing, medication administration, radiologic imaging, and patient satisfaction during a 4-week baseline measurement period and then tracked changes in these variables during the 24 weeks after implementation of the electronic health record. Results Median length of stay increased and patient satisfaction was reduced transiently, returning to baseline after 4 to 8 weeks. Rates of laboratory testing, medication administration, overall radiologic imaging, radiographs, computed tomography scans, and ECG ordering all showed sustained increases throughout the 24 weeks after electronic health record implementation. Conclusion Electronic health record implementation in this single-center study was associated with both transient and sustained changes in metrics of ED performance, as well as laboratory and medication ordering. Understanding ways in which an ED can be affected by electronic health record implementation is critical to providing insight about ways to mitigate transient disruption and to maximize potential benefits of the technology. PMID:24041783

  2. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

    PubMed Central

    Jin, Jing-fen; Zhu, Ling-ling; Chen, Meng; Xu, Hui-min; Wang, Hua-fen; Feng, Xiu-qin; Zhu, Xiu-ping; Zhou, Quan

    2015-01-01

    Background Intravenous (IV), intramuscular (IM), and subcutaneous (SC) are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods. Methods A literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies. Results “SC better than IV” involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. “IV better than SC” involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. “IM better than IV” involves epinephrine, hepatitis B immu-noglobulin, pegaspargase, and some antibiotics. “IV better than IM” involves ketamine, morphine, and antivenom. “IM better than SC” involves epinephrine. “SC better than IM” involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles governing the choice of injection route. Safety and efficacy must be the preferred principles to be considered (eg, epinephrine should be given intramuscularly during an episode of systemic anaphylaxis). If the safety and efficacy of two injection routes are equivalent, clinicians should consider more about patient preference and

  3. Product-line administration: a framework for redefining medical record department services.

    PubMed

    Postal, S N

    1990-06-01

    Product-line administration is a viable approach for managing medical records services in an environment that demands high quantity and quality service levels. Product-line administration directs medical record department team members to look outside of the department and seek input from the customers it is intended to serve. The feedback received may be alarming at first, as the current state of products usually reveals a true lack of customer input. As the planning, defining, managing, and marketing phases are implemented, the road will not be easy and rewards will be slow to come. Product-line administration does not provide quick fixes, but it does provide long-term problem resolution as products are refined and new products developed to meet customer needs and expectations. In addition to better meeting the needs of the department's external customers, the department's internal customers' needs and expectations will be addressed. The participative management approach will help nurture each team member's creativity. The team members will have the opportunity to reach their full potential while reaping the rewards and benefits of providing products and services that meet the needs and expectations of all department customers. The future of the health care industry promises more changes as the country moves toward some form of prospective payment in the ambulatory setting. Reactive management and the constant struggle to catch up can no longer be accepted as a management approach. It is imperative that the medical record department be viewed as a business with product lines composed of quality products. The planning, defining, managing, and marketing components of product-line administration afford responsiveness to the current situation and the development of quality products that will ensure that medical record departments are prepared for the future. PMID:10106655

  4. Improving Medication Administration Safety in a Community Hospital Setting Using Lean Methodology.

    PubMed

    Critchley, Sandy

    2015-01-01

    Virtually all health care organizations have goals of improving patient safety, but despite clear goals and considerable investments, gains have been limited. This article explores a community hospital's resounding success using Lean methodology to improve medication administration safety with process changes designed by engaged employees and leaders with the knowledge and skill to effect improvements. This article inspires an interdisciplinary approach to quality improvement using reproducible strategies. PMID:25599523

  5. [Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

    PubMed

    Halidou Doudou, M; Manzo, M L; Guero, D

    2014-12-01

    In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. PMID:25449444

  6. [Urgency and acuity judgment systems before medical care (emergency telephone consultation center #7119, JTAS etc.)].

    PubMed

    Ishikawa, Hideki; Yoshida, Masashi; Sakamoto, Tetsuya

    2016-02-01

    Currently growing the demand of the emergency medical care in Japan, sharing the concept about medical urgency is needed in the whole society in order to maintain the emergency medical systems as social resources. The present conditions and challenges are outlined: Emergency Telephone Consultation Center in Tokyo Fire Department (established in June 2007) and on-site triage as representatives of "pre-hospital urgency determination systems", and JTAS (Japan Triage and Acuity System, introduced in April 2012) as a representative of "in-hospital, pre-examination urgency determination systems". PMID:26915257

  7. Legal aspects of administrating antipsychotic medications to jail and prison inmates.

    PubMed

    Dlugacz, Henry; Wimmer, Christopher

    2013-01-01

    The administration of antipsychotic medications to jail and prison inmates involves two related components: conducting the informed consent process in a coercive environment and, where consent is not obtained, forcible administration of medication if needed. In the United States, both involve common law, statutory, and constitutional principles. Obtaining informed consent in correctional institutions is complicated. Patients in correctional institutions lack access to alternate sources of information, and depend on the correctional system completely - a system which they may distrust. This may influence the patient's view of the administering physician. Where consent cannot be obtained, forcible administration may be legally permissible for two primary reasons: to restore a criminal defendant to competency in order to stand trial and to ameliorate severe symptoms of mental disability, particularly when they threaten the safety of self, others, or in some instances, property. The interests at stake for the individual and the government, and the legal standards developed to balance these interests, differ between the two situations. When considering challenges to forcible medication of inmates serving a prison sentence, the United States Supreme Court has treated the interest of the institution in maintaining security as paramount. By contrast, when considering challenges to forcible medication of pretrial detainees, the Court's concern for the fair trial rights guaranteed by the Sixth Amendment has seemingly led it to moderate its emphasis on security. However, this distinction is not stable and may in fact be breaking down, as the recent case of Jared Loughner demonstrates. This article discusses the various federal, state, and international legal standards applicable to both informed consent and forcible medication, and their implementation in the correctional setting, focusing on issues related to the United States. PMID:23683884

  8. Evolution and Integration of Medical Laboratory Information System in an Asia National Medical Center

    NASA Astrophysics Data System (ADS)

    Cheng, Po-Hsun; Chen, Sao-Jie; Lai, Jin-Shin

    This work elucidates the evolution of three generations of the laboratory information system in the National Taiwan University Hospital, which were respectively implemented in an IBM Series/1 mini-computer, a client/server and a plug-and-play HL7 interface engine environment respectively. The experience of using the HL7 healthcare information exchange in the hospital information system, laboratory information system, and automatic medical instruments over the past two decades are illustrated and discussed. The latest design challenge in developing intelligent laboratory information services is to organize effectively distributed and heterogeneous medical instruments through the message gateways. Such experiences had spread to some governmental information systems for different purposes in Taiwan; besides, the healthcare information exchange standard, software reuse mechanism, and application service provider adopted in developing the plug-and-play laboratory information system are also illustrated.

  9. Should We Offer Medication to Reduce Breast Cancer Risk?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    PubMed

    Burns, Risa B; Schonberg, Mara A; Tung, Nadine M; Libman, Howard

    2016-08-01

    In November 2013, the U.S. Preventive Services Task Force issued a guideline on medications for risk reduction of primary breast cancer in women. Although mammography can detect early cases, it cannot prevent development of breast cancer. Tamoxifen and raloxifene are selective estrogen receptor modulators that have been shown to reduce the risk for estrogen receptor-positive breast cancer and are approved by the U.S. Food and Drug Administration (FDA) for this indication. However, neither medication reduces the risk for estrogen receptor-negative breast cancer or all-cause mortality. The Task Force concluded that postmenopausal women with an estimated 5-year risk for breast cancer of 3% or greater will probably have more net benefit than harm and recommends that clinicians engage in shared, informed decision making about these medications. The American Society of Clinical Oncology issued a practice guideline on use of pharmacologic interventions for breast cancer in 2013. It recommends that women aged 35 years or older at increased risk, defined as a 5-year absolute risk for breast cancer of 1.66% or greater, discuss breast cancer prevention medications with their primary care practitioner. The Society includes the aromatase inhibitor exemestane in addition to tamoxifen and raloxifene as a breast cancer prevention medication, although exemestane is not FDA approved for this indication. Here, an oncologist and an internist discuss how they would balance these recommendations and what they would suggest for an individual patient. PMID:27479221

  10. Involvement of Pharmacists in Medical Care in Emergency and Critical Care Centers.

    PubMed

    Imai, Toru; Yoshida, Yoshikazu

    2016-01-01

    Emergency and critical care centers provide multidisciplinary therapy for critically ill patients by centralizing the expertise and technology of many medical professionals. Because the patients' conditions vary, different drug treatments are administered along with surgery. Therefore, the role of pharmacists is important. Critically ill patients who receive high-level invasive treatment undergo physiological changes differing from their normal condition along with variable therapeutic effects and pharmacokinetics. Pharmacists are responsible for recommending the appropriate drug therapy using their knowledge of pharmacology and pharmacokinetics. Further, pharmacists need to determine the general condition of patients by understanding vital signs, blood gas analysis results, etc. It is therefore necessary to conduct consultations with physicians and nurses. The knowledge required for emergency medical treatment is not provided during systematic training in pharmaceutical education, meaning that pharmacists acquire it in the clinical setting through trial and error. To disseminate the knowledge of emergency medical care to pharmacy students, emergency care training has been started in a few facilities. I believe that medical facilities and universities need to conduct joint educational sessions on emergency medical care. Moreover, compared with other medical fields, there are fewer studies on emergency medical care. Research-oriented pharmacists must resolve this issue. This review introduces the work conducted by pharmacists for clinical student education and clinical research at the Emergency and Critical Care Center of Nihon University Itabashi Hospital and discusses future prospects. PMID:27374959

  11. MedReach: building an Area Health Education Center medical information outreach system for northwest Ohio.

    PubMed

    Steiner, Victoria; Hartmann, Jonathan; Ronau, Theodore

    2002-07-01

    In collaboration with regional partners in northwest Ohio, the Area Health Education Center (AHEC) program at the Medical College of Ohio (MCO) at Toledo is reaching out to underserved areas, helping to provide educational opportunities to health care professionals in these communities. This paper describes the development of MedReach, a medical information outreach system that connects regional AHEC sites to MCO via the Internet. MedReach provides physicians and other health care professionals access and support to search computerized textbooks and databases for current information on medical diagnoses, treatments, and research. A unique aspect of the MedReach project is that users are able to receive personal help with information retrieval by calling or emailing MCO's outreach librarian. Periodically, the AHEC program and the Mulford Library at MCO also sponsor an educational program, titled "Medical Applications of Computers," for regional practitioners. Current feedback on both the medical information outreach system and the educational program has been positive. PMID:12113517

  12. The medical information needs of internists and pediatricians at an academic medical center.

    PubMed

    Woolf, S H; Benson, D A

    1989-10-01

    Medical information needs were examined in a survey of sixty-seven physicians selected from the faculty and housestaff at Johns Hopkins Hospital. A standardized questionnaire was administered personally by a medical informatics physician to collect data on information needs, attitudes, and previous experience with computers. The types of information most frequently required by both faculty and housestaff were treatment recommendations and differential diagnosis. The sources of reference information most commonly used were textbooks and colleagues. The information needs of housestaff differed significantly in several categories from those of faculty physicians. Housestaff more frequently needed information for patient care (P less than 0.05), and preferred the use of textbooks (P less than 0.01) and handbooks (P less than 0.001) as information sources. Faculty more frequently needed information for activities unrelated to patient care (P less than 0.01) and placed greater importance on basic science information (P less than 0.01). When asked to suggest references for online access, the respondents named 143 journals and textbooks, with journals overwhelmingly preferred over textbooks. Only one reference, the New England Journal of Medicine, was requested by a majority of the respondents. The importance of a broad understanding of physician information needs through improved data-collection techniques is discussed as a means of increasing the use of medical information systems. PMID:2790344

  13. [Current aspects of war surgery. From the trauma center to precarious medical care].

    PubMed

    Houdelette, P

    1997-01-01

    War, said Carl von Clausewitz, is a cameleon. In this century, each armed conflict has proved to be unique, particularly in its medical aspects, with its own features and teaching its won lessons. As recent events show, no conflict is a fact of the past. Medical care delivered to war casualties depend on the circumstances of the war, on the medical resources available, but also on the price that cultures or circumstances place on it. Everything separates these two paradigms; on the one hand the "precious" casualty of western armies whose medical support is organized in a concept (forward medical and surgical care, ultra-rapid medical evacuation) tailored to each case, and as close as possible to the medical care of a civilian trauma patient whose models remains the North-American ballistic wound managed in trauma centers; on the other hand, civilian victims, in large numbers, in poor and disorganized countries, often abandoned to their own fate or sorted by "epidemiological" triage, which guarantees a distribution, as efficient as possible, of limited medical care. In war, advanced medical care and precarious medicine may work side by side according to two logics which do not exclude one another and constantly improve. PMID:9297902

  14. Impact of Institution of a Stroke Program upon Referral Bias at a Rural Academic Medical Center

    ERIC Educational Resources Information Center

    Riggs, Jack E.; Libell, David P.; Brooks, Claudette E.; Hobbs, Gerald R.

    2005-01-01

    Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a…

  15. 78 FR 10608 - David Grant United States Air Force Medical Center Specialty Care Travel Reimbursement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... appropriately trained provider within 4 weeks or sooner, if required, and within 1-hour travel time from the beneficiary's residence. The geographic area that represents 1-hour travel time surrounding an MTF is referred... of the Secretary David Grant United States Air Force Medical Center Specialty Care...

  16. The History of SHSAAMc: Student Health Services at Academic Medical Centers

    ERIC Educational Resources Information Center

    Veeser, Peggy Ingram; Hembree, Wylie; Bonner, Julia

    2008-01-01

    This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at…

  17. Crossing the Great Divide: Adoption of New Technologies, Therapeutics and Diagnostics at Academic Medical Centers

    ERIC Educational Resources Information Center

    DeMonaco, Harold J.; Koski, Greg

    2007-01-01

    The role of new technology in healthcare continues to expand from both the clinical and financial perspectives. Despite the importance of innovation, most academic medical centers do not have a clearly defined process for technology assessment. Recognizing the importance of new drugs, diagnostics and procedures in the care of patients and in the…

  18. Impact on Seniors of the Patient-Centered Medical Home: Evidence from a Pilot Study

    ERIC Educational Resources Information Center

    Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.

    2012-01-01

    Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…

  19. Family-Centered Health Care for Medically Fragile Children: Principles and Practices.

    ERIC Educational Resources Information Center

    Nelkin, Valerie

    The booklet explains ten principles of family-centered health care and six components of community based programs for children with significant medical problems. The principles are: The child and the family have basic rights of self-determination and autonomy. Health care services should be family oriented and maximize family control. Service…

  20. Veterans Affairs and Academic Medical Center Affiliations: The North Texas Experience

    ERIC Educational Resources Information Center

    Mohl, Paul Cecil; Hendrickse, William; Orsak, Catherine; Vermette, Heidi

    2009-01-01

    Objective: The authors review the more than 30-year history of the academic affiliation between the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas and the Mental Health Service at the Veterans Affairs North Texas Health Care System. Methods: The authors interviewed individuals involved at various stages…

  1. Using a facilitation model to achieve patient-centered medical home recognition.

    PubMed

    Lane, Sandi J; Watkins, R W Chip

    2015-01-01

    This article describes how a facilitation model that included a partnership between a Community Care of North Carolina network and undergraduates at a regional university supported rural primary care practices in transforming their practices to become National Committee for Quality Assurance-recognized patient-centered medical homes. Health care management and preprofessional undergraduate students worked with 14 rural primary care practices to redesign practice processes and complete the patient-centered medical home application. Twelve of the practices participated in the evaluation of the student contribution. A semistructured interview guide containing questions about practice characteristics, student competencies, and the value of the student's contribution to their practice's achievement of patient-centered medical home recognition was used to interview practice managers or their designee. Analysis included item-descriptive statistics and qualitative analysis of narrative content. All 12 participating practices achieved 2011 National Committee for Quality Assurance patient-centered medical home recognition, with 4 practices achieving level 3, 5 practices achieving level 2, and 3 practices achieving level 1. The facilitation model using partnerships between health care agencies and universities might be an option for enhancing a practice's internal capacity for successful transformation and should be explored further. PMID:25909396

  2. Developing physician leaders in academic medical centers. Part 1: Their changing role.

    PubMed

    Bachrach, D J

    1996-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management, intramurally conducted courses in leadership skill development; management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. This article article was prepared by the author from research into and presentation of a thesis entitled. "The Importance of Leadership Training And Development For Physicians In Academic Medical Centers In An Increasingly Complex Healthcare Environment, " prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in the College (ACHE). Part 2 will appear in the next issue of the Journal. PMID:10162876

  3. Program review of the USDA Center for Medical, Agricultural and Veterinary Entomology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The USDA-ARS Center for Medical, Agricultural and Veterinary Entomology (CMAVE) has a history that starts in 1932 in Orlando to develop methods to control mosquitoes, including malaria vectors under conditions simulating those of the south Pacific jungles, and other insects affecting man and animals...

  4. A User-Centered Cooperative Information System for Medical Imaging Diagnosis.

    ERIC Educational Resources Information Center

    Gomez, Enrique J.; Quiles, Jose A.; Sanz, Marcos F.; del Pozo, Francisco

    1998-01-01

    Presents a cooperative information system for remote medical imaging diagnosis. General computer-supported cooperative work (CSCW) problems addressed are definition of a procedure for the design of user-centered cooperative systems (conceptual level); and improvement of user feedback and optimization of the communication bandwidth in highly…

  5. Impact of Institution of a Stroke Program Upon Referral Bias at a Rural Academic Medical Center

    ERIC Educational Resources Information Center

    Riggs, Jack E.; Libell, David P.; Brooks, Claudette E.; Hobbs, Gerald R.

    2005-01-01

    Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a…

  6. WASTE MINIMIZATION OPPORTUNITY ASSESSMENT: OPTICAL FABRICATION LABORATORY - FITZSIMMONS ARMY MEDICAL CENTER

    EPA Science Inventory

    Under the Waste Reduction Evaluations at Federal Sites (WREAFS) program, RREL has taken the initiative to merge the experience and resources of the EPA with other Federal agencies. t the Fitzsimmons Army Medical Center (FAMC) in Aurora, Colorado, the Army and the EPA cooperated i...

  7. WASTE MINIMIZATION OPPORTUNITY ASSESSMENT: OPTICAL FABRICATION LABORATORY - FITZSIMMONS ARMY MEDICAL CENTER

    EPA Science Inventory

    Under the Waste Reduction Evaluations at Federal Sites (WREAFS) program, RREL has taken the initiative to merge the experience and resources of the EPA with other Federal agencies. At the Fitzsimmons Army Medical Center (FAMC) in Aurora, Colorado, the Army and the EPA cooperated ...

  8. Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

    ERIC Educational Resources Information Center

    Behkami, Nima A.

    2012-01-01

    It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

  9. Developing a Sustainable Research Culture in an Independent Academic Medical Center

    ERIC Educational Resources Information Center

    Joyce, Jeffrey N.

    2013-01-01

    Independent academic medical centers (IAMC) are challenged to develop and support a research enterprise and maintain primary goals of healthcare delivery and financial solvency. Strategies for promoting translational research have been shown to be effective at institutions in the top level of federal funding, but not for smaller IAMCs. The…

  10. Which Sexual Abuse Victims Receive a Forensic Medical Examination?: The Impact of Children's Advocacy Centers

    ERIC Educational Resources Information Center

    Walsh, Wendy A.; Cross, Theodore P.; Jones, Lisa M.; Simone, Monique; Kolko, David J.

    2007-01-01

    Objective: This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. Methods: This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of…

  11. Preparing Academic Medical Centers for the Clinical Learning Environment Review: Alliance of Independent Academic Medical Centers National Initiative IV Outcomes and Evaluation

    PubMed Central

    Wehbe-Janek, Hania; Markova, Tsveti; Polis, Rachael L.; Peters, Marguerite; Liu, Yang

    2016-01-01

    Background: Driven by changes to improve quality in patient care and population health while reducing costs, evolvement of the health system calls for restructuring health professionals' education and aligning it with the healthcare delivery system. In response to these changes, the Accreditation Council for Graduate Medical Education's Clinical Learning Environment Review (CLER) encourages the integration of health system leadership, faculty, and residents in restructuring graduate medical education (GME). Innovative approaches to achieving this restructuring and the CLER objectives are essential. Methods: The Alliance of Independent Academic Medical Centers National Initiative (NI) IV provided a multiinstitutional learning collaborative focused on supporting GME redesign. From October 2013 through March 2015, participants conducted relevant projects, attended onsite meetings, and participated in teleconferences and webinars addressing the CLER areas. Participants shared best practices, resources, and experiences. We designed a pre/post descriptive study to examine outcomes. Results: Thirty-three institutions completed NI IV, and at its conclusion, the majority reported greater CLER readiness compared with baseline. Twenty-two (88.0%) institutions reported that NI IV had a great impact on advancing their efforts in the CLER area of their project focus, and 15 (62.5%) reported a great impact in other CLER focus areas. Opportunities to share progress with other teams and the national group meetings were reported to contribute to teams' success. Conclusion: The NI IV learning collaborative prepared institutions for CLER, suggesting successful integration of the clinical and educational enterprises. We propose that national learning collaboratives of GME-sponsoring health systems enable advancement of their education mission, leading ultimately to better healthcare outcomes. This learning model may be generalizable to newfound programs for academic medical centers

  12. Is there a role for academic medical centers in emerging markets?

    PubMed

    Wiener, Charles M; Thompson, Steven J; Wu, Sandford; Chellappa, Mohan; Hasham, Salim

    2012-01-01

    Governments in emerging markets face mounting challenges in managing health spending, building capability and capacity, modernizing ageing infrastructure, and investing in skills and resources. One path to overcoming these challenges is to establish new public-private models of health care development and delivery based on United States academic medical centers, whose missions are to advance medical education and clinical delivery. Johns Hopkins Medicine is a participant in the collaboration developing between the Perdana University Hospital and the Perdana University Graduate School of Medicine in Malaysia. These two organizations comprise an academic health science center based on the United States model. The Perdana project provides constructive insights into the opportunities and challenges that governments, universities, and the private sector face when introducing new models of patient care that are integrated with medical education, clinical training, and biomedical research. PMID:23484425

  13. The Inflammatory Bowel Disease Specialty Medical Home: A New Model of Patient-centered Care.

    PubMed

    Regueiro, Miguel D; McAnallen, Sandra E; Greer, Julia B; Perkins, Stephen E; Ramalingam, S; Szigethy, Eva

    2016-08-01

    New models of health care have emerged over the past decade. Accountable care organizations and patient-centered medical homes are designed to improve the patient experience, enhance health care quality, and decrease cost. These models have been developed in the primary care domain and have yet to be tested in specialty care. Certain chronic diseases require principal care by a specialist or health care team. The specialty medical home would provide patient-centered care for specific populations of patients whose health care derives from a single chronic disease. This article defines the parameters for a specialty medical home and provides a specific payer-provider experience for the comprehensive care of an inflammatory bowel disease population. PMID:27135486

  14. An Advanced Pharmacy Practice Experience in a Student-Staffed Medication Therapy Management Call Center

    PubMed Central

    Hall, Anna M.; Roane, Teresa E.; Mistry, Reena

    2012-01-01

    Objective. To describe the implementation of an advanced pharmacy practice experience (APPE) in medication therapy management (MTM) designed to contribute to student pharmacists’ confidence and abilities in providing MTM. Design. Sixty-four student pharmacists provided MTM services during an APPE in a communication and care center. Assessment. Students conducted 1,495 comprehensive medication reviews (CMRs) identifying 6,056 medication-related problems. Ninety-eight percent of the students who completed a survey instrument (52 of 53) following the APPE expressed that they had the necessary knowledge and skills to provide MTM services. Most respondents felt that pharmacist participation in providing Medicare MTM could move the profession of pharmacy forward and that pharmacists will have some role in deciding the specific provisions of the Medicare MTM program (92% and 91%, respectively). Conclusion. Students completing the MTM APPE received patient-centered experiences that supplemented their confidence, knowledge, and skill in providing MTM services in the future. PMID:22919086

  15. Development of a Hospital-based Massage Therapy Course at an Academic Medical Center

    PubMed Central

    Dion, Liza J.; Cutshall, Susanne M.; Rodgers, Nancy J.; Hauschulz, Jennifer L.; Dreyer, Nikol E.; Thomley, Barbara S.; Bauer, Brent

    2015-01-01

    Background: Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. Methods: A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. Results: The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. Conclusions: The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment. PMID

  16. Using a medical simulation center as an electronic health record usability laboratory

    PubMed Central

    Landman, Adam B; Redden, Lisa; Neri, Pamela; Poole, Stephen; Horsky, Jan; Raja, Ali S; Pozner, Charles N; Schiff, Gordon; Poon, Eric G

    2014-01-01

    Usability testing is increasingly being recognized as a way to increase the usability and safety of health information technology (HIT). Medical simulation centers can serve as testing environments for HIT usability studies. We integrated the quality assurance version of our emergency department (ED) electronic health record (EHR) into our medical simulation center and piloted a clinical care scenario in which emergency medicine resident physicians evaluated a simulated ED patient and documented electronically using the ED EHR. Meticulous planning and close collaboration with expert simulation staff was important for designing test scenarios, pilot testing, and running the sessions. Similarly, working with information systems teams was important for integration of the EHR. Electronic tools are needed to facilitate entry of fictitious clinical results while the simulation scenario is unfolding. EHRs can be successfully integrated into existing simulation centers, which may provide realistic environments for usability testing, training, and evaluation of human–computer interactions. PMID:24249778

  17. Readiness for the Patient-Centered Medical Home: Structural Capabilities of Massachusetts Primary Care Practices

    PubMed Central

    Friedberg, Mark W.; Safran, Dana G.; Coltin, Kathryn L.; Dresser, Marguerite

    2008-01-01

    Background The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied. Objective To measure the prevalence of recommended structural capabilities among primary care practices and to determine whether prevalence varies among practices of different size (number of physicians) and administrative affiliation with networks of practices. Design Cross-sectional analysis. Participants One physician chosen at random from each of 412 primary care practices in Massachusetts was surveyed about practice capabilities during 2007. Practice size and network affiliation were obtained from an existing database. Measurements Presence of 13 structural capabilities representing 4 domains relevant to quality: patient assistance and reminders, culture of quality, enhanced access, and electronic health records (EHRs). Main Results Three hundred eight (75%) physicians responded, representing practices with a median size of 4 physicians (range 2–74). Among these practices, 64% were affiliated with 1 of 9 networks. The prevalence of surveyed capabilities ranged from 24% to 88%. Larger practice size was associated with higher prevalence for 9 of the 13 capabilities spanning all 4 domains (P < 0.05). Network affiliation was associated with higher prevalence of 5 capabilities (P < 0.05) in 3 domains. Associations were not substantively altered by statistical adjustment for other practice characteristics. Conclusions Larger and network-affiliated primary care practices are more likely than smaller, non-affiliated practices to have adopted several recommended capabilities. In order to achieve PCMH designation, smaller non-affiliated practices may require the greatest investments. Electronic supplementary material The online version of this article (doi:10

  18. MiPLAN: a learner-centered model for bedside teaching in today's academic medical centers.

    PubMed

    Stickrath, Chad; Aagaard, Eva; Anderson, Mel

    2013-03-01

    Clinician educators and medical trainees face intense pressure to complete numerous patient care and teaching activities in a limited amount of time. To address the need for effective and efficient teaching methods for use in the inpatient setting, the authors used constructivist learning theory, the principles of adult learning, and their expertise as clinician educators to develop the MiPLAN model for bedside teaching. This three-part model is designed to enable clinical teachers to simultaneously provide care to patients while assessing learners, determining high-yield teaching topics, and providing feedback to learners.The "M" refers to a preparatory meeting between teacher and learners before engaging in patient care or educational activities. During this meeting, team members should become acquainted and the teacher should set goals and clarify expectations. The "i" refers to five behaviors for the teacher to adopt during learners' bedside presentations: introduction, in the moment, inspection, interruptions, and independent thought. "PLAN" is an algorithm to establish priorities for teaching subsequent to a learner's presentation: patient care, learners' questions, attending's agenda, and next steps.The authors suggest that the MiPLAN model can help clinical teachers gain more confidence in their ability to teach at the bedside and increase the frequency and quality of bedside teaching. They propose further research to assess the generalizability of this model to other institutions, settings, and specialties and to evaluate educational and patient outcomes. PMID:23348088

  19. Improving the Transition of Care in Patients Transferred Through the Ochsner Medical Center Transfer Center

    PubMed Central

    Amedee, Ronald G.; Maronge, Genevieve F.; Pinsky, William W.

    2012-01-01

    Background Patient transfers from other hospitals within the Ochsner Health System to the main campus are coordinated through a Transfer Center that was established in fall 2008. We analyzed the transfer process to assess distinct opportunities to enhance the overall transition of patient care. Methods We surveyed internal medicine residents and nocturnists to determine their satisfaction with transfers in terms of safety, efficiency, and usefulness of information provided at the time of transfer. After a kaizen event at which complementary goals for the institution and members of the study team were recognized and implemented, we resurveyed the group to evaluate improvement in the transfer process. Results The preintervention average satisfaction score was 1.18 (SD=0.46), while the postintervention score was 3.7 (SD=1.01). A t test showed a significant difference in the average scores between the preintervention and postintervention surveys (P<0.0001). Conclusions By including residents in the transfer calls (a result of the kaizen event), data were collected that facilitated fewer and higher quality handoffs that were performed in less time. In addition, the process resulted in increased awareness of the value of resident participation in institutional quality improvement projects. PMID:23267257

  20. The effect of organizational climate on patient-centered medical home implementation.

    PubMed

    Reddy, Ashok; Shea, Judy A; Canamucio, Anne; Werner, Rachel M

    2015-01-01

    Organizational climate is a key determinant of successful adoption of innovations; however, its relation to medical home implementation is unknown. This study examined the association between primary care providers' (PCPs') perception of organization climate and medical home implementation in the Veterans Health Administration. Multivariate regression was used to test the hypothesis that organizational climate predicts medical home implementation. This analysis of 191 PCPs found that higher scores in 2 domains of organizational climate (communication and cooperation, and orientation to quality improvement) were associated with a statistically significantly higher percentage (from 7 to 10 percentage points) of PCPs implementing structural changes to support the medical home model. In addition, some aspects of a better organizational climate were associated with improved organizational processes of care, including a higher percentage of patients contacted within 2 days of hospital discharge (by 2 to 3 percentage points) and appointments made within 3 days of a patient request (by 2 percentage points). PMID:24788252

  1. Every move counts in learning: filipino clinical instructors' scaffolding behaviors in teaching medication administration.

    PubMed

    Valdez, Les Paul M; de Guzman, Allan B; Escolar-Chua, Rowena L

    2013-10-01

    The role of clinical instructors in preparing student nurses for the realities and dynamics of clinical practice cannot be underestimated. Previous literature has identified scaffolding as a diagnostic tool that enables both supervisor and learner to recognize knowledge-in-waiting and knowledge-in-use (Spouse, 1998). The pivotal role of scaffolding in the teaching-learning process cannot be underestimated. However, literature pertaining to its use in nursing is hard to locate (Dickieson, Carter and Walsh, 2008; Spouse, 1998). Hence, this qualitative study was conducted to capture nursing students' views and experiences of the scaffolding moves of their clinical instructors as they learn medication administration. From the thickness and richness of the descriptions of a select group of nursing students (n=31) in a comprehensive university in the Philippines, three interesting and yet intersecting themes surfaced relative to the scaffolding moves employed by clinical instructors, which include: (1) thought-provoking; (2) focus-steering; and (3) action-enabling. The said moves are carried out in a timely fashion to facilitate students' acquisition of knowledge, skills and attitudes pertaining to medication administration. Through the understanding of clinical instructors' scaffolding behaviors, this study provides a platform for more effective clinical instruction aimed at supporting future nurses' role in medication safety. PMID:22818953

  2. A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

    PubMed Central

    Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

    2015-01-01

    Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

  3. Proposal for a European Public Health Research Infrastructure for Sharing of health and Medical administrative data (PHRIMA).

    PubMed

    Burgun, Anita; Oksen, Dina V; Kuchinke, Wolfgang; Prokosch, Hans-Ulrich; Ganslandt, Thomas; Buchan, Iain; van Staa, Tjeerd; Cunningham, James; Gjerstorff, Marianne L; Dufour, Jean-Charles; Gibrat, Jean-Francois; Nikolski, Macha; Verger, Pierre; Cambon-Thomsen, Anne; Masella, Cristina; Lettieri, Emanuele; Bertele, Paolo; Salokannel, Marjut; Thiebaut, Rodolphe; Persoz, Charles; Chêne, Geneviève; Ohmann, Christian

    2015-01-01

    In Europe, health and medical administrative data is increasingly accumulating on a national level. Looking further than re-use of this data on a national level, sharing health and medical administrative data would enable large-scale analyses and European-level public health projects. There is currently no research infrastructure for this type of sharing. The PHRIMA consortium proposes to realise the Public Health Research Infrastructure for Sharing of health and Medical Administrative data (PHRIMA) which will enable and facilitate the efficient and secure sharing of healthcare data. PMID:26262306

  4. 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

  5. Towards Interactive Medical Content Delivery Between Simulated Body Sensor Networks and Practical Data Center.

    PubMed

    Shi, Xiaobo; Li, Wei; Song, Jeungeun; Hossain, M Shamim; Mizanur Rahman, Sk Md; Alelaiwi, Abdulhameed

    2016-10-01

    With the development of IoT (Internet of Thing), big data analysis and cloud computing, traditional medical information system integrates with these new technologies. The establishment of cloud-based smart healthcare application gets more and more attention. In this paper, semi-physical simulation technology is applied to cloud-based smart healthcare system. The Body sensor network (BSN) of system transmit has two ways of data collection and transmission. The one is using practical BSN to collect data and transmitting it to the data center. The other is transmitting real medical data to practical data center by simulating BSN. In order to transmit real medical data to practical data center by simulating BSN under semi-physical simulation environment, this paper designs an OPNET packet structure, defines a gateway node model between simulating BSN and practical data center and builds a custom protocol stack. Moreover, this paper conducts a large amount of simulation on the real data transmission through simulation network connecting with practical network. The simulation result can provides a reference for parameter settings of fully practical network and reduces the cost of devices and personnel involved. PMID:27562482

  6. Montefiore Medical Center in The Bronx, New York: improving health in an urban community.

    PubMed

    Foreman, Spencer

    2004-12-01

    The author calls on academic medical centers that serve urban communities to go beyond the traditional mission of patient care, teaching, and research by accepting responsibility to build community-based care systems that are capable of improving the health of underserved populations within their reach. The experience of Montefiore Medical Center in the Bronx, New York, is presented to illustrate the nature, scope, and complexity of the undertaking that is required. Eight initiatives are described: expanding the primary care network, creating The Children's Hospital at Montefiore and the Child Health Network, responding to the needs of other high-risk populations, integrating the network with health information technology, using care-management systems to improve quality, reinforcing ethical allocation of resources, building teaching and research into the network, and preserving community vitality. The author believes that the current health care environment offers opportunities that may help to stimulate change in the direction of community-based systems. Managed care provides financial incentives to academic centers that are willing to accept risk and responsibly manage the care of a defined community, and advanced information technologies can support them in that endeavor. The author concludes that for academic medical centers with the proper systems in place, accepting responsibility for the community is not only the right thing to do, it is the strategic thing to do. PMID:15563649

  7. United States academic medical centers: priorities and challenges amid market transformation.

    PubMed

    Thompson, Irene M; Anason, Barbara

    2012-01-01

    United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation. PMID:23484431

  8. The Effects of Corporatization on Academic Medical Centers. How Will the Corporatization of Health Care Influence Health Professions Education?

    ERIC Educational Resources Information Center

    Dunn, Marvin R.

    Areas of agreement/conflict between academic medical centers and investor owned corporations are considered. Academic medical centers are part of the university system, which is responsible for education, research, and the related public good (e.g., nurturing of professions). Major areas for a potential confluence of interest between the academic…

  9. Regulatory administrative databases in FDA's Center for Biologics Evaluation and Research: convergence toward a unified database.

    PubMed

    Smith, Jeffrey K

    2013-04-01

    Regulatory administrative database systems within the Food and Drug Administration's (FDA) Center for Biologics Evaluation and Research (CBER) are essential to supporting its core mission, as a regulatory agency. Such systems are used within FDA to manage information and processes surrounding the processing, review, and tracking of investigational and marketed product submissions. This is an area of increasing interest in the pharmaceutical industry and has been a topic at trade association conferences (Buckley 2012). Such databases in CBER are complex, not for the type or relevance of the data to any particular scientific discipline but because of the variety of regulatory submission types and processes the systems support using the data. Commonalities among different data domains of CBER's regulatory administrative databases are discussed. These commonalities have evolved enough to constitute real database convergence and provide a valuable asset for business process intelligence. Balancing review workload across staff, exploring areas of risk in review capacity, process improvement, and presenting a clear and comprehensive landscape of review obligations are just some of the opportunities of such intelligence. This convergence has been occurring in the presence of usual forces that tend to drive information technology (IT) systems development toward separate stovepipes and data silos. CBER has achieved a significant level of convergence through a gradual process, using a clear goal, agreed upon development practices, and transparency of database objects, rather than through a single, discrete project or IT vendor solution. This approach offers a path forward for FDA systems toward a unified database. PMID:23269527

  10. A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program

    PubMed Central

    Duong, David B.; Sullivan, Erin E.; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L.

    2016-01-01

    Background In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. Methods The AoC is modeled in the form of a ‘grants challenge’, offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Results Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Conclusions Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment. PMID:27306994

  11. Medical diplomacy and global mental health: from community and national institutions to regional centers of excellence.

    PubMed

    Aggarwal, Neil Krishan; Kohrt, Brandon A

    2013-12-01

    We explore how regional medical diplomacy can increase funding for global mental health initiatives. Interventions for infectious diseases have dominated medical diplomacy by focusing on security concerns. The global mental health movement has adopted similar strategies, but unsuccessfully since mental illnesses do not cause international epidemics. Instead, realpolitik arguments may increase funding by prioritizing economic productivity and regional diplomacy based on cultural ties to advance mental health services and research at the community level. In South Asia, initiatives to train personnel and provide refugee services offer a foundation for regional centers of excellence. This model can be expanded elsewhere. PMID:23918068

  12. Medical devices; revocation of cardiac pacemaker registry. Food and Drug Administration, HHS. Final rule.

    PubMed

    1999-11-24

    The Food and Drug Administration (FDA) is issuing a final rule to revoke a regulation requiring a cardiac pacemaker registry. The registry, which was mandated by the Deficit Reduction Act of 1984, requires any physician and any provider of services who requests or receives Medicare payment for an implantation, removal, or replacement of permanent cardiac pacemaker devices and pacemaker leads to submit certain information to the registry. The information is used by FDA to track the performance of permanent cardiac pacemakers and pacemaker leads and by the Health Care Finance Administration (HCFA) to administer its Medicare payment program for these devices. This action is being taken to implement an act to Repeal An Unnecessary Medical Device Reporting Requirement passed by Congress in 1996 to remove the cardiac pacemaker registry to eliminate duplicative and unnecessary reporting. PMID:11010690

  13. Diseases pattern among patients attending Holy Mosque (Haram) Medical Centers during Hajj 1434 (2013)

    PubMed Central

    Bakhsh, Abdulrahman R.; Sindy, Abdulfattah I.; Baljoon, Mostafa J.; Dhafar, Khalid O.; Gazzaz, Zohair J.; Baig, Mukhtiar; Deiab, Basma A.; Hothali, Fauzea T. Al

    2015-01-01

    Objective: To evaluate the diseases pattern among pilgrims attending the 2 Holy Mosque (Haram) Health Care Centers during the Hajj season 2013 (Hijra 1434). Methods: In this cross-sectional study, data was collected from 2 medical centers located in the Holy Mosque in Makkah city, Saudi Arabia, from the first of Dhul-Hijjah to sixteenth Dhul-Hijjah 1434. The present study was completed in 16 days (6th October to 21st October 2013). Results: Over 16 days, 1008 patients attended the medical centers during Hajj 1434, (2013), out of which 554 (55%) were males and 454 (45%) were females. Most of the patients were Egyptians (n=242, 24%), followed by Saudis (n=116, 11.5%), Pakistani (n=114, 11.3%), Turkish (n=50, 5%), and other nationalities (n=404). According to age distribution, mostly were in the 51-60 years age group (n=237, 23.5%), followed by other age groups. Out of 1008 patients, 842 (83.5%) patients were treated and subsequently discharged, while 166 patients (16.5%) were referred to the tertiary centers. According to the diseases pattern, most of the patients were suffering from respiratory problems (n=177, 17.6%) followed by skin diseases (n=158, 15.7%), gastrointestinal tract (GIT) diseases (n=133, 13.2%), and others. Conclusion: Most of the patients were suffering from respiratory problems followed by skin and GIT diseases, and <25% of patients were referred to tertiary care centers. PMID:26219447

  14. Using administrative medical claims data to supplement state disease registry systems for reporting zoonotic infections

    PubMed Central

    Coulter, Steven; Conner, William

    2013-01-01

    Objective To determine what, if any, opportunity exists in using administrative medical claims data for supplemental reporting to the state infectious disease registry system. Materials and methods Cases of five tick-borne (Lyme disease (LD), babesiosis, ehrlichiosis, Rocky Mountain spotted fever (RMSF), tularemia) and two mosquito-borne diseases (West Nile virus, La Crosse viral encephalitis) reported to the Tennessee Department of Health during 2000–2009 were selected for study. Similarly, medically diagnosed cases from a Tennessee-based managed care organization (MCO) claims data warehouse were extracted for the same time period. MCO and Tennessee Department of Health incidence rates were compared using a complete randomized block design within a general linear mixed model to measure potential supplemental reporting opportunity. Results MCO LD incidence was 7.7 times higher (p<0.001) than that reported to the state, possibly indicating significant under-reporting (∼196 unreported cases per year). MCO data also suggest about 33 cases of RMSF go unreported each year in Tennessee (p<0.001). Three cases of babesiosis were discovered using claims data, a significant finding as this disease was only recently confirmed in Tennessee. Discussion Data sharing between MCOs and health departments for vaccine information already exists (eg, the Vaccine Safety Datalink Rapid Cycle Analysis project). There may be a significant opportunity in Tennessee to supplement the current passive infectious disease reporting system with administrative claims data, particularly for LD and RMSF. Conclusions There are limitations with administrative claims data, but health plans may help bridge data gaps and support the federal administration's vision of combining public and private data into one source. PMID:22811492

  15. The Institute of Public Administration's Document Center: From Paper to Electronic Records--A Full Image Government Documents Database.

    ERIC Educational Resources Information Center

    Al-Zahrani, Rashed S.

    Since its establishment in 1960, the Institute of Public Administration (IPA) in Riyadh, Saudi Arabia has had responsibility for documenting Saudi administrative literature, the official publications of Saudi Arabia, and the literature of regional and international organizations through establishment of the Document Center in 1961. This paper…

  16. 75 FR 77665 - Frank Russell Company, Administrative Service Center, Including On-Site Leased Workers From Volt...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Frank Russell Company, Administrative Service Center, Including On-Site Leased Workers From Volt Services, Tacoma, WA; Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance In...

  17. Trastuzumab Administration in Patients with Metastatic Breast Cancer – Experience of a Large University Breast Center

    PubMed Central

    Hartkopf, A. D.; Brendel, M. H.; Wallwiener, M.; Taran, F.-A.; Brucker, S.; Grischke, E.-M.

    2014-01-01

    Background: Administered either alone or in combination with various cytostatic, endocrine or targeted therapies, trastuzumab significantly improves the prognosis of patients with HER2-positive breast cancer. As trastuzumab is effective across multiple lines of therapy in the metastatic setting (treatment beyond progression: TBP), it is often administered over a long period of time. The aim of this study was to evaluate the tolerability and clinical practice of long-term trastuzumab administration (> 1 year) in metastatic breast cancer patients treated in a large university breast center. Methods: Metastatic breast cancer patients who received at least 18 cycles of trastuzumab administered every three weeks at the University Gynecological Hospital of Tuebingen between 1999 and 2012 were included in this retrospective study. Typical combination drugs, side effects, and the impact of administration on left ventricular ejection fraction (LVEF) were investigated. Results: 72 patients were eligible for inclusion in the study. The mean number of administrations was 50.14 (SD: 27.51). In 53 patients the principle of TBP was followed across an average of 2.4 therapy lines. Classic cardiac risk factors were present at the beginning of trastuzumab treatment in 34 patients (47 %). Seven patients (10 %) experienced a decrease in LVEF during treatment, 9 patients (13 %) had hypersensitivity reactions. Treatment was discontinued in two patients due to side effects (1 × progressive LVEF decrease, 1 × intolerance). Summary: The administration of trastuzumab across multiple lines of therapy was generally tolerated well. Cardiac risk factors were not a limiting factor. If regular cardiac monitoring is done, trastuzumab appears not only to improve survival but also helps preserve the quality of life of patients with HER2-positive metastatic breast cancer. PMID:24976638

  18. Patient Navigators: Agents of Creating Community-Nested Patient-Centered Medical Homes for Cancer Care.

    PubMed

    Simon, Melissa A; Samaras, Athena T; Nonzee, Narissa J; Hajjar, Nadia; Frankovich, Carmi; Bularzik, Charito; Murphy, Kara; Endress, Richard; Tom, Laura S; Dong, XinQi

    2016-01-01

    Patient navigation is an internationally utilized, culturally grounded, and multifaceted strategy to optimize patients' interface with the health-care team and system. The DuPage County Patient Navigation Collaborative (DPNC) is a campus-community partnership designed to improve access to care among uninsured breast and cervical cancer patients in DuPage County, IL. Importantly, the DPNC connects community-based social service delivery with the patient-centered medical home to achieve a community-nested patient-centered medical home model for cancer care. While the patient navigator experience has been qualitatively documented, the literature pertaining to patient navigation has largely focused on efficacy outcomes and program cost effectiveness. Here, we uniquely highlight stories of women enrolled in the DPNC, told from the perspective of patient navigators, to shed light on the myriad barriers that DPNC patients faced and document the strategies DPNC patient navigators implemented. PMID:27594792

  19. Patient Navigators: Agents of Creating Community-Nested Patient-Centered Medical Homes for Cancer Care

    PubMed Central

    Simon, Melissa A.; Samaras, Athena T.; Nonzee, Narissa J.; Hajjar, Nadia; Frankovich, Carmi; Bularzik, Charito; Murphy, Kara; Endress, Richard; Tom, Laura S.; Dong, XinQi

    2016-01-01

    Patient navigation is an internationally utilized, culturally grounded, and multifaceted strategy to optimize patients’ interface with the health-care team and system. The DuPage County Patient Navigation Collaborative (DPNC) is a campus–community partnership designed to improve access to care among uninsured breast and cervical cancer patients in DuPage County, IL. Importantly, the DPNC connects community-based social service delivery with the patient-centered medical home to achieve a community-nested patient-centered medical home model for cancer care. While the patient navigator experience has been qualitatively documented, the literature pertaining to patient navigation has largely focused on efficacy outcomes and program cost effectiveness. Here, we uniquely highlight stories of women enrolled in the DPNC, told from the perspective of patient navigators, to shed light on the myriad barriers that DPNC patients faced and document the strategies DPNC patient navigators implemented. PMID:27594792

  20. Pathology service line: a model for accountable care organizations at an academic medical center.

    PubMed

    Sussman, Ira; Prystowsky, Michael B

    2012-05-01

    Accountable care is designed to manage the health of patients using a capitated cost model rather than fee for service. Pay for performance is an attempt to use quality and not service reduction as the way to decrease costs. Pathologists will have to demonstrate value to the system. This value will include (1) working with clinical colleagues to optimize testing protocols, (2) reducing unnecessary testing in both clinical and anatomic pathology, (3) guiding treatment by helping to personalize therapy, (4) designing laboratory information technology solutions that will promote and facilitate accurate, complete data mining, and (5) administering efficient cost-effective laboratories. The pathology service line was established to improve the efficiency of delivering pathology services and to provide more effective support of medical center programs. We have used this model effectively at the Montefiore Medical Center for the past 14 years. PMID:22333926

  1. St. Luke's Medical Center Global City--Global Trigger Tool (GTT) Project.

    PubMed

    Dizon, Alejandro C; Macaraig, Victor J; Magpusao, Eulalia C

    2016-01-01

    The Global Trigger Tool (GTT) was developed by the Institute of Healthcare Improvement (IHI), to identify and measure the rate of adverse events over time in a healthcare facility. It is a sampling methodology that utilizes "triggers" in the detection of random adverse events and harms and it also measures the adverse events overtime. The Quality and Patient Safety Group of St. Luke's Medical Center--Global City initiated the implementation of the Global Trigger Tool as a proactive solution using retrospective information gathered to address the growing challenge that adverse events and harms impose in the institution with the ultimate goat of improving patient safety. St. Luke's Medical Center Global City is the first and only hospital in the Philippines to implementand utilize the Global Trigger Tool. PMID:27180470

  2. Medical Student Volunteerism Addresses Patients' Social Needs: A Novel Approach to Patient-Centered Care

    PubMed Central

    Onyekere, Chinwe; Ross, Sandra; Namba, Alexa; Ross, Justin C.; Mann, Barry D.

    2016-01-01

    Background: Healthcare providers must be equipped to recognize and address patients' psychosocial needs to improve overall health outcomes. To give future healthcare providers the tools and training necessary to identify and address psychosocial issues, Lankenau Medical Center in partnership with the Philadelphia College of Osteopathic Medicine designed the Medical Student Advocate (MSA) program. Methods: The MSA program places volunteer second-year osteopathic medical students in care coordination teams at Lankenau Medical Associates, a primary care practice serving a diverse patient population in the Philadelphia, PA, region. As active members of the team, MSAs are referred high-risk patients who have resource needs such as food, employment, child care, and transportation. MSAs work collaboratively with patients and the multidisciplinary team to address patients' nonmedical needs. Results: From August 2013 to August 2015, 31 osteopathic medical students volunteered for the MSA program and served 369 patients with 720 identified needs. Faculty and participating medical students report that the MSA program provided an enhanced understanding of the holistic nature of patient care and a comprehensive view of patient needs. Conclusion: The MSA program provides students with a unique educational opportunity that encompasses early exposure to patient interaction, social determinants of health, population health, and interdisciplinary collaboration. Students develop skills to help them build patient relationships, understand the psychosocial factors shaping health outcomes, and engage with other healthcare professionals. This work in the preclinical years provides students with the knowledge to help them perform more effectively in the changing healthcare environment. PMID:27046404

  3. Evaluating A Patient-Centered Medical Home From the Patient's Perspective

    PubMed Central

    Kennedy, Betty M.; Moody-Thomas, Sarah; Katzmarzyk, Peter T.; Horswell, Ronald; Griffin, Willene P.; Coleman, Mary T.; Herwehe, Jane; Besse, Jay A.; Willis, Kathleen H.

    2013-01-01

    Background The medical home is an organizational approach for improving care, improving patient experience, and reducing costs. The purpose of this qualitative project was to obtain input from patients that could be used to improve their experiences in the medical home for ongoing disease management and health improvement and to obtain their recommendations for the most effective methods to involve patients in shaping system policies, procedures, and practices consistent with patient- and family-centered care principles. Methods We conducted cognitive interviews to complete patient experience surveys, structured focus groups, and exit surveys. A sample of 32 adults participated in cognitive interviews (n=15) and structured focus groups (n=17) using the nominal group technique (NGT). Exit surveys collected demographic information and input from patients about opportunities for their involvement in shaping medical homes. Results Cognitive interviews, NGT sessions, and exit surveys revealed patient-perceived strengths and inadequacies within the medical home. Better access to care, including more efficient appointment scheduling and reduced wait times to see a physician once patients arrived for scheduled appointments, was identified as a necessary improvement. Patients' positive perceptions included how the medical home helps them reach their health goals and their overall satisfaction with the quality of care received. Conclusion The input received from patients through the methods used in this project was useful in revealing needed improvements within a medical home and, if resolved, will ensure that all patients have access to the kind of care that works for them. PMID:24052763

  4. Positioning academic medical centers and teaching hospitals to thrive in the next decade.

    PubMed

    Morris, D E

    1985-06-01

    Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification. PMID:10271804

  5. Information Technology Support for Clinical Genetic Testing within an Academic Medical Center

    PubMed Central

    Aronson, Samuel; Mahanta, Lisa; Ros, Lei Lei; Clark, Eugene; Babb, Lawrence; Oates, Michael; Rehm, Heidi; Lebo, Matthew

    2016-01-01

    Academic medical centers require many interconnected systems to fully support genetic testing processes. We provide an overview of the end-to-end support that has been established surrounding a genetic testing laboratory within our environment, including both laboratory and clinician facing infrastructure. We explain key functions that we have found useful in the supporting systems. We also consider ways that this infrastructure could be enhanced to enable deeper assessment of genetic test results in both the laboratory and clinic. PMID:26805890

  6. Information Technology Support for Clinical Genetic Testing within an Academic Medical Center.

    PubMed

    Aronson, Samuel; Mahanta, Lisa; Ros, Lei Lei; Clark, Eugene; Babb, Lawrence; Oates, Michael; Rehm, Heidi; Lebo, Matthew

    2016-01-01

    Academic medical centers require many interconnected systems to fully support genetic testing processes. We provide an overview of the end-to-end support that has been established surrounding a genetic testing laboratory within our environment, including both laboratory and clinician facing infrastructure. We explain key functions that we have found useful in the supporting systems. We also consider ways that this infrastructure could be enhanced to enable deeper assessment of genetic test results in both the laboratory and clinic. PMID:26805890

  7. Television spots win national award. Part of OSF Saint Francis Medical Center's branding effort.

    PubMed

    Rees, Tom

    2004-01-01

    "Miracles in Medicine," a series of award-winning television spots, was produced for OSF Saint Francis Medical Center, Peoria, Ill., by The Roberts Group, Inc., Waukesha, Wis. They are an integral part of a broader branding campaign, launched in May 2003, that includes newspaper, radio, and outdoor elements. The spots were deemed so successful, the branding effort was expanded to include Children's Hospital of Illinois. PMID:15162576

  8. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People's Republic of China.

    PubMed

    Fang, Xu; Zhu, Ling-Ling; Pan, Sheng-Dong; Xia, Ping; Chen, Meng; Zhou, Quan

    2016-01-01

    Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A "Plan, Do, Check, Act" cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000), and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People's Republic of China, (April 2012-October 2012), the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values <0.05). Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine equivalent dose per discharged patient increased from 8.52 mg/person to 20.36 mg/person. A 100% implementation rate of independent double-check prior to narcotics dosing has been achieved since January 2013. From 2014 to 2015, the ratio of number of narcotics-related medication errors to number of discharged patients significantly decreased (6.95% versus 0.99%, P=0.0000). Taken together, continuous quality improvements have been

  9. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People’s Republic of China

    PubMed Central

    Fang, Xu; Zhu, Ling-ling; Pan, Sheng-dong; Xia, Ping; Chen, Meng; Zhou, Quan

    2016-01-01

    Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People’s Republic of China during 2011–2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A “Plan, Do, Check, Act” cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000), and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People’s Republic of China, (April 2012–October 2012), the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values <0.05). Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine equivalent dose per discharged patient increased from 8.52 mg/person to 20.36 mg/person. A 100% implementation rate of independent double-check prior to narcotics dosing has been achieved since January 2013. From 2014 to 2015, the ratio of number of narcotics-related medication errors to number of discharged patients significantly decreased (6.95% versus 0.99%, P=0.0000). Taken together, continuous quality improvements

  10. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    ERIC Educational Resources Information Center

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill…

  11. Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

    PubMed

    Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

    2015-08-01

    There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. PMID:25861803

  12. Key Elements of Clinical Physician Leadership at an Academic Medical Center

    PubMed Central

    Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

    2011-01-01

    Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

  13. 77 FR 41413 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices: The Pre...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... the pre- Investigational Device Exemption (IDE) program) for medical devices reviewed in the Center... establishment in 1995, the pre-IDE program has been a successful resource for both medical device applicants and... feedback on future IDE applications prior to their submission. Over time, the pre-IDE program evolved...

  14. Eye drop administration in patients attending and not attending a glaucoma education center

    PubMed Central

    Al-Busaidi, Aisha; Samek, Debbie Anne; Kasner, Oscar

    2016-01-01

    Background: To assess the technique of glaucoma eye drop instillation in patients who have and have not attended glaucoma education sessions. To compare this with their subjective perception of eye drop use and identify factors associated with improved performance. Patients and Methods: An observational study of 55 participants who instill their topical glaucoma medication for more than 1 year. Twenty-five patients attended (A) glaucoma teaching sessions >1 year before the study and were compared to thirty patients who never attended (NA). Patients completed a self-reporting questionnaire. They instilled their eye drop, and the technique was video-recorded digitally and later graded by two masked investigators. The results were analyzed using Fisher's exact test and Chi-square test. Predictors were assessed using logistic regression models. Results: There was no significant difference in overall performance scores between the two groups. Good technique was observed in 16% of (A) group versus 23% (NA) group, (P = 0.498). There was a mismatch between patient's subjective and actual performance. Female gender and higher educational level were found to be predictors of good performance of drop instillation on univariable logistic regression analysis. Conclusion: Glaucoma patients are challenged with eye drop instillation despite receiving education on drop administration. There is a discrepancy between patient's perceptions and observed technique of drop administration. PMID:27013822

  15. Parental Perceptions of Family Centered Care in Medical Homes of Children with Neurodevelopmental Disabilities.

    PubMed

    Zajicek-Farber, Michaela L; Lotrecchiano, Gaetano R; Long, Toby M; Farber, Jon Matthew

    2015-08-01

    Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers. PMID:25724538

  16. Analysis of 10-Year Training Results of Medical Students Using the Microvascular Research Center Training Program.

    PubMed

    Onoda, Satoshi; Kimata, Yoshihiro; Sugiyama, Narushi; Tokuyama, Eijiro; Matsumoto, Kumiko; Ota, Tomoyuki; Thuzar, Moe

    2016-06-01

    Background In this article, we reviewed the training results of medical students using the Microvascular Research Center Training Program (MRCP), and proposed an ideal microsurgical training program for all individuals by analyzing the training results of medical students who did not have any surgical experience. Methods As of 2015, a total of 29 medical students completed the MRCP. In the most recent 12 medical students, the number of trials performed for each training stage and the number of rats needed to complete the training were recorded. Additionally, we measured the operating time upon finishing stage 5 for the recent six medical students after it became a current program. Results The average operating time upon finishing stage 5 for the recent six medical students was 120 minutes ± 11 minutes (standard deviation [SD]). The average vascular anastomosis time (for the artery and vein) was 52 minutes ± 2 minutes (SD). For the most recent 12 medical students, there was a negative correlation between the number of trials performed in the non-rat stages (stages 1-3) and the number of rats used in the rat stages (stages 4-5). Conclusion Analysis of the training results of medical students suggests that performing microsurgery first on silicon tubes and chicken wings saves animals' lives later during the training program. We believe that any person can learn the technique of microsurgery by performing 7 to 8 hours of training per day over a period of 15 days within this program setting. PMID:26636888

  17. Improving Patient Safety by Identifying Side Effects from Introducing Bar Coding in Medication Administration

    PubMed Central

    Patterson, Emily S.; Cook, Richard I.; Render, Marta L.

    2002-01-01

    Objective. In addition to providing new capabilities, the introduction of technology in complex, sociotechnical systems, such as health care and aviation, can have unanticipated side effects on technical, social, and organizational dimensions. To identify potential accidents in the making, the authors looked for side effects from a natural experiment, the implementation of bar code medication administration (BCMA), a technology designed to reduce adverse drug events (ADEs). Design. Cross-sectional observational study of medication passes before (21 hours of observation of 7 nurses at 1 hospital) and after (60 hours of observation of 26 nurses at 3 hospitals) BCMA implementation. Measurements. Detailed, handwritten field notes of targeted ethnographic observations of in situ nurse–BCMA interactions were iteratively analyzed using process tracing and five conceptual frameworks. Results. Ethnographic observations distilled into 67 nurse–BCMA interactions were classified into 12 categories. We identified five negative side effects after BCMA implementation: (1) nurses confused by automated removal of medications by BCMA, (2) degraded coordination between nurses and physicians, (3) nurses dropping activities to reduce workload during busy periods, (4) increased prioritization of monitored activities during goal conflicts, and (5) decreased ability to deviate from routine sequences. Conclusion. These side effects might create new paths to ADEs. We recommend design revisions, modification of organizational policies, and “best practices” training that could potentially minimize or eliminate these side effects before they contribute to adverse outcomes. PMID:12223506

  18. The Relationship Between Nursing Experience and Education and the Occurrence of Reported Pediatric Medication Administration Errors.

    PubMed

    Sears, Kim; O'Brien-Pallas, Linda; Stevens, Bonnie; Murphy, Gail Tomblin

    2016-01-01

    Medication errors are one of the most common incidents in the hospitals. They can be harmful, and they are even more detrimental for pediatric patients. This study explored the relationship between nursing experience, education, the frequency and severity of reported pediatric medication administration errors (PMAEs). The data for this study were collected from a larger pan Canadian study. A survey tool was developed to collect self-reported data from nurses. In addition to descriptive statistics, a Poisson regression or a multiple linear regression was completed to address the research questions, and a Boneferrai correction was conducted to adjust for the small sample size. Results demonstrated that on units with more nurses with a higher level of current experience, more PMAEs were reported (p=.001), however; the PMAEs reported by these nurses were not as severe (p=.003). Implications to advance both safe medication delivery in the pediatric setting and safe culture of reporting for both actual and potential errors are identified. PMID:26872514

  19. Neurosurgery at All India Institute of Medical Sciences, a center of excellence: A success story.

    PubMed

    Singh, Manmohan; Sawarkar, Dattaraj; Sharma, Bhawani S

    2015-01-01

    The department of neurosurgery at All India Institute of Medical Sciences (AIIMS) started its humble beginning in 1965. With the untiring and selfless hard work of Prof. P N Tandon and Prof. A K Banerji, the department progressed over time to become a center of excellence in the subcontinent. To establish a neurosciences center at AIIMS was an uphill task, which was accomplished with great efforts. The department has established itself as one of the highest centers of learning in the country with its vast infrastructure and diversity in all fields of neurosurgery. AIIMS, New Delhi was established by an act of the parliament in 1956. It was started with a grant from the Government of New Zealand under the "Colombo Plan." It was the vision of Rajkumari Amrita Kaur, the first Health Minister of India, that led to the establishment of a medical institute of international repute in India. AIIMS, New Delhi is an autonomous institute and is governed by the AIIMS Act, 1956. The department of neurosurgery at AIIMS was started in March 1965 with Prof. P.N. Tandon as the Head of the Department. Prof. A.K. Banerji joined him a few months later. The Department celebrated its golden jubilee in the year 2015, and has tremendously grown in stature from its humble beginnings to being a center of excellence with world-wide recognition. PMID:26238896

  20. The Tulane University Medical Center/Columbia partnership: opportunities and challenges for pathology.

    PubMed

    Krause, J R; Salmon, B C; Gerber, M A

    1996-01-01

    A joint venture between the largest health-care corporation in the country (Columbia/HCA) and Tulane University Hospital/Clinic was established about 1 year ago. Early indications are that the partnership is successful and mutually beneficial. For Tulane University Medical Center, the joint venture provides financial stability and support for academic centers of excellence. Tulane University Hospital/Clinic will become the referral center for complicated cases from the regional Columbia hospitals. The Tulane University Hospital laboratories are positioned to become the regional referral laboratory for esoteric testing. For the pathologists of the regional Columbia hospitals, the opportunity beckons to form a group of equal partners that will contract with Columbia to provide laboratory services at Columbia hospitals and to consolidate the laboratories in the New Orleans division. Columbia has brought corporate expertise, capital, and opportunities for cost-saving economies of scale to the partnership. Quality and cost-effectiveness of patients care will be emphasized as will research on clinical outcomes. This model of corporate/academic partnership represents a new option for academic medical centers around the country as they respond to the rapid changes in the health-care environment. PMID:10162016

  1. Strom Thurmond Biomedical Research Center at the Medical Univesity for South Carolina Charleston, South Carolina

    SciTech Connect

    Not Available

    1994-02-01

    The Department of Energy (DOE) has prepared an Environmental Assessment (EA) evaluating the proposed construction and operation of the Strom Thurmond Biomedical Research Center (Center) at the Medical University of South Carolina (MUSC), Charleston, SC. The DOE is evaluating a grant proposal to authorize the MUSC to construct, equip and operate the lower two floors of the proposed nine-story Center as an expansion of on-going clinical research and out-patient diagnostic activities of the Cardiology Division of the existing Gazes Cardiac Research Institute. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major federal action significantly affecting the quality of the human environment within the meaning of the NEPA. Therefore, the preparation of an Environmental Impact Statement is not required.

  2. Training Tomorrow's Doctors: The Medical Education Mission of Academic Health Centers. A Report of the Commonwealth Fund Task Force on Academic Health Centers.

    ERIC Educational Resources Information Center

    Commonwealth Fund, New York, NY.

    This report, fifth of a series on Academic Health Centers (AHCs), addresses the fundamental rationale of such centers: the education of the health care workforce. None of the missions of the 125 AHCs in the United States, medical schools and their closely affiliated hospitals and physician groups, is more important than the education of…

  3. Administration, Best Practices, and Evaluation of the National Weather Center REU Program

    NASA Astrophysics Data System (ADS)

    Zaras, D. S.; Gonzalez-Espada, W.

    2005-12-01

    The National Weather Center Research Experiences for Undergraduates program in Norman, Oklahoma, is a unique undergraduate career exploration experience, drawing upon the resources available in the National Weather Center's (NWC) state, federal, and university groups. This program takes full advantage of our location by including a wide variety of professionals from throughout the NWC community as mentors and contributors of lectures, workshops, tours, field trips, and job shadow experiences to expose the students to a broad spectrum of research topics and careers in meteorology. Students actively practice good research methodology by being paired with mentors who are productive researchers. The program aims to provide a strong and transformative educational experience that models the life of a scientist. This presentation will include a brief overview of program administration, analysis of applicant characteristics, "best practices" learned since 2001, and new additions to the NWC program funded through a 2-Year Extension for Special Creativity. The presentation will conclude with a brief evaluation of how well the program meets its goals of helping students clarify graduate school and career plans, and build self-efficacy regarding their potential for a career in scientific research.

  4. Contribution of the National Aeronautics and Space Administration Langley Research Center

    NASA Technical Reports Server (NTRS)

    Compton, W. B., III; Runckel, J. F.

    1975-01-01

    As part of a special international effort, three nozzles were designed and tested on single nacelle models in wind tunnels of several nations belonging to the North Atlantic Treaty Organization. All three of these nozzles were investigated in the Langley 16-foot transonic wind tunnel at the National Aeronautics and Space Administration's Langley Research Center. Langley Research Center also contributed theoretical calculations of the jet plume boundary and afterbody pressures. The calculations were obtained using an iterative solution which combined the inviscid Douglas Neumann method for the external flow with the method of characteristics for the flow in the jet plume. For the investigation, the nozzles were mounted on a single nacelle model 15.24 centimeters in diameter and 162.56 centimeters long. Tests were made at free stream Mach number from 0.4 to 1.2, and at Reynolds numbers per meter from 7.38 million to 13.78 million depending on the Mach number. Four types of data were recorded: afterbody pressure data, afterbody force data, model boundary layer data, and tunnel wall pressure data. The ratio of jet total pressure to free stream static pressure ranged up to 8.5. A description of the wind tunnel, model, and test procedure is included.

  5. Contingency Operations Support to NASA Johnson Space Center Medical Operations Division

    NASA Technical Reports Server (NTRS)

    Stepaniak, Philip; Patlach, Bob; Swann, Mark; Adams, Adrien

    2005-01-01

    The Wyle Laboratories Contingency Operations Group provides support to the NASA Johnson Space Center (JSC) Medical Operations Division in the event of a space flight vehicle accident or JSC mishap. Support includes development of Emergency Medical System (EMS) requirements, procedures, training briefings and real-time support of mishap investigations. The Contingency Operations Group is compliant with NASA documentation that provides guidance in these areas and maintains contact with the United States Department of Defense (DOD) to remain current on military plans to support NASA. The contingency group also participates in Space Operations Medical Support Training Courses (SOMSTC) and represents the NASA JSC Medical Operations Division at contingency exercises conducted worldwide by the DOD or NASA. The events of September 11, 2001 have changed how this country prepares and protects itself from possible terrorist attacks on high-profile targets. As a result, JSC is now considered a high-profile target and thus, must prepare for and develop a response to a Weapons of Mass Destruction (WMD) incident. The Wyle Laboratories Contingency Operations Group supports this plan, specifically the medical response, by providing expertise and manpower.

  6. Multimedia-based courseware in the Virtual Learning Center at the Hannover Medical School.

    PubMed

    Matthies, H K; von Jan, U; Porth, A J; Tatagiba, M; Stan, A C; Walter, G F

    2000-01-01

    The commercial use of the World Wide Web causes an extensive change in information technology. Web browser are becoming the universal front-end for all kinds of client-server applications. The possibilities of telematics offer a base for multimedia applications, for instance telelearning. Learning is not limited by geography and does not cause pressure of time by the user. The development of such multimedia information and communication systems demands cooperative working teams of authors, who are able to master several areas of medical knowledge as well as the presentation of these using different multimedia facilities. A very important part of graphic design in the context of multimedia applications is the creation and interactive use of images (still, moving). The growth and the complexity of medical knowledge as well as the need for continuous, fast, and economically feasible maintenance impose requirements on the media used for medical education and training. Web-based courseware in the Virtual Learning Center at the Hannover Medical School is an innovative education resource for medical students and professionals. PMID:11187611

  7. [Bioethics in medical institutions--new custom or help? The example of clinical ethics consultation at a University Medical Center].

    PubMed

    Richter, G

    2014-08-01

    Although ethics committees are well established in the medical sciences for human clinical trials, animal research and scientific integrity, the development of clinical ethics in German hospitals started much later during the first decade of the twenty-first century. Clinical ethics consultation should be pragmatic and problem-centered and can be defined as an ethically qualified and informed conflict management within a given legal framework to deal with and resolve value-driven, normative problems in the care of patients. Clinical ethics consultations enable shared clinical decision-making of all parties (e.g. clinicians, patients, family and surrogates) involved in a particular patient's care. The clinical ethicist does not act as an ethics expert by making independent recommendations or decisions; therefore, the focus is different from other medical consultants. Ethics consultation was first established by healthcare ethics committees (HEC) or clinical ethics consultation (CEC) groups which were called in to respond to an ethically problematic situation. To avoid ethical dilemmas or crises and to act preventively with regard to ethical issues in individual patients, an ethics liaison service is an additional option to ethics case consultations which take place on a regular basis by scheduled ethics rounds during the normal ward rounds. The presence of the ethicist offers some unique advantages: it allows early recognition of even minor ethical problems and accommodates the dynamics of ethical and clinical goal-setting in the course of patient care. Most importantly, regular and non-authoritative participation of the ethicist in normal ward rounds allows continuous ethical education of the staff within the everyday clinical routine. By facilitating clinical ethical decision-making, the ethicist seeks to empower physicians and medical staff to deal appropriately with ethical problems by themselves. Because of this proactive approach, the ethics liaison service

  8. How Strong Is the Primary Care Safety Net? Assessing the Ability of Federally Qualified Health Centers to Serve as Patient-Centered Medical Homes.

    PubMed

    Ryan, Jamie; Riley, Pamela; Abrams, Melinda; Nocon, Robert

    2015-09-01

    By expanding access to affordable insurance coverage for millions of Americans, the Affordable Care Act will likely increase demand for the services provided by federally qualified health centers (FQHCs), which provide an important source of care in low-income communities. A pair of Commonwealth Fund surveys asked health center leaders about their ability to function as medical homes. Survey findings show that between 2009 and 2013, the percentage of centers exhibiting medium or high levels of medical home capability almost doubled, from 32 percent to 62 percent. The greatest improvement was reported in patient tracking and care management. Despite this increased capability, health centers reported diminished ability to coordinate care with providers outside of the practice, particularly specialists. Ongoing federal funding and technical support for medical home transformation will be needed to ensure that FQHCs can fulfill their mission of providing high-quality, comprehensive care to low-income and minority populations. PMID:26372972

  9. The empires strike back. Broken promises: Columbia-Presbyterian Medical Center. Ignoring the community's needs: St. Luke's-Roosevelt Hospital Center.

    PubMed

    Neal, R

    1990-01-01

    In the fall of 1985 in an issue titled "Fighting Back Against the Empires" (Vol. 16, No. 5), Health/PAC reported on the plans of four of New York City's academic medical center "empires" for major expansion. The focus of our coverage was the efforts of two of the communities served by these institutions to ensure that the plans were responsive to their needs. At the time, we were cautiously optimistic that these events were signs that "although the empires still dominate New York City's health care system, they no longer rule unchallenged." In the past six months, the plans of two of these institutions, Columbia-Presbyterian Medical Center and St. Luke's-Roosevelt Hospital Center, warrant another look at the success of the efforts to hold the major medical centers responsible for the welfare of the communities in which they are located. PMID:10104819

  10. A comparison of comorbidities obtained from hospital administrative data and medical charts in older patients with pneumonia

    PubMed Central

    2011-01-01

    Background The use of comorbidities in risk adjustment for health outcomes research is frequently necessary to explain some of the observed variations. Medical charts reviews to obtain information on comorbidities is laborious. Increasingly, electronic health care databases have provided an alternative for health services researchers to obtain comorbidity information. However, the rates obtained from databases may be either over- or under-reported. This study aims to (a) quantify the agreement between administrative data and medical charts review across a set of comorbidities; and (b) examine the factors associated with under- or over-reporting of comorbidities by administrative data. Methods This is a retrospective cross-sectional study of patients aged 55 years and above, hospitalized for pneumonia at 3 acute care hospitals. Information on comorbidities were obtained from an electronic administrative database and compared with information from medical charts review. Logistic regression was performed to identify factors that were associated with under- or over-reporting of comorbidities by administrative data. Results The prevalence of almost all comorbidities obtained from administrative data was lower than that obtained from medical charts review. Agreement between comorbidities obtained from medical charts and administrative data ranged from poor to very strong (kappa 0.01 to 0.78). Factors associated with over-reporting of comorbidities were increased length of hospital stay, disease severity, and death in hospital. In contrast, those associated with under-reporting were number of comorbidities, age, and hospital admission in the previous 90 days. Conclusions The validity of using secondary diagnoses from administrative data as an alternative to medical charts for identification of comorbidities varies with the specific condition in question, and is influenced by factors such as age, number of comorbidities, hospital admission in the previous 90 days, severity

  11. Aprepitant and Fosaprepitant Use in Children and Adolescents at an Academic Medical Center

    PubMed Central

    Biondo, Lisa

    2014-01-01

    OBJECTIVE: To describe the use of aprepitant and fosaprepitant, a neurokinin 1 (NK-1) receptor inhibitor, in children and adolescents at a large academic medical center, for the prevention and management of chemotherapy-induced nausea and vomiting (CINV). METHODS: A retrospective chart review was conducted using an electronic medical record system to evaluate the use of aprepitant and fosaprepitant in all pediatric patients that were discharged from a single academic medical center between February 25, 2009 and May 25, 2012. RESULTS: Twenty-six patients were included in this review and received a total of 287 doses over the span of 114 cycles. Mean age was 10.1 years, with a range of 11 months to 17 years old. In 16 of 26 patients, aprepitant was used as the primary prophylaxis. Of those patients who received primary prophylaxis, 6 of 16 received it for highly emetogenic chemotherapy, and 10 of 16 received it for moderately emetogenic chemotherapy. Intravenous fosaprepitant was used in 7 of 26 patients, ages 13 to 17 (median 14) years old. No adverse effects attributable to aprepitant were reported. CONCLUSIONS: Use of aprepitant and fosaprepitant in pediatric patients appeared to be well tolerated. No currently published reports data using aprepitant in a patient younger than 32 months old, whereas we reported its use in patients as young as 11 months old. PMID:25024673

  12. Finding Common Ground: Interprofessional Collaborative Practice Competencies in Patient-Centered Medical Homes.

    PubMed

    Swihart, Diana

    2016-01-01

    The patient-centered medical home model is predicated on interprofessional collaborative practice and team-based care. While information on the roles of various providers is increasingly woven into the literature, the competencies of those providers have been generally profession-specific. In 2011, the Interprofessional Education Collaborative comprising the American Association of Colleges of Nursing, the American Association of Colleges of Osteopathic Medicine, the American Association of Colleges of Pharmacy, the American Dental Education Association, the Association of American Medical Colleges, and the Association of Schools of Public Health sponsored an expert panel of their members to identify and develop 4 domains of core competencies needed for a successful interprofessional collaborative practice: (1) Values/Ethics for Interprofessional Practice; (2) Roles/Responsibilities; (3) Interprofessional Communication; and (4) Teams and Teamwork. Their findings and recommendations were recorded in their Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. This article explores these 4 domains and how they provide common ground for team-based care within the context of the medical home model approach to patient-centered primary care. PMID:26938181

  13. THE ROLE OF OBSERVATION AND FEEDBACK IN ENHANCING PERFORMANCE WITH MEDICATION ADMINISTRATION.

    PubMed

    Davies, Karen; Mitchell, Charles; Coombes, Ian

    2015-12-01

    Legislation in Queensland such as the Health (Drugs and Poisons) Regulation 1996, the national registration competency standards set by the Nursing and Midwifery Board of Australia, and the Continuing Professional Development Registration Standards made pursuant to the Health Practitioner Regulation National Law define expected standards of practice for nurses. The Framework for Assessing Standards for Practice for Registered Nurses, Enrolled Nurses and Midwives, released in July 2015, includes the principles for assessing standards but not the methods. Local policies and procedures offer specific requirements founded on evidence-based practice. Observation of clinical practice with the provision of immediate descriptive feedback to individual practitioners has been associated with improved performance. This column describes the role of regular observation and individual feedback on medication administration as a strategy to enhance performance and patient care. PMID:26939498

  14. An experience of liver transplantation in Latin America: a medical center in Colombia

    PubMed Central

    Londoño, Mauricio; Marín, Juan; Muñoz, Octavio; Mena, Álvaro; Guzmán, Carlos; Hoyos, Sergio; Restrepo, Juan; Arbeláez, María; Correa, Gonzalo

    2015-01-01

    Objectives: Liver transplantation is the treatment of choice for acute and chronic liver failure, for selected cases of tumors, and for conditions resulting from errors in metabolism. This paper reports the experience of a medical center in Latin America. Methods: Were conducted 305 orthotopic liver transplantations on 284 patients between 2004 and 2010. Of these patients, 241 were adults undergoing their first transplantation. Results: The average age of patients was 52 years old, and 62% of the individuals were male. The most common indication was alcoholic cirrhosis. The rate of patient survival after 1 and 5 years was 82 and 72% respectively. The rate of liver graft survival after 1 and 5 years was 78 and 68% respectively. The main cause of death was sepsis. Complications in the hepatic artery were documented for 5% of the patients. Additionally, 14.5% of the patients had complications in the biliary tract. Infections were found in 41% of the individuals. Acute rejection was observed in 30% of the subjects, and chronic rejection in 3%. Conclusion: In conclusion, liver transplantation at our medical center in Colombia offers good mid-term results, with a complication rate similar to that reported by other centers around the world. PMID:26019379

  15. Recognition as a Patient-Centered Medical Home: Fundamental or Incidental?

    PubMed Central

    Dohan, Daniel; McCuistion, Mary Honodel; Frosch, Dominick L.; Hung, Dorothy Y.; Tai-Seale, Ming

    2013-01-01

    PURPOSE Little is known about reasons why a medical group would seek recognition as a patient-centered medical home (PCMH). We examined the motivations for seeking recognition in one group and assessed why the group allowed recognition to lapse 3 years later. METHODS As part of a larger mixed methods case study, we conducted 38 key informant interviews with executives, clinicians, and front-line staff. Interviews were conducted according to a guide that evolved during the project and were audio-recorded and fully transcribed. Transcripts were analyzed and thematically coded. RESULTS PCMH principles were consistent with the organization’s culture and mission, which valued innovation and putting patients first. Motivations for implementing specific PCMH components varied; some components were seen as part of the organization’s patient-centered culture, whereas others helped the practice compete in its local market. Informants consistently reported that National Committee for Quality Assurance recognition arose incidentally because of a 1-time incentive from a local group of large employers and because the organization decided to allocate some organizational resources to respond to the complex reporting requirements for about one-half of its clinics. CONCLUSIONS Becoming patient centered and seeking recognition as such ran along separate but parallel tracks within this organization. As the Affordable Care Act continues to focus attention on primary care redesign, this apparent disconnect should be borne in mind. PMID:23690381

  16. Energy survey of Eisenhower Army Medical Center, Fort Gordon, Augusta, Georgia. Volume 2. Appendices. Final report

    SciTech Connect

    1996-12-23

    1.1 Perform a complete energy audit of the entire Army Medical Center`s (AMC) heating and cooling systems, lighting system, and other systems and areas as indicated in Annex A. 1.2 Perform a comprehensive analysis of all data collected during the audit. 1.3 Identify all Energy Conservation Opportunities (ECO`s) including low cost/no cost ECO`s and perform complete evaluations of each. Energy equipment replacement projects already underway, approved, or planned by the Medical Center staff will be factored into the evaluations. 1.4 Prepare programming documentation for all Federal Energy Management Program (FEMP) and/or Energy Conservation Improvement Program (ECIP) projects. 1.5 Prepare implementation documentation and instructions for those projects recommended for accomplishment by local forces. 1.6 List and prioritize all recommended ECO`s. 1.7 Prepare a comprehensive report which will docwnent the work accomplished, the results of the field investigation and engineering analysis, the conclusions, and recommendations.

  17. Total Cost of Care Lower among Medicare Fee-for-Service Beneficiaries Receiving Care from Patient-Centered Medical Homes

    PubMed Central

    van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W

    2015-01-01

    Objective To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Data Sources Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. Study Design This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008–June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Data Collection Methods Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Principal Findings Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. Conclusions This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. PMID:25077375

  18. Ninety-day readmissions after degenerative cervical spine surgery: A single-center administrative database study

    PubMed Central

    Akamnonu, Chibuikem; Goldstein, Jeffrey A.; Errico, Thomas J.; Bendo, John A.

    2015-01-01

    Background Unplanned hospital readmissions result in significant clinical and financial burdens to patients and the healthcare system. Readmission rates and causes have been investigated using large administrative databases which have certain limitations in data reporting and coding. The objective of this study was to provide a description of 90 day post-discharge readmissions following surgery for common degenerative cervical spine pathologies at a large-volume tertiary hospital. The study also compared the readmission rates of patients who underwent anterior- and posterior-approach procedures. Methods The administrative records from a single-center, high-volume tertiary institution were queried using ICD-9 codes for common cervical pathology over a three year period to determine the rate and causes of readmissions within the 90 days following the index surgery. Results A total of 768 patients underwent degenerative cervical spine surgery during the three year study period. Within 90 days of discharge, 24 (3.13%) patients were readmitted; 16 (2.06%) readmissions were planned for lumbar surgery; 8 (1.04%) readmissions were unplanned. 640 patients underwent procedures involving an anterior approach and 128 patients underwent procedures involving a posterior approach. There were 14 (2.17%) planned readmissions in the anterior group and 2 (1.5%) in the posterior group. The unplanned readmission rate was 0.63% (4 patients) and 3.13% (4 patients) in the anterior and posterior groups, respectively. (p=0.0343). Conclusion The 90 day post-discharge unplanned readmission rate that followed elective degenerative cervical spine surgery was 1.04%. The unplanned readmission rate associated with posterior-approach procedures (3.13%) was significantly higher than that of anterior-approach procedures (0.63%). Level of evidence: IV PMID:26114088

  19. The tele-interpreter service at the Bangkok Hospital Medical Center, Thailand.

    PubMed

    Jaroensawat, Boonthida; Wankijcharoen, Somsak

    2013-01-01

    Thailand has become one of the most famous medical hub countries, which is reflected in the increasing number of international patients visiting the Bangkok Hospital Medical Center (BMC). In response, the Interpreter Department at BMC has been established to provide translation for non-English speaking patients. Overtime the Interpreter Department frequently reaches maximum capacity when providing prompt services on demand, resulting in long waiting times and delayed medical treatment. BMC has foreseen the necessity to implement a tele-interpreter system via videoconferencing technology to provide effective translations in the medical environment where delay is usually not tolerated. Tele-interpretation allows doctors to simply select a language icon on their Wi-Fi IP telephone to instantly connect to an interpreter. After implementation in 2oo9, the overall customer satisfaction index for the Interpreter Department increased from 64.5% in Quarter 1 to 85.5% in Quarter 3 of 2011. The tele-interpretation system is currently the closest approximation to the face-to-face interpretation method. PMID:24228346

  20. Effectiveness of a modified administration protocol for the medical treatment of canine pyometra.

    PubMed

    Contri, Alberto; Gloria, Alessia; Carluccio, Augusto; Pantaleo, Stefania; Robbe, Domenico

    2015-03-01

    Pyometra is one of the most common diseases in intact bitches. The aim of this study was to evaluate the effectiveness of a modified aglepristone protocol for the medical treatment of pyometra in the bitch. Of these, 73 bitches affected by pyometra of different breeds and age (2-14 years old) were enrolled. They were randomly assigned to a control group (CTG - 26 bitches) treated with classical protocol (aglepristone at 0, 1 and 6 days - day 0 = day of the diagnosis) and a modified treated group (MTG - 47 bitches) treated with a different administration protocol (aglepristone at 0, 2, 5 and 8 days). The classical protocol with the anti-progestagen aglepristone was effective in 88.5 % (23/26) of CTG bitches while the modified protocol was effective in all (47/47) of MTG bitches. One of the 23 CTG bitches received a further administration on day 14, which resolved the pyometra, while in the three cases of CTG bitches, in which the treatment was ineffective, an ovariohysterectomy was carried out. The modified protocol showed a success rate of 100 %, compared with the classical protocol proposed in the literature, and no recurrence of the disease was recorded in the 24 months follow up. After treatment, the oestrus onset was earlier than expected (interoestrus of 128 ± 32 days). In this study, the modified treatment protocol showed high efficacy and lack of recurrence within 24 months, suggesting a complete recovery of reproductive function in the bitch, with a normal fertility. PMID:25323020

  1. Helicopter emergency medical services crew administration of antibiotics for open fractures.

    PubMed

    Thomas, Stephen H; Arthur, Annette O; Howard, Zoe; Shear, Melissa L; Kadzielski, John L; Vrahas, Mark S

    2013-01-01

    This study had 3 major aims: (1) to ascertain the degree to which helicopter emergency medical services (HEMS) administration of antibiotics (Abx) can streamline the time to Abx in open fracture patients, (2) to determine whether any clinical outcome improvements were associated with HEMS Abx therapy, and (3) to calculate the cost-effectiveness of prehospital HEMS Abx. The design of the study was a prospective, nonrandomized, nonintervention, natural study of timing and clinical outcomes for patients with suspected open extremity fracture. There were 138 scene trauma cases transported by 8 participating HEMS programs from July 2009 to June 2010. The participating HEMS programs were both urban and rural. The diagnosis of an open fracture by the HEMS crews had an accuracy rate of 97.8% (95% confidence interval, 90.8%-98.4%). The time from the incident to Abx was 30 minutes shorter (P = .0001) when Abx were administered by HEMS crews. There was no statistical significance (P = 1.0) regarding the endpoint of infection or nonunion development in HEMS- versus hospital-administered Abx. In conclusion, the administration of Abx by HEMS crews to patients diagnosed with open extremity fractures is feasible, it may decrease the time to Abx by 30 minutes, and the effect magnitude (40.3% relative risk reduction) was promising. PMID:23452364

  2. Changing environment and the academic medical center: the Johns Hopkins Hospital.

    PubMed

    Heyssel, R M

    1989-01-01

    Academic medical centers need strong patient bases and strong financial bases to educate and to support research. After careful delineation of its mission with regard to patient care, research, and education, the Johns Hopkins Hospital expanded its health care delivery capabilities and strengthened its position in the health care marketplace by acquisitions of and mergers with other hospitals and a health maintenance organization in the Baltimore area. The resulting conglomerate, operating under the direction of a holding company, the Johns Hopkins Health System, has achieved its goals of expanding patient care capabilities, broadening the patient base, and enlarging the asset base and cash flow. Half the medical residents at the Johns Hopkins School of Medicine receive training at nontraditional sites, and further expansion of teaching activities is being explored. Potential roles of traditional and nontraditional teachers in these activities are discussed. PMID:2914070

  3. Socioeconomic disparities in lung cancer treatment and outcome persist within a single academic medical center

    PubMed Central

    Yorio, Jeffrey T.; Yan, Jingsheng; Xie, Yang; Gerber, David E.

    2012-01-01

    Background Socioeconomic disparities in treatment and outcomes of non-small cell lung cancer (NSCLC) are well established. To explore whether these differences are secondary to individual or institutional characteristics, we examined treatment selection and outcome in a diverse population treated at a single medical center. Patient and Methods We performed a retrospective analysis of consecutive patients diagnosed with NSCLC stages I-III from 2000-2005 at the University of Texas Southwestern Medical Center. Treatment selection was dichotomized as “standard” (surgery for stage I-II; surgery and/or radiation therapy for stage III) or “other.” Associations between patient characteristics (including socioeconomic status) and treatment selection were examined using logistic regression; associations between characteristics and overall survival were examined using Cox regression models and Kaplan-Meier survival analysis. Results A total of 450 patients were included. Twenty-eight percent of patients had private insurance, 43% had Medicare, and 29% had an indigent care plan. The likelihood of receiving “standard” therapy was significantly associated with insurance type [indigent plan versus private insurance OR 0.13 (95% CI 0.04-0.43) for stage I-II; OR 0.38 (95% CI 0.14-1.00) for stage III]. For patients with stage I-II NSCLC, survival was associated with age, gender, insurance type (indigent plan versus private insurance HR 1.98; 95% CI 1.16-3.37), stage, and treatment selection. In stage III NSCLC, survival was associated with treatment selection. Conclusion Within a single academic medical center, socioeconomically disadvantaged patients with stage I-III NSCLC are less likely to receive “standard” therapy. Socioeconomically disadvantaged patients with stage I-II NSCLC have inferior survival independent of therapy. PMID:22512997

  4. Health IT–Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians

    PubMed Central

    Morton, Suzanne; Shih, Sarah C.; Winther, Chloe H.; Tinoco, Aldo; Kessler, Rodger S.; Scholle, Sarah Hudson

    2015-01-01

    PURPOSE Health information technology (IT) offers promising tools for improving care coordination. We assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards. METHODS We surveyed physician-owned and hospital/health system–affiliated primary care practices that achieved patient-centered medical home recognition and participated in the Meaningful Use program, and community health clinics with patient-centered medical home recognition (most with certified electronic health record systems). The response rate was 35.1%. We ascertained whether practices had implemented proposed objectives and perceptions of their importance. We analyzed the association of organizational and contextual factors with self-reported use of health IT to support care coordination activities. RESULTS Although 78% of the 350 respondents viewed timely notification of hospital discharges as very important, only 48.7% used health IT systems to accomplish this task. The activity most frequently supported by health IT was providing clinical summaries to patients, in 76.6% of practices; however, merely 47.7% considered this activity very important. Greater use of health IT to support care coordination activities was positively associated with the presence of a nonclinician responsible for care coordination and the practice’s capacity for systematic change. CONCLUSIONS Even among practices having a strong commitment to the medical home model, the use of health IT to support care coordination objectives is not consistent. Health IT capabilities are not currently aligned with clinicians’ priorities. Many practices will need financial and technical assistance for health IT to enhance care coordination. PMID:25964403

  5. 38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and...

  6. 38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and...

  7. 38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and...

  8. 38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and...

  9. 38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and...

  10. Administration of Computer Resources.

    ERIC Educational Resources Information Center

    Franklin, Gene F.

    Computing at Stanford University has, until recently, been performed at one of five facilities. The Stanford hospital operates an IBM 370/135 mainly for administrative use. The university business office has an IBM 370/145 for its administrative needs and support of the medical clinic. Under the supervision of the Stanford Computation Center are…

  11. mHealth tools for the pediatric patient-centered medical home.

    PubMed

    Slaper, Michael R; Conkol, Kimberly

    2014-02-01

    The concept of the pediatric patient-centered medical home (PCMH) as a theory has been evolving since it was initially conceived more than 40 years ago. When the American Academy of Pediatrics' (AAP) Council on Pediatric Practice first wrote about this model, "medical home" was defined solely as the central location of a pediatric patient's medical records. Approximately two decades later, the AAP published its inaugural policy statement on this topic. Through this policy statement, the medical home was defined as a place where care for pediatric patients would be accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. Although the lack of access to providers, especially in rural communities, may inhibit the adoption of the PCMH or chronic care models, technology has evolved to the point where many of the gaps in care can be bridged. mHealth, defined by the National Institutes of Health (NIH) as the use of mobile and wireless devices to improve health outcomes, health care services, and health research, can be one specific example of how technology can address these issues. One early study has shown that patients who use mHealth tools are more likely to adhere to self-monitoring requirements and, in turn, have significantly improved outcomes. A rapidly evolving and scalable mHealth technology that has the ability to address these issues are self-management mobile applications, or apps. It has been estimated that there are currently more than 40,000 health care-related apps available. Furthermore, use of these apps is growing, as more than 50% of smartphone users surveyed responded that they have used their device to gather health information, and almost 20% of this population has at least one health care app on their device. PMID:24512160

  12. Primary care program improves reimbursement. The Federally Qualified Health Center program helps hospitals improve services to the medically indigent.

    PubMed

    Fahey, T M; Gallitano, D G

    1993-03-01

    Under a program created by Congress in 1989, certain primary care treatment centers serving the medically and economically indigent can become Federally Qualified Health Centers (FQHCs). Recently enacted rules and regulations allow participants in the FQHC program to receive 100 percent reasonable cost reimbursement for Medicaid services and 80 percent for Medicare services. An all-inclusive annual cost report is the basis for determining reimbursement rates. The report factors in such expenses as physician and other healthcare and professional salaries and benefits, medical supplies, certain equipment depreciation, and overhead for facility and administrative costs. Both Medicaid and Medicare reimbursement is based on an encounter rate, and states employ various methodologies to determine the reimbursement level. In Illinois, for example, typical reimbursement for a qualified encounter ranges from $70 to $88. To obtain FQHC status, an organization must demonstrate community need, deliver the appropriate range of healthcare services, satisfy management and finance requirements, and function under a community-based governing board. In addition, an FQHC must provide primary healthcare by physicians and (where appropriate) midlevel practitioners; it must also offer its community diagnostic laboratory and x-ray services, preventive healthcare and dental care, case management, pharmacy services, and arrangements for emergency services. Because FQHCs must be freestanding facilities, establishing them can trigger a number of ancillary legal issues, such as those involved in forming a new corporation, complying with not-for-profit corporation regulations, applying for tax-exempt status, and applying for various property and sales tax exemptions. Hospitals that establish FQHCs must also be prepared to relinquish direct control over the delivery of primary care services. PMID:10124301

  13. A decade of offering a Healing Enhancement Program at an academic medical center.

    PubMed

    Cutshall, Susanne M; Rodgers, Nancy J; Dion, Liza J; Dreyer, Nikol E; Thomley, Barbara S; Do, Alexander; Wood, Christina; Pronk, Susan C; Bauer, Brent A

    2015-11-01

    An increased focus has been given to improving the patient experience in health care. This focus has included placing value in a patient-centric, holistic approach to patient care. In the past decade, the Healing Enhancement Program was developed at 1 large medical center to address this focus through implementation of such integrative medicine services as massage, acupuncture, and music therapy to holistically address the pain, anxiety, and tension that hospitalized patients often experience. We describe the development and growth of this program over the past decade. PMID:26573445

  14. Maternal mortality in the American University of Beirut Medical Center (AUBMC) 1971-1982.

    PubMed

    Mashini, I; Mroueh, A; Hadi, H

    1984-08-01

    Maternal deaths were reviewed at the American University of Beirut Medical Center (AUBMC) during an 11-year period, 1971-1982. There were 35,058 live births and 45 deaths making a maternal mortality rate of 128 per 100,000 live births. Hemorrhage, sepsis and toxemia were the main direct obstetric causes of death. The most important indirect causes were cerebrovascular accidents and heart disease. In this review, an analytic discussion of the direct and indirect causes of maternal death in Lebanon are presented and preventive measures are discussed. PMID:6152795

  15. Inventory management for cardiac catheterization labs: the Princeton-Baptist Medical Center experience.

    PubMed

    Long, T A

    1993-08-01

    Several issues must be considered for implementation in order to decrease inventories and make them more manageable. Physician consensus on products, strict vendor control by the department manager, setting and maintaining low par levels, inventorying stock daily, negotiating just-in-time deliveries, conservation-minded staff, and working in concert with central supply and materiel management personnel are steps that when employed correctly can lead to more manageable inventories in cardiac catheterization departments. If these steps are implemented, they will enhance the liquidity of the department and ultimately that of the medical center. PMID:10127553

  16. Multidisciplinary Teams and Obesity: Role of the Modern Patient-Centered Medical Home.

    PubMed

    Bernstein, Kevin M; Manning, Debra A; Julian, Regina M

    2016-03-01

    With the growing obesity epidemic, it is difficult for individual primary care providers to devote the time and effort necessary to achieve meaningful weight loss for significant numbers of patients. A variety of health care professionals provide value and evidence-based care that is effective in treating obesity and other preventable diseases. Multidisciplinary collaboration between primary care physicians and other trained health professionals within patient-centered medical homes offers an effective approach to sustainable behavioral treatment options for individuals who are obese or overweight. PMID:26896199

  17. Conjoined twins: three cases in one tertiary medical center and literature review.

    PubMed

    Kongling, L; Shi, X; Yao, Q

    2014-01-01

    Conjoined twins are so rare that most obstetricians will not be personally exposed to such cases during their professional lifetimes. The authors report three cases including one of dicephalic parapagus conjoined twins and two thoracopagus conjoined twins in the present tertiary medical center, and discuss the diagnosis and management details. They also review the incidence, embryological, diagnostic, obstetrical, and prognostic aspects of conjoined twins. Regular antenatal visits and serial ultrasound scanning are crucial for early diagnosis of conjoined twins, optimal obstetric management and perinatal preparation still remain challenging, and multidisciplinary cooperation is urgently needed. PMID:25864269

  18. Accelerating change: Fostering innovation in healthcare delivery at academic medical centers.

    PubMed

    Ostrovsky, Andrey; Barnett, Michael

    2014-03-01

    Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research. This paper proposes two initiatives to jumpstart disruptive innovation at AMCs: an institutional "innovation incubator" program and a clinician-innovator career track coupled with innovation training programs. PMID:26250082

  19. Cost outcomes of supplemental nurse staffing in a large medical center.

    PubMed

    Xue, Ying; Chappel, Andre R; Freund, Deborah A; Aiken, Linda H; Noyes, Katia

    2015-01-01

    Use of agency-employed supplemental nurses on nursing personnel costs was examined in 19 adult patient care units in a large academic medical center. Results indicated that the modest use of supplemental nurses was cost-efficient with regard to overall nursing personnel costs, but heavy reliance on supplemental nurses to meet staffing needs was not cost-efficient. In addition, there was no statistical difference in hourly personnel cost between the use of supplemental nurses and overtime worked by permanent nurses. PMID:25479239

  20. Prevalence of the microbiologic flora in contact lens wearers at the Puerto Rico Medical Center.

    PubMed

    Izquierdo, N; Díaz Mendoza, S; Townsend, W; Carro, J

    1991-03-01

    The prevalence of microbioogic flora was determined in a convenience sample of contact lens wearers at the Puerto Rico Medical Center, ophthalmology clinics obtaining cultures from the conjunctival fornices. Gram positive bacterial prevalence was 100% in the control group, as well as in rigid gas permeable lens wearers. In the soft contact lens group, gram positive bacterial prevalence was 94.7%. On the other hand prevalence of Gram negative bacteria is null in the soft contact lens wearer population, being only 2.5% in control group, and 45.5% for Rigid Gas Permeable wearers. These contact lens wearers were using different disinfection systems. PMID:1854385

  1. Spreading a patient-centered medical home redesign: a case study.

    PubMed

    Hsu, Clarissa; Coleman, Katie; Ross, Tyler R; Johnson, Eric; Fishman, Paul A; Larson, Eric B; Liss, David; Trescott, Claire; Reid, Robert J

    2012-01-01

    Health care leaders and policymakers are turning to the patient-centered medical home (PCMH) model to contain costs, improve the quality of care, and create a more positive primary care work environment. We describe how Group Health, an integrated delivery system, developed and implemented a PCMH intervention that included standardized structural and practice level changes. This intervention was spread to a diverse set of 26 primary care practices in 14 months using Lean Management principles. Group Health's experience provides valuable insights that can be used to improve the design and implementation of future PCMH models. PMID:22415283

  2. The Citizen Health System (CHS): a modular medical contact center providing quality telemedicine services.

    PubMed

    Maglaveras, Nicos; Chouvarda, Ioanna; Koutkias, Vassilis G; Gogou, George; Lekka, Irini; Goulis, Dimitrios; Avramidis, Avram; Karvounis, Charalambos; Louridas, George; Balas, E Andrew

    2005-09-01

    In the context of the Citizen Health System (CHS) project, a modular Medical Contact Center (MCC) was developed, which can be used in the monitoring, treatment, and management of chronically ill patients at home, such as diabetic or congestive heart failure patients. The virtue of the CHS contact center is that, using any type of communication and telematics technology, it is able to provide timely and preventive prompting to the patients, thus, achieving better disease management. In this paper, we present the structure of the CHS system, describing the modules that enable its flexible and extensible architecture. It is shown, through specific examples, how quality of healthcare delivery can be increased by using such a system. PMID:16167689

  3. Effectiveness of Diabetes Interventions in the Patient-Centered Medical Home

    PubMed Central

    Ackroyd, Sarah A.; Wexler, Deborah J.

    2014-01-01

    The patient-centered medical home (PCMH) is an innovative care model for the provision of primary care that is being rapidly adopted in the U.S. with the support of federal agencies and professional organizations. Its goal is to provide comprehensive, patient-centered care with increased access, quality, and efficiency. Diabetes, as a common, costly, chronic disease that requires ongoing management by patients and providers, is a condition that is frequently monitored as a test case in PCMH implementations. While in theory a PCMH care model that supports patient engagement and between-visit care may help improve diabetes care delivery and outcomes, the success of this approach may depend largely upon the specific strategies used and implementation approach. The cost-effectiveness of diabetes care in the PCMH model is not yet clear. Interventions have been most effective and most cost-effective for those with the poorest diabetes management at baseline. PMID:24477830

  4. Hurley Medical Center report makes fund-raising look like fun. Hackensack, CMH use styles suited to their donors.

    PubMed

    Botvin, J D

    2000-01-01

    Myriad elements go into making a great fund-raising publication. Judges singled out three reports with content and design clearly aimed at thanking supporters and stimulating the flow of contributions. They are: Hurley Medical Center, Grand Rapids, Mich., first place; Hackensack University Medical Center, Hackensack, N.J., second place; and Clinton Memorial Healthcare Regional Health System Foundation, Wilmington, Ohio, third place. PMID:11188143

  5. Clostridium difficile Infections in Medical Intensive Care Units of a Medical Center in Southern Taiwan: Variable Seasonality and Disease Severity

    PubMed Central

    Lin, Hsiao-Ju; Tsai, Pei-Jane; Ko, Wen-Chien

    2016-01-01

    Critical patients are susceptible to Clostridium difficile infections (CDIs), which cause significant morbidity and mortality in the hospital. In Taiwan, the epidemiology of CDI in intensive care units (ICUs) is not well understood. This study was aimed to describe the incidence and the characteristics of CDI in the ICUs of a medical center in southern Taiwan. Adult patients with diarrhea but without colostomy/colectomy or laxative use were enrolled. Stool samples were collected with or without 5 ml alcohol and were plated on cycloserine-cefoxitin-fructose agar. C. difficile identification was confirmed by polymerase chain reaction. There were 1,551 patients admitted to ICUs, 1,488 screened, and 145 with diarrhea. A total of 75 patients were excluded due either to laxative use, a lack of stool samples, or refusal. Overall, 70 patients were included, and 14 (20%) were diagnosed with CDI, with an incidence of 8.8 cases per 10,000 patient-days. The incidence of CDI was found to be highest in March 2013 and lowest in the last quarter of 2013. The cases were categorized as the following: 5 severe, complicated, 5 severe, and 4 mild or moderate diseases. Among the 14 cases of CDI, the median patient age was 74 (range: 47–94) years, and the median time from admission to diarrhea onset was 16.5 (4–53) days. Eight cases received antimicrobial treatment (primarily metronidazole), and the time to diarrheal resolution was 11.5 days. Though 6 cases were left untreated, no patients died of CDI. The in-hospital mortality of CDI cases was 50%, similar to that of patients without CDI (46.4%; P = 1.0). We concluded that the overall incidence of CDI in our medical ICUs was low and there were variable seasonal incidences and disease severities of CDI. PMID:27509051

  6. Health Maintenance Organizations and Academic Medical Centers. Proceedings of a National Conference (Colorado Springs, Colorado, October 1980).

    ERIC Educational Resources Information Center

    Hudson, James I., Ed.; Nevins, Madeline M., Ed.

    In October 1980 a national conference on health maintenance organizations (HMOs) and Academic Medical Centers (AMCs) was held by the Association of American Medical Colleges and supported by the Henry J. Kaiser Family Foundation, in response to inquiries about the advantages and disadvantages of AMC affiliation with or sponsorship of HMOs.…

  7. Use of an Electronic Medication Administration Record (eMAR) for Surveillance of Medication Omissions: Results of a One Year Study of Antimicrobials in the Inpatient Setting

    PubMed Central

    Dalton, Bruce R.; Sabuda, Deana M.; Bresee, Lauren C.; Conly, John M.

    2015-01-01

    Introduction Medication administration omissions (MAO) are usually considered medication errors but not all MAO are clinically relevant. We determined the frequency of clinically relevant MAO of antimicrobial drugs in adult hospitals in Calgary, Alberta, Canada based on electronic medication administration record (eMAR). Methods We examined 2011 data from eMAR records on medical wards and developed a reproducible assessment scheme to categorize and determine clinical relevance of MAO. We applied this scheme to records from 2012 in a retrospective cohort study to quantify clinically relevant MAO. Significant predictors of clinically relevant MAO were identified. Results A total of 294,718 dose records were assessed of which 10,282 (3.49%) were for doses not administered. Among these 4903 (1.66% of total); 47.68% of MAO were considered clinically relevant. Significant positive predictors of clinically relevant MAO included inhaled (OR 4.90, 95% CI 3.54-6.94) and liquid oral (OR 1.32, 95% CI 1.18-1.47) route of medication compared to solid oral and irregular dose schedules. Evening nursing shift compared to night shift (OR 0.77 95% CI 0.70-0.85) and parenteral (OR 0.50, 95% CI 0.46-0.54) were negative predictors, The commonest reasons for relevant MAO were patient preference, unspecified reason, administration access issues, drug not available or patient condition. Conclusion Assessment of MAO by review of computer records provides a greater scope and sample size than directly observed medication administration assessments without “observer” effect. We found that MAO of antimicrobials in inpatients were uncommon but were seen more frequently with orally administered antimicrobials which may have significance to antimicrobial stewardship initiatives. PMID:25856373

  8. Medical devices; gastroenterology-urology devices; nonimplanted, peripheral electrical continence device. Food and Drug Administration, HHS. Final rule.

    PubMed

    2000-04-01

    The Food and Drug Administration (FDA) is classifying the nonimplanted, peripheral electrical continence device into class II (special controls). The special controls that will apply to this device are set forth below. The agency is taking this action in response to a petition submitted under the Federal Food, Drug, and Cosmetic Act (the act) as amended by the Medical Device Amendments of 1976, the Safe Medical Devices Act of 1990, and the Food and Drug Administration Modernization Act of 1997. The agency is classifying this device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. PMID:11010624

  9. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

    PubMed

    Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John

    2015-01-01

    We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy. PMID:26230276

  10. Information technology leadership in academic medical centers: a tale of four cultures.

    PubMed

    Friedman, C P

    1999-07-01

    Persons and groups within academic medical centers bring consistent and predictable viewpoints to planning and decision making. The varied professional and academic cultures of these individuals appear to account primarily for the diversity of their viewpoints. Understanding these professional cultures can help leaders achieve some predictability in the complex environments for which they are responsible. Leaders in information technology in particular, in order to be successful, must become part-time anthropologists, immersing themselves in the varied workplaces of their constituents to understand the work they do and the cultures that have grown up around this work. Only in this way will they be able to manage the challenges that arise continuously as the technology and the needs it can address change over time. In this article, the author briefly describes the concept of culture, portrays four specific professional cultures that typically coexist in academic medical centers, and argues that understanding these cultures is absolutely critical to effective management and use of information resources. PMID:10429588

  11. Implementation of Single Source Based Hospital Information System for the Catholic Medical Center Affiliated Hospitals

    PubMed Central

    Choi, Inyoung; Choi, Ran; Lee, Jonghyun

    2010-01-01

    Objectives The objective of this research is to introduce the unique approach of the Catholic Medical Center (CMC) integrate network hospitals with organizational and technical methodologies adopted for seamless implementation. Methods The Catholic Medical Center has developed a new hospital information system to connect network hospitals and adopted new information technology architecture which uses single source for multiple distributed hospital systems. Results The hospital information system of the CMC was developed to integrate network hospitals adopting new system development principles; one source, one route and one management. This information architecture has reduced the cost for system development and operation, and has enhanced the efficiency of the management process. Conclusions Integrating network hospital through information system was not simple; it was much more complicated than single organization implementation. We are still looking for more efficient communication channel and decision making process, and also believe that our new system architecture will be able to improve CMC health care system and provide much better quality of health care service to patients and customers. PMID:21818432

  12. A comprehensive model to build improvement capability in a pediatric academic medical center.

    PubMed

    Kaminski, Gerry M; Schoettker, Pamela J; Alessandrini, Evaline A; Luzader, Carolyn; Kotagal, Uma

    2014-01-01

    Cincinnati Children's Hospital Medical Center developed a comprehensive model to build quality improvement (QI) capability to support its goal to transform its delivery system through a series of training courses. Two online modules orient staff to basic concepts and terminology and prepare them to participate more effectively in QI teams. The basic program (Rapid Cycle Improvement Collaborative, RCIC) is focused on developing the capability to use basic QI tools and complete a narrow-scoped project in approximately 120 days. The Intermediate Improvement Science Series (I(2)S(2)) program is a leadership course focusing on improvement skills and developing a broader and deeper understanding of QI in the context of the organization and external environment. The Advanced Improvement Methods (AIM) course and Quality Scholars Program stimulate the use of more sophisticated methods and prepare Cincinnati Children's Hospital Medical Center (CCHMC) and external faculty to undertake QI research. The Advanced Improvement Leadership Systems (AILS) sessions enable interprofessional care delivery system leadership teams to effectively lead a system of care, manage a portfolio of projects, and to deliver on CCHMC's strategic plan. Implementing these programs has shown us that 1) a multilevel curricular approach to building improvement capability is pragmatic and effective, 2) an interprofessional learning environment is critical to shifting mental models, 3) repetition of project experience with coaching and feedback solidifies critical skills, knowledge and behaviors, and 4) focusing first on developing capable interprofessional improvement leaders, versus engaging in broad general QI training across the whole organization, is effective. PMID:24369867

  13. Phased Implementation Of At&T PACS At Duke University Medical Center

    NASA Astrophysics Data System (ADS)

    Stockbridge, Chris; Ravin, Carl E.

    1986-01-01

    "Help me communicate more quickly and more effectively with referring clinicians". This request was the driving force behind the installation of the AT&T CommViewm System at Duke. The CommView System is a type of Digital Image Management System and Picture Archival Communication System whose chief purpose is to deliver interpreted diagnostic images to referring clinicians and attending physicians. The system acquires electronic images from modal-ities in a diagnostic imaging facility, stores these images in computer managed patient files and distributes these on demand over fiber optic cable to Display Consoles. The CommView System was designed at AT&T Bell Labs; it uses fiber optic ribbon cable between buildings fused to multistrand lightguide building cables to distribute images, typically around a medical center or campus at data transfer rates of 40 Mbps. This paper gives the rationale used in designing a start-up network and placing the initial equipment for a field trial of the AT&T CommView System in the Radiology Department of Duke University Medical Center.

  14. "Phased Implementation Of AT&T PACS At Duke University Medical Center"

    NASA Astrophysics Data System (ADS)

    Stockbridge, Chris; Ravin, Carl E.

    1986-06-01

    "Help me communicate more quickly and more effectively with referring clinicians". This request was the driving force behind the installation of the AT&T CommView System at Duke. The CommView System is a type of Digital Image Management System and Picture Archival Communication System whose chief purpose is to deliver interpreted diagnostic images to referring clinicians and attending physicians. The system acquires electronic images from modalities in a diagnostic imaging facility, stores these images in computer managed patient files and distributes these on demand over fiber optic cable to Display Consoles. The CommView System was designed at AT&T Bell Labs; it uses fiber optic ribbon cable between buildings fused to multistrand lightguide building cables to distribute images, typically around a medical center or campus at data transfer rates of 40 Mbps. This paper gives the rationale used in designing a start-up network and placing the initial equipment for a field trial of the AT&T CommView System in the Radiology Department of Duke University Medical Center.

  15. Patient-Centered Medical Home Adoption: Results From Aligning Forces For Quality.

    PubMed

    McHugh, Megan; Shi, Yunfeng; Ramsay, Patricia P; Harvey, Jillian B; Casalino, Lawrence P; Shortell, Stephen M; Alexander, Jeffrey A

    2016-01-01

    To improve health care quality within communities, increasing numbers of multistakeholder alliances-groups of payers, purchasers, providers, and consumers-have been created. We used data from two rounds (conducted in July 2007-March 2009 and January 2012-November 2013) of a large nationally representative survey of small and medium-size physician practices. We examined whether the adoption of patient-centered medical home processes spread more rapidly in fourteen Robert Wood Johnson Foundation Aligning Forces for Quality communities, where multistakeholder health care alliances promoted their use, than in other communities. We found no difference in the overall growth of adoption of the processes between the two types of communities. However, improvement on a care coordination subindex was 7.17 percentage points higher in Aligning Forces for Quality communities than in others. Despite the enthusiasm for quality improvement led by multistakeholder alliances, such alliances may not be a panacea for spreading patient-centered medical home processes across a community. PMID:26733712

  16. Health Information Security: A Case Study of Three Selected Medical Centers in Iran

    PubMed Central

    Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

    2013-01-01

    Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients’ electronic records and health information systems have become a source for hackers. Methods This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts’ points of view. Results and discussion Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of “verification and system design, user access management, access control system”, Al Zahra Hospital in two indicators of “access management and network access control” and Amin Hospital in “equipment safety and system design”. In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place. PMID:23572861

  17. Needs Assessment for Research Use of High-Throughput Sequencing at a Large Academic Medical Center.

    PubMed

    Geskin, Albert; Legowski, Elizabeth; Chakka, Anish; Chandran, Uma R; Barmada, M Michael; LaFramboise, William A; Berg, Jeremy; Jacobson, Rebecca S

    2015-01-01

    Next Generation Sequencing (NGS) methods are driving profound changes in biomedical research, with a growing impact on patient care. Many academic medical centers are evaluating potential models to prepare for the rapid increase in NGS information needs. This study sought to investigate (1) how and where sequencing data is generated and analyzed, (2) research objectives and goals for NGS, (3) workforce capacity and unmet needs, (4) storage capacity and unmet needs, (5) available and anticipated funding resources, and (6) future challenges. As a precursor to informed decision making at our institution, we undertook a systematic needs assessment of investigators using survey methods. We recruited 331 investigators from over 60 departments and divisions at the University of Pittsburgh Schools of Health Sciences and had 140 respondents, or a 42% response rate. Results suggest that both sequencing and analysis bottlenecks currently exist. Significant educational needs were identified, including both investigator-focused needs, such as selection of NGS methods suitable for specific research objectives, and program-focused needs, such as support for training an analytic workforce. The absence of centralized infrastructure was identified as an important institutional gap. Key principles for organizations managing this change were formulated based on the survey responses. This needs assessment provides an in-depth case study which may be useful to other academic medical centers as they identify and plan for future needs. PMID:26115441

  18. The role of the academic medical center library in training public librarians*†

    PubMed Central

    Wessel, Charles B.; Wozar, Jody A.; Epstein, Barbara A.

    2003-01-01

    Purpose: This project enhanced access to and awareness of health information resources on the part of public libraries in western Pennsylvania. Setting/Participants/Resources: The Health Sciences Library System (HSLS), University of Pittsburgh, conducted a needs assessment and offered a series of workshops to 298 public librarians. Brief Description: The National Library of Medicine–funded project “Access to Electronic Health Information” at the HSLS, University of Pittsburgh, provided Internet health information training to public libraries and librarians in sixteen counties in western Pennsylvania. Through this project, this academic medical center library identified the challenges for public librarians in providing health-related reference service, developed a training program to address those challenges, and evaluated the impact of this training on public librarians' ability to provide health information. Results/Outcome: The HSLS experience indicates academic medical center libraries can have a positive impact on their communities by providing health information instruction to public librarians. The success of this project—demonstrated by the number of participants, positive course evaluations, increased comfort level with health-related reference questions, and increased use of MEDLINEplus and other quality information resources—has been a catalyst for continuation of this programming, not only for public librarians but also for the public in general. Evaluation Method: A training needs assessment, course evaluation, and impact training survey were used in developing the curriculum and evaluating the impact of this training on public librarians' professional activities. PMID:12883558

  19. Needs Assessment for Research Use of High-Throughput Sequencing at a Large Academic Medical Center

    PubMed Central

    Geskin, Albert; Legowski, Elizabeth; Chakka, Anish; Chandran, Uma R; Barmada, M. Michael; LaFramboise, William A.; Berg, Jeremy; Jacobson, Rebecca S.

    2015-01-01

    Next Generation Sequencing (NGS) methods are driving profound changes in biomedical research, with a growing impact on patient care. Many academic medical centers are evaluating potential models to prepare for the rapid increase in NGS information needs. This study sought to investigate (1) how and where sequencing data is generated and analyzed, (2) research objectives and goals for NGS, (3) workforce capacity and unmet needs, (4) storage capacity and unmet needs, (5) available and anticipated funding resources, and (6) future challenges. As a precursor to informed decision making at our institution, we undertook a systematic needs assessment of investigators using survey methods. We recruited 331 investigators from over 60 departments and divisions at the University of Pittsburgh Schools of Health Sciences and had 140 respondents, or a 42% response rate. Results suggest that both sequencing and analysis bottlenecks currently exist. Significant educational needs were identified, including both investigator-focused needs, such as selection of NGS methods suitable for specific research objectives, and program-focused needs, such as support for training an analytic workforce. The absence of centralized infrastructure was identified as an important institutional gap. Key principles for organizations managing this change were formulated based on the survey responses. This needs assessment provides an in-depth case study which may be useful to other academic medical centers as they identify and plan for future needs. PMID:26115441

  20. Population Health and the Academic Medical Center: The Time Is Right

    PubMed Central

    Gourevitch, Marc N.

    2014-01-01

    Optimizing the health of populations, whether defined as persons receiving care from a healthcare delivery system or more broadly as persons in a region, is emerging as a core focus in the era of healthcare reform. To achieve this goal requires an approach in which preventive care is valued and “non-medical” determinants of patients’ health are engaged. For large multi-mission systems such as academic medical centers, navigating the evolution to a population-oriented paradigm across the domains of patient care, education, and research poses real challenges but also offers tremendous opportunities, as important objectives across each mission begin to align with external trends and incentives. In clinical care, opportunities exist to improve capacity for assuming risk, optimize community benefit, and make innovative use of advances in health information technology. Education must equip the next generation of leaders to understand and address population-level goals in addition to patient-level needs. And the prospects for research to define strategies for measuring and optimizing the health of populations have never been stronger. A remarkable convergence of trends has created compelling opportunities for academic medical centers to advance their core goals by endorsing and committing to advancing the health of populations. PMID:24556766

  1. Patient-centered medical home: how it affects psychosocial outcomes for diabetes.

    PubMed

    Jortberg, Bonnie T; Miller, Benjamin F; Gabbay, Robert A; Sparling, Kerri; Dickinson, W Perry

    2012-12-01

    Fragmentation of the current U.S. health care system and the increased prevalence of chronic diseases in the U.S. have led to the recognition that new models of care are needed. Chronic disease management, including diabetes, is often accompanied by a myriad of associated psychosocial issues that need to be addressed as part of a comprehensive treatment plan. Diabetes care should be aligned with comprehensive whole-person health care. The patient-centered medical home (PCMH) has emerged as a model for enhanced primary care that focuses on comprehensive integrated care. PCMH demonstration projects have shown improvements in quality of care, patient experience, care coordination, access to care, and quality measures for diabetes. Key PCMH transformative features associated with psychosocial issues related to diabetes reviewed in this article include integration of mental and behavioral health, care management/coordination, payment reform, advanced access, and putting the patient at the center of health care. This article also reviews the evidence supporting comprehensive and integrated care for addressing psychosocial issues associated with diabetes in the medical home. PMID:22961115

  2. A Problem Solving Curriculum for Active Learning at the Northwest Center for Medical Education, Indiana University School of Medicine.

    ERIC Educational Resources Information Center

    Iatridis, Panayotis G.

    An innovative curriculum called the "Regional Center Alternative Pathway," recently adopted by the Northwest Center for Medical Education (part of Indiana University's School of Medicine), is presented. The curriculum combines the traditional structure's didactic approach with a new problem-based tutorial curriculum. In this curriculum the…

  3. Providing Medical Information to College Health Center Personnel: A Circuit Librarian Service at the University of Illinois

    ERIC Educational Resources Information Center

    Stumpff, Julia C.

    2003-01-01

    College health center personnel are no different from other health practitioners in their need for medical information. To help meet this need, the McKinley Health Center, University of Illinois Urbana-Champaign, developed a partnership in 1997 with the Library of the Health Sciences-Urbana, a regional site library of the University of Illinois at…

  4. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    PubMed Central

    Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

    2015-01-01

    Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary. PMID:26268830

  5. Methods for Evaluating Practice Change Toward a Patient-Centered Medical Home

    PubMed Central

    Jaén, Carlos Roberto; Crabtree, Benjamin F.; Palmer, Raymond F.; Ferrer, Robert L.; Nutting, Paul A.; Miller, William L.; Stewart, Elizabeth E.; Wood, Robert; Davila, Marivel; Stange, Kurt C.

    2010-01-01

    PURPOSE Understanding the transformation of primary care practices to patient-centered medical homes (PCMHs) requires making sense of the change process, multilevel outcomes, and context. We describe the methods used to evaluate the country’s first national demonstration project of the PCMH concept, with an emphasis on the quantitative measures and lessons for multimethod evaluation approaches. METHODS The National Demonstration Project (NDP) was a group-randomized clinical trial of facilitated and self-directed implementation strategies for the PCMH. An independent evaluation team developed an integrated package of quantitative and qualitative methods to evaluate the process and outcomes of the NDP for practices and patients. Data were collected by an ethnographic analyst and a research nurse who visited each practice, and from multiple data sources including a medical record audit, patient and staff surveys, direct observation, interviews, and text review. Analyses aimed to provide real-time feedback to the NDP implementation team and lessons that would be transferable to the larger practice, policy, education, and research communities. RESULTS Real-time analyses and feedback appeared to be helpful to the facilitators. Medical record audits provided data on process-of-care outcomes. Patient surveys contributed important information about patient-rated primary care attributes and patient-centered outcomes. Clinician and staff surveys provided important practice experience and organizational data. Ethnographic observations supplied insights about the process of practice development. Most practices were not able to provide detailed financial information. CONCLUSIONS A multimethod approach is challenging, but feasible and vital to understanding the process and outcome of a practice development process. Additional longitudinal follow-up of NDP practices and their patients is needed. PMID:20530398

  6. Assessing patient experiences in the pediatric patient-centered medical home: a comparison of two instruments.

    PubMed

    Knapp, Caprice; Chakravorty, Shourjo; Madden, Vanessa; Baron-Lee, Jacqueline; Gubernick, Ruth; Kairys, Steven; Pelaez-Velez, Cristina; Sanders, Lee M; Thompson, Lindsay

    2014-11-01

    The Patient-Centered Medical Home (PCMH) is a model of care that has been promoted as a way to transform a broken primary care system in the US. However, in order to convince more practices to make the transformation and to properly reimburse practices who are PCMHs, valid and reliable data are needed. Data that capture patient experiences in a PCMH is valuable, but which instrument should be used remains unclear. Our study aims to compare the validity and reliability of two national PCMH instruments. Telephone surveys were conducted with children who receive care from 20 pediatric practices across Florida (n = 990). All of the children are eligible for Medicaid or the Children's Health Insurance Program. Analyses were conducted to compare the Consumer Assessment of Health Plan Survey-Patient-Centered Medical Home (CAHPS-PCMH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN) medical home domain. Respondents were mainly White non-Hispanic, female, under 35 years old, and from a two-parent household. The NS-CSHCN outperformed the CAHPS-PCMH in regard to scale reliability (Cronbach's alpha coefficients all ≥0.81 vs. 0.56-0.85, respectively). In regard to item-domain convergence and discriminant validity the CAHPS-PCMH fared better than the NS-CSHCN (range of convergence 0.66-0.93 vs. 0.32-1.00). The CAHPS-PCMH did not correspond to the scale structure in construct validity testing. Neither instrument performed well in the known-groups validity tests. No clear best instrument was determined. Further revision and calibration may be needed to accurately assess patient experiences in the PCMH. PMID:24585412

  7. Assessment of medical waste management at a primary health-care center in Sao Paulo, Brazil

    SciTech Connect

    Moreira, A.M.M.; Guenther, W.M.R.

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer Assessment of medical waste management at health-care center before/after intervention. Black-Right-Pointing-Pointer Qualitative and quantitative results of medical waste management plan are presented. Black-Right-Pointing-Pointer Adjustments to comply with regulation were adopted and reduction of waste was observed. Black-Right-Pointing-Pointer The method applied could be useful for similar establishments. - Abstract: According to the Brazilian law, implementation of a Medical Waste Management Plan (MWMP) in health-care units is mandatory, but as far as we know evaluation of such implementation has not taken place yet. The purpose of the present study is to evaluate the improvements deriving from the implementation of a MWMP in a Primary Health-care Center (PHC) located in the city of Sao Paulo, Brazil. The method proposed for evaluation compares the first situation prevailing at this PHC with the situation 1 year after implementation of the MWMP, thus allowing verification of the evolution of the PHC performance. For prior and post-diagnosis, the method was based on: (1) application of a tool (check list) which considered all legal requirements in force; (2) quantification of solid waste subdivided into three categories: infectious waste and sharp devices, recyclable materials and non-recyclable waste; and (3) identification of non-conformity practices. Lack of knowledge on the pertinent legislation by health workers has contributed to non-conformity instances. The legal requirements in force in Brazil today gave origin to a tool (check list) which was utilized in the management of medical waste at the health-care unit studied. This tool resulted into an adequate and simple instrument, required a low investment, allowed collecting data to feed indicators and also conquered the participation of the unit whole staff. Several non-conformities identified in the first diagnosis could be corrected by the instrument utilized

  8. How psoriasis patients perceive, obtain, and use biologic agents: Survey from an academic medical center.

    PubMed

    Kamangar, Faranak; Isip, Leah; Bhutani, Tina; Dennis, Madison; Heller, Misha M; Lee, Eric S; Nie, Hong; Liao, Wilson

    2013-02-01

    The availability of new biologic agents for the treatment of psoriasis provides hope for improved quality of life outcomes. However, the way patients come to use biologics, the potential barriers they encounter, and their attitudes towards using these medications are still not well studied. Here, we conducted a survey of 106 psoriasis patients at an academic medical center to discern patient attitudes towards biologics. We found that most patients learn of biologics through their physician and perform follow-up research using the Internet. Most patients did not find it difficult to make the decision to start a biologic. Difficulty in obtaining biologics was associated with age less than 55 (p = 0.01), lower income level (p = 0.007), and lack of insurance (p = 0.04). Patients were found to have high satisfaction and compliance rates on biologics. Of patients who missed a dose of their biologic, this was mainly due to logistical reasons such as not having the medication or forgetting to take it, rather than being depressed or overwhelmed. Patients with lower income levels had increased cut backs in personal expenses due to co-payments (p = 0.001). Among respondents, the mean annual out-of-pocket expense for a biologic was $557.12 per year, with a range of $0-7000. PMID:22007699

  9. Rancho Los Amigos Medical Center. A unique orthopaedic resource and teaching institution.

    PubMed

    Hsu, J D

    2000-05-01

    Rancho Los Amigos Medical Center, initially a poor farm in the County of Los Angeles, CA became a world renown medical institution because of the polio epidemics in the 1950s. Responding to the need for day to day inpatient care were an overflow of victims of polio who had spine and extremity weakness and were dependent on respirators. Team care, developed at the institution, was used by Vernon L. Nickel, chief orthopaedic surgeon so that maximum use of the limited staff's efforts would be to take care of patients. This need spawned many innovative developments through clinical observations and trials, basic research, and engineering innovations that resulted in the patient's functional improvement and helped return many victims of polio to independence and to their communities. Subsequently, orthopaedic surgeons, Jacquelin Perry, and Alice Garrett joined the full-time staff as the workload increased. Stabilizing the spine using fascial supports, spinal fusion, spinal instrumentation, orthoses, and seating systems allowed those patients who were not totally dependent on respirators to be upright and mobilized. When polio was eradicated, newer programs were established for physically disabled persons with musculoskeletal disorders affecting the spine and extremities and for those patients with congenital, acquired, neurologic, and neuromuscular disorders. In formal graduate residency affiliations, fellowships, and continuing medical education programs orthopaedic surgeons from around the world have been taught the basic principles of "categorical care" for physically disabled people for 50 years. Orthopaedic care given through these programs formed the basis of a new orthopaedic subspecialty, Orthopaedic Rehabilitation. PMID:10818973

  10. The patient-centered medical home in oncology: from concept to reality.

    PubMed

    Page, Ray D; Newcomer, Lee N; Sprandio, John D; McAneny, Barbara L

    2015-01-01

    In recent years, the cost of providing quality cancer care has been subject to an epic escalation causing concerns on the verge of a health care crisis. Innovative patient-management models in oncology based on patient-centered medical home (PCMH) principles, coupled with alternative payments to traditional fee for service (FFS), such as bundled and episodes payment are now showing evidence of effectiveness. These efforts have the potential to bend the cost curve while also improving quality of care and patient satisfaction. However, going forward with FFS alternatives, there are several performance-based payment options with an array of financial risks and rewards. Most novel payment options convey a greater financial risk and accountability on the provider. Therefore, the oncology medical home (OMH) can be a way to mitigate some financial risks by sharing savings with the payer through better global care of the patient, proactively preventing complications, emergency department (ED) visits, and hospitalizations. However, much of the medical home infrastructure that is required to reduced total costs of cancer care comes as an added expense to the provider. As best-of-practice quality standards are being elucidated and refined, we are now at a juncture where payers, providers, policymakers, and other stakeholders should work in concert to expand and implement the OMH framework into the variety of oncology practice environments to better equip them to assimilate into the new payment reform configurations of the future. PMID:25993243

  11. A Survey of Vocational Administrators and Teachers in Career and Technical Education Centers regarding Their Perception of Vocational Program Improvements

    ERIC Educational Resources Information Center

    Hummel, Richard Lynn, Jr.

    2012-01-01

    The purpose of this statewide study is to assess the perceived improvements made to programs that are offered at Career and Technical Education Centers from the perspective of vocational administrators and teachers following the Bureau of Career and Technical Education conduction of an Approved Program Evaluation. The Pennsylvania Bureau of Career…

  12. Two-Year College Faculty and Administrator Thoughts about the Transition to a Learning-Centered College

    ERIC Educational Resources Information Center

    Brackin, Mike

    2012-01-01

    A single qualitative case study design was used to determine the opinions of administrators and faculty from a community college that is considered to be transitioning to a learning-centered college. The researcher conducted the case study to describe, explain, and evaluate the phenomenon. The researcher also recorded facilitators or roadblocks…

  13. Policies pertaining to complementary and alternative medical therapies in a random sample of 39 academic health centers.

    PubMed

    Cohen, Michael H; Sandler, Lynne; Hrbek, Andrea; Davis, Roger B; Eisenberg, David M

    2005-01-01

    This research documents policies in 39 randomly selected academic medical centers integrating complementary and alternative medical (CAM) services into conventional care. Twenty-three offered CAM services-most commonly, acupuncture, massage, dietary supplements, mind-body therapies, and music therapy. None had written policies concerning credentialing practices or malpractice liability. Only 10 reported a written policy governing use of dietary supplements, although three sold supplements in inpatient formularies, one in the psychiatry department, and five in outpatient pharmacies. Thus, few academic medical centers have sufficiently integrated CAM services into conventional care by developing consensus-written policies governing credentialing, malpractice liability, and dietary supplement use. PMID:15712764

  14. How big should an integrated health care delivery system be at an academic medical center?

    PubMed

    Lewis, J E

    1995-07-01

    The author defines integrated health care delivery systems and comments that there are few such systems now but many in various stages of development. The size of such a system can be described in terms of the number of patients it serves, including their health status and utilization of care, the geographic configuration of the served area, the number of physicians, and the scope and extent of the facilities network. There are a variety of factors that influence a system's size; the author concentrates on the factors that an academic medical center must consider when formulating system-size goals. He discusses (1) the influence of how the institution structures itself to survive; (2) the effects of technology, innovation, and health care costs on the size and organization of these systems; and (3) the effects of the specific characteristics of the institutions' missions of education, research, and patient care. Real numbers describing integrated systems are presented as they relate to three possible institutional goals: economic viability, academic viability, and academic leadership. The author explains why academic medical centers should not try to be only tertiary or quaternary care providers for other integrated health care delivery systems, but at the same time emphasizes that there is no easy or inexpensive way for centers to develop their own systems. Alternative structures for integrated systems are discussed, such as "disease management systems" being developed by the pharmaceutical industry, an "end-to-end linkage" approach, and various ideas to include "captive markets," such as prisoners, university students, and members of communities for the elderly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7612122

  15. 48 CFR 19.403 - Small Business Administration breakout procurement center representatives.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Small Business... System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Cooperation With the Small Business Administration 19.403 Small Business Administration breakout procurement...

  16. 34 CFR 668.152 - Administration of tests by assessment centers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... publisher and an assessment center indicates otherwise, an assessment center scores the tests it gives and... test publisher— (i) All copies of completed tests; or (ii) A report listing all test-takers' scores...

  17. Creating an academy of clinical excellence at Johns Hopkins Bayview Medical Center: a 3-year experience.

    PubMed

    Wright, Scott M; Kravet, Steven; Christmas, Colleen; Burkhart, Kathleen; Durso, Samuel C

    2010-12-01

    Academic health centers (AHCs) are committed to the tripartite missions of research, education, and patient care. Promotion decisions at many AHCs focus predominantly on research accomplishments, and some members of the community remain concerned about how to reward clinicians who excel in, and spend a majority of their time, caring for patients. Many clinically excellent physicians contribute substantively to all aspects of the mission by collaborating with researchers (either through intellectual discourse or enrolling participants in trials), by serving as role models for trainees with respect to ideal caring and practice, and by attracting patients to the institution. Not giving fair and appreciative recognition to these clinically excellent faculty places AHCs at risk of losing them. The Center for Innovative Medicine at Johns Hopkins set out to address this concern by defining, measuring, and rewarding clinical excellence. Prior to this initiative, little attention was directed toward the "bright spots" of excellence in patient care at Johns Hopkins Bayview. Using a scholarly approach, the authors launched a new academy; this manuscript describes the history, creation, and ongoing activities of the Miller-Coulson Academy of Clinical Excellence at Johns Hopkins University Bayview Medical Center. While membership in the academy is honorific, the members of this working academy are committed to influencing institutional culture as they collaborate on advocacy, scholarship, and educational initiatives. PMID:20978424

  18. Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication.

    PubMed

    Crellin, Steven Jason; Katz, Kenneth D

    2016-01-01

    Suicide attempt via sodium pentobarbital is uncommon. A 48-year-old woman with a history of depression and prior suicide attempt was found unresponsive by her veterinarian spouse near a syringe containing pink solution. Upon EMS' arrival, the patient was experiencing apnea, hypoxemia, and miotic pupils; her blood glucose level measured 73 mg/dL. She was bradycardic and administered atropine with transient improvement in heart rate and transported to an emergency department; 2 mg of intravenous naloxone was administered without effect. She was endotracheally intubated via rapid sequence intubation. Rapid urine drug screening detected both benzodiazepines and barbiturates. The patient was transferred to an intensive care unit where she demonstrated a nearly absent radial pulse. Emergent fasciotomy to the left forearm and carpal tunnel was performed for acute compartment syndrome; "Euthasol" had been self-administered into the antecubital fossa. Expanded toxicological analysis via liquid chromatography/mass spectroscopy detected caffeine, atropine, 7-aminoclonazepam, phenytoin, citalopram, and naproxen. The patient's coma resolved over 48 hours and she was successfully extubated without complication. Emergency physicians must closely monitor patients exposed to veterinary euthanasia agents who develop central nervous system and respiratory depression, hypothermia, bradycardia, hypotension, or skin injury. Consultation with a regional poison center and medical toxicologist is recommended. PMID:26881149

  19. Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication

    PubMed Central

    Crellin, Steven Jason; Katz, Kenneth D.

    2016-01-01

    Suicide attempt via sodium pentobarbital is uncommon. A 48-year-old woman with a history of depression and prior suicide attempt was found unresponsive by her veterinarian spouse near a syringe containing pink solution. Upon EMS' arrival, the patient was experiencing apnea, hypoxemia, and miotic pupils; her blood glucose level measured 73 mg/dL. She was bradycardic and administered atropine with transient improvement in heart rate and transported to an emergency department; 2 mg of intravenous naloxone was administered without effect. She was endotracheally intubated via rapid sequence intubation. Rapid urine drug screening detected both benzodiazepines and barbiturates. The patient was transferred to an intensive care unit where she demonstrated a nearly absent radial pulse. Emergent fasciotomy to the left forearm and carpal tunnel was performed for acute compartment syndrome; “Euthasol” had been self-administered into the antecubital fossa. Expanded toxicological analysis via liquid chromatography/mass spectroscopy detected caffeine, atropine, 7-aminoclonazepam, phenytoin, citalopram, and naproxen. The patient's coma resolved over 48 hours and she was successfully extubated without complication. Emergency physicians must closely monitor patients exposed to veterinary euthanasia agents who develop central nervous system and respiratory depression, hypothermia, bradycardia, hypotension, or skin injury. Consultation with a regional poison center and medical toxicologist is recommended. PMID:26881149

  20. P30 Cancer Center Support Grant Administrative Supplements to NCI-designated Cancer Centers not affiliated with the Experimental Therapeutics Clinical Trials Network (ETCTN) to support participation in the ETCTN

    Cancer.gov

    P30 Cancer Center Support Grant Administrative Supplements to NCI-designated Cancer Centers not affiliated with the Experimental Therapeutics Clinical Trials Network (ETCTN) to support participation in the ETCTN

  1. 78 FR 17611 - Provisions of the Food and Drug Administration Safety and Innovation Act Related to Medical Gases...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... these new sections. On November 23, 2012 (77 FR 70166), FDA issued a Federal Register notice... FR 74852), FDA issued a notice of availability announcing publication of a draft guidance for... Administration Safety and Innovation Act Related to Medical Gases; Request for Comments Regarding...

  2. 75 FR 28257 - Draft Guidance for Industry, Third Parties and Food and Drug Administration Staff; Medical Device...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ... Administration Staff; Medical Device ISO 13485:2003 Voluntary Audit Report Submission Program; Availability... Voluntary Audit Report Submission Program.'' This draft guidance is intended to provide information on the... Voluntary Audit Report Submission Program'' to the Division of Small Manufacturers, International,...

  3. 77 FR 16036 - Guidance for Industry, Third Parties and Food and Drug Administration Staff; Medical Device ISO...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-19

    ...--Requirements for regulatory purposes,'' (ISO 13485:2003) audit report provides FDA a degree of assurance of... Submission Program'' was published for comment in the Federal Register of May 20, 2010 (75 FR 28257... Administration Staff; Medical Device ISO 13485:2003 Voluntary Audit Report Submission Pilot Program;...

  4. Glossitis and tongue trauma subsequent to administration of an oral medication, using an udder infusion cannula, in a horse.

    PubMed

    Fuller, Mark C; Abutarbush, Sameeh M

    2007-08-01

    A 10-year-old gelding was presented with a tongue that had swelled immediately after oral administration of oxfendazole, using an udder infusion cannula. The tongue appeared to have been punctured inadvertently. The horse recovered after treatment with intravenous fluid, antibiotics, and anti-inflammatory drugs. Administering oral medication by this method should be discouraged. PMID:17824329

  5. [The provision of quality and security of medical care on the basis of standardization of medical nurse activities in counseling diagnostic center].

    PubMed

    Chikineva, A V

    2010-01-01

    The enhancement of curative diagnostic process and the increase of its quality depend not only on the management, but on the reasonable implementation of high-tech new technologies. Nowadays, the evidence-based medical nursing practice represents an actively developing direction of medical nurse business. The State Novosibirsk oblast diagnostic center has developed the standards of nurse activities targeted to decrease the duplication in work, the provision of personnel and patient security. The audit of implementation of standards and the monitoring of nursing process permit to timely input the adjustments to the provision of quality of medical nurse care. PMID:20967968

  6. Improvement in the family-centered medical home enhances outcomes for children and youth with special healthcare needs.

    PubMed

    McAllister, Jeanne W; Sherrieb, Kathleen; Cooley, W Carl

    2009-01-01

    Family-centered, coordinated, comprehensive, and culturally competent care for children and youth with special healthcare needs is a national priority. Access to a primary care medical home is a US Maternal and Child Health Bureau performance measure. Most primary care practices lack methods by which to partner with families and improve care. Gaps remain in the number of children with access to a high-quality medical home. The Medical Home Index and Medical Home Family Index and Survey resulting from 10 pilot practices reveal improvements in practice capacity and subsequently in child and family outcomes. PMID:19542808

  7. Treatment Outcomes From a Specialist Model for Treating Tobacco Use Disorder in a Medical Center

    PubMed Central

    Burke, Michael V.; Ebbert, Jon O.; Schroeder, Darrell R.; McFadden, David D.; Hays, J. Taylor

    2015-01-01

    Abstract Cigarette smoking causes premature mortality and multiple morbidity; stop smoking improves health. Higher rates of smoking cessation can be achieved through more intensive treatment, consisting of medication and extended counseling of patients, but there are challenges to integrating these interventions into healthcare delivery systems. A care model using a master-level counselor trained as a tobacco treatment specialist (TTS) to deliver behavioral intervention, teamed with a supervising physician/prescriber, affords an opportunity to integrate more intensive tobacco dependence treatment into hospitals, clinics, and other medical systems. This article analyzes treatment outcomes and predictors of abstinence for cigarette smokers being treated using the TTS-physician team in a large outpatient clinic over a 7-year period. This is an observational study of a large cohort of cigarette smokers treated for tobacco dependence at a medical center. Patients referred by the primary healthcare team for a TTS consult received a standard assessment and personalized treatment planning guided by a workbook. Medication and behavioral plans were developed collaboratively with each patient. Six months after the initial assessment, a telephone call was made to ascertain a 7-day period of self-reported abstinence. The univariate association of each baseline patient characteristic with self-reported tobacco abstinence at 6 months was evaluated using the chi-squared test. In addition, a multiple logistic regression analysis was performed with self-reported tobacco abstinence as the dependent variable and all baseline characteristics included as explanatory variables. Over a period of 7 years (2005–2011), 6824 cigarette smokers who provided general research authorization were seen for treatment. The 6-month self-reported abstinence rate was 28.1% (95% confidence interval: 27.7–30.1). The patients most likely to report abstinence were less dependent, more motivated to quit

  8. Activity of daptomycin against staphylococci collected from bloodstream infections in Spanish medical centers.

    PubMed

    Picazo, Juan J; Betriu, Carmen; Culebras, Esther; Rodríguez-Avial, Iciar; Gómez, María; López, Fátima

    2009-08-01

    We used the broth microdilution method to determine the MICs of daptomycin and 13 comparator agents against 319 methicillin-susceptible Staphylococcus aureus isolates, 201 methicillin-resistant S. aureus (MRSA) isolates, and 183 coagulase-negative staphylococci (CoNS). Isolates were consecutively collected from bloodstream infections in 39 Spanish medical centers during a 3-month period (March through May 2008). Among MRSA, 1 isolate with intermediate susceptibility to vancomycin and 6 isolates resistant to linezolid were found. Nonsusceptibility to teicoplanin was detected in 3.9% of CoNS. Daptomycin was highly active against the staphylococcal blood isolates tested-all were inhibited at the daptomycin susceptibility breakpoint of < or = 1 microg/mL. Daptomycin retained its activity against the isolates that were resistant to teicoplanin or linezolid, or that had reduced susceptibility to vancomycin. These data suggest that daptomycin could be useful for the treatment of bloodstream infections caused by staphylococci. PMID:19631100

  9. Clinical, scholarly & campus information hypertext tools at Columbia-Presbyterian Medical Center.

    PubMed Central

    Zucker, J.; Kahn, R. M.; Natarajan, N.

    1993-01-01

    In conjunction with other researchers at Columbia-Presbyterian Medical Center (CPMC) we have developed a number of hypertext and free text retrieval computer applications aimed at an extremely diverse audience which includes students and faculty in a university setting as well as health care providers and patients in hospital and clinic settings. Hypertext and free text systems offer features which make them ideal for presenting information in a wide variety of contexts; however, they also have several major weaknesses which must be addressed before these applications can be useful tools. We have learned to maximize the strengths and minimize the weaknesses to present material in a manner that is individualized to the needs of each user from the research scientist in the lab to the patient at the bedside. PMID:8130531

  10. History of the Georgia Baptist/Atlanta Medical Center surgical residency.

    PubMed

    Fuhrman, George M; Humphries, Timothy

    2010-07-01

    The Georgia Baptist Hospital established itself as a premier healthcare facility during the first 50 years of the 20th century. The surgical residency started in the 1940s, became accredited in 1958, and has grown into one of the most respected independent programs in the country. The development and growth of the program was a result of the commitment and dedication of the Program Directors in Surgery over the past 50 years. These key leaders included A. Hamblin Letton, John P. Wilson, Paul Stanton, and George Lucas. The hospital's name has changed to Atlanta Medical Center with the sale of the hospital to Tenet in 1997. The same old school approach to surgical training that characterized the residency when it was known as Georgia Baptist persists and provides outstanding training for future surgeons interested in a broadly based surgical education and experience. PMID:20698368

  11. The Patient-Centered Medical Home: Preparation of the Workforce, More Questions than Answers.

    PubMed

    Reynolds, P Preston; Klink, Kathleen; Gilman, Stuart; Green, Larry A; Phillips, Russell S; Shipman, Scott; Keahey, David; Rugen, Kathryn; Davis, Molly

    2015-07-01

    As American medicine continues to undergo significant transformation, the patient-centered medical home (PCMH) is emerging as an interprofessional primary care model designed to deliver the right care for patients, by the right professional, at the right time, in the right setting, for the right cost. A review of local, state, regional and national initiatives to train professionals in delivering care within the PCMH model reveals some successes, but substantial challenges. Workforce policy recommendations designed to improve PCMH effectiveness and efficiency include 1) adoption of an expanded definition of primary care, 2) fundamental redesign of health professions education, 3) payment reform, 4) responsiveness to local needs assessments, and 5) systems improvement to emphasize quality, population health, and health disparities. PMID:25707941

  12. Searching for Excellence & Diversity: Increasing the Hiring of Women Faculty at One Academic Medical Center

    PubMed Central

    Sheridan, Jennifer T.; Fine, Eve; Pribbenow, Christine Maidl; Handelsman, Jo; Carnes, Molly

    2014-01-01

    One opportunity to realize the diversity goals of academic health centers comes at the time of hiring new faculty. To improve the effectiveness of search committees in increasing the gender diversity of faculty hires, the authors created and implemented a training workshop for faculty search committees designed to improve the hiring process and increase the diversity of faculty hires at the University of Wisconsin–Madison. They describe the workshops, which they presented in the School of Medicine and Public Health between 2004 and 2007, and they compare the subsequent hiring of women faculty in participating and nonparticipating departments and the self-reported experience of new faculty within the hiring process. Attendance at the workshop correlates with improved hiring of women faculty and with a better hiring experience for faculty recruits, especially women. The authors articulate successful elements of workshop implementation for other medical schools seeking to increase gender diversity on their faculties. PMID:20505400

  13. The Houston Academy of Medicine--Texas Medical Center Library management information system.

    PubMed Central

    Camille, D; Chadha, S; Lyders, R A

    1993-01-01

    A management information system (MIS) provides a means for collecting, reporting, and analyzing data from all segments of an organization. Such systems are common in business but rare in libraries. The Houston Academy of Medicine-Texas Medical Center Library developed an MIS that operates on a system of networked IBM PCs and Paradox, a commercial database software package. The data collected in the system include monthly reports, client profile information, and data collected at the time of service requests. The MIS assists with enforcement of library policies, ensures that correct information is recorded, and provides reports for library managers. It also can be used to help answer a variety of ad hoc questions. Future plans call for the development of an MIS that could be adapted to other libraries' needs, and a decision-support interface that would facilitate access to the data contained in the MIS databases. PMID:8251972

  14. Perspectives on the role of patient-centered medical homes in HIV Care.

    PubMed

    Pappas, Gregory; Yujiang, Jia; Seiler, Naomi; Malcarney, Mary-Beth; Horton, Katherine; Shaikh, Irshad; Freehill, Gunther; Alexander, Carla; Akhter, Mohammad N; Hidalgo, Julia

    2014-07-01

    To strengthen the quality of HIV care and achieve improved clinical outcomes, payers, providers, and policymakers should encourage the use of patient-centered medical homes (PCMHs), building on the Ryan White CARE Act Program established in the 1990s. The rationale for a PCMH with HIV-specific expertise is rooted in clinical complexity, HIV's social context, and ongoing gaps in HIV care. Existing Ryan White HIV/AIDS Program clinicians are prime candidates to serve HIV PCMHs, and HIV-experienced community-based organizations can play an important role. Increasingly, state Medicaid programs are adopting a PCMH care model to improve access and quality to care. Stakeholders should consider several important areas for future action and research with regard to development of the HIV PCMH. PMID:24832431

  15. Perspectives on the Role of Patient-Centered Medical Homes in HIV Care

    PubMed Central

    Yujiang, Jia; Seiler, Naomi; Malcarney, Mary-Beth; Horton, Katherine; Shaikh, Irshad; Freehill, Gunther; Alexander, Carla; Akhter, Mohammad N.; Hidalgo, Julia

    2014-01-01

    To strengthen the quality of HIV care and achieve improved clinical outcomes, payers, providers, and policymakers should encourage the use of patient-centered medical homes (PCMHs), building on the Ryan White CARE Act Program established in the 1990s. The rationale for a PCMH with HIV-specific expertise is rooted in clinical complexity, HIV’s social context, and ongoing gaps in HIV care. Existing Ryan White HIV/AIDS Program clinicians are prime candidates to serve HIV PCMHs, and HIV-experienced community-based organizations can play an important role. Increasingly, state Medicaid programs are adopting a PCMH care model to improve access and quality to care. Stakeholders should consider several important areas for future action and research with regard to development of the HIV PCMH. PMID:24832431

  16. Rebuilding a statewide network of community health centers for the medically underserved: a longitudinal assessment.

    PubMed

    Verderber, Stephen; Thomas, Cabrenia M

    2013-01-01

    The Strategic Facility Improvement (SFI) initiative, has resulted in the replacement of 44 outpatient clinics and 28 clinic renovation capital improvement projects across Louisiana's 64 parishes. A total of $67.3 million has been invested in this effort to date. The goal of the SFI is to improve the health status of medically underserved patient populations. It remains the sole capital improvement effort of its kind and has been in continuous implementation since 1991. The SFI consists of predesign needs assessment, analysis of alternate site planning options, historic preservation options in the adaptation of noteworthy community civic resources to healthcare uses, and the postoccupancy assessment of completed capital improvements with the aim of learning positive lessons that can be carried into future efforts. It is based on advocacy and guided by a statewide public health agency. The discussion is centered on a status report on a 21-year period and is examined critically from the perspective of key stakeholders. PMID:23892383

  17. The first private-hospital based proton therapy center in Korea; status of the Proton Therapy Center at Samsung Medical Center

    PubMed Central

    Chung, Kwangzoo; Kim, Jinsung; Ahn, Sung Hwan; Ju, Sang Gyu; Jung, Sang Hoon; Chung, Yoonsun; Cho, Sungkoo; Jo, Kwanghyun; Shin, Eun Hyuk; Hong, Chae-Seon; Shin, Jung Suk; Park, Seyjoon; Kim, Dae-Hyun; Kim, Hye Young; Lee, Boram; Shibagaki, Gantaro; Nonaka, Hideki; Sasai, Kenzo; Koyabu, Yukio; Choi, Changhoon; Huh, Seung Jae; Ahn, Yong Chan; Pyo, Hong Ryull; Lim, Do Hoon; Park, Hee Chul; Park, Won; Oh, Dong Ryul; Noh, Jae Myung; Yu, Jeong Il; Song, Sanghyuk; Lee, Ji Eun; Lee, Bomi; Choi, Doo Ho

    2015-01-01

    Purpose The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. Materials and Methods The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. Results The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. Conclusion The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015. PMID:26756034

  18. The response of academic medical centers to the 2010 Haiti earthquake: the Mount Sinai School of Medicine experience.

    PubMed

    Ripp, Jonathan A; Bork, Jacqueline; Koncicki, Holly; Asgary, Ramin

    2012-01-01

    On January 12, 2010, Haiti was struck by a 7.0 earthquake which left the country in a state of devastation. In the aftermath, there was an enormous relief effort in which academic medical centers (AMC) played an important role. We offer a retrospective on the AMC response through the Mount Sinai School of Medicine (MSSM) experience. Over the course of the year that followed the Earthquake, MSSM conducted five service trips in conjunction with two well-established groups which have provided service to the Haitian people for over 15 years. MSSM volunteer personnel included nurses, resident and attending physicians, and specialty fellows who provided expertise in critical care, emergency medicine, wound care, infectious diseases and chronic disease management of adults and children. Challenges faced included stressful and potentially hazardous working conditions, provision of care with limited resources and cultural and language barriers. The success of the MSSM response was due largely to the strength of its human resources and the relationship forged with effective relief organizations. These service missions fulfilled the institution's commitment to social responsibility and provided a valuable training opportunity in advocacy. For other AMCs seeking to respond in future emergencies, we suggest early identification of a partner with field experience, recruitment of administrative and faculty support across the institution, significant pre-departure orientation and utilization of volunteers to fundraise and advocate. Through this process, AMCs can play an important role in disaster response. PMID:22232447

  19. Acinetobacter Infections and Outcomes at an Academic Medical Center: A Disease of Long-Term Care

    PubMed Central

    Townsend, Jennifer; Park, An Na; Gander, Rita; Orr, Kathleen; Arocha, Doramarie; Zhang, Song; Greenberg, David E.

    2015-01-01

    Background. Our study aims to describe the epidemiology, microbial resistance patterns, and clinical outcomes of Acinetobacter infections at an academic university hospital. This retrospective study analyzed all inpatient clinical isolates of Acinetobacter collected at an academic medical center over 4 years. The data were obtained from an Academic tertiary referral center between January 2008 and December 2011. All consecutive inpatients during the study period who had a clinical culture positive for Acinetobacter were included in the study. Patients without medical records available for review or less than 18 years of age were excluded. Methods. Records were reviewed to determine source of isolation, risk factors for acquisition, drug resistance patterns, and clinical outcomes. Repetitive sequence-based polymerase chain reaction of selected banked isolates was used to determine patterns of clonal spread in and among institutions during periods of higher infection rates. Results. Four hundred eighty-seven clinical isolates of Acinetobacter were found in 212 patients (in 252 admissions). Patients with Acinetobacter infections were frequently admitted from healthcare facilities (HCFs) (59%). One hundred eighty-three of 248 (76%) initial isolates tested were resistant to meropenem. One hundred ninety-eight of 249 (79.5%) initial isolates were multidrug resistant (MDR). Factors associated with mortality included bacteremia (odds ratio [OR] = 1.93, P = .024), concomitant steroid use (OR = 2.87, P < .001), admission from a HCF (OR = 6.34, P = .004), and chronic obstructive pulmonary disease (OR = 3.17, P < .001). Conclusions. Acinetobacter isolates at our institution are frequently MDR and are more common among those who reside in HCFs. Our findings underline the need for new strategies to prevent and treat this pathogen, including stewardship efforts in long-term care settings. PMID:26034772

  20. Implementation of Epic Beaker Clinical Pathology at an academic medical center

    PubMed Central

    Krasowski, Matthew D.; Wilford, Joseph D.; Howard, Wanita; Dane, Susan K.; Davis, Scott R.; Karandikar, Nitin J.; Blau, John L.; Ford, Bradley A.

    2016-01-01

    Background: Epic Beaker Clinical Pathology (CP) is a relatively new laboratory information system (LIS) operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration. Methods: Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after) using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project. Results: We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS. Conclusions: Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS. PMID:26955505