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Sample records for administration va hospitals

  1. Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

    ERIC Educational Resources Information Center

    Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

    2009-01-01

    Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

  2. FACILITIES FOR EDUCATION IN VA HOSPITALS. FINAL REPORT.

    ERIC Educational Resources Information Center

    GREEN, ALAN C.; AND OTHERS

    THIS STUDY WAS AUTHORIZED BY THE VA DEPARTMENT OF MEDICINE AND SURGERY FOR THE PURPOSE OF IDENTIFYING AND DETERMINING THE FACILITIES NEEDED TO PROPERLY HOUSE AND SUPPORT EDUCATION ACTIVITIES IN EXISTING AND FUTURE VA HOSPITALS AND TO PRODUCE ARCHITECTURAL GUIDANCE IN THE DESIGN OF THE FACILITIES. CURRENT PRACTICES AND SIGNIFICANT TRENDS IN MEDICAL…

  3. Denver VA Hospital MS4 NPDES Permit

    EPA Pesticide Factsheets

    Under NPDES permit CO-R042008, the Veterans Administration (Medical Center, Denver Campus) is authorized to discharge from all municipal separate storm sewer system outfalls to the receiving waters specified in the permit in the City of Denver, Colorado.

  4. 48 CFR 819.602-3 - Resolving differences between VA and the Small Business Administration.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... between VA and the Small Business Administration. 819.602-3 Section 819.602-3 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Certificates... Small Business Administration. The Director, OSDBU, is the VA liaison with the SBA. Information...

  5. Eastern Colorado Health Care System (VA Hospital) NPDES Permit

    EPA Pesticide Factsheets

    Under NPDES permit CO-0034991, the U.S. Department of Veterans Affairs (VA) is authorized to discharge from its wastewater treatment facility in Adams County, Colorado, to a storm sewer to Toll Gate Creek, a tributary of Sand Creek.

  6. 38 CFR 3.1706 - Burial allowance for a veteran who died while hospitalized by VA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Burial allowance for a... DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Burial Benefits Burial Benefits: Allowances & Expenses Paid by Va A08se3. § 3.1706 Burial allowance for a veteran who died while hospitalized by VA. Pt. 3, Subpt. B,...

  7. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

    PubMed Central

    Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

  8. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    PubMed

    Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  9. Organization and administration of the NIDCD/VA Hearing Aid Clinical Trial.

    PubMed

    Henderson, William G; Larson, Vernon D; Williams, David; Leuthke, Lynn

    2002-08-01

    This article describes the organization and administration of the NIDCD/VA Hearing Aid Clinical Trial. The trial involved a total of 360 patients with bilateral, sensorineural hearing loss from eight VA Medical Centers to study three different hearing aid circuits in a three-period, three-treatment crossover design. Strong central coordination of such a complex multi-center clinical trial is essential to its success. The trial took more than 5 years to design, implement, and complete. This timeline is also described.

  10. Hospital Library Standards: An Administrator's View

    ERIC Educational Resources Information Center

    Koughan, William P.

    1975-01-01

    The current Standards for Professional Library Services of the Joint Commission on Accreditation of Hospitals are analyzed. It is concluded that the standards are weak and that this has a negative effect on both hospital administrators and hospital librarians. Recommendations to remedy the situation are offered. (Author)

  11. Approaching hospital administration about adopting cooling technologies.

    PubMed

    Kirkland, Lisa L; Parham, William M; Pastores, Stephen M

    2009-07-01

    The purpose of this article is to provide intensivists with information and examples regarding cooling technology selection, cost assessment, adaptation, barriers, and presentation to hospital administrators. A review of medical and business literature was conducted using the following search terms: technology assessment, organizational innovation, intensive care, critical care, hospital administration, and presentation to administrators. General recommendations for intensivists are made for assessing cooling technology with descriptions of common new technology implementation stages. A study of 16 hospitals implementing a new cardiac surgery technology is described. A description of successful implementation of an induced hypothermia protocol by one of the authors is presented. Although knowledgeable about the applications of new technologies, including cooling technology, intensivists have little guidance or training on tactics to obtain a hospital administration's funding and support. Intensive care unit budgets are usually controlled by nonintensivists whose interests are neutral, at best, to the needs of intensivists. To rise to the top of the large pile of requisition requests, an intensivist's proposal must be well conceived and aligned with hospital administration's strategic goals. Intensivists must understand the hospital acquisition process and administrative structure and participate on high-level hospital committees. Using design thinking and strong leadership skills, the intensivist can marshal support from staff and administrators to successfully implement cooling technology.

  12. Social work in the Veterans Health Administration (VA) System: rewards, challenges, roles and interventions.

    PubMed

    Beder, Joan; Postiglione, Paul

    2013-01-01

    For the social worker in the Veterans Health Administration (VA) System, numerous challenges are faced and met while serving the nation's Veterans. As part of the multidisciplinary team, social workers perform a variety of tasks and function in diverse roles. The qualitative survey research reported in this article sought to detail what social workers identified about the impact and rewards of their work and what they saw as the challenges and frustrations. In addition the social workers were asked to clarify their role with the patient and the family. Intervention strategies used in the course of the social workers interaction with the Veterans was also ascertained.

  13. USAF Hospital Administrator Management Indicator Information Requirements.

    DTIC Science & Technology

    1987-12-01

    1 General Issue................................. 1 Specific Research Problem ...................... 3 Investigative Questions...included in a management reporting system for Air Force medical facility administrators. Also, recommendations are made as to further. research in this... Research Problem In the Judgment of administrators of USAF Hospitals. what are their management indicator information requirements for the four primary

  14. Relationship of hospital organizational culture to patient safety climate in the Veterans Health Administration.

    PubMed

    Hartmann, Christine W; Meterko, Mark; Rosen, Amy K; Shibei Zhao; Shokeen, Priti; Singer, Sara; Gaba, David M

    2009-06-01

    Improving safety climate could enhance patient safety, yet little evidence exists regarding the relationship between hospital characteristics and safety climate. This study assessed the relationship between hospitals' organizational culture and safety climate in Veterans Health Administration (VA) hospitals nationally. Data were collected from a sample of employees in a stratified random sample of 30 VA hospitals over a 6-month period (response rate = 50%; n = 4,625). The Patient Safety Climate in Healthcare Organizations (PSCHO) and the Zammuto and Krakower surveys were used to measure safety climate and organizational culture, respectively. Higher levels of safety climate were significantly associated with higher levels of group and entrepreneurial cultures, while lower levels of safety climate were associated with higher levels of hierarchical culture. Hospitals could use these results to design specific interventions aimed at improving safety climate.

  15. Nursing administration in small rural hospitals.

    PubMed

    Henry, B M; Moody, L E

    1986-01-01

    Most of the world's population is rural and 45% of all United States hospitals are small or located outside of urban centers. The interdependence of rapidly changing rural communities and hospitals is described in this study of nursing directors' jobs. Findings provide needed information about the challenges and demands of nursing administration in small organizations useful for development of curriculums sensitive to values, politics, and economies; and for all nurse executives eager to understand the complexity of decisions and actions, whether in small organizations or in large multi-institutional systems comprising hospitals of varying sizes.

  16. Exploring the link between ambulatory care and avoidable hospitalizations at the Veteran Health Administration.

    PubMed

    Pracht, Etienne E; Bass, Elizabeth

    2011-01-01

    This paper explores the link between utilization of ambulatory care and the likelihood of rehospitalization for an avoidable reason in veterans served by the Veteran Health Administration (VA). The analysis used administrative data containing healthcare utilization and patient characteristics stored at the national VA data warehouse, the Corporate Franchise Data Center. The study sample consisted of 284 veterans residing in Florida who had been hospitalized at least once for an avoidable reason. A bivariate probit model with instrumental variables was used to estimate the probability of rehospitalization. Veterans who had at least 1 ambulatory care visit per month experienced a significant reduction in the probability of rehospitalization for the same avoidable hospitalization condition. The findings suggest that ambulatory care can serve as an important substitute for more expensive hospitalization for the conditions characterized as avoidable.

  17. Effects of Resident Duty Hour Reform on Surgical and Procedural Patient Safety Indicators Among Hospitalized VA and Medicare Patients

    PubMed Central

    Rosen, Amy K.; Loveland, Susan A.; Romano, Patrick S.; Itani, Kamal MF; Silber, Jeffrey H.; Even-Shoshan, Orit O.; Halenar, Michael J.; Teng, Yun; Zhu, Jingsan; Volpp, Kevin G.

    2009-01-01

    Objective Improving patient safety was a strong motivation behind duty hour regulations implemented by ACGME on July 1, 2003. We investigated whether rates of Patient Safety Indicators (PSIs) changed following these reforms. Research Design Observational study of patients admitted to VA (N=826,047) and Medicare (N=13,367,273) acute-care hospitals from 7/1/2000–6/30/2005. We examined changes in patient safety events in more vs. less teaching-intensive hospitals before (2000–2003) and after (2003–2005) duty hour reform, using conditional logistic regression, adjusting for patient age, gender, comorbidities, secular trends, baseline severity, and hospital site. Measures Ten PSIs were aggregated into 3 composite measures based on factor analyses: “Continuity of Care,” “Technical Care,” and “Other” composites. Results “Continuity of Care” composite rates showed no significant changes post-reform in hospitals of different teaching intensity in either VA or Medicare. In the VA, there were no significant changes post-reform for the “Technical Care” composite. In Medicare, the odds of a Technical Care PSI event in more vs. less teaching-intensive hospitals in post-reform year 1 were 1.12 (95% CI; 1.01–1.25); there were no significant relative changes in post-reform year 2. “Other” composite rates increased in VA in post-reform year 2 in more vs. less teaching-intensive hospitals (OR, 1.63; 95% CI, 1.10–2.41), but not in Medicare in either post-reform year. Conclusions Duty hour reform had no systematic impact on PSI rates. In the few cases where there were statistically significant increases in the relative odds of developing a PSI, the magnitude of the absolute increases were too small to be clinically meaningful. PMID:19536029

  18. The Impact of VA and Navy Hospital Collaboration on Medical School Education

    ERIC Educational Resources Information Center

    Atre-Vaidya, Nutan; Ross, Arthur, III; Sandu, Ioana C.; Hassan, Tariq

    2009-01-01

    Objective: The U.S. Department of Veterans Affairs (VA) is the largest single provider of medical education in the United States and is often the preferred training site for medical students and residents. However, changing priorities of patients and the marketplace are forcing medical schools and the VA to consider new ways of practicing medicine…

  19. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... complete treatment may continue for up to 12 months, and new authorizations may be issued by VA as needed), and (iii) A veteran of the Mexican border period or World War I or who is in receipt of increased... facilities (on an inpatient or outpatient basis) in order to complete requests from VA Regional Offices for...

  20. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... complete treatment may continue for up to 12 months, and new authorizations may be issued by VA as needed), and (iii) A veteran of the Mexican border period or World War I or who is in receipt of increased... facilities (on an inpatient or outpatient basis) in order to complete requests from VA Regional Offices for...

  1. Information technology orientation for young hospital administrators.

    PubMed

    Bakshi, Syed Murtuza Hussain

    2012-01-01

    Information technology has evolved over the years and taken its place in every sector, including health care. Every health care professional uses a computer almost every day. Information technology is expected to provide the staff with reliable information for decision making, reducing medical errors and processing time and improving communication. As the health care market grows increasingly competitive and complex, hospitals are relying more and more on information technology as a primary tool to help them compete. Every postgraduate should take a basic course on computers and IT applications. Many universities and colleges offer a masters program in health administration, and with enormous numbers of new post graduates, well grounded in IT, are offering their services to hospitals and allied health care divisions. Their experiences are reflected in the various job codes, which illustrate the need for planning, careful investment, and educational training to put information technology to work in today's sophisticated advanced health care setting. Information technology cannot reach its full potential without a properly trained staff working together as a team.

  2. Marketing orientation: how do hospital administrators compare with marketing managers?

    PubMed

    Bartlett, P J; Schewe, C D; Allen, C T

    1984-01-01

    A recent study shows that the marketing orientation of hospital administrators is similar to that of marketing practitioners but that hospital administrators have an underdeveloped sense of market segmentation and market aggressiveness regarding their patients and physicians. Studies such as this one can be helpful in applying marketing techniques to today's hospitals.

  3. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... World War I or who is in receipt of increased pension or additional compensation based on the need for... life or health of a veteran which developed during authorized travel to the hospital, or...

  4. The Impact of Private Insurance Coverage on Veterans' Use of VA Care: Insurance and Selection Effects

    PubMed Central

    Shen, Yujing; Hendricks, Ann; Wang, Fenghua; Gardner, John; Kazis, Lewis E

    2008-01-01

    Objective To examine private insurance coverage and its impact on use of Veterans Health Administration (VA) care among VA enrollees without Medicare coverage. Data Sources The 1999 National Health Survey of Veteran Enrollees merged with VA administrative data, with other information drawn from American Hospital Association data and the Area Resource File. Study Design We modeled VA enrollees' decision of having private insurance coverage and its impact on use of VA care controlling for sociodemographic information, patients' health status, VA priority status and access to VA and non-VA alternatives. We estimated the true impact of insurance on the use of VA care by teasing out potential selection bias. Bias came from two sources: a security selection effect (sicker enrollees purchase private insurance for extra security and use more VA and non-VA care) and a preference selection effect (VA enrollees who prefer non-VA care may purchase private insurance and use less VA care). Principal Findings VA enrollees with private insurance coverage were less likely to use VA care. Security selection dominated preference selection and naïve models that did not control for selection effects consistently underestimated the insurance effect. Conclusions Our results indicate that prior research, which has not controlled for insurance selection effects, may have underestimated the potential impact of any private insurance policy change, which may in turn affect VA enrollees' private insurance coverage and consequently their use of VA care. From the decline in private insurance coverage from 1999 to 2002, we projected an increase of 29,400 patients and 158 million dollars for VA health care services. PMID:18211529

  5. Hospital administrator's perspectives regarding the health care industry.

    PubMed

    McDermott, D R; Little, M W

    1988-01-01

    Based on responses from 52 hospital administrators, four areas of managerial concern have been addressed, including: (1) decision-making factors; (2) hospital service offerings: current and future; (3) marketing strategy and service priorities; and (4) health care industry challenges. Of the total respondents, 35 percent indicate a Director of Marketing has primary responsibility for making marketing-related decisions in their hospital, and 19 percent, a Vice-President of Marketing, thus demonstrating the increased priority of the marketing function. The continued importance of the physician being the primary market target is highlighted by 70 percent of the administrators feeling physician referrals will be more important regarding future admissions than in the past, compared to only two percent feeling the physicians' role will be less important. Of primary importance to patients selecting a hospital, as perceived by the administrators, are the physician's referral, the patient's previous experience, the hospital's reputation, and the courtesy of the staff. The clear majority of the conventional-care hospitals surveyed offer out-patient surgery, a hospital pharmacy, obstetrics/maternity care, and diabetic services. The future emphasis on expanding services is evidenced by some 50 percent of the hospital administrators indicating they either possibly or definitely plan to offer long-term nursing care, out-patient substance abuse programs, and cancer clinics by 1990. In addition, some one-third of the respondents are likely to expand their offerings to include wellness/fitness centers, in-patient substance abuse programs, remote or satellite primary care clinics, and diabetic services. Other areas having priority for future offerings include services geared specifically toward women and the elderly. Perceived as highest in priority by the administrators regarding how their hospital can achieve its goals in the next three years are market development strategies

  6. Nurses' medication administration practices at two Singaporean acute care hospitals.

    PubMed

    Choo, Janet; Johnston, Linda; Manias, Elizabeth

    2013-03-01

    This study examined registered nurses' overall compliance with accepted medication administration procedures, and explored the distractions they faced during medication administration at two acute care hospitals in Singapore. A total of 140 registered nurses, 70 from each hospital, participated in the study. At both hospitals, nurses were distracted by personnel, such as physicians, radiographers, patients not under their care, and telephone calls, during medication rounds. Deviations from accepted medication procedures were observed. At one hospital, the use of a vest during medication administration alone was not effective in avoiding distractions during medication administration. Environmental factors and distractions can impact on the safe administration of medications, because they not only impair nurses' level of concentration, but also add to their work pressure. Attention should be placed on eliminating distractions through the use of appropriate strategies. Strategies that could be considered include the conduct of education sessions with health professionals and patients about the importance of not interrupting nurses while they are administering medications, and changes in work design.

  7. Interdisciplinary Quality Improvement Conference: Using a Revised Morbidity and Mortality Format to Focus on Systems-Based Patient Safety Issues in a VA Hospital: Design and Outcomes.

    PubMed

    Gerstein, Wendy H; Ledford, Judith; Cooper, Jacqueline; Lloyd, Melissa G; Moore, Timothy; Harji, Farzana; Twitty, Vivian; Brooks, Annette; Oliver, Rosalinda C; Goff, James M

    2016-01-01

    The Veterans Healthcare Administration (VA) has embraced patient safety and quality improvement in the quest to improve care for veterans. The New Mexico VA Health Care System introduced a new morbidity and mortality conference, called the Interdisciplinary Quality Improvement Conference (IQIC), using patient case presentations to focus on underlying systems in the clinical care environment. The revised conference design also effectively teaches the 6 Accreditation Council for Graduate Medical Education (ACGME) core requirements for resident education. A formal process was established for case selection, presentation, systems issue identification, tracking, and follow-up. The IQIC has enabled the identification of more than 20 system issues at the study institution. Outcome data show lasting improvement in system issues that were addressed by this mechanism. The VA IQIC is an effective method to both identify and correct systems issues that affect patient care and is an effective method for teaching residents the 6 ACGME requirements for residency education.

  8. IVR and administrative operations in healthcare and hospitals.

    PubMed

    Mouza, Anna-Maria

    2003-01-01

    IVR (Interactive Voice Response) systems are effectively used in healthcare and hospitals for drug and health library information, prescription refills, history records, medical transcripts, patient information services, automated pre-admissions, patient account records, appointment scheduling and reminder, lab results notification, food services, and many other applications. Among its benefits, IVR relieves administrative staff and physicians of routine customer interactions and helps healthcare organizations increase their efficiency, productivity, and profitability.

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

    PubMed

    Allen, C W; Branson, J R

    1982-07-01

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

  10. Evaluation of drug administration errors in a teaching hospital

    PubMed Central

    2012-01-01

    Background Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors. Methods Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds). A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects. Results Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations (430 errors) with one or more errors were detected (27.6%). There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% (113/1501). The most frequently administered drugs were the cardiovascular drugs (425/1501, 28.3%). The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients (mainly omission). In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification (ATC) and the number of patient under the nurse's care. Conclusion Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions. PMID:22409837

  11. VA (Veterans Administration) can Reduce Excess Disability Payments by Improving Pay Data Exchange with the Military Services.

    DTIC Science & Technology

    2014-09-26

    HUMAN RESOURCES DIV 29 MAY 85 UNCLASSIFIED 6GAO/HRD-85-38 F/G 5/9 NL EEEEEEEEEE mEEhEh~hEE L8 1112 .-. 0 I111 1125 1111 JII llii MICROCOPY RESOLUTION...1" 0 ,- , GAO/HRD-85-38 " (MAY 29.1985 80 8 05 o03 UNITED STATES GENERAL ACCOUNTING OFFICE WASHINGTON, D.C. 20548 HUMAN RESOURCES DIVISION B...benefits. To help prevent human errors, VA should print a reminder on the award processing screen when- ever a separation payment needs to be recouped

  12. Drug Administration Errors in Hospital Inpatients: A Systematic Review

    PubMed Central

    Berdot, Sarah; Gillaizeau, Florence; Caruba, Thibaut; Prognon, Patrice; Durieux, Pierre; Sabatier, Brigitte

    2013-01-01

    Context Drug administration in the hospital setting is the last barrier before a possible error reaches the patient. Objectives We aimed to analyze the prevalence and nature of administration error rate detected by the observation method. Data Sources Embase, MEDLINE, Cochrane Library from 1966 to December 2011 and reference lists of included studies. Study Selection Observational studies, cross-sectional studies, before-and-after studies, and randomized controlled trials that measured the rate of administration errors in inpatients were included. Data Extraction Two reviewers (senior pharmacists) independently identified studies for inclusion. One reviewer extracted the data; the second reviewer checked the data. The main outcome was the error rate calculated as being the number of errors without wrong time errors divided by the Total Opportunity for Errors (TOE, sum of the total number of doses ordered plus the unordered doses given), and multiplied by 100. For studies that reported it, clinical impact was reclassified into four categories from fatal to minor or no impact. Due to a large heterogeneity, results were expressed as median values (interquartile range, IQR), according to their study design. Results Among 2088 studies, a total of 52 reported TOE. Most of the studies were cross-sectional studies (N=46). The median error rate without wrong time errors for the cross-sectional studies using TOE was 10.5% [IQR: 7.3%-21.7%]. No fatal error was observed and most errors were classified as minor in the 18 studies in which clinical impact was analyzed. We did not find any evidence of publication bias. Conclusions Administration errors are frequent among inpatients. The median error rate without wrong time errors for the cross-sectional studies using TOE was about 10%. A standardization of administration error rate using the same denominator (TOE), numerator and types of errors is essential for further publications. PMID:23818992

  13. Implementation of an advanced clinical and administrative hospital information system.

    PubMed

    Vegoda, P R; Dyro, J F

    1986-01-01

    Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks. University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool. The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system. In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications

  14. 77 FR 70967 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-28

    ..., Alcoholism, Claims, Day care, Dental health, Drug abuse, Government contracts, Grant programs--health... its regulation governing payment by VA for non-VA outpatient care under VA's statutory authority to provide non-VA care. Under this authority, VA may contract for certain hospital care (inpatient care)...

  15. The Perceptions of Key Hospital Leaders as to the Competencies Required for Hospital Administration and Their Implications for Professional Education.

    ERIC Educational Resources Information Center

    Austin, Theodore Arnold

    This study sought to define competencies hospital executives need to perform their role effectively as perceived by hospital leaders, and to analyze the implications of these competency requirements for the professional education of hospital administrators. A semi-projective questionnaire was devised with the help of a panel of 10 administrators…

  16. Training of Health Service Personnel in the Veterans' Administration.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

    During fiscal year 1970, more than 49,000 persons received training through the Veterans' Administration (VA) in 125 different health services programs, including 21,550 physicians, 1,359 dentists, and 26,142 trainees in the allied and administrative health fields. Many VA hospitals and out-patient clinics indicated that more than 12,000…

  17. Interior detail of stainedglass window in administrative wing, looking southeast ...

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

    Interior detail of stained-glass window in administrative wing, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Chapel, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  18. Expanded Access to Non-VA Care Through the Veterans Choice Program. Interim final rule.

    PubMed

    2015-12-01

    The Department of Veterans Affairs (VA) revises its medical regulations that implement section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (hereafter referred to as "the Choice Act"), which requires VA to establish a program to furnish hospital care and medical services through eligible non-VA health care providers to eligible veterans who either cannot be seen within the wait-time goals of the Veterans Health Administration (VHA) or who qualify based on their place of residence (hereafter referred to as the "Veterans Choice Program" or the "Program"). These regulatory revisions are required by the most recent amendments to the Choice Act made by the Construction Authorization and Choice Improvement Act of 2014, and by the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. The Construction Authorization and Choice Improvement Act of 2014 amended the Choice Act to define additional criteria that VA may use to determine that a veteran's travel to a VA medical facility is an "unusual or excessive burden," and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 amended the Choice Act to cover all veterans enrolled in the VA health care system, remove the 60-day limit on an episode of care, modify the wait-time and 40-mile distance eligibility criteria, and expand provider eligibility based on criteria as determined by VA. This interim final rule revises VA regulations consistent with the changes made to the Choice Act as described above.

  19. Physiotherapy Practice and Delegation Policies in Oxygen Administration: A Survey of Ontario Hospitals

    PubMed Central

    Espiritu, Olivia; Schaeffer, Erin; Bhesania, Natasha; Perera, Sarah; Dickinson, Emma; Nussbaum, Ethne

    2009-01-01

    ABSTRACT Purpose: As of 2008, the Regulated Health Professions Act in Ontario stipulates that administration of oxygen is a controlled act, which physiotherapists are not authorized to perform but which may be delegated to physiotherapists by another health professional authorized to perform this act. The aims of this study were (1) to survey physiotherapy practice of oxygen administration in Ontario hospitals and (2) to determine the proportion and characteristics of hospitals with delegation policies for physiotherapists to administer oxygen. Method: Postal surveys were sent to 208 hospitals. Data were collected on hospital characteristics; the presence of delegation policies; and the practice and training of physiotherapists, physiotherapy assistants, and students in oxygen administration. Data were described by summative statistics. Fisher's exact test and Cramer's V statistic were used to examine associations. Potential prognostic factors were analyzed using logistic regression. Results: Response rate was 82.7%. Physiotherapists administered oxygen in 39% of hospitals, and 28% of hospitals had delegation policies. Larger, urban, or teaching hospitals and those with a matrix structure were most likely to have delegation policies and physiotherapists who administered oxygen. Rehabilitation hospitals were also likely to have such policies. Conclusion: Physiotherapists administer oxygen in less than half of Ontario hospitals, very few of which have delegation policies. PMID:20514179

  20. Putting on a clinic in Va. Carilion, a not-for-profit hospital system based in Roanoke, is taking a $100 million risk to become a physician-run venture.

    PubMed

    Evans, Melanie

    2006-06-26

    Carilion Health System needs to change or die, according to its leaders, so the Roanoke, Va., organization is converting from a typical not-for-profit system into a physician-run clinic. The switch is an extreme version of an industrywide push to employ doctors. James Thweatt Jr., left, of rival Lewis-Gale, says his hospital joined the trend when it hired 80 specialists from a failing local clinic.

  1. Organizational entrepreneurship and administrators of hospitals: case study of Iran.

    PubMed

    Raadabadi, Mehdi; Fayaz-Bakhsh, Ahmad; Nazari, Aslan; Mousavi, Seyed Masood; Fayaz-Bakhsh, Mohammadali

    2014-04-11

    Due to rapid changes of technology and scientific advances in health systems and need for fast planning in health care, entrepreneurial spirit among employers and employees is a crucial element. According to the field of entrepreneurship research has not been solved and where learning and innovation for healthcare organizations due to the nature of the work required. This study aims to examine the entrepreneurial activities within the hospitals affiliated to Tehran University of Medical Sciences, Iran. To achieve the aim of the study, a questionnaire containing 29 items regarding the areas of innovation, creative behavior, flexibility, empowerment, rewarding systems and the management support was distributed among the hospitals' managers. Establishment of a culture of entrepreneurship in healthcare organizations led to the development unit controlled, changing the culture of the hospital. The analysis of the data showed that the majority of the managers agreed with all five areas of entrepreneurship namely the existence of innovation and innovative behavior, flexibility, decision making, rewarding and encouraging system, as well as management supportive system of personnel's new ideas. In fact, the managers generally had positive attitude towards entrepreneurship in their organizations The Pearson correlation test also showed that there is a significant relationship between the areas of entrepreneurship and the managers' age as well as their working experience (P<0.05). Entrepreneurial activities in healthcare can be improved through providing a suitable environment, adjusting reward and encouragement systems, giving more authority to subordinates, promoting awareness and education, and mobilizing managers to attract appropriate opportunities for organization. Further active involvement of employees, more stable in front of changes and increased ability managers to capture opportunities in domestic and foreign situation.

  2. General Surgery Programs in Small Rural New York State Hospitals: A Pilot Survey of Hospital Administrators

    ERIC Educational Resources Information Center

    Zuckerman, Randall; Doty, Brit; Gold, Michael; Bordley, James; Dietz, Patrick; Jenkins, Paul; Heneghan, Steven

    2006-01-01

    Context: Hospitals play a central role in small rural communities and are frequently one of the major contributors to the local economy. Surgical services often account for a substantial proportion of hospital revenues. The current shortage of general surgeons practicing in rural communities may further threaten the financial viability of rural…

  3. Orthopedic Surgery in Rural American Hospitals: A Survey of Rural Hospital Administrators

    ERIC Educational Resources Information Center

    Weichel, Derek

    2012-01-01

    Rural American residents prefer to receive their medical care locally. Lack of specific medical services in the local community necessitates travel to a larger center which is less favorable. This study was done to identify how rural hospitals choose to provide orthopedic surgical services to their communities. Methods: All hospitals in 5 states…

  4. Organizational Entrepreneurship and Administrators of Hospitals: Case Study of Iran

    PubMed Central

    Raadabadi, Mehdi; Fayaz-Bakhsh, Ahmad; Nazari, Aslan; Mousavi, Seyed Masood; Fayaz-Bakhsh, MohammadAli

    2014-01-01

    Due to rapid changes of technology and scientific advances in health systems and need for fast planning in health care, entrepreneurial spirit among employers and employees is a crucial element. According to the field of entrepreneurship research has not been solved and where learning and innovation for healthcare organizations due to the nature of the work required. This study aims to examine the entrepreneurial activities within the hospitals affiliated to Tehran University of Medical Sciences, Iran. To achieve the aim of the study, a questionnaire containing 29 items regarding the areas of innovation, creative behavior, flexibility, empowerment, rewarding systems and the management support was distributed among the hospitals’ managers. Establishment of a culture of entrepreneurship in healthcare organizations led to the development unit controlled, changing the culture of the hospital. The analysis of the data showed that the majority of the managers agreed with all five areas of entrepreneurship namely the existence of innovation and innovative behavior, flexibility, decision making, rewarding and encouraging system, as well as management supportive system of personnel’s new ideas. In fact, the managers generally had positive attitude towards entrepreneurship in their organizations The Pearson correlation test also showed that there is a significant relationship between the areas of entrepreneurship and the managers’ age as well as their working experience (P<0.05). Entrepreneurial activities in healthcare can be improved through providing a suitable environment, adjusting reward and encouragement systems, giving more authority to subordinates, promoting awareness and education, and mobilizing managers to attract appropriate opportunities for organization. Further active involvement of employees, more stable in front of changes and increased ability managers to capture opportunities in domestic and foreign situation. PMID:24762370

  5. A comparison of hospital administrative costs in eight nations: US costs exceed all others by far.

    PubMed

    Himmelstein, David U; Jun, Miraya; Busse, Reinhard; Chevreul, Karine; Geissler, Alexander; Jeurissen, Patrick; Thomson, Sarah; Vinet, Marie-Amelie; Woolhandler, Steffie

    2014-09-01

    A few studies have noted the outsize administrative costs of US hospitals, but no research has compared these costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital administrative costs across eight nations: Canada, England, Scotland, Wales, France, Germany, the Netherlands, and the United States. We found that administrative costs accounted for 25.3 percent of total US hospital expenditures--a percentage that is increasing. Next highest were the Netherlands (19.8 percent) and England (15.5 percent), both of which are transitioning to market-oriented payment systems. Scotland and Canada, whose single-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest administrative costs. Costs were intermediate in France and Germany (which bill per patient but pay separately for capital projects) and in Wales. Reducing US per capita spending for hospital administration to Scottish or Canadian levels would have saved more than $150 billion in 2011. This study suggests that the reduction of US administrative costs would best be accomplished through the use of a simpler and less market-oriented payment scheme.

  6. Anaphylaxis: lack of hospital doctors' knowledge of adrenaline (epinephrine) administration in adults could endanger patients' safety.

    PubMed

    Droste, J; Narayan, N

    2012-06-01

    Adrenaline (epinephrine) is the first line drug to be given in anaphylaxis and can save patients' lives. Conversely, incorrect administration of adrenaline in anaphylaxis has caused patients serious harm, including death. We compared the survey results of doctors' knowledge of adrenaline administration in adults of two District General Hospitals Trusts in England and found, that from 284 Hospital Doctors, 14.4% (n = 41) would administer adrenaline as recommended by published anaphylaxis guidelines. This survey comparison shows that a significant number of hospital doctors, regardless of seniority and specialty, have an educational deficit regarding correct administration of adrenaline (epinephrine) administration in adults with anaphylaxis. Multilevel strategies to educate doctors and prevent patient harm are needed. We propose a mnemonic for remembering the recommended treatment for anaphylaxis in the adult: "A Thigh 500" forAdrenaline into the antero-lateral thigh, 500 micrograms.

  7. Are diagnosis specific outcome indicators based on administrative data useful in assessing quality of hospital care?

    PubMed Central

    Scott, I; Youlden, D; Coory, M

    2004-01-01

    Background: Hospital performance reports based on administrative data should distinguish differences in quality of care between hospitals from case mix related variation and random error effects. A study was undertaken to determine which of 12 diagnosis-outcome indicators measured across all hospitals in one state had significant risk adjusted systematic (or special cause) variation (SV) suggesting differences in quality of care. For those that did, we determined whether SV persists within hospital peer groups, whether indicator results correlate at the individual hospital level, and how many adverse outcomes would be avoided if all hospitals achieved indicator values equal to the best performing 20% of hospitals. Methods: All patients admitted during a 12 month period to 180 acute care hospitals in Queensland, Australia with heart failure (n = 5745), acute myocardial infarction (AMI) (n = 3427), or stroke (n = 2955) were entered into the study. Outcomes comprised in-hospital deaths, long hospital stays, and 30 day readmissions. Regression models produced standardised, risk adjusted diagnosis specific outcome event ratios for each hospital. Systematic and random variation in ratio distributions for each indicator were then apportioned using hierarchical statistical models. Results: Only five of 12 (42%) diagnosis-outcome indicators showed significant SV across all hospitals (long stays and same diagnosis readmissions for heart failure; in-hospital deaths and same diagnosis readmissions for AMI; and in-hospital deaths for stroke). Significant SV was only seen for two indicators within hospital peer groups (same diagnosis readmissions for heart failure in tertiary hospitals and inhospital mortality for AMI in community hospitals). Only two pairs of indicators showed significant correlation. If all hospitals emulated the best performers, at least 20% of AMI and stroke deaths, heart failure long stays, and heart failure and AMI readmissions could be avoided

  8. Strategic plan modelling by hospital senior administration to integrate diversity management.

    PubMed

    Newhouse, John J

    2010-11-01

    Limited research suggests that some hospital senior administrators and chief executive officers (CEOs) have employed a strategic planning function to achieve diversity management practices. As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavour becomes significant for senior hospital administrators. What is not well understood is what this strategic planning process represents and how it is applied to integrate diversity management. Scant research exists about the type of strategic models that hospital CEOs employ when they wish to reposition their organizations through diversity management. This study examines the strategic planning models used by senior administrators to integrate diversity management for an institutional-wide agenda. A qualitative survey process was used for CEOs in the states of New York, Pennsylvania, New Jersey and Delaware. The key research questions dealt with what type of strategic plan approach senior administrators used for integrating diversity management and what rationale they used to pursue this. Significant differences were reported between three types of strategic plan modelling used by CEOs. Also, when comparing past and current practices over time, such differences existed. The need to integrate diversity management is underscored by this study. How senior hospital administrators apply strategic plan models and what impact these approaches have represent the major implications that this study offers.

  9. Veterans Health Administration

    MedlinePlus

    ... code here VA » Veterans Health Administration Veterans Health Administration Marine Continues to Serve by Serving Veterans David ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  10. Differences in perceptions of hospital marketing orientation between administrators and marketing officers.

    PubMed

    Wrenn, B; LaTour, S A; Calder, B J

    1994-01-01

    Hospital administrators have been struggling for more than a decade to determine the role and proper position for marketing and marketers within their organizations. Results of a study now confirm the expected--administrators and their chief marketing officers do not see the same marketing actions being conducted for their hospitals. The consequence of such perceptual differences in marketing orientation for the role of marketers within the hospital are significant and are discussed in this article. Of particular importance is the finding that the marketing behaviors of the organization as identified by line managers correlate strongly with both revenues (r = .6r for inpatient revenue) and occupancy levels (r = .44). Additionally, it was found that as little as a 10 percent improvement in a hospital's marketing orientation is associated with a $25 million increase in total net patient revenues and an 8 percentage point increase in occupancy rate.

  11. 75 FR 4963 - Federal Housing Administration (FHA): Hospital Mortgage Insurance Program-Refinancing Hospital Loans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-29

    ... or renovation, which is the existing program requirement. The current downturn in the economy, which... industry, but has had a serious impact on hospitals across the Nation. At a time when the demand for health... of Insured Health Care Facilities, Office of Housing, Department of Housing and Urban...

  12. 78 FR 8329 - Federal Housing Administration (FHA): Hospital Mortgage Insurance Program-Refinancing Hospital Loans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ... variable interest rates) constitutes a type of debt eligible for refinancing. The commenter stated that the... capital debt of a hospital.'' HUD Response: HUD has added new definitions to clarify the types of costs..., the regulations provide that ``the mortgagor shall not enter into any * * * derivative-...

  13. A Comparison of Administrative Data Versus Surveillance Data for Hospital-Associated Methicillin-Resistant Staphylococcus aureus Infections in Canadian Hospitals.

    PubMed

    Ramirez Mendoza, Jessica Y; Daneman, Nick; Elias, Mary N; Amuah, Joseph E; Bush, Kathryn; Couris, Chantal M; Leeb, Kira

    2017-04-01

    BACKGROUND In Canadian hospitals, clinical information is coded according to national coding standards and is routinely collected as administrative data. Administrative data may complement active surveillance programs by providing in-hospital MRSA infection data in a standardized and efficient manner, but only if infections are accurately captured. OBJECTIVE To assess the accuracy of administrative data regarding in-hospital bloodstream infections (BSIs) and all-body-site infections due to MRSA. METHODS A retrospective study of all (adult and pediatric) in-hospital MRSA infections was conducted by comparing administrative data against surveillance data from 217 acute Canadian hospitals (124 in Ontario, 93 in Alberta) over a 12-month period. Hospital-associated MRSA BSI cases in Ontario, and for all-body-site MRSA infections in Alberta were identified. Pearson correlation coefficients were used to compare the number of hospital-level MRSA cases within administrative versus surveillance datasets. The correlation of all-body-site MRSA infections versus MRSA BSIs was also assessed using the Ontario administrative data. RESULTS Strong correlations between hospital-level MRSA cases in administrative and surveillance datasets were identified for Ontario (r=0.79; 95% CI, 0.72-0.85) and Alberta (r=0.92; 95% CI, 0.88-0.94). A strong correlation between all-body-site and bloodstream-only MRSA infection rates was identified across Ontario hospitals (r=0.95; P<.0001; 95% CI, 0.93-0.96). CONCLUSIONS This study provides good evidence of the comparability of administrative and surveillance datasets in identifying in-hospital MRSA infections. With standard definitions, administrative data can provide estimates of in-hospital infections for monitoring and/or comparisons across hospitals. Infect Control Hosp Epidemiol 2017;38:436-443.

  14. Determination of VA health care costs.

    PubMed

    Barnett, Paul G

    2003-09-01

    In the absence of billing data, alternative methods are used to estimate the cost of hospital stays, outpatient visits, and treatment innovations in the U.S. Department of Veterans Affairs (VA). The choice of method represents a trade-off between accuracy and research cost. The direct measurement method gathers information on staff activities, supplies, equipment, space, and workload. Since it is expensive, direct measurement should be reserved for finding short-run costs, evaluating provider efficiency, or determining the cost of treatments that are innovative or unique to VA. The pseudo-bill method combines utilization data with a non-VA reimbursement schedule. The cost regression method estimates the cost of VA hospital stays by applying the relationship between cost and characteristics of non-VA hospitalizations. The Health Economics Resource Center uses pseudo-bill and cost regression methods to create an encounter-level database of VA costs. Researchers are also beginning to use the VA activity-based cost allocation system.

  15. Hospital Administration and Nursing Leadership in Disasters: An Exploratory Study Using Concept Mapping.

    PubMed

    Veenema, Tener Goodwin; Deruggiero, Katherine; Losinski, Sarah; Barnett, Daniel

    Strong leadership is critical in disaster situations when "patient surge" challenges a hospital's capacity to respond and normally acceptable patterns of care are disrupted. Activation of the emergency operations plan triggers an incident command system structure for leadership decision making. Yet, implementation of the emergency operations plan and incident command system protocols is ultimately subject to nursing and hospital leadership at the service- and unit level. The results of these service-/unit-based leadership decisions have the potential to directly impact staff and patient safety, quality of care, and ultimately, patient outcomes. Despite the critical nature of these events, nurse leaders and administrators receive little education regarding leadership and decision making during disaster events. The purpose of this study is to identify essential competencies of nursing and hospital administrators' leadership during disaster events. An integrative mixed-methods design combining qualitative and quantitative approaches to data collection and analysis was used. Five focus groups were conducted with nurse leaders and hospital administrators at a large urban hospital in the Northeastern United States in a collaborative group process to generate relevant leadership competencies. Concept Systems Incorporated was used to sort, prioritize, and analyze the data (http://conceptsystemsinc.com/). The results suggest that participants' institutional knowledge (of existing resources, communications, processes) and prior disaster experience increase leadership competence.

  16. Building capacity for the conduct of nursing research at a Veterans Administration hospital.

    PubMed

    Phelan, Cynthia H; Schumacher, Sandra; Roiland, Rachel; Royer, Heather; Roberts, Tonya

    2015-05-01

    Evidence is the bedrock of nursing practice, and nursing research is the key source for this evidence. In this article, we draw distinctions between the use and the conduct of nursing research and provide a perspective for how the conduct of nursing research in a Veterans Administration hospital can build an organization's capacity for nursing research.

  17. Incidence and Variation of Discrepancies in Recording Chronic Conditions in Australian Hospital Administrative Data

    PubMed Central

    Assareh, Hassan; Achat, Helen M.; Stubbs, Joanne M.; Guevarra, Veth M.; Hill, Kim

    2016-01-01

    Diagnostic data routinely collected for hospital admitted patients and used for case-mix adjustment in care provider comparisons and reimbursement are prone to biases. We aim to measure discrepancies, variations and associated factors in recorded chronic morbidities for hospital admitted patients in New South Wales (NSW), Australia. Of all admissions between July 2010 and June 2014 in all NSW public and private acute hospitals, admissions with over 24 hours stay and one or more of the chronic conditions of diabetes, smoking, hepatitis, HIV, and hypertension were included. The incidence of a non-recorded chronic condition in an admission occurring after the first admission with a recorded chronic condition (index admission) was considered as a discrepancy. Poisson models were employed to (i) derive adjusted discrepancy incidence rates (IR) and rate ratios (IRR) accounting for patient, admission, comorbidity and hospital characteristics and (ii) quantify variation in rates among hospitals. The discrepancy incidence rate was highest for hypertension (51% of 262,664 admissions), followed by hepatitis (37% of 12,107), smoking (33% of 548,965), HIV (27% of 1500) and diabetes (19% of 228,687). Adjusted rates for all conditions declined over the four-year period; with the sharpest drop of over 80% for diabetes (47.7% in 2010 vs. 7.3% in 2014), and 20% to 55% for the other conditions. Discrepancies were more common in private hospitals and smaller public hospitals. Inter-hospital differences were responsible for 1% (HIV) to 9.4% (smoking) of variation in adjusted discrepancy incidences, with an increasing trend for diabetes and HIV. Chronic conditions are recorded inconsistently in hospital administrative datasets, and hospitals contribute to the discrepancies. Adjustment for patterns and stratification in risk adjustments; and furthermore longitudinal accumulation of clinical data at patient level, refinement of clinical coding systems and standardisation of comorbidity

  18. Optimal administrative scale for planning public services: a social cost model applied to Flemish hospital care.

    PubMed

    Blank, Jos L T; van Hulst, Bart

    2015-01-01

    In choosing the scale of public services, such as hospitals, both economic and public administrative considerations play important roles. The scale and the corresponding spatial distribution of public institutions have consequences for social costs, defined as the institutions' operating costs and the users' travel costs (which include the money and time costs). Insight into the relationship between scale and spatial distribution and social costs provides a practical guide for the best possible administrative planning level. This article presents a purely economic model that is suitable for deriving the optimal scale for public services. The model also reveals the corresponding optimal administrative planning level from an economic perspective. We applied this model to hospital care in Flanders for three different types of care. For its application, we examined the social costs of hospital services at different levels of administrative planning. The outcomes show that the social costs of rehabilitation in Flanders with planning at the urban level (38 areas) are 11% higher than those at the provincial level (five provinces). At the regional level (18 areas), the social costs of rehabilitation are virtually equal to those at the provincial level. For radiotherapy, there is a difference of 88% in the social costs between the urban and the provincial level. For general care, there are hardly any cost differences between the three administrative levels. Thus, purely from the perspective of social costs, rehabilitation should preferably be planned at the regional level, general services at the urban level and radiotherapy at the provincial level.

  19. 78 FR 76061 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse...-VA medical care. In the Federal Register on November 28, 2012, VA proposed to remove an outdated regulatory limitation on veterans' eligibility to be referred for non- VA medical care. On the same date,...

  20. Integrating hospital administrative data to improve health care efficiency and outcomes: "the socrates story".

    PubMed

    Lawrence, Justin; Delaney, Conor P

    2013-03-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes.

  1. Integrating Hospital Administrative Data to Improve Health Care Efficiency and Outcomes: “The Socrates Story”

    PubMed Central

    Lawrence, Justin; Delaney, Conor P.

    2013-01-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes. PMID:24436649

  2. 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.

  3. The effects of local culture on hospital administration in West Sumatra, Indonesia.

    PubMed

    Semiarty, Rima; Fanany, Rebecca

    2017-02-06

    Purpose Problems in health-care leadership are serious in West Sumatra, Indonesia, especially in hospitals, which are controlled locally. The purpose of this paper is to present the experience of three hospitals in balancing the conflicting demands of the national health-care system and the traditional model of leadership in the local community. Design/methodology/approach Three case studies of the hospital leadership dynamic in West Sumatra were developed from in-depth interviews with directors, senior administrators and a representative selection of employees in various professional categories. Findings An analysis of findings shows that traditional views about leadership remain strong in the community and color the expectations of hospital staff. Hospital directors, however, are bound by the modern management practices of the national system. This conflict has intensified since regional autonomy which emphasizes the local culture much more than in the past. Research limitations/implications The research was carried out in one Indonesian province and was limited to three hospitals of different types. Practical implications The findings elucidate a potential underlying cause of problems in hospital management in Indonesia and may inform culturally appropriate ways of addressing them. Originality/value The social and cultural contexts of management have not been rigorously studied in Indonesia. The relationship between local and national culture reported here likely has a similar effect in other parts of the country.

  4. Provision of CT Scanning Capability to VA/DoD (Veterans Administration/ Department of Defense) Health Care Facilities through a Shared Mobile CT Unit: A Feasibility Study

    DTIC Science & Technology

    1984-07-27

    all Federal sectoT facilities. Shared services have long been recna, nzed as one way to reduce costs, throuph optima’ itilizaticn of capacity, but...stock arguments against shared services . A CT scanner may be installed in a mobile van and the service moved in its entirety from hospital to hospital...annually. This severely restricted further acquisition by hospitals in most health service areas (5,9,14). Shared Services : A Response to Regulation

  5. Proceedings of the First Annual Meeting of the American College of Mental Health Administration, September 21-23, 1980, Williamsburg, VA.

    ERIC Educational Resources Information Center

    Feldman, Saul; And Others

    1981-01-01

    Presents three keynote speeches focusing on the topics of leadership development in mental health services administration and ethical dilemmas in the administration of mental health services. Suggests that didactic content and specific skill training activities must be provided for administrators at all levels. (HLM)

  6. 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.

  7. Work mistreatment and hospital administrative staff: policy implications for healthier workplaces.

    PubMed

    Harlos, Karen P; Axelrod, Lawrence J

    2008-08-01

    Research on work life quality in hospitals has focused on how nurses and physicians perceive or react to work conditions. We extend this focus to another major professional group - healthcare administrators - to learn more about how these employees experience the work environment. Administrators merit such attention given their key roles in sustaining the financial health of the hospital and in fulfilling management functions efficiently to support consistent, high-quality care. Specifically, we examined mistreatment in the workplace experienced by administrative staff from a hospital in a large Canadian city. Three dimensions of mistreatment - verbal abuse, work obstruction and emotional neglect - have been associated with diminished well-being, work satisfaction and organizational commitment, along with stronger intent to leave. In this paper, we provide additional support for interpreting these three dimensions as mistreatment and report on their frequencies in our sample. We then consider implications for policy development (e.g., communication and conflict resolution skills training, mentoring programs, respect-at-work policies) to make workplaces healthier for these neglected but important healthcare professionals.

  8. Accessing VA Healthcare During Large-Scale Natural Disasters.

    PubMed

    Der-Martirosian, Claudia; Pinnock, Laura; Dobalian, Aram

    2017-01-01

    Natural disasters can lead to the closure of medical facilities including the Veterans Affairs (VA), thus impacting access to healthcare for U.S. military veteran VA users. We examined the characteristics of VA patients who reported having difficulty accessing care if their usual source of VA care was closed because of natural disasters. A total of 2,264 veteran VA users living in the U.S. northeast region participated in a 2015 cross-sectional representative survey. The study used VA administrative data in a complex stratified survey design with a multimode approach. A total of 36% of veteran VA users reported having difficulty accessing care elsewhere, negatively impacting the functionally impaired and lower income VA patients.

  9. A data base management system for the administration of hospital pharmacy personnel.

    PubMed

    Ingrim, N B; Guernsey, B G; Doutre, W H; Galvan, E; Hokanson, J A; Richard, P L

    1983-09-01

    A data base management system (System 2000) was utilized to develop a pharmacy personnel inventory that would allow the pharmacy and hospital administrators to quickly and easily obtain biographic and demographic information about employees in a large pharmacy department. The inventory provides personal information about each employee and administrative data such as previous employment and salary histories, benefits packages, and special skills. In addition, the personnel inventory provides other administrative functions including: 1) a tally of vacation or sick days accrued; 2) salary and merit increase information for pay evaluations; 3) a personnel telephone directory; 4) the immediate access to employee emergency contact information; 5) a tally of continuing education credits accrued by each pharmacist; 6) a list of languages, other than English, spoken by pharmacy personnel; 7) pharmacist licensure information; and 8) a list of the ethnic groups represented in the department for use in equal opportunity employment. Computer-prompted instructions allow use of the system by individuals with little or no computer background. Implementation of the system required less than 200 hours and maintenance costs have been relatively minimal. Recent advances in computer technology have made data base management systems similar to that described in this report, a realistic investment for the administrative needs of even the smaller hospital pharmacy.

  10. Mentoring junior healthcare administrators: a description of mentoring practices in 127 U.S. hospitals.

    PubMed

    Finley, Frances R; Ivanitskaya, Lana V; Kennedy, Michael H

    2007-01-01

    A survey instrument about mentoring junior healthcare administrators was mailed to 485 senior-level executives-chief executive officers, hospital administrators, and presidents. Completed surveys were returned by 127 senior executives (26 percent response rate). On average, the respondents were 53 years old, had nine years of organizational tenure in their current position, and had 16.5 years of career tenure as a senior healthcare executive. The mean age of when the respondents first had a mentor was 28 years old. The average length of the respondents' relationship with their mentor was 3.56 years. Although healthcare executives believed mentoring benefits the healthcare industry as a whole, they reported that the benefits were even greater for the hospital where mentoring was done. Personal satisfaction was cited as the primary reason for serving as a mentor. In the 127 organizations represented by the respondents, informal mentoring programs were more prevalent than formal mentoring programs. Our findings suggest that healthcare executives in formal mentoring programs may be more likely to support mentoring than individuals who entered informal mentoring relationships. Those who reported being mentors or engaging in mentoring-supportive activities had a longer job tenure and career tenure than did individuals who had not served as mentors. The study suggests that mentoring--in particular, informal mentoring--is a popular activity in U.S. hospitals and is carried out by experienced healthcare executives whose primary motivation is personal satisfaction.

  11. Assessing Hospital Disaster Readiness Over Time at the US Department of Veterans Affairs.

    PubMed

    Der-Martirosian, Claudia; Radcliff, Tiffany A; Gable, Alicia R; Riopelle, Deborah; Hagigi, Farhad A; Brewster, Pete; Dobalian, Aram

    2017-02-01

    Introduction There have been numerous initiatives by government and private organizations to help hospitals become better prepared for major disasters and public health emergencies. This study reports on efforts by the US Department of Veterans Affairs (VA), Veterans Health Administration, Office of Emergency Management's (OEM) Comprehensive Emergency Management Program (CEMP) to assess the readiness of VA Medical Centers (VAMCs) across the nation. Hypothesis/Problem This study conducts descriptive analyses of preparedness assessments of VAMCs and examines change in hospital readiness over time.

  12. 75 FR 35511 - Virginia Disaster Number VA-00028

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster Number VA-00028 AGENCY: Small Business Administration. ACTION: Amendment 3..., is hereby amended to include the following areas as adversely affected by the disaster....

  13. Impact of Early Vasopressor Administration on Neurological Outcomes after Prolonged Out-of-Hospital Cardiac Arrest.

    PubMed

    Hubble, Michael W; Tyson, Clark

    2017-02-22

    Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest. Hypothesis The likelihood of favorable neurological outcome declines with increasing PPI.

  14. Classification algorithms to improve the accuracy of identifying patients hospitalized with community-acquired pneumonia using administrative data.

    PubMed

    Yu, O; Nelson, J C; Bounds, L; Jackson, L A

    2011-09-01

    In epidemiological studies of community-acquired pneumonia (CAP) that utilize administrative data, cases are typically defined by the presence of a pneumonia hospital discharge diagnosis code. However, not all such hospitalizations represent true CAP cases. We identified 3991 hospitalizations during 1997-2005 in a managed care organization, and validated them as CAP or not by reviewing medical records. To improve the accuracy of CAP identification, classification algorithms that incorporated additional administrative information associated with the hospitalization were developed using the classification and regression tree analysis. We found that a pneumonia code designated as the primary discharge diagnosis and duration of hospital stay improved the classification of CAP hospitalizations. Compared to the commonly used method that is based on the presence of a primary discharge diagnosis code of pneumonia alone, these algorithms had higher sensitivity (81-98%) and positive predictive values (82-84%) with only modest decreases in specificity (48-82%) and negative predictive values (75-90%).

  15. [Risk assessment concerning hospital personnel participating in the preparation and administration of antineoplastic drugs].

    PubMed

    Minoia, C; Turci, R; Sottani, C; Schiavi, A; Perbellini, L; Angeleri, S; Frigerio, F; Draicchio, F; Apostoli, P

    1999-01-01

    24 workers (10 involved in the preparation and 14 in administration) exposed to cyclophosphamide (CP) and ifosfamide (IF) in two Italian hospitals were monitored. The extent of exposure was assessed by the analysis of air samples, wipe samples, pads and gloves. Urinary excretion at the beginning and at the end of the work shift was also measured by liquid-liquid extraction and analysis by HPLC-MS/MS. 3 out of 24 air samples resulted to be positive for CP or IF. In wipe samples, CP concentrations ranging from < 0.001 to 82.4 micrograms/dm2 in Hospital A (32 samples) and from 0.2 to 383.3 micrograms/dm2 in Hospital B (17 samples), were found. IF concentrations varied from < 0.001 to 90.9 micrograms/dm2 in Hospital A and from 0.01 to 141.5 micrograms/dm2 in Hospital B. Pads (from 11 to 13 for each operator) were contaminated with CP and IF especially on arms, legs and chest. The use of a plastic-backed liner on the working tray in the laminar flow hoods was demonstrated to compromise the containment properties of the hood. Urine samples were positive for CP in 50% of the workers (range: 0.1-2.1 micrograms/L), whereas IF was detected in 2 subjects only (range: 0.1-0.8 microgram/L). The results from this investigation demonstrated that vertical laminar airflow hoods, when incorrectly used, might represent a source of contamination and that higher risk may depend on lack of educational programmes and observance of preventive guidelines.

  16. Hospital administration team development and support in a children's cancer service.

    PubMed

    Slater, Penelope J

    2011-11-01

    The administration team in the Queensland Children's Cancer Centre at the Royal Children's Hospital, Brisbane, included a team of 16 administration staff supporting the service and the state-wide clinical network. Shortly after the creation of a new expanded service, issues became apparent in administration team morale, relationships, communication, processes, leadership, support and training. The analysis of these issues included team interviews and surveys, consultation with senior administration staff and monthly sick leave monitoring. Strategies implemented included providing information; the joint development of a team business plan and individual performance plans; a review of the team's structure, workload and business processes; engaging staff in quality improvements; and the development of relationships and leadership. As a result, the team reported being more comfortable and supported in their roles, had improved morale and worked better together with more consistent and improving business processes. They had clear purpose and expectations of their roles, displayed better customer service and had reduced sick leave. The study shows that in a high stress environment, such as a children's cancer centre, attention to the team's culture, vision and purpose, providing information and improving communication and relationships, when combined with a team's enthusiasm, will improve the team's growth, cooperation and work outcomes.

  17. Education does pay off: pneumococcal vaccine screening and administration in hospitalized adult patients with pneumonia.

    PubMed

    Kruspe, Rachel; Lillis, Rebecca; Daberkow, Dayton W; Blais, Christopher M; Wilbright, Wayne; Gupta, Shaminder; Gould, Cynthia A; Sun, Tony; Martinez, Jorge A; deBoisblanc, Ben; Ladabaum, Uri; Sanders, Charles V; Lopez, Fred A

    2003-01-01

    Streptococcus pneumoniae-associated infections are an important cause of hospitalization and mortality in high-risk and elderly patients. Even in the setting of appropriate therapy, the case fatality rate of invasive pneumococcal disease in the elderly may approach 40%. Since approximately 40,000 people die annually from pneumococcal-associated disease, it represents a substantial target for vaccine-preventable, bacterial fatalities. The 23-valent pneumococcal polysaccharide vaccine has proven consistently effective in preventing invasive pneumococcal disease. Despite its endorsement by numerous specialty societies, the pneumococcal vaccine is underutilized in the inpatient setting. In a recent report of quality indicators for Medicare beneficiaries, the percentage of Medicare beneficiaries in Louisiana admitted with pneumonia who were screened or received the pneumococcal vaccination prior to discharge was only 4%, the lowest percentage in the United States. The Louisiana State University-New Orleans Internal Medicine Department and its house staff embarked upon a retrospective study to determine its baseline pneumococcal vaccination or screening rates for all patients with pneumonia on its inpatient services at the The Medical Center of Louisiana in New Orleans from July 2000 through June 2001. From July 2001 through June 2002 an intensive educational intervention concentrating on the indications and benefits of pneumococcal vaccination was directed toward the Louisiana State University Internal Medicine house staff assigned to the inpatient service. Retrospective analysis for pneumococcal vaccine screening and administration of charts of all patients with pneumonia on the LSU Medicine service from July 2001 through June 2002 was performed in order to determine the effects of the intervention. Data from the pre-educational intervention period revealed a baseline pneumococcal vaccine screening or administration rate of 11% for all patients with pneumonia on the

  18. 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

  19. Analysis of the technology acceptance model in examining hospital nurses' behavioral intentions toward the use of bar code medication administration.

    PubMed

    Song, Lunar; Park, Byeonghwa; Oh, Kyeung Mi

    2015-04-01

    Serious medication errors continue to exist in hospitals, even though there is technology that could potentially eliminate them such as bar code medication administration. Little is known about the degree to which the culture of patient safety is associated with behavioral intention to use bar code medication administration. Based on the Technology Acceptance Model, this study evaluated the relationships among patient safety culture and perceived usefulness and perceived ease of use, and behavioral intention to use bar code medication administration technology among nurses in hospitals. Cross-sectional surveys with a convenience sample of 163 nurses using bar code medication administration were conducted. Feedback and communication about errors had a positive impact in predicting perceived usefulness (β=.26, P<.01) and perceived ease of use (β=.22, P<.05). In a multiple regression model predicting for behavioral intention, age had a negative impact (β=-.17, P<.05); however, teamwork within hospital units (β=.20, P<.05) and perceived usefulness (β=.35, P<.01) both had a positive impact on behavioral intention. The overall bar code medication administration behavioral intention model explained 24% (P<.001) of the variance. Identified factors influencing bar code medication administration behavioral intention can help inform hospitals to develop tailored interventions for RNs to reduce medication administration errors and increase patient safety by using this technology.

  20. 77 FR 76451 - Designation for the West Sacramento, CA; Frankfort, IN; and Richmond, VA Areas.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... Administration Designation for the West Sacramento, CA; Frankfort, IN; and Richmond, VA Areas. AGENCY: Grain... Frankfort, IN(765) 258-3624........ 1/1/2013 12/31/2015 Virginia Richmond, VA(757) 494-2464............

  1. Whole-patient measure of safety: using administrative data to assess the probability of highly undesirable events during hospitalization.

    PubMed

    Perla, Rocco J; Hohmann, Samuel F; Annis, Karen

    2013-01-01

    Hospitals often have limited ability to obtain primary clinical data from electronic health records to use in assessing quality and safety. We outline a new model that uses administrative data to gauge the safety of care at the hospital level. The model is based on a set of highly undesirable events (HUEs) defined using administrative data and can be customized to address the priorities and needs of different users. Patients with HUEs were identified using discharge abstracts from July 1, 2008 through June 30, 2010. Diagnoses were classified as HUEs based on the associated present-on-admission status. The 2-year study population comprised more than 6.5 million discharges from 161 hospitals. The proportion of hospitalizations including at least one HUE during the 24-month study period varied greatly among hospitals, with a mean of 7.74% (SD 2.3%) and a range of 13.32% (max, 15.31%; min, 1.99%). The whole-patient measure of safety provides a global measure to use in assessing hospitals with the patient's entire care experience in mind. As administrative and clinical datasets become more consistent, it becomes possible to use administrative data to compare the rates of HUEs across organizations and to identify opportunities for improvement.

  2. Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study

    PubMed Central

    Keers, Richard N; Williams, Steven D; Cooke, Jonathan; Ashcroft, Darren M

    2015-01-01

    Objectives To investigate the underlying causes of intravenous medication administration errors (MAEs) in National Health Service (NHS) hospitals. Setting Two NHS teaching hospitals in the North West of England. Participants Twenty nurses working in a range of inpatient clinical environments were identified and recruited using purposive sampling at each study site. Primary outcome measures Semistructured interviews were conducted with nurse participants using the critical incident technique, where they were asked to discuss perceived causes of intravenous MAEs that they had been directly involved with. Transcribed interviews were analysed using the Framework approach and emerging themes were categorised according to Reason's model of accident causation. Results In total, 21 intravenous MAEs were discussed containing 23 individual active failures which included slips and lapses (n=11), mistakes (n=8) and deliberate violations of policy (n=4). Each active failure was associated with a range of error and violation provoking conditions. The working environment was implicated when nurses lacked healthcare team support and/or were exposed to a perceived increased workload during ward rounds, shift changes or emergencies. Nurses frequently reported that the quality of intravenous dose-checking activities was compromised due to high perceived workload and working relationships. Nurses described using approaches such as subconscious functioning and prioritising to manage their duties, which at times contributed to errors. Conclusions Complex interactions between active and latent failures can lead to intravenous MAEs in hospitals. Future interventions may need to be multimodal in design in order to mitigate these risks and reduce the burden of intravenous MAEs. PMID:25770226

  3. VA/DoD Collaboration Guidebook for Healthcare Research

    DTIC Science & Technology

    2011-01-24

    Fort Hood, TX Reynolds Army Community Hospital, Fort Sill, OK Bayne Jones Army Community Hospital, Fort Polk, LA VA/DoD Research Collaboration...www.rach.sill.amedd.army.mil/ Bayne Jones Army Community Hospital, Fort Polk, LA http://www.polk.amedd.army.mil/ 50 (IRB) Dwight D. Eisenhower AMC, Fort

  4. Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012

    PubMed Central

    Wright, Brad; O'Shea, Amy M.J.; Glasgow, Justin M.; Ayyagari, Padmaja; Vaughan-Sarrazin, Mary

    2016-01-01

    Abstract Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals. The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals. Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient and enrollment files, American Hospital Association Survey, and Area Health Resource File. We used these data to estimate linear regression models of hospitals’ observation stay rates as a function of hospital, patient, and local health system characteristics, while controlling for time trends and Veterans Integrated Service Network level fixed effects. We found that observation stay rates are inversely related to hospital bed size and that hospitals with a greater proportion of younger or rural patients have higher observation stay rates. Observation stay rates were nearly 15 percentage points higher in 2012 than 2005. Although we identify several characteristics associated with variation in VHA hospital observation stay rates, many factors remain unmeasured. PMID:27603391

  5. 76 FR 52230 - Establishment of Class E Airspace; Forest, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; Forest, VA AGENCY... Airspace at Forest, VA, to accommodate the new Area Navigation (RNAV) Global Positioning System (GPS... published in the Federal Register a notice of proposed rulemaking to establish Class E airspace at...

  6. Do new workforce roles reduce waiting times in ED? A difference-in-difference evaluation using hospital administrative data.

    PubMed

    Scott, Anthony; Yong, Jongsay

    2015-04-01

    This paper evaluates the effect of introducing two new workforce roles under a pilot program conducted in Victoria, Australia. The trial took place at a regional hospital's emergency department (ED) between 1 July 2008 and 30 June 2009. The evaluation is based on three outcome measures: waiting time (in minutes) at ED before treatment; proportion of presentations with waiting time on target; and length of stay (in days), for ED presentations that led to in-patient admissions. The technique of difference-in-differences analysis is used. A total of 142,980 patient records from the pilot hospital and three comparison hospitals were extracted from the Victorian Emergency Minimum Dataset (VEMD). Further, 21,925 records of patients whose ED presentations led to in-patient admissions were extracted from the Victorian Admitted Episodes Dataset (VAED). The evaluation finds the piloted roles have lowered waiting time and raised the proportion of on-target presentations. These effects were found to be the strongest for less urgent triage categories. However, the evidence on in-patient length of stay was mixed. The results provide positive evidence that new workforce roles can be effective in improving the efficiency of emergency care delivery.

  7. 77 FR 51100 - Virginia Disaster No. VA-00048

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-23

    ... ADMINISTRATION Virginia Disaster No. VA-00048 AGENCY: U.S. Small Business Administration. ACTION: Amendment 1.... ADDRESSES: Submit completed loan applications to: U.S. Small Business Administration, Processing and..., Office of Disaster Assistance, U.S. Small Business Administration, 409 3rd Street, SW., Suite...

  8. Impact of implementing an Internal Bed Regulation Committee on administrative and care indicators at a teaching hospital

    PubMed Central

    Rodrigues, Luciane Cristine Ribeiro; Juliani, Carmen Maria Casquel Monti

    2015-01-01

    Objective To compare hospital indicators before and after implementing an Internal Bed Regulation Committee at a reference hospital. Methods It is an quantitative, evaluation, exploratory, descriptive and cross-sectional research. The data was gathered from the hospital administrative reports for the period 2008-2013, provided by the Information Technology Center of the Complexo FAMEMA. Results The indicators improved after implementation of the Internal Bed Regulation Committee. Conclusion The individuals involved in the process acknowledged the improvement. It is necessary to carry on the regulatory actions, especially in a comprehensive and complex healthcare system, such as the brazilian Sistema Único de Saúde. PMID:25993075

  9. A Study of Veterans Administration/Department of Defense Health Care Resources Sharing at Keller Army Community Hospital West Point, New York 10996

    DTIC Science & Technology

    1984-04-01

    potential to reduce the excess capacity of participating facilities. 6. Provide a mechanism for notifying participating facilities that the purchase...imminent. 7. Provide a mechanism for addressing joint acquisition of major equipment/services. 8. Demonstrate a potential cost savings for resources...VA) first expressed a desire to share medical resources with Keller Army Community Hospital (KACH), West Point, New York.1 The mechanics of Federal

  10. Hospitalizations of Infants and Young Children with Down Syndrome: Evidence from Inpatient Person-Records from a Statewide Administrative Database

    ERIC Educational Resources Information Center

    So, S. A.; Urbano, R. C.; Hodapp, R. M.

    2007-01-01

    Background: Although individuals with Down syndrome are increasingly living into the adult years, infants and young children with the syndrome continue to be at increased risk for health problems. Using linked, statewide administrative hospital discharge records of all infants with Down syndrome born over a 3-year period, this study "follows…

  11. Veterans Administration Databases

    Cancer.gov

    The Veterans Administration Information Resource Center provides database and informatics experts, customer service, expert advice, information products, and web technology to VA researchers and others.

  12. 78 FR 2708 - Virginia Disaster Number VA-00052

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-14

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster Number VA-00052 AGENCY: U.S. Small Business Administration. ACTION: Amendment 1... completed loan applications to: U.S. Small Business Administration, Processing and Disbursement...

  13. Modeling nurses' acceptance of bar coded medication administration technology at a pediatric hospital

    PubMed Central

    Brown, Roger L; Scanlon, Matthew C; Karsh, Ben-Tzion

    2012-01-01

    Objective To identify predictors of nurses' acceptance of bar coded medication administration (BCMA). Design Cross-sectional survey of registered nurses (N=83) at an academic pediatric hospital that recently implemented BCMA. Methods Surveys assessed seven BCMA-related perceptions: ease of use; usefulness for the job; social influence from non-specific others to use BCMA; training; technical support; usefulness for patient care; and social influence from patients/families. An all possible subset regression procedure with five goodness-of-fit indicators was used to identify which set of perceptions best predicted BCMA acceptance (intention to use, satisfaction). Results Nurses reported a moderate perceived ease of use and low perceived usefulness of BCMA. Nurses perceived moderate-or-higher social influence to use BCMA and had moderately positive perceptions of BCMA-related training and technical support. Behavioral intention to use BCMA was high, but satisfaction was low. Behavioral intention to use was best predicted by perceived ease of use, perceived social influence from non-specific others, and perceived usefulness for patient care (56% of variance explained). Satisfaction was best predicted by perceived ease of use, perceived usefulness for patient care, and perceived social influence from patients/families (76% of variance explained). Discussion Variation in and low scores on ease of use and usefulness are concerning, especially as these variables often correlate with acceptance, as found in this study. Predicting acceptance benefited from using a broad set of perceptions and adapting variables to the healthcare context. Conclusion Success with BCMA and other technologies can benefit from assessing end-user acceptance and elucidating the factors promoting acceptance and use. PMID:22661559

  14. 75 FR 70351 - Termination of Environmental Review Process Cities of Chesapeake and Virginia Beach, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... Virginia Beach, VA AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Termination of environmental... the Cities of Chesapeake and Virginia Beach, Virginia, is terminated. FOR FURTHER INFORMATION...

  15. 4. Hospital Point, Saunders Monument, view to northeast Portsmouth ...

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

    4. Hospital Point, Saunders Monument, view to northeast - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  16. 1. Oblique view of east portion of Portsmouth Naval Hospital ...

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

    1. Oblique view of east portion of Portsmouth Naval Hospital Complex showing in middle ground, from left to right, Medical Ward A (HABS No. VA01287-G), Medical Ward B (HABS No. VA-1287-H), Medical Ward C (HABS No. VA-1287-I, Portsmouth Naval Hospital Building (HABS No. VA-1287-A), Hospital Point; and in foreground, from left to right, gardener's tool shed (HABS No. VA-1287-C), Service Building (HABS No. VA01287-D), garage (HABS No. VA-1287-F), Medical Officer's Quarters C (HABS No. VA-1287-B), and Medical Officer's Quarters B (HAQBS No. VA-1287-E), view to north from roof of 1960 high-rise hospital - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  17. Oral drug dosage forms administered to hospitalized children: Analysis of 117,665 oral administrations in a French paediatric hospital over a 1-year period.

    PubMed

    Lajoinie, A; Henin, E; Nguyen, K A; Malik, S; Mimouni, Y; Sapori, J M; Bréant, V; Cochat, P; Kassai, B

    2016-03-16

    Selecting the most appropriate dosage form, that ensures safe administration and adherence of medications, is a major issue for children. Marketed drugs, however, have rarely been tested for their use in children. There is a need for more data on drug formulations administered to children to identify unmet needs, and drive future paediatric research. We observed, over a 12-month follow-up, 117,665 oral drug administrations to 1998 hospitalized children. Nine-tenths belonged to five Anatomical Therapeutic Chemical classes: Alimentary tract & metabolism, Nervous system, Cardiovascular system, Anti-infectives for systemic use and Blood & blood forming organs, one third of drug doses administered to school-age children and adolescents were liquids, and extemporaneous capsules were commonly used in younger children. Our study shows that despite the advantages of solid dosage forms and recent evidence from randomized controlled trials showing their acceptability in infants, they are seldom used in paediatric practice.

  18. 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

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

    PubMed Central

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

    2015-01-01

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

  20. 75 FR 20774 - Establishment of Class E Airspace; Fort A.P. Hill, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; Fort A.P. Hill, VA... Register December 7, 2009 that establishes Class E airspace at Fort A.P. Hill, VA. DATES: Effective Date..., Eastern Service Center, Federal Aviation Administration, P.O. Box 20636, Atlanta, Georgia 30320;...

  1. Comparison of growth in compensation for hospital administrators and nurses in Kansas, 2003 to 2005.

    PubMed

    Anno, Tony; Hornberger, Cynthia

    2007-04-01

    The current nursing shortage is reaching a critical level (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2006). As baby boomers reach an age when they will require increased healthcare the demand for nurses will accelerate over the foreseeable future. One issue impacting the desirability of nursing as a career is salary compensation. Nurse salaries have not kept up with the rate of inflation (American Association of State Colleges and Universities, 2005) while hospital Chief Executive Officer (CEO) compensation has increased (Westfall, 2005). The purpose of this study was to examine the compensation growth of hospital CEO's compared to nurses over the past three years in Kansas. Hospital CEO data was obtained from the Internal Revenue Service form 990 retrieved from the public domain. Nursing salary data was obtained from archival data published by the Kansas Department of Labor Statistics. Data analyses described differences in the salaries of nurses and chief executive officers in Kansas over a three-year period and within subgroups defined by geographical region. During this three year period Kansas hospital CEOs' compensation increased 23.2% compared to a national increase of 9%. Registered Nurses' compensation in Kansas increased 17.39% compared to a national average of 11%. Licensed Practical Nurse compensation in Kansas increased 6.28% compared to a national average of 9%. The population in the United States is growing older at the same time demand for nurses will accelerate (Lovell, 2006). The shortage of nurses is reaching a critical level as hospitals try to provide care. Causes of the shortage are multifaceted and include the demand for nurses outpacing supply and compensation trends. In Kansas, the supply of nurses is hampered by a present shortage of nursing faculty that will be exacerbated by the impending retirement of a sizable portion of the faculty in the next decade (Hornberger, Hess, & Thompson, 2005). The lack of faculty impairs nursing programs

  2. Administrative measures for preventing Mycobacterium tuberculosis infection among healthcare workers in a teaching hospital in Rio de Janeiro, Brazil

    PubMed Central

    da Costa, P. Albuquerque; Trajman, A.; de Queiroz Mello, F. Carvalho; Goudinho, S.; Silva, M.A. Monteiro Vieira; Garret, D.; Ruffino-Netto, A.; Kritski, A. Lineu

    2009-01-01

    Summary Tuberculosis (TB) is an occupational disease of healthcare workers (HCWs). Administrative and engineering interventions simultaneously implemented in hospitals of developed countries have reduced the risk of nosocomial transmission of M. tuberculosis. We have studied the impact of administrative infection control measures on the risk for latent TB infection (LTBI) among HCWs in a resource-limited, high-burden country. An intervention study was undertaken in a university-affiliated, inner-city hospital in Rio de Janeiro, where routine serial tuberculin skin test (TST) is offered to all HCWs. From October 1998 to February 2001, the following administrative infection control measures were progressively implemented: isolation of TB suspects and confirmed TB inpatients, quick turnaround for acid-fast bacilli sputum tests and HCW education in use of protective respirators. Among 1336 initially tested HCWs, 599 were retested. The number of TST conversions per 1000 person-months during and after the implementation of these measures was reduced from 5.8/1000 to 3.7/1000 person-months (P = 0.006). The most significant reductions were observed in the intensive care unit (from 20.2 to 4.5, P < 0.001) and clinical wards (from 10.3 to 6.0, P < 0.001). Physicians and nurses had the highest reductions (from 7.6 to 0, P < 0.001; from 9.9 to 5.8, P = 0.001, respectively). We conclude that isolated administrative measures for infection control can significantly reduce LTBI among HCWs in high-burden countries and should be implemented even when resources are not available for engineering infection control measures. PMID:19278753

  3. Characteristics and VA Health Care Utilization of U.S. Veterans Who Completed Suicide in Oregon between 2000 and 2005

    ERIC Educational Resources Information Center

    Basham, Chandra; Denneson, Lauren M.; Millet, Lisa; Shen, Xun; Duckart, Jonathan; Dobscha, Steven K.

    2011-01-01

    Oregon Violent Death Reporting System data were linked with Veterans Affairs (VA) administrative data to identify and describe veterans who completed suicide in Oregon from 2000 to 2005 (n = 968), and to describe their VA health care utilization in the year prior to death. Twenty-two percent had received health care in the VA system. Of these, 57%…

  4. A Study of the Utility of a Participative Approach to Employee Attitude Surveys as a Management Tool at the Audie L. Murphy Memorial VA Hospital in San Antonio, Texas

    DTIC Science & Technology

    1979-05-01

    Classification) A Study of the Utility of a Participative Approach to Employee Attitude Surveys as a Management Tool at the Audie L. Murphy Memoria VA...Engineering-49, Medical-38, Laboratory-32, Social Work-23, and RMS-19.) The responses of employees in all other services would be collectively identified...Laboratory 47 Social Work 78 All Others 50 TABLE 3 Positive Responses to Question Thirteen By Service Comparing responses by salary level the average positive

  5. Greening America's Capitals - Richmond, VA

    EPA Pesticide Factsheets

    Report from the Greening America's Capitals project in Richmond, VA, to help the city develop design options to protect pedestrians, bicyclists, transit users, and drivers; improve stormwater management; and spur revitalization.

  6. VA Health Care Facilities Locator

    MedlinePlus

    ... VA » Locations » Find Locations Locations Find Locations The javascript used here is for validation purpose only. Your browser doesn't seem to support javascript or has it disabled. This site is a ...

  7. National Veterans Health Administration inpatient risk stratification models for hospital-acquired acute kidney injury

    PubMed Central

    Cronin, Robert M; VanHouten, Jacob P; Siew, Edward D; Eden, Svetlana K; Fihn, Stephan D; Nielson, Christopher D; Peterson, Josh F; Baker, Clifton R; Ikizler, T Alp; Speroff, Theodore

    2015-01-01

    Objective Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset of kidney injury is a key step towards AKI prevention. Materials and Methods A national retrospective cohort of 1,620,898 patient hospitalizations from 116 Veterans Affairs hospitals was assembled from electronic health record (EHR) data collected from 2003 to 2012. HA-AKI was defined at stage 1+, stage 2+, and dialysis. EHR-based predictors were identified through logistic regression, least absolute shrinkage and selection operator (lasso) regression, and random forests, and pair-wise comparisons between each were made. Calibration and discrimination metrics were calculated using 50 bootstrap iterations. In the final models, we report odds ratios, 95% confidence intervals, and importance rankings for predictor variables to evaluate their significance. Results The area under the receiver operating characteristic curve (AUC) for the different model outcomes ranged from 0.746 to 0.758 in stage 1+, 0.714 to 0.720 in stage 2+, and 0.823 to 0.825 in dialysis. Logistic regression had the best AUC in stage 1+ and dialysis. Random forests had the best AUC in stage 2+ but the least favorable calibration plots. Multiple risk factors were significant in our models, including some nonsteroidal anti-inflammatory drugs, blood pressure medications, antibiotics, and intravenous fluids given during the first 48 h of admission. Conclusions This study demonstrated that, although all the models tested had good discrimination, performance characteristics varied between methods, and the random forests models did not calibrate as well as the lasso or logistic regression models. In addition, novel modifiable risk factors were explored and found to be significant. PMID:26104740

  8. An empirical evaluation of devolving administrative control to Costa Rican hospital and clinic directors.

    PubMed

    Lee, Theodore; McKee, Douglas

    2015-01-01

    In the early 2000s, Costa Rica implemented comprehensive reforms of its health care system, including devolving administrative power from the central government to some providers that remain part of the national system. In this article, we evaluate how this aspect of the reform affected clinic efficiency and population health by analyzing administrative data on regional providers and mortality rates in local areas. We compare changes in outcomes across time between areas that signed performance contracts with the central government and received limited budgetary control to those that continued to be managed directly by the central government. We believe the reform created opportunities for providers to become more efficient and effective. Our results suggest that the reform significantly decreased costs without adversely affecting quality of care or population health.

  9. Effectiveness of an improvement programme to prevent interruptions during medication administration in a paediatric hospital: a preintervention–postintervention study

    PubMed Central

    Dall'Oglio, Immacolata; Fiori, Martina; Di Ciommo, Vincenzo; Tiozzo, Emanuela; Mascolo, Rachele; Bianchi, Natalia; Ciofi Degli Atti, Marta Luisa; Ferracci, Antonella; Gawronski, Orsola; Pomponi, Manuel; Raponi, Massimiliano

    2017-01-01

    Objective To assess the effectiveness of an improvement programme to reduce the number of interruptions during the medication administration process in a paediatric hospital. Design and methods A prestudy–post study design was used to monitor nursing interruptions during medication cycles in a paediatric hospital. Interruptions were reported on an observation sheet (MADOS-P) adapted to the paediatric context. Setting A 600-bed tertiary paediatric research hospital in Italy. Intervention The interventions included a yellow sash worn by nurses during medication cycles, a yellow-taped floor area indicating the ‘No interruption area’, visual notices in the medication areas, education sessions for healthcare providers and families, patient and parent information material. Results 225 medication cycles were observed before the intervention (T0) and 261 after the intervention (T1). The median of interruptions occurring in each cycle decreased significantly from baseline to postintervention (8.0 vs 2.0, p=0.002), as the rate ratios (interruptions/patient post–pre ratio: 0.34; interruptions/medication post–pre ratio: 0.37; interruptions/hour of medication cycle post–pre ratio: 0.53, p<0.001). During preintervention, the main causes of interruptions were ‘other patients’ (19.9%), ‘other nurses’ (17.2%) and ‘conversation’ (15.7%); during postintervention, they were ‘other nurses’ (26.1%), ‘conversation’ (18.2%) and ‘other patients’ (17.4%). Conclusions This bundle of interventions proved to be an effective improvement programme to prevent interruptions during medication administration in a paediatric context. PMID:28062470

  10. Administrative measures for preventing Mycobacterium tuberculosis infection among healthcare workers in a teaching hospital in Rio de Janeiro, Brazil.

    PubMed

    da Costa, P Albuquerque; Trajman, A; Mello, F Carvalho de Queiroz; Goudinho, S; Silva, M A Monteiro Vieira; Garret, D; Ruffino-Netto, A; Kritski, A Lineu

    2009-05-01

    Tuberculosis (TB) is an occupational disease of healthcare workers (HCWs). Administrative and engineering interventions simultaneously implemented in hospitals of developed countries have reduced the risk of nosocomial transmission of M. tuberculosis. We studied the impact of administrative infection control measures on the risk for latent TB infection (LTBI) among HCWs in a resource-limited, high-burden country. An intervention study was undertaken in a university-affiliated, inner-city hospital in Rio de Janeiro, where routine serial tuberculin skin testing (TST) is offered to all HCWs. From October 1998 to February 2001, the following infection control measures were progressively implemented: isolation of TB suspects and confirmed TB inpatients, quick turnaround for acid-fast bacilli sputum tests and HCW education in use of protective respirators. Among 1336 initially tested HCWs, 599 were retested. The number of TST conversions per 1000 person-months during and after the implementation of these measures was reduced from 5.8/1000 to 3.7/1000 person-months (P=0.006). The most significant reductions were observed in the intensive care unit (from 20.2 to 4.5, P<0.001) and clinical wards (from 10.3 to 6.0, P<0.001). Physicians and nurses had the highest reductions (from 7.6 to 0, P<0.001; from 9.9 to 5.8, P=0.001, respectively). We conclude that administrative measures for infection control can significantly reduce LTBI among HCWs in high-burden countries and should be implemented even when resources are not available for engineering infection control measures.

  11. Enhancing Clinical Content and Race/Ethnicity Data in Statewide Hospital Administrative Databases: Obstacles Encountered, Strategies Adopted, and Lessons Learned

    PubMed Central

    Pine, Michael; Kowlessar, Niranjana M; Salemi, Jason L; Miyamura, Jill; Zingmond, David S; Katz, Nicole E; Schindler, Joe

    2015-01-01

    Objectives Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. Principal Findings Grantees faced common challenges, including recruiting data partners and ensuring their continued effective participation, acquiring and validating the accuracy and utility of new data elements, and linking data from multiple sources to create internally consistent enhanced administrative databases. Successful strategies to overcome these challenges included aggressively engaging with providers of critical sources of data, emphasizing potential benefits to participants, revising requirements to lessen burdens associated with participation, maintaining continuous communication with participants, being flexible when responding to participants’ difficulties in meeting program requirements, and paying scrupulous attention to preparing data specifications and creating and implementing protocols for data auditing, validation, cleaning, editing, and linking. In addition to common challenges, grantees also had to contend with unique challenges from local environmental factors that shaped the strategies they adopted. Conclusions The creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources. Excellent communication, flexibility, and attention to detail are essential ingredients in accomplishing this task. Additional research is needed to develop strategies for maintaining these databases when initial funding is exhausted. PMID:26119470

  12. Validity of Selected AHRQ Patient Safety Indicators Based on VA National Surgical Quality Improvement Program Data

    PubMed Central

    Romano, Patrick S; Mull, Hillary J; Rivard, Peter E; Zhao, Shibei; Henderson, William G; Loveland, Susan; Tsilimingras, Dennis; Christiansen, Cindy L; Rosen, Amy K

    2009-01-01

    Objectives To examine the criterion validity of the Agency for Health Care Research and Quality (AHRQ) Patient Safety Indicators (PSIs) using clinical data from the Veterans Health Administration (VA) National Surgical Quality Improvement Program (NSQIP). Data Sources Fifty five thousand seven hundred and fifty two matched hospitalizations from 2001 VA inpatient surgical discharge data and NSQIP chart-abstracted data. Study Design We examined the sensitivities, specificities, positive predictive values (PPVs), and positive likelihood ratios of five surgical PSIs that corresponded to NSQIP adverse events. We created and tested alternative definitions of each PSI. Data Collection FY01 inpatient discharge data were merged with 2001 NSQIP data abstracted from medical records for major noncardiac surgeries. Principal Findings Sensitivities were 19–56 percent for original PSI definitions; and 37–63 percent using alternative PSI definitions. PPVs were 22–74 percent and did not improve with modifications. Positive likelihood ratios were 65–524 using original definitions, and 64–744 using alternative definitions. “Postoperative respiratory failure” and “postoperative wound dehiscence” exhibited significant increases in sensitivity after modifications. Conclusions PSI sensitivities and PPVs were moderate. For three of the five PSIs, AHRQ has incorporated our alternative, higher sensitivity definitions into current PSI algorithms. Further validation should be considered before most of the PSIs evaluated herein are used to publicly compare or reward hospital performance. PMID:18823449

  13. Development of nursing CAI in the administration: nursing daily hospital problems.

    PubMed

    Carmagnani, M I; Cunha, I C; Marin, H F

    1995-01-01

    Since the nurse emerged as a qualified professional to attend human beings, the role which always characterized his/her action was assistance. Already since the foundation of the first nursing school, teaching aimed at developing the student to dispense nursing care necessary for the patient's assistance. When the nurse started to perform their activities in nosocomial and community institutions, the need for someone who would be responsible for the organization, coordination and control of nursing personnel and the Nursing Unit itself, in short, someone who would head the services became apparent. At present, the professional role of the nurse is changing regarding his/her overall assistance to the patient, caring directly, determining and/or carrying out nursing assistance necessary for the patient's health, maintenance or recovery. In this manner, it is necessary for nurses to use tools of administration science such as planning, decision making, and planned changes in order to be able to provide the nursing assistance with quality. Thus, this study aims at helping the development of the nurse's interest in computer during the teaching-learning process, motivating the search for knowledge in computerized sources. We intended to offer the opportunity for discussion and reflection on problems of nosocomial nursing practice, favoring interchange of theory and practice. The system is being developing using ToolBook Live Software to be run in Windows environment. The content of the subject allow the user (student or professional nursing) to choose the most correct answers to questions in the knowledge area. In this case, to discuss nursing administration issues through the study of practical situations is possible, such as the opportunity the verify the performance in tests.

  14. Acquired Immune Deficiency Syndrome (AIDS) and the Veterans' Administration. Hearing before the Subcommittee on Hospitals and Health Care of the Committee on Veterans' Affairs. House of Representatives, One Hundredth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

    This document presents witness testimony and prepared statements from the Congressional hearing called to examine the issue of acquired immune deficiency syndrome (AIDS) and the role of the Veterans' Administration (VA) in combating AIDS. Opening statements are included from Representatives G. V. Montgomery, J. Roy Rowland, Joseph P. Kennedy, II,…

  15. Reduction of Aggressive Episodes After Repeated Transdermal Nicotine Administration in a Hospitalized Adolescent with Autism Spectrum Disorder.

    PubMed

    Van Schalkwyk, Gerrit I; Lewis, Alan S; Qayyum, Zheala; Koslosky, Kourtney; Picciotto, Marina R; Volkmar, Fred R

    2015-09-01

    Aggression remains a major cause of morbidity in patients with autism spectrum disorder (ASD). Current pharmacotherapy for aggression is not always effective and is often associated with morbidity. Nicotinic acetylcholinergic neurotransmission may play a prominent role in ASD pathophysiology based on human and animal studies, and preclinical studies show nicotine administration can reduce aggression-related behaviors. Transdermal nicotine has been used to treat agitation in neuropsychiatric conditions with cholinergic dysfunction. Here we report the use of transdermal nicotine as an adjunctive medication to treat aggression in a hospitalized adolescent with ASD. Nicotine patch was recurrently well tolerated, and reduced the need for emergency medication and restraint. These findings suggest further study of transdermal nicotine for aggression comorbid with ASD is warranted.

  16. Reduction of Aggressive Episodes After Repeated Transdermal Nicotine Administration in a Hospitalized Adolescent with Autism Spectrum Disorder

    PubMed Central

    Lewis, Alan S.; Qayyum, Zheala; Koslosky, Kourtney; Picciotto, Marina R.; Volkmar, Fred R.

    2016-01-01

    Aggression remains a major cause of morbidity in patients with autism spectrum disorder (ASD). Current pharmacotherapy for aggression is not always effective and is often associated with morbidity. Nicotinic acetylcholinergic neurotransmission may play a prominent role in ASD pathophysiology based on human and animal studies, and preclinical studies show nicotine administration can reduce aggression-related behaviors. Transdermal nicotine has been used to treat agitation in neuropsychiatric conditions with cholinergic dysfunction. Here we report the use of transdermal nicotine as an adjunctive medication to treat aggression in a hospitalized adolescent with ASD. Nicotine patch was recurrently well tolerated, and reduced the need for emergency medication and restraint. These findings suggest further study of transdermal nicotine for aggression comorbid with ASD is warranted. PMID:25982311

  17. A rapid infusion pump driven by micro electromagnetic linear actuation for pre-hospital intravenous fluid administration.

    PubMed

    Zhao, Peng; Chong, Yinbao; Zhao, An; Lang, Lang; Wang, Qing; Liu, Jiuling

    2015-02-01

    A rapid infusion pump with a maximum flow rate of 6 L/h was designed experimentally using a micro electromagnetic linear actuator, and its effectiveness was evaluated by comparing with that of a commercial Power Infuser under preset flow rates of 0.2, 2, and 6 L/h. The flow rate, air detection sensitivity, occlusion response time, quantitative determination of hemolysis, and power consumption of the infusion devices were extensively investigated using statistical analysis methods (p < 0.05). The experimental results revealed that the flow rate of the designed infusion pump was more stable and accurate, and the hemolysis was significantly less than that of the Power Infuser. The air detection sensitivity and the power consumption could be comparable to that of the Power Infuser except the occlusion response time. The favorable performance made the designed infusion pump a potential candidate for applications in pre-hospital fluid administration.

  18. VA/DoD Joint Executive Council FY 2009: Joint Strategic Plan FY 2010-2012

    DTIC Science & Technology

    2009-01-01

    90 percent of initial TRICARE Prime appointments to MH providers in MH clinics are seen within seven days. This includes all individuals ...Virginia replacement hospital continued its construction in 2009 along with a VA Community Based Outpatient Clinic . ■ Fort Bliss, Texas hospital replacement...Community Based Outpatient Clinic . The funding of a VA clinic in Monterey, California offered an opportunity for the Army to share some of the

  19. Phenytoin blood concentrations in hospitalized geriatric patients: oral versus nasogastric feeding tube administration.

    PubMed

    Lubart, Emilia; Berkovitch, Matitiahu; Leibovitz, Arthur; Orly, Dafni; Segal, Refael

    2010-04-01

    Many medications administered to frail geriatric patients are not in a liquid form, but are crushed and dissolved in water before their administration through a nasogastric tube (NGT). Some medications are enteric coated and others are extended release. Only sparse information is available on their pharmacokinetics when administered through NGT. The aim of our study was to evaluate the pharmacokinetics of phenytoin administered through an NGT and to compare these with the pharmacokinetics of a group of patients receiving the drug orally. Twenty patients were studied in a stable clinical condition, from the long-term care ward of the Geriatric Medical Center Shmuel Harofeh. They were consistently treated with phenytoin for the prevention of seizure disorders. Patients in group 1 (n = 12) had oropharyngeal dysphagia and received feeding and medications by NGT. Group 2 (n = 8), included age-matched orally fed patients from the same department, who received phenytoin orally. Blood samples for phenytoin concentration were taken at baseline, time 0, and at 1, 3, 4, 6, and 8 hours postdrug administration; phenytoin was measured using the AxSYM assay. The mean daily dose was not statistically different between the 2 groups: 291 +/- 28 (200-300) mg/d and 300 +/- 53 (200-400) mg/d, in the NGT, and the orally fed group, respectively, in one dose. Pharmacokinetic parameters of phenytoin were not significantly different between the 2 groups; trough concentrations, 1.9 +/- 1.7 (0.5-4.9) versus 2.2 +/- 1.8 (1.0-6.5) microg/mL; Cmax, 6.6 +/- 3.4 (2.5-9.1) versus 7.3 +/- 6.7 (2.7-8.4) microg/mL; tmax, 5.1 +/- 3.1 (3.1-8.2) versus 4.6 +/- 2.7 (2.3-8.4) hours; area under the curve, 52.2 +/- 40.1 (41.1-61.2) versus 62.3 +/- 84.7 (30.2-77.2) microg/h/mL, in the NGT fed versus the oral fed, respectively. Phenytoin pharmacokinetic parameters are not significantly different between patients receiving the drug through NGT as compared with those who received it orally, but the implication

  20. VA Library Service--Today's look at Tomorrow's Library.

    ERIC Educational Resources Information Center

    Veterans Administration, Washington, DC.

    The Conference Poceedings are divided into three broad topics: systems planning, audiovisuals in biomedical communication, and automation and networking. Speakers from within the Veterans Administration (VA), from the National Medical Audiovisual Center, and the Lister Hill National Center for Biomedical Communications, National Library of…

  1. 76 FR 72838 - Amendment of Class E Airspace; Luray, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... management of Instrument Flight Rules (IFR) operations within the National Airspace System. This action also..., 2011, and effective September 15, 2011, which is incorporated by reference in 14 CFR 71.1. The Class E... Federal Aviation Administration 14 CFR Part 71 Amendment of Class E Airspace; Luray, VA AGENCY:...

  2. Military and VA General Dentistry Training: A National Resource.

    ERIC Educational Resources Information Center

    Atchison, Kathryn A.; Bachand, William; Buchanan, C. Richard; Lefever, Karen H.; Lin, Sylvia; Engelhardt, Rita

    2002-01-01

    Compared the program characteristics of the postgraduate general dentistry (PGD) training programs sponsored by the military and the Veterans Health Administration (VA). Gathered information on program infrastructure and emphasis, resident preparation prior to entering the program, and patients served and types of services provided. Programs…

  3. 76 FR 64236 - Establishment of Class E Airspace; New Market, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; New Market, VA AGENCY... Airspace at New Market, VA, to accommodate the new Standard Instrument Approach Procedures serving New Market Airport. This action enhances the safety and airspace management of Instrument Flight Rules...

  4. 76 FR 44288 - Establishment of Class E Airspace; New Market, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-25

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; New Market, VA AGENCY... action proposes to establish Class E Airspace at New Market, VA, to accommodate the additional airspace needed for the Standard Instrument Approach Procedures developed for New Market Airport. This...

  5. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Self-contained breathing apparatus (V-A mines). 57.22315 Section 57.22315 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  6. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Self-contained breathing apparatus (V-A mines). 57.22315 Section 57.22315 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  7. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Self-contained breathing apparatus (V-A mines). 57.22315 Section 57.22315 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  8. 76 FR 70831 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... Care)) Activity; Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs... Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of... necessary to promote quality and efficient delivery of health care through the use of health...

  9. 77 FR 3841 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... Care)) Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans... VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of a... promote quality and efficient delivery of health care through the use of health information...

  10. Early Aspirin administration post Coronary Artery Bypass Graft Surgery – Changing hospital culture through a two-cycled audit

    PubMed Central

    Parikh, Shefali; Ratnasingham, Justin

    2017-01-01

    “Early Aspirin” or a medium dose of aspirin 6 hours after Coronary Artery Bypass Graft (CABG) Surgery is strongly recommend by international guidelines (EACTS 2007/AHA 2011 guidelines, Level1a evidence) to protect venous graft patency. However, compliance with Early Aspirin prescription at our centre is poor due to long standing hospital cultural practices and lack of awareness. We completed a two-cycled retrospective audit of 53 (September 2015 Baseline), 65 (January 2016 First Cycle) and 58 (June 2016 Second Cycle) consecutive CABG patients. Interval interventions included educational presentations, educational leaflets/posters, pharmacy liaison and modifications to e-prescription order-sets. Medical, nursing and pharmacy staff were involved in the audit strategies. Early aspirin prescription improved from 23% to 48% to 55% while administration of Early Aspirin improved from 17% to 38% and finally to 48% by second improvement cycle. Significantly, the proportion of patients with omission of early aspirin despite a clear clinical indication, decreased by 50% over the audit period. Important practical considerations were the last dose of anti-platelets preoperatively and amount of of bleeding from mediastinal drains post operatively. A multidisciplinary team based approach led to a 139% improvement in prescription and 182% improvement in administration of “Early Aspirin” after CABG surgery. PMID:28321301

  11. 75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ...The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed......

  12. 78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ...The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed......

  13. A random effects multinomial logit analysis of using Medicare and VA healthcare among veterans with dementia

    PubMed Central

    Zhu, Carolyn W.; Livote, Elayne E.; Ross, Joseph S.; Penrod, Joan D.

    2011-01-01

    Aims To examine longitudinal patterns of VA-only use, dual VA and Medicare use, or Medicare-only use among veterans with dementia. Methods Data on VA and Medicare use (1998–2001) were obtained from and VA administrative datasets and Medicare claims for 2,137 male veterans with a formal diagnosis of Alzheimer’s disease or vascular dementia enrolled in the National Longitudinal Caregiver Study. A random effects multinomial logit model accounting for unobserved individual heterogeneity was used to estimate the effects of patient and caregiver characteristics on use group over time. Results Compared to VA-only use, dual VA and Medicare use was associated with being white, married, higher education, having private insurance, Medicaid, low VA priority level, more functional limitations, and having lived in a nursing home or died in that year. Medicare-only use was associated with older age, being married, higher education, having private insurance, low VA priority level, living further from a VA Medical Center, having more comorbidities, functional limitations, and having lived in a nursing home or died. Veterans whose caregivers reported better health were more likely to be dual users, but those whose caregivers reported more comorbidities were more likely to use Medicare only. Discussion Different aspects of veterans’ needs and caregiver characteristics have differential effect on where veterans seek care. Efforts to coordinate care between VA and Medicare providers are necessary to ensure patients receive high quality care. PMID:20635273

  14. Incidence of Hospitalization for Respiratory Syncytial Virus Infection amongst Children in Ontario, Canada: A Population-Based Study Using Validated Health Administrative Data

    PubMed Central

    Pisesky, Andrea; Benchimol, Eric I.; Wong, Coralie A.; Hui, Charles; Crowe, Megan; Belair, Marc-Andre; Pojsupap, Supichaya; Karnauchow, Tim; O'Hearn, Katie; Yasseen, Abdool S.; McNally, James D.

    2016-01-01

    Importance RSV is a common illness among young children that causes significant morbidity and health care costs. Objective Routinely collected health administrative data can be used to track disease incidence, explore risk factors and conduct health services research. Due to potential for misclassification bias, the accuracy of data-elements should be validated prior to use. The objectives of this study were to validate an algorithm to accurately identify pediatric cases of hospitalized respiratory syncytial virus (RSV) from within Ontario’s health administrative data, estimate annual incidence of hospitalization due to RSV and report the prevalence of major risk factors within hospitalized patients. Study Design and Setting A retrospective chart review was performed to establish a reference-standard cohort of children from the Ottawa region admitted to the Children’s Hospital of Eastern Ontario (CHEO) for RSV-related disease in 2010 and 2011. Chart review data was linked to Ontario’s administrative data and used to evaluate the diagnostic accuracy of algorithms of RSV-related ICD-10 codes within provincial hospitalization and emergency department databases. Age- and sex-standardized incidence was calculated over time, with trends in incidence assessed using Poisson regression. Results From a total of 1411 admissions, chart review identified 327 children hospitalized for laboratory confirmed RSV-related disease. Following linkage to administrative data and restriction to first admissions, there were 289 RSV patients in the reference-standard cohort. The best algorithm, based on hospitalization data, resulted in sensitivity 97.9% (95%CI: 95.5–99.2%), specificity 99.6% (95%CI: 98.2–99.8%), PPV 96.9% (95%CI: 94.2–98.6%), NPV 99.4% (95%CI: 99.4–99.9%). Incidence of hospitalized RSV in Ontario from 2005–2012 was 10.2 per 1000 children under 1 year and 4.8 per 1000 children aged 1 to 3 years. During the surveillance period, there was no identifiable

  15. A study conducted on the demographic factors of victims of violence in support and administrative departments of hospital in 2013

    PubMed Central

    Keyvanara, Mahmoud; Maracy, Mohammad Reza; Ziari, Najmeh Bahman

    2015-01-01

    Background: Violence is now regarded as a serious problem and its complication causes heavy costs on the healthcare systems. The present study aimed to investigate the correlation between some demographic characteristics and confrontation with violence. Since there is no study on the prevalence of violence among the support and administration staff of hospitals in Iran, this study was conducted to investigate violence in these departments. Materials and Methods: This descriptive–analytical and correlation survey was carried out by census among the support and administrative staff interacting with patients and their companions in Al-Zahra University Hospital of Isfahan in 2013. Research tool was a researcher-made questionnaire including five domains: Personal information, workplace information, verbal violence, physical violence, and other violent acts. Its validity was evaluated by experts reviewing it and its reliability by test–retest (r =0.9). Finally, data were analyzed using descriptive statistical indicators and statistical tests such as Chi-square for sex, marital status, and work department and Mann–Whitney U test for age, level of education, work experience, and violence types by the statistical software SPSS version 20. Results: According to the results obtained, 81% of subjects had been abused at least once and the most reported violence was related to verbal violence (78.4%). There was significant correlation between sex and violence and men were the main victims of violence, but there was no relation between marital status, age, and violence. Work experience was correlated to physical violence and other violent acts conversely. There was also an inverse correlation between physical violence and education; also, security staff faced more violence than others. Conclusion: As high prevalence of violence was found especially among the security staff and personnel with less education and work experience, it is suggested to take actions such as

  16. Genetics Home Reference: carbonic anhydrase VA deficiency

    MedlinePlus

    ... people with carbonic anhydrase VA deficiency have excess ammonia in the blood (hyperammonemia), problems with acid-base ... anhydrases VA and VB implicates both enzymes in ammonia detoxification and glucose metabolism. Proc Natl Acad Sci ...

  17. 75 FR 77664 - Vaughan Furniture Company, Galax, VA; Notice of Affirmative Determination Regarding Application...

    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 Vaughan Furniture Company, Galax, VA; Notice of Affirmative Determination Regarding Application for Reconsideration By application dated November 4, 2010, a...

  18. 75 FR 52989 - Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application for Reconsideration By applications dated July 9, 2010 and July 16,...

  19. 3. Hospital Point, general view toward Portsmouth Naval Hospital Building ...

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

    3. Hospital Point, general view toward Portsmouth Naval Hospital Building showing cannon (at left) and Saunders Monument (at right in distance), view to southwest - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  20. Large Scale Portability of Hospital Information System Software

    PubMed Central

    Munnecke, Thomas H.; Kuhn, Ingeborg M.

    1986-01-01

    As part of its Decentralized Hospital Computer Program (DHCP) the Veterans Administration installed new hospital information systems in 169 of its facilities during 1984 and 1985. The application software for these systems is based on the ANS MUMPS language, is public domain, and is designed to be operating system and hardware independent. The software, developed by VA employees, is built upon a layered approach, where application packages layer on a common data dictionary which is supported by a Kernel of software. Communications between facilities are based on public domain Department of Defense ARPA net standards for domain naming, mail transfer protocols, and message formats, layered on a variety of communications technologies.

  1. VA-academic partnerships: challenges and rewards for new VA mental health investigators.

    PubMed

    Ayers, Catherine; Arch, Joanna

    2013-12-01

    This study presents the perspectives of academic-VA partners who have recently completed a randomized clinical trial within a VA outpatient clinic. The authors reflect on the challenges and rewards of implementing academic-VA community clinical research partnerships with the aim of assisting new VA investigators and VA collaborators. Staff resistance, time demands, processing delays, and unforeseen barriers represent challenges. However, they are balanced by numerous rewards, including establishment of a research clinic, innovative staff training, and advancement of effectiveness knowledge in community settings. Implications and recommendations for successful VA-academic partnerships are described to help future projects minimize challenges and maximize rewards.

  2. KaVA ESTEMA project

    NASA Astrophysics Data System (ADS)

    Oyadomari, Miyako; Imai, Hiroshi; Cho, Se-Hyung; Asaki, Yoshiharu; Choi, Yoon-Kyong; Kim, Jaeheon; Yun, Youngjoo; Matsumoto, Naoko; Min, Cheul-Hong; Oyama, Tomoaki; Yoon, Sung-Chul; Yoon, Dong-Hwan; Kim, Dong-Jin; Dodson, Richard; Rioja, Maria; Burns, Ross; Orosz, Gabor; Nakagawa, Akiharu; Chibueze O, James; Nakashima, Jun-ichi; Sobolev, Andrey

    2016-07-01

    The ESTEMA (Expanded Study on Stellar Masers) project is one of three Large Programs of the KaVA (the combined array of the Korean VLBI Network and Japanese VLBI Exploration of Radio Astrometry), and conducted in 2015-2016. It aims to publish a database of the largest sample of VLBI images of circumstellar water (H2O) and silicon-monoxide (SiO) maser sources towards circumstellar envelopes (CSEs) of 80 evolved stars in late AGB to early post-AGB phase. Here we present the specifications of the ESTEMA observations and the planned scientific goals in order to share the basic information of the ESTEMA with astronomical community and encourage future collaborations with the ESTEMA and future follow-up observations for the targeted stars.

  3. Conducting research using the electronic health record across multi-hospital systems: semantic harmonization implications for administrators.

    PubMed

    Bowles, Kathryn H; Potashnik, Sheryl; Ratcliffe, Sarah J; Rosenberg, Melissa; Shih, Nai-Wei; Topaz, Maxim; Holmes, John H; Naylor, Mary D

    2013-06-01

    Administrators play a major role in choosing and managing the use of the electronic health record (EHR). The documentation policies and EHR changes enacted or approved by administrators affect the ability to use clinical data for research. This article illustrates the challenges that can be avoided through awareness of the consequences of customization, variations in documentation policies and quality, and user interface features. Solutions are posed that assist administrators in avoiding these challenges and promoting data harmonization for research and quality improvement.

  4. VA Health Care: Improved Monitoring Needed for Effective Oversight of Care for Women Veterans

    DTIC Science & Technology

    2016-12-01

    of community providers of specialty care, mental health care, limited emergency care, and maternity and limited newborn care when such care is not...and Percentage of VA Community -Based Outpatient Clinics that Provide Primary Care Lacking a Women’s Health Primary Care Provider and Women Veteran... Community Care TPA third party administrator VA Department of Veterans Affairs VAMC Veterans Affairs medical center VHA Veterans Health

  5. Delivery of gender-sensitive comprehensive primary care to women veterans: implications for VA Patient Aligned Care Teams.

    PubMed

    Yano, Elizabeth M; Haskell, Sally; Hayes, Patricia

    2014-07-01

    The Veterans Health Administration (VA) has undertaken a major initiative to transform primary care delivery through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home concept, PACTs aim to improve access, continuity, coordination, and comprehensiveness using team-based care that is patient driven and patient centered. However, how PACT principles should be applied to meet the needs of special populations, including women veterans, is not entirely clear. While historical differences in military participation meant women veterans were rarely seen in VA healthcare settings, they now represent the fastest growing segment of new VA users. They also have complex healthcare needs, adding gender-specific services and other needs to the spectrum of services that the VA must deliver. These trends are changing the VA landscape, introducing challenges to how VA care is organized, how VA providers need to be trained, and how VA considers implementation of new initiatives, such as PACT. We briefly describe the evolution of VA primary care delivery for women veterans, review VA policy for delivering gender-sensitive comprehensive primary care for women, and discuss the challenges that women veterans' needs pose in the context of PACT implementation. We conclude with recommendations for addressing some of these challenges moving forward.

  6. 77 FR 12517 - VA Dental Insurance Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... ``be carried out in such Veterans Integrated Services Networks as the Secretary considers appropriate... Veterans Omnibus Health Services Act of 2010 (the 2010 Act). DATES: Comments must be received by VA on or... eligibility for VA outpatient dental services and treatment, and related dental appliances under 38...

  7. 78 FR 32126 - VA Dental Insurance Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN99 VA Dental Insurance Program AGENCY: Department of Veterans Affairs... rules and procedures for the VA Dental Insurance Program (VADIP), a pilot program that offers premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Under...

  8. Conducting Research Using the Electronic Health Record Across Multi-Hospital Systems: Semantic Harmonization Implications for Administrators

    PubMed Central

    Bowles, Kathryn H.; Potashnik, Sheryl; Ratcliffe, Sarah J.; Rosenberg, Melissa; Shih, Nai-Wei; Topaz, Maxim; Holmes, John H.; Naylor, Mary D.

    2013-01-01

    Administrators play a major role in choosing and managing the use of the electronic health record (EHR). The documentation policies and EHR changes enacted or approved by administrators affect the ability to use clinical data for research. This article illustrates the challenges that can be avoided through awareness of the consequences of customization, variations in documentation policies and quality, and user interface features. Solutions are posed that assist administrators in avoiding these challenges and promoting data harmonization for research and quality improvement. PMID:23708504

  9. Retrospective observational study of trends in hospital admissions for idiopathic pulmonary fibrosis in Spain (2004–2013) using administrative data

    PubMed Central

    Pedraza-Serrano, Fernando; López de Andrés, Ana; Jiménez-García, Rodrigo; Jiménez-Trujillo, Isabel; Hernández-Barrera, Valentín; Sánchez-Muñoz, Gema; Puente-Maestu, Luis; de Miguel-Díez, Javier

    2017-01-01

    Objective To assess changes in incidence, diagnostic procedures, comorbidity profiles, length of hospital stay (LOHS), economic costs and in-hospital mortality (IHM) associated with idiopathic pulmonary fibrosis (IPF). Methods We identified patients hospitalised with IPF in Spain from 2004 to 2013. Data were collected from the National Hospital Discharge Database. Results The study population comprised 22 214 patients. Overall crude incidence increased from 3.82 to 6.98 admissions per 100 000 inhabitants from 2004 to 2013 (p<0.05). The percentage of lung biopsies decreased significantly from 10.68% in 2004 to 9.04% in 2013 (p<0.05). The percentage of patients with a Charlson comorbidity index ≥2 was 15.14% in 2004, increasing to 26.95% in 2013 (p<0.05). IHM decreased from 14.77% in 2004 to 13.72% in 2013 (adjusted OR 0.98; 95% CI 0.97 to 0.99). Mean LOHS was 11.87±11.18 days in 2004, decreasing to 10.20±11.12 days in 2013 (p<0.05). The mean cost per patient increased from €4838.51 in 2004 to €5410.90 in 2013 (p<0.05). Conclusions The frequency of hospital admissions for IPF increased during the study period, as did healthcare costs. However, IHM and LOHS decreased. PMID:28193850

  10. Payment for Assistive Devices by the Veterans Administration.

    ERIC Educational Resources Information Center

    Reeb, Kenneth G., Jr.; Stripling, Thomas E.

    This report provides an overview of the Veterans Administration (VA) and how it pays for assistive devices for veterans. It explains the VA payment structure and decision-making responsibilities concerning assistive equipment. Following an introductory section, the report provides background on the VA system, summarizing its legislative origins,…

  11. Homeless and nonhomeless VA service users likely eligible for Medicaid expansion.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2014-01-01

    Administrative data on the population of Department of Veterans Affairs (VA) service users in 2010 under the age of 65 (n = 3,841,225) were analyzed to identify the number and characteristics of homeless and nonhomeless VA service users who are likely to be eligible for the Medicaid expansion (LEME) option under the Affordable Care Act. Results showed that, estimating conservatively, about 1.2 million (21%) current VA users are LEME if all states implement the expansion. Homeless service users were twice as likely to be eligible than nonhomeless users (64% vs 30%). VA service users who are LEME, regardless of housing status, were physically healthier than those not LEME but were more likely to have substance use disorders and posttraumatic stress disorder. These findings suggest that many VA service users are LEME, particularly those who are homeless and/or have mental health needs. Cross-system use of VA and Medicaid-funded services may be advantageous for veterans with extensive medical and psychiatric needs but also risks fragmented care. Information and education for VA clinicians and their patients about possible implications of the Affordable Care Act may be important.

  12. [An a priori risk analysis study. Securisation of transfusion of blood product in a hospital: from the reception in the medical unit to its administration].

    PubMed

    Bertrand, E; Lévy, R; Boyeldieu, D

    2013-12-01

    Following an ABO accident after transfusion of red blood cells, an a priori risk analysis study is being performed in a hospital. The scope of this analysis covers from the reception of the blood product in the medical unit to its administration. The risk analysis enables to identify the potentially dangerous situations and the evaluation of the risks in order to propose corrective measures (precautionary or protective) and bring the system back to an acceptable risk level. The innovative concept of an a priori risk analysis in the medical field allows the extension of the analysis of this transfusion risk to other hospitals. In addition, it allows the extension of the use of this approach to other medical fields.

  13. Outbreak of a Cluster with Epidemic Behavior Due to Serratia marcescens after Colistin Administration in a Hospital Setting

    PubMed Central

    Merkier, Andrea Karina; Rodríguez, María Cecilia; Togneri, Ana; Brengi, Silvina; Osuna, Carolina; Pichel, Mariana; Cassini, Marcelo H.

    2013-01-01

    Serratia marcescens causes health care-associated infections with important morbidity and mortality. Particularly, outbreaks produced by multidrug-resistant isolates of this species, which is already naturally resistant to several antibiotics, including colistin, are usually described with high rates of fatal outcomes throughout the world. Thus, it is important to survey factors associated with increasing frequency and/or emergence of multidrug-resistant S. marcescens nosocomial infections. We report the investigation and control of an outbreak with 40% mortality due to multidrug-resistant S. marcescens infections that happened from November 2007 to April 2008 after treatment with colistin for Acinetobacter baumannii meningitis was started at hospital H1 in 2005. Since that year, the epidemiological pattern of frequently recovered species has changed, with an increase of S. marcescens and Proteus mirabilis infections in 2006 in concordance with a significant decrease of the numbers of P. aeruginosa and A. baumannii isolates. A single pulsed-field gel electrophoresis (PFGE) cluster of S. marcescens isolates was identified during the outbreak. When this cluster was compared with S. marcescens strains (n = 21) from 10 other hospitals (1997 to 2010), it was also identified in both sporadic and outbreak isolates circulating in 4 hospitals in Argentina. In132::ISCR1::blaCTX-M-2 was associated with the multidrug-resistant cluster with epidemic behavior when isolated from outbreaks. Standard infection control interventions interrupted transmission of this cluster even when treatment with colistin continued in several wards of hospital H1 until now. Optimizing use of colistin should be achieved simultaneously with improved infection control to prevent the emergence of species naturally resistant to colistin, such as S. marcescens and P. mirabilis. PMID:23698525

  14. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  15. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  16. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  17. Executive skills 21: a forecast of leadership skills and associated competencies required by naval hospital administrators into the 21st century.

    PubMed

    Sentell, J W; Finstuen, K

    1998-01-01

    Those in the Naval Medical Department are experiencing an exciting time of bridled chaos and creative change. Many mid-career officers are uncertain of the leadership behaviors and skills that will be necessary for successful managerial careers. Changes in the method of health care delivery of this nation combined with the reengineering of the armed forces' world-wide mission has driven military medical leaders to expand their professional skills, knowledge, and abilities beyond the clinical sciences. This research identifies the most critical domains in the science of health care administration and differentiates and ranks job skill, knowledge, and ability requirements that will be necessary for successful health care management into the 21st century. Top Naval hospital executives responded to two iterations of a Delphi inquiry. These medical leaders identified 106 unique issues that were content-analyzed into nine domains by a neutral, expert panel. Domains, in order of ranked importance, were leadership, health care delivery systems, cost-finance, technology, accessibility, professional staff relations, marketing, quality-risk management, and ethics. In the second Delphi iteration, hospital executives reviewed domain results and rated identified job requirements on their required job importance. The top-10 rated skills, knowledge, and abilities are reported. Results indicated that although a business orientation is needed for organizational survival, an emphasis on person-oriented skills, knowledge, and abilities is required for future success as a health care administrator in the Naval health care system.

  18. 'Superbug' Infections Down 30 Percent At VA Hospitals

    MedlinePlus

    ... Health and Human Services. More Health News on: Antibiotic Resistance Veterans and Military Health Recent Health News Related MedlinePlus Health Topics Antibiotic Resistance MRSA Veterans and Military Health About MedlinePlus Site ...

  19. Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients

    PubMed Central

    Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

    2016-01-01

    This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication). RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient. PMID:27483269

  20. Paleoepidemiologic investigation of Legionnaires disease at Wadsworth Veterans Administration Hospital by using three typing methods for comparison of legionellae from clinical and environmental sources.

    PubMed Central

    Edelstein, P H; Nakahama, C; Tobin, J O; Calarco, K; Beer, K B; Joly, J R; Selander, R K

    1986-01-01

    Multilocus enzyme electrophoresis, monoclonal antibody typing for Legionella pneumophila serogroup 1, and plasmid analysis were used to type 89 L. pneumophila strains isolated from nosocomial cases of Legionnaires disease at the Veterans Administration Wadsworth Medical Center (VAWMC) and from the hospital environment. Twelve L. pneumophila clinical isolates, obtained from patients at non-VAWMC hospitals, were also typed by the same methods to determine typing specificity. Seventy-nine percent of 33 VAWMC L. pneumophila serogroup 1 clinical isolates and 70% of 23 environmental isolates were found in only one of the five monoclonal subgroups. Similar clustering was found for the other two typing methods, with excellent correlation between all methods. Enzyme electrophoretic typing divided the isolates into the greatest number of distinct groups, resulting in the identification of 10 different L. pneumophila types and 5 types not belonging to L. pneumophila, which probably constitute an undescribed Legionella species; 7 clinical and 34 environmental VAWMC isolates and 2 non-VAWMC clinical isolates were found to be members of the new species. Twelve different plasmid patterns were found; 95% of VAWMC clinical isolates contained plasmids. Major VAWMC epidemic-bacterial types were common in the hospital potable-water distribution system and cooling towers. Strains of L. pneumophila which persisted after disinfection of contaminated environmental sites were of a different type from the prechlorination strains. All three typing methods were useful in the epidemiologic analysis of the VAWMC outbreak. PMID:3711303

  1. Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients.

    PubMed

    Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

    2016-07-28

    This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication). RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient.

  2. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule.

    PubMed

    2014-08-22

    are participating in Medicare. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. In addition, we are making technical corrections to the regulations governing provider administrative appeals and judicial review; updating the reasonable compensation equivalent (RCE) limits, and revising the methodology for determining such limits, for services furnished by physicians to certain teaching hospitals and hospitals excluded from the IPPS; making regulatory revisions to broaden the specified uses of Medicare Advantage (MA) risk adjustment data and to specify the conditions for release of such risk adjustment data to entities outside of CMS; and making changes to the enforcement procedures for organ transplant centers. We are aligning the reporting and submission timelines for clinical quality measures for the Medicare HER Incentive Program for eligible hospitals and critical access hospitals (CAHs) with the reporting and submission timelines for the Hospital IQR Program. In addition, we provide guidance and clarification of certain policies for eligible hospitals and CAHs such as our policy for reporting zero denominators on clinical quality measures and our policy for case threshold exemptions. In this document, we are finalizing two interim final rules with comment period relating to criteria for disproportionate share hospital uncompensated care payments and extensions of temporary changes to the payment adjustment for low-volume hospitals and of the Medicare-Dependent, Small Rural Hospital (MDH) Program.

  3. Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals

    PubMed Central

    Guest, Charlotte; Sobotka, Fabian; Karavasopoulou, Athina; Ward, Stephen; Bantel, Carsten

    2017-01-01

    Objective Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses’ mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. Material and methods A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses’ mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580) and one German (n=799) hospital between September 2014 and February 2015. Results A total of 511 (37.1%) questionnaires were returned. Mean (standard deviation) age of participants were 37 (11) years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87% did not regard opioids as drugs to help patients die, and 72% did not view them as drugs of abuse. More English (41%) than German (28%) nurses were afraid of criminal investigations and were constantly aware of side effects (UK, 94%; Germany, 38%) when using opioids. Four latent variables were identified which likely influence nurses’ mental models: “conscious decision-making”; “medication-related fears”; “practice-based observations”; and “risk assessment”. They were predicted by strength of religious beliefs and indicators of informal learning such as experience but not by indicators of formal learning such as conference attendance. Conclusion Nurses in both countries employ analytical and affective mental

  4. Evaluating the Effectiveness of Self-Administration of Medication (SAM) Schemes in the Hospital Setting: A Systematic Review of the Literature

    PubMed Central

    Richardson, Suzanna J.; Brooks, Hannah L.; Bramley, George; Coleman, Jamie J.

    2014-01-01

    Background Self-administration of medicines is believed to increase patients' understanding about their medication and to promote their independence and autonomy in the hospital setting. The effect of inpatient self-administration of medication (SAM) schemes on patients, staff and institutions is currently unclear. Objective To systematically review the literature relating to the effect of SAM schemes on the following outcomes: patient knowledge, patient compliance/medication errors, success in self-administration, patient satisfaction, staff satisfaction, staff workload, and costs. Design Keyword and text word searches of online databases were performed between January and March 2013. Included articles described and evaluated inpatient SAM schemes. Case studies and anecdotal studies were excluded. Results 43 papers were included for final analysis. Due to the heterogeneity of results and unclear findings it was not possible to perform a quantitative synthesis of results. Participation in SAM schemes often led to increased knowledge about drugs and drug regimens, but not side effects. However, the effect of SAM schemes on patient compliance/medication errors was inconclusive. Patients and staff were highly satisfied with their involvement in SAM schemes. Conclusions SAM schemes appear to provide some benefits (e.g. increased patient knowledge), but their effect on other outcomes (e.g. compliance) is unclear. Few studies of high methodological quality using validated outcome measures exist. Inconsistencies in both measuring and reporting outcomes across studies make it challenging to compare results and draw substantive conclusions about the effectiveness of SAM schemes. PMID:25463269

  5. 78 FR 42455 - Medications Prescribed by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO77 Medications Prescribed by Non-VA Providers AGENCY: Department of... that eligible veterans engaged in current and future conflicts receive medications prescribed by non-VA... comply with a statutory mandate that VA provide medications prescribed by non-VA providers to...

  6. Security Station and Front Entrance to hospital property, looking northeast ...

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

    Security Station and Front Entrance to hospital property, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Security Station & Front Gate, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  7. Uniform administrative requirements for grants and agreements with institutions of higher education, hospitals and other non-profit organizations--OMB. Final revision to OMB circular A-110.

    PubMed

    1993-11-29

    Office of Management and Budget (OMB) Circular A-110 provides standards for obtaining consistency and uniformity among Federal agencies in the administration of grants and agreements with institutions of higher education, hospitals, and other non-profit organizations. OMB issued Circular A-110 in 1976 and, except for a minor revision in February 1987, the Circular contains its original provisions. To update the Circular, OMB established an interagency task force to review the Circular. The task force solicited suggestions for changes to the Circular from university groups, non-profit organizations and other interested parties and compared, for consistency, the provisions of similar provisions applied to State and local governments. The revised Circular reflects the results of these efforts.

  8. 75 FR 55615 - Hanesbrands, Inc., Galax, VA; Notice of Negative Determination on Reconsideration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    ... Employment and Training Administration Hanesbrands, Inc., Galax, VA; Notice of Negative Determination on... initial investigation resulted in a negative determination based on the finding that Parkdale Mills..., I affirm the original notice of negative determination of eligibility to apply for worker...

  9. 76 FR 2148 - Specialty Minerals, Inc., Franklin, VA; Notice of Revised Determination on Reconsideration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... Employment and Training Administration Specialty Minerals, Inc., Franklin, VA; Notice of Revised... Minerals, Inc., Franklin, Virginia (the subject firm). The Notice was published ] in the Federal Register... reconsideration, I determine that workers of Specialty Minerals, Inc., Franklin, Virginia, who are engaged...

  10. VA Health Care: Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed

    DTIC Science & Technology

    2016-09-01

    VA HEALTH CARE Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed Report to...Monitor Organizational Structure Changes Needed What GAO Found Recent internal and external reviews of Veterans Health Administration (VHA...operations have identified deficiencies in its organizational structure and recommended changes that would require significant restructuring to address

  11. 77 FR 6587 - Startek USA, Inc. Alexandria, LA; Startek USA, Inc., Collinsville, VA; Amended Certification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-08

    ... Employment and Training Administration Startek USA, Inc. Alexandria, LA; Startek USA, Inc., Collinsville, VA..., applicable to workers of StarTek USA, Inc., Alexandria, Louisiana. The workers are engaged in the supply of..., Virginia location of StarTek USA, Inc. supplied call center services such as sales and technical...

  12. Medical procedures and outcomes of Japanese patients with trisomy 18 or trisomy 13: analysis of a nationwide administrative database of hospitalized patients.

    PubMed

    Ishitsuka, Kazue; Matsui, Hiroki; Michihata, Nobuaki; Fushimi, Kiyohide; Nakamura, Tomoo; Yasunaga, Hideo

    2015-08-01

    The choices of aggressive treatment for trisomy 18 (T18) and trisomy 13 (T13) remain controversial. Here, we describe the current medical procedures and outcomes of patients with T18 and T13 from a nationwide administrative database of hospitalized patients in Japan. We used the database to identify eligible patients with T18 (n = 438) and T13 (n = 133) who were first admitted to one of 200 hospitals between July 2010 and March 2013. Patients were divided into admission at day <7 (early neonatal) and admission at day ≥7 (late neonatal and post neonatal) groups, and we described the medical intervention and status at discharge for each group. In the day <7 groups, surgical interventions were performed for 56 (19.9%) T18 patients and 22 (34.4%) T13 patients, including pulmonary artery banding, and procedures for esophageal atresia and omphalocele. None received intracardiac surgery. The rate of patients discharged to home was higher in the day ≥7 groups than the day <7 groups (T18: 72.6 vs. 38.8%; T13: 73.9 vs. 21.9%, respectively). Our data show that a substantial number of patients with trisomy received surgery and were then discharged home, but, of these, a considerable number required home medical care. This included home oxygen therapy, home mechanical ventilation, and tube feeding. These findings will be useful to clinicians or families who care for patients with T18 and T13.

  13. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People’s Republic of China

    PubMed Central

    Zhu, Ling-ling; Li, Wei; Song, Ping; Zhou, Quan

    2014-01-01

    The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People’s Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan–do–check–act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety. PMID:24669192

  14. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People's Republic of China.

    PubMed

    Zhu, Ling-Ling; Li, Wei; Song, Ping; Zhou, Quan

    2014-01-01

    The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People's Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan-do-check-act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety.

  15. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  16. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  17. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  18. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  19. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  20. 77 FR 38179 - Autopsies at VA Expense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... clarifies that the authority to order an autopsy includes transporting the body at VA's expense to the place... dies while receiving fee-basis care under Sec. 17.52 and to pay the expense of transporting the body... substantive changes. We made a couple of nonsubstantive edits to proposed Sec. 17.170(a)(1). Effect...

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

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

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

  2. Window Details U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise ...

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

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

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

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

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

  4. 75 FR 32240 - Draft Tier II Environmental Impact Statement: Southeast High Speed Rail Corridor-Richmond, VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-07

    ... Federal Railroad Administration Draft Tier II Environmental Impact Statement: Southeast High Speed Rail... Administration (FRA), U.S. Department of Transportation (DOT). ACTION: Notice of Availability of the Tier II... availability of the Southeast High Speed Rail, Richmond, VA to Raleigh, NC Project Draft Tier II...

  5. The burden and management of TIA and stroke in the Veterans Administration and Department of Defense.

    PubMed

    Singh, Steven N

    2009-06-01

    Transient ischemic attack (TIA) and stroke are commonly occurring cerebrovascular events that require prompt and appropriate treatment to reduce the risk of secondary stroke. The US Department of Veterans Affairs (VA) and the Department of Defense constitute 2 large medical systems treating military personnel, both active and retired, as well as many of their dependents. In the area of stroke and TIA management, the VA in particular has instituted far-reaching measures, including those to ensure adherence to clinical treatment guidelines shown to produce optimal outcomes in stroke. The result of these measures has been that VA patients experience lower morbidity and mortality risk, as well as lower rates of stroke-related rehospitalization, than comparable patients treated through Medicare and Medicaid and in university hospitals. These successes in part may be an advantage derived from a relatively closed system with sufficient administrative discipline to maintain clinical guidelines treatment standards. It may also be the case that continuity of care in these systems produces better outcomes than more fragmentary treatment that may be experienced in the civilian realm. In addition, the VA system avoids incentivizing physicians for performing medical services, and instead incentivizes quality of care, which may provide a further advantage for patients treated within that system.

  6. The transformation experience of the Veterans Health Administration and its relevance to Canada.

    PubMed

    Fooks, Cathy; Decter, Michael

    2005-01-01

    Over the past few years, there has been a steady stream of visitors to Canada from the US Veterans Health Administration (VA). Led by the former Under Secretary for Health in the Department of Veterans Affairs, Dr. Ken Kizer, they come to tell the remarkable story of how the VA transformed itself from a hospital-based bureaucracy described as "dangerous, dirty and scandal-ridden" to a healthcare system for veterans recognized for its high-quality, patient-centred care. It is a fascinating story of how a publicly funded healthcare service changed its entire approach to patient care with a quality improvement lens at its core. Fifteen years ago, critics of the VA called for its complete privatization as the only solution to fixing its problems. A team of quality champions set out to prove otherwise. Canada has some lessons to learn. The VA is a compelling role model for Canadian reformers, in large measure, due to its public sector character.

  7. The Veterans Administration's Asbestos Abatement Program

    SciTech Connect

    Schepers, G.W. )

    1991-12-31

    The Veterans Administration has developed a program of asbestos abatement for its more than 1000 buildings, where health care personnel from 173 hospitals and 238 ambulatory care clinics are likely to encounter respirable asbestos. This is a costly program, which has averaged about $25 million annually for the past ten years. The VA has banned the use of new asbestos products containing more than 1% of asbestos in building construction or renovation projects. Industrial hygiene engineering programs have been ordered instituted at all VA medical centers to monitor dust levels in compliance with OSHA and EPA requirements. Health surveillance programs, managed by an environmental health physician at each medical center, have been instituted for all personnel who have been identified to have breathed asbestos fibers in excess of OSHA-EPA threshold limit values. The health care program focuses on the identification of asbestosis and asbestos-related cancer through periodic X-ray films, lung function tests, and electrocardiographic and physical examination screening. The program also stresses cessation of smoking.

  8. Uniform administrative requirements for grants and agreements with institutions of higher education, hospitals, other non-profit, and commercial organizations--Department of Commerce. Interim final rule.

    PubMed

    1998-09-04

    This interim final rule implements the revisions to the Office of Management and Budget (OMB) Circular A-110, "Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations" which was published in the Federal Register on November 29, 1993. The revised Circular was developed by an interagency task force for governmentwide use in a model rule format to facilitate regulatory adoption by executive departments and agencies. In the published revised Circular, OMB specified as "required action" that Federal agencies responsible for awarding and administering grants and other agreements to recipients described therein, shall adopt the language of the Circular unless other provisions are required by Federal statute or exceptions or deviations are approved by OMB. This interim final rule adopts the provisions of the Circular and its language to the maximum extent feasible. However, minor changes were made to update the procedures, clarify the language, and make the language apply specifically to the DoC and its operating units. No changes are intended to deviate from the substance of Circular A-110. The Circular covers both grants and cooperative agreements made by Federal agencies and subawards, unless sections of the Circular specifically exclude subrecipients from coverage. Consistent with guidance provided in the Circular, DoC will apply its provisions to grants and agreements with institutions of higher education, hospitals, other nonprofit, and commercial organizations. The provisions of the interim final rule will also apply to foreign governments, organizations under the jurisdiction of foreign governments, and international organizations when appropriate.

  9. Variation between Hospitals with Regard to Diagnostic Practice, Coding Accuracy, and Case-Mix. A Retrospective Validation Study of Administrative Data versus Medical Records for Estimating 30-Day Mortality after Hip Fracture

    PubMed Central

    Kristoffersen, Doris Tove; Skyrud, Katrine Damgaard; Lindman, Anja Schou

    2016-01-01

    Background The purpose of this study was to assess the validity of patient administrative data (PAS) for calculating 30-day mortality after hip fracture as a quality indicator, by a retrospective study of medical records. Methods We used PAS data from all Norwegian hospitals (2005–2009), merged with vital status from the National Registry, to calculate 30-day case-mix adjusted mortality for each hospital (n = 51). We used stratified sampling to establish a representative sample of both hospitals and cases. The hospitals were stratified according to high, low and medium mortality of which 4, 3, and 5 hospitals were sampled, respectively. Within hospitals, cases were sampled stratified according to year of admission, age, length of stay, and vital 30-day status (alive/dead). The final study sample included 1043 cases from 11 hospitals. Clinical information was abstracted from the medical records. Diagnostic and clinical information from the medical records and PAS were used to define definite and probable hip fracture. We used logistic regression analysis in order to estimate systematic between-hospital variation in unmeasured confounding. Finally, to study the consequences of unmeasured confounding for identifying mortality outlier hospitals, a sensitivity analysis was performed. Results The estimated overall positive predictive value was 95.9% for definite and 99.7% for definite or probable hip fracture, with no statistically significant differences between hospitals. The standard deviation of the additional, systematic hospital bias in mortality estimates was 0.044 on the logistic scale. The effect of unmeasured confounding on outlier detection was small to moderate, noticeable only for large hospital volumes. Conclusions This study showed that PAS data are adequate for identifying cases of hip fracture, and the effect of unmeasured case mix variation was small. In conclusion, PAS data are adequate for calculating 30-day mortality after hip-fracture as a quality

  10. 34. Photographic copy of historic drawing, "Naval Hospital and Battery ...

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

    34. Photographic copy of historic drawing, "Naval Hospital and Battery at Portsmouth, VA.," ca. 1862. (From Paul F. Moteelay and T. Campbell-Copeland's The Soldier in Our Civil War: A Pictorial History of the Conflict, 1861-1865. New York: Stanley Bradley Publishing Company, 1890, vol. 1, p. 320.) - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  11. 38 CFR 3.1700 - Types of VA burial benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Types of VA burial... ADJUDICATION Burial Benefits Burial Benefits: General § 3.1700 Types of VA burial benefits. Pt. 3, Subpt. B, Nt. (a) Burial benefits. VA provides the following types of burial benefits, which are discussed in §§...

  12. 12 CFR 3.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 1 2014-01-01 2014-01-01 false VaR-based measure. 3.205 Section 3.205 Banks...-Weighted Assets-Market Risk § 3.205 VaR-based measure. (a) General requirement. A national bank or Federal... VaR-based measure described in paragraph (c)(1) of this section)....

  13. 12 CFR 324.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false VaR-based measure. 324.205 Section 324.205... CAPITAL ADEQUACY OF FDIC-SUPERVISED INSTITUTIONS Risk-Weighted Assets-Market Risk § 324.205 VaR-based... VaR-based measure described in paragraph (c)(1) of this section)....

  14. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ..., manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the VA... Intent to Enter into an Enhanced-Use Lease. SUMMARY: The Secretary of VA intends to enter into an EUL...

  15. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  16. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  17. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  18. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  19. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  20. West wing, northwest corner, looking southeast U.S. Veterans Hospital, ...

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

    West wing, northwest corner, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Main Hospital, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  1. North wing, west wall, looking northeast U.S. Veterans Hospital, ...

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

    North wing, west wall, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Neuropsychiatric Hospital Infirm Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  2. East wing, northwest corner, looking southeast U.S. Veterans Hospital, ...

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

    East wing, northwest corner, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Main Hospital, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  3. 78 FR 55671 - Hospital Care and Medical Services for Camp Lejeune Veterans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO78 Hospital Care and Medical Services for Camp Lejeune Veterans AGENCY...) proposes to amend its regulations to implement a statutory mandate that VA provide health care to certain... January 1, 1957, and ending on December 31, 1987. The law requires VA to furnish hospital care and...

  4. Educational Facilities in the Hospital for Teaching.

    ERIC Educational Resources Information Center

    Green, Alan C.

    1965-01-01

    Planning and design criteria are established for educational facilities in VA hospitals, rendering them more effective for medical education. Rather than developing plans for prototype teaching hospitals, guidelines are presented which may be utilized to meet the needs of a particular situation. Three broad categories of facilities are…

  5. Incidence and Risk Factors Associated With Hospitalization for Variant Angina in Korea

    PubMed Central

    Kim, Hack-Lyoung; Lee, Sang Hyung; Kim, Jayeun; Kim, Hyun Joo; Lim, Woo-Hyun; Seo, Jae-Bin; Chung, Woo-Young; Kim, Sang-Hyun; Zo, Joo-Hee; Kim, Myung-A; Lee, Jin Yong

    2016-01-01

    Abstract This study aimed to determine the incidence and the risk factors of hospitalization for variant angina (VA) in Korean patients. Using the National Inpatient Sample (NIS) database, manufactured and released by the Health Insurance Review and Assessment Service (HIRA) in Korea, the incidence of hospitalization and rehospitalization for VA were calculated. The numbers of patients hospitalized for VA were estimated to be 14,362 in 2009, 17,492 in 2010, and 20,592 in 2011. The standardized incidence rates of hospitalization for VA were 31.4% in 2009, 36.5% in 2010, and 41.7% in 2011 (relative increase rate from 2009 to 2011, 33.0%, P for trend < 0.0001). VA patients predominantly belonged to the middle-age group between 40 and 69 years (75.5%), and there were 54.3% male. Based on the hospitalization episodes, the number of rehospitalization was calculated to be 879, 1141, and 1446 patients out of 1867, 2274, and 2677 patients from 2009, 2010, and 2011, respectively. The rates of rehospitalization for VA were 47.1% in 2009, 50.2% in 2010, and 54.0% in 2011 (P for trend < 0.0001). Age was an independent factor associated with rehospitalization for VA. Hospitalization for VA occurred most frequently in fall from 2009 to 2011. In conclusion, hospitalization rates for VA steadily increased from 2009 to 2011 in Korea, and about a half of VA patients was hospitalized more than once a year in 2009 to 2011. Proper health policy and patient education are warranted to control the high rate of hospitalization for VA. PMID:27043695

  6. Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites

    ERIC Educational Resources Information Center

    Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola

    2009-01-01

    Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…

  7. 32 CFR 728.52 - Veterans Administration beneficiaries (VAB).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... eligible VABs medical and surgical care, including prostheses such as eyes and limbs and appliances such as... MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other... have been determined by the Veterans Administration (VA) to be eligible for care at VA expense....

  8. Improving Performance through Knowledge Translation in the Veterans Health Administration

    ERIC Educational Resources Information Center

    Francis, Joseph; Perlin, Jonathan B.

    2006-01-01

    The Veterans Health Administration (VA) provides a case study for linking performance measurement, information technology, and aligned research efforts to facilitate quality improvement in a large, complex health system. Dialogue between clinical researchers and VA leaders occurs through structured activities (e.g., the Quality Enhancement…

  9. VA eScreening program: Technology to improve care for post-9/11 veterans.

    PubMed

    Pittman, James O E; Floto, Elizabeth; Lindamer, Laurie; Baker, Dewleen G; Lohr, James B; Afari, Niloofar

    2017-02-01

    The Veterans Health Administration (VHA) provides health care services to a growing number of veterans. There is ample support for the use of technology-based self-screening to support health care delivery. We developed the VA eScreening program for veterans to directly provide self-report mental and physical health information through a veteran-facing portal that communicates with the electronic medical records system. A total of 1,372 newly enrolling veterans in 2 cohorts participated in a study to assess veteran satisfaction, determine accessibility and clinical processes, measure screening differences, and examine connection to care between eScreening and paper screening. Veterans who completed eScreening were slightly more satisfied with screening than those who completed paper screening. Accessibility, rate of screening completion, and clinical processes were significantly better with eScreening than paper screening. Except for higher alcohol use in the paper-based cohort, veterans who completed paper and eScreening were similar in the rates of positive health screens. Connection to VA services, rate and speed of vesting in the health care system, and time to document required suicide risk assessments were better with the VA eScreening program than paper screening. The VA eScreening program is a unique and promising tool that may leverage limited resources to improve screening and care for veterans. (PsycINFO Database Record

  10. 12 CFR 217.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 2 2014-01-01 2014-01-01 false VaR-based measure. 217.205 Section 217.205... ADEQUACY OF BOARD-REGULATED INSTITUTIONS Risk-Weighted Assets-Market Risk § 217.205 VaR-based measure. (a... paragraph (c)(2) of this section based on the model used to calculate the VaR-based measure described...

  11. Strategies from a nationwide health information technology implementation: the VA CART story.

    PubMed

    Box, Tamára L; McDonell, Mary; Helfrich, Christian D; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S

    2010-01-01

    The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

  12. VA Community Mental Health Service Providers' Utilization of and Attitudes toward Telemental Health Care: The Gatekeeper's Perspective

    ERIC Educational Resources Information Center

    Jameson, John Paul; Farmer, Mary Sue; Head, Katharine J.; Fortney, John; Teal, Cayla R.

    2011-01-01

    Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined. Purpose: The purpose of this study was to investigate the…

  13. Network of fully integrated multispecialty hospital imaging systems

    NASA Astrophysics Data System (ADS)

    Dayhoff, Ruth E.; Kuzmak, Peter M.

    1994-05-01

    The Department of Veterans Affairs (VA) DHCP Imaging System records clinically significant diagnostic images selected by medical specialists in a variety of departments, including radiology, cardiology, gastroenterology, pathology, dermatology, hematology, surgery, podiatry, dental clinic, and emergency room. These images are displayed on workstations located throughout a medical center. All images are managed by the VA's hospital information system, allowing integrated displays of text and image data across medical specialties. Clinicians can view screens of `thumbnail' images for all studies or procedures performed on a selected patient. Two VA medical centers currently have DHCP Imaging Systems installed, and others are planned. All VA medical centers and other VA facilities are connected by a wide area packet-switched network. The VA's electronic mail software has been modified to allow inclusion of binary data such as images in addition to the traditional text data. Testing of this multimedia electronic mail system is underway for medical teleconsultation.

  14. Hospital benefits when managers put their heads together.

    PubMed

    Bare, B G; Battista, S G; Mork, D L; Bigelow, V; Ritz, A M

    1988-04-01

    To improve its efficiency and effectiveness, Alexandria Hospital, Alexandria, VA, has developed a strategy of participatory management: the management advisory board. The board, made up of 16 middle managers elected for six-month terms, is a problem-solving, idea-generating forum that may get involved in almost any aspect of hospital operations. Project ideas, which must be aimed at increasing the morale, efficiency, and effectiveness of the hospital and employees, can come from any employee at any level. Once a project has been accepted, it is assigned to a project committee, made up of at least three members who are given much latitude and are encouraged to use their individual and group talents and creativity. After the project has been completed and approved by the full board, it is submitted to the administration for approval and implementation. The board's results have led to a number of new policies and programs at the hospital, including "employee-of-the-year" recognition, standardized uniforms, disaster plans, quality circles, and management orientation. The board is now developing a physician orientation program, identifying outpatient service opportunities, investigating ways to control the use of copying machines, and studying the feasibility of using one particular travel agency for hospital travel.

  15. 30 CFR 57.22220 - Air passing unsealed areas (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Air passing unsealed areas (I-A, II-A, III, and V-A mines). 57.22220 Section 57.22220 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... passing unsealed areas (I-A, II-A, III, and V-A mines). Air that has passed by or through...

  16. Contraceptive Provision in the VA Healthcare System to Women Who Report Military Sexual Trauma

    PubMed Central

    Mattocks, Kristin; Schwarz, Eleanor Bimla; Borrero, Sonya; Skanderson, Melissa; Zephyrin, Laurie; Brandt, Cynthia; Haskell, Sally

    2014-01-01

    Abstract Background: Women Veterans who suffered military sexual trauma (MST) may be at high risk for unintended pregnancy and benefit from contraceptive services. The objective of this study is to compare documented provision of contraceptives to women Veterans using the Department of Veterans Affairs (VA) health system who report or deny MST. Methods: This retrospective cohort study included women Veterans aged 18–45 years who served in Operation Enduring or Iraqi Freedom and had at least one visit to a VA medical center between 2002 and 2010. Data were obtained from VA administrative and clinical databases. Chi-squared tests and logistic regression were conducted to evaluate the association between MST, ascertained by routine clinical screening, and first documented receipt of hormonal or long-acting contraception. Results: Of 68,466 women Veterans, 13% reported, 59% denied and 28% had missing data for the MST screen. Among the entire study cohort, 30% of women had documented receipt of a contraceptive method. Women reporting MST were significantly more likely than those denying MST to receive a method of contraception (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.07–1.18) including an intrauterine device (odds ratio [OR] 1.29, 95% CI 1.17–1.41) or contraceptive injection (OR 1.17, 95% CI 1.05–1.29). Women who were younger, unmarried, seen at a women's health clinic, or who had more than one visit were more likely to receive contraception. Conclusions: A minority of women Veterans of reproductive age receive contraceptive services from the VA. Women Veterans who report MST, and particularly those who seek care at VA women's health clinics, are more likely to receive contraception. PMID:24787680

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

    PubMed

    Rees, Tom

    2003-01-01

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

  18. 76 FR 75509 - Autopsies at VA Expense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-02

    ... November 21, 2011, for publication. List of Subjects in 38 CFR Part 17 Administrative practice and...; Health records; Homeless; Mental health programs; Nursing homes; Philippines, Reporting and...

  19. 76 FR 34576 - Amendment of Class E Airspace; Waynesboro, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... Airspace at Waynesboro, VA, to accommodate the additional airspace need for the Standard Instrument Approach Procedures developed for Eagle's Nest Airport. This action enhances the safety and management of... procedures developed at Eagle's Nest Airport, Waynesboro, VA. This action is necessary for the safety...

  20. 38 CFR 17.71 - Revocation of VA approval.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Revocation of VA approval... Community Residential Care § 17.71 Revocation of VA approval. (a) If a hearing official determines under... residential care facility and notify the community residential care facility of this revocation. (b)...

  1. 78 FR 71041 - VA Compensation and Pension Regulation Rewrite Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-27

    ...The Department of Veterans Affairs (VA) proposes to reorganize and rewrite its compensation and pension regulations in a logical, claimant-focused, and user-friendly format. The intended effect of the proposed revisions is to assist claimants, beneficiaries, veterans' representatives, and VA personnel in locating and understanding these...

  2. 78 FR 63143 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO86 VA Dental Insurance Program--Federalism AGENCY: Department of... its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of...

  3. 78 FR 62441 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO85 VA Dental Insurance Program--Federalism AGENCY: Department of... direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and...

  4. 38 CFR 74.27 - How will VA store information?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false How will VA store information? 74.27 Section 74.27 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information?...

  5. Using the AHRQ PSIs to Detect Post-Discharge Adverse Events in the Veterans Health Administration

    PubMed Central

    Mull, Hillary J.; Borzecki, Ann M.; Chen, Qi; Shin, Marlena H.; Rosen, Amy K.

    2015-01-01

    Background PSIs use inpatient administrative data to flag cases with potentially preventable adverse events (AEs) attributable to hospital care. We explored how many AEs the PSIs identified in the 30 days post-discharge. Methods We ran the PSI software (version 3.1a) on VA 2003–2007 administrative data for ten recently validated PSIs. Among PSI-eligible index hospitalizations not flagged with an AE, we evaluated how many AEs occurred within 1–14 and 15–30 days post-discharge using inpatient and outpatient administrative data. Results Considering all PSI-eligible index hospitalizations, we identified 11,141 post-discharge AEs, compared to 40,578 inpatient-flagged AEs. More than 60% of post-discharge AEs were detected within 14 days of discharge. The majority of post-discharge AEs were decubitus ulcers and postoperative pulmonary embolisms or deep vein thromboses. Conclusions Extending PSI algorithms to the post-discharge period may provide a more complete picture of hospital quality. Future work should use chart review to validate post-discharge PSI events. PMID:23939485

  6. Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

    ERIC Educational Resources Information Center

    Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

    2008-01-01

    Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…

  7. 78 FR 76064 - Authorization for Non-VA Medical Services; Withdrawal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO47 Authorization for Non-VA Medical Services; Withdrawal AGENCY... amended its regulations regarding payment by VA for medical services under VA's statutory authority to provide non-VA medical care. VA sought to remove an outdated regulatory limitation on...

  8. VA Health Care: Further Action Needed to Address Weaknesses in Management and Oversight of Non-VA Medical Care

    DTIC Science & Technology

    2014-06-18

    medical care when a VA facility is unable to provide certain specialty care services, such as cardiology or orthopedics, or when a veteran would have...needing treatment in several specialties—including audiology, cardiology , and ophthalmology—were referred to non-VA providers for this reason

  9. 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

  10. Night and Day in the VA: Associations between Night Shift Staffing, Nurse Workforce Characteristics, and Length of Stay

    PubMed Central

    de Cordova, Pamela B.; Phibbs, Ciaran S.; Schmitt, Susan; Stone, Patricia W.

    2014-01-01

    In hospitals, nurses provide patient care around the clock, but the impact of night staff characteristics on patient outcomes is not well understood. The aim of this study was to examine the association between night nurse staffing and workforce characteristics and the length of stay (LOS) in 138 Veterans Affairs (VA) hospitals using panel data from 2002 through 2006. Staffing in hours per patient day was higher during the day than at night. The day nurse workforce had more educational preparation than the night workforce. Nurses’ years of experience at the unit, facility, and VA level were greater at night. In multivariate analyses controlling for confounding variables, higher night staffing and a higher skill mix were associated with reduced LOS. PMID:24403000

  11. 75 FR 73016 - Proposed Establishment of Class E Airspace; Kenbridge, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ... examined during normal business hours at the office of the Eastern Service Center, Federal Aviation... the Earth. * * * * * AEA VA E5 Kenbridge, VA Lunenburg County Airport, VA (Lat. 36 57'37'' N.,...

  12. Haemophilia utilization group study - Part Va (HUGS Va): design, methods and baseline data.

    PubMed

    Zhou, Z-Y; Wu, J; Baker, J; Curtis, R; Forsberg, A; Huszti, H; Koerper, M; Lou, M; Miller, R; Parish, K; Riske, B; Shapiro, A; Ullman, M; Johnson, K

    2011-09-01

    To describe the study design, procedures and baseline characteristics of the Haemophilia Utilization Group Study - Part Va (HUGS Va), a US multi-center observational study evaluating the cost of care and burden of illness in persons with factor VIII deficiency. Patients with factor VIII level ≤ 30%, age 2-64 years, receiving treatment at one of six federally supported haemophilia treatment centres (HTCs) were enrolled in the study. Participants completed an initial interview including questions on socio-demographical characteristics, health insurance status, co-morbidities, access to care, haemophilia treatment regimen, factor utilization, self-reported joint pain and motion limitation and health-related quality of life. A periodic follow-up survey collected data regarding time lost from usual activities, disability days, health care utilization and outcomes of care. HTC clinicians documented participants' baseline clinical characteristics and pharmacy dispensing records for 2 years. Between July 2005 and July 2007, 329 participants were enrolled. Average age was 9.7 years for children and 33.5 years for adults; two-thirds had severe haemophilia. The distributions of age, marital status, education level and barriers to haemophilia care were relatively consistent across haemophilic severity categories. Differences were found in participants' employment status, insurance status and income. Overall, children with haemophilia had quality of life scores comparable to healthy counterparts. Adults had significantly lower physical functioning than the general US population. As one of the largest economic studies of haemophilia care, HUGS Va will provide detailed information regarding the burden of illness and health care utilization in the US haemophilia A population.

  13. End points in hospital-acquired pneumonia and/or ventilator-associated pneumonia clinical trials: food and drug administration perspective.

    PubMed

    Laessig, Katherine A

    2010-08-01

    Identification of reliable, reproducible, and precise end points for future studies of hospital-acquired and ventilator-associated pneumonia is of paramount importance for approval of new therapeutic agents. As required by the Code of Federal Regulations 21 CFR 314.126, the methods of assessment of a subject's response (ie, end points) must be well defined and reliable. The study protocol and results should explain the variables measured, the methods of observation, and criteria used to assess response. Meeting these requirements has proven to be problematic in clinical trials for the evaluation of new products for the treatment of hospital-acquired and ventilator-associated pneumonia because of the subjectivity of assessing a clinical response end point. There are multiple issues and caveats to consider when selecting appropriate end points for these trials.

  14. The need to immobilise the cervical spine during cardiopulmonary resuscitation and electric shock administration in out-of-hospital cardiac arrest.

    PubMed

    Desroziers, Milene; Mole, Sophie; Jost, Daniel; Tourtier, Jean-Pierre

    2016-06-13

    In cases of out-of hospital cardiac arrest (OHCA), falling to the ground can cause brain and neck trauma to the patient. We present a case of a man in his mid-60s who suffered from an OHCA resulting in a violent collapse. The patient received immediate cardiopulmonary resuscitation, but his spine was immobilised only after a large frontal haematoma was found. The resuscitation efforts resulted in return of spontaneous circulation and discharge from hospital. After this, doctors performed angioplasty, followed by a cardiopulmonary bypass. Later, CT scan examination reported a displaced and unstable fracture of the 6th vertebra without bone marrow involvement. The patient underwent a second operation. 40 days later, he was able to return home without sequela. This case shows the importance of analysing the circumstances of a fall, considering the possibility of two concomitant diagnoses and prioritising investigations and treatment.

  15. A clinical management system for patient participatory health care support. Assuring the patients' rights and confirming operation of clinical treatment and hospital administration.

    PubMed

    Ishikawa, Kiyomu; Konishi, Nakao; Tsukuma, Hidehiko; Tsuru, Satoko; Kawamura, Akie; Iwata, Norikazu; Tanaka, Takeshi

    2004-03-31

    We conducted a drastic change in our hospital information system to support patient participatory health care provided in the New Hiroshima University Hospital (HUH). The new information system in HUH (HU-MIND II-Hiroshima University Hospital Medical Intelligence and Notice Delivery system II) is designed as "clinical management system" (CMS). The core of this CMS is the electronic health record (EHR), which aims to assure both the patients' right to know, and the attendants' accountability. It is evident that the team practice including patients requires close communication. Data in the EHR are written not only by physicians, but also by all coworkers, which will enable them to realize the team communication and the ordering in a reliable way and to leave the evidence of conducted practices. Moreover, the bedside information systems were set-up at all 700 beds. Patients can access their anamnesis and future clinical care procedures themselves. Based on the demand outlined above, the new regulations of HUH are composed of 21 requirements, conditions of information collection, accumulation and use. Our focus was how to make patients' right compatible with attendants' accountability. As the data owners, patients have the facility to access their own data at their bedsides. They can view their own health condition and treatment program and can control the data flow.

  16. Pre-hospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug administration In Cardiac arrest (PARAMEDIC-2): Trial protocol.

    PubMed

    Perkins, Gavin D; Quinn, Tom; Deakin, Charles D; Nolan, Jerry P; Lall, Ranjit; Slowther, Anne-Marie; Cooke, Matthew; Lamb, Sarah E; Petrou, Stavros; Achana, Felix; Finn, Judith; Jacobs, Ian G; Carson, Andrew; Smyth, Mike; Han, Kyee; Byers, Sonia; Rees, Nigel; Whitfield, Richard; Moore, Fionna; Fothergill, Rachael; Stallard, Nigel; Long, John; Hennings, Susie; Horton, Jessica; Kaye, Charlotte; Gates, Simon

    2016-11-01

    Despite its use since the 1960s, the safety or effectiveness of adrenaline as a treatment for cardiac arrest has never been comprehensively evaluated in a clinical trial. Although most studies have found that adrenaline increases the chance of return of spontaneous circulation for short periods, many studies found harmful effects on the brain and raise concern that adrenaline may reduce overall survival and/or good neurological outcome. The PARAMEDIC-2 trial seeks to determine if adrenaline is safe and effective in out-of-hospital cardiac arrest. This is a pragmatic, individually randomised, double blind, controlled trial with a parallel economic evaluation. Participants will be eligible if they are in cardiac arrest in the out-of-hospital environment and advanced life support is initiated. Exclusions are cardiac arrest as a result of anaphylaxis or life threatening asthma, and patient known or appearing to be under 16 or pregnant. 8000 participants treated by 5 UK ambulance services will be randomised between December 2014 and August 2017 to adrenaline (intervention) or placebo (control) through opening pre-randomised drug packs. Clinical outcomes are survival to 30 days (primary outcome), hospital discharge, 3, 6 and 12 months, health related quality of life, and neurological and cognitive outcomes (secondary outcomes). Trial registration (ISRCTN73485024).

  17. RadNet Air Data From Virginia Beach, VA

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Virginia Beach, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  18. 75 FR 76279 - Drawbridge Operation Regulation; James River, Hopewell, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... the SR 156 Benjamin Harrison Memorial Bridge, across the James River, mile 65.0, at Hopewell, VA. The... the closed to navigation position the SR 156 Benjamin Harrison Memorial Bridge across the James...

  19. 76 FR 43575 - Amendment of Class E Airspace; Staunton, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-21

    ... 30320; telephone (404) 305-6364. SUPPLEMENTARY INFORMATION: History On March 18, 2011, the FAA published... areas extending upward from 700 feet or more above the surface of the earth. * * * * * AEA VA...

  20. Exploration Day at Busch Gardens, Williamsburg, Va. - Aug. 5, 2011

    NASA Video Gallery

    Friday, August 8, was NASA Days at Busch Gardens Williamsburg, Va. NASA exhibits and educational specialists worked to inspire young and old, and NASA astronaut Susan Kilrain -- a veteran of two Sp...

  1. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-08

    ... technological information from political or commercial influence; Prohibit suppression or alteration of... ``inappropriate influence.'' The definition of ``inappropriate influence'' should be more explicit. VA Response... analyses will be protected from political and commercial influence. The term ``inappropriate...

  2. VA Is Here for the People Who Support Our Veterans

    MedlinePlus

    ... on track. Calls can be referred to local Suicide Prevention Coordinators and other VA providers who specialize in issues such as: Post-traumatic stress (PTS/PTSD) Traumatic brain injury (TBI) Military sexual ...

  3. VA INFORMATION TECHNOLOGY: Important Initiatives Begun, Yet Serious Vulnerabilities Persist

    DTIC Science & Technology

    2007-11-02

    Technology Management Issues United States General Accounting Office GAO Testimony Before the Subcommittee on Oversight and Investigations, Committee on...VA INFORMATION TECHNOLOGY Important Initiatives Begun, Yet Serious Vulnerabilities Persist Statement of David L. McClure Director, Information

  4. RadNet Air Data From Harrisonburg, VA

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Harrisonburg, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  5. RadNet Air Data From Richmond, VA

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Richmond, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  6. Toward a DoD/VA longitudinal health record: politics and the policy landscape.

    PubMed

    Gimbel, Ronald W; Clyburn, Conrad A

    2009-05-01

    Policy implications of an interoperable Department of Defense (DoD) and Veterans Administration (VA) longitudinal health record (LHR) are substantial and far reaching. In this manuscript the authors explore the existing challenges and opportunities, the political landscape, and alternative solutions that have created a favorable environment for legislation and funding to support its development. The authors identify six policy themes emerging from the historic National Forum on the Future of the Defense Health Information System held recently at Georgetown University in Washington DC.

  7. Evaluation of Pentravan(®), Pentravan(®) Plus, Phytobase(®), Lipovan(®) and Pluronic Lecithin Organogel for the transdermal administration of antiemetic drugs to treat chemotherapy-induced nausea and vomiting at the hospital.

    PubMed

    Bourdon, F; Lecoeur, M; Leconte, L; Ultré, V; Kouach, M; Odou, P; Vaccher, C; Foulon, C

    2016-12-30

    The objective of this study was to evaluate five commercial ready-to-use transdermal vehicles (Phytobase(®), Lipovan(®), Pentravan(®), Pentravan(®) Plus and Pluronic Lecithin Organogel (PLO)), for the compounding of three antiemetic drugs (ondansetron, dexamethasone and aprepitant) and their administration in combination to treat chemotherapy-induced nausea and vomiting (CINV) at the hospital. Drugs were individually formulated in these vehicles and in mixture in Pentravan(®) Plus using different penetration enhancers. Quality control of the forms has demonstrated that formulation process was mastered and convenient for the hospital (time required: 20min). Diffusion experiments through synthetic membranes and pig ear epidermis performed using Franz-type diffusion cells, have shown that the release and permeation process were greater for ondansetron than for dexamethasone and aprepitant, with a release step not limiting. As permeation of aprepitant was too low, it was discarded of the study. When ondansetron and dexamethasone were compounded in combination in Pentravan(®) Plus, the most efficient vehicle, a permeation decrease was observed. Finally, the use of tween 20 instead of EtOH as chemical enhancer has led to 2-fold factor increase in the flux of dexamethasone, resulting in fluxes convenient for transdermal administration of ondansetron to a child, but insufficient for an adult and for dexamethasone.

  8. 76 FR 72020 - Virginia Disaster #VA-00039

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... 11/14/2011. Incident: Tropical Storm Lee. Incident Period: 09/08/2011 Through 09/09/2011. Effective Date: 11/14/2011. Physical Loan Application Deadline Date: 01/13/2012. Economic Injury (EIDL) Loan...: November 14, 2011. Karen G. Mills, Administrator. BILLING CODE 8025-01-P...

  9. Administrators: Nursing Home Administrator

    ERIC Educational Resources Information Center

    Kahl, Anne

    1976-01-01

    Responsibilities, skills needed, training needed, earnings, employment outlook, and sources of additional information are outlined for the administrator who holds the top management job in a nursing home. (JT)

  10. 38 CFR 3.551 - Reduction because of hospitalization.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... veteran is hospitalized for Hansen's disease. The provisions of this section apply to initial periods of... VA institution begins a new period of hospitalization, unless the veteran was released for purposes... release shall be considered a new admission. (Authority: 38 U.S.C. 5503(a)) (c) Section 306 pension....

  11. 38 CFR 51.210 - Administration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.210 Administration. A facility must be... (annual at time of survey); (6) The number of nursing home patients who are veterans and non-veterans, the... residents eligible for VA nursing home care must be at least 75 percent veterans except that the...

  12. 38 CFR 51.210 - Administration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.210 Administration. A facility must be... (annual at time of survey); (6) The number of nursing home patients who are veterans and non-veterans, the... Veterans. The percent of the facility residents eligible for VA nursing home care must be at least...

  13. 38 CFR 51.210 - Administration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.210 Administration. A facility must be... (annual at time of survey); (6) The number of nursing home patients who are veterans and non-veterans, the... Veterans. The percent of the facility residents eligible for VA nursing home care must be at least...

  14. 38 CFR 51.210 - Administration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.210 Administration. A facility must be... (annual at time of survey); (6) The number of nursing home patients who are veterans and non-veterans, the... Veterans. The percent of the facility residents eligible for VA nursing home care must be at least...

  15. Binding of bovine factor Va to phosphatidylcholine membranes.

    PubMed Central

    Koppaka, V; Lentz, B R

    1996-01-01

    The interaction of bovine factor Va with phosphatidylcholine membranes was examined using four different fluorescence techniques: 1) changes in the fluorescence anisotropy of the fluorescent membrane probe 1,6-diphenyl-1,3,5-hexatriene (DPH) to monitor the interaction of factor Va with 1,2-dimyristoyl-3-sn-phosphatidylcholine (DMPC) small unilamellar vesicles (SUVs), 2) changes in the fluorescence anisotropy of N-(lissamine rhodamine B sulfonyl) diacyl phosphati-dylethanolamine (Rh-PE) incorporated into SUVs prepared from 1-palmitoyl-2-oleoyl-3-sn-phosphatidylcholine (POPC), 3) changes in the fluorescence anisotropy of fluorescein-labeled factor Va (labeled in the heavy chain) upon interaction with POPC SUVs, 4) fluorescence energy transfer from fluorescein-labeled factor Va to rhodamine-labeled POPC SUVs. In the first two sets of experiments, labeled lipid vesicles were titrated with unlabeled protein, whereas, in the latter two types of experiments, labeled factor Va was titrated with vesicles. For the weak binding observed here, it was impossible from any one binding experiment to obtain precise estimates of the three parameters involved in modeling the lipid-protein interaction, namely, the dissociation constant Kd, the stoichiometry of binding i, and the saturation value of the observable Rmax from any one experiment. However, a global analysis of the four data sets involving POPC SUVs yielded a stable estimate of the binding parameters (Kd of approximately 3.0 microM and a stoichiometry of approximately 200 lipids per bound factor Va). Binding to DMPC SUVs may be of slightly higher affinity. These observations support the contention that association of factor Va with a membrane involves a significant acidic-lipid-independent interaction along with the more commonly accepted acidic-lipid-dependent component of the total binding free energy. PMID:8744331

  16. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... AFFAIRS Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment... applicant's qualification and suitability as a VA police officer. DATES: Written comments and... information technology. Title: VA Police Officer Pre-Employment Screening Checklist, VA Form 0120. OMB...

  17. VA Health Care. Additional Efforts to Better Assess Joint Ventures Needed

    DTIC Science & Technology

    2008-03-01

    Kans. Okla. Minn. Iowa Mo. Ark. La. Ill. Miss. Ind. Ky. Tenn. Ala. Ga. S.C. N.C. Va. Ohio N.H. Mass. Mich . Calif. Wash. Wis. N.Y. Maine Vt. W.Va...train VA personnel in a variety of areas, including basic life support and advanced cardiac life support. Finally, VA officials and academic

  18. Real-time seismic monitoring of instrumented hospital buildings

    USGS Publications Warehouse

    Kalkan, Erol; Fletcher, Jon Peter B.; Leith, William S.; McCarthy, William S.; Banga, Krishna

    2012-01-01

    In collaboration with the Department of Veterans Affairs (VA), the U.S. Geological Survey's National Strong Motion Project has recently installed sophisticated seismic monitoring systems to monitor the structural health of two hospital buildings at the Memphis VA Medical Center in Tennessee. The monitoring systems in the Bed Tower and Spinal Cord Injury buildings combine sensing technologies with an on-site computer to capture and analyze seismic performance of buildings in near-real time.

  19. Roles of factor Va heavy and light chains in protein and lipid rearrangements associated with the formation of a bovine factor Va-membrane complex.

    PubMed Central

    Koppaka, V; Talbot, W F; Zhai, X; Lentz, B R

    1997-01-01

    Factor Va is an essential protein cofactor of the enzyme factor Xa, which activates prothrombin to thrombin during blood coagulation. Peptides with an apparent Mr of approximately 94,000 (heavy chain; HC) and approximately 74,000 or 72,000 (light chain; LC) interact in the presence of Ca2+ to form active Va. The two forms of Va-LC differ in their carboxyl-terminal C2 domain. Using Va reconstituted with either LC form, we examined the effects of the two LC species on membrane binding and on the activity of membrane-bound Va. We found that 1) Va composed of the 72,000 LC bound only slightly more tightly to membranes composed of a mixture of neutral and acidic lipids, the Kd being reduced by a factor of approximately 3 at 5 mM and by a factor of 6 at 2 mM Ca2+. 2) The two forms of Va seemed to undergo different conformational changes when bound to a membrane. 3) The activity of bovine Va varied somewhat with LC species, the difference being greatest at limiting Xa concentration. We have also addressed the role of the two Va peptides in membrane lipid rearrangements and binding: 1) Va binding increased lateral packing density in mixed neutral/acidic lipid membranes. In the solid phase, Va-HC had no effect, whereas Va-LC and whole Va had similar but small effects. In the fluid phase, Va-HC and whole Va both altered membrane packing, with Va-HC having the largest effect. 2) Va-HC bound reversibly and in a Ca2+-independent fashion to membranes composed of neutral phospholipid (Kd, approximately 0.3 microM; stoichiometry approximately 91). High ionic strength had little effect on binding. 3) The substantial effect of Va on packing within neutral phospholipid membranes was mimicked by Va-HC. 4) Based on measurements of membrane phase behavior, binding of Va or its peptide components did not induce thermodynamically discernible lateral membrane domains. These results suggest that the membrane association of factor Va is a complex process involving both chains of Va, changes

  20. Drug and drug-related supply promotion by pharmaceutical company representatives at VA facilities. Final rule.

    PubMed

    2012-03-05

    This final rule amends the Department of Veterans Affairs (VA) regulations regarding access to VA facilities by pharmaceutical company representatives. The purposes of the rule are to reduce or eliminate any potential for disruption in the patient care environment, manage activities and promotions at VA facilities, and provide pharmaceutical company representatives with a consistent standard of permissible business practice at VA facilities. The amendments will facilitate mutually beneficial relationships between VA and pharmaceutical company representatives.

  1. [SIM and SINASC: social representation of nurses and professional in administrative sectors who work in hospitals in the city of São Paulo].

    PubMed

    Schoeps, Daniela; Almeida, Marcia Furquim de; Raspantini, Priscila Ribeiro; Novaes, Hillegonda Maria Dutilh; Silva, Zilda Pereira da; Lefevre, Fernando

    2013-05-01

    Few studies have analyzed the SINASC (Live Birth Information System) and MIS (Mortality Information System) applying qualitative methodology seeking to understand data production processes and contexts. This article aims to study the social representation of health professionals about Live Birth Certificates (LBC) and perinatal Death Certificates (DC). A total of 24 interviews were conducted with nurses and other professionals of 16 Unified Health System (SUS) and non-SUS hospitals of the city of São Paulo in 2009. Qualitative methodology was adopted along with the Collective Subject Discourse technique. Professionals acknowledged that they are an integral part of the information production process of SINASC and their reports indicate that they incorporate it in their work routine. They also perceive that training activities are a tool to understand the information produced by them and are aware of the utility of LBC information. Although physicians are legally responsible for the DC, other professionals frequently provide some of the information to complete it. The professionals see themselves as participants of the SINASC. Despite providing information to complete the DC, they do not see themselves as participants of the MIS operation.

  2. Blood oxygenation during hyperpressure intraperitoneal fluid administration in a rabbit model of severe liver injury: Evaluation of a novel concept for control of pre-hospital liver bleeding.

    PubMed

    Ahmadi-Noorbakhsh, Siavash; Azizi, Saeed; Dalir-Naghadeh, Bahram; Maham, Masoud

    2012-01-01

    Oxygen is an essential part of the most important metabolic pathways in aerobic organisms. Oxygen delivery is merely dependent on blood, rendering blood loss a devastating event. Traumatic pre-hospital liver bleeding is a major cause of early trauma deaths in human and animals, with no established therapeutic method yet. Increasing intra-abdominal pressure (IAP) has been shown to reduce liver bleeding by half. Although reduction of blood loss could be in favor of blood oxygen delivery, however, the complex interaction between increased IAP and respiratory mechanics during severe hemorrhagic shock remained unclear. We used a novel model of liver trauma in 16 rabbits and randomly assigned them to either normotensive abdomen group or increased IAP by fluid infusion (HA) groups (n=8 each). Liver size and the amount of liver injury were evaluated. Various blood oxygenation parameters were recorded. Both groups were identical in terms of the liver size and injury. The HA group had significantly lower shock index. Arterial oxygen capacity and oxygen content were higher in the HA group. No significant statistical difference was seen between groups in terms of abdominal perfusion pressure; alveolar pressure of oxygen; dissolved oxygen in blood plasma; alveolar to arterial oxygen tension gradient; arterial to alveolar oxygen pressure ratio; the ratio between partial pressure of arterial oxygen and fraction of inspired oxygen; and respiratory index. In conclusion, the novel therapeutic method of increasing IAP by fluid infusion in a rabbit model of liver hemorrhage preserved blood oxygenation better than the classic therapeutic method.

  3. Centralized administrative services management.

    PubMed

    Freed, D H

    1994-06-01

    Virtually every hospital has imposed guidelines or controls on one or more administrative service expenses. However, the actual deployment of such strategies is often voluntary, decentralized, disjointed and episodic. An alternative approach is to cluster administrative elements across hospital departments and make them the responsibility of a dedicated manager. This approach treats administrative services as an organizing principle with uniform, predictable standards of service and cost. Customer requirements for products and services are met without the need for them to physically manage that process. Materiel managers can demonstrate a leadership role by applying their professionalism and know-how to a set of products and services traditionally ignored or dealt with in an uncoordinated manner. While some initial resistance can be expected as traditional barriers are disassembled, the results should be very rewarding for the hospital and materiel manager alike.

  4. North and South Elevations U.S. Veterans Hospital, Jefferson Barracks, ...

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

    North and South Elevations - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  5. Building Sections and Detailed Wall Sections U.S. Veterans Hospital, ...

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

    Building Sections and Detailed Wall Sections - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  6. West wall, looking northeast U.S. Veterans Hospital, Jefferson Barracks, ...

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

    West wall, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

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

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

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

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

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

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

  9. U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and ...

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

    U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

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

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

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

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

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

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

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

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

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

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

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

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

  14. Southeast corner, looking northwest U.S. Veterans Hospital, Jefferson Barracks, ...

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

    Southeast corner, looking northwest - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  15. Interior, south wing, corridor, looking west U.S. Veterans Hospital, ...

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

    Interior, south wing, corridor, looking west - U.S. Veterans Hospital, Jefferson Barracks, Medical Rehabilitation Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  16. Interior, food processing room, looking northeast U.S. Veterans Hospital, ...

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

    Interior, food processing room, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Kitchen, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  17. Northeast corner, looking southwest U.S. Veterans Hospital, Jefferson Barracks, ...

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

    Northeast corner, looking southwest - U.S. Veterans Hospital, Jefferson Barracks, Hazardous Waste Storage, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  18. 42 CFR 412.278 - Administrator's review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Administrator's review. 412.278 Section 412.278... Review Board Composition and Procedures § 412.278 Administrator's review. (a) Hospitals requests for review. A hospital or group of hospitals dissatisfied with the MGCRB's decision regarding its...

  19. Uniform administrative requirements for grants and agreements with institutions of higher education, hospitals and other non-profit organizations--OMB Circular A-110 (revised)--HUD. Final rule.

    PubMed

    1995-06-20

    Office of Management and Budget (OMB) Circular A-110 provides standards for obtaining consistency and uniformity among Federal agencies in the administration of grants and agreements with institutions of higher education, hospitals, and other non-profit organizations. On September 13, 1994, the Department published a final rule which adopted the revised circular as it pertains to HUD. However, the September 13, 1994 rule contained, in subpart E, special provisions relating to the use of lump sum grants. Therefore, subpart E was treated as an interim rule, and the public was invited to submit comments on subpart E. This final rule addresses the public comments received on subpart E and makes final the provisions of subpart E.

  20. Technology Changes and VA Mental Health Computer Applications

    PubMed Central

    Gottfredson, Douglas; Finkelstein, Allan; Christensen, Phillip; Weaver, Richard; Sells, Jeffery; Miller, David; Anderson, Ronald

    1993-01-01

    Since 1972, the Department of Veterans Affairs has had mental health computer applications for clinicians, managers, and researchers, operating on main frame and mini computers. The advent of personal computers has provided the opportunity to further enhance mental health automation. With Congressional support, VA's Mental Health and Behavioral Sciences Service placed micro computers in 168 VA Medical Centers and developed additional mental health applications. Using wide area networking procedures, a National Mental Health Database System (NMHDS) was established. In addition, a Computer-assisted Assessment, Psychotherapy, Education, and Research system (CAPER), a Treatment Planner, a Suicide and Assaultive Behavior Monitoring system, and a national registry of VA mental health treatment resources were developed. Each of these computer applications is demonstrated and discussed.

  1. [Impact of new information and communication technologies (NTIC) on hospital administration and patient management. Care Network for Diagnosing and Treating Neurologic Emergencies].

    PubMed

    Moulin, T; Retel, O; Chavot, D

    2003-04-01

    The combination of specialised in-patient management, the development of diagnostic and therapeutic tools, the standardisation of procedures and organisation of the dies will allow for improving the prognosis of neurological patients seen in emergency situations. In order to achieve this objective, the Networks for Diagnosing and Treating Neurological Emergencies (RAIDS-UN) in Franche-Comté (FC) aim to better the quality of in-patient management for emergency on-set neurological pathologies such as traumatic brain injuries and strokes, the preparation and structuring of the dies for diagnosis and treatment, and assistance in neurology decision making. Based upon the needs of networks which approach the problem from two different directions--the RAIDS-UN/FC network (for neurological emergencies) and the RAIDS-UN/AVC network (for prevention and treatment of strokes)--they should both be able to benefit from new information and communication technologies (ICTs) in order to promote and support innovations in practice and contribute to the improvement in quality and health promotion effectiveness. In light of these developments, one may better understand the significance of the School of Medicine's role in training experts, advisors and supervisors as well as in providing a high level of quality and effective continuing education. Since 2001, the expansion of the RAIDS-UN networks has emphasised the need for the development of new professional specialties arising on the border between technology and medicine. The operation of these networks requires a strong partnership with health professionals and strategically relies upon a regional dynamic interaction which includes the hospitals, the city, the institutions and the university. It is in this manner that the RAIDS-UN networks will support other initiatives such as the Towards Unity for Health project.

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

    ERIC Educational Resources Information Center

    Cramer, Anne

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

  3. Evaluation of drug treatment in mild hypertension: VA-NHLBI feasibility trial. Plan and preliminary results of a two-year feasibility trial for a multicenter intervention study to evaluate the benefits versus the disadvantages of treating mild hypertension. Prepared for the Veterans Administration-National Heart, Lung, and Blood Institute Study Group for Evaluating Treatment in Mild Hypertension.

    PubMed

    1978-03-30

    A feasibility trial to investigate the practicality of determining the advantages and disadvantages of prompt pharmacologic treatment for mild hypertension was jointly funded by the Veterans Administration and the National Heart, Lung and Blood Institute. Its clinical phase has been completed, and it demonstrated 1. that the required relatively young asymptomatic population could be enrolled in the study and 2. that it could be persuaded to adhere to the protocol for 2 years; however, it was evident that intensive efforts would be required in both areas. The feasibility trial screened almost 120,000 potential subjects over a period of 16 months to randomize about 1,000 subjects at four clinical centers. These men and women were 21 to 50 years old, had diastolic pressures from 85 to 105 mm Hg as outpatients, and had no evidence of cardiovascular renal abnormalities. They were randomized in double-blind fashion into active drug therapy and placebo groups. Stepped care therapy involved 50 mg chlorthalidone (Step 1), 100 mg chlorthalidone (Step 2) and 100 chlorthalidone plus 0.25 mg reserpine (Step 3). Death, myocardial infarction, stroke, angina pectoris, and congestive heart failure were the "major" morbid events that were looked for; also recorded were "minor" morbid events consisting primarily of electrocardiographic arrhythmias. The development of significant hypertension was considered a treatment failure. Side effects were carefully tabulated in both active drug and placebo groups. The study revealed an average drop in diastolic pressure of almost 12 mm Hg for active drug group and less than half of that for the placebo group; once established 6 months after randomization, the new pressure levels persisted almost without change throughout the study. Although the feasibility trial was not designed to answer the primary question regarding the benefits of treatment, the events were tabulated for each group. A total of 12 placebo-treated subjects developed

  4. Antidepressant adherence after psychiatric hospitalization

    PubMed Central

    Zivin, Kara; Ganoczy, Dara; Pfeiffer, Paul N.; Miller, Erin M.; Valenstein, Marcia

    2010-01-01

    Objective Depressed patients discharged from psychiatric hospitalizations face increased risks for adverse outcomes including suicide, yet antidepressant adherence rates during this high-risk period are unknown. Using Veterans Affairs (VA) data, we assessed antidepressant adherence and predictors of poor adherence among depressed veterans following psychiatric hospitalization. Method We identified VA patients nationwide with depressive disorders who had a psychiatric hospitalization between April 1, 1999 and September 30, 2003, received antidepressant medication, and had an outpatient appointment following discharge. We calculated medication possession ratios (MPRs), a measure of medication adherence, within three and six months following discharge. We assessed patient factors associated with having lower levels of adherence (MPRs <0.8) after discharge. Results 20,931 and 23,182 patients met criteria for three and six month MPRs. The mean three month MPR was 0.79 (s.d.=0.37). The mean six month MPR was 0.66 (s.d.=0.40). Patients with poorer adherence were male, younger, non-white, and had a substance abuse disorder, but were less likely to have PTSD or other anxiety disorders. Conclusion Poor antidepressant adherence is common among depressed patients after psychiatric hospitalization. Efforts to improve adherence at this time may be critical in improving the outcomes of these high-risk patients. PMID:19609666

  5. Does one-to-one demonstration with insulin pads by health-care providers improves the insulin administration techniques among diabetic patients of a Tertiary Care Teaching Hospital in South India?

    PubMed Central

    Kapoor, Urvasi; Ramasamy, Gomathi; Selvaraj, Kalaiselvi; Sahoo, Jaya Prakash; Kar, Sitanshu Sekhar

    2016-01-01

    Objectives: The study was aimed to capture the effect of using injection pads as a tool in educating the diabetic patients who were on insulin. The attitude and practice of the patients in storage of insulin vials and disposal of insulin syringes were also assessed. Materials and Methods: A facility based Quasi-experimental study was carried out among the diabetic patients on insulin, attending diabetic clinic in endocrinology OPD in a tertiary care hospital, Puducherry. One to one intervention was given to the study participants or their attendants (who were involved in injecting insulin), by a trained investigator regarding all the steps of insulin administration. The insulin administration practices before and immediately after the intervention was assessed using a checklist. Results: In total 91 patients were included for the study with mean (SD) age of 53.9 (10.6) years and of them 76% were females. The attitude and practices of the study participants, such as hand washing before handling insulin, checking the expiry date, storage of insulin, inspection of injection site, rolling and cleaning the vial, withdrawal of the syringe up to the required dose, pushing the plunger after inserting the syringe into the vial, checking and removal of air bubbles, cleaning the injection site and allow to dry and injection technique improved significantly after the intervention (P < 0.05). Conclusion: This study findings shows that using injection pads for educating patients helps them to practise better insulin administration. The findings from the study can be applied in routine care and has to be explored further in diabetic patient management. PMID:27867877

  6. Medicare program; hospital outpatient prospective payment system and CY 2007 payment rates; CY 2007 update to the ambulatory surgical center covered procedures list; Medicare administrative contractors; and reporting hospital quality data for FY 2008 inpatient prospective payment system annual payment update program--HCAHPS survey, SCIP, and mortality. Final rule with comment period and final rule.

    PubMed

    2006-11-24

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system, and to implement certain related provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 and the Deficit Reduction Act (DRA) of 2005. In this final rule with comment period, we describe changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2007. In addition, this final rule with comment period implements future CY 2009 required reporting on quality measures for hospital outpatient services paid under the prospective payment system. This final rule with comment period revises the current list of procedures that are covered when furnished in a Medicare-approved ambulatory surgical center (ASC), which are applicable to services furnished on or after January 1, 2007. This final rule with comment period revises the emergency medical screening requirements for critical access hospitals (CAHs). This final rule with comment period supports implementation of a restructuring of the contracting entities responsibilities and functions that support the adjudication of Medicare fee-for-service (FFS) claims. This restructuring is directed by section 1874A of the Act, as added by section 911 of the MMA. The prior separate Medicare intermediary and Medicare carrier contracting authorities under Title XVIII of the Act have been replaced with the Medicare Administrative Contractor (MAC) authority. This final rule continues to implement the requirements of the DRA that require that we expand the "starter set" of 10 quality measures that we used in FY 2005 and FY 2006 for the hospital inpatient prospective payment system (IPPS) Reporting Hospital Quality Data

  7. 32 CFR 105.10 - SARC and SAPR VA procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... community education publicizing available SAPR services. (7) Provide a 24 hour, 7 day per week response... counsel as soon as the victim seeks assistance from a SARC or SAPR VA. (x) Facilitate education of command... the report of sexual assault. In deployed locations that have internet connectivity issues, the...

  8. Geropsychology Training in a VA Nursing Home Setting

    ERIC Educational Resources Information Center

    Karel, Michele J.; Moye, Jennifer

    2005-01-01

    There is a growing need for professional psychology training in nursing home settings, and nursing homes provide a rich environment for teaching geropsychology competencies. We describe the nursing home training component of our Department of Veterans Affairs (VA) Predoctoral Internship and Geropsychology Postdoctoral Fellowship programs. Our…

  9. 27. INTERIOR, ADMINISTRATION BUILDING, 2ND FLOOR, SOUTHEAST CORNER SPACE, LOOKING ...

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

    27. INTERIOR, ADMINISTRATION BUILDING, 2ND FLOOR, SOUTHEAST CORNER SPACE, LOOKING UP AT CIRCULAR MOTIF AND BANDS IN THE CEILING ABOVE THE ACOUSTICAL TILES - Ford Motor Company Plant, 700 South Union Street, Alexandria, Independent City, VA

  10. EPA, W. Va. DEP File Settlement with Justice Companies to Restore and Protect Monroe Co., W. Va. Waterways

    EPA Pesticide Factsheets

    CHARLESTON, W.Va. (Dec. 10, 2015) Today, the U.S. Environmental Protection Agency and the West Virginia Department of Environmental Protection filed a settlement with James C. Justice II, the James C. Justice Companies, Inc. and High Mountain Living

  11. Variations in the Use of mHealth Tools: The VA Mobile Health Study

    PubMed Central

    2016-01-01

    Background Mobile health (mHealth) technologies exhibit promise for offering patients and their caregivers point-of-need tools for health self-management. This research study involved the dissemination of iPads containing a suite of mHealth apps to family caregivers of veterans who receive care from the Veterans Affairs (VA) Health Administration and have serious physical or mental injuries. Objective The goal of the study was to identify factors and characteristics of veterans and their family caregivers that predict the use of mHealth apps. Methods Veteran/family caregiver dyads (N=882) enrolled in VA’s Comprehensive Assistance for Family Caregivers program were recruited to participate in an mHealth pilot program. Veterans and caregivers who participated and received an iPad agreed to have their use of the apps monitored and were asked to complete a survey assessing Caregiver Preparedness, Caregiver Traits, and Caregiver Zarit Burden Inventory baseline surveys. Results Of the 882 dyads, 94.9% (837/882) of caregivers were women and 95.7% (844/882) of veteran recipients were men. Mean caregiver age was 40 (SD 10.2) years and mean veteran age was 39 (SD 9.15) years, and 39.8% (351/882) lived in rural locations. Most (89%, 788/882) of the caregivers were spouses. Overall, the most frequently used app was Summary of Care, followed by RX Refill, then Journal, Care4Caregivers, VA Pain Coach, and last, VA PTSD Coach. App use was significantly predicted by the caregiver being a spouse, increased caregiver computer skills, a rural living location, lower levels of caregiver preparedness, veteran mental health diagnosis (other than posttraumatic stress disorder), and veteran age. Conclusions This mHealth Family Caregiver pilot project effectively establishes the VA’s first patient-facing mHealth apps that are integrated within the VA data system. Use varied considerably, and apps that were most used were those that assisted them in their caregiving responsibilities

  12. Comparative Analysis of the VA/Kaiser and NLM CORE Problem Subsets: An Empirical Study Based on Problem Frequency

    PubMed Central

    Wright, Adam; Feblowitz, Joshua; McCoy, Allison B.; Sittig, Dean F.

    2011-01-01

    The problem list is a critical component of the electronic medical record, with implications for clinical care, provider communication, clinical decision support, quality measurement and research. However, many of its benefits depend on the use of coded terminologies. Two standard terminologies (ICD-9 and SNOMED-CT) are available for problem documentation, and two SNOMED-CT subsets (VA/KP and CORE) are available for SNOMED-CT users. We set out to examine these subsets, characterize their overlap and measure their coverage. We applied the subsets to a random sample of 100,000 records from Brigham and Women’s Hospital to determine the proportion of problems covered. Though CORE is smaller (5,814 terms vs. 17,761 terms for VA/KP), 94.8% of coded problem entries from BWH were in the CORE subset, while only 84.0% of entries had matches in VA/KP (p<0.001). Though both subsets had reasonable coverage, CORE was superior in our sample, and had fewer clinically significant gaps. PMID:22195218

  13. 75 FR 17832 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity... techniques or the use of other forms of information technology. Title: VA Loan Electronic Reporting...

  14. 75 FR 33898 - Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity.... 2900-0021.'' SUPPLEMENTARY INFORMATION: Title: VA Loan Electronic Reporting Interface (VALERI)...

  15. 78 FR 36642 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity... techniques or the use of other forms of information technology. Title: VA Loan Electronic Reporting...

  16. 77 FR 24268 - Agency Information Collection (Dependents' Application for VA Educational Benefits) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... AFFAIRS Agency Information Collection (Dependents' Application for VA Educational Benefits) Activity Under... INFORMATION: Title: Dependents' Application for VA Educational Benefits (Under Provisions of Chapters 33 and... spouses and children of veterans or servicemembers to apply for Survivors' and Dependents'...

  17. 76 FR 40452 - Agency Information Collection (VA MATIC Authorization) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ...: VA MATIC Authorization, VA Form 29-0532-1. OMB Control Number: 2900-0492. Type of Review: Extension... authorize deduction of Government Life Insurance premiums from their bank account. An agency may not...

  18. 66. ISTHMUS BRIDGE (HAER No. VA48P) TO JAMESTOWN ISLAND, GENERAL ...

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

    66. ISTHMUS BRIDGE (HAER No. VA-48-P) TO JAMESTOWN ISLAND, GENERAL VIEW FROM SOUTHEAST ON ROAD. NOTE FERRY PIER IN BACKGROUND. - Colonial Parkway, Yorktown to Jamestown Island, Yorktown, York County, VA

  19. 78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ..., and leadership to meet our clients' needs and expectations. DATES: Comments must be received by VA on... and expectations. VA's FY 2014-2020 strategic goals are to: (1) Empower Veterans to Improve Their...

  20. Norovirus - hospital

    MedlinePlus

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

  1. Physical and Mental Health and Access to Care among Nonmetropolitan Veterans Health Administration Patients Younger than 65 Years

    ERIC Educational Resources Information Center

    West, Alan; Weeks, William B.

    2006-01-01

    Context: The 4.5 million military veterans treated by the Veterans Health Administration (VA) are believed to experience poorer physical and mental health than nonveterans. Furthermore, nonmetropolitan residents have less access to medical services, whether or not they are veterans in VA care. A direct comparison of metropolitan and…

  2. A Registrar Administration System Requirements Analysis and Product Recommendation for Marine Corps University, Quantico, VA

    DTIC Science & Technology

    2011-09-01

    critical to the progress and relevance of this study. Thank you for investing your time and effort. To Luis Velazquez who preceded me at NPS (2000...to thank Keith Jones for the illuminating and helpful conversations “over a beer” in the Trident Room. Next, I would like to acknowledge the joint...evaluation process was gathered through private communication with Mike Andersen, NPS Registrar, and Keith Jones , Director of Application Support with

  3. 78 FR 48543 - Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... adequate supervision, including supervision of medication and monitoring of medication compliance; and (6... supervision, including supervision of medication and monitoring of medication compliance; and (5) Provide... medication and monitoring of medication compliance; and (5) Provide opportunities for participants,...

  4. 76 FR 14820 - Proposed Amendment of Class E Airspace; Waynesboro, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... Instrument Approach Procedures (SIAPs) developed for Eagle's Nest Airport. This action would enhance the... Waynesboro, VA to accommodate new standard instrument approach procedures developed for Eagle's Nest Airport... Feet or More Above the Surface of the Earth. * * * * * AEA VA E5 Waynesboro, VA Eagle's Nest...

  5. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Display of the VA Hotline... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  6. 77 FR 2348 - Agency Information Collection (VA Enrollment Certification): Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (VA Enrollment Certification): Activity Under OMB Review AGENCY... INFORMATION: Title: VA Enrollment Certification, VA Form 22-1999. OMB Control Number: 2900-0073. Type...

  7. 38 CFR 26.9 - Information on and public participation in VA environmental process.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT...) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During the..., the Office of Environmental Affairs, or a VA element, information is available by writing to...

  8. 78 FR 31840 - Safety Zone; USO Patriotic Festival Air Show, Atlantic Ocean; Virginia Beach, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-28

    ... Ocean; Virginia Beach, VA AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast... Beach, VA. This action is necessary to provide for the safety of life on navigable waters during the USO... Concerts Entertainment, Inc. will host an air show event over the Atlantic Ocean in Virginia Beach, VA....

  9. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  10. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  11. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  12. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  13. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  14. 38 CFR 21.1032 - VA has a duty to assist claimants in obtaining evidence.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false VA has a duty to assist claimants in obtaining evidence. 21.1032 Section 21.1032 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... Educational Assistance Claims § 21.1032 VA has a duty to assist claimants in obtaining evidence. (a) VA's...

  15. 38 CFR 21.1032 - VA has a duty to assist claimants in obtaining evidence.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false VA has a duty to assist claimants in obtaining evidence. 21.1032 Section 21.1032 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... Educational Assistance Claims § 21.1032 VA has a duty to assist claimants in obtaining evidence. (a) VA's...

  16. 38 CFR 21.1032 - VA has a duty to assist claimants in obtaining evidence.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false VA has a duty to assist claimants in obtaining evidence. 21.1032 Section 21.1032 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... Educational Assistance Claims § 21.1032 VA has a duty to assist claimants in obtaining evidence. (a) VA's...

  17. 38 CFR 21.1032 - VA has a duty to assist claimants in obtaining evidence.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false VA has a duty to assist claimants in obtaining evidence. 21.1032 Section 21.1032 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... Educational Assistance Claims § 21.1032 VA has a duty to assist claimants in obtaining evidence. (a) VA's...

  18. 78 FR 11094 - Drawbridge Operation Regulation; James River, Between Isle of Wight and Newport News, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... and Newport News, VA AGENCY: Coast Guard, DHS. ACTION: Notice of deviation from drawbridge regulation... News, VA. This deviation is necessary to facilitate generator replacement on the James River Draw... operating schedule, the James River Bridge, mile 5.0, between Isle of Isle and Newport News, VA opens...

  19. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Form 10-6298, Architect... VETERANS AFFAIRS CLAUSES AND FORMS FORMS Prescription of Forms 853.236-70 VA Form 10-6298, Architect-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in...

  20. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Display of the VA Hotline... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  1. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Display of the VA Hotline... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  2. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Display of the VA Hotline... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  3. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Display of the VA Hotline... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  4. The Impact of VA's Geriatric Research, Education and Clinical Centers on Academic Affiliates

    ERIC Educational Resources Information Center

    Bragg, Elizabeth J.; Meganathan, Karthikeyan; Shay, Kenneth; Gilman, Stuart C.; Zeiss, Robert A.; Hettler, Debbie L.

    2011-01-01

    The education mission of the Department of Veterans Affairs (VA) is to train health professionals to benefit VA and the United States. One approach for achieving that mission, along with VA's research and clinical missions, was the establishment of Geriatric Research, Education and Clinical Centers (GRECCs) in 1975. These were developed at VA…

  5. Extracting Concepts Related to Homelessness from the Free Text of VA Electronic Medical Records.

    PubMed

    Gundlapalli, Adi V; Carter, Marjorie E; Divita, Guy; Shen, Shuying; Palmer, Miland; South, Brett; Durgahee, B S Begum; Redd, Andrew; Samore, Matthew

    2014-01-01

    Mining the free text of electronic medical records (EMR) using natural language processing (NLP) is an effective method of extracting information not always captured in administrative data. We sought to determine if concepts related to homelessness, a non-medical condition, were amenable to extraction from the EMR of Veterans Affairs (VA) medical records. As there were no off-the-shelf products, a lexicon of terms related to homelessness was created. A corpus of free text documents from outpatient encounters was reviewed to create the reference standard for NLP training and testing. V3NLP Framework was used to detect instances of lexical terms and was compared to the reference standard. With a positive predictive value of 77% for extracting relevant concepts, this study demonstrates the feasibility of extracting positively asserted concepts related to homelessness from the free text of medical records.

  6. [Quality of involuntary hospital administration in Switzerland].

    PubMed

    Jäger, Matthias; Ospelt, Isabelle; Kawohl, Wolfram; Theodoridou, Anastasia; Rössler, Wulf; Hoff, Paul

    2014-05-21

    Fragestellung: Diese Studie hat zum Ziel, die vor Einführung des neuen Kindes- und Erwachsenenschutzrechts per Januar 2013 bestehende Praxis der Fürsorgerischen Freiheitsentziehung (FFE) anhand formaler und inhaltlicher Kriterien der Zuweisungsschreiben zu untersuchen. Hinweise auf Unterschiede zwischen Zuweisern mit verschiedenen professionellen Hintergründen sollen überprüft und die eingewiesenen Personen charakterisiert werden. Methode: Retrospektive Auswertung der Zuweisungsformulare und der Krankenakten sämtlicher per FFE in die Psychiatrische Universitätsklinik Zürich eingetretenen Patienten in einem Zeitraum von sechs Monaten (n=489). Resultate: Es bestehen erhebliche Mängel bezüglich formaler und insbesondere inhaltlicher Qualitätskriterien. Psychiatrische Fachärzte erstellen die Zeugnisse mit der höchsten Qualität, gefolgt von Notärzten sowie Spitälern und Hausärzten. Die Patienten dieser Zuweisergruppen unterscheiden sich bezüglich soziodemographischer und klinischer Variablen. Schlussfolgerungen: Die formale und insbesondere inhaltliche Qualität der Zwangseinweisungen ist angesichts der schwerwiegenden ethischen und juristischen Konsequenzen für die betroffene Person verbesserungsbedürftig. Die Auswirkungen der neuen Gesetzgebung auf die Qualität der Zuweisungen sollten überprüft werden, sodass etwaige Defizite in der Anwendung freiheitsbeschränkender Massnahmen in der Aus- und Weiterbildungspraxis adressiert werden können.

  7. Length of Hospital Stay: Some Administrative Considerations.

    ERIC Educational Resources Information Center

    Stoffelmayr, Bertram E.; And Others

    1984-01-01

    Compared, during a two-year period, lengths of stay of patients on two admission wards that served the same community mental health center. Results showed a significant difference in length of stay for voluntary and involuntary patients. (BH)

  8. Uniform administrative requirements for grants and agreements with institutions of higher education, hospitals and other non-profit organizations, and with commercial organizations, foreign governments, organizations under the jurisdiction of foreign governments, and international organizations--DOL. Final rule.

    PubMed

    1994-07-27

    The Department of Labor is issuing these regulations pursuant to the requirements of the Office of Management and Budget (OMB) Circular No. A-110 (Revised), which provides standards for obtaining consistency and uniformity among Federal agencies in the administration of grants and agreements with institutions of higher education, hospitals, and other non-profit organizations. This rule also applies to the Department of Labor's grants to commercial organizations, foreign governments, organizations under the jurisdiction of foreign governments and international organizations. OMB issued Circular A-110 in 1976 and, except for a minor revision in February 1987, the Circular remained unchanged until revised in 1993. To update the Circular, OMB established an interagency task force to review the Circular. The task force solicited suggestions for changes to the Circular from university groups, non-profit organizations and other interested parties and compared for consistency the provisions of similar provisions applied to State and local governments. The revised Circular and these regulations reflect the results of these efforts.

  9. VA/DoD Joint Executive Council Fiscal Year 2010

    DTIC Science & Technology

    2010-01-01

    impede collaborative efforts, assert and support mutually beneficial opportunities to improve business practices, ensure high quality cost- effective...in-depth Lean-Six Sigma business process improvement study conducted last year and described in last year’s AR. The first milestone for the MRWG...computable electronic health data sharing between VA and DoD. The number of CHDR active dual consumers increased from over 45,900 in October 2009 to

  10. Hospital-acquired infections - when are hospitals legally liable?

    PubMed

    McQuoid-Mason, David

    2012-04-12

    Hospital-acquired infections (nosocomial infections) are acquired in healthcare settings by patients admitted for reasons unrelated to the infection or not previously infected when admitted to the facility. Liability for hospital-acquired infections depends on whether the hospital: (i) has introduced best practice infection control measures; (ii) has implemented best practice infection control measures; or (iii) will be vicariously liable for negligent or intentional failures by staff to comply with the infection control measures implemented. A hospital and hospital administrators may be held directly liable for not introducing or implementing best practice infection control measures, resulting in harm to patients. The hospital may also be held vicariously liable where patients have been harmed because hospital staff negligently or intentionally failed to comply with the infection control measures that have been implemented by the hospital, during the course and scope of their employment.

  11. Changing Patterns of Glucose-Lowering Medication Use in VA Nursing Home Residents with Diabetes, 2005 – 2011

    PubMed Central

    Lee, Sei J.; Stijacic-Cenzer, Irena; Barnhart, Caroline; McClymont, Keelan; Steinman, Michael A

    2015-01-01

    Objective Although nursing home (NH) residents make up a large and growing proportion of Americans with diabetes mellitus, little is known about how glucose-lowering medications are used in this population. We sought to examine glucose-lowering medication use in Veterans Affairs (VA) NH residents with diabetes between 2005–2011. Research Design and Methods Retrospective cohort study, utilizing linked laboratory, pharmacy, administrative and NH Minimum Dataset (MDS) 2.0 databases in 123 VA NHs. A total of 9,431 long-stay (>90 days) VA NH residents over age 65 followed for 52,313 person-quarters. We identified receipt of glucose lowering medications including insulin, metformin, sulfonylureas, thiazolidinediones and others (alpha-glucosidase inhibitors, meglitinides, glucagon like peptide-1 analogs, dipeptidyl peptidase-4 inhibitors and amylin analogues) per quarter. Results The rates of sulfonylurea use in long-stay NH residents dropped dramatically from 24% in 2005 to 12% in 2011 (p<0.001), driven in large part by the dramatic decrease in glyburide use (10% to 2%, p<0.001). There was sharp drop in thiazolidinedione use in 2007 (4% to <1%, p<0.001). Metformin use was stable, ranging between 7% to 9% (p=0.24). Insulin use increased slightly from 30% to 32% (p<0.001). Use of other classes of glucose-lowering medications was stable (p=0.22) and low, remaining below 1.3%. Conclusions and Relevance Between 2005 and 2011, there were dramatic declines in use of sulfonylureas and thiazolidinediones in VA NH residents, suggesting that prescribing practices can be quickly changed in this setting. PMID:26272298

  12. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... admission for veterans in Alaska, Hawaii, Virgin Islands and other territories of the United States except... the United States an amount as determined in § 17.48(e). (Authority: 38 U.S.C. 1703, 1710 and 1712... care for women veterans; (Authority: 38 U.S.C. 1703; sec. 19012, Pub. L. 99-272) (5) Through...

  13. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... disabilities being treated, and (iii) A veteran of the Mexican border period or World War I or who is in...-272) (2) Medical services for the treatment of any disability of— (i) A veteran who has a service... prisoner of war and was detained or interned for a period of not less that 181 days. (Authority: 38...

  14. Administrative Synergy

    ERIC Educational Resources Information Center

    Hewitt, Kimberly Kappler; Weckstein, Daniel K.

    2012-01-01

    One of the biggest obstacles to overcome in creating and sustaining an administrative professional learning community (PLC) is time. Administrators are constantly deluged by the tyranny of the urgent. It is a Herculean task to carve out time for PLCs, but it is imperative to do so. In this article, the authors describe how an administrative PLC…

  15. Using multiple sources of data for surveillance of postoperative venous thromboembolism among surgical patients treated in Department of Veterans Affairs hospitals, 2005–2010

    PubMed Central

    Nelson, Richard E.; Grosse, Scott D.; Waitzman, Norman J.; Lin, Junji; DuVall, Scott L.; Patterson, Olga; Tsai, James; Reyes, Nimia

    2015-01-01

    Background There are limitations to using administrative data to identify postoperative venous thromboembolism (VTE). We used a novel approach to quantify postoperative VTE events among Department of Veterans Affairs (VA) surgical patients during 2005–2010. Methods We used VA administrative data to exclude patients with VTE during 12 months prior to surgery. We identified probable postoperative VTE events within 30 and 90 days post-surgery in three settings: 1) pre-discharge inpatient, using a VTE diagnosis code and a pharmacy record for anticoagulation; 2) post-discharge inpatient, using a VTE diagnosis code followed by a pharmacy record for anticoagulation within 7 days; and 3) outpatient, using a VTE diagnosis code and either anticoagulation or a therapeutic procedure code with natural language processing (NLP) to confirm acute VTE in clinical notes. Results Among 468,515 surgeries without prior VTE, probable VTEs were documented within 30 and 90 days in 3,931 (0.8%) and 5,904 (1.3%), respectively. Of probable VTEs within 30 or 90 days post-surgery, 47.8% and 62.9%, respectively, were diagnosed post-discharge. Among post-discharge VTE diagnoses, 86% resulted in a VA hospital readmission. Fewer than 25% of outpatient records with both VTE diagnoses and anticoagulation prescriptions were confirmed by NLP as acute VTE events. Conclusion More than half of postoperative VTE events were diagnosed post-discharge; analyses of surgical discharge records are inadequate to identify postoperative VTE. The NLP results demonstrate that the combination of VTE diagnoses and anticoagulation prescriptions in outpatient administrative records cannot be used to validly identify postoperative VTE events. PMID:25666908

  16. Veterans Health Administration

    MedlinePlus

    ... for Vets VetSuccess Performance Based Interviewing Clinical Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries ( ...

  17. 43 CFR 4.1391 - Who may file; where to file; when to file; filing of administrative record.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., 801 N. Quincy Street, Suite 300, Arlington, VA 22203 (telephone 703-235-3750). OSM shall file the complete administrative record of the determination under review with the Board as soon as practicable....

  18. Hospital projects whose designers and builders know how to get along. The VISTA Awards.

    PubMed

    1999-03-01

    The customer is the big picture for all three teams honored with 1998-99 VISTA Awards for innovative construction. Their tasks couldn't have differed more: a new VA medical center in Michigan, a children's hospital in Texas, and a major hospital addition in Oregon. What unites them is a team spirit and sense of partnership behind their success.

  19. 38 CFR 17.55 - Payment for authorized public or private hospital care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., not to exceed the full DRG rate as provided in paragraph (a) of this section. The hospital that... section. (c) VA shall pay the providing facility the full DRG-based rate or reasonable cost, without... each discharge, an amount to cover the non-Federal hospital's capital-related costs, kidney, heart...

  20. 38 CFR 17.55 - Payment for authorized public or private hospital care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., not to exceed the full DRG rate as provided in paragraph (a) of this section. The hospital that... section. (c) VA shall pay the providing facility the full DRG-based rate or reasonable cost, without... each discharge, an amount to cover the non-Federal hospital's capital-related costs, kidney, heart...

  1. 38 CFR 17.55 - Payment for authorized public or private hospital care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., not to exceed the full DRG rate as provided in paragraph (a) of this section. The hospital that... section. (c) VA shall pay the providing facility the full DRG-based rate or reasonable cost, without... each discharge, an amount to cover the non-Federal hospital's capital-related costs, kidney, heart...

  2. 38 CFR 17.55 - Payment for authorized public or private hospital care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., not to exceed the full DRG rate as provided in paragraph (a) of this section. The hospital that... section. (c) VA shall pay the providing facility the full DRG-based rate or reasonable cost, without... each discharge, an amount to cover the non-Federal hospital's capital-related costs, kidney, heart...

  3. 38 CFR 17.55 - Payment for authorized public or private hospital care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., not to exceed the full DRG rate as provided in paragraph (a) of this section. The hospital that... section. (c) VA shall pay the providing facility the full DRG-based rate or reasonable cost, without... each discharge, an amount to cover the non-Federal hospital's capital-related costs, kidney, heart...

  4. 76 FR 38743 - Proposed Information Collection (Report of Treatment in Hospital); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (Report of Treatment in Hospital); Comment Request AGENCY... of Treatment in Hospital, VA FL 29-551. OMB Control Number: 2900-0119. Type of Review: Extension of...

  5. 76 FR 56503 - Agency Information Collection (Report of Treatment in Hospital) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Report of Treatment in Hospital) Activity Under OMB Review AGENCY... INFORMATION: Title: Report of Treatment in Hospital, VA FL 29-551. OMB Control Number: 2900-0119. Type...

  6. Noncoherent detection of DQPSK in OFDM systems using predictive VA

    NASA Astrophysics Data System (ADS)

    Veludandi, Vineel K.; Vasudevan, K.

    2017-01-01

    Noncoherent detection of differential quaternary phase shift keying (DQPSK) signals in OFDM systems is efficiently implemented using a predictive Viterbi algorithm (VA) operating on a trellis with just S T = MP‑1 states instead of M P states, where M denotes an M-ary PSK constellation and P denotes the order of the prediction filter. The prediction filter coefficients are generated based on the channel DFT alone making a high SNR approximation, since the estimation of the noise-variance using training symbols results in loss of throughput.

  7. Understanding hospitality.

    PubMed

    Patten, C S

    1994-03-01

    Bridging patient/"customer" issues and business aspects can be aided through developing a specific nursing basis for hospitality. The ancient practice of hospitality has evolved into three distinct levels: public, personal and therapeutic. Understanding these levels is helpful in integrating various dimensions of guest relations programs in hospitals into a more comprehensive vision. Hospitality issues must become a greater part of today's nursing management.

  8. Cooperative Education, General and Vocational and the Veterans Administration.

    ERIC Educational Resources Information Center

    Cute, Brian; Shenk, Ed

    In an attempt to correct recent Veterans Administration (VA) regulations restricting benefits for veterans enrolled in cooperative education programs at community colleges, this paper describes the value of cooperative education, both vocational and general, and argues the supporting intent of federal law in Title 38 of the U. S. Code. Many…

  9. Practical and Policy Implications of Using Different Rural-Urban Classification Systems: A Case Study of Inpatient Service Utilization among Veterans Administration Users

    ERIC Educational Resources Information Center

    Berke, Ethan M.; West, Alan N.; Wallace, Amy E.; Weeks, William B.

    2009-01-01

    Context: Several classification systems exist for defining rural areas, which may lead to different interpretations of rural health services data. Purpose: To compare rural classification systems on their implications for estimating Veterans Administration (VA) utilization. Methods: Using 7 classification systems, we counted VA health care…

  10. Administrative Ecology

    ERIC Educational Resources Information Center

    McGarity, Augustus C., III; Maulding, Wanda

    2007-01-01

    This article discusses how all four facets of administrative ecology help dispel the claims about the "impossibility" of the superintendency. These are personal ecology, professional ecology, organizational ecology, and community ecology. Using today's superintendency as an administrative platform, current literature describes a preponderance of…

  11. KENO V.a Primer: A Primer for Criticality Calculations with SCALE/KENO V.a Using CSPAN for Input

    SciTech Connect

    Busch, R.D.

    2003-01-17

    The SCALE (Standardized Computer Analyses for Licensing Evaluation) computer software system developed at Oak Ridge National Laboratory (ORNL) is widely used and accepted around the world for criticality safety analyses. The well-known KENO V.a three-dimensional Monte Carlo criticality computer code is the primary criticality safety analysis tool in SCALE. The KENO V.a primer is designed to help a new user understand and use the SCALE/KENO V.a Monte Carlo code for nuclear criticality safety analyses. It assumes that the user has a college education in a technical field. There is no assumption of familiarity with Monte Carlo codes in general or with SCALE/KENO V.a in particular. The primer is designed to teach by example, with each example illustrating two or three features of SCALE/KENO V.a that are useful in criticality analyses. The primer is based on SCALE 4.4a, which includes the Criticality Safety Processor for Analysis (CSPAN) input processor for Windows personal computers (PCs). A second edition of the primer, which uses the new KENO Visual Editor, is currently under development at ORNL and is planned for publication in late 2003. Each example in this first edition of the primer uses CSPAN to provide the framework for data input. Starting with a Quickstart section, the primer gives an overview of the basic requirements for SCALE/KENO V.a input and allows the user to quickly run a simple criticality problem with SCALE/KENO V.a. The sections that follow Quickstart include a list of basic objectives at the beginning that identifies the goal of the section and the individual SCALE/KENO V.a features which are covered in detail in the example problems in that section. Upon completion of the primer, a new user should be comfortable using CSPAN to set up criticality problems in SCALE/KENO V.a.

  12. Molecular mechanism of myosin Va recruitment to dense core secretory granules.

    PubMed

    Brozzi, Flora; Diraison, Frederique; Lajus, Sophie; Rajatileka, Shavanthi; Philips, Thomas; Regazzi, Romano; Fukuda, Mitsunori; Verkade, Paul; Molnár, Elek; Váradi, Anikó

    2012-01-01

    The brain-spliced isoform of Myosin Va (BR-MyoVa) plays an important role in the transport of dense core secretory granules (SGs) to the plasma membrane in hormone and neuropeptide-producing cells. The molecular composition of the protein complex that recruits BR-MyoVa to SGs and regulates its function has not been identified to date. We have identified interaction between SG-associated proteins granuphilin-a/b (Gran-a/b), BR-MyoVa and Rab27a, a member of the Rab family of GTPases. Gran-a/b-BR-MyoVa interaction is direct, involves regions downstream of the Rab27-binding domain, and the C-terminal part of Gran-a determines exon specificity. MyoVa and Gran-a/b are partially colocalised on SGs and disruption of Gran-a/b-BR-MyoVa binding results in a perinuclear accumulation of SGs which augments nutrient-stimulated hormone secretion in pancreatic beta-cells. These results indicate the existence of at least another binding partner of BR-MyoVa that was identified as rabphilin-3A (Rph-3A). BR-MyoVa-Rph-3A interaction is also direct and enhanced when secretion is activated. The BR-MyoVa-Rph-3A and BR-MyoVa-Gran-a/b complexes are linked to a different subset of SGs, and simultaneous inhibition of these complexes nearly completely blocks stimulated hormone release. This study demonstrates that multiple binding partners of BR-MyoVa regulate SG transport, and this molecular mechanism is universally used by neuronal, endocrine and neuroendocrine cells.

  13. Helping safeguard Veterans Affairs' hospital buildings by advanced earthquake monitoring

    USGS Publications Warehouse

    Kalkan, Erol; Banga, Krishna; Ulusoy, Hasan S.; Fletcher, Jon Peter B.; Leith, William S.; Blair, James L.

    2012-01-01

    In collaboration with the U.S. Department of Veterans Affairs (VA), the National Strong Motion Project of the U.S. Geological Survey has recently installed sophisticated seismic systems that will monitor the structural integrity of hospital buildings during earthquake shaking. The new systems have been installed at more than 20 VA medical campuses across the country. These monitoring systems, which combine sensitive accelerometers and real-time computer calculations, are capable of determining the structural health of each structure rapidly after an event, helping to ensure the safety of patients and staff.

  14. Rights and Responsibilities of VA Patients and Residents of Community Living Centers

    MedlinePlus

    ... for Vets VetSuccess Performance Based Interviewing Clinical Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries ( ...

  15. Marketing the hospital library.

    PubMed

    Bridges, Jane

    2005-01-01

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

  16. 20 CFR 435.47 - Contract administration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Contract administration. 435.47 Section 435.47 Employees' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS,...

  17. 38 CFR 49.47 - Contract administration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Contract administration..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 49.47 Contract administration. A system for contract administration shall be maintained to ensure contractor conformance...

  18. Parallelization of KENO-Va Monte Carlo code

    NASA Astrophysics Data System (ADS)

    Ramón, Javier; Peña, Jorge

    1995-07-01

    KENO-Va is a code integrated within the SCALE system developed by Oak Ridge that solves the transport equation through the Monte Carlo Method. It is being used at the Consejo de Seguridad Nuclear (CSN) to perform criticality calculations for fuel storage pools and shipping casks. Two parallel versions of the code: one for shared memory machines and other for distributed memory systems using the message-passing interface PVM have been generated. In both versions the neutrons of each generation are tracked in parallel. In order to preserve the reproducibility of the results in both versions, advanced seeds for random numbers were used. The CONVEX C3440 with four processors and shared memory at CSN was used to implement the shared memory version. A FDDI network of 6 HP9000/735 was employed to implement the message-passing version using proprietary PVM. The speedup obtained was 3.6 in both cases.

  19. Health Services Research and Development: the Veterans Administration Program.

    PubMed Central

    Goldschmidt, P G

    1986-01-01

    Health expenditures are rising inexorably; health status shows relatively little gain; technological possibilities are outstripping our ability or willingness to provide a commensurate level of resources. Clinical and administrative managers face increasingly difficult choices among alternative interventions in attempting to resolve these problems. If health services research is to succeed as a tool for assisting these decisions, clinicians, administrators, and researchers must view it as an integral part of management. This paper describes this concept of health services research and its implementation by the VA HSR&D Service, results from 1981 to date, and future directions. Four programs implement the Service's system to make relevant, valid information accessible to VA staff who can use it to improve veterans' health care: Investigator-Initiated Research (IIR) Program; HSR&D Field Program, which implements the Service's mission in various local areas VA-wide; Special Projects Program, responsive to system-wide issues, including technology assessment and transfer; and Resources Program, the Service's own management system. The Service's impact on improving veterans health care is already apparent. However, the true value of the HSR&D system will become apparent only in the 1990s, after the capacity for conducting health services research has been built and integrated fully with clinical and administrative practice. The VA, the nation's largest health care system, has a unique opportunity to demonstrate how health services research can improve health care. PMID:3081467

  20. Myosin Va is developmentally regulated and expressed in the human cerebellum from birth to old age

    PubMed Central

    Souza, C.C.R.; Dombroski, T.C.D.; Machado, H.R.; Oliveira, R.S.; Rocha, L.B.; Rodrigues, A.R.A.; Neder, L.; Chimelli, L.; Corrêa, V.M.A.; Larson, R.E.; Martins, A.R.

    2013-01-01

    Myosin Va functions as a processive, actin-based motor molecule highly enriched in the nervous system, which transports and/or tethers organelles, vesicles, and mRNA and protein translation machinery. Mutation of myosin Va leads to Griscelli disease that is associated with severe neurological deficits and a short life span. Despite playing a critical role in development, the expression of myosin Va in the central nervous system throughout the human life span has not been reported. To address this issue, the cerebellar expression of myosin Va from newborns to elderly humans was studied by immunohistochemistry using an affinity-purified anti-myosin Va antibody. Myosin Va was expressed at all ages from the 10th postnatal day to the 98th year of life, in molecular, Purkinje and granular cerebellar layers. Cerebellar myosin Va expression did not differ essentially in localization or intensity from childhood to old age, except during the postnatal developmental period. Structures resembling granules and climbing fibers in Purkinje cells were deeply stained. In dentate neurons, long processes were deeply stained by anti-myosin Va, as were punctate nuclear structures. During the first postnatal year, myosin Va was differentially expressed in the external granular layer (EGL). In the EGL, proliferating prospective granule cells were not stained by anti-myosin Va antibody. In contrast, premigratory granule cells in the EGL stained moderately. Granule cells exhibiting a migratory profile in the molecular layer were also moderately stained. In conclusion, neuronal myosin Va is developmentally regulated, and appears to be required for cerebellar function from early postnatal life to senescence. PMID:23558932

  1. Union Density and Hospital Outcomes.

    PubMed

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

    2015-01-01

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

  2. Strategies and performance in hospitals.

    PubMed

    Madorrán García, Cristina; de Val Pardo, Isabel

    2004-01-01

    Today, more than ever in the past, the variables within the health care environment (demand, costs, system deregulation) are undergoing such rapid change that hospital administrators are finding it necessary to develop and implement competitive strategies in order to survive in the increasingly competitive hospital environment. The primary aim of this paper is to answer the following question: Is it possible to transfer strategic management research from other sectors into the hospital industry? The first objective was to identify strategies in hospital management. A questionnaire was designed and sent to hospital CEOs and the data extracted were used to construct the variables needed to identify strategies and perform the subsequent analyses. The second aim was to try to identify groups of organizations using similar strategies and, finally, analyse the impact of these on hospital performance.

  3. Long-term effect of home telehealth services on preventable hospitalization use.

    PubMed

    Jia, Huanguang; Chuang, Ho-Chih; Wu, Samuel S; Wang, Xinping; Chumbler, Neale R

    2009-01-01

    In this study, we assessed the longitudinal effect of a Department of Veterans Affairs (VA) patient-centered Care Coordination Home Telehealth (CCHT) program on preventable hospitalization use by veterans with diabetes mellitus (DM) at four VA medical centers. We used a matched treatment-control design (n = 387 for both groups). All patients were followed for 4 years. We operationalized ambulatory care-sensitive conditions (ACSCs) by applying Agency for Healthcare Research and Quality criteria to VA inpatient databases to determine preventable hospitalization use. We used a generalized linear mixed model to estimate the adjusted effect of the CCHT program on preventable hospitalization use over time. During the initial 18 months of follow-up, CCHT enrollees were less likely to be admitted for a preventable hospitalization than their nonenrollee counterparts, and this difference diminished during the rest of the 4-year follow-up period. The VA CCHT program for DM patients reduced preventable hospitalizations. These findings are some of the first that have systematically examined the extent to which home telehealth programs have a long-term effect on preventable hospitalization use.

  4. 77 FR 30050 - VA National Academic Affiliations Council, Notice of meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ... AFFAIRS VA National Academic Affiliations Council, Notice of meeting The Department of Veterans Affairs... the National Academic Affiliations Council will be held on June 5-6, 2012, in Suite 878 at 1800 G... affecting partnerships between VA and its academic affiliates. On June 5, the Council will review the...

  5. 38 CFR 74.25 - What types of personally identifiable information will VA collect?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... identifiable information will VA collect? 74.25 Section 74.25 Pensions, Bonuses, and Veterans' Relief... What types of personally identifiable information will VA collect? In order to establish owner eligibility, the Department will collect individual names and Social Security numbers for veterans,...

  6. 30 CFR 57.22312 - Distribution boxes (II-A and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Distribution boxes (II-A and V-A mines). 57... MINES Safety Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22312 Distribution boxes (II-A and V-A mines). Distribution boxes containing short circuit protection for trailing cables...

  7. 38 CFR 26.7 - VA environmental decision making and documents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... environmental decision making and documents. (a) Relevant environmental documents shall accompany other decision documents as they proceed through the decision-making process. (b) The major decision points for VA actions... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false VA environmental...

  8. 38 CFR 26.7 - VA environmental decision making and documents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... environmental decision making and documents. (a) Relevant environmental documents shall accompany other decision documents as they proceed through the decision-making process. (b) The major decision points for VA actions... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false VA environmental...

  9. 38 CFR 26.7 - VA environmental decision making and documents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... environmental decision making and documents. (a) Relevant environmental documents shall accompany other decision documents as they proceed through the decision-making process. (b) The major decision points for VA actions... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false VA environmental...

  10. 38 CFR 26.7 - VA environmental decision making and documents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... environmental decision making and documents. (a) Relevant environmental documents shall accompany other decision documents as they proceed through the decision-making process. (b) The major decision points for VA actions... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false VA environmental...

  11. 33 CFR 334.350 - Chesapeake Bay off Fort Monroe, Va.; firing range danger zone.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., Va.; firing range danger zone. 334.350 Section 334.350 Navigation and Navigable Waters CORPS OF....350 Chesapeake Bay off Fort Monroe, Va.; firing range danger zone. (a) The danger zone. All of the...°17′54″ W. (b) The regulations. (1) No weapon having a greater range than the 30-calibre carbine is...

  12. 33 CFR 334.220 - Chesapeake Bay, south of Tangier Island, Va.; naval firing range.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Island, Va.; naval firing range. 334.220 Section 334.220 Navigation and Navigable Waters CORPS OF....220 Chesapeake Bay, south of Tangier Island, Va.; naval firing range. (a) The danger zone. Beginning... the range will be conducted intermittently by one or more vessels, depending on weather and...

  13. 33 CFR 334.220 - Chesapeake Bay, south of Tangier Island, Va.; naval firing range.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Island, Va.; naval firing range. 334.220 Section 334.220 Navigation and Navigable Waters CORPS OF....220 Chesapeake Bay, south of Tangier Island, Va.; naval firing range. (a) The danger zone. Beginning... the range will be conducted intermittently by one or more vessels, depending on weather and...

  14. 38 CFR 3.1701 - Deceased veterans for whom VA may provide burial benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... whom VA may provide burial benefits. 3.1701 Section 3.1701 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Burial Benefits Burial Benefits: General § 3.1701 Deceased veterans for whom VA may provide burial benefits. For purposes of providing burial benefits under subpart...

  15. 78 FR 52085 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-22

    ... AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business Verification Guidelines AGENCY... requires the Department of Veterans Affairs (VA) to verify ownership and control of veteran- ] owned small businesses (VOSBs), including service-disabled veteran- owned small businesses (SDVOSBs), in order for...

  16. 33 CFR 334.350 - Chesapeake Bay off Fort Monroe, Va.; firing range danger zone.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., Va.; firing range danger zone. 334.350 Section 334.350 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.350 Chesapeake Bay off Fort Monroe, Va.; firing range danger zone. (a) The danger zone. All of...

  17. 77 FR 13519 - Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. SUMMARY... Virginia Beach, VA. This action is necessary to provide for the safety of life on navigable waters...

  18. 77 FR 27120 - Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The... Beach, VA to support the Virginia Beach Oceanfront Air Show. This action is necessary to provide for...

  19. 33 CFR 334.220 - Chesapeake Bay, south of Tangier Island, Va.; naval firing range.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Chesapeake Bay, south of Tangier Island, Va.; naval firing range. 334.220 Section 334.220 Navigation and Navigable Waters CORPS OF....220 Chesapeake Bay, south of Tangier Island, Va.; naval firing range. (a) The danger zone....

  20. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ...-day period was $2,537.40 in FY 2010. The average Medicare reimbursement level for skilled home care....74 less per day from VA for a 60-day episode of care. On average, each of the 8400 providers cares... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care by Non-VA...

  1. 78 FR 51067 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-20

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO34 VA Health Professional Scholarship and Visual Impairment and... Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual... provide financial assistance to certain students seeking a degree in visual impairment or orientation...

  2. 33 CFR 334.130 - Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone. 334.130 Section 334.130 Navigation and Navigable Waters... REGULATIONS § 334.130 Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone. (a) The...

  3. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements... plan, the minimum goals for award of subcontracts to service-disabled veteran-owned small...

  4. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements... plan, the minimum goals for award of subcontracts to service-disabled veteran-owned small...

  5. 76 FR 3017 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-19

    ... to one business has no foundation in law and that there is no compelling reason to limit... AFFAIRS 38 CFR Part 74 RIN 2900-AM78 VA Veteran-Owned Small Business Verification Guidelines AGENCY..., and Information Technology Act of 2006. This law requires the Department of Veterans Affairs (VA)...

  6. Veterans Justice Outreach Program: VA Could Improve Management by Establishing Performance Measures and Fully Assessing Risks

    DTIC Science & Technology

    2016-04-01

    VETERANS JUSTICE OUTREACH PROGRAM VA Could Improve Management by Establishing Performance Measures and Fully...VA Could Improve Management by Establishing Performance Measures and Fully Assessing Risks Why GAO Did This Study Most veterans transition to...treatment. GAO was asked to review the management of the VJO Program. This report examines 1) how the program delivers services and the number and

  7. 77 FR 38181 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business Verification Guidelines AGENCY... Department of Veterans Affairs (VA) to verify ownership and control of veteran-owned small businesses (VOSBs), including service-disabled veteran-owned small businesses (SDVOSBs) in order for these firms to...

  8. 38 CFR 58.16 - VA Form 10-0144-Certification Regarding Lobbying.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0144-Certification Regarding Lobbying. 58.16 Section 58.16 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.16 VA Form 10-0144—Certification Regarding Lobbying. ER06JA00.013...

  9. Myosin-Va binds to and mechanochemically couples microtubules to actin filaments.

    PubMed

    Cao, Tracy T; Chang, Wakam; Masters, Sarah E; Mooseker, Mark S

    2004-01-01

    Myosin-Va was identified as a microtubule binding protein by cosedimentation analysis in the presence of microtubules. Native myosin-Va purified from chick brain, as well as the expressed globular tail domain of this myosin, but not head domain bound to microtubule-associated protein-free microtubules. Binding of myosin-Va to microtubules was saturable and of moderately high affinity (approximately 1:24 Myosin-Va:tubulin; Kd = 70 nM). Myosin-Va may bind to microtubules via its tail domain because microtubule-bound myosin-Va retained the ability to bind actin filaments resulting in the formation of cross-linked gels of microtubules and actin, as assessed by fluorescence and electron microscopy. In low Ca2+, ATP addition induced dissolution of these gels, but not release of myosin-Va from MTs. However, in 10 microM Ca2+, ATP addition resulted in the contraction of the gels into aster-like arrays. These results demonstrate that myosin-Va is a microtubule binding protein that cross-links and mechanochemically couples microtubules to actin filaments.

  10. 77 FR 72816 - Foreign-Trade Zone 20-Suffolk, VA; Authorization of Production Activity; Usui International...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Foreign-Trade Zones Board Foreign-Trade Zone 20--Suffolk, VA; Authorization of Production Activity; Usui International Corporation (Diesel Engine Fuel Lines); Chesapeake, VA On June 28, 2012, the Virginia...

  11. 30 CFR 57.22309 - Methane monitors (V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Methane monitors (V-A mines). 57.22309 Section... Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22309 Methane monitors (V-A mines). (a) Methane monitors shall be installed on continuous mining machines used in or beyond the last open...

  12. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Medication prescribed by non-VA physicians. 17.96 Section 17.96 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any...

  13. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Self-contained breathing apparatus (V-A mines... NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22315 Self-contained breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  14. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Self-contained breathing apparatus (V-A mines... NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22315 Self-contained breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  15. 78 FR 55777 - Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... AFFAIRS Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event... Events, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of National Veterans Sports Programs and Special Events (NVSP), Department of Veterans Affairs (VA), is announcing an opportunity...

  16. 78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA has specifically contracted, this rulemaking will only affect home health and hospice care providers who do...

  17. 78 FR 77204 - Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-20

    ... AFFAIRS Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys... solicits comments on the information needed to evaluate the National Veterans Sports Programs and Special... ``OMB Control No. 2900-NEW (VA National Veterans Sports Programs and Special Event Surveys)'' in...

  18. 76 FR 34248 - Equestrian Stables at Meadowood Special Recreation Management Area, VA; Information Sharing Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-13

    ... Equestrian Stables at Meadowood Special Recreation Management Area, VA; Information Sharing Meeting AGENCY... equestrian stables at Meadowood Special Recreation Management Area (SRMA), located in Lorton, VA, and collect... will begin with an overview of the status of equestrian activities at the Meadowood SRMA....

  19. 30 CFR 57.22309 - Methane monitors (V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Methane monitors (V-A mines). 57.22309 Section... Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22309 Methane monitors (V-A mines). (a) Methane monitors shall be installed on continuous mining machines used in or beyond the last open...

  20. VA/DOD Federal Health Care Center: Costly Information Technology Delays Continue and Evaluation Plan Lacking

    DTIC Science & Technology

    2012-06-01

    portability, which would allow VA and DOD clinicians to place, manage, and update clinical orders from either VA or DOD electronic health records systems...on, which includes five dedicated, full-time pharmacists to conduct manual checks of patient records to reconcile allergy information and identify

  1. Making Bullying Prevention a Priority in Finnish Schools: The KiVa Antibullying Program

    ERIC Educational Resources Information Center

    Salmivalli, Christina; Poskiparta, Elisa

    2012-01-01

    The KiVa antibullying program has been widely implemented in Finnish comprehensive schools since 2009. The program is predicated on the idea that a positive change in the behaviors of classmates can reduce the rewards gained by the perpetrators of bullying and consequently their motivation to bully in the first place. KiVa involves both universal…

  2. 33 CFR 334.130 - Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone. 334.130 Section 334.130 Navigation and Navigable Waters... REGULATIONS § 334.130 Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone. (a) The...

  3. 33 CFR 334.130 - Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone. 334.130 Section 334.130 Navigation and Navigable Waters... REGULATIONS § 334.130 Atlantic Ocean off Wallops Island and Chincoteague Inlet, Va.; danger zone. (a) The...

  4. 77 FR 21158 - VA Directive 0005 on Scientific Integrity: Availability for Review and Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... AFFAIRS VA Directive 0005 on Scientific Integrity: Availability for Review and Comment AGENCY: Office of... (VA) Directive 0005 on Scientific Integrity. The Draft Directive incorporates the principles of scientific integrity contained in the Presidential Memorandum of March 9, 2009, and the Director, Office...

  5. 38 CFR 74.26 - What types of business information will VA collect?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.26 What types of business information will VA collect? VA will examine a variety of business records. See § 74.12, “What is... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false What types of...

  6. 78 FR 27882 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... AFFAIRS 38 CFR Part 74 RIN 2900-AO63 VA Veteran-Owned Small Business (VOSB) Verification Guidelines AGENCY... and Disadvantaged Business Utilization (OSDBU) is currently reviewing its regulations governing the Department of Veterans Affairs (VA) Veteran-Owned Small Business (VOSB) Verification Program. OSDBU...

  7. 77 FR 48127 - Foreign-Trade Zone 20-Suffolk, VA; Notification of Proposed Production Activity, Usui...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Foreign-Trade Zones Board Foreign-Trade Zone 20--Suffolk, VA; Notification of Proposed Production Activity, Usui International Corporation, (Diesel Engine Fuel Lines), Chesapeake, VA The Virginia Port Authority, grantee of FTZ 20, submitted a...

  8. Bidirectional ACR-NEMA interface between the VA's DHCP integrated imaging system and the Siemens-Loral PACS

    NASA Astrophysics Data System (ADS)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    1994-05-01

    At the Baltimore VA Medical Center, the DHCP Integrated Imaging System and a commercial Picture Archiving and Communication System (PACS) work in concert to provide a wide- range of departmental and hospital-wide imaging capabilities. An interface between the DHCP and the Siemens-Loral PACS systems enables patient text and image data to be passed between the two systems. The interface uses ACR-NEMA 2.0 Standard messages extended with shadow groups based on draft ACR-NEMA 3.0 prototypes. A Novell file server, accessible to both systems via Ethernet, is used to communicate all the messages. Patient identification information, orders, ADT, procedure status, changes, patient reports, and images are sent between the two systems across the interface. The systems together provide an extensive set of imaging capabilities for both the specialist and the general practitioner.

  9. Empirical analysis on future-cash arbitrage risk with portfolio VaR

    NASA Astrophysics Data System (ADS)

    Chen, Rongda; Li, Cong; Wang, Weijin; Wang, Ze

    2014-03-01

    This paper constructs the positive arbitrage position by alternating the spot index with Chinese Exchange Traded Fund (ETF) portfolio and estimating the arbitrage-free interval of futures with the latest trade data. Then, an improved Delta-normal method was used, which replaces the simple linear correlation coefficient with tail dependence correlation coefficient, to measure VaR (Value-at-risk) of the arbitrage position. Analysis of VaR implies that the risk of future-cash arbitrage is less than that of investing completely in either futures or spot market. Then according to the compositional VaR and the marginal VaR, we should increase the futures position and decrease the spot position appropriately to minimize the VaR, which can minimize risk subject to certain revenues.

  10. VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs. Final rule.

    PubMed

    2013-08-20

    The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations.

  11. Personnel administration can act on cost containment.

    PubMed

    Adams, J

    1980-01-01

    Hosiptal personnel administration programs have the potential to contain costs in a variety of areas, including human resources management, payroll costs, benefits costs, labor turnover, and recruitment costs. Recognizing this, the Maine Society for Hospital Personnel Administration presented a seminar and prepared a guide for trustees and administrators on the role that personnel administration can play in the Voluntary Effort to contain costs. The following article is an adaptation of the information included in the seminar and guide.

  12. Building strong research partnerships between public health and researchers: a VA case study.

    PubMed

    Midboe, Amanda M; Elwy, A Rani; Durfee, Janet M; Gifford, Allen L; Yakovchenko, Vera; Martinello, Richard A; Ross, David; Czarnogorski, Maggie; Goetz, Matthew B; Asch, Steven M

    2014-12-01

    We are in a new era of partner-based implementation research, and we need clear strategies for how to navigate this new era. Drawing on principles from community-based participatory research, the Clinical Public Health group of the Department of Veterans Affairs and the HIV/Hepatitis Quality Enhancement Research Initiative (HHQUERI) forged a longstanding partnership that has improved the care of Veterans with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus. An exemplar HIV testing project epitomizes this partnership and is discussed in terms of the lessons learned as a result of our high level of collaboration around design, analysis, implementation, and dissemination across projects over the past several years. Lessons learned through this partnered testing program involve respecting different time horizons among the partners, identifying relevant research questions for both parties, designing flexible studies, engaging all partners throughout the research, and placing an emphasis on relationship building at all times. These lessons and strategies can benefit others conducting partner-based research both within the Veterans Health Administration (VA) and in other integrated healthcare systems.

  13. Engineering Administration.

    ERIC Educational Resources Information Center

    Naval Personnel Program Support Activity, Washington, DC.

    This book is intended to acquaint naval engineering officers with their duties in the engineering department. Standard shipboard organizations are analyzed in connection with personnel assignments, division operations, and watch systems. Detailed descriptions are included for the administration of directives, ship's bills, damage control, training…

  14. Administrative IT

    ERIC Educational Resources Information Center

    Grayson, Katherine, Ed.

    2006-01-01

    When it comes to Administrative IT solutions and processes, best practices range across the spectrum. Enterprise resource planning (ERP), student information systems (SIS), and tech support are prominent and continuing areas of focus. But widespread change can also be accomplished via the implementation of campuswide document imaging and sharing,…

  15. Database Administrator

    ERIC Educational Resources Information Center

    Moore, Pam

    2010-01-01

    The Internet and electronic commerce (e-commerce) generate lots of data. Data must be stored, organized, and managed. Database administrators, or DBAs, work with database software to find ways to do this. They identify user needs, set up computer databases, and test systems. They ensure that systems perform as they should and add people to the…

  16. Hospital care and medical services for Camp Lejeune veterans. Final rule.

    PubMed

    2014-09-24

    This document amends Department of Veterans Affairs (VA) regulations in order to implement a statutory mandate that VA provide health care to certain veterans who served at Camp Lejeune, North Carolina, for at least 30 days during the period beginning on January 1, 1957, and ending on December 31, 1987. The law requires VA to furnish hospital care and medical services for these veterans for certain illnesses and conditions that may be attributed to exposure to toxins in the water system at Camp Lejeune. This rule does not implement the statutory provision requiring VA to provide health care to these veterans' family members; regulations applicable to such family members will be promulgated through a separate notice.

  17. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the non-VA provider may have within the commercial health care industry. (iii) The amount that the... Health Insurance Portability and Accountability Act mandated national standard coding sets. VA will pay...

  18. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the non-VA provider may have within the commercial health care industry. (iii) The amount that the... Health Insurance Portability and Accountability Act mandated national standard coding sets. VA will pay...

  19. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the non-VA provider may have within the commercial health care industry. (iii) The amount that the... Health Insurance Portability and Accountability Act mandated national standard coding sets. VA will pay...

  20. 78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... 106-554 BLS Bureau of Labor Statistics CAH Critical access hospital CARE Continuity Assessment Record... Disproportionate share hospital ECI Employment cost index EDB Enrollment Database EHR Electronic health record EMR Electronic medical record FAH Federation of American Hospitals FDA Food and Drug Administration FFY...

  1. Hospital marketing.

    PubMed

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  2. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

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

  3. Identification and characterization of multiple novel Rab–myosin Va interactions

    PubMed Central

    Lindsay, Andrew J.; Jollivet, Florence; Horgan, Conor P.; Khan, Amir R.; Raposo, Graça; McCaffrey, Mary W.; Goud, Bruno

    2013-01-01

    Myosin Va is a widely expressed actin-based motor protein that binds members of the Rab GTPase family (3A, 8A, 10, 11A, 27A) and is implicated in many intracellular trafficking processes. To our knowledge, myosin Va has not been tested in a systematic screen for interactions with the entire Rab GTPase family. To that end, we report a yeast two-hybrid screen of all human Rabs for myosin Va-binding ability and reveal 10 novel interactions (3B, 3C, 3D, 6A, 6A′, 6B, 11B, 14, 25, 39B), which include interactions with three new Rab subfamilies (Rab6, Rab14, Rab39B). Of interest, myosin Va interacts with only a subset of the Rabs associated with the endocytic recycling and post-Golgi secretory systems. We demonstrate that myosin Va has three distinct Rab-binding domains on disparate regions of the motor (central stalk, an alternatively spliced exon, and the globular tail). Although the total pool of myosin Va is shared by several Rabs, Rab10 and Rab11 appear to be the major determinants of its recruitment to intracellular membranes. We also present evidence that myosin Va is necessary for maintaining a peripheral distribution of Rab11- and Rab14-positive endosomes. PMID:24006491

  4. Myosin Va Is Required for P Body but Not Stress Granule Formation*

    PubMed Central

    Lindsay, Andrew J.; McCaffrey, Mary W.

    2011-01-01

    In the present study we demonstrate an association between mammalian myosin Va and cytoplasmic P bodies, microscopic ribonucleoprotein granules that contain components of the 5′–3′ mRNA degradation machinery. Myosin Va colocalizes with several P body markers and its RNAi-mediated knockdown results in the disassembly of P bodies. Overexpression of a dominant-negative mutant of myosin Va reduced the motility of P bodies in living cells. Co-immunoprecipitation experiments demonstrate that myosin Va physically associates with eIF4E, an mRNA binding protein that localizes to P bodies. In contrast, we find that myosin Va does not play a role in stress granule formation. Stress granules are ribonucleoprotein structures that are involved in translational silencing and are spatially, functionally, and compositionally linked to P bodies. Myosin Va is found adjacent to stress granules in stressed cells but displays minimal localization within stress granules, and myosin Va knockdown has no effect on stress granule assembly or disassembly. Combined with recently published reports demonstrating a role for Drosophila and mammalian class V myosins in mRNA transport and the involvement of the yeast myosin V orthologue Myo2p in P body assembly, our results provide further evidence that the class V myosins serve an important role in the transport and turnover of mRNA. PMID:21245139

  5. The molecular motor Myosin Va interacts with the cilia-centrosomal protein RPGRIP1L

    PubMed Central

    Assis, L. H. P.; Silva-Junior, R. M. P.; Dolce, L. G.; Alborghetti, M. R.; Honorato, R. V.; Nascimento, A. F. Z.; Melo-Hanchuk, T. D.; Trindade, D. M.; Tonoli, C. C. C.; Santos, C. T.; Oliveira, P. S. L.; Larson, R. E.; Kobarg, J.; Espreafico, E. M.; Giuseppe, P. O.; Murakami, M. T.

    2017-01-01

    Myosin Va (MyoVa) is an actin-based molecular motor abundantly found at the centrosome. However, the role of MyoVa at this organelle has been elusive due to the lack of evidence on interacting partners or functional data. Herein, we combined yeast two-hybrid screen, biochemical studies and cellular assays to demonstrate that MyoVa interacts with RPGRIP1L, a cilia-centrosomal protein that controls ciliary signaling and positioning. MyoVa binds to the C2 domains of RPGRIP1L via residues located near or in the Rab11a-binding site, a conserved site in the globular tail domain (GTD) from class V myosins. According to proximity ligation assays, MyoVa and RPGRIP1L can interact near the cilium base in ciliated RPE cells. Furthermore, we showed that RPE cells expressing dominant-negative constructs of MyoVa are mostly unciliated, providing the first experimental evidence about a possible link between this molecular motor and cilia-related processes. PMID:28266547

  6. Flexural Stiffness of Myosin Va Subdomains as Measured from Tethered Particle Motion

    PubMed Central

    Michalek, Arthur J.; Kennedy, Guy G.; Warshaw, David M.; Ali, M. Yusuf

    2015-01-01

    Myosin Va (MyoVa) is a processive molecular motor involved in intracellular cargo transport on the actin cytoskeleton. The motor's processivity and ability to navigate actin intersections are believed to be governed by the stiffness of various parts of the motor's structure. Specifically, changes in calcium may regulate motor processivity by altering the motor's lever arm stiffness and thus its interhead communication. In order to measure the flexural stiffness of MyoVa subdomains, we use tethered particle microscopy, which relates the Brownian motion of fluorescent quantum dots, which are attached to various single- and double-headed MyoVa constructs bound to actin in rigor, to the motor's flexural stiffness. Based on these measurements, the MyoVa lever arm and coiled-coil rod domain have comparable flexural stiffness (0.034 pN/nm). Upon addition of calcium, the lever arm stiffness is reduced 40% as a result of calmodulins potentially dissociating from the lever arm. In addition, the flexural stiffness of the full-length MyoVa construct is an order of magnitude less stiff than both a single lever arm and the coiled-coil rod. This suggests that the MyoVa lever arm-rod junction provides a flexible hinge that would allow the motor to maneuver cargo through the complex intracellular actin network. PMID:26770194

  7. Effects of inspired CO2, hyperventilation, and time on VA/Q inequality in the dog

    NASA Technical Reports Server (NTRS)

    Tsukimoto, K.; Arcos, J. P.; Schaffartzik, W.; Wagner, P. D.; West, J. B.

    1992-01-01

    In a recent study by Tsukimoto et al. (J. Appl. Physiol. 68: 2488-2493, 1990), CO2 inhalation appeared to reduce the size of the high ventilation-perfusion ratio (VA/Q) mode commonly observed in anesthetized mechanically air-ventilated dogs. In that study, large tidal volumes (VT) were used during CO2 inhalation to preserve normocapnia. To separate the influences of CO2 and high VT on the VA/Q distribution in the present study, we examined the effect of inspired CO2 on the high VA/Q mode using eight mechanically ventilated dogs (4 given CO2, 4 controls). The VA/Q distribution was measured first with normal VT and then with increased VT. In the CO2 group at high VT, data were collected before, during, and after CO2 inhalation. With normal VT, there was no difference in the size of the high VA/Q mode between groups [10.5 +/- 3.5% (SE) of ventilation in the CO2 group, 11.8 +/- 5.2% in the control group]. Unexpectedly, the size of the high VA/Q mode decreased similarly in both groups over time, independently of the inspired PCO2, at a rate similar to the fall in cardiac output over time. The reduction in the high VA/Q mode together with a simultaneous increase in alveolar dead space (estimated by the difference between inert gas dead space and Fowler dead space) suggests that poorly perfused high VA/Q areas became unperfused over time. A possible mechanism is that elevated alveolar pressure and decreased cardiac output eliminate blood flow from corner vessels in nondependent high VA/Q regions.

  8. 33 CFR 334.340 - Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Island, Hampton, Va.; Air Force precision test area. 334.340 Section 334.340 Navigation and Navigable... REGULATIONS § 334.340 Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area. (a) The... Command, Langley Air Force Base, Va., shall be responsible for publicizing in advance through the...

  9. 33 CFR 334.340 - Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Island, Hampton, Va.; Air Force precision test area. 334.340 Section 334.340 Navigation and Navigable... REGULATIONS § 334.340 Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area. (a) The... Command, Langley Air Force Base, Va., shall be responsible for publicizing in advance through the...

  10. 33 CFR 334.340 - Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Island, Hampton, Va.; Air Force precision test area. 334.340 Section 334.340 Navigation and Navigable... REGULATIONS § 334.340 Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area. (a) The... Command, Langley Air Force Base, Va., shall be responsible for publicizing in advance through the...

  11. 33 CFR 334.340 - Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Island, Hampton, Va.; Air Force precision test area. 334.340 Section 334.340 Navigation and Navigable... REGULATIONS § 334.340 Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area. (a) The... Command, Langley Air Force Base, Va., shall be responsible for publicizing in advance through the...

  12. 33 CFR 334.340 - Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Island, Hampton, Va.; Air Force precision test area. 334.340 Section 334.340 Navigation and Navigable... REGULATIONS § 334.340 Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area. (a) The... Command, Langley Air Force Base, Va., shall be responsible for publicizing in advance through the...

  13. 75 FR 51331 - Draft Tier II Environmental Impact Statement: Southeast High Speed Rail Corridor-Richmond, VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ... Corridor--Richmond, VA (Main Street Station) to Raleigh, NC (Boylan Wye) AGENCY: Federal Railroad... the Tier II Draft Environmental Impact Statement for the Southeast High Speed Rail, Richmond, VA to... the Draft Tier II Environmental Impact Statement for the Southeast High Speed Rail, Richmond, VA...

  14. Federal Health Care Center: VA and DOD Need to Address Ongoing Difficulties and Better Prepare for Future Integrations

    DTIC Science & Technology

    2016-02-01

    which provide health care to both VA and DOD beneficiaries. The encounters for the West Campus include care provided at VA’s three offsite community ...29For example, geriatric and mental health clinical areas were initially grouped with other...clinical areas in directorates led by the VA Chief Medical Executive and VA Nurse Executive, respectively. The reorganization grouped geriatric and mental

  15. 77 FR 64388 - Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... AFFAIRS Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Former POW Medical History, VA Form 10-0048. OMB Control Number: 2900-0427. Type of Review: Extension of a currently approved collection. Abstract: VA Form 10-0048 is completed...

  16. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17... Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

  17. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17... Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

  18. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17... Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

  19. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17... Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

  20. Community residential care program and contract program for veterans with alcohol and drug dependence disorders--VA. Final rule.

    PubMed

    1996-12-02

    This document updates the Department of Veterans Affairs (VA) regulations concerning the Community Residential Care Program and the Contract Program for Veterans with Alcohol and Drug Dependence Disorders by incorporating by reference relevant portions of the latest editions of the National Fire Protection Association Life Safety Code entitled "NFPA 101, Life Safety Code" and "NFPA 101A, Guide on Alternative Approaches to life Safety." This is intended to ensure that buildings used for treatment and residential services for veterans meet appropriate fire and safety standards. Also, this document amends the regulations for such programs by delegating authority to each of the Veterans Integrated Service Network (VISN) Directors of the Veterans Health Administration to grant certain equivalencies or variances to building standards of the Life Safety Code. Further, this final rule does not adopt the portion of the proposed rule concerning the Adult Day Health Care Program since the Adult Day Health Care Program and the corresponding regulations are no longer in existence.

  1. Persistent Serious Mental Illness Among Former Applicants for VA PTSD Disability Benefits and Long-Term Outcomes: Symptoms, Functioning, and Employment.

    PubMed

    Murdoch, Maureen; Spoont, Michele Roxanne; Kehle-Forbes, Shannon Marie; Harwood, Eileen Mae; Sayer, Nina Aileen; Clothier, Barbara Ann; Bangerter, Ann Kay

    2017-02-01

    Millions of U.S. veterans have returned from military service with posttraumatic stress disorder (PTSD), for which a substantial number receive U.S. Department of Veterans Affairs (VA) disability benefits. Although PTSD is treatable, comorbid serious mental illness (defined here as schizophrenia, schizoaffective disorder, and bipolar spectrum disorders) could complicate these veterans' recovery. Using VA administrative data, we examined the burden of persistent serious mental illness in a nationally representative cohort of 1,067 men and 1,513 women who applied for VA PTSD disability benefits between 1994 and 1998 and served during or after the Vietnam conflict. Self-reported outcomes were restricted to the 713 men and 1,015 women who returned surveys at each of 3 collection points. More than 10.0% of men and 20.0% of women had persistent serious mental illness; of these, more than 80.0% also had persistent PTSD. On repeated measures modeling, those with persistent serious mental illness consistently reported more severe PTSD symptoms and poorer functioning in comparison to other participants (ps < .001); their employment rate did not exceed 21.0%. Interactions between persistent serious mental illness and PTSD were significant only for employment (p = .002). Persistent serious mental illness in this population was almost 2 to 19 times higher than in the general U.S.

  2. The changing power equation in hospitals.

    PubMed

    Rayburn, J M; Rayburn, L G

    1997-01-01

    This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur.

  3. One-year outcomes of out-of-hospital administration of intravenous glucose, insulin, and potassium (GIK) in patients with suspected acute coronary syndromes (from the IMMEDIATE [Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care] Trial).

    PubMed

    Selker, Harry P; Udelson, James E; Massaro, Joseph M; Ruthazer, Robin; D'Agostino, Ralph B; Griffith, John L; Sheehan, Patricia R; Desvigne-Nickens, Patrice; Rosenberg, Yves; Tian, Xin; Vickery, Ellen M; Atkins, James M; Aufderheide, Tom P; Sayah, Assaad J; Pirrallo, Ronald G; Levy, Michael K; Richards, Michael E; Braude, Darren A; Doyle, Delanor D; Frascone, Ralph J; Kosiak, Donald J; Leaming, James M; Van Gelder, Carin M; Walter, Gert-Paul; Wayne, Marvin A; Woolard, Robert H; Beshansky, Joni R

    2014-05-15

    The Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency care Trial of very early intravenous glucose-insulin-potassium (GIK) for acute coronary syndromes (ACS) in out-of-hospital emergency medical service (EMS) settings showed 80% reduction in infarct size at 30 days, suggesting potential longer-term benefits. Here we report 1-year outcomes. Prespecified 1-year end points of this randomized, placebo-controlled, double-blind, effectiveness trial included all-cause mortality and composites including cardiac arrest, mortality, or hospitalization for heart failure (HF). Of 871 participants randomized to GIK versus placebo, death occurred within 1 year in 11.6% versus 13.5%, respectively (unadjusted hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.57 to 1.23, p = 0.36). The composite of cardiac arrest or 1-year mortality was 12.8% versus 17.0% (HR 0.71, 95% CI 0.50 to 1.02, p = 0.06). The composite of hospitalization for HF or mortality within 1 year was 17.2% versus 17.2% (HR 0.98, 95% CI 0.70 to 1.37, p = 0.92). The composite of mortality, cardiac arrest, or HF hospitalization within 1 year was 18.1% versus 20.4% (HR 0.85, 95% CI 0.62 to 1.16, p = 0.30). In patients presenting with suspected ST elevation myocardial infarction, HRs for 1-year mortality and the 3 composites were, respectively, 0.65 (95% CI 0.33 to 1.27, p = 0.21), 0.52 (95% CI 0.30 to 0.92, p = 0.03), 0.63 (95% CI 0.35 to 1.16, p = 0.14), and 0.51 (95% CI 0.30 to 0.87, p = 0.01). In patients with suspected acute coronary syndromes, serious end points generally were lower with GIK than placebo, but the differences were not statistically significant. However, in those with ST elevation myocardial infarction, the composites of cardiac arrest or 1-year mortality, and of cardiac arrest, mortality, or HF hospitalization within 1 year, were significantly reduced.

  4. EPA brownfields grants support jobs, property assessments in Huntington and 4 southern W. Va. counties

    EPA Pesticide Factsheets

    HUNTINGTON, W. VA. (July 7, 2015) -- The U.S. Environmental Protection Agency today announced $592,300 in brownfields grants that will provide job training and environmental property assessments in Huntington and southern West Virginia.

  5. 75 FR 34372 - Safety Zone; Fourth of July Fireworks Event, Pagan River, Smithfield, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... establishing a 420-foot radius safety zone on the navigable waters of the Pagan River in Smithfield, VA in... navigable waters of the Pagan River within the area bounded by a 420-foot radius circle centered on...

  6. 77 FR 35848 - Safety Zone, Fourth of July Fireworks Event, Pagan River, Smithfield, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... establishing a 420-foot radius safety zone on the navigable waters of the Pagan River in Smithfield, VA in... the navigable waters of the Pagan River within the area bounded by a 420-foot radius circle...

  7. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  8. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  9. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  10. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  11. AdvanSix Resins & Chemicals LLC – Chester, VA VAD023690183

    EPA Pesticide Factsheets

    The EPA is announcing its environmental remediation under the Resource Conservation and Recovery Act, as amended (RCRA), as complete with Controls for the AdvanSix Resins & Chemicals LLC facility, Chester, VA (EPA ID: VAD023690183).

  12. 78 FR 56151 - Safety Zone, North Atlantic Ocean; Virginia Beach, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... offshore between 17th and 31st Streets of Virginia Beach, VA. The fireworks debris fallout area will extend... site and fallout area and is expected to have no impact on the water or environment. This zone...

  13. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... AFFAIRS Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration Applications); Comment Request AGENCY: Office of National Programs and Special Events, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of National Programs and Special Events (NPSE), Department...

  14. 77 FR 38396 - Agency Information Collection (One-VA Identification Verification Card) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... Control Number: 2900-0673. Type of Review: Extension of a currently approved collection. Abstract: VA PIV... personalize, print, and issue a PIV card. An agency may not conduct or sponsor, and a person is not...

  15. 75 FR 3968 - Fund Availability Under the VA Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-25

    ... throughout by an approved automatic sprinkler system unless a facility is specifically exempted under the...-funded program will participate in VA's National Program Monitoring and Evaluation System administered...

  16. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.10 Selection of non-VA... providers who provide temporary residential assistance for homeless persons with serious mental illness,...

  17. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.10 Selection of non-VA... providers who provide temporary residential assistance for homeless persons with serious mental illness,...

  18. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.10 Selection of non-VA... providers who provide temporary residential assistance for homeless persons with serious mental illness,...

  19. 78 FR 33223 - Drawbridge Operation Regulation; York River, Between Yorktown and Gloucester Point, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-04

    ... Gloucester Point and Yorktown, VA. This deviation is necessary to facilitate electrical motor maintenance on... operating regulations set out in 33 CFR 117.1025, to facilitate electric motor maintenance on the...

  20. 78 FR 34892 - Drawbridge Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ..., VA. This deviation is necessary to facilitate thermite welding on rail joints on the Norfolk Southern... 33 CFR 117.5 to facilitate thermite welding on the rails. Under the regular operating schedule,...

  1. 30 CFR 57.22240 - Actions at 2.0 percent methane (V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... percent methane (V-A mines). If methane reaches 2.0 percent in the mine atmosphere, all persons other than competent persons necessary to make ventilation changes shall be withdrawn from affected areas until...

  2. 30 CFR 57.22240 - Actions at 2.0 percent methane (V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... percent methane (V-A mines). If methane reaches 2.0 percent in the mine atmosphere, all persons other than competent persons necessary to make ventilation changes shall be withdrawn from affected areas until...

  3. 30 CFR 57.22240 - Actions at 2.0 percent methane (V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... percent methane (V-A mines). If methane reaches 2.0 percent in the mine atmosphere, all persons other than competent persons necessary to make ventilation changes shall be withdrawn from affected areas until...

  4. 38 CFR 74.29 - When will VA dispose of records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.29 When will VA dispose of records? The records, including those pertaining to businesses not determined to be eligible for the...

  5. 79. Credit JTL. Detail of 2000 kVA generator (unit 2) ...

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

    79. Credit JTL. Detail of 2000 kVA generator (unit 2) looking southwest. Note the elevated neutral on upper part of generator (added later). - Battle Creek Hydroelectric System, Battle Creek & Tributaries, Red Bluff, Tehama County, CA

  6. 77 FR 74279 - Agency Information Collection (VA/DOD Joint Disability Evaluation Board Claim): Activity under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... President Bush's Interagency Task Force on Returning Global War on Terror Heroes, VA and the Department of Defense (DOD) have agreed to develop a joint process in which Global War on Terror (GWOT) service...

  7. 77 FR 60746 - Proposed Information Collection (VA/DOD Joint Disability Evaluation Board Claim) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... Interagency Task Force on Returning Global War on Terror Heroes, VA and the Department of Defense (DOD) have agreed to develop a joint process in which Global War on Terror (GWOT) service members are evaluated...

  8. 34 CFR 74.47 - Contract administration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Contract administration. 74.47 Section 74.47 Education Office of the Secretary, Department of Education ADMINISTRATION OF GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award...

  9. Knowledge and Skills for Nurse Administrators.

    ERIC Educational Resources Information Center

    Mark, Barbara A.; And Others

    1990-01-01

    Looks at the education needs of nurse executives and nurse managers and compares them to the typical education provided in nursing administration programs. Concludes that educators need to be directly involved in hospital settings in order to update nursing administration education. (JOW)

  10. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  11. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  12. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  13. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  14. Review and Evaluation of the VA Enrollee Health Care Projection Model

    DTIC Science & Technology

    2008-01-01

    ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INTERNATIONAL AFFAIRS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND TECHNOLOGY...SUBTITLE Review and Evaluation of the VA Enrollee Health Care Projection Model 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...Military Health Policy Research Review and Evaluation of the VA Enrollee Health Care Projection Model The RAND Corporation is a nonprofit research

  15. 30 CFR 57.22240 - Actions at 2.0 percent methane (V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Actions at 2.0 percent methane (V-A mines). 57... MINES Safety Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22240 Actions at 2.0 percent methane (V-A mines). If methane reaches 2.0 percent in the mine atmosphere, all persons other...

  16. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2”...

  17. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2”...

  18. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2”...

  19. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2”...

  20. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2”...

  1. VA Health Care: Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events

    DTIC Science & Technology

    2015-07-01

    VA HEALTH CARE Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events Report to Congressional...2015 4. TITLE AND SUBTITLE VA Health Care: Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events 5a. CONTRACT NUMBER 5b...Analyses of Adverse Events Why GAO Did This Study Adverse events are incidents that pose a risk of injury to a patient as the result of a medical

  2. DoD/VA Care Transition Process for Service Members Injured in OIF/OEF

    DTIC Science & Technology

    2008-06-12

    Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time...REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 DEPARTMENT OF...Department of Veterans Affairs (VA) Offices of the Inspector General formed an interagency team, allowing access to DoD and VA facilities, records, and

  3. 30 CFR 57.22240 - Actions at 2.0 percent methane (V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Actions at 2.0 percent methane (V-A mines). 57... MINES Safety Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22240 Actions at 2.0 percent methane (V-A mines). If methane reaches 2.0 percent in the mine atmosphere, all persons other...

  4. NATIVE AMERICAN HOUSING: VA Could Address Some Barriers to Participation in Direct Loan Program

    DTIC Science & Technology

    2002-08-01

    other organizations that focus on mortgage lending on trust lands, such as the One - Stop Mortgage Centers17 located on the Navajo reservation in New...centers and have not used them to identify, educate, and assist prospective borrowers. For example, a One - Stop Mortgage Center official in Arizona...about the VA program because the One - Stop Mortgage Center’s staff was not familiar with it. VA has conducted outreach but has taken limited steps to

  5. Test Results for the 2.5-kVA Ground Fault Detector.

    DTIC Science & Technology

    1986-01-01

    Officer. Code 60 Williamsburg , VA NAVCOASTSYSCEN CO. Panama City, FL; Code 223(0 (J. Quirk) Panama City. FL; Code 423, Panama City. FL; Code 630...Twentynine Plams, CA; ROICC/AROICC, Brooklyn , NY. ROICC/AROICC. Colts Neck. NJ; ROICC/OICC, SPA, Norfolk, VA; SW Pac, Dir. Engr Div, Mania. RP; SW Pac. OICC...Supt (Code 453). Vallejo. CA NAVSTA A. Sugihara, Pearl Harbor. HI; CO. Brooklyn , NY; CO, Long Beach. CA; CO. Roosevelt Roads. PR; Code 18. Midway

  6. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

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

  7. Hospital finance.

    PubMed

    Herman, M J

    1998-01-01

    This article summarizes key areas of focus for the analysis of risk in the hospital segment of the health care industry. The article is written from a commercial bank lending perspective. Both for-profit (C-corporations) and 501 (c)(3) not-for-profit segments are addressed.

  8. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

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

  9. VaRank: a simple and powerful tool for ranking genetic variants

    PubMed Central

    Geoffroy, Véronique; Pizot, Cécile; Redin, Claire; Piton, Amélie; Vasli, Nasim; Stoetzel, Corinne; Blavier, André; Laporte, Jocelyn

    2015-01-01

    Background. Most genetic disorders are caused by single nucleotide variations (SNVs) or small insertion/deletions (indels). High throughput sequencing has broadened the catalogue of human variation, including common polymorphisms, rare variations or disease causing mutations. However, identifying one variation among hundreds or thousands of others is still a complex task for biologists, geneticists and clinicians. Results. We have developed VaRank, a command-line tool for the ranking of genetic variants detected by high-throughput sequencing. VaRank scores and prioritizes variants annotated either by Alamut Batch or SnpEff. A barcode allows users to quickly view the presence/absence of variants (with homozygote/heterozygote status) in analyzed samples. VaRank supports the commonly used VCF input format for variants analysis thus allowing it to be easily integrated into NGS bioinformatics analysis pipelines. VaRank has been successfully applied to disease-gene identification as well as to molecular diagnostics setup for several hundred patients. Conclusions. VaRank is implemented in Tcl/Tk, a scripting language which is platform-independent but has been tested only on Unix environment. The source code is available under the GNU GPL, and together with sample data and detailed documentation can be downloaded from http://www.lbgi.fr/VaRank/. PMID:25780760

  10. Semi-nonparametric VaR forecasts for hedge funds during the recent crisis

    NASA Astrophysics Data System (ADS)

    Del Brio, Esther B.; Mora-Valencia, Andrés; Perote, Javier

    2014-05-01

    The need to provide accurate value-at-risk (VaR) forecasting measures has triggered an important literature in econophysics. Although these accurate VaR models and methodologies are particularly demanded for hedge fund managers, there exist few articles specifically devoted to implement new techniques in hedge fund returns VaR forecasting. This article advances in these issues by comparing the performance of risk measures based on parametric distributions (the normal, Student’s t and skewed-t), semi-nonparametric (SNP) methodologies based on Gram-Charlier (GC) series and the extreme value theory (EVT) approach. Our results show that normal-, Student’s t- and Skewed t- based methodologies fail to forecast hedge fund VaR, whilst SNP and EVT approaches accurately success on it. We extend these results to the multivariate framework by providing an explicit formula for the GC copula and its density that encompasses the Gaussian copula and accounts for non-linear dependences. We show that the VaR obtained by the meta GC accurately captures portfolio risk and outperforms regulatory VaR estimates obtained through the meta Gaussian and Student’s t distributions.

  11. Partnership to improve quality care for veterans: the VA Nursing Academy.

    PubMed

    Harper, Doreen C; Selleck, Cynthia S; Eagerton, Gregory; Froelich, Kimberly

    2015-01-01

    More than 22 million living veterans reside in the United States. In fact, understanding military culture and the experiences of these veterans is important to their ongoing health care and the unique challenges faced by many. The Veterans Affairs (VA) Nursing Academy began in 2007 to fund pilot partnerships between schools of nursing and local VA health care facilities to better serve our veteran population. Fifteen academic/service partnerships were selected for funding between 2007 and 2009 with the goals of expanding faculty and professional development, increasing nursing student enrollment, providing opportunities for educational and practice innovations, and increasing the recruitment and retention of VA nurses. This article details critical components of the partnership developed between the Birmingham VA Medical Center and the University of Alabama at Birmingham School of Nursing, a VA Nursing Academy partnership funded in the 2009 cohort. Site-specific goals of the partnership are described along with a discussion of the framework used to develop the Birmingham VA Nursing Academy, which includes relationship building, engagement, governance, evaluation of outcomes, and sustainability. The logic model developed for the partnership is included, and the interim outputs and outcomes of this practice-academic partnership are detailed, a number of which can be replicated by VAs and schools of nursing across the country.

  12. Myosin-Va Mediates RNA Distribution in Primary Fibroblasts From Multiple Organs

    PubMed Central

    Salerno, Verônica P.; Calliari, Aldo; William Provance, D.; Sotelo-Silveira, José R.; Sotelo, José R.; Mercer, John A.

    2008-01-01

    Myosin-Va has been shown to have multiple functions in a variety of cell types, including a role in RNA transport in neurons. Using primary cultures of cells from organs of young dilute-lethal (Myo5ad-l/Myo5ad-l) null mutant mice and wild-type controls, we show that in some, but not all, tissues, RNA distribution is dramatically different in the homozygous null mutant cells. The dependence of RNA localization on myosin-Va correlates with the relative abundance of the brain-specific splicing pattern of the myosin-Va tail. We also show that myosin-Va is involved in RNA localization soon after synthesis, because the effects of its absence are diminished for RNAs that are more than 30 min old. Finally, we show that localization of β-actin mRNA is significantly changed by the absence of myosin-Va. These results suggest that myosin-Va is involved in a transient transport or tethering function in the perinuclear region. Cell Motil. PMID:18357619

  13. The globular tail domain puts on the brake to stop the ATPase cycle of myosin Va

    PubMed Central

    Li, Xiang-dong; Jung, Hyun Suk; Wang, Qizhi; Ikebe, Reiko; Craig, Roger; Ikebe, Mitsuo

    2008-01-01

    Myosin Va is a well known processive motor involved in transport of organelles. A tail-inhibition model is generally accepted for the regulation of myosin Va: inhibited myosin Va is in a folded conformation such that the tail domain interacts with and inhibits myosin Va motor activity. Recent studies indicate that it is the C-terminal globular tail domain (GTD) that directly inhibits the motor activity of myosin Va. In the present study, we identified a conserved acidic residue in the motor domain (Asp-136) and two conserved basic residues in the GTD (Lys-1706 and Lys-1779) as critical residues for this regulation. Alanine mutations of these conserved charged residues not only abolished the inhibition of motor activity by the GTD but also prevented myosin Va from forming a folded conformation. We propose that Asp-136 forms ionic interactions with Lys-1706 and Lys-1779. This assignment locates the GTD-binding site in a pocket of the motor domain, formed by the N-terminal domain, converter, and the calmodulin in the first IQ motif. We propose that binding of the GTD to the motor domain prevents the movement of the converter/lever arm during ATP hydrolysis cycle, thus inhibiting the chemical cycle of the motor domain. PMID:18216256

  14. Multidisciplinary VA Cardiac Rehabilitation: Preliminary Results and Treatment Efficacy.

    ERIC Educational Resources Information Center

    Daly, Susan S.; And Others

    Initial studies have suggested that a cardiac rehabilitation program (CRP) may improve the physical and psychological functioning of participants. However, these studies have generally addressed a relatively young group of employed adult males. Three studies were designed to target an older, generally retired Veterans Administration population for…

  15. Predicting Adoption of Telemedicine by VA Mental Health Professionals

    ERIC Educational Resources Information Center

    Pak, Wesley Chong Y.

    2013-01-01

    Providing primary health and specialty services to 3.4 million rural and highly rural veterans is a challenging task because of geographic barriers and the uneven distribution of rural healthcare providers. Although the Veterans Health Administration is hoping that technology such as telemedicine expands availability of specialties' access to…

  16. Medication safety during your hospital stay

    MedlinePlus

    Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... Medication safety means you get the right medicine, the right dose, at the right times. During your ...

  17. Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

    PubMed Central

    2012-01-01

    Background Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA) has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs). However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI) as a strategy to facilitate the adoption of collaborative-care management in CBOCs. Methods This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews. Results Adoption: 69.0% (58/84) of primary care providers referred patients to the program. Reach: 9.0% (298/3,296) of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. Fidelity: During baseline care manager encounters, education/activation was provided to 100% (298/298) of patients, barriers were assessed and addressed for 100% (298/298) of patients, and depression severity was monitored for 100% (298/298) of patients. Less than half (42.5%, 681/1603) of follow-up encounters during the acute stage were completed

  18. Use of Veterans Health Administration Mental Health and Substance Use Disorder Treatment After Exiting Prison: The Health Care for Reentry Veterans Program.

    PubMed

    Finlay, Andrea K; Stimmel, Matthew; Blue-Howells, Jessica; Rosenthal, Joel; McGuire, Jim; Binswanger, Ingrid; Smelson, David; Harris, Alex H S; Frayne, Susan M; Bowe, Tom; Timko, Christine

    2017-03-01

    The Veterans Health Administration (VA) Health Care for Reentry Veterans (HCRV) program links veterans exiting prison with treatment. Among veterans served by HCRV, national VA clinical data were used to describe contact with VA health care, and mental health and substance use disorder diagnoses and treatment use. Of veterans seen for an HCRV outreach visit, 56 % had contact with VA health care. Prevalence of mental health disorders was 57 %; of whom 77 % entered mental health treatment within a month of diagnosis. Prevalence of substance use disorders was 49 %; of whom 37 % entered substance use disorder treatment within a month of diagnosis. For veterans exiting prison, increasing access to VA health care, especially for rural veterans, and for substance use disorder treatment, are important quality improvement targets.

  19. VA Education Benefits: VA Should Strengthen Its Efforts to Help Veterans Make Informed Education Choices. Report to Congressional Requesters. GAO-14-324

    ERIC Educational Resources Information Center

    Emrey-Arras, Melissa

    2014-01-01

    In fiscal year 2013, VA provided over $12 billion in benefits for veterans' postsecondary education; however, questions have been raised as to whether some schools are receiving these funds as a result of inappropriate recruiting practices. GAO was asked to examine issues related to schools' recruitment of veterans. This report examines (1) how…

  20. VA/Q distribution during heavy exercise and recovery in humans: implications for pulmonary edema

    NASA Technical Reports Server (NTRS)

    Schaffartzik, W.; Poole, D. C.; Derion, T.; Tsukimoto, K.; Hogan, M. C.; Arcos, J. P.; Bebout, D. E.; Wagner, P. D.

    1992-01-01

    Ventilation-perfusion (VA/Q) inequality has been shown to increase with exercise. Potential mechanisms for this increase include nonuniform pulmonary vasoconstriction, ventilatory time constant inequality, reduced large airway gas mixing, and development of interstitial pulmonary edema. We hypothesized that persistence of VA/Q mismatch after ventilation and cardiac output subside during recovery would be consistent with edema; however, rapid resolution would suggest mechanisms related to changes in ventilation and blood flow per se. Thirteen healthy males performed near-maximal cycle ergometry at an inspiratory PO2 of 91 Torr (because hypoxia accentuates VA/Q mismatch on exercise). Cardiorespiratory variables and inert gas elimination patterns were measured at rest, during exercise, and between 2 and 30 min of recovery. Two profiles of VA/Q distribution behavior emerged during heavy exercise: in group 1 an increase in VA/Q mismatch (log SDQ of 0.35 +/- 0.02 at rest and 0.44 +/- 0.02 at exercise; P less than 0.05, n = 7) and in group 2 no change in VA/Q mismatch (n = 6). There were no differences in anthropometric data, work rate, O2 uptake, or ventilation during heavy exercise between groups. Group 1 demonstrated significantly greater VA/Q inequality, lower vital capacity, and higher forced expiratory flow at 25-75% of forced vital capacity for the first 20 min during recovery than group 2. Cardiac index was higher in group 1 both during heavy exercise and 4 and 6 min postexercise. However, both ventilation and cardiac output returned toward baseline values more rapidly than did VA/Q relationships. Arterial pH was lower in group 1 during exercise and recovery. We conclude that greater VA/Q inequality in group 1 and its persistence during recovery are consistent with the hypothesis that edema occurs and contributes to the increase in VA/Q inequality during exercise. This is supported by observation of greater blood flows and acidosis and, presumably therefore