Science.gov

Sample records for agreement hospital services

  1. Exclusive hospital-based service agreements: what radiologists need to know.

    PubMed

    Blau, Michael L

    2004-07-01

    This article provides radiologists with the information that they need to know to participate meaningfully in negotiating or renegotiating an exclusive hospital-based radiology service agreement. It discusses the contract negotiation process, including how to identify and prioritize contract objectives, and how to assess and create bargaining leverage. Options for achieving contract longevity, for resolving "turf" issues and for achieving financial objectives are also addressed. The article further explains the key regulatory issues that shape exclusive hospital-based radiology service agreements, including antitrust, fraud and abuse, Stark Law, HIPAA, tax, and Medicare reimbursement considerations. The author discusses the contract negotiation process from both the radiology group and hospital perspectives. He suggests that successful negotiation will depend on "fitting" the group's contracting agenda with the hospital's priorities, organizational structure, culture and resources.

  2. Application Agreement and Integration Services

    NASA Technical Reports Server (NTRS)

    Driscoll, Kevin R.; Hall, Brendan; Schweiker, Kevin

    2013-01-01

    Application agreement and integration services are required by distributed, fault-tolerant, safety critical systems to assure required performance. An analysis of distributed and hierarchical agreement strategies are developed against the backdrop of observed agreement failures in fielded systems. The documented work was performed under NASA Task Order NNL10AB32T, Validation And Verification of Safety-Critical Integrated Distributed Systems Area 2. This document is intended to satisfy the requirements for deliverable 5.2.11 under Task 4.2.2.3. This report discusses the challenges of maintaining application agreement and integration services. A literature search is presented that documents previous work in the area of replica determinism. Sources of non-deterministic behavior are identified and examples are presented where system level agreement failed to be achieved. We then explore how TTEthernet services can be extended to supply some interesting application agreement frameworks. This document assumes that the reader is familiar with the TTEthernet protocol. The reader is advised to read the TTEthernet protocol standard [1] before reading this document. This document does not re-iterate the content of the standard.

  3. 76 FR 4393 - Discover Financial Services Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... Discover Financial Services Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION... Financial Services negotiated service agreement to the market dominant product list. This notice addresses... 3020, et seq., to add a Discover Financial Services (DFS) negotiated service agreement to the...

  4. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    PubMed

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation

  5. Hospital service recovery.

    PubMed

    Gutbezahl, Cary; Haan, Perry

    2006-01-01

    An organization's ability to correct service errors is an important factor in achieving success in today's service economy. This paper examines service recovery in hospitals in the U.S. First is a general review of service recovery theories. Next is a discussion of specific service issues related to the hospital environment. The literature on service recovery is used to make specific recommendations to hospitals for ways to improve their ability to remedy service errors when they occur. Suggestions for future research in the field of service recovery are also made.

  6. Contracting for professional service agreements.

    PubMed

    Berman, M L

    1995-08-01

    A review of several professional service agreements (PSA) of managed care organizations which contract with gynecologic oncologists in the Southern California area demonstrates several distinct patterns of practice restrictions and financial benefits which can help guide the physician who is considering signing such an agreement. These contracts must be evaluated in a manner similar to any business transaction as they are legally binding and can enhance or adversely impact one's clinical practice. Their advantages include increased numbers of referrals resulting in higher practice income; however, their disadvantages include practice restrictions which can adversely impact office overhead, practice efficiency, and the ability to deliver quality medical care. General guidelines to physicians evaluating a PSA include (1) avoiding "hold harmless" clauses, (2) avoiding contracts which tie enrollment in one plan to others, (3) the need to enter any verbal agreements by managed care administrators into the contract language, and (4) avoidance of actions which might be construed as being in violation of antitrust activities. Furthermore, physicians must avoid contracts which will result in the uncontrolled growth of a practice beyond its capabilities for expansion.

  7. Hospitality Services Reference Book.

    ERIC Educational Resources Information Center

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

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

  8. 7 CFR 3431.18 - Service agreement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.18 Service agreement. (a) The...

  9. 78 FR 35649 - Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ... Commission is noticing a recent Postal Service filing concerning an amendment to the 2013 Singapore Post... inbound market dominant services with Singapore Post Limited (2013 Agreement).\\1\\ The 2013 Agreement... Foreign Postal Operators 1 Negotiated Service Agreement (with Singapore Post Limited), June 4,...

  10. Hospitality Services. Curriculum Guide.

    ERIC Educational Resources Information Center

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

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

  11. 78 FR 33864 - Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-05

    ...\\ The Modification pertains to rates for an inbound product the Agreement referred to as ``yet to be launched.'' Notice at 1. Pursuant to the Agreement, prior to launching the anticipated product, the Postal... Postal Service Multi-Product Bilateral Negotiated Service Agreement, May 29, 2013 (Notice); see...

  12. 5 CFR 537.107 - Service agreements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STUDENT LOANS § 537.107 Service agreements. (a) Before an employing agency makes any loan payments for an employee, the employee (or job candidate) must sign a written service agreement to complete a specified period of service with the agency and to reimburse the agency for the student loan repayment benefit...

  13. 5 CFR 537.107 - Service agreements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... STUDENT LOANS § 537.107 Service agreements. (a) Before an employing agency makes any loan payments for an employee, the employee (or job candidate) must sign a written service agreement to complete a specified period of service with the agency and to reimburse the agency for the student loan repayment benefit...

  14. 5 CFR 537.107 - Service agreements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STUDENT LOANS § 537.107 Service agreements. (a) Before an employing agency makes any loan payments for an employee, the employee (or job candidate) must sign a written service agreement to complete a specified period of service with the agency and to reimburse the agency for the student loan repayment benefit...

  15. 5 CFR 537.107 - Service agreements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STUDENT LOANS § 537.107 Service agreements. (a) Before an employing agency makes any loan payments for an employee, the employee (or job candidate) must sign a written service agreement to complete a specified period of service with the agency and to reimburse the agency for the student loan repayment benefit...

  16. 5 CFR 537.107 - Service agreements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STUDENT LOANS § 537.107 Service agreements. (a) Before an employing agency makes any loan payments for an employee, the employee (or job candidate) must sign a written service agreement to complete a specified period of service with the agency and to reimburse the agency for the student loan repayment benefit...

  17. Hospitality Services. Student Activity Book.

    ERIC Educational Resources Information Center

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

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

  18. 48 CFR 237.7201 - Educational service agreement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Educational service... SYSTEM, DEPARTMENT OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Educational Service Agreements 237.7201 Educational service agreement. (a) An educational service agreement is not a...

  19. 48 CFR 237.7201 - Educational service agreement.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Educational service... SYSTEM, DEPARTMENT OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Educational Service Agreements 237.7201 Educational service agreement. (a) An educational service agreement is not a...

  20. Service Level Agreements in Service-Oriented Architecture Environments

    DTIC Science & Technology

    2008-09-01

    reports, please visit the publications portion of our website (http://www.sei.cmu.edu/publications/pubweb.html). Table of Contents Abstract vii 1... report_en.pdf (2006). [Ludwig 2003] Ludwig, Heiko; Keller, Alexander; Dan, Asit; King, Richard; & Franck, Richard. Web Service Level Agreement

  1. Hospitals look to hospitality service firms to meet TQM goals.

    PubMed

    Hard, R

    1992-05-20

    Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

  2. Health services under the General Agreement on Trade in Services.

    PubMed Central

    Adlung, R.; Carzaniga, A.

    2001-01-01

    The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services. PMID:11357215

  3. 18 CFR 154.601 - Change in executed service agreement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... service agreement. 154.601 Section 154.601 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS... superseding executed service agreement only. Service agreements may not contain any supplements, but...

  4. 78 FR 12108 - New Postal Product; Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-21

    ... New Postal Product; Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing concerning an amendment to the existing Express Mail & Priority Mail Contract 11 Negotiated Service Agreement. This notice informs the public...

  5. 78 FR 12368 - Priority Mail Contract; Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... Priority Mail Contract; Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION: Notice... Priority Mail Contract 47 Negotiated Service Agreement. This notice informs the public of the filing... Service filed notice that it has agreed to an amendment to existing Priority Mail Contract 47, which...

  6. 46 CFR Sec. 4 - Service agreements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... will include the employer contributions for social security and pensions, as well as life/health and... as an independent contractor, to exercise delegated authority of the Director, NSA, in the control of... agreement are in effect, to the extent necessary to enable them to exercise diligently the...

  7. 78 FR 12801 - New Postal Product; Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... New Postal Product; Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION: Notice... Parcel Return Service Contract 3 to the competitive product list.\\1\\ The Postal Service asserts that Parcel Return Service Contract 3 is a competitive product ``not of general applicability'' within...

  8. 7 CFR 762.147 - Servicing shared appreciation agreements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the value of the security at the time of writedown, as shown on the shared appreciation agreement. (ii... 7 Agriculture 7 2010-01-01 2010-01-01 false Servicing shared appreciation agreements. 762.147..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.147 Servicing shared...

  9. 46 CFR Sec. 4 - Service agreements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... port in accordance with such directions, orders, regulations, supervision, and inspections as the... supervision and inspection, in accordance with customary commercial practice). Responsibilities generally... provisions are governed by State civil service commissions or comparable government agencies. The...

  10. 46 CFR Sec. 4 - Service agreements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... port in accordance with such directions, orders, regulations, supervision, and inspections as the... supervision and inspection, in accordance with customary commercial practice). Responsibilities generally... provisions are governed by State civil service commissions or comparable government agencies. The...

  11. 78 FR 48729 - Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    .... SUPPLEMENTARY INFORMATION: Table of Contents I. Introduction II. Contents of Filing III. Commission Action I... periodic basis, with a list of countries to which Commercial ePacket service is available.\\2\\ Notice at 1... addition of Paragraph 7 to Article 6, captioned ``Obligations of the USPS.'' Id., Attachment 1 at 2....

  12. Strategic management of Public Hospitals' medical services.

    PubMed

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

    2016-01-01

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

  13. 77 FR 63898 - New Postal Product; Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-17

    ... New Postal Product; Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION: Notice... competitive product list.\\1\\ The Postal Service asserts that Express Mail & Priority Mail Contract 11 is a... Postal Service contemporaneously filed a redacted contract related to the proposed new product under 39...

  14. 77 FR 63899 - New Postal Product; Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-17

    ... New Postal Product; Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is establishing a docket to consider the Postal Service's request to add Priority... list.\\1\\ The Postal Service asserts that Priority Mail Contract 44 is a competitive product ``not...

  15. 7 CFR 3431.17 - VMLRP service agreement offer.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.17 VMLRP service agreement offer. The... provide veterinary services under the VMLRP. As part of the offer, successful VMLRP applicants will...

  16. 7 CFR 762.147 - Servicing shared appreciation agreements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Servicing shared appreciation agreements. 762.147 Section 762.147 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.147 Servicing shared...

  17. Markets for hospital services in Zambia.

    PubMed

    Nakamba, Pamela; Hanson, Kara; McPake, Barbara

    2002-01-01

    Hospital reforms involving the introduction of measures to increase competition in hospital markets are being implemented in a range of low and middle-income countries. However, little is understood about the operation of hospital markets outside the USA and the UK. This paper assesses the degree of competition for hospital services in two hospital markets in Zambia (Copperbelt and Midlands), and the implications for prices, quality and efficiency. We found substantial differences among different hospital types in prices, costs and quality, suggesting that the hospital service market is a segmented market. The two markets differ significantly in their degree of competition, with the high cost inpatient services market in Copperbelt relatively more competitive than that in the Midlands market. The implications of these differences are discussed in terms of the potential for competition to improve hospital performance, the impact of market structure on equity of access, and how the government should address the problem of the mine hospitals.

  18. The quality of nursing service management in South African hospitals.

    PubMed

    Muller, M

    2000-06-01

    The purpose of this study is to determine--explore and describe--the quality of nursing service management in South African hospitals. A combined qualitative and quantitative pre- and post-test research strategy, in accordance with the COHSASA programme, was utilised. The hospitals implement the national standards during the preparatory phase, after having entered into an agreement with COHSASA. They determine their baseline status by means of an assisted self-evaluation. This is followed by an external survey phase where the hospital's compliance with the standards is evaluated. The nursing service is one of the professional services included in the accreditation programme. Their performance is compared with selected other professional services and their compliance with the core elements is also evaluated. The nursing services in South Africa are compliant with the national standards. The deficiencies are mainly within the quality improvement programmes that require further development and refinement.

  19. 77 FR 28904 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ...The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add a domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification Schedule's Competitive Products...

  20. 77 FR 28903 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ...The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add a domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification Schedule's Competitive Products...

  1. Aggregating Hierarchical Service Level Agreements in Business Value Networks

    NASA Astrophysics Data System (ADS)

    Ul Haq, Irfan; Huqqani, Altaf; Schikuta, Erich

    Business scenarios such as Business Value Networks and Extended Enterprises pose new challenges for service choreographies across heterogeneous Virtual Organizations. In such scenarios, services compose together hierarchically in a producer-consumer manner to form service supply-chains of added value. Service Level Agreements (SLAs) are defined at various levels in this hierarchy to ensure the expected quality of service for different stakeholders. Automation of service composition directly implies the aggregation of their corresponding SLAs. But so far, the aggregation of SLAs has been treated only as a single layer process which is insufficient to complement the hierarchical aggregation of services. In this paper we elaborate on the requirement of a hierarchical aggregation of SLAs corresponding to service choreographies in Business Value Networks. During the hierarchical aggregation of SLAs, certain SLA information pertaining to different stakeholders is meant to be restricted and can be only partially revealed to a subset of their business partners. We introduce the concept of SLA-Views to protect such privacy concerns. We, then formalize the notion of SLA Choreography and define an aggregation model based on SLA-Views to enable the automation of hierarchical aggregation of Service Level Agreements. The aggregation model has been designed to comply with the WS-Agreement standard.

  2. 77 FR 38864 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION... Service Contract 8 to Competitive Product List. Documents are available at www.prc.gov , Docket...

  3. 77 FR 43868 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION...-Class Package Service Contract 10 to Competitive Product List. Documents are available at...

  4. 77 FR 60731 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... First-Class Package Service Contract 16 to Competitive Product List. Documents are available at...

  5. 77 FR 60730 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... First-Class Package Service Contract 20 to Competitive Product List. Documents are available at...

  6. 78 FR 65392 - Product Change-Parcel Return Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Return Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice... Return Service Contract 5 to Competitive Product List. Documents are available at www.prc.gov ,...

  7. 77 FR 60730 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... First-Class Package Service Contract 17 to Competitive Product List. Documents are available at...

  8. 77 FR 38864 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION... Service Contract 9 to Competitive Product List. Documents are available at www.prc.gov , Docket...

  9. 77 FR 60730 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... First-Class ] Package Service Contract 19 to Competitive Product List. Documents are available at...

  10. 77 FR 60731 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... First-Class Package Service Contract 18 to Competitive Product List. Documents are available at...

  11. 77 FR 51583 - Product Change-First-Class Package Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-24

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--First-Class Package Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... First-Class Package Service Contract 15 to Competitive Product List. Documents are available at...

  12. 77 FR 28409 - Product Change-Parcel Select & Parcel Return Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select & Parcel Return Service Negotiated Service Agreement AGENCY: Postal Service\\TM... Postal Regulatory Commission a Request of the United States Postal Service to Add Parcel Select &...

  13. 78 FR 63521 - Product Change-Parcel Select & Parcel Return Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select & Parcel Return Service Negotiated Service Agreement AGENCY: Postal Service TM... Parcel Select & Parcel Return Service Contract 5 to Competitive Product List. Documents are available...

  14. 75 FR 74755 - Product Change-Parcel Return Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-01

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Return Service Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory Commission to add...

  15. A new look at OEM (original equipment manufacturer) service agreements.

    PubMed

    Gregory, S; David, G

    1995-01-01

    Next to personnel services, equipment maintenance is the second largest budgetary expense in large radiology departments. Because they are under constant pressure to contain costs, radiology administrators spend considerable time negotiating the best service at the lowest cost. Today, administrators have several options for imaging equipment maintenance: equipment maintenance insurance, in-house engineering, and various arrangements with original equipment manufacturers (OEMs) and independent service organizations (ISOs). In response to increased competition, OEMs have become more price-competitive with ISOs and have expanded their service menu and equipment maintenance insurance programs. OEM service menu options include: full service, tiered pricing, labor only, planned maintenance, full service with deductible, shared maintenance and extended warranty. Any type of service arrangement can be customized according to equipment age and sophistication, redundancy, income-producing potential, criticality of downtime and the strength and depth of the service organization. Even when vendor maintenance contracts are more expensive than purchasing service on a time-and-materials basis, they allow customers to budget accurately for the service of covered equipment. The authors' institution gets the best results for the best price from a judicious mix of maintenance options. Wise customers will explore many options before choosing a service agreement.

  16. Volunteer Service Agreements: A New Strategy for Volunteer Management.

    ERIC Educational Resources Information Center

    Meltzer, Phyllis

    As new types of volunteers come into the field--working people, retirees, executives--new methods are needed to hold their interest and ensure their cooperation while preserving the goals of the organizations they serve. Some of those organizations, especially museums, are using volunteer service agreements to attract and hold volunteers and to…

  17. 18 CFR 35.10a - Forms of service agreements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Forms of service agreements. 35.10a Section 35.10a Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... and where it is located in its tariff(s). The standard format must provide spaces for insertion of...

  18. 18 CFR 154.110 - Form of service agreement.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Form of service agreement. 154.110 Section 154.110 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... rendered and the applicable rate schedule of the tariff; and, provide spaces for insertion of the name...

  19. 7 CFR 762.147 - Servicing shared appreciation agreements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... sum, the lender may: (A) Reschedule the recapture debt with the consent of the Agency, provided the lender can document the borrower's ability to make amortized payments on the recapture debt, plus pay all... property securing the loan or line of credit agreement. (3) Servicing recapture debt. (i) If recapture...

  20. 7 CFR 762.147 - Servicing shared appreciation agreements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... sum, the lender may: (A) Reschedule the recapture debt with the consent of the Agency, provided the lender can document the borrower's ability to make amortized payments on the recapture debt, plus pay all... property securing the loan or line of credit agreement. (3) Servicing recapture debt. (i) If recapture...

  1. 7 CFR 762.147 - Servicing shared appreciation agreements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... sum, the lender may: (A) Reschedule the recapture debt with the consent of the Agency, provided the lender can document the borrower's ability to make amortized payments on the recapture debt, plus pay all... property securing the loan or line of credit agreement. (3) Servicing recapture debt. (i) If recapture...

  2. Hospital pharmacists' evaluation of drug wholesaler services.

    PubMed

    Allen, W O; Ryan, M R; Roberts, K B

    1983-10-01

    Services provided by drug wholesalers were evaluated by hospital pharmacists. A survey was mailed to 1500 randomly selected pharmacy directors. Respondents indicated availability and use of 26 customer services. Pharmacists rated the services that they used on the basis of importance of the service and satisfaction with the service. The 644 returned questionnaires indicated that most services were available to a large majority of respondents. Most services used were rated as important or essential. Most respondents were satisfied with wholesaler services; the service with which the most respondents were dissatisfied was stocking of pharmaceuticals in single-unit packaging. Of other services that were widely used and rated important, prompt crediting for delivery errors, few out-of-stock items, frequent pickup of return merchandise, and stocking of injectable pharmaceuticals received low satisfaction ratings. Same-day delivery service and emergency delivery of prescription items were unavailable to more than 40% of respondents. Hospital pharmacists were generally satisfied with services provided by drug wholesalers. Wholesalers should be aware of the particular service needs of hospital pharmacists, and further studies of these needs should be conducted.

  3. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    PubMed

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement

  4. Medicare program: hospital outpatient prospective payment system and CY 2011 payment rates; ambulatory surgical center payment system and CY 2011 payment rates; payments to hospitals for graduate medical education costs; physician self-referral rules and related changes to provider agreement regulations; payment for certified registered nurse anesthetist services furnished in rural hospitals and critical access hospitals. Final rule with comment period; final rules; and interim final rule with comment period.

    PubMed

    2010-11-24

    The final rule with comment period in this document revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this final rule with comment period, we describe the 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, 2011. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These changes are applicable to services furnished on or after January 1, 2011. In this document, we also are including two final rules that implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest. In the interim final rule with comment period that is included in this document, we are changing the effective date for otherwise eligible hospitals and critical access hospitals that have been reclassified from urban to rural under section 1886(d)(8)(E) of the Social Security

  5. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals age 65 or older in institutions for... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care...

  6. 42 CFR 447.280 - Hospital providers of NF services (swing-bed hospitals).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Hospital providers of NF services (swing-bed... Inpatient Hospital and Long-Term Care Facility Services Swing-Bed Hospitals § 447.280 Hospital providers of NF services (swing-bed hospitals). (a) General rule. If the State plan provides for NF...

  7. 42 CFR 447.280 - Hospital providers of NF services (swing-bed hospitals).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Hospital providers of NF services (swing-bed... Inpatient Hospital and Long-Term Care Facility Services Swing-Bed Hospitals § 447.280 Hospital providers of NF services (swing-bed hospitals). (a) General rule. If the State plan provides for NF...

  8. 39 CFR 3010.42 - Contents of notice of agreement in support of a negotiated service agreement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... operative components of the agreement. (c) Details regarding the expected improvements in the net financial position or operations of the Postal Service. The projection of change in net financial position as a... from implementation of the negotiated service agreement; (3) An analysis of the effects of...

  9. The General Agreement on Trade in Services and Educational Services: An Australian Perspective

    ERIC Educational Resources Information Center

    Tangas, Jim; Calderon, Angel J.

    2004-01-01

    This paper discusses the implications for higher education of the World Trade Organisation (WTO) negotiations towards the General Agreement on Trade in Services (GATS; see http://www.wto.org/) from the perspective of Australian educational institutions.

  10. 76 FR 67567 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts... Services RIN 0938-AQ14 Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care... extended care services coinsurance amounts for services furnished in calendar year (CY) 2012 under...

  11. 76 FR 23859 - Financial Management Service Proposed Collection of Information; Financial Institution Agreement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... Fiscal Service Financial Management Service Proposed Collection of Information; Financial Institution... the Financial Institution Agreement and Application AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service,...

  12. Hospital service quality: a managerial challenge.

    PubMed

    Rose, Raduan Che; Uli, Jegak; Abdul, Mohani; Ng, Kim Looi

    2004-01-01

    While much is known generally about predictions of customer-perceived service quality, their application to health services is rarer. No attempt has been made to examine the impact of social support and patient education on overall service quality perception. Together with six quality dimensions identified from the literature, this study seeks to provide a more holistic comprehension of hospital service quality prediction. Although 79 percent of variation is explained, other than technical quality the impact of the remaining factors on quality perception is far from constant, and socio-economic variables further complicate unpredictability. Contrary to established beliefs, the cost factor was found to be insignificant. Hence, to manage service quality effectively, the test lies in how well healthcare providers know the customers they serve. It is not only crucial in a globalized environment, where trans-national patient mobility is increasingly the norm, but also within homogeneous societies that appear to converge culturally.

  13. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... under section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing...

  14. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing facility...

  15. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... under section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing...

  16. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Inpatient hospital services, nursing facility... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... under section 1903(i)(4) of the Act and subpart H of part 456 of this chapter. (b) Nursing...

  17. Uninterrupted service on the hospital menu.

    PubMed

    Vines, Lee

    2014-09-01

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

  18. 75 FR 62896 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service. TM ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... Regulatory Commission a Request of the United States Postal Service to Add Priority Mail Contract 28...

  19. 78 FR 70971 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-27

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... the Postal Regulatory Commission a Request of the United States Postal Service to Add Priority...

  20. 78 FR 70971 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-27

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... the Postal Regulatory Commission a Request of the United States Postal Service to Add Priority...

  1. 77 FR 49032 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... Commission a Request of the United States Postal Service to Add Priority Mail Contract 41 to...

  2. 78 FR 6360 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... Change--Express Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... the Postal Regulatory Commission a Request of the United States Postal Service to Add Express...

  3. 78 FR 20361 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... Regulatory Commission a Request of the United States Postal Service to Add Priority Mail Contract 56...

  4. 78 FR 43249 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-19

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... Regulatory Commission a Request of the United States Postal Service to Add Priority Mail Contract 61...

  5. 77 FR 48179 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    ... Change--Express Mail Negotiated Service Agreement AGENCY: Postal Service.\\TM\\ ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... Postal Regulatory Commission a Request of the United States Postal Service To Add Express Mail...

  6. 77 FR 48179 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service.\\TM\\ ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... Postal Regulatory Commission a Request of the United States Postal Service To Add Priority Mail...

  7. 78 FR 6361 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... domestic shipping services contract to the list of Negotiated Service Agreements in the Mail Classification... the Postal Regulatory Commission a Request of the United States Postal Service to Add Priority...

  8. Service dogs, psychiatric hospitalization, and the ADA.

    PubMed

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    2015-01-01

    A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.

  9. Who provides nursing services in Cambodian hospitals?

    PubMed Central

    Sakurai-Doi, Yukie; Mochizuki, Noriko; Phuong, Keat; Sung, Chao; Visoth, Pheng; Sriv, Bun; Amara, Sar Rath; Murakami, Hitoshi; Komagata, Tomoko; Fujita, Noriko

    2014-01-01

    In Cambodia, the number of nurses is insufficient and details of nursing services are unknown and undocumented. This research explored who provides nursing service activities in Cambodia. The study was conducted at nine hospitals in Cambodia. Findings indicate that non-invasive medical care such as vital signs taking was designated to nurses. In performing more complex medical interventions, nurses shared the tasks with medical doctors. Conversely, simpler nursing tasks, including maintaining bedside environment/hygiene and supporting patient activities, tasks were shared by nurses with patients' family. This study elucidated an optimal personnel mix and task shared between nurses, doctors and patients' families. There are important implications for nursing legislation related to streamlining the production of nurses to provide an adequate and qualified nursing service in Cambodia. PMID:24661282

  10. Focus on: Good Samaritan Hospital Biomedical Services Department.

    PubMed

    Shreve, R B

    1987-01-01

    The Biomedical Services Department of the Good Samaritan Hospital, located in Central Pennsylvania, has responsibility for preventive maintenance, safety and regulation compliance (appropriate to a biomedical department) and repairs for the Hospital. These services have resulted in substantial cost savings. In addition, the Department's Shared Service activity has produced alternative revenue sources. The combined hospital and shared service inventory of approximately 1100 instruments is serviced by the Department Staff, which consists of one Director and two technicians.

  11. 78 FR 39344 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-01

    ... Doc No: 2013-15649] POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY... Service Agreements in the Mail Classification Schedule's Competitive Products List. DATES: Effective date... States Postal Service to Add Priority Mail Contract 60 to Competitive Product List. Documents...

  12. 29 CFR 1425.2 - Notice to the Service of agreement negotiations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Notice to the Service of agreement negotiations. 1425.2... MEDIATION ASSISTANCE IN THE FEDERAL SERVICE § 1425.2 Notice to the Service of agreement negotiations. (a) In order that the Service may provide assistance to the parties, the party initiating negotiations...

  13. 29 CFR 1425.2 - Notice to the Service of agreement negotiations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 4 2011-07-01 2011-07-01 false Notice to the Service of agreement negotiations. 1425.2... MEDIATION ASSISTANCE IN THE FEDERAL SERVICE § 1425.2 Notice to the Service of agreement negotiations. (a) In order that the Service may provide assistance to the parties, the party initiating negotiations...

  14. 77 FR 26796 - Product Change-Standard Mail Saturation Flats Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-07

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Standard Mail Saturation Flats Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... Regulatory Commission to add a Standard Mail Saturation Flats negotiated service agreement to the...

  15. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... agency may exclude from the definition of “outpatient hospital services” those types of items and... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural...

  16. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... beds in intensive care type inpatient units (for eligibility of hospitals with distinct parts electing...-term care services (âswing-bedsâ). 482.66 Section 482.66 Public Health CENTERS FOR MEDICARE & MEDICAID... providers of long-term care services (“swing-beds”). A hospital that has a Medicare provider agreement...

  17. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... beds in intensive care type inpatient units (for eligibility of hospitals with distinct parts electing...-term care services (âswing-bedsâ). 482.66 Section 482.66 Public Health CENTERS FOR MEDICARE & MEDICAID... providers of long-term care services (“swing-beds”). A hospital that has a Medicare provider agreement...

  18. 40 CFR 35.2107 - Intermunicipal service agreements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... executed intermunicipal agreements, contracts or other legally binding instruments necessary for the... participate. (Approved by the Office of Management and Budget under control number 2040-0027)...

  19. Planned Parenthood services in teaching hospitals.

    PubMed

    1973-06-01

    As a contribution to the continuing discussion stimulated by the WHO Study Group on education and training for family planning in health services (December 1971, Geneva), the Regional Medical Executive Committee of IPPF commissioned articles on planned parenthood services and training in the university hospital context in both Austria and Belgium. In Vienna, Graz, and Innsbruck medical students receive regular instruction in the physiology and pathology of reproduction and contraceptive methods. Training in methods of fertility regulation is integrated into the gynecology curriculum in both lectures and group discussion. Planned parenthood and social medicine are at present not essential examination subjects. In obligatory practical work in gynecology clinics there are only 2 periods of 6 days in which the student can obtain only a very superficial picture of gynecology and obstetrics. If a qualified physician remains in a university clinic to specialize in these fields, instruction includes complete training in family planning with the possibility of comprehensive practical experience. In Belgium the introduction of planned parenthood into departmental policy and the attainment of national uniformity in thinking and application are recent, due mainly to the coincidence the present chairmen of most departments of obstetrics and gynecology regard planned parenthood as socially indispensable. It is imperative that the education and training of both providers and users be not limited to technical knowledge but expanded to include the all- important psychological, socioeconomic, and health aspects and implications of sexuality. The theory and practice of family planning must be transmitted to the mediical profession, the paramedical professions, and such nonmedical professions as pharmacy. It is noted that the most important new accomplishments of the teaching hospitals lie in the provision of planned parenthood service.

  20. 46 CFR 535.309 - Marine terminal services agreements-exemption.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 9 2014-10-01 2014-10-01 false Marine terminal services agreements-exemption. 535.309... COMMERCE OCEAN COMMON CARRIER AND MARINE TERMINAL OPERATOR AGREEMENTS SUBJECT TO THE SHIPPING ACT OF 1984 Exemptions § 535.309 Marine terminal services agreements—exemption. (a) Marine terminal services...

  1. 46 CFR 535.309 - Marine terminal services agreements-exemption.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 9 2013-10-01 2013-10-01 false Marine terminal services agreements-exemption. 535.309... COMMERCE OCEAN COMMON CARRIER AND MARINE TERMINAL OPERATOR AGREEMENTS SUBJECT TO THE SHIPPING ACT OF 1984 Exemptions § 535.309 Marine terminal services agreements—exemption. (a) Marine terminal services...

  2. 46 CFR 535.309 - Marine terminal services agreements-exemption.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 9 2011-10-01 2011-10-01 false Marine terminal services agreements-exemption. 535.309... COMMERCE OCEAN COMMON CARRIER AND MARINE TERMINAL OPERATOR AGREEMENTS SUBJECT TO THE SHIPPING ACT OF 1984 Exemptions § 535.309 Marine terminal services agreements—exemption. (a) Marine terminal services...

  3. 46 CFR 535.309 - Marine terminal services agreements-exemption.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 9 2012-10-01 2012-10-01 false Marine terminal services agreements-exemption. 535.309... COMMERCE OCEAN COMMON CARRIER AND MARINE TERMINAL OPERATOR AGREEMENTS SUBJECT TO THE SHIPPING ACT OF 1984 Exemptions § 535.309 Marine terminal services agreements—exemption. (a) Marine terminal services...

  4. Computerized system for hospital engineering service management

    NASA Astrophysics Data System (ADS)

    Centeno, C. A.; Gonzalez, E. A.; Cagnolo, F. J.; Olmos, C. E.

    2007-11-01

    When a Hospital Engineering Service (HES) is implemented within a health care environment, the idea is to improve service conditions and costs as well as to provide timely responses to equipment preventive maintenance and infrastructure requirements. An HES must, within the shortest possible period of time, meet the above requirements at the cost necessary to provide the service quality sought. In many cases there is a lack of minimal materials and staff who are qualified to attain the objectives that have been set. Therefore, external assistance becomes necessary. In this context, actions are often taken which, because they are not recorded, cannot be assessed in order to evaluate the HES. Since all action taken is appraised from the purely economic point of view, in the final analysis the contributions from staff remain invisible. This situation works against the possibility of quantifying the convenience of possessing an internal HES. The software support system we have developed here is oriented toward providing all the necessary data to address this issue.

  5. Model construction of nursing service satisfaction in hospitalized tumor patients

    PubMed Central

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients’ expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved. PMID:25419410

  6. Model construction of nursing service satisfaction in hospitalized tumor patients.

    PubMed

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.

  7. [Development and application of hospital customer service center platform].

    PubMed

    Chen, Minya; Zheng, Konglin; Xia, Yong

    2012-01-01

    This paper introduces the construction and application of the platform of client service center in the general hospital and discusses how to provide patients with an entire service including service before clinic, on clinic and after clinic. It can also provide references for a new service mode for clinic service.

  8. Unit Cost of Medical Services at Different Hospitals in India

    PubMed Central

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

  9. 77 FR 69848 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

    ... 21st through 100th day of extended care services in a skilled nursing facility in a benefit period... the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2013 AGENCY:...

  10. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... 21st through 100th day of extended care services in a skilled nursing facility in a benefit period... through 100th day of extended care services in a skilled nursing facility in a benefit period will be $152... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2014 AGENCY:...

  11. 40 CFR 35.2107 - Intermunicipal service agreements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... historic service relationships for water supply, wastewater or other services between the affected... supplier agency is adequate to continue the project, even if one of the proposed customer agencies fails to participate. (Approved by the Office of Management and Budget under control number 2040-0027)...

  12. Agriculture Signs Agreement to Provide Services to Tribal Colleges.

    ERIC Educational Resources Information Center

    Tribal College, 1998

    1998-01-01

    Describes the memorandum of agreement created by the American Indian Higher Education Consortium and the Secretary of Agriculture in an effort to assure that tribal colleges can participate fully in federal agriculture programs. Discusses the activities and improvements of tribal colleges made possible by four $50,000 grants from the United States…

  13. 75 FR 81318 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Express Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory ] Commission to add a...

  14. 78 FR 4174 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-18

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Express Mail Negotiated Service Agreement AGENCY: Postal Service\\TM.\\ ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  15. 77 FR 49032 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  16. 77 FR 4062 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-26

    ... From the Federal Register Online via the Government Publishing Office ] POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service. TM ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  17. 76 FR 396 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Express Mail Negotiated Service Agreement AGENCY: Postal Service \\TM\\. ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory Commission to add a...

  18. 75 FR 47317 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory Commission to add a...

  19. 76 FR 80987 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  20. 78 FR 59383 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  1. 78 FR 4175 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-18

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM.\\ ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  2. 76 FR 396 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service \\TM\\. ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory Commission to add a...

  3. 78 FR 76336 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... From the Federal Register Online via the Government Publishing Office ] POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  4. 75 FR 81319 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory Commission to add a...

  5. 77 FR 77122 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service. ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add a...

  6. 78 FR 13715 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  7. 77 FR 64150 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  8. 77 FR 77121 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ] ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  9. 78 FR 26406 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  10. 78 FR 76335 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  11. 78 FR 43249 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-19

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  12. 75 FR 62896 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service. TM ACTION: Notice. SUMMARY: Postal Service gives notice of filing of a request with the Postal Regulatory Commission to add...

  13. 77 FR 58186 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add a...

  14. 78 FR 79027 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  15. 76 FR 2931 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory Commission to add a...

  16. 78 FR 30344 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Express Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  17. 78 FR 13715 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Express Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  18. 78 FR 20361 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  19. 78 FR 62714 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  20. 78 FR 59382 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  1. 75 FR 62896 - Product Change-Express Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Express Mail Negotiated Service Agreement AGENCY: Postal ServiceTM. ACTION: Notice. SUMMARY: Postal Service gives notice of filing of a request with the Postal Regulatory Commission to add...

  2. 78 FR 36796 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  3. 77 FR 58186 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  4. 76 FR 2931 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: Postal Service notice of filing of a request with the Postal Regulatory Commission to add a...

  5. 78 FR 8599 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  6. 75 FR 47317 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. Summary: Postal Service notice of filing of a request with the Postal Regulatory Commission to add a...

  7. 78 FR 65393 - Product Change-Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY: The Postal Service gives notice of filing a request with the Postal Regulatory Commission to add...

  8. 77 FR 42780 - Product Change-Parcel Select Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... Regulatory Commission a Request of the United States Postal Service to Add Parcel Select Contract 5...

  9. 77 FR 42780 - Product Change-Parcel Select Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY... Regulatory Commission a Request of the United States Postal Service to Add Parcel Select Contract 3...

  10. 77 FR 28410 - Product Change-Parcel Select Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY... Commission a Request of the United States Postal Service to Add Parcel Select Contract 1 to...

  11. 77 FR 66193 - Product Change-Parcel Select Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-02

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... the Postal Regulatory Commission a Request of the United States Postal Service To Add Parcel...

  12. 77 FR 42780 - Product Change-Parcel Select Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION: Notice. SUMMARY... Regulatory Commission a Request of the United States Postal Service to Add Parcel Select Contract 4...

  13. 76 FR 2930 - Product Change-Parcel Select Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... ] Commission a Request of the United States Postal Service to Add Parcel Select Contract 1 to...

  14. 78 FR 56248 - Product Change-Parcel Select Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE Product Change--Parcel Select Negotiated Service Agreement AGENCY: Postal Service TM . ACTION: Notice. SUMMARY... the Postal Regulatory Commission a Request of the United States Postal Service to Add Parcel...

  15. 78 FR 10117 - Use of Medicare Procedures To Enter Into Provider Agreements for Extended Care Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... to use Medicare or State procedures to enter into provider agreements to obtain extended care services from non-VA providers. In addition, this rulemaking proposes to include home health care... Medicare Procedures to Enter Into Provider Agreements for Extended Care Services.'' Copies of...

  16. 77 FR 2573 - International Product Change-Global Plus 1C and 2C Negotiated Service Agreements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... International Product Change--Global Plus 1C and 2C Negotiated Service Agreements AGENCY: Postal Service TM... Regulatory Commission to add Global Plus 1C and 2C Negotiated Service Agreements to the Competitive Products... of United States Postal Service to Add Global Plus 1C and 2C Negotiated Service Agreements to...

  17. Hospital dental service: a clinical evaluation to determine its justification.

    PubMed

    Emery, A C

    1975-05-01

    A research study was undertaken to determine the importance of a hospital dental service in civilian hospitals. Two hundred hospitalized patients were evaluated to determine their oral health status and possible effects of poor oral health on related physical situations. Both cental caries and periodontal disease were prelavlent in the hospital patient population, and 83.5% of the patients suffered from some type of oral pathosis that required treatment. Hospital dental care is important, not only for the health and improvement of the total patient but also for the hospital to provide complete patient care.

  18. Trends in hospital librarianship and hospital library services: 1989 to 2006

    PubMed Central

    Thibodeau, Patricia L.; Funk, Carla J.

    2009-01-01

    Objective: The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. Methods: The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. Results: The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Conclusions: Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends. PMID:19851491

  19. Measuring service line competitive position. A systematic methodology for hospitals.

    PubMed

    Studnicki, J

    1991-01-01

    To mount a broad effort aimed at improving their competitive position for some service or group of services, hospitals have begun to pursue product line management techniques. A few hospitals have even reorganized completely under the product line framework. The benefits include focusing accountability for operations and results, facilitating coordination between departments and functions, stimulating market segmentation, and promoting rigorous examination of new and existing programs. As part of its strategic planning process, a suburban Baltimore hospital developed a product line management methodology with six basic steps: (1) define the service lines (which they did by grouping all existing diagnosis-related groups into 35 service lines), (2) determine the contribution of each service line to total inpatient volume, (3) determine trends in service line volumes (by comparing data over time), (4) derive a useful comparison group (competing hospitals or groups of hospitals with comparable size, scope of services, payer mix, and financial status), (5) review multiple time frames, and (6) summarize the long- and short-term performance of the hospital's service lines to focus further analysis. This type of systematic and disciplined analysis can become part of a permanent strategic intelligence program. When hospitals have such a program in place, their market research, planning, budgeting, and operations will be tied together in a true management decision support system.

  20. Reforming the hospital service structure to improve efficiency: urban hospital specialization.

    PubMed

    Lee, Kwang-soo; Chun, Ki-Hong; Lee, Jung-Soo

    2008-07-01

    The objective of this study is to explain the relationship between the case-mix specialization index and efficiency of inpatient hospital care services. Hospital specialization was measured using the information theory index constructed from diagnosis-related group numbers of hospitals in Seoul, Korea, in 2004. Hospital performance was measured by technical efficiency scores computed by data envelopment analysis for 2004. Multiple regression analysis models were applied to identify the internal and external factors that affected the extent of hospital specialization status as well as the efficiency of hospitals. The data envelopment analysis showed that input variables such as the number of beds, doctors and nurses were related to hospital efficiency. Hospitals had different levels of specialization in patient services, and more specialized hospitals were more likely to be efficient (odds ratio=25.95). Internal characteristics of providers had more significant effects on the extent of specialization than market conditions. These findings help to explain the relationship among hospitals, specialization, market conditions and provider performance. The study results related to the rearrangement of hospital services in a city. Further study including hospitals from other regions will increase the generalizability of results, and policy makers can use the information in making policy for the specialized hospital industry in Korea.

  1. 77 FR 38684 - Product Change-Express Mail & Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-28

    ... Change--Express Mail & Priority Mail Negotiated Service Agreement AGENCY: Postal Service. TM ACTION... Mail Classification Schedule's Competitive Products List. DATES: June 28, 2012. FOR FURTHER INFORMATION... Postal Regulatory Commission a Request of the United States Postal Service to Add Express Mail &...

  2. Factor selection for service quality evaluation: a hospital case study.

    PubMed

    Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad

    2017-02-13

    Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.

  3. 48 CFR 952.237-70 - Collective bargaining agreements-protective services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... collective bargaining agreements applicable to the work force under this contract, the Contractor shall use... services. All such agreements entered into during the contract period of performance should provide that... resorting to strike, lockout, or other interruption of normal operations. For this purpose, each...

  4. 29 CFR 1425.2 - Notice to the Service of agreement negotiations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... 20427. The zip code is important because our cases are routed by computer through zip code, and... the reopener date of an existing agreement. In the case of an initial agreement the notice shall be... to perform grievance mediation, as such service may not be appropriate in all cases. (d)...

  5. 46 CFR 535.309 - Marine terminal services agreements-exemption.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Marine terminal services agreements-exemption. 535.309 Section 535.309 Shipping FEDERAL MARITIME COMMISSION REGULATIONS AFFECTING OCEAN SHIPPING IN FOREIGN COMMERCE OCEAN COMMON CARRIER AND MARINE TERMINAL OPERATOR AGREEMENTS SUBJECT TO THE SHIPPING ACT OF...

  6. [General Agreement on Trade in Services and its implications for public health].

    PubMed

    Umaña-Peña, Román; Alvarez-Dardet, Carlos

    2005-01-01

    Due to the economic importance of the service sector and its trade potential, in 1995 the World Trade Organization (WTO) launched the General Agreement on Trade in Services with the objective of liberalizing trade in services worldwide and of establishing rules and disciplines to regulate it. Until now, the Agreement has produced few case laws on its rules and some of them are in the process of being developed, which makes the Agreement ambiguous and hampers accurate forecasting of its implications. Nevertheless, some analysts consider that certain characteristics and rules represent a threat to the funding mechanisms of public services and to the sovereignty of governments to generate their own rules. Moreover, the Agreement would lead to irreversible formalization of commitments, without the possibility of returning to previous conditions in the case of failure of the market and/or private participation. In addition, the Agreement acts against exclusive monopolies and providers and to a certain extent this will affect subsidies to local providers. The ability of the European Communities Court of Justice to enforce the implementation of competitive measures in public services has produced uncertainty because of the implications for health services. The Spanish Agreement with the WTO contains many questions that remain open, representing an opportunity for the participation of the health sector in the next negotiation rounds.

  7. Books for the Hospital Emergency Service

    PubMed Central

    Roy, Donald E.; Morgan, Virginia W.

    1966-01-01

    This is a list of books that should be available in either the hospital emergency room or the medical library. The forty-nine books listed are divided into the following categories: General, Surgery and Trauma, Burns, Cardiology, Dentistry, Disaster Medicine, First Aid, Geriatrics, Obstetrics, Pediatrics, Psychiatry, Toxicology, and Transportation. An asterisk has been placed before twelve books that are particularly recommended for the hospital emergency room as well as the medical library. The latest edition is given for each book, and, unless otherwise noted, each has been annotated by one of the authors. PMID:5945569

  8. 42 CFR 447.321 - Outpatient hospital and clinic services: Application of upper payment limits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment Methods for Other Institutional and Noninstitutional Services Outpatient Hospital...

  9. 77 FR 60730 - Product Change-Express Mail and Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... Change--Express Mail and Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION... Mail Classification Schedule's Competitive Products List. DATES: Effective date: October 4, 2012. FOR... Express Mail & Priority Mail Contract 10 to Competitive Product List. Documents are available at...

  10. 77 FR 64150 - Product Change-Express Mail and Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ... Change--Express Mail and Priority Mail Negotiated Service Agreement AGENCY: Postal Service\\TM\\. ACTION... Mail Classification Schedule's Competitive Products List. DATES: Effective date: October 18, 2012. FOR... Express Mail & Priority Mail Contract 11 to Competitive Product List. Documents are available at...

  11. 78 FR 6361 - Product Change-Express Mail and Priority Mail Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... Change--Express Mail and Priority Mail Negotiated Service Agreement AGENCY: Postal Service TM . ACTION... Mail Classification Schedule's Competitive Products List. DATES: Effective date: January 30, 2013. FOR... Express Mail & Priority Mail Contract 13 to Competitive Product List. Documents are available at...

  12. 29 CFR 1425.2 - Notice to the Service of agreement negotiations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 4 2014-07-01 2014-07-01 false Notice to the Service of agreement negotiations. 1425.2 Section 1425.2 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE... be present at the grievance mediation conference. (3) Any times limits in the parties labor...

  13. The contribution of hospital library services to continuing medical education.

    PubMed

    Gluck, Jeannine Cyr

    2004-01-01

    Much of the literature relating to continuing medical education programs laments the lack of effectiveness of traditional lecture-based format, the most often used method of presentation in hospitals. A gap exists between the content taught in lectures and the application of that knowledge in actual patient care. The services of the medical librarian, already employed in most hospitals, can help ameliorate this problem. Further, libraries help to support quality improvement efforts. These three functions (library services, continuing medical education, and quality improvement) are interdependent. Each lends strength to the other, and, ideally, all are coordinated within the hospital structure.

  14. Performance indicators for information technology services at four community hospitals.

    PubMed

    Rappaport, Pegi; Dimnik, Gerry; Burns, Rodney; Bowie, Jamie

    2006-01-01

    During the 2004/05 fiscal year, the Directors of Information Technology Services (ITS) at four Toronto-area hospitals agreed to participate in a detailed benchmarking exercise looking at ITS costs and services in their organizations. The indicators presented in this article highlight some of the findings from this data analysis.

  15. Embedded ubiquitous services on hospital information systems.

    PubMed

    Kuroda, Tomohiro; Sasaki, Hiroshi; Suenaga, Takatoshi; Masuda, Yasushi; Yasumuro, Yoshihiro; Hori, Kenta; Ohboshi, Naoki; Takemura, Tadamasa; Chihara, Kunihiro; Yoshihara, Hiroyuki

    2012-11-01

    A Hospital Information Systems (HIS) have turned a hospital into a gigantic computer with huge computational power, huge storage and wired/wireless local area network. On the other hand, a modern medical device, such as echograph, is a computer system with several functional units connected by an internal network named a bus. Therefore, we can embed such a medical device into the HIS by simply replacing the bus with the local area network. This paper designed and developed two embedded systems, a ubiquitous echograph system and a networked digital camera. Evaluations of the developed systems clearly show that the proposed approach, embedding existing clinical systems into HIS, drastically changes productivity in the clinical field. Once a clinical system becomes a pluggable unit for a gigantic computer system, HIS, the combination of multiple embedded systems with application software designed under deep consideration about clinical processes may lead to the emergence of disruptive innovation in the clinical field.

  16. Hospital Emergency Services for Children and Adolescents

    PubMed Central

    Robinson, Geoffrey C.; Klonoff, Harry

    1967-01-01

    The records of visits of children and adolescents to the emergency department of the Vancouver General Hospital were reviewed during the period July 1, 1965, to June 30, 1966, and the diagnostic and disposal data recorded. One-quarter of all visits were made by children and adolescents. Three-quarters of the visits were made for surgical conditions. There were more males than females in both surgical and medical groups, and the peaks in attendance were of those in the early preschool and late adolescent age groups. Three-quarters of the patients were referred to the family doctor and approximately one-sixth were admitted to the hospital. These findings suggested that while prompt medical attention was usually indicated, the majority of problems were not urgent and that the emergency department was becoming a substitute for the office of the family physician. PMID:6023997

  17. Who decides which pharmacy services are provided in UK National Health Service hospitals?

    PubMed

    Cotter, S M; McKee, M; Strong, P M

    1997-02-01

    An interview survey of 129 UK National Health Service doctors, nurses, pharmacists and managers at eight acute care hospitals was conducted in 1994. The survey examined several topics including whether the introduction of the internal market had affected hospital pharmacy services and what those effects had been. An internal market has been introduced and it has had significant effects on the nature and structure of hospital pharmacy services. Directorate pharmacy services were available at six sites. Contracts for specific, usually novel, services had been implemented at one site and contracts had been introduced widely at another hospital. However, all the features of a market were not present at any site. Market orientation also has implications for the equity of service provision, primarily because decision-making regarding service provision is increasingly in the hands of the clinical directors, rather than pharmacy managers. The effects of this change are not yet clear.

  18. Adapting the SERVQUAL scale to hospital services: an empirical investigation.

    PubMed Central

    Babakus, E; Mangold, W G

    1992-01-01

    Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified. PMID:1737708

  19. Adapting the SERVQUAL scale to hospital services: an empirical investigation.

    PubMed

    Babakus, E; Mangold, W G

    1992-02-01

    Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified.

  20. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services; use of hospital or CAH facilities. 409.12 Section 409.12 Public Health CENTERS FOR MEDICARE... services, medical social services; use of hospital or CAH facilities. (a) Except as provided in paragraph... facilities, and medical social services as inpatient hospital or inpatient CAH services only if...

  1. Hospital and corporate information services: introducing a new column.

    PubMed

    Jajko, P

    1992-01-01

    Successful hospital and corporate libraries offer customized resources and services to meet the needs of their dynamic organizations. Concepts such as customer-driven, service-oriented and value-added are central to these libraries. Serving decision makers and integrating the library into the decision-making process of the organization is critical. Future articles in this new column will further explore the underlying philosophies and the specialized resources and services that characterize these libraries.

  2. Health care agreements as a tool for coordinating health and social services

    PubMed Central

    Rudkjøbing, Andreas; Strandberg-Larsen, Martin; Vrangbaek, Karsten; Andersen, John Sahl; Krasnik, Allan

    2014-01-01

    Introduction In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social services, a survey was conducted before (2005–2006) and after the reform (2011). Theory and methods The study was designed on the basis of a modified version of Alter and Hage's framework for conceptualising coordination. Both surveys addressed all municipal level units (n = 271/98) and a random sample of general practitioners (n = 700/853). Results The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work. Discussion Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify a useful tool for the coordination of health and social services. Conclusion There are substantial improvements with the new health agreements in terms of formalising a better coordination of the health care system. PMID:25550691

  3. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.10 Inpatient hospital services, other than services in an institution... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, other than services...

  4. Service quality of private hospitals: The Iranian Patients' perspective

    PubMed Central

    2012-01-01

    Background Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. Methods A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. Results The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p < 0.001). There was a significant difference between the expectations scores based on gender, education level, and previous hospitalization in that same hospital. Also, there was a significant difference between the perception scores based on insurance coverage, average length of stay, and patients' health conditions on discharge. Conclusion The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients. PMID:22299830

  5. 77 FR 37078 - Product Change-Parcel Select and Parcel Return Service Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... [Federal Register Volume 77, Number 119 (Wednesday, June 20, 2012)] [Notices] [Page 37078] [FR Doc No: 2012-14936] POSTAL SERVICE Product Change--Parcel Select and Parcel Return Service Negotiated... of the United States Postal Service to Add Parcel Select & Parcel Return Service Contract 4...

  6. 41 CFR 302-2.16 - Must I sign a service agreement for a “last move home” relocation?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... agreement for a âlast move homeâ relocation? 302-2.16 Section 302-2.16 Public Contracts and Property... REQUIREMENTS General Rules Service Agreements § 302-2.16 Must I sign a service agreement for a “last move home” relocation? No, you do not need to sign a service agreement for a “last move home” relocation....

  7. Identifying Key Hospital Service Quality Factors in Online Health Communities

    PubMed Central

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain

    2015-01-01

    Background The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods We defined social media–based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea’s two biggest online portals were used to test the effectiveness of detection of social media–based key quality factors for hospitals. Results To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is

  8. Measuring patient-perceived hospital service quality: a conceptual framework.

    PubMed

    Pai, Yogesh P; Chary, Satyanarayana T

    2016-04-18

    Purpose - Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognizing healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The purpose of this paper is to design a conceptual framework for measuring patient perceived hospital service quality (HSQ), based on existing service quality literature. Design/methodology/approach - Using HSQ theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure HSQ. The paper outlines patient perceived service quality dimensions. Findings - An instrument for measuring HSQ dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications - The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value - The paper helps academics and practitioners to assess HSQ from a patient perspective.

  9. Safe space. How you can define fair market value for medical-office building lease agreements with hospitals.

    PubMed

    Murray, Chuck

    2007-04-01

    When entering into office-space lease agreements with hospitals, physician practice administrators need to pay close attention to the federal antikick-back statute and the Stark law. Compliance with these regulations calls for adherence to fair market value and commercial reasonableness--blurry terms open to interpretation. This article provides you with a framework for defining fair market value and commercial reasonableness in regard to real-estate transactions with hospitals.

  10. Strategies for cutting hospital beds: the impact on patient service.

    PubMed Central

    Green, L V; Nguyen, V

    2001-01-01

    OBJECTIVE: To develop insights on the impact of size, average length of stay, variability, and organization of clinical services on the relationship between occupancy rates and delays for beds. DATA SOURCES: The primary data source was Beth Israel Deaconess Medical Center in Boston. Secondary data were obtained from the United Hospital Fund of New York reflecting data from about 150 hospitals. STUDY DESIGN: Data from Beth Israel Deaconess on discharges and length of stay were analyzed and fit into appropriate queueing models to generate tables and graphs illustrating the relationship between the variables mentioned above and the relationship between occupancy levels and delays. In addition, specific issues of current concern to hospital administrators were analyzed, including the impact of consolidation of clinical services and utilizing hospital beds uniformly across seven days a week rather than five. PRINCIPAL FINDINGS: Using target occupancy levels as the primary determinant of bed capacity is inadequate and may lead to excessive delays for beds. Also, attempts to reduce hospital beds by consolidation of different clinical services into single nursing units may be counterproductive. CONCLUSIONS: More sophisticated methodologies are needed to support decisions that involve bed capacity and organization in order to understand the impact on patient service. Images Figure 2 PMID:11409821

  11. Modeling hospitals' adaptive capacity during a loss of infrastructure services.

    PubMed

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

    2015-01-01

    Resilience in hospitals - their ability to withstand, adapt to, and rapidly recover from disruptive events - is vital to their role as part of national critical infrastructure. This paper presents a model to provide planning guidance to decision makers about how to make hospitals more resilient against possible disruption scenarios. This model represents a hospital's adaptive capacities that are leveraged to care for patients during loss of infrastructure services (power, water, etc.). The model is an optimization that reallocates and substitutes resources to keep patients in a high care state or allocates resources to allow evacuation if necessary. An illustrative example demonstrates how the model might be used in practice.

  12. The seven common pitfalls of customer service in hospitals.

    PubMed

    Domingo, Rene T

    2015-01-01

    Operating simultaneously like a repair shop, prison, and hotel, hospitals are prone to seven common pitfalls in customer service. Patient care is often fragmented, inscrutable, inflexible, insensitive, reactive, myopic, and unsafe. Hospitals are vying to be more high-tech, rather than high-touch even though staff engagement with patients rather than facilities and equipment strongly influence patient satisfaction. Unless processes, policies, and people are made customer-centered, the high quality of the hospital's human and hardware resources will not translate into high patient satisfaction and patient loyalty.

  13. Factors Affecting the Agreement Between Emergency Psychiatrists and General Practitioners Regarding Involuntary Psychiatric Hospitalizations.

    PubMed

    Geoffroy, Pierre Alexis; Duhamel, Alain; Behal, Hélène; Zouitina-Lietaert, Nadia; Duthilleul, Julie; Marquette, Louise; Ducrocq, François; Vaiva, Guillaume; Rolland, Benjamin

    2016-06-21

    Important discrepancies exist between physicians in deciding when to perform involuntary hospitalization measures (IHMs). The factors underlying these differences are poorly known.We conducted a two-year single-center retrospective study in France on patients who were referred to the emergency department (ED) with an IHM certificate written by a private-practice General Practitioner (GP). For each consultation, the official IHM motive was categorized into four groups: Suicide; Psychosis, Mania, or Melancholia (PMM); Agitation; and Other. The alcohol status of the patient was also noted. The factors underlying the ED psychiatrists' confirmation of the use of IHMs were determined using a logistic regression model. One hundred eighty-nine cases were found (165 patients; 44.2 ± 16 years, 41.3% women). The ED psychiatrists confirmed the use of IHMs in 123 instances (65.1% agreement rate). Multivariate analyses found that IHM disagreement was significantly associated with patient alcohol status and the reason for referral. Specifically, there was an increased risk of IHM disagreement when the patient had an alcohol-positive status (OR = 15.80; 95% CI [6.45-38.67]; p < 0.0001) and when the motive for IHM was "agitation" compared with "suicide" (OR = 11.44; 95% CI[3.38-38.78]; p < 0.0001). These findings reflect significant disparities between GPs and ED psychiatrists regarding the decision to proceed to an IHM.

  14. Availability of software services for a hospital information system.

    PubMed

    Sakamoto, N

    1998-03-01

    Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability of computers, in which all that matters is that the computer is functioning. It means the provision of necessary information for hospital operations by the computer software, and we will call it the availability of software services. HISs these days are mostly client-server systems. To increase availability of software services in these systems, it is not enough to just use system structures that are highly reliable in existing host-centred systems. Four main components which support availability of software services are network systems, client computers, server computers, and application software. In this paper, we suggest how to structure these four components to provide the minimum requested software services even if a part of the system stops to function. The network system should be double-protected in stratus using Asynchronous Transfer Mode (ATM) as its base network. Client computers should be fat clients with as much application logic as possible, and reference information which do not require frequent updates (master files, for example) should be replicated in clients. It would be best if all server computers could be double-protected. However, if that is physically impossible, one database file should be made accessible by several server computers. Still, at least the basic patients' information and the latest clinical records should be double-protected physically. Application software should be tested carefully before introduction. Different versions of the application software should always be kept and managed in case the new version has problems. If a hospital

  15. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  16. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  17. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  18. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  19. 75 FR 71441 - Universal Health Services, Inc. and Psychiatric Solutions, Inc.; Analysis of Agreement Containing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-23

    ... contract management business accounted for the remaining 7%. Acute Inpatient Psychiatric Services UHS's... largest hospital management companies, with 2009 revenues totaling approximately $5.2 billion. In 2009... business, and includes all of the assets necessary for a Commission-approved buyer to independently...

  20. 76 FR 55378 - Alabama Power Company; Notice of Proposed Restricted Service List for a Programmatic Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Alabama Power Company; Notice of Proposed Restricted Service List for a Programmatic Agreement Rule 2010 of the Federal Energy Regulatory Commission's (Commission) Rules of...

  1. 78 FR 55135 - Request for Comments on Additional Participants in Trade in Services Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-09

    ... intention to enter into negotiations for a Trade in Services Agreement (TISA) with an initial group of 20... negotiations progress to include others who share our ambitious goals. This expansion will help further U.S... participants to join the negotiations. The Office of the United States Trade Representative (USTR) is...

  2. 78 FR 5238 - Request for Comments on an International Services Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-24

    ... negotiations for an International Services Agreement (ISA) with an initial group of 20 trading partners. The... following twenty trading partners have expressed their intention to participate in negotiations with the... negotiations proceed, includes a range of developed and developing economies, representing nearly two-thirds...

  3. 75 FR 78237 - Notice of Proposed Restricted Service List for a Programmatic Agreement for Managing Properties...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-15

    ... Managing Properties Included in or Eligible for Inclusion in the National Register of Historic Places... prepare a Programmatic Agreement for managing properties included in, or eligible for inclusion in, the... official service list for the above-captioned proceedings may request inclusion on the restricted...

  4. 18 CFR 35.10 - Form and style of rate schedules, tariffs and service agreements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Form and style of rate schedules, tariffs and service agreements. 35.10 Section 35.10 Conservation of Power and Water Resources... OF RATE SCHEDULES AND TARIFFS Application § 35.10 Form and style of rate schedules, tariffs...

  5. The General Agreement on Trade in Services (GATS): Why You Need To Be Concerned.

    ERIC Educational Resources Information Center

    Schacter, Noel

    2002-01-01

    The General Agreement on Trade in Services gives priority to international commercial interests, and unless this trend is countered, public policy authority for education will shift to the World Trade Organization. While the Canadian government has stated that public education systems are not negotiable, the exclusion provisions it bases that…

  6. The Determination of Jurisdiction in Grid and Cloud Service Level Agreements

    NASA Astrophysics Data System (ADS)

    Parrilli, Davide Maria

    Service Level Agreements in Grid and Cloud scenarios can be a source of disputes particularly in case of breach of the obligations arising under them. It is then important to determine where parties can litigate in relation with such agreements. The paper deals with this question in the peculiar context of the European Union, and so taking into consideration Regulation 44/2001. According to the rules on jurisdiction provided by the Regulation, two general distinctions are drawn in order to determine which (European) courts are competent to adjudicate disputes arising out of a Service Level Agreement. The former is between B2B and B2C transactions, and the latter regards contracts which provide a jurisdiction clause and contracts which do not.

  7. 75 FR 33313 - Medicare and Medicaid Programs; Procedure for Hospitals Seeking To Enter Into an Agreement With a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ... of transplantable organs to transplant centers throughout the country. Qualified OPOs are designated... providing organs for transplant, pursuant to section 1138(a)(1)(C) of the Social Security Act (the Act), and... Hospitals Seeking To Enter Into an Agreement With a Different Organ Procurement Organization Following...

  8. Hospitality, Recreation, and Personal Service Occupations: Grade 8. Cluster V.

    ERIC Educational Resources Information Center

    Calhoun, Olivia H.

    A curriculum guide for grade 8, the document is devoted to the occupational cluster "Hospitality, Recreation, and Personal Service Occupations." It is divided into four units: recreational resources for education, employment, and professional opportunities; barbering and cosmetology; mortuary science; hotel-motel management. Each unit is…

  9. Evaluation of Service Level Agreement Approaches for Portfolio Management in the Financial Industry

    NASA Astrophysics Data System (ADS)

    Pontz, Tobias; Grauer, Manfred; Kuebert, Roland; Tenschert, Axel; Koller, Bastian

    The idea of service-oriented Grid computing seems to have the potential for fundamental paradigm change and a new architectural alignment concerning the design of IT infrastructures. There is a wide range of technical approaches from scientific communities which describe basic infrastructures and middlewares for integrating Grid resources in order that by now Grid applications are technically realizable. Hence, Grid computing needs viable business models and enhanced infrastructures to move from academic application right up to commercial application. For a commercial usage of these evolutions service level agreements are needed. The developed approaches are primary of academic interest and mostly have not been put into practice. Based on a business use case of the financial industry, five service level agreement approaches have been evaluated in this paper. Based on the evaluation, a management architecture has been designed and implemented as a prototype.

  10. The public health implications of world trade negotiations on the general agreement on trade in services and public services.

    PubMed

    Pollock, Allyson M; Price, David

    2003-09-27

    Trade ministries from the World Trade Organization's (WTO's) 144 member states are presently deciding which public services to open to foreign competition under the complex liberalisation rules of the general agreement on trade in services (GATS). A frequent criticism of the WTO system is that it reduces national autonomy over public policy. However, respect for national sovereignty is asserted in the GATS treaty. Here, we examine claims made by the WTO and others that GATS exempts public services and does not require their privatisation. We discuss trade treaty processes that can subject public services to commercial rules, the treaty's flexibility with respect to national autonomy, and the effect of GATS in situations in which national autonomy is not protected. We conclude that national autonomy over health policy is not preserved under GATS, and that accordingly, there is a role for international standards that protect public services from the adverse effect of trade and market forces.

  11. The Effect of Hospital Service Quality on Patient's Trust

    PubMed Central

    Zarei, Ehsan; Daneshkohan, Abbas; Khabiri, Roghayeh; Arab, Mohammad

    2014-01-01

    Background: The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient’s trust is the service quality. Objectives: This study aimed to examine the effect of quality of services provided in private hospitals on the patient’s trust. Patients and Methods: In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression. Results: The mean score of patients' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P < 0.001) were the strongest factors in predicting patient’s trust, but the quality of the environment had no significant effect on the patients' degree of trust. Conclusions: The interaction quality and process quality were the key determinants of patient’s trust in the private hospitals of Tehran. To enhance the patients' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff. PMID:25763258

  12. 'The hospital was just like a home': self, service and the 'McCord Hospital Family'.

    PubMed

    Noble, Vanessa; Parle, Julie

    2014-04-01

    For more than a century, McCord Hospital, a partly private and partly state-subsidised mission hospital has provided affordable health-care services, as well as work and professional training opportunities for thousands of people in Durban, a city on the east coast of South Africa. This article focuses on one important aspect of the hospital's longevity and particular character, or 'organisational culture': the ethos of a 'McCord Family', integral to which were faith and a commitment to service. While recognising that families - including 'hospital families' like that at McCord - are contentious social constructs, with deeply embedded hierarchies and inequalities based on race, class and gender, we also consider however how the notion of 'a McCord family' was experienced and shared in complex ways. Indeed, during the twentieth century, this ethos was avidly promoted by the hospital's founders and managers and by a wide variety of employees and trainees. It also extended to people at a far geographical remove from Durban. Moreover, this ethos became so powerful that many patients felt that it shaped their convalescence experience positively. This article considers how this 'family ethos' was constructed and what made it so attractive to this hospital's staff, trainees and patients. Furthermore, we consider what 'work' it did for this mission hospital, especially in promoting bonds of multi-racial unity in the contexts of segregation and apartheid society. More broadly, it suggests that critical histories of the ways in which individuals, hospitals, faith and 'families' intersect may be of value for the future of hospitals as well as of interest in their past.

  13. Perceived nursing service quality in a tertiary care hospital, Maldives.

    PubMed

    Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee

    2011-12-01

    The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality.

  14. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of the patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in... hospitalization if the physician finds that the patient could receive proper treatment in a SNF but no bed...

  15. 78 FR 41088 - Solicitation for a Cooperative Agreement-Support Services for Community Services Division Networks

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE... Services Division Networks AGENCY: National Institute of Corrections, U.S., Department of Justice. ACTION... proposed that are new to NIC and will enhance the project? Organizational (35%) Do the proposed...

  16. An Investigation into Specifying Service Level Agreements for Provisioning Cloud Computing Services

    DTIC Science & Technology

    2012-12-01

    of the computing environment . An SLA for a traditional network system covers network support services, application performance, client-side...53  G.   LESSONS LEARNED FROM AMAZON EC2 BLACKOUTS ................56  VI.  CONCLUSIONS...61  A.   ISSUES AND LESSONS LEARNED

  17. Hospitality: transformative service to children, families, and communities.

    PubMed

    Melton, Gary B

    2014-11-01

    Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents.

  18. [Care management: nurses' actions in a hospital emergency service].

    PubMed

    dos Santos, José Luís Guedes; Lima, Maria Alice Dias da Silva

    2011-12-01

    This study aimed to analyze care management actions performed by nurses in a hospital emergency service. This is a qualiative research of the case study type, carried out with nurses from the Emergency Service of a University Hospital in southern Brazil. The data were collected through participant observation and semi-structured interviews, and analyzed using thematic analysis. The results show nurses' actions in care planning, forecasting and provisioning of resources, supervision, leadership and training of the nursing team. In care planning, there is the execution of the nursing process and the control of the realization of laboratory and radiological tests. The actions of forecasting and provisioning of resources were: elaboration of the monthly schedule of employees, daily distribution of the staff and the management of material resources. Leadership encourages the planning of care, the coordination of the nursing staff and the delegation of activities.

  19. 41 CFR 302-2.16 - Must I sign a service agreement for a “last move home” relocation?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... agreement for a âlast move homeâ relocation? 302-2.16 Section 302-2.16 Public Contracts and Property... agreement for a “last move home” relocation? No, you do not need to sign a service agreement for a “last move home” relocation....

  20. 41 CFR 302-2.16 - Must I sign a service agreement for a “last move home” relocation?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... agreement for a âlast move homeâ relocation? 302-2.16 Section 302-2.16 Public Contracts and Property... agreement for a “last move home” relocation? No, you do not need to sign a service agreement for a “last move home” relocation....

  1. 41 CFR 302-2.16 - Must I sign a service agreement for a “last move home” relocation?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... agreement for a âlast move homeâ relocation? 302-2.16 Section 302-2.16 Public Contracts and Property... agreement for a “last move home” relocation? No, you do not need to sign a service agreement for a “last move home” relocation....

  2. 41 CFR 302-2.16 - Must I sign a service agreement for a “last move home” relocation?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... agreement for a âlast move homeâ relocation? 302-2.16 Section 302-2.16 Public Contracts and Property... agreement for a “last move home” relocation? No, you do not need to sign a service agreement for a “last move home” relocation....

  3. A novel differentiated-resilience provisioning scheme of service level agreements for the GMPLS/ASON network

    NASA Astrophysics Data System (ADS)

    Tan, Zhi; Cao, Hongyu

    2008-11-01

    Network service support to ensure quality of service (QoS) is a key requirement for many applications, we present a novel management plane oriented service architecture which provides network resource scheduling service in large-scale GMPLS/ASON network environment based on the service level agreement(SLA) conducted between service customers and service providers. It applies the updated service-oriented and policy translation structure with excellent expansibility and efficiency in the running process. The architecture contains four components: Application Monitor Service, SLA Management, Policy management and Service management. In addition, vertical service mapping and differentiated-resilience provisioning schemes of service level agreement(SLA) applied to the GMPLS/ASON networks are discussed, which is expected to be the near- and long-term network technology thanks, among other things, to the great bandwidth capacity offered by optical devices.

  4. Hospital image and the positioning of service centers: an application in market analysis and strategy development.

    PubMed

    Smith, S M; Clark, M

    1990-09-01

    The research confirms the coexistence of different images for hospitals, service centers within the same hospitals, and service programs offered by each of the service centers. The images of individual service centers are found not to be tied to the image of the host facility. Further, service centers and host facilities have differential rankings on the same service decision attributes. Managerial recommendations are offered for "image differentiation" between a hospital and its care centers.

  5. 42 CFR 412.20 - Hospital services subject to the prospective payment systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL... Operating Costs and Inpatient Capital-Related Costs § 412.20 Hospital services subject to the...

  6. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted...

  7. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted from employment, if...

  8. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 15 2012-04-01 2012-04-01 false Services of student nurse or hospital intern...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted from employment, if...

  9. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 15 2011-04-01 2011-04-01 false Services of student nurse or hospital intern... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted...

  10. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 15 2012-04-01 2012-04-01 false Services of student nurse or hospital intern... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted...

  11. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 15 2011-04-01 2011-04-01 false Services of student nurse or hospital intern...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted from employment, if...

  12. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 15 2013-04-01 2013-04-01 false Services of student nurse or hospital intern...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted from employment, if...

  13. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 15 2014-04-01 2014-04-01 false Services of student nurse or hospital intern...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted from employment, if...

  14. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 15 2013-04-01 2013-04-01 false Services of student nurse or hospital intern... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted...

  15. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 15 2014-04-01 2014-04-01 false Services of student nurse or hospital intern... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student nurse in the employ of a hospital or a nurses' training school are excepted...

  16. Hospital library service and the changes in national standards.

    PubMed Central

    Glitz, B; Flack, V; Lovas, I M; Newell, P

    1998-01-01

    Two important sets of standards affecting hospital libraries were significantly revised in 1994, those of the Medical Library Association (MLA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). As part of its continuing efforts to monitor library services within its region, the University of California, Los Angeles Biomedical Library, Regional Medical Library for the Pacific Southwest Region of the National Network of Libraries of Medicine (NN/LM) conducted a survey in late 1994, in part to determine the effects of these revised standards on regional hospital libraries. Data from the survey were also used to provide a view of hospital libraries in the Pacific Southwest region, and to make comparisons with similar data collected in 1989. Results showed that while libraries remained stable in overall number, size, and staffing, services, especially those associated with end-user searching and interlibrary loan, increased enormously. With respect to the MLA standards, results show a high compliance level. Interesting differences were seen between the perceptions of library staff concerning their rate of compliance with the JCAHO standards and their actual compliance as measured by the MLA criteria. While some libraries appear to measure up better than their own perceptions would indicate, others may be fully aware of their actual compliance level. PMID:9549016

  17. 20 CFR 404.1911 - Effects of a totalization agreement on entitlement to hospital insurance benefits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Act by combining the person's periods of coverage under the social security system of the United States with the person's periods of coverage under the social security system of the foreign country... entitlement to hospital insurance benefits. 404.1911 Section 404.1911 Employees' Benefits SOCIAL...

  18. 20 CFR 404.1911 - Effects of a totalization agreement on entitlement to hospital insurance benefits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Act by combining the person's periods of coverage under the social security system of the United States with the person's periods of coverage under the social security system of the foreign country... entitlement to hospital insurance benefits. 404.1911 Section 404.1911 Employees' Benefits SOCIAL...

  19. 77 FR 31010 - Proposed CERCLA Agreement for Recovery of Past Response Costs; Piqua Hospital Site

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ...] [FR Doc No: 2012-12627] ENVIRONMENTAL PROTECTION AGENCY [FRL-9677-5] Proposed CERCLA Agreement for... Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is... Hazardous Substance Superfund. The settlement includes a covenant not to sue the settling parties...

  20. Effects of reduction of acute hospital services on district nursing services: implications for quality assurance.

    PubMed

    MacDonald, L D; Addington-Hall, J M; Hennessy, D A; Gould, T R

    1991-01-01

    Two questions of importance to those concerned with maintaining standards and increasing the efficiency of Community Nursing are: (1) does reducing hospital provision alter the number of patients referred for Community Nursing or the type of care provided; (2) are Community Nursing Services directed towards those who most require them? A base-line study was carried out in the first quarter of 1988, before the closure of one of two general hospitals in an inner London Health Authority and was replicated in the same quarter of 1989, after all acute inpatient services had been transferred to the other hospital. Comparison of patients discharged before and after closure showed no significant differences in patients' age, sex, proportion living alone, length of stay in hospital, readmissions or deaths within one month of discharge. There was some decline in general nursing care. Total discharges declined by 20% while the number of referrals remained the same, indicating that proportionately more patients were discharged with a referral. Comparing referred and unreferred patients showed that Community Nursing Services were already being directed towards those most in need both before and after hospital closure. Results suggest that Community Nursing helps to maintain patients in the community.

  1. 21 CFR 203.36 - Fulfillment houses, shipping and mailing services, comarketing agreements, and third-party...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Fulfillment houses, shipping and mailing services... Samples § 203.36 Fulfillment houses, shipping and mailing services, comarketing agreements, and third... manufacturer or authorized distributor of record that uses a fulfillment house, shipping or mailing service,...

  2. Detecting hospital fraud and claim abuse through diabetic outpatient services.

    PubMed

    Liou, Fen-May; Tang, Ying-Chan; Chen, Jean-Yi

    2008-12-01

    Hospitals and health care providers tend to get involved in exaggerated and fraudulent medical claims initiated by national insurance schemes. The present study applies data mining techniques to detect fraudulent or abusive reporting by healthcare providers using their invoices for diabetic outpatient services. This research is pursued in the context of Taiwan's National Health Insurance system. We compare the identification accuracy of three algorithms: logistic regression, neural network, and classification trees. While all three are quite accurate, the classification tree model performs the best with an overall correct identification rate of 99%. It is followed by the neural network (96%) and the logistic regression model (92%).

  3. The use of urological hospital services by nonagenarians

    PubMed Central

    Pridgeon, S; Nagarajan, E; Ellis, G; Green, JS

    2016-01-01

    Introduction The super-elderly population is a small but expanding group of patients who will pose a significant challenge to future healthcare resources. A snapshot audit was completed of all emergency and elective urological nonagenarian activity in a UK general hospital, including surgical outcomes in this group of patients. Methods Prospective and retrospective databases and clinical records were examined to identify all patients aged 90–99 years who had patient episodes between January 2006 and August 2012. Patient outcomes were compared with those for a similar cohort of 80–89-year-olds during the same time period. Results A total of 653 nonagenarian patient episodes were identified (including 138 emergency admissions, 25 emergency surgical procedures, 71 elective surgical procedures, 173 local anaesthetic procedures and 270 outpatient visits). The in-hospital mortality rate for emergency admissions was 10%. The mean length of hospital stay was significantly longer for nonagenarians than for octogenarians (14.4 vs 6.5 days, p<0.00001). The postoperative mortality rate following emergency and elective surgery was 16% and 1% for nonagenarians and octogenarians respectively. Conclusions Nonagenarian patients often have complex medical co-morbidities and challenging social circumstances that contribute to delayed recovery from acute illness and surgery as well as long periods of hospitalisation. Adopting a multidisciplinary approach with formal input from specialist geriatric surgical services may improve patient outcomes and allow patients to be discharged to their former places of residence. PMID:26673045

  4. Determinants of hospital choice of rural hospital patients: the impact of networks, service scopes, and market competition.

    PubMed

    Roh, Chul-Young; Lee, Keon-Hyung; Fottler, Myron D

    2008-08-01

    Among 10,384 rural Colorado female patients who received MDC 14 (obstetric services) from 2000 to 2003, 6,615 (63.7%) were admitted to their local rural hospitals; 1,654 (15.9%) were admitted to other rural hospitals; and 2,115 (20.4%) traveled to urban hospitals for inpatient services. This study is to examine how network participation, service scopes, and market competition influences rural women's choice of hospital for their obstetric care. A conditional logistic regression analysis was used. The network participation (p < 0.01), the number of services offered (p < 0.05), and the hospital market competition had a positive and significant relationship with patients' choice to receive obstetric care. That is, rural patients prefer to receive care from a hospital that participates in a network, that provides more number of services, and that has a greater market share (i.e., a lower level of market competition) in their locality. Rural hospitals could actively increase their competitiveness and market share by increasing the number of health care services provided and seeking to network with other hospitals.

  5. [Hospital food: proposals for qualification of the Food and Nutrition Service, evaluated by the scientific community].

    PubMed

    Diez-Garcia, Rosa Wanda; Padilha, Marina; Sanches, Maísa

    2012-02-01

    The scope of this paper is to validate proposals used to qualify hospital food by the Brazilian scientific community. An electronic questionnaire was applied to clinical nutrition professionals registered on the Lattes Platform (Brazilian database of institutions and researchers' curricula in the areas of Science and Technology). The questionnaire incorporated a Likert scale and had spaces for comments. The themes dealt with patient participation, the nutritional and sensory quality of hospital diets, and planning and goals of the Hospital Food and Nutrition Service (HFNS). The questionnaire also asked for the top five priorities for a HFNS. Proposals with total or partial adherence equal to or greater than 70% were considered to be approved. All proposals had total adherence equal to or greater than 70%. The proposal that had minimal adherence (70%) was the one that proposed that nutritional intervention must be arranged by mutual agreement with the patient. The proposal that had maximal adherence (93%) was the one advocating that there must be statistical control on diets prescribed by the HFNS. The most cited priorities referred to infrastructure and training of human resources (40%), the quality of hospital food (27%) and the nutritional status of the patient.

  6. Re-engineering surgical services in a community teaching hospital.

    PubMed

    Cohen, M M; Wreford, M; Barnes, M; Voight, P

    1997-04-01

    The Grace Hospital Surgical Services redesign project began in December 1995 and concluded in November 1996. It was led by the Chief of Surgery, the Surgical/Anesthesia Services Director, and the Associate Director of Critical Care/Trauma. The project was undertaken in order to radically redesign the delivery of surgical services in the Detroit Medical Center (DMC) Northwest Region. It encompassed the Grace Hospital Main Operating Room (10 operating theatres) and Post-Anesthesia Recovery Unit, and a satellite Ambulatory Surgery Center in Southfield, Michigan. The four areas of focus were materials management, case scheduling, patient flow/staffing, and business planning. The guiding objectives of the project were to improve upon the quality of surgical services for patients and physicians, to substantially reduce costs, and to increase case volume. Because the Grace Surgical Services redesign project was conducted in a markedly open communicative, and inclusive fashion and drew participation from a broad range of medical professionals, support staff, and management, it created positive ripple effects across the institution by raising staff cost-consciousness, satisfaction, and morale. Other important accomplishments of the project included: Introduction of block scheduling in the ORs, which improved room utilization and turnaround efficiencies, and greatly smoothed the boarding process for physicians. Centralization of all surgical boarding, upgrading of computer equipment to implement "one call" surgery scheduling, and enlarging the capacity for archiving, managing and retrieving OR data. Installation of a 23-hour, overnight recovery unit and provision of physician assistants at the Ambulatory Surgery Center, opening the doors to an expanded number of surgical procedures, and enabling higher quality care for patients. Reduction of FTE positions by 27 percent at the Ambulatory Surgery Center. This yielded a total cost reduction of +1.5 million per annum in the

  7. Service mix in the hospital outpatient department: implications for Medicare payment reform.

    PubMed Central

    Miller, M E; Sulvetta, M B; Englert, E

    1995-01-01

    OBJECTIVE. To determine if implementation of a PPS for Medicare hospital outpatient department (HOPD) services will have distributional consequences across hospital types and regions, this analysis assesses variation in service mix and the provision of high-technology services in the HOPD. DATA. HCFA's 1990 claims file for a 5 percent random sample of Medicare beneficiaries using the HOPD was merged, by hospital provider number, with various HCFA hospital characteristic files. STUDY DESIGN. Hospital characteristics examined are urban/rural location, teaching status, disproportionate-share status, and bed size. Two analyses of HOPD services are presented: mix of services provided and the provision of high-technology services. The mix of services is measured by the percentage of services in each of 14 type-of-service categories (e.g., medical visits, advanced imaging services, diagnostic testing services). Technology provision is measured by the percentage of hospitals providing selected high-technology services. FINDINGS/CONCLUSIONS. The findings suggest that the role hospital types play in providing HOPD services warrants consideration in establishing a PPS. HOPDs in major teaching hospitals and hospitals serving a disproportionate share of the poor play an important role in providing routine visits. HOPDs in both major and minor teaching hospitals are important providers of high-technology services. Other findings have implications for the structure of an HOPD PPS as well. First, over half of the services provided in the HOPD are laboratory tests and HOPDs may have limited control over these services since they are often for patients referred from local physician offices. Second, service mix and technology provision vary markedly among regions, suggesting the need for a transition to prospective payment. Third, the organization of service supply in a region may affect service provision in the HOPD suggesting that an HOPD PPS needs to be coordinated with payment

  8. Rural Hospital Ownership: Medical Service Provision, Market Mix, and Spillover Effects

    PubMed Central

    Horwitz, Jill R; Nichols, Austin

    2011-01-01

    Objective To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data Sources/Study Setting Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. Study Design We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Principal Findings Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Conclusions Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. PMID:21639860

  9. The impact of chaplaincy services in selected hospitals in the eastern United States.

    PubMed

    Parkum, K H

    1985-09-01

    Surveys a stratified sample of patients in six different hospitals and compares their perceptions of hospital chaplaincy and other pastoral care efforts with related hospital services. Reports the presence of a strong impact of pastoral care services and discusses these findings from the perspective of a theory of expressive and instrumental social orientations as explicated by the sociologist Talcott Parsons.

  10. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Helicopter hospital emergency...

  11. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Helicopter hospital emergency...

  12. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Helicopter hospital emergency...

  13. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Helicopter hospital emergency...

  14. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Helicopter hospital emergency...

  15. Nurses' attitudes to a medical emergency team service in a teaching hospital

    PubMed Central

    Jones, D; Baldwin, I; McIntyre, T; Story, D; Mercer, I; Miglic, A; Goldsmith, D; Bellomo, R

    2006-01-01

    Background Cultural barriers including allegiance to traditional models of ward care and fear of criticism may restrict use of a medical emergency team (MET) service, particularly by nursing staff. A 1‐year preparation and education programme was undertaken before implementing the MET at the Austin Hospital, Melbourne, Australia. During the 4 years after introduction of the MET, the programme has continued to inform staff of the benefits of the MET and to overcome barriers restricting its use. Objective To assess whether nurses value the MET service and to determine whether barriers to calling the MET exist in a 400‐bed teaching hospital. Methods Immediately before hand‐over of ward nursing, we conducted a modified personal interview, using a 17‐item Likert agreement scale questionnaire. Results We created a sample of 351 ward nurses and obtained a 100% response rate. This represents 50.9% of the 689 ward nurses employed at the hospital. Most nurses felt that the MET prevented cardiac arrests (91%) and helped manage unwell patients (97%). Few nurses suggested that they restricted MET calls because they feared criticism of their patient care (2%) or criticism that the patient was not sufficiently unwell to need a MET call (10%). 19% of the respondents indicated that MET calls are required because medical management by the doctors has been inadequate; many ascribed this to junior doctors and a lack of knowledge and experience. Despite hospital MET protocol, 72% of nurses suggested that they would call the covering doctor before the MET for a sick ward patient. However, 81% indicated that they would activate the MET if they were unable to contact the covering doctor. In line with hospital MET protocol, 56% suggested that they would make a MET call for a patient they were worried about even if the patient's vital signs were normal. Further, 62% indicated that they would call the MET for a patient who fulfilled MET physiological criteria but did not look

  16. Using Collaborative Drug Therapy Agreements to Train Student Pharmacists to Provide Clinical Patient Care Services

    PubMed Central

    Akers, Julie M.; Czapinski, Jennifer C.; Robinson, Jennifer D.

    2017-01-01

    Objective. To assess the impact of a new course designed to train student pharmacists to provide clinical patient care services delivered through collaborative drug practice agreements. Design. An intensive two-credit, one-week course with a combined self-study and interactive pedagogical approach was developed. Content from the online Washington State Pharmacy Association Clinical Community Pharmacist training program was integrated with a live, eight-hour seminar. Assessment. Student-pharmacist learning, effectiveness of content presented, and perceived value of the material were evaluated. Scores on quizzes, a knowledge assessment, a patient-case examination, pre- and post-seminar surveys, and voluntary student certification rate were collected and analyzed. Of 132 student pharmacists enrolled in the course, 121 students met competency on their first attempt at completing the knowledge assessment and 126 students met competency on their first attempt at completing the practical examination. A pre- and post-training survey found that student pharmacists were significantly more comfortable performing and recommending implementation of services after completing the course. Conclusions. Training student pharmacists who are competent and comfortable providing clinical patient care services can improve access to care and reduce the impact of the impending physician shortage. PMID:28381891

  17. The Delivery of Health Services to Demented Patients at a University Hospital: A Pilot Study.

    ERIC Educational Resources Information Center

    Colenda, Christopher C.; And Others

    1988-01-01

    Conducted chart review of inpatient dementia patients cared for by neurology, psychiatry, medicine, and surgery services at university hospital. Found differences in symptom profiles, hospital utilization trends, medical comorbidity, and post-hospitalization dispositions. Examined how patients entered hospital system, were assigned to different…

  18. On the Supply Chain Management Supported by E-Commerce Service Platform for Agreement based Circulation of Fruits and Vegetables

    NASA Astrophysics Data System (ADS)

    Bao, Liwei; Huang, Yuchi; Ma, Zengjun; Zhang, Jie; Lv, Qingchu

    According to analysis of the supply chain process of agricultural products, the IT application requirements of the market entities participating in the agreement based circulation of fruits and vegetables have been discussed. The strategy of supply chain management basing on E-commerce service platform for fruits and vegetables has been proposed in this paper. The architecture and function composing of the service platform have been designed and implemented. The platform is constructed on a set of application service modules User can choose some of the application service modules and define them according to the business process. The application service modules chosen and defined by user are integrated as an application service package and applied as management information system of business process. With the E-commerce service platform, the supply chain management for agreement based circulation of agricultural products of vegetables and fruits can be implemented.

  19. The value of improved telecommunications service to hospitals: A preliminary assessment

    NASA Technical Reports Server (NTRS)

    Potter, J. G.

    1979-01-01

    In view of the rapid rate of development of domestic telecommunication services and the emphasis on private networks, it was sought to determine if hospitals had major requirements which could be aggregated and served by such networks. The value of the information transfer services judged to be most promising over the next twenty years was evaluated, based on expenditures and activity levels in five hospitals and one management services firm and the judgement of their senior staff. An implicit assumption is that services will become affordable once the hospital industry aggregates its requirements. A methodology to evaluate the value of telecommunication services in a hospital was developed and tested.

  20. [Emergency Psychiatric Service in general hospitals: a retrospective study].

    PubMed

    de Sousa, Fernando Sérgio Pereira; da Silva, Cezar Augusto Ferreira; Oliveira, Eliany Nazaré

    2010-09-01

    The Emergency Psychiatric Service in General Hospitals (SEPHG, acronym in Portuguese) is a service included in the psychiatric reform movement. The purpose of the present study was to characterize patients with psychological distress treated at the Dr. Estevam SEPHG, located in Sobral, Cear state. This exploratory study was performed using documental analyses with a quantitative approach, and involved 191 clients treated at the referred SEPHG from January to December 2007. Data collection was performed using a client register book, which contained information obtained from the patients' medical record. There was a predominance of male patients (70.15%), aged 30-49 years (48.71%) and single (74.86%). Most patients were from the city of Sobral (69.64%). In 42.40% of cases, the diagnosis was of alcohol use/abuse. Most clients (66.50%) sought the service voluntarily. After being evaluated at the SEPHG, 43.45% of patients were referred to the local Center for Psychosocial Care-Alcohol and other Drugs. The results emphasize the importance of mental health.

  1. Are inspectors’ assessments reliable? Ratings of NHS acute hospital trust services in England

    PubMed Central

    Addicott, Rachael; Robertson, Ruth; Ross, Shilpa; Walshe, Kieran

    2016-01-01

    The credibility of a regulator could be threatened if stakeholders perceive that assessments of performance made by its inspectors are unreliable. Yet there is little published research on the reliability of inspectors’ assessments of health care organizations’ services. Objectives We investigated the inter-rater reliability of assessments made by inspectors inspecting acute hospitals in England during the piloting of a new regulatory model implemented by the Care Quality Commission (CQC) during 2013 and 2014. Multi-professional teams of inspectors rated service provision on a four-point scale for each of five domains: safety; effectiveness; caring; responsiveness; and leadership. Methods In an online survey, we asked individual inspectors to assign a domain and a rating to each of 10 vignettes of service information extracted from CQC inspection reports. We used these data to simulate the ratings that might be produced by teams of inspectors. We also observed inspection teams in action, and interviewed inspectors and staff from hospitals that had been inspected. Results Levels of agreement varied substantially from vignette to vignette. Characteristics such as professional background explained only a very small part of the variation. Overall, agreement was higher on ratings than on domains, and for groups of inspectors compared with individual inspectors. A number of potential causes of disagreement were identified, such as differences regarding the weight that should be given to contextual factors and general uncertainty about interpreting the rating and domain categories. Conclusion Groups of inspectors produced more reliable assessments than individual inspectors, and there is evidence to support the utility of appropriate discussions between inspectors in improving reliability. The reliability of domain allocations was lower than for ratings. It is important to define categories and rating levels clearly, and to train inspectors in their use. Further

  2. 42 CFR 403.321 - State systems for hospital outpatient services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false State systems for hospital outpatient services. 403.321 Section 403.321 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Control Systems § 403.321 State systems for hospital outpatient services. CMS may approve a...

  3. 42 CFR 410.66 - Emergency outpatient services furnished by a nonparticipating hospital and services furnished in...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency outpatient services furnished by a nonparticipating hospital and services furnished in a foreign country. 410.66 Section 410.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI)...

  4. The Health Information Specialist: A New Resource for Hospital Library Services and Education Programs *

    PubMed Central

    Gold, Robert A.; Fink, Wendy Ratcliff; Stearns, Norman S.; Bloomquist, Harold

    1974-01-01

    Growing pressures for more effective education programs at community hospitals demand better and more responsive hospital library resources and services. It is suggested that, with a modest amount of additional training and support, a community hospital librarian can play a key role in (1) improving the effectiveness of the hospital's library services and resources, (2) assisting hospital educators with the task of developing, implementing, and evaluating education programs, and (3) facilitating coordination of health information resources and services with all aspects of hospital education programs. An expanded, more active role, that of the Health Information Specialist, is suggested for hospital librarians. A one-week training program for librarians and special orientation for hospital educators and administrators plus followup field consultation for all three is described and proposed as an implementation strategy to provide the background and impetus needed to help hospital librarians evolve and expand their functional role into that of a Health Information Specialist. PMID:4466504

  5. Factors and Models Associated with the amount of Hospital Care Services as Demanded by Hospitalized Patients: A Systematic Review

    PubMed Central

    van Oostveen, Catharina J.; Ubbink, Dirk T.; Huis in het Veld, Judith G.; Bakker, Piet J.; Vermeulen, Hester

    2014-01-01

    Background Hospitals are constantly being challenged to provide high-quality care despite ageing populations, diminishing resources, and budgetary restraints. While the costs of care depend on the patients' needs, it is not clear which patient characteristics are associated with the demand for care and inherent costs. The aim of this study was to ascertain which patient-related characteristics or models can predict the need for medical and nursing care in general hospital settings. Methods We systematically searched MEDLINE, Embase, Business Source Premier and CINAHL. Pre-defined eligibility criteria were used to detect studies that explored patient characteristics and health status parameters associated to the use of hospital care services for hospitalized patients. Two reviewers independently assessed study relevance, quality with the STROBE instrument, and performed data analysis. Results From 2,168 potentially relevant articles, 17 met our eligibility criteria. These showed a large variety of factors associated with the use of hospital care services; models were found in only three studies. Age, gender, medical and nursing diagnoses, severity of illness, patient acuity, comorbidity, and complications were the characteristics found the most. Patient acuity and medical and nursing diagnoses were the most influencing characteristics. Models including medical or nursing diagnoses and patient acuity explain the variance in the use of hospital care services for at least 56.2%, and up to 78.7% when organizational factors were added. Conclusions A larger variety of factors were found to be associated with the use of hospital care services. Models that explain the extent to which hospital care services are used should contain patient characteristics, including patient acuity, medical or nursing diagnoses, and organizational and staffing characteristics, e.g., hospital size, organization of care, and the size and skill mix of staff. This would enable healthcare managers

  6. Consequences of the North American Free Trade Agreement for health services: a perspective from Mexico.

    PubMed Central

    Frenk, J; Gómez-Dantés, O; Cruz, C; Chacón, F; Hernández, P; Freeman, P

    1994-01-01

    OBJECTIVES. The purposes of the study were to assess the potential impact of the North American Free Trade Agreement (NAFTA) on medical care in Mexico and to identify internal measures Mexico could take to increase the benefits and minimize the risks of free trade. METHODS. The dual nature of the health sector is examined; the Mexican, Canadian, and US health care systems are compared; and modes and consequences of international exchange of health services are analyzed. RESULTS. Four issues require immediate attention: accreditation of health care facilities, licensing and certification of professionals, technology assessment, and financial equity. CONCLUSIONS. NAFTA offers opportunities for positive developments in Mexico, provided risks can be anticipated and preventive measures can be taken to avoid negative impacts on the health system. Medical services, like other elements of the Mexican economy, must be modernized to respond to the demands of global competition. The Mexican National Academy of Medicine has recommended to the Mexican government (1) internal strengthening of the Mexican health care system to improve its ability to respond to the new conditions created by NAFTA and (2) a gradual process to facilitate equitable and mutually beneficial interactions among the three countries. PMID:7943476

  7. 42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Provision of emergency services by nonparticipating... General Provisions § 482.2 Provision of emergency services by nonparticipating hospitals. (a) The services..., nevertheless, be reimbursed under the program if— (1) The services are emergency services; and (2)...

  8. Access to hospitals with high-technology cardiac services: how is race important?

    PubMed Central

    Blustein, J; Weitzman, B C

    1995-01-01

    OBJECTIVES. Relatively few hospitals in the United States offer high-technology cardiac services (cardiac catheterization, bypass surgery, or angioplasty). This study examined the association between race and admission to a hospital offering those services. METHODS. Records of 11,410 patients admitted with acute myocardial infarction to hospitals in New York State in 1986 were analyzed. RESULTS. Approximately one third of both White and Black patients presented to hospitals offering high-technology cardiac services. However, in a multivariate model adjusting for home-to-hospital distance, the White-to-Black odds ratio for likelihood of presentation to such a hospital was 1.68 (95% confidence interval = 1.42, 1.98). This discrepancy between the observed and "distance-adjusted" probabilities reflected three phenomena: (1) patients presented to nearby hospitals; (2) Blacks were more likely to live near high-technology hospitals; and (3) there were racial differences in travel patterns. For example, when the nearest hospitals did not include a high-technology hospital, Whites were more likely than Blacks to travel beyond those nearest hospitals to a high-technology hospital. CONCLUSIONS. Whites and Blacks present equally to hospitals offering high-technology cardiac services at the time of acute myocardial infarction. However, there are important underlying racial differences in geographic proximity and tendencies to travel to those hospitals. PMID:7892917

  9. [Evaluation of emergency services of the hospitals from the QualiSUS program].

    PubMed

    O'Dwyer, Gisele Oliveira; de Oliveira, Sergio Pacheco; de Seta, Marismary Horsth

    2009-01-01

    The aid lent by the emergency services is the object of this paper, which aims to assess the emergency service of the QualiSUS program. The study is descriptive with the application of a questionnaire to the responsible of the emergency services in eight hospitals. The emergency services were always overcrowded, and the causes pointed were the low resolutivity of basic attention and the precariousness of the hospital network. Contributing to this there is the primary care decreased resolutivity and the precariousness of the hospital network. Six hospitals do not manage the emergency service. The entrance system is not organized and only three hospitals work with risk classification. All of them refer difficulties with internal and external services. The hardest pathologies to refer to other services are the chronicles, neurological and social. The professionals do not have specific qualification and the precariousness job contracts do not contribute neither for the professional's fixation nor for his qualification. Clinical protocols are used by one service. It was noticed the influence of the QualiSUS in the hospitals. The failure of the health services network interferes with the emergency patient's profile. The investment of the QualiSUS cannot be restrained to the hospital. Emergency should be more integrated to the system and hospital. The qualification of human resources is indispensable as well as the bed's regulation.

  10. "Trade creep" and implications of the Transatlantic Trade and Investment Partnership Agreement for the United Kingdom National Health Service.

    PubMed

    Koivusalo, Meri; Tritter, Jonathan

    2014-01-01

    The ambitious and comprehensive Transatlantic Trade and Investment Partnership Agreement (TTIP/TAFTA) agreement between the European Union and United States is now being negotiated and may have far-reaching consequences for health services. The agreement extends to government procurement, investment, and further regulatory cooperation. In this article, we focus on the United Kingdom National Health Service and how these negotiations can limit policy space to change policies and to regulate in relation to health services, pharmaceuticals, medical devices, and health industries. The negotiation of TTIP/TAFTA has the potential to "harmonize" more corporate-friendly regulation, resulting in higher costs and loss of policy space, an example of "trade creep" that potentially compromises health equity, public health, and safety concerns across the Atlantic.

  11. Commerce in health services in North America within the context of the North American Free Trade Agreement.

    PubMed

    Gómez-Dantés, O; Frenk, J; Cruz, C

    1997-06-01

    This article discusses the future of commercial trade in personal health services in North America within the context of the North American Free Trade Agreement (NAFTA) and the latter's potential influence on health care for the Mexican people. It begins by defining concepts related to international trade of services, particularly health services, and then proceeds to analyze elements of NAFTA that affect the delivery, regulation, and financing of such services, as well as their future trade within the NAFTA area. It concludes with some recommendations directed at helping Mexico's national health care system confront the risks posed while taking advantage of the opportunities offered by the Mexican economy's entry into a broader market.

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

    PubMed

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

    2009-01-01

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

  13. Hospital bodies: the genesis of Italian National Health Service.

    PubMed

    Vannelli, Alberto; Buongiorno, Massimo; Battaglia, Luigi; Poiasina, Elia; Boati, Paolo; Rampa, Mario; Leo, Ermanno

    2010-01-01

    Hospital public bodies were instituted in Italy in 1968. Their creation represents a fundamental step forward in the evolution of the national healthcare system and has allowed improvements in social equity in hospitals. The lack of independent funding beyond the insurance-type healthcare system existing at the time, hindered its success. The hospital body has however left a trace in the modern national healthcare system with the introduction of the hospital corporation.

  14. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... furnished to hospital outpatients. 410.42 Section 410.42 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.42 Limitations on coverage of certain services...

  15. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... furnished to hospital outpatients. 410.42 Section 410.42 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.42 Limitations on coverage of certain services...

  16. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... furnished to hospital outpatients. 410.42 Section 410.42 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.42 Limitations on coverage of certain services...

  17. Reference Materials and Services for a Small Hospital Library. 5th Revised Edition.

    ERIC Educational Resources Information Center

    Kesti, Julie, Comp.; Graham, Elaine, Comp.

    This manual suggests and describes recommended reference services and sources for a small hospital library. Focusing on reference services, the first section includes information on ready-reference services; bibliographic search services, including taking and processing a request for a bibliography, National Library of Medicine literature…

  18. Impact of the Pacific Southwest Regional Medical Library Service on hospital library development.

    PubMed Central

    Graham, E; Van Vuren, D D; Flack, V

    1987-01-01

    A study was designed to evaluate the progress of hospital libraries within Region 7 since the Pacific Southwest Regional Medical Library Services (PSRMLS) began in 1969. Library progress was defined as an increase in extent and types of services and resources offered. The study assessed the impact of Regional Medical Library programs on hospital libraries and compared resources and services reported in 1969, 1971, and 1984. The 1984 data were also measured against a set of core library services and resources that should be provided by a full-service hospital library. In addition to assessing the quality of PSRMLS programs and their effect on Region 7 hospital libraries, the study documented extensive growth in staffing, collection size, and services. PSRMLS programs were highly rated by the respondents, who also indicated that participation in PSRMLS programs improved specific library resources and services. PMID:3676532

  19. The 2012 derecho: emergency medical services and hospital response.

    PubMed

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

  20. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  1. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  2. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  3. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  4. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Hospital care and medical services in foreign countries. 17.35 Section 17.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  5. Personnel Training and Employment Needs of Hospital Food Services in Tennessee.

    ERIC Educational Resources Information Center

    Peay, Moiselle

    Personnel training and employment needs in connection with food service were studied through interviews with hospital administrators and food service managers in 25 selected Tennessee hospitals. Mentioned most often by managers as important were the areas of communications and human relations for all job classifications except food preparation,…

  6. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 7 2013-04-01 2013-04-01 false Cooperative hospital service organizations. 1... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Exempt Organizations § 1.501(e)-1 Cooperative hospital service organizations. (a) General rule. Section 501(e) is the exclusive and controlling...

  7. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Cooperative hospital service organizations. 1.501... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Exempt Organizations § 1.501(e)-1 Cooperative hospital service organizations. (a) General rule. Section 501(e) is the exclusive and controlling...

  8. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Community Mental Health Centers (CMHCs) Providing Partial Hospitalization Services § 410.110 Requirements... 42 Public Health 2 2013-10-01 2013-10-01 false Requirements for coverage of partial hospitalization services by CMHCs. 410.110 Section 410.110 Public Health CENTERS FOR MEDICARE & MEDICAID...

  9. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Community Mental Health Centers (CMHCs) Providing Partial Hospitalization Services § 410.110 Requirements... 42 Public Health 2 2012-10-01 2012-10-01 false Requirements for coverage of partial hospitalization services by CMHCs. 410.110 Section 410.110 Public Health CENTERS FOR MEDICARE & MEDICAID...

  10. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Community Mental Health Centers (CMHCs) Providing Partial Hospitalization Services § 410.110 Requirements... 42 Public Health 2 2011-10-01 2011-10-01 false Requirements for coverage of partial hospitalization services by CMHCs. 410.110 Section 410.110 Public Health CENTERS FOR MEDICARE & MEDICAID...

  11. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Community Mental Health Centers (CMHCs) Providing Partial Hospitalization Services § 410.110 Requirements... 42 Public Health 2 2014-10-01 2014-10-01 false Requirements for coverage of partial hospitalization services by CMHCs. 410.110 Section 410.110 Public Health CENTERS FOR MEDICARE & MEDICAID...

  12. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Community Mental Health Centers (CMHCs) Providing Partial Hospitalization Services § 410.110 Requirements... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements for coverage of partial hospitalization services by CMHCs. 410.110 Section 410.110 Public Health CENTERS FOR MEDICARE & MEDICAID...

  13. 42 CFR 136.30 - Payment to Medicare-participating hospitals for authorized Contract Health Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... prospective payment system (PPS) will be based on that PPS. For example, payment for inpatient hospital services shall be made per discharge based on the applicable PPS used by the Medicare program to pay for... based on a PPS used in the Medicare program to pay for similar hospital services under 42 CFR part...

  14. 78 FR 79451 - Service Corporation International, and Stewart Enterprises, Inc.; Analysis of Agreement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ... do not include cremation services because consumers generally do not substitute cremation services... based on their personal or religious views, these consumers do not view cremation services as a viable... would not switch to cremation services. Further, the competitive conditions for cremation services...

  15. Hospital customer service in a changing healthcare world: does it matter?

    PubMed

    Howard, J

    1999-01-01

    The healthcare industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of the patient population. Employers and health plans such as HMOs are demanding better service and higher quality care, and hospitals are trying to tackle reimbursement cutbacks, streamline services, and serve a diverse population. Hospitals have begun to realize that to overcome these obstacles and meet the needs of the health care plans and consumers, they must focus on the demands of the customer. Customer service initiatives increase patient satisfaction and loyalty and overall hospital quality, and many hospitals have found that consumer demands can be met through initiating and maintaining a customer service program. This article describes how the administrator can create, implement, and manage customer service initiatives within the hospital.

  16. Hospital ownership and medical services: market mix, spillover effects, and nonprofit objectives.

    PubMed

    Horwitz, Jill R; Nichols, Austin

    2009-09-01

    Hospitals operate in markets with varied demographic, competitive, and ownership characteristics, yet research on ownership tends to examine hospitals in isolation. Here we examine three hospital ownership types -- nonprofit, for-profit, and government -- and their spillover effects. We estimate the effects of for-profit market share in two ways, on the provision of medical services and on operating margins at the three types of hospitals. We find that nonprofit hospitals' medical service provision systematically varies by market mix. We find no significant effect of market mix on the operating margins of nonprofit hospitals, but find that for-profit hospitals have higher margins in markets with more for-profits. These results fit best with theories in which hospitals maximize their own output.

  17. A comparison of service predispositions between NHS nurses and hospitality workers.

    PubMed

    Lee-Ross, D

    1999-01-01

    The following study sought to develop an instrument to elicit the service predispositions of nurses and hospitality foodservice workers. Results of a pilot study suggested that the service predisposition instrument (SPI) was valid and therefore appropriate to investigate the service attitudes of these workers. Service predispositions of nurses from two NHS Trusts were compared with those of hospitality foodservice workers in two large hotels. Overall, both nurses and foodservice workers were found to have similar positive service predispositions. However, significant differences were present between groups for certain service dimensions.

  18. Concomitants of perceived trust in hospital and medical services following Hurricane Sandy.

    PubMed

    Ben-Ezra, Menachem; Goodwin, Robin; Palgi, Yuval; Kaniasty, Krzysztof; Crawford, Marsha Zibalese; Weinberger, Aviva; Hamama-Raz, Yaira

    2014-12-30

    The relationship between factors associated with perceived trust in hospital and medical services in the aftermath of a natural disaster is understudied. An online sample of 1000 people mainly from affected states was surveyed after Hurricane Sandy. Participants completed a survey which included disaster related questions and PTSD symptoms. Logistic regression revealed a significant association between perceived trust in hospital services to education, subjective well-being, being scared for the life of a loved one and perceived trust in emergency services. These findings may emphasis the positive association between maintaining active hospital services and mental health among the general population during crisis.

  19. The role of veterinary epidemiology and veterinary services in complying with the World Trade Organization SPS agreement.

    PubMed

    Zepeda, C; Salman, M; Thiermann, A; Kellar, J; Rojas, H; Willeberg, P

    2005-02-01

    The agreement on the application of sanitary and phytosanitary measures (SPS agreement) was one of the major products of the GATT's Uruguay round of multilateral trade negotiations, signed in Marrakesh on 15 April 1994. This agreement and others are part of the treaty that established the World Trade Organization (WTO). The WTO superseded the GATT as the umbrella organization for international trade (WTO, 1998a). The SPS agreement's main intent is to provide guidelines and provisions to member countries to facilitate trade while taking measures to protect human, animal or plant life or health. The agreement dictates that all sanitary measures must be scientifically based and not more restrictive than required to avoid the risk identified. The agreement recommends the use of international standards from the World Organization for Animal Health (OIE), Codex Alimentarius (CAC) and the International Plant Protection Convention (IPPC) as the basis for import requirements. If a country chooses to apply more restrictive measures than those in the international standards, it has to justify its position through a risk analysis, thus avoiding the use of sanitary and phytosanitary measures as unjustified barriers to trade. More than ever, veterinary services worldwide are faced with having to fulfill a crucial role in protecting their country's animal health status, provide sound surveillance information on the occurrence of diseases within their territories, and conduct scientifically valid risk analyses to establish justified import requirements. During the past two decades, most countries have experienced resource reduction in their veterinary services. The effect of these policies has been severe, in many cases leading to an inability of veterinary services to conduct their disease prevention and control duties. There is a clear inconsistency between the demands placed on veterinary services and the current level of funding and support they are receiving, particularly in

  20. 77 FR 2974 - Yuba County Water Agency; Notice of Proposed Restricted Service List for a Programmatic Agreement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Yuba County Water Agency; Notice of Proposed Restricted Service List for a Programmatic Agreement for Managing Properties Included in or Eligible for Inclusion in the National Register of Historic Places Rule 2010 of...

  1. 38 CFR 51.41 - Contracts and provider agreements for certain veterans with service-connected disabilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF... may enter into both contracts and provider agreements. VA will pay for each eligible veteran's care... are those who: (1) Are in need of nursing home care for a VA adjudicated service-connected...

  2. 38 CFR 51.41 - Contracts and provider agreements for certain veterans with service-connected disabilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF... may enter into both contracts and provider agreements. VA will pay for each eligible veteran's care... are those who: (1) Are in need of nursing home care for a VA adjudicated service-connected...

  3. 78 FR 69848 - Birch Power Company; Notice of Proposed Revised Restricted Service List for a Programmatic Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-21

    ..., the Secretary may establish a restricted service list for a particular phase or issue in a proceeding... phase or issue in the proceeding for which the list is established. The Commission staff is consulting...) Nation. For purposes of commenting on the Programmatic Agreement, we propose to make changes to...

  4. 18 CFR 154.204 - Changes in rate schedules, forms of service agreements, or the general terms and conditions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Changes in rate... REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Procedures for Changing Tariffs § 154.204 Changes in rate schedules, forms of service agreements, or the general terms and conditions. A filing...

  5. An Analysis of Purchasing and Cooperative Agreements among School Corporations, Charter Schools, and Education Service Centers. Special Report

    ERIC Educational Resources Information Center

    Hiller, Stephen C.; Spradlin, Terry E.

    2007-01-01

    Under IC 21-10-3, the Indiana State Board of Education is required to submit a report by November 1st of each year to the state superintendent, governor, and Indiana General Assembly concerning: (1) Consolidated purchasing agreements by school corporations, charter schools, or by Education Service Centers (ESCs) on behalf of member school…

  6. Student-Led Services in a Hospital Aged Care Temporary Stay Unit: Sustaining Student Placement Capacity and Physiotherapy Service Provisions

    ERIC Educational Resources Information Center

    Nicole, Madelyn; Fairbrother, Michele; Nagarajan, Srivalli Vilapakkam; Blackford, Julia; Sheepway, Lyndal; Penman, Merrolee; McAllister, Lindy

    2015-01-01

    Through a collaborative university-hospital partnership, a student-led service model (SLS-model) was implemented to increase student placement capacity within a physiotherapy department of a 150 bed Sydney hospital. This study investigates the perceived barriers and enablers to increasing student placement capacity through student-led services…

  7. Competition among Turkish hospitals and its effect on hospital efficiency and service quality.

    PubMed

    Torun, Nazan; Celik, Yusuf; Younis, Mustafa Z

    2013-01-01

    The level of competition among hospitals in Turkey was analyzed for the years 1990 through 2006 using the Herfindahl-Hirschman Index (HHI). Multiple and simple regression analyses were run to observe the development of competition among hospitals over this period of time, to examine likely determinants of competition, and to calculate the effects of competition on efficiency and quality in individual hospitals. This study found that the level of competition among hospitals in Turkey has increased throughout the years. Also, competition has had a positive effect on the efficiency of hospitals; however, it did not have a significant positive effect on their quality. Moreover, there are important differences in the level of competition among hospitals that vary according to the geographical region, the type of ownership, and the type of hospital. This study is one of the first to evaluate the effects of health policies on competition as well as the effects of increasing competition on hospital quality and efficiency in Turkey.

  8. Proposed standards for professional health sciences library services in hospitals of New York State.

    PubMed Central

    Hutchinson, A P; O'Connell, M; Richards, B B; Thompson, J L; Wheeler, R A

    1981-01-01

    Hospital libraries are considered to be the basic unit of the medical information system. A major statewide effort was begun in 1978 to introduce and support legislation in the New York State Legislature which would encourage hospitals to establish and maintain libraries that meet minimum services standards. Included in this legislation is the concept that the Commissioner of Education in consultation with the Commissioner of Health shall have the power to establish standards for hospital libraries. The Ad Hoc Committee for the Promotion of Hospital Library Services, Western New York Library Resources Council, proposes The Standards for Professional Health Sciences Library Services in Hospitals of New York State to clarify and to strengthen existing hospital library standards. These standards differ specifically from the Joint Commission on Accreditation of Hospitals standards in that they place equal and specific emphasis on eleven points: administration, qualifications of library staff, continuing education of library staff, requirement for a library advisory committee, required library services, required library resources, library space requirements, library budget, library network and consortium membership, documentation of library policy, and continued evaluation of the needs of the hospital for library service. Detailed interpretations are provided. An appendix describes the qualifications of a hospital library consultant. PMID:7248591

  9. Risk Factors for Psychiatric Hospital Admission for Participants in California's Full-Service Partnership Program.

    PubMed

    Penkunas, Michael J; Hahn-Smith, Stephen

    2016-08-01

    This study investigated the demographic and clinical predictors of psychiatric hospitalization during the first 2 years of treatment for adults participating in the full-service partnership (FSP) program, based on Assertive Community Treatment, in a large county in northern California. Clinical and demographic characteristics, data on prior hospitalizations, length of enrollment, and living situation for 328 FSP participants were collected from the county's internal billing system and the California Department of Health Care Services. In univariate models, the probability of hospitalization varied by diagnosis, age, and hospitalization history. In the multivariate model, younger age and frequent hospitalization prior to enrollment predicted hospitalization during enrollment. Findings support prior research on hospital recidivism and may be beneficial in refining future strategies for meeting the needs of adults with serious mental illness.

  10. Hospital competition and inpatient services efficiency in Taiwan: a longitudinal study.

    PubMed

    Chu, Chiao-Lee; Chiang, Tung-Liang; Chang, Ray-E

    2011-10-01

    There is no consistent evidence of the relationship between market competition and hospital efficiency. Some studies indicated that more competition led to a faster patient turnover rate, higher hospital costs, and lower hospital efficiency. Since the 1980s some studies found market competition could increase the efficiency of inpatient services. However, there were few studies testing the market competition during a hospital's earlier stages on its efficiency during later stages, or the dynamic of efficiency. In this study, we examined the effect of early-stage market competition on later-stage hospital efficiency in Taiwan, and we determine the efficiency change using longitudinal study design. The data for the analysis came from the annual national hospital survey of 1996 and 2001 provided by the Department of Health. There were 102 teaching hospital be analysed. The results show that no evidence supports the proposition that higher market competition would improve the efficiency of hospitals in delivering inpatient services in Taiwan. Importantly, neither was the inefficiency score nor the Malmquist productivity index of inpatient services associated with the level of hospital market competition, regardless of the adjustment for hospital characteristics. However, the results may be related with the hospital increasing beds investment behavior.

  11. Cloud-based hospital information system as a service for grassroots healthcare institutions.

    PubMed

    Yao, Qin; Han, Xiong; Ma, Xi-Kun; Xue, Yi-Feng; Chen, Yi-Jun; Li, Jing-Song

    2014-09-01

    Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance.

  12. 18 CFR 35.1 - Application; obligation to file rate schedules, tariffs and certain service agreements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... jurisdiction of this Commission, the classifications, practices, rules and regulations affecting such rates, charges, classifications, services, rules, regulations or practices, as required by section 205(c) of the... as providing for other or additional rates, charges, classifications or services, or...

  13. 18 CFR 35.1 - Application; obligation to file rate schedules, tariffs and certain service agreements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... jurisdiction of this Commission, the classifications, practices, rules and regulations affecting such rates, charges, classifications, services, rules, regulations or practices, as required by section 205(c) of the... as providing for other or additional rates, charges, classifications or services, or...

  14. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or...

  15. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or...

  16. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or...

  17. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or...

  18. [Surgical service at the Central Military Hospital of People's Commissariat of Defence shortly before the Great Patriotic War].

    PubMed

    Krainyukov, P E; Efimenko, N A; Abashin, V G

    2015-04-01

    Authors present the article historical data on the foundation and development of surgical service at the 1st Therapeutic Red Cross Hospital (Central Military Hospital of People's Commissariat. of Defense) since its organization. The structure of the hospital surgical service and organization of surgical activity during the pre-war years is presented. Provided information about outstanding surgeons who was working in the hospital.

  19. [Evaluation of financial status of public hospitals considering the updated costs of their services].

    PubMed

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

    In 2011 the Chilean National Health Fund (FONASA) commissioned a study to assess the costs of the 120 most relevant hospital care services with an established fee, in a large sample of public hospitals. We herein report the cost evaluation results of such study, considering the financial condition of those hospitals in the year of the study. Based on the premise that the expenses derived from the provision of institutional and appraised hospital services should be identical to the billing of hospitals to FONASA, the prices are undervalued, since they cover only 56% of billing, generating a gap between expenses and invoicing. This gap shows an important limitation of tariffs, since their prices do not cover the real costs. However not all hospitals behave in the same way. While the provision of services of some hospitals is even higher than their billing, most hospitals do not completely justify their invoicing. These assumptions would imply that, generally speaking, hospital debts are justified by the costs incurred. However, hospitals have heterogeneous financial situations that need to be analyzed carefully. In particular, nothing can be said about their relative efficiency if cost estimations are not adjusted by the complexity of patients attended and comparison groups are not defined.

  20. Rural hospitals: a literature synthesis and health services research agenda.

    PubMed Central

    Moscovice, I S

    1989-01-01

    The economic decline of rural America and an inability to respond to pressures created by the evolving American health care system are making it increasingly hard for rural hospitals to survive. PMID:2645251

  1. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  2. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  3. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  4. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  5. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... AFFAIRS MEDICAL Use of Department of Defense, Public Health Service Or Other Federal Hospitals § 17.50 Use of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to...

  6. Characteristics of acute care hospitals with diversity plans and translation services.

    PubMed

    Moseley, Charles B; Shen, Jay J; Ginn, Gregory O

    2011-01-01

    Hospitals provide diversity activities for a number of reasons. The authors examined community demand, resource availability, managed care, institutional pressure, and external orientation related variables that were associated with acute care hospital diversity plans and translation services. The authors used multiple logistic regression to analyze the data for 478 hospitals in the 2006 National Inpatient Sample (NIS) dataset that had available data on the racial and ethnic status of their discharges. We also used 2004 and 2006 American Hospital Association (AHA) data to measure the two dependent diversity variables and the other independent variables. We found that resource, managed care, and external orientation variables were associated with having a diversity plan and that resource, managed care, institutional, and external orientation variables were associated with providing translation services. The authors concluded that more evidence for diversity's impact, additional resources, and more institutional pressure may be needed to motivate more hospitals to provide diversity planning and translation services.

  7. [Pharmaceutical Service after the Fukushima Disaster: A Case Report of Soma General Hospital].

    PubMed

    Fukunaga, Hisanori; Momonoi, Toshiyuki; Kumakawa, Hiromi

    2016-01-01

      Despite being damaged by the 2011 Tohoku earthquake, tsunami, and nuclear disaster, Soma General Hospital, located approximately 40 km north of Fukushima Daiichi nuclear power plant, was able to fulfill its role as a key regional hospital in northeast Fukushima. To elucidate the pharmaceutical service in response to the disaster, we investigated the hospital's operations in 2011 according to the medical records and prescriptions. One of the difficulties that the department of pharmaceutical service faced at that time was the increase in emergency healthcare requests by evacuated patients from other hospitals and clinics. Herein, we propose the following countermeasures to be considered in future disaster preparations: (1) establishing a medical and pharmaceutical service coordinator for disaster relief; (2) sharing all local patients' medical information in emergencies (at least contraindicated drugs or allergy history); and (3) reviewing disaster stockpiles, especially pharmaceuticals (both at the hospital and in nearby locations).

  8. Pediatric Hospital School Programming: An Examination of Educational Services for Students Who Are Hospitalized

    ERIC Educational Resources Information Center

    Steinke, Sarah M.; Elam, Megan; Irwin, Mary Kay; Sexton, Karen; McGraw, Anne

    2016-01-01

    This study aimed to define the current functions and operations of hospital school programs nationwide. A 56-item survey was disseminated to hospital teachers across the country to examine perceptions about their work, programs, and professional practice. Quantitative findings were analyzed using descriptive statistics at the individual…

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

    PubMed Central

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

    2015-01-01

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

  10. 9 CFR 354.109 - Fees or charges for inspection service performed under cooperative agreement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND...

  11. 42 CFR 424.122 - Conditions for payment for emergency inpatient hospital services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... hospital services, the beneficiary was— (1) In the United States; or (2) In Canada traveling between Alaska... was closer to, or more accessible from, the site of the emergency than the nearest United...

  12. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar...

  13. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar...

  14. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... illustrated by the following example. Example. An organization performs industrial engineering services on a...-hospitals), warehousing, billing and collection, food, clinical (including radiology), industrial engineering (including the installation, maintenance and repair of biomedical and similar...

  15. Importance-performance analysis as a guide for hospitals in improving their provision of services.

    PubMed

    Whynes, D K; Reed, G

    1995-11-01

    As a result of the 1990 National Health Services Act, hospitals now compete with one another to win service contracts. A high level of service quality represents an important ingredient of a successful competitive strategy, yet, in general, hospitals have little external information on which to base quality decisions. Specifically, in their efforts to win contracts from fundholding general practitioners, hospitals require information on that which these purchasers deem important with respect to quality, and on how these purchasers assess the quality of their current service performance. The problem is complicated by the fact that hospital service quality, in itself, is multi-dimensional. In other areas of economic activity, the information problem has been resolved by importance-performance analysis and this paper reports the findings of such an analysis conducted for hosptials in the Trent region. The importance and performance service quality ratings of fundholders were obtained from a questionnaire survey and used in a particular variant of importance-performance analysis, which possesses certain advantages over more conventional approaches. In addition to providing empirical data on the determinants of service quality, as perceived by the purchasers of hospital services, this paper demonstrates how such information can be successfully employed in a quality enhancement strategy.

  16. 75 FR 42486 - Financial Management Service; Proposed Collection of Information: Authorization Agreement for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ... for Preauthorized Payment (SF 5510) AGENCY: Financial Management Service, Fiscal Service, Treasury...: Pursuant to the Paperwork Reduction Act of 1995, (44 U.S.C. 3506(c)(2)(A)), the Financial Management... for Preauthorized Payment. OMB Number: 1510-0059. Form Number: SF 5510. Abstract: This form is used...

  17. 75 FR 17407 - Service Corporation International and Keystone North America Inc.; Analysis of Agreement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ... promotion, marketing, sale, and provision of funeral services and goods, including, but not limited to... disposition of human remains. Cemetery services include all activities relating to the promotion, marketing... benefitted from the rivalry between SCI and KNA in the form of lower prices, improved products, and...

  18. 77 FR 37036 - Alabama Power Company; Notice of Revised Restricted Service List for a Programmatic Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...-013--Alabama Holt Hydroelectric Project] Alabama Power Company; Notice of Revised Restricted Service... inclusion in, the National Register of Historic Places at the Holt Hydroelectric Project. The PA, when... established a restricted service list for the Holt Hydroelectric Project. On June 6, 2012, the Jena Band...

  19. Treating Family Violence in a Pediatric Hospital: A Program of Training, Research, and Services.

    ERIC Educational Resources Information Center

    White, Kathleen M.; And Others

    This monograph describes a project developed at Children's Hospital of Boston as an innovative, exemplary program of training, research, and services for the treatment of family violence in a pediatric hospital, with a particular focus on child abuse and neglect. Chapter 1 explains why it is important to study the area of family violence,…

  20. 38 CFR 17.49 - Priorities for outpatient medical services and inpatient hospital care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Priorities for outpatient medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities...

  1. 38 CFR 17.49 - Priorities for outpatient medical services and inpatient hospital care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Priorities for outpatient medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities...

  2. 38 CFR 17.49 - Priorities for outpatient medical services and inpatient hospital care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Priorities for outpatient medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities...

  3. 38 CFR 17.49 - Priorities for outpatient medical services and inpatient hospital care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Priorities for outpatient medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities...

  4. 38 CFR 17.49 - Priorities for outpatient medical services and inpatient hospital care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Priorities for outpatient medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities...

  5. Information for integration. A senior services program spurs development of a multi-hospital integrated network.

    PubMed

    Sampsel, D; McNichols, S; Kordash, R D; Bonitati, D

    1994-09-01

    In 1985 St. Charles Hospital, Oregon, OH, and Mercy Hospital of Toledo, OH, launched a plan to jointly offer a continuum of services to area seniors. A multidisciplinary team of professionals from both hospitals decided that a membership program (titled the Senior Advantage Program) would be the most effective way to market the services and make them available. As part of the program's development, professionals from the two facilities created a personal computer-based software package that enabled them to capture and update information about Senior Advantage participants. The software program includes a detailed application form and a section for recording enrollees' service utilization. The program enables care givers to enter data when they interact with clients in any healthcare or community-based setting. To complement the personal computer software, a program to construct a central data base was written for the two hospitals' main computer systems. In 1991 St. Charles and Mercy hospitals joined two other facilities to form First InterHealth Network, a for-profit integrated delivery network. The Senior Advantage Program became the basis for the first package of services offered by First InterHealth. In 1992 the program became the catalyst for yet another collaborative venture, linking two rural Ohio Mercy hospitals to St. Charles and Mercy hospitals. The expanded network encouraged rural patients to remain within the Mercy network, utilizing inner-city and suburban Mercy-sponsored hospitals when appropriate.

  6. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services furnished in a teaching hospital. (g) Aggregate per diem methods of apportionment—(1) For the... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN...

  7. 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...

  8. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required...

  9. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false UR plan required for inpatient mental hospital... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required...

  10. Saint Anthony Hospital: Infusing Developmental and Family Support Services in Community-Based Medical Practice

    ERIC Educational Resources Information Center

    Casas, Paula; Isarowong, Nucha

    2015-01-01

    Physicians affiliated with small community hospitals face numerous barriers to using developmentally oriented best practices in primary care with young children. Saint Anthony Hospital's Developmental Support Project model promotes improved developmental outcomes for children through two complementary strands of services: (a) training and…

  11. The key to health services in Turkey: new perspectives on leadership and hospital management.

    PubMed

    Sahin, Alper A

    2014-01-01

    Health services are one of the most important criteria for making a country function. Turkey has mobilized all of its resources to provide high-quality, easily accessible and patient-friendly services for its population. To achieve this aim, the Turkish health care system has been undergoing a significant transformation through its Health Transformation Programme begun in 2005. The reforms focus on the introduction of a general health insurance system, changing hospital health services, improvements in hospital management and transformational leadership skills. Firstly, all state-run hospitals in the country were merged under the same umbrella, giving millions of people covered by the national security agency access to all of these hospitals. Secondly, all drugs and medical equipment used by patients were made free of charge. Thanks to these developments, hospitals were modernized, and this modernization process in the health sector is still continuing swiftly. On the other hand, for Turkish hospitals to survive, they need to modernize further and become closer to European models, and produce new leaders with new paradigms. In this new and changing health system, hospital leaders and executive officers should be visionaries and strategists advising when to change direction. Following this doctrine, most Turkish hospitals are now run by two top executives: the hospital manager and the chief executive officer who is in charge of business functions. These executives should clearly be the leaders of high-quality, health care organizations.

  12. Depot Sales of Goods and Services to Private Parties: Pricing in Partnering Agreements

    DTIC Science & Technology

    2003-07-01

    Public - private partnerships are agreements among organic depot maintenance activities and private industries or other entities to perform work or...shared risk than less collaborative business arrangements. Because the effort to build strong public - private partnerships within the Department of Defense

  13. Medicare program; prospective payment system for hospital outpatient services--HCFA. Proposed rule.

    PubMed

    1998-09-08

    As required by sections 4521, 4522, and 4523 of the Balanced Budget Act of 1997, this proposed rule would eliminate the formula-driven overpayment for certain outpatient hospital services, extend reductions in payment for costs of hospital outpatient services, and establish in regulations a prospective payment system for hospital outpatient services (and for Medicare Part B services furnished to inpatients who have no Part A coverage). The prospective payment system would simplify our current payment system and apply to all hospitals, including those that are excluded from the inpatient prospective payment system. The Balanced Budget Act provides for implementation of the prospective payment system effective January 1, 1999, but delays application of the system to cancer hospitals until January 1, 2000. The hospital outpatient prospective payment system would also apply to partial hospitalization services furnished by community mental health centers. Although the statutory effective date for the outpatient prospective payment system is January 1, 1999, implementation of the new system will have to be delayed because of year 2000 systems concerns. The demands on intermediary bill processing systems and HCFA internal systems to become compliant for the year 2000 preclude making the major systems changes that are required to implement the prospective payment system. The outpatient prospective payment system will be implemented for all hospitals and community mental health centers as soon as possible after January 1, 2000, and a notice of the anticipated implementation date will be published in the Federal Register at least 90 days in advance. This document also proposes new requirements for provider departments and provider-based entities. These proposed changes, as revised based on our consideration of public comments, will be effective 30 days after publication of a final rule. This proposed rule would also implement section 9343(c) of the Omnibus Budget

  14. Third-party reimbursement of therapeutic recreation services within a national sample of United States hospitals.

    PubMed

    Teaff, J D; Van Hyning, T E

    1988-01-01

    The purpose of this study was to determine the status of third-party reimbursement for therapeutic recreation services within three types of hospital classifications: Government, nonfederal (GNF); non-government, not-for-profit (NFP); and investor-owned (IO). A sample of 580 hospitals was drawn by the American Hospital Association through a randomly selected, proportionate sample from the universe of 5,799 GNF, NFP, and IO hospitals. Three hundred-twenty hospitals (55.2 percent) returned usable instruments. Based upon the analysis of 33 therapeutic recreation services approved for third-party reimbursement, it was found that: Significantly more therapeutic recreation directors who gave financing a higher priority tended to direct programs whose services were approved for third-party reimbursement; significantly more therapeutic recreation services were successful in their efforts to obtain third-party reimbursement even though they were denied approval in their initial efforts and approaches to obtain third-party reimbursement; and significantly more IO hospitals with therapeutic recreation services were approved for third-party reimbursement than either GNF or NFP therapeutic recreation services.

  15. The optimal design of service level agreement in IAAS based on BDIM

    NASA Astrophysics Data System (ADS)

    Liu, Xiaochen; Zhan, Zhiqiang

    2013-03-01

    Cloud Computing has become more and more prevalent over the past few years, and we have seen the importance of Infrastructure-as-a-service (IaaS). This kind of service enables scaling of bandwidth, memory, computing power and storage. But the SLA in IaaS also faces complexity and variety. Users also consider the business of the service. To meet the most users requirements, a methodology for designing optimal SLA in IaaS from the business perspectives is proposed. This method is different from the conventional SLA design method, It not only focuses on service provider perspective, also from the customer to carry on the design. This methodology better captures the linkage between service provider and service client by considering minimizing the business loss originated from performance degradation and IT infrastructure failures and maximizing profits for service provider and clients. An optimal design in an IaaS model is provided and an example are analyzed to show this approach obtain higher profit.

  16. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM... services that meet the requirements of § 415.102(a) of this chapter for payment on a fee schedule basis. (b... in section 1861(v)(1)(U) of the Act, or, if applicable, the fee schedule established under...

  17. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-09

    ... the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period... deductible); and the daily coinsurance for the 21st through 100th day of extended care services in a skilled... Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers for Medicare & Medicaid...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the Act. (c) Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Act. (d...) Services for patients with ESRD that are paid under the ESRD composite rate and drugs and supplies furnished during dialysis but not included in the composite rate. (n) Services and procedures that...

  19. A new customer service partnership for hospitals and physicians.

    PubMed

    Sanford, Kathleen D

    2011-12-01

    To promote better customer service, clinical and finance leaders should work as partners to: Make customer service as important a goal as clinical quality. Educate staff on better communication with patients and families. Perform a root-cause analysis to identify problem trends.

  20. Implementation of an Acute Care Surgery Service in a Community Hospital: Impact on Hospital Efficiency and Patient Outcomes.

    PubMed

    Kalina, Michael

    2016-01-01

    A service led by acute care surgeons managing trauma, critically ill surgical, and emergency general surgery patients via an acute care surgery model of patient care improves hospital efficiency and patient outcomes at university-affiliated hospitals and American College of Surgeons-verified trauma centers. Our goal was to determine whether an acute care surgeon led service, entitled the Surgical Trauma and Acute Resuscitative Service (STARS) that implemented an acute care surgery model of patient care, could improve hospital efficiency and patient outcomes at a community hospital. A total of 492 patient charts were reviewed, which included 230 before the implementation of the STARS [pre-STARS (control)] and 262 after the implementation of the STARS [post-STARS (study)]. Demographics included age, gender, Acute Physiology and Chronic Health Evaluation 2 score, and medical comorbidities. Efficiency data included length of stay in emergency department (ED-LOS), length of stay in surgical intensive care unit (SICU-LOS), and length of stay in hospital (H-LOS), and total in hospital charges. Average age was 64.1 + 16.4 years, 255 males (51.83%) and 237 females (48.17%). Average Acute Physiology and Chronic Health Evaluation 2 score was 11.9 + 5.8. No significant differences in demographics were observed. Average decreases in ED-LOS (9.7 + 9.6 hours, pre-STARS versus 6.6 + 4.5 hours, post-STARS), SICU-LOS (5.3 + 9.6 days, pre-STARS versus 3.5 + 4.8 days, post-STARS), H-LOS (12.4 + 12.7 days, pre-STARS versus 11.4 + 11.3 days, post-STARS), and total in hospital charges ($419,602.6 + $519,523.0 pre-STARS to $374,816.7 + $411,935.8 post-STARS) post-STARS. Regression analysis revealed decreased ED-LOS-2.9 hours [P = 0.17; 95% confidence interval (CI): -7.0, 1.2], SICU-LOS-6.3 days (P < 0.001; 95% CI: -9.3, -3.2), H-LOS-7.6 days (P = 0.001; 95% CI: -12.1, -3.1), and 3.4 times greater odds of survival (P = 0.04; 95% CI: 1.1, 10.7) post-STARS. In conclusion, implementation of

  1. Improving service quality in NHS Trust hospitals: lessons from the hotel sector.

    PubMed

    Desombre, T; Eccles, G

    1998-01-01

    This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.

  2. 7 CFR 70.78 - Fees or charges for grading service performed under cooperative agreement.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF POULTRY PRODUCTS AND RABBIT PRODUCTS Grading of Poultry Products and Rabbit Products Fees and Charges § 70.78 Fees or charges for grading service performed...

  3. 7 CFR 70.78 - Fees or charges for grading service performed under cooperative agreement.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF POULTRY PRODUCTS AND RABBIT PRODUCTS Grading of Poultry Products and Rabbit Products Fees and Charges § 70.78 Fees or charges for grading service performed...

  4. 7 CFR 70.78 - Fees or charges for grading service performed under cooperative agreement.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF POULTRY PRODUCTS AND RABBIT PRODUCTS Grading of Poultry Products and Rabbit Products Fees and Charges § 70.78 Fees or charges for grading service performed...

  5. 7 CFR 70.78 - Fees or charges for grading service performed under cooperative agreement.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF POULTRY PRODUCTS AND RABBIT PRODUCTS Grading of Poultry Products and Rabbit Products Fees and Charges § 70.78 Fees or charges for grading service performed...

  6. 7 CFR 70.78 - Fees or charges for grading service performed under cooperative agreement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF POULTRY PRODUCTS AND RABBIT PRODUCTS Grading of Poultry Products and Rabbit Products Fees and Charges § 70.78 Fees or charges for grading service performed...

  7. 77 FR 65024 - New Postal Product and Related Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... F. It maintains that the redacted portions of the contract, customer- identifying information, and... structure, underlying costs and assumptions, pricing formulas, information relevant to the customer's mailing profile, and cost coverage projections. Id. The Postal Service asks the Commission to...

  8. Hospitality and Facility Care Services. Ohio's Competency Analysis Profile.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for hospitality and facility care occupations. The list contains units (with and without subunits), competencies, and…

  9. Action Research on Development and Application of Internet of Things Services in Hospital

    PubMed Central

    Park, Arum; Chang, Hyejung

    2017-01-01

    Objectives Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals. Methods Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases. Results During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively. Conclusions From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital. PMID:28261528

  10. The value-added services of hospital-based radiology groups.

    PubMed

    Rao, Vijay M; Levin, David C

    2011-09-01

    The authors discuss the ways in which a single, cohesive, on-site radiology group adds value to both the processes of patient care and the success of the hospital. The value-added services fall into 6 categories: (1) patient safety, (2) quality of the images, (3) quality of the interpretations, (4) service to patients and referring physicians, (5) cost containment, and (6) helping build the hospital's business. If the hospital allows its radiology department to become fragmented by the intrusion of other specialists or teleradiology companies in remote locations, most of these added values would be lost, and chaos could ensue.

  11. Pediatric hospital dermatology: experience with inpatient and consult services at the Mayo Clinic.

    PubMed

    Storan, Eoin R; McEvoy, Marian T; Wetter, David A; el-Azhary, Rokea A; Hand, Jennifer L; Davis, Dawn M R; Bridges, Alina G; Camilleri, Michael J; Davis, Mark D P

    2013-01-01

    Data describing the management of pediatric patients admitted to a hospital under the care of a dermatologist and dermatology hospital consults for pediatric inpatients are limited. We aim to describe the role of an inpatient hospital service jointly run by dermatology and pediatrics and the activities of a pediatric dermatology hospital consult service. We retrospectively identified pediatric (age < 18 yrs) dermatology inpatients and hospital consult patients from January 1, 2009, through December 31, 2010. We examined patient demographics, indications for admission, length of stay, treatment provided, consult-requesting service, and consult diagnosis. One hundred eight admissions were by a dermatologist. The mean age was 5.8 years; the median length of stay was 3 days. Indications for admission included atopic dermatitis (86.1%), psoriasis (3.7%), and eczema herpeticum (2.8%). The main treatment provided was wet dressings (97.2%). Eighty-three dermatology hospital consults were requested. The mean age was 7.4 years. The main indications for dermatology consultation included drug rash (12.1%), cutaneous infections (12.1%), contact dermatitis (9.6%), psoriasis (8.4%), atopic dermatitis (6.0%), and hemangiomas (6.0%). This study describes the utility of the hospital pediatric dermatology inpatient and consult services in treating patients with severe skin disease.

  12. Hippi Care Hospital: Towards Proactive Business Processes in Emergency Room Services. Teaching Case

    ERIC Educational Resources Information Center

    Tan, Kar Way; Shankararaman, Venky

    2014-01-01

    It was 2:35 am on a Saturday morning. Wiki Lim, process specialist from the Process Innovation Centre (PIC) of Hippi Care Hospital (HCH), desperately doodling on her notepad for ideas to improve service delivery at HCH's Emergency Department (ED). HCH has committed to the public that its ED would meet the service quality criterion of serving 90%…

  13. Food Services and Hospitality for 10th, 11th, and 12th Grades. Course Outline.

    ERIC Educational Resources Information Center

    Bucks County Technical School, Fairless Hills, PA.

    The outline describes the food services and hospitality course offered to senior high school students at the Bucks County Technical School. Specifically, the course seeks to provide students with a workable knowledge of food services and foster in them a sense of personal pride for quality workmanship. In addition to a statement of the philosophy…

  14. 42 CFR 410.28 - Hospital or CAH diagnostic services furnished to outpatients: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS...). (d) Rules on emergency services furnished to outpatients by nonparticipating hospitals are set forth..., “direct supervision” means the physician must be present in the off-campus provider-based department...

  15. 26 CFR 1.513-6 - Certain hospital services not unrelated trade or business.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Certain hospital services not unrelated trade or business. 1.513-6 Section 1.513-6 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Taxation of Business Income of Certain...

  16. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... hospice benefit: (1) Antigens. (2) Splints and casts. (3) Hepatitis B vaccine. (e) Effective January 1... prospective payment system for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered...

  17. 42 CFR 419.21 - Hospital services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... (2) Splints and casts. (3) Hepatitis B vaccine. (e)(1) Effective January 1, 2005 through December 31... for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered under Medicare Part...

  18. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... hospice benefit: (1) Antigens. (2) Splints and casts. (3) Hepatitis B vaccine. (e)(1) Effective January 1... prospective payment system for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered...

  19. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hospice benefit: (1) Antigens. (2) Splints and casts. (3) Hepatitis B vaccine. (e)(1) Effective January 1... prospective payment system for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered...

  20. 42 CFR 419.21 - Hospital services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... (2) Splints and casts. (3) Hepatitis B vaccine. (e)(1) Effective January 1, 2005 through December 31... for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered under Medicare Part...

  1. Patient Views on Three Key Service Areas within Hospital COPD Care

    ERIC Educational Resources Information Center

    Roberts, C. Michael; Seiger, Anil; Ingham, Jane

    2009-01-01

    Objective: The views of patients with Chronic Obstructive Pulmonary Disease (COPD) about three key services (non-invasive ventilation [NIV], early discharge schemes and rehabilitation) were sought in order to inform recommendations for the delivery of optimum care within a national programme of hospital COPD service development. Design: Four focus…

  2. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE...) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment...

  3. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE...) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment...

  4. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE...) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment...

  5. 42 CFR 410.28 - Hospital or CAH diagnostic services furnished to outpatients: Conditions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... where the procedure is performed. (2) For services furnished under arrangement in nonhospital locations... 42 Public Health 2 2014-10-01 2014-10-01 false Hospital or CAH diagnostic services furnished to outpatients: Conditions. 410.28 Section 410.28 Public Health CENTERS FOR MEDICARE & MEDICAID...

  6. How Does Degree of Rurality Impact the Provision of Surgical Services at Rural Hospitals?

    ERIC Educational Resources Information Center

    Doty, Brit; Zuckerman, Randall; Finlayson, Samuel; Jenkins, Paul; Rieb, Nathaniel; Heneghan, Steven

    2008-01-01

    Context: Rural residents frequently have decreased access to surgical services. Consequences of this situation include increased travel time and financial costs for patients. There are also economic implications for hospitals as they may lose revenue when patients leave the area in order to obtain surgical services. Rural communities vary in size…

  7. Hospital takes customer service to new level, sees positive effect on bottom line.

    PubMed

    1997-06-01

    Service with a smile boosts bottom line. Treating co-workers and patients like guests is the linchpin of a whole new philosophy at Bradley Memorial Hospital in Cleveland, TN. Administrators there insist a host of new customer service programs, from cap and gown graduation ceremonies to bunny bucks, has resulted in dramatic financial improvements and more satisfied patients and staff.

  8. Location-aware access to hospital information and services.

    PubMed

    Rodríguez, Marcela D; Favela, Jesus; Martínez, Edgar A; Muñoz, Miguel A

    2004-12-01

    Hospital workers are highly mobile; they are constantly changing location to perform their daily work, which includes visiting patients, locating resources, such as medical records, or consulting with other specialists. The information required by these specialists is highly dependent on their location. Access to a patient's laboratory results might be more relevant when the physician is near the patient's bed and not elsewhere. We describe a location-aware medical information system that was developed to provide access to resources such as patient's records or the location of a medical specialist, based on the user's location. The system is based on a handheld computer which includes a trained backpropagation neural-network used to estimate the user's location and a client to access information from the hospital information system that is relevant to the user's current location.

  9. ‘The Hospital was just like a Home’: Self, Service and the ‘McCord Hospital Family’

    PubMed Central

    Noble, Vanessa; Parle, Julie

    2014-01-01

    For more than a century, McCord Hospital, a partly private and partly state-subsidised mission hospital has provided affordable health-care services, as well as work and professional training opportunities for thousands of people in Durban, a city on the east coast of South Africa. This article focuses on one important aspect of the hospital’s longevity and particular character, or ‘organisational culture’: the ethos of a ‘McCord Family’, integral to which were faith and a commitment to service. While recognising that families – including ‘hospital families’ like that at McCord – are contentious social constructs, with deeply embedded hierarchies and inequalities based on race, class and gender, we also consider however how the notion of ‘a McCord family’ was experienced and shared in complex ways. Indeed, during the twentieth century, this ethos was avidly promoted by the hospital’s founders and managers and by a wide variety of employees and trainees. It also extended to people at a far geographical remove from Durban. Moreover, this ethos became so powerful that many patients felt that it shaped their convalescence experience positively. This article considers how this ‘family ethos’ was constructed and what made it so attractive to this hospital’s staff, trainees and patients. Furthermore, we consider what ‘work’ it did for this mission hospital, especially in promoting bonds of multi-racial unity in the contexts of segregation and apartheid society. More broadly, it suggests that critical histories of the ways in which individuals, hospitals, faith and ‘families’ intersect may be of value for the future of hospitals as well as of interest in their past. PMID:24775429

  10. Key facilitators and best practices of hotel-style room service in hospitals.

    PubMed

    Sheehan-Smith, Lisa

    2006-04-01

    This qualitative study sought to identify the features, advantages, and disadvantages of hotel-style room service; the barriers to, and facilitators for, implementing the process; and "best practices." The study took place in four heterogeneous hospitals. Participants included hospital administrators, managers, and room-service employees. Data-collection methods included semi-structured interviews, observations, and document analysis. Common features of hotel-style room service were meal delivery within 30 to 45 minutes, a restaurant-style menu, procedures to feed ineligible patients, tray assembly on demand, scripting, and waitstaff uniforms for room-service employees. The major barrier to implementing room service was obtaining nursing support. The key facilitators were the hospital's service-oriented culture, using a multidisciplinary planning team, engaging nursing departments early in the planning stages, and intense customer-service training of room-service employees. The overwhelming advantage was patients' control over their food choices. The main disadvantage was cost. Initial best practices in hotel-style room service include: (a) taking a multidisciplinary team approach for developing and implementing the process, (b) customer-service training, (c) using a customer-driven menu, (d) wearing waitstaff uniforms, and (e) using carts with airpots for dispensing hot beverages.

  11. The effects of increased market competition on hospital services in Shandong and Henan Provinces.

    PubMed

    Forbes, Ian; Hindle, Don; Degeling, Pieter; Zhang, Kai; Xu, Lingzhong; Meng, Qingyue; Wang, Jian

    2002-01-01

    The Chinese government began a major reform of the hospital sector in the early 1980s. The main aim was to increase productivity by phasing out prospective global budgets from the government, and encouraging between-hospital competition for the business of user-pay and insured patients. This goal was to be achieved without unreasonable prejudice to the financial sustainability of hospitals or to the fairness of access and service provision. We explored the effects of these changes by analysing data for four levels of hospital in two of the most populous provinces between 1985 and 1999. We used data envelope analysis, and found that the majority of hospitals experienced a decline in productivity. Social efficiency (measured by the level of provision of unnecessary services) also declined, especially in the largest hospitals that could easily increase the use of expensive technologies. Most hospitals increased their economic sustainability, measured as the ratio between revenue and expenditures. However, the lowest-level hospitals experienced stable or reduced sustainability due to their inability to compete with marketing by higher-level hospitals. We conclude that, although there were many benefits, the overall impact of the introduction of market forces may have been negative. An important factor was that not all aspects (such as supplier-induced demand) were adequately controlled by government agencies. We suggest ways of alleviating the most problematic elements of current arrangements.

  12. [Definition of "Safety and Hygiene Packages" as a management model for the Hospital Hygiene Service (HHS)].

    PubMed

    Raponi, Matteo; Damiani, Gianfranco; Vincenti, Sara; Wachocka, Malgorzata; Boninti, Federica; Bruno, Stefania; Quaranta, Gianluigi; Moscato, Umberto; Boccia, Stefania; Ficarra, Maria Giovanna; Specchia, Maria Lucia; Posteraro, Brunella; Berloco, Filippo; Celani, Fabrizio; Ricciardi, Walter; Laurenti, Patrizia

    2014-01-01

    The purpose of this research is to identify and formalize the Hospital Hygiene Service activities and products, evaluating them in a cost accounting management view. The ultimate aim, is to evaluate the financial adverse events prevention impact, in an Hospital Hygiene Service management. A three step methodology based on affinity grouping activities, was employed. This methodology led us to identify 4 action areas, with 23 related productive processes, and 86 available safety packages. Owing to this new methodology, we was able to implement a systematic evaluation of the furnished services.

  13. 48 CFR 237.7204 - Format and clauses for educational service agreements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... normal schedule of tuition and fees applicable to the public and in effect at the time the services are... shall, where the resident or nonresident status involves a difference in tuition or fees— (i) Determine... consent. 3. Payment. (a) The Government shall pay the Contractor the normal tuition and fees which...

  14. 48 CFR 237.7204 - Format and clauses for educational service agreements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... normal schedule of tuition and fees applicable to the public and in effect at the time the services are... shall, where the resident or nonresident status involves a difference in tuition or fees— (i) Determine... consent. 3. Payment. (a) The Government shall pay the Contractor the normal tuition and fees which...

  15. 48 CFR 237.7204 - Format and clauses for educational service agreements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... normal schedule of tuition and fees applicable to the public and in effect at the time the services are... shall, where the resident or nonresident status involves a difference in tuition or fees— (i) Determine... consent. 3. Payment. (a) The Government shall pay the Contractor the normal tuition and fees which...

  16. 48 CFR 237.7204 - Format and clauses for educational service agreements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... normal schedule of tuition and fees applicable to the public and in effect at the time the services are... shall, where the resident or nonresident status involves a difference in tuition or fees— (i) Determine... consent. 3. Payment. (a) The Government shall pay the Contractor the normal tuition and fees which...

  17. 48 CFR 237.7204 - Format and clauses for educational service agreements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... normal schedule of tuition and fees applicable to the public and in effect at the time the services are... shall, where the resident or nonresident status involves a difference in tuition or fees— (i) Determine... consent. 3. Payment. (a) The Government shall pay the Contractor the normal tuition and fees which...

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...)(ii) of the Act. (c) Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Act... the ESRD composite rate and drugs and supplies furnished during dialysis but not included in the composite rate. (2) Renal dialysis services provided on or after January 1, 2011, for patients with...

  19. Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

    PubMed Central

    Kim, Jinkyung; Han, Woosok

    2012-01-01

    Objectives To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents’ and organizational characteristics. Results The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. Conclusion The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria. PMID:24159497

  20. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

    PubMed Central

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids. Results Throughout the services, hospital duvets, cotton blankets and plastic “bubble-wrap” were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols. Conclusion The most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic “bubble wrap”, and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units. PMID:23938145

  1. Communication services for a distributed hospital information system.

    PubMed

    Graeber, S

    1996-09-01

    Planning principles and development are described of a communication server which controls and performs all information exchange between distributed and heterogeneous applications in a hospital information system. The analysis is based on business process modeling. At present, the core of the server uses a commercial product (Cloverleaf). This allows to connect both old systems with no or few interface features and new systems with modern interface facilities (such as HL7). Prerequisites, functions, and configuration of the server software are described in detail. Experiences, advantages, and disadvantages are discussed.

  2. The use of bed distribution and service population indexes for hospital bed allocation.

    PubMed Central

    Bay, K S; Nestman, L J

    1984-01-01

    To provide an empirical base for bed reallocation within a hospital planning jurisdiction in Canada, this article proposes a population-based method to measure the distribution of acute care beds for each district and the service load for each hospital. The measure for the bed distribution (BDI) is the number of beds per 1,000 age-sex-adjusted number of residents in a district, while the service load of a hospital is measured by the number of persons being served per bed (SPI). The number of beds allocated to each district, or the number of persons served by each hospital, was estimated by applying the hospital service population model, which employs both relevance- and commitment-index methods. The method thus proposed was applied to Alberta data. It appears that both BDI and SPI measures are stable across the variation of methods or data sources, yet sensitive enough to detect changes over the years. Using these indexes, potentially over- or underbedded districts and over- or underloaded hospitals can be identified for further investigation so that possible reallocation of acute care beds among the hospitals may take place. PMID:6547418

  3. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    PubMed Central

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2017-01-01

    Background: This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Methods: Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results: In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion: By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. PMID:28005539

  4. "Hotel-style services" evolve in hospital setting.

    PubMed

    Schirg, G

    1995-10-01

    Glenn Schirg has been the director of nutrition services at Vanderbilt University Medical Center in Nashville, Tennessee for the past 11 years. Besides taking full responsibility for his department, he now acts as a team leader responsible for facilitating one of the medical center's 10 major initiatives.

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

    ERIC Educational Resources Information Center

    Young, Derrick P.

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

  6. The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran

    PubMed Central

    Arab, M; Tabatabaei, SM Ghazi; Rashidian, A; Forushani, A Rahimi; Zarei, E

    2012-01-01

    Background: Service quality is perceived as an important factor for developing patient’s loyalty. The aim of this study was to determine the hospital service quality from the patients’ viewpoints and the relative importance of quality dimensions in predicting the patient’s loyalty. Methods: A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient’s loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient’s loyalty. Result: The mean score of service quality and patient’s loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality) were found to be key determinants of the patient’s loyalty in the private hospitals of Tehran. Conclusion: The patients’ experience in relation to the private hospitals’ services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient’s loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share. PMID:23193509

  7. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  8. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  9. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  10. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  11. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  12. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  13. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  14. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  15. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  16. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  17. Postdeployment Hospitalizations among Service Members Deployed in Support of the Operations in Iraq and Afghanistan

    DTIC Science & Technology

    2009-09-01

    10 ICD-9-CM diagnoses. For these analyses, only the first hospitalization for the targeted diagnosis or group of diagnoses was included.Outcomes To...injuries or illnesses that may be found after deploy- ment. Other categories such as neoplasms, found the most frequent diagnosis of uterine leiomyoma...phic lateral sclerosis, or fibromyalgia associated with Persian Gulf War service? An examination of Department of Defense hospitalization data. Am J

  18. A Business Case Analysis on the Feasibility of Recapturing Inpatient Obstetrical Services for Naval Hospital Beaufort

    DTIC Science & Technology

    2006-06-14

    its impact on surrounding health care facilities, to include Naval Hospital Beaufort. The National Defense Authorization Act for fiscal year 2002...will be examined along with its impact on TRICARE Obstetrical in-patient beneficiaries and their available choices. The author will examine the...Facility (MTF), it services and treats the eligible population surrounding Beaufort County, Beaufort, SC. Naval Hospital Beaufort is fully accredited by

  19. A longitudinal analysis of the impact of hospital service line profitability on the likelihood of readmission.

    PubMed

    Navathe, Amol S; Volpp, Kevin G; Konetzka, R Tamara; Press, Matthew J; Zhu, Jingsan; Chen, Wei; Lindrooth, Richard C

    2012-08-01

    Quality of care may be linked to the profitability of admissions in addition to level of reimbursement. Prior policy reforms reduced payments that differentially affected the average profitability of various admission types. The authors estimated a Cox competing risks model, controlling for the simultaneous risk of mortality post discharge, to determine whether the average profitability of hospital service lines to which a patient was admitted was associated with the likelihood of readmission within 30 days. The sample included 12,705,933 Medicare Fee for Service discharges from 2,438 general acute care hospitals during 1997, 2001, and 2005. There was no evidence of an association between changes in average service line profitability and changes in readmission risk, even when controlling for risk of mortality. These findings are reassuring in that the profitability of patients' admissions did not affect readmission rates, and together with other evidence may suggest that readmissions are not an unambiguous quality indicator for in-hospital care.

  20. Using creative problem solving (TRIZ) in improving the quality of hospital services.

    PubMed

    LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

    2014-08-14

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.

  1. Using Creative Problem Solving (TRIZ) in Improving the Quality of Hospital Services

    PubMed Central

    LariSemnani, Behrouz; Far, Rafat Mohebbi; Shalipoor, Elham; Mohseni, Mohammad

    2015-01-01

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients’ expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients’ satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ’ needs. PMID:25560360

  2. Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

    PubMed Central

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

    2015-01-01

    Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions

  3. Military hospitalizations among deployed US service members following anthrax vaccination, 1998-2001.

    PubMed

    Wells, Timothy Steven; Sato, Paul A; Smith, Tyler Clain; Wang, Linda Zhenling; Reed, Robert John; Ryan, Margaret Angela Kappel

    2006-01-01

    Safety concerns have confronted the Department of Defense Anthrax Vaccine Immunization Program since inception in 1998. To determine if anthrax vaccination was associated with an increased risk of hospitalization, a historical cohort study utilizing pre- and post-anthrax-vaccination hospitalizations was undertaken and analyzed with Cox proportional hazards models. The study population consisted of 170,723 active duty US service members who were anthrax-vaccinated and deployed during the time period January 1, 1998 to December 31, 2001. Study outcomes included hospitalizations due to any-cause, 14 broad International Classification of Diseases diagnostic categories, autoimmune organ specific and organ non-specific hospitalizations, and asthma. After adjustment, anthrax vaccination was associated with significantly fewer hospitalizations for any-cause, diseases of the blood and blood forming organs, and diseases of the respiratory system. Comparing anthrax post-vaccination hospitalization experience with the pre-vaccination period resulted in no significant increased hazard for any of the hospitalization outcomes studied. Although there was no apparent increase in risk of morbidity in this study population, the relationship between anthrax vaccine and deployment on health outcomes among US service members needs further study.

  4. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in subpart F of part 412 of... physician finds that the patient could receive proper treatment in a SNF but no bed is available in...

  5. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in subpart F of part 412 of... physician finds that the patient could receive proper treatment in a SNF but no bed is available in...

  6. THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN

    PubMed Central

    Pouragha, Behrouz; Zarei, Ehsan

    2016-01-01

    Aim: The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. Methods: this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson’s correlation, and multivariate regression methods with the SPSS.18 software. Results: According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. Conclusion: The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction. PMID:27047262

  7. [A call for organizational and managerial changes in primary and hospital care services].

    PubMed

    Meloni, Cesare

    2005-01-01

    The changing epidemiological situation and socio-economic conditions in Italy have led to a situation where the Italian health care system no longer adequately satisfies the actual needs of society. Organizational and managerial changes in both primary and hospital care are needed and are proposed in this article. As regards general practice and primary healthcare it is crucial that a stable and exclusive relationship between GPs and their patients be regained through continuous and qualified care by the GP. This can be achieved through the establishment of primary care structures where a team of general practitioners work in association with nursing personnel for the delivery of key services including continuous at-home assistance. As for the organization of hospital care it would be useful to set up, in addition to existing general hospitals, "zonal inpatient facilities", resembling the old "infirmaries", directed by a specialized nurse and with a small full-time medical staff. In these facilities, designed for brief hospitalizations of patients with chronic conditions, GPs could take part in the management of their patients. Two important results could be achieved by establishing such facilities: a substantial reduction of healthcare costs related to frequent hospitalizations of patients with chronic medical conditions, and a structural reorganization of existing hospitals. Presently hospitals are often too large especially considering the continuous progresses made in diagnostic and therapeutic techniques which allow consistently shorter lengths of hospital stay and consequently, a more rapid turnover of patients.

  8. Military Hospitalizations among Deployed US Service Members Following Anthrax Vaccination, 1998-2001

    DTIC Science & Technology

    2006-04-01

    for unmeasured confounding, and to decrease heterogeneity among subjects, the analytic cohort was restricted to those service members who had received...modeling was restricted to those 170,723 service members who had received one or more anthrax vaccinations and had been deployed (Table 2). Compared to...and pericarditis as there were no hospitalizations during the post-vaccination period. DISCUSSION This 4-year historical cohort study used a large

  9. Military Hospitalizations Among Deployed US Service Members Following Anthrax Vaccination, 1998-2001

    DTIC Science & Technology

    2006-04-01

    to account for unmeasured confounding, and to decrease heterogeneity among subjects, the analytic cohort was restricted to those service members who...was restricted to those 170,723 service members who had received one or more anthrax vaccinations and had been deployed (Table 2). Compared to any...hypersensitiviry pneumonitis, immune pneumoni- tis, or myocarditis and pericarditis as there were no hospitalizations during the post-vaccination

  10. Clinicians' satisfaction with a hospital blood transfusion service: a marketing analysis of a monopoly supplier.

    PubMed Central

    Pennington, S J; McClelland, D B; Murphy, W G

    1993-01-01

    One of the objectives of the NHS reforms is to improve customer focus within the health service. In a study to assess the quality of customer service provided by the Edinburgh and South East Scotland Blood Transfusion Service a 19 item questionnaire survey of the main clinical users of the service was performed to ascertain their satisfaction, measured on a 5 point anchored scale, with important aspects of the service, including medical consultation, diagnostic services, blood and blood components or products and their delivery, and general satisfaction with the service. Of 122 clinicians in medical and surgical disciplines in five hospitals in Edinburgh, 72 (59%) replied. Fourteen (22%) indicated dissatisfaction with any aspect of the medical consultation service, owing to inadequate follow up of clinical contacts and unsatisfactory routing of incoming calls. Diagnostic services were criticised for the presentation, communication, and interpretation of results. The restricted availability of whole blood, the necessity to order platelets and plasma through the duty blood transfusion service doctor, and the use of a group and screen policy, attracted criticism from a small number of clinicians. Ten of 68 respondents expressed dissatisfaction with delivery of blood and components to the wards and theatres. The findings indicate that the clinicians served by this blood transfusion service are largely satisfied with the service. Changes are being implemented to improve reporting of laboratory results and measures taken to improve liaison with clinicians. PMID:10132458

  11. Patient management: measuring patients' expectations and perceptions of service quality in a dental training hospital.

    PubMed

    White, J G; Slabber, J; Schreuder, A

    2001-04-01

    The difference between service quality expectations and perceptions (experiences) of patients (customers) attending a dental training hospital was investigated by using a modified version of the Parasuraman SERVQUAL model. A questionnaire comprising 28 service quality-related statements and four open-ended questions was used at the interviews. The study showed that 11.6% of respondents experienced problems with the service. A principal component factor analysis indicated that two of the five dimensions of service quality, namely reliability and assurance, contributed to 59% of service level variance. Female patients showed larger mean differences than male patients. The greater the number of visits to the hospital, the smaller the difference between expectations and perceptions. Patients in the category 36-45 years of age, showed larger mean differences than younger or older patients. Respondents with no academic qualifications had lower expectations of the service, while professional people seemed to have more realistic expectations prior to a visit to the hospital than respondents in the technical/clerical category.

  12. Pharmaceutical services in an Army field hospital in Haiti during Operation Uphold Democracy.

    PubMed

    Frank, K J

    1996-07-15

    The pharmaceutical services provided by an Army field hospital in Haiti during Operation Uphold Democracy are described. In January 1995, 155 soldiers of the 47th Field Hospital from Ft. Sill, Oklahoma, were deployed to Haiti to provide medical care for 2400 U.S. troops and 7000 multinational troops and police officers. The pharmacy staff (one pharmacist and two technicians) provided patient counseling, drug information, staff consultation, and clinical support to the intensive and intermediate care wards and emergency medical tent of the field hospital. Other responsibilities were providing nonprescription drugs to outpatients, interpreting and evaluating drug orders, participating in drug selection, and ordering supplies. A 30- to 60-day drug supply was maintained. The formulary was designed by the pharmacist and an internist and was based on the mission requirements and conditions in Haiti. Of the 10 oral medications most commonly dispensed to outpatients, 6 were antibacterials and 1 was an antimalarial. An average of two patients were admitted to the hospital daily. Some 240 inpatients were recorded in the pharmacy computer during the hospital's six-month deployment, and more than 5000 were treated in the emergency tent. The pharmacy service of the 47th Field Hospital met the challenge of supporting U.S. and multinational troops in Haiti during Operation Uphold Democracy.

  13. Reimbursement patterns in a hospital-based fixed-wing aeromedical service.

    PubMed

    Lindbeck, G H

    1993-11-01

    Reimbursement, expressed as a percentage of total charges recovered, was examined for inpatients transported by a university hospital-based, dedicated, fixed-wing aeromedical service between July 1, 1988 and June 30, 1990. A total of 410 patients were transported; account information was available for 404 patients (98%). Patients transported from in-state institutions (n = 174) had a hospital reimbursement rate of 53.3%, whereas the flight program recovered 46.1% of transportation charges. Patients transported from out-of-state institutions (n = 150) had a hospital reimbursement rate of 51.3%, whereas the flight program recovered 69.3% of charges. More patients referred from in-state sources were covered by Medicaid than from out-of-state sources (31% vs 11%), and less were covered by Medicare (17% vs 30%). Reimbursement for hospital charges was low for patients covered by Medicaid (44% for in-state and 16% for out-of-state), and Medicaid reimbursed no flight charges for either in-state or out-of-state patients. The flight program recovered 86.7% of charges for "triangle" flights, which transported patients between two hospitals other than the sponsoring institution (n = 80). The overall hospital reimbursement rate for inpatients was 70% during the study period. The flight program recovered 53.7% of its operating costs from payment of charges for transport services. Aeromedically transported patients may represent a financial "high-risk" group of patients for the sponsoring institution.

  14. 42 CFR 419.32 - Calculation of prospective payment rates for hospital outpatient services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... outpatient services furnished in 1999 would have equaled the base expenditure target calculated in § 419.30... inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced... 1, 2001 and before April 1, 2001, by the hospital inpatient market basket percentage...

  15. 42 CFR 419.32 - Calculation of prospective payment rates for hospital outpatient services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... outpatient services furnished in 1999 would have equaled the base expenditure target calculated in § 419.30... inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced... 1, 2001 and before April 1, 2001, by the hospital inpatient market basket percentage...

  16. Using Multimedia to Enhance Knowledge of Service Attitude in the Hospitality Industry

    ERIC Educational Resources Information Center

    Kuo, Chun Min

    2012-01-01

    Having used a quasi-experimental research model and the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) calibration method to gather and implement data, the researcher developed an interactive multimedia assisted learning (MAL) program promoting proper service attitudes in the hospitality industry. In order to gauge MAL program's…

  17. The Centers For Medicare And Medicaid Services Electronic Health Records for hospitals.

    PubMed

    Elliott, Brett

    2012-06-01

    The Centers for Medicare and Medicaid Services (CMS) Electronic Health Records (EHR) incentive program for hospitals is described with respect to the requirements to receive the incentive payments, how to calculate the amount, and the pertinent time frames. Comparisons between the CMS EHR and Picture Archiving and Communication Systems (PACS) are presented. The hallmarks of successful computerized health records are reviewed.

  18. MICRO-CARES: An Information Management System for Psychosocial Services in Hospital Settings

    PubMed Central

    Hammer, Jeffrey S.; Lyons, John S.; Strain, James J.

    1984-01-01

    This paper presents a flexible software system that is adaptable to a variety of information management uses across different psychosocial service departments in hospital settings. Initially developed for Consultation Liaison Psychiatry, the present system has now been adapted for a Social Work department and is being adapted to Hospice, Home Care, Patient Representative, and Pastoral Care departmental uses.

  19. Community Pathways: Hospital-Based Services that Individualize Supports for Families and Children

    ERIC Educational Resources Information Center

    Boone, Harriet A.; Freund, Peggy J.; Barlow, Jane H.; Van Ark, Gwenn G.; Wilson, Thea K.

    2004-01-01

    Increasing numbers of infants and toddlers who were premature, had low birth weight, or experience chronic medical conditions are referred to early intervention services (Bernstein, Heimler, & Sasidharan, 1998). These young children often endure prolonged hospitalizations and are at risk for developmental disabilities by nature of their illnesses,…

  20. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

    ERIC Educational Resources Information Center

    Burra, Tara A.; Hwang, Stephen W.; Rourke, Sean B.; Stergiopoulos, Vicky

    2012-01-01

    This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender,…

  1. Hospitality Services. Curriculum Guide [and] Student Activity Book [and] Reference Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Curriculum Center for Family and Consumer Sciences.

    These three publications comprise a course that provides occupationally specific training designed to develop knowledge and skills for employment in the multifaceted hospitality services industry. The curriculum guide is the teacher component of the series. Contents include the Texas Essential Knowledge and Skills (TEKS); sample course outlines;…

  2. Internal Revenue Service General Counsel's Memorandum threatens tax exemption for charitable hospitals.

    PubMed

    Ball, D W

    1992-01-01

    A recent memorandum from the General Counsel of the Internal Revenue Service changes the standard against which tax exempt entities will be measured, which change can adversely affect charitable hospitals' tax exempt status. In addition, the memorandum makes clear that a violation of the Anti-Kickback statute, discussed in Mr. Aaron's article, is inconsistent with tax exempt status.

  3. Career Preparation Program Curriculum Guide for: Hospitality/Tourism Industry (Food Services).

    ERIC Educational Resources Information Center

    British Columbia Dept. of Education, Victoria. Curriculum Development Branch.

    This curriculum outline provides secondary and postsecondary instructors with detailed information on student learning outcomes for completion of the food services program requirements in the hospitality/tourism industry. A program overview discusses the aims of education; secondary school philosophy; and career preparation programs and their…

  4. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than inpatient psychiatric facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) The reasons for either— (i) Hospitalization of the patient for inpatient medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases... treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for...

  5. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than inpatient psychiatric facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) The reasons for either— (i) Hospitalization of the patient for inpatient medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases... treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for...

  6. An Investigation into the Length of Hospital Stay for Deaf Mental Health Service Users

    ERIC Educational Resources Information Center

    Baines, Di; Patterson, Neil; Austen, Sally

    2010-01-01

    This study looked at the average length of hospital stay for inpatients in a specialist deaf mental health service over a 10-year period, in comparison to that of a general psychiatric hearing cohort. In addition, two case studies of deaf inpatients were carried out looking specifically at the prerequisite factors governing discharge. Finally, a…

  7. Department of Health and Human Services Changes: Implications for Hospital Social Workers

    ERIC Educational Resources Information Center

    Conlon, Annemarie; Aldredge, Patti A.

    2013-01-01

    In April 2010, President Obama issued a directive to the Secretary of Health and Human Services (HHS) regarding patient visitation, advance directives, and other initiatives to improve the lives of lesbian, gay, bisexual, and transgender people and their families. The HHS response to this directive has implications for hospital social workers. The…

  8. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician...

  9. [Evaluation of financial performance of health services: reflections of operational policies in the hospital sector].

    PubMed

    Bonacim, Carlos Alberto Grespan; de Araujo, Adriana Maria Procópio

    2011-01-01

    Discussions about management manners and procedures has been relevant among organization managers in the health services. The health services economic evaluation approaches this theme and is taking an important role around the world, demanding the manager new challenges concerning the continuous search of activities efficiency and efficacy. The objective is to describe the consequences of operational changes in the economic-financial indicators of a Public Hospital. The methodology applied included besides the literature research, a case study in the "Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto--USP". The values found confirm the context of the hospital. One concludes that the average costs present similar behaviors with trend to stabilization, thus confirming improvements in efficiency. The importance of the rendering of accounts for the society related to the use of public resources and how this study can help in this way.

  10. The psychiatric hospital and its place in a mental health service

    PubMed Central

    Tooth, Geoffrey

    1958-01-01

    Modern methods of treatment of mental disease enable the average length of stay in hospital to be drastically reduced. The former overcrowding is therefore disappearing; in fact, it should be possible to contemplate a reduction in the size of the hospitals, particularly if new admissions are kept to a minimum by the provision of efficient out-patient clinics and of adequate geriatric and domiciliary nursing services. Taking recent trends in England and Wales as his starting point, the author outlines ways in which a modern mental health service might be built up around existing facilities under a variety of conditions. He advocates that, as far as possible, the treatment of mental disease should be integrated into general medicine, and emphasises the need for close co-operation between psychiatrists, family doctors, and the staff of general hospitals. PMID:13585081

  11. 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.

  12. An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

    PubMed Central

    Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

    2015-01-01

    Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. Result: this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Conclusions: Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers. PMID:25560338

  13. Managing hospital quality performance in two related areas: patient care and customer service.

    PubMed

    Dwore, R B

    1993-01-01

    The Joint Commission on Accreditation of Healthcare Organization's new emphasis on continuous quality improvement provides hospitals with an opportunity to enhance both customer service as well as patient care. Both are expected by patients and delivered by providers. Patient care is the core product; customer service augments it by adding value and providing the opportunity for a competitive advantage. This article discusses issues for administrators to consider before including customer service as a component of continuous quality improvement and then presents methods for bringing about change.

  14. Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

    PubMed

    Linggi, A; Pelham, L D

    1986-09-01

    A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

  15. Prime costs of clinical laboratory services in Tehran Valiasr Hospital in 2009.

    PubMed

    Nouroozi, T; Salehi, A

    2014-01-09

    Prime cost determinations can increase managerial effectiveness in budget allocation and strategic planning. This study was designed to calculate the prime cost of clinical laboratory services in Tehran Valiasr Hospital using the activity-based costing (ABC) model. The highest costs were for human recourses (44%) and the lowest for energy (5%). The largest proportion of activities (97%) was by specialists, reflecting the importance of human recourses in prime costs. The highest prime cost was for urinalysis (11% of tests) and the lowest for sodium determination (21% of tests), which demonstrates that prime cost decreases as service frequency increases. The average estimated prime cost was 63% higher than the fees established by the Ministry of Health and Medical Education. The results show that the Tehran Valiasr Hospital laboratory faces a budgetary deficit. The prime cost of services can be reduced by improving human recourse management and standardization of resource consumption.

  16. Evidence Points To 'Gaming' At Hospitals Subject To National Health Service Cleanliness Inspections.

    PubMed

    Toffolutti, Veronica; McKee, Martin; Stuckler, David

    2017-02-01

    Inspections are a key way to monitor and ensure quality of care and maintain high standards in the National Health Service (NHS) in England. Yet there is a perception that inspections can be gamed. This can happen, for example, when staff members know that an inspection will soon take place. Using data for 205 NHS hospitals for the period 2011-14, we tested whether patients' perceptions of cleanliness increased during periods when inspections occurred. Our results show that during the period within two months of an inspection, there was a significant elevation (2.5-11.0 percentage points) in the share of patients who reported "excellent" cleanliness. This association was consistent even after adjustment for secular time trends. The association was concentrated in hospitals that outsourced cleaning services and was not detected in those that used NHS cleaning services.

  17. 42 CFR 409.68 - Guarantee of payment for inpatient hospital or inpatient CAH services furnished before...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits. 409.68 Section 409.68 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.68 Guarantee of payment...

  18. Initiation of a medical toxicology consult service at a tertiary care children’s hospital

    PubMed Central

    WANG, GEORGE SAM; MONTE, ANDREW; HATTEN, BENJAMIN; BRENT, JEFFREY; BUCHANAN, JENNIE; HEARD, KENNON J.

    2015-01-01

    Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children < 6 years, poisoning continues to be a common pediatric diagnosis and bedside toxicology consultation is not common at children’s hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children’s hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8–16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship. PMID:25686099

  19. Room service improves patient food intake and satisfaction with hospital food.

    PubMed

    Williams, R; Virtue, K; Adkins, A

    1998-07-01

    Cancer therapy causes side effects that interfere with oral intake. Frequently, patients undergoing such therapy suffer from anorexia, nausea, vomiting, food aversions, dysgeusia, and xerostomia, all which adversely affect oral intake. Adequate nutrition intake is an important part of therapy for the cancer patient, especially when that patient is a child. Children who are well nourished are better able to withstand infection and tolerate therapy. Parents and staff at our hospital have worked diligently to improve patient's oral intake with limited success. Hence, a multidisciplinary team was organized to develop a new approach to food services that would improve patients' oral intake. The team initiated patient "room service," and patients were allowed to call the kitchen when they were ready to eat. The system works much like room service in a hotel. After the introduction of room service, patients' caloric intake improved significantly (P = .008), and protein intake increased by 18%. Patient satisfaction with hospital food service also improved; excellent ratings increased by as much as 35%. We conclude that room service is a viable alternative to traditional food services in the pediatric oncology setting and may be useful in other patient populations, such as maternity and general pediatrics.

  20. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... If nurse practitioners or physician assistants (as defined in § 481.1 of this chapter) are not... paid by it for such services. (2) Services furnished by a physician assistant, nurse practitioner, nurse midwife or other specialized nurse practitioner (as defined in §§ 405.2401 and 491.2 of...

  1. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... If nurse practitioners or physician assistants (as defined in § 481.1 of this chapter) are not... paid by it for such services. (2) Services furnished by a physician assistant, nurse practitioner, nurse midwife or other specialized nurse practitioner (as defined in §§ 405.2401 and 491.2 of...

  2. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... If nurse practitioners or physician assistants (as defined in § 481.1 of this chapter) are not... paid by it for such services. (2) Services furnished by a physician assistant, nurse practitioner, nurse midwife or other specialized nurse practitioner (as defined in §§ 405.2401 and 491.2 of...

  3. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... If nurse practitioners or physician assistants (as defined in § 481.1 of this chapter) are not... paid by it for such services. (2) Services furnished by a physician assistant, nurse practitioner, nurse midwife or other specialized nurse practitioner (as defined in §§ 405.2401 and 491.2 of...

  4. A Review on influencing criteria for selecting supplier of information technology services in the hospital

    PubMed Central

    Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

    2014-01-01

    Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals. PMID:25540781

  5. A Review on influencing criteria for selecting supplier of information technology services in the hospital.

    PubMed

    Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

    2014-01-01

    Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals.

  6. Combining resources, combining forces: regionalizing hospital library services in a large statewide health system*

    PubMed Central

    Martin, Heather J.; Delawska-Elliott, Basia

    2015-01-01

    After a reduction in full-time equivalents, 2 libraries in large teaching hospitals and 2 libraries in small community hospitals in a western US statewide health system saw opportunity for expansion through a regional reorganization. Despite a loss of 2/3 of the professional staff and a budgetary decrease of 27% over the previous 3 years, the libraries were able to grow business, usage, awareness, and collections through organizational innovation and improved efficiency. This paper describes the experience—including process, challenges, and lessons learned—of an organizational shift to regionalized services, collections, and staffing. Insights from this process may help similar organizations going through restructuring. PMID:25552945

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

    PubMed

    Adams, Marsha Howell; Crow, Carolyn S

    2005-01-01

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

  8. Combining resources, combining forces: regionalizing hospital library services in a large statewide health system.

    PubMed

    Martin, Heather J; Delawska-Elliott, Basia

    2015-01-01

    After a reduction in full-time equivalents, 2 libraries in large teaching hospitals and 2 libraries in small community hospitals in a western US statewide health system saw opportunity for expansion through a regional reorganization. Despite a loss of 2/3 of the professional staff and a budgetary decrease of 27% over the previous 3 years, the libraries were able to grow business, usage, awareness, and collections through organizational innovation and improved efficiency. This paper describes the experience--including process, challenges, and lessons learned--of an organizational shift to regionalized services, collections, and staffing. Insights from this process may help similar organizations going through restructuring.

  9. 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.

  10. Health services reform and human resource management in Hong Kong public hospitals.

    PubMed

    Thompson, D; Snape, E; Stokes, C

    1999-01-01

    This article discusses the empirical study of reform in the human resource management function in the Hong Kong Hospital Authority. It describes the prior management of the hospitals based on the civil service administration model before looking at management reform in general. From this research, the creative tensions between the centrifugal and centripetal forces in the pursuit of 'effectiveness', 'efficiency' and 'economy' are explored in terms of decentralization. A survey of line managers, in eleven Hospital Authority hospitals, revealed the progress of decentralization: a majority of respondents felt that, over the previous five years, managers at their level had been given greater responsibility for human resource management issues. In spite of the widespread perception of increased decentralization, however, it was recognized that there are limits to decentralization. It was the routine administration rather than the policy formulation and interpretation which had been decentralized, and hospitals continued to rely on the Hospital Authority Head of Office for guidance on policy interpretation. Several barriers to the effective decentralization of responsibility for human resource management were identified, including a lack of management skill, knowledge and time, the attitudes of some managers and the tight control of budget.

  11. 42 CFR 489.24 - Special responsibilities of Medicare hospitals in emergency cases.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... emergency cases. 489.24 Section 489.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER... hospital's emergency department, including ancillary services routinely available to the...

  12. Availability and Structure of Ambulatory Rehabilitation Services: A Survey of Hospitals with Designated Rehabilitation Beds in Ontario, Canada

    PubMed Central

    Passalent, Laura A.; Cott, Cheryl A.

    2008-01-01

    Purpose: To determine the degree to which ambulatory physical therapy (PT), occupational therapy (OT), and speech language pathology (SLP) services are available in hospitals with designated rehabilitation beds (DRBs) in Ontario, and to explore the structure of delivery and funding among services that exist. Methods: Questions regarding ambulatory services were included in the System Integration and Change (SIC) survey sent to all hospitals participating in the Hospital Report 2005: Rehabilitation initiative. Results: The response rate was 75.9% (41 of 54 hospitals). All hospitals surveyed provide some degree of ambulatory rehabilitation services, but the nature of these services varies according to rehabilitation client groups (RCGs). The majority of hospitals continue to deliver services through their employees rather than by contracting out or by creating for-profit subsidiary clinics, but an increasing proportion is accessing private sources to finance ambulatory services. Conclusions: Most hospitals with DRBs provide some degree of ambulatory rehabilitation services. Privatization of delivery is not widespread in these facilities. PMID:20145757

  13. [Improvement of medical equipment setting for the hospital link of the medical service during wartime].

    PubMed

    Miroshnichenko, Yu V; Goryachev, A B; Popov, A A; Rodionov, E O

    2016-04-01

    One of the priorities of the military health care is to improve the system of rationing medical equipment for the hospital unit of the medical service of the Armed Forces in wartime. This is determined the fact that the effectiveness of measures to provide military field hospitals with medical supplies depends on the quality of medical care for the wounded and sick, as well as the level of their return to duty. The article presents the characteristics of modern standards medical supplies procurement of military field hospitals included in the new regulatory legal act of the Russian Federation Ministry of Defence--"Standards of supplies medical supplies medical and pharmaceutical organizations (units) of the Russian Federation on the wartime armed forces", approved and put into effect in 2015 by order of the Minister of Defence of the Russian Federation.

  14. Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

    PubMed

    Benbenishty, Rami; Jedwab, Merav; Chen, Wendy; Glasser, Saralee; Slutzky, Hanna; Siegal, Gil; Lavi-Sahar, Zohar; Lerner-Geva, Liat

    2014-01-01

    This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement.

  15. Evaluation of pharmacy information system in teaching, private and social services Hospitals in 2011

    PubMed Central

    Saghaeiannejad-Isfahani, Sakineh; Mirzaeian, Razieh; Jannesari, Hasan; Ehteshami, Asghar; Feizi, Awat; Raeisi, Ahmadreza

    2014-01-01

    Objective: Supporting a therapeutic approach and medication therapy management, the pharmacy information system (PIS) acts as one of the pillars of hospital information system. This ensures that medication therapy is being supported with an optimal level of safety and quality similar to other treatments and services. Materials and Methods: The present study is an applied, cross-sectional study conducted on the PIS in use in selected hospitals. The research population included all users of PIS. The research sample is the same as the research population. The data collection instrument was the self-designed checklist developed from the guidelines of the American Society of Health System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and PIS users and pharmacists. Findings: The findings of this study were revealed that regarding the degree of meeting the standards given in the guidelines issued by the Society of Pharmacists, the highest rank in observing input standards belonged to Social Services hospitals with a mean score of 32.75. Although teaching hospitals gained the highest score both in process standards with a mean score of 29.15 and output standards with a mean score of 43.95, the private hospitals had the lowest mean score of 23.32, 17.78, 24.25 in input, process and output standards, respectively. Conclusion: Based on the findings, it can be claimed that the studied hospitals had a minimal compliance with the input, output and processing standards related to the PIS. PMID:25013832

  16. Gold award: mental health services for the deaf--St. Elizabeths Hospital, Washington, D.C.

    PubMed

    1978-10-01

    The mental health program for the deaf at St. Elizabeths Hospital offers comprehensive services to adolescents and adults who were born deaf or who became deaf early in life. A staff of 49, six of whom have impaired hearing, provide services to about 33 inpatients and about 71 outpatients. Activity therapies that do not require oral communication, such as occupational therapy, art therapy, dance therapy, and psychodrama, play an important role in the program, as does group psychotherapy. The program provides training, field experience, and consultation for workers throughout the U.S. and from foreign countries. Some guidelines for communicating with the deaf are given.

  17. EXPERIENCES OF PSYCHIATRIC CONSULTATION SERVICE IN TWO COALFIELD HOSPITALS OF BIHAR

    PubMed Central

    Sharma, L.N.; Khanna, R.; Chatterjee, S.

    1990-01-01

    SUMMARY The Central Institute of Psychiatry provides extension consultation services at two coalfield hospitals of Bihar, representing the intermediate and central level of health care delivery system. Analysis of data covering a period of one year, from September 1988 to August 1989, revealed significant differences in the utilization pattern of the two centres. The differences relate to the proportion of population observed, their demographic characteristics, diagnostic break-up, and follow-up pattern. The provision of psychiatric extension services at the intermediate level is recommended. PMID:21927441

  18. Medicus Deus: a review of factors affecting hospital library services to patients between 1790–1950

    PubMed Central

    Perryman, Carol

    2006-01-01

    Question: What are some of the historical societal, medical, and public health trends leading to today's provision of hospital library services to patients? Data Sources: Literature from the archives of the Bulletin of the Medical Library Association and other library sources, medical journals, primary historical documents, and texts from the history of medicine form the core of this review. Study Selection: The period of review extends from about 1790 through 1950 and focuses solely on trends in the United States. Of primary concern are explicitly documented examples that appear to illustrate the patient-physician relationship and those between librarians and their patient-patrons during the earliest years of the profession's development. Data Extraction: An historical timeline was created to allow the identification of major trends that may have affected library services. Multiple literature searches were conducted using library, medical, and health anthropology resources. When possible, primary sources were preferred over reviews. Main Results: Juxtapositioning historical events allows the reader to obtain an overview of the roots of consumer health services in medical libraries and to consider their potential legacy in today's health care libraries. Conclusion: This review article highlights early developments in hospital library service to patients. Further research is needed to verify a preliminary conclusion that in some medical library settings, services to the general public are shaped by the broader health care environment as it has evolved. PMID:16888658

  19. Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria

    PubMed Central

    Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

    2015-01-01

    Introduction Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. Methods A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Results Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001). Conclusion The overall perceived service quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services. PMID:26834921

  20. Factors Affecting Quality of Emergency Service in Iran’s Military Hospitals: A Qualitative Study

    PubMed Central

    Zaboli, Rouhollah; Shokri, Mohamad; Javadi, Maryam Seyed; Teymourzadeh, Ehsan; Ameryoun, Ahmad

    2016-01-01

    Introduction Quality is a key factor for the success of any organization. Moreover, accessing quality in the emergency department is highly significant due to the sensitive and complex role of this department in hospitals as well as the healthcare and medical treatment system. This study aimed to identify, from the perspective of medical experts and nurses serving in the military health and medical treatment system, the factors that affect the quality of emergency service provided in selected military hospitals in Iran. Methods This qualitative research was performed in Valiaser Hospital of Tehran (Iran) in 2015, using the framework analysis method. The purposive sampling technique was used for data collection. A total of 14 participants included two emergency medicine specialists, four general physicians, two senior nurses (holding M.Sc. degrees), and six nurses (holding B.Sc. degree). Data were collected through semistructured interviews. Sampling continued until data saturation occurred. The Atlas/Ti software was employed for data analysis. Results Four basic themes emerged as the effective factors on the quality of emergency services, namely, structural themes, process/performance themes, outcome themes, and environmental/contextual themes. Moreover, through a framework analysis, 47 subthemes were specified and summarized as indicators of the different aspects of the main themes. Conclusion The factors affecting the quality of emergency services in Iran’s selected military hospitals are especially complicated due to the diversity of the missions involved; thus, different factors can influence this quality. Therefore, an effort should be made to tackle the existing obstacles, facilitate the identification of these effective factors, and promotion of the quality of healthcare services. PMID:27790355

  1. Clinical benefits, referral practice and cost implications of an in-hospital pain service: results of a service evaluation in a London teaching hospital

    PubMed Central

    Sussman, Maya; Goodier, Elizabeth; Fabri, Izabella; Borrowman, Jessica; Thomas, Sarah; Guest, Charlotte; Bantel, Carsten

    2016-01-01

    Background: In-hospital pain services (IPS) are commonplace, but evidence of efficacy is inadequate, and patients’ pain management in any hospital ward remains problematic. This service evaluation aimed to measure the effect of a contemporary IPS, its appropriate use and cost-efficacy. Methods: Records of 249 adults reviewed by the IPS in an inner London Teaching Hospital over an 8-month period were analysed for demographic data, interventions, workload and change in pain intensity measured by numerical rating scale (NRS). Non-parametric tests were used to evaluate differences between initial and final NRS. Spearman’s rank correlation analysis was used to create a correlation matrix to evaluate associations between all identified independent variables with the change in NRS. All strongly correlated variables (ρ > 0.5) were subsequently included in a binary logistic regression analysis to identify predictors of pain resolution greater than 50% NRS and improvement rather than deterioration or no change in NRS. Finally, referral practice and cost of inappropriate referrals were estimated. Referrals were thought to be inappropriate when pain was not optimised by the referring team; they were identified using a set algorithm. Results: Initial median NRS and final median NRS were significantly different when a Wilcoxon signed-rank test was applied to the whole cohort; Z = –5.5 (p = 0.000). Subgroup analysis demonstrated no significant difference in the ‘mild’ pain group; z = –1.1 (p = 0.253). Regression analysis showed that for every unit increase in initial NRS, there was a 62% chance of general and a 33% chance of >50% improvement in final NRS. An estimated annual cost-saving potential of £1546 to £4558 was found in inappropriate referrals and patients experiencing no benefit from the service. Discussion: Results suggest that patients with moderate to severe pain benefit most from IPS input. Also pain management resources are often

  2. Acute pain management services: a comparison between Air Force and U.S. hospitals.

    PubMed

    Rayos, C L; McDonough, J P

    1999-12-01

    The purpose of this descriptive study was to assess the prevalence of acute pain management services (APMS) in Air Force medical facilities. There are no published reports on the current status of Air Force pain programs. This study used a telephone survey to all facilities worldwide that house an anesthesia department. Anesthesia providers in charge of pain services or department chiefs were interviewed from December 1996 to May 1997. Respondents were asked questions related to the initiation of a formal APMS, components, and familiarity with the Agency for Health Care Policy and Research guidelines on pain management. Data analysis described current practices and used chi 2 analysis to compare results with a national study of U.S. hospitals. Air Force anesthesia departments (45%) had established as many acute pain services as U.S. hospitals (42%). Formal pain programs are becoming more prevalent in Air Force hospitals. These findings suggest an increased awareness of the need for pain management and future establishment of pain programs.

  3. Improving ECG Services at a Children's Hospital: Implementation of a Digital ECG System

    PubMed Central

    Osei, Frank A.; Gates, Gregory J.; Choi, Steven J.; Hsu, Daphne T.; Pass, Robert H.; Ceresnak, Scott R.

    2015-01-01

    Background. The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children's hospital. Methods. As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE) was implemented at the Children's Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared via t-tests. Results. The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p < 0.001), a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p < 0.001). Conclusion. Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported. PMID:26451150

  4. Effects of changes in micro- and macro-environmental factors on the supply of hospitals services.

    PubMed

    Kassaye, W W; Tseng, K C

    1990-01-01

    The failures, marketing difficulties and financial hardships hospitals have experienced raises a question as to whether they have been responsive to the changes in the micro and macro-environmental factors. To determine how responsive hospitals have been to these changes, we investigate the impact of a number of selected factors on the supply of hospital services during 1972 through 1978. The findings indicate that despite the fact that the economy went through recessionary periods, and the demographic distribution exhibited both a shift and a change in the aging and birth rates of the nation, the changes in hospitals' responsiveness have been less than satisfactory. It appears that hospitals readily respond to the changes in the micro-environment than to the changes in macro-environment. Their response to the changes in the macro-environment. Their response to the changes in the macro-environment may be characterized as an effort to create a higher level of production whose goal is to create a still higher level of needs and wants.

  5. 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.

  6. Salang Hospital: Lack of Water and Power Severely Limits Hospital Services, and Major Construction Deficiencies Raise Safety Concerns

    DTIC Science & Technology

    2014-01-01

    the contract had not been provided. Because there was no clean water, staff at the hospital were washing newborns with untreated river water. SIGAR’s...The water is then gravity fed through pipes when needed in the hospital. Hospital staff told us that, as a result, patients, including newborn ... infants , are washed in untreated river water. • The hospital staff told us the hospital roof was leaking, causing mold and mildew on the ceiling and

  7. 42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Method of payment for preadmission services under the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

  8. Going beyond information management: using the Comprehensive Accreditation Manual for Hospitals to promote knowledge-based information services.

    PubMed

    Schardt, C M

    1998-10-01

    In 1987, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) initiated the Agenda for Change, a major revision in the evaluation process for hospitals. An essential component of that change was to shift the emphasis away from standards for individual departments to standards for hospital-wide functions. In recent years, hospital librarians have focused their energy and attention on complying with the standards for the "Management of Information" chapter, specifically the IM.9 section on knowledge-based information. However, the JCAHO has listed the health sciences librarian and library services as having responsibilities in six other chapters within the Comprehensive Accreditation Manual for Hospitals. These chapters can have a major impact on the services of the hospital library for two reasons: (1) they are being read by hospital leaders and other professionals in the organization, and (2) they articulate specific ways to apply knowledge-based information services to the major functions within the hospital. These chapters are "Education"; "Improving Organizational Performance"; "Leadership"; "Management of Human Resources"; "Management of the Environment of Care"; and "Surveillance, Prevention, and Control of Infection." The standards that these chapters promote present specific opportunities for hospital librarians to apply knowledge-based information resources and service to hospital-wide functions. This article reviews these chapters and discusses the standards that relate to knowledge-based information.

  9. An empirical analysis of the public's attitudes toward advertising hospital services: a comparative cross-sectional study.

    PubMed

    Moser, H Ronald; Freeman, Gordon L

    2014-01-01

    This study investigates current opinions about hospital advertising and compares them to the attitudes expressed 25 years ago. It replicates a survey done in 1985, using the same questionnaire and population to compare responses longitudinally. The study indicates some changes in the public's opinions of hospital advertising. Although the image of hospitals remains positive, most of the 2010 respondents' opinions were rather mixed regarding whether it is proper for hospitals to advertise. The study also confirmed that the quality of service and reputation of hospitals remain more important to the public than price.

  10. Community services' involvement in the discharge of older adults from hospital into the community

    PubMed Central

    Guerin, Michelle; Grimmer, Karen; Kumar, Saravana

    2013-01-01

    Background Community services are playing an increasing role in supporting older adults who are discharged from hospital with ongoing non-acute care needs. However, there is a paucity of information regarding how community services are involved in the discharge process of older individuals from hospital into the community. Methods Twenty-nine databases were searched from 1980 to 2012 (inclusive) for relevant primary published research, of any study design, as well as relevant unpublished work (e.g. clinical guidelines) which investigated community services' involvement in the discharge of older individuals from hospital into the community. Data analysis and quality appraisal (using McMaster critical appraisal tools) were undertaken predominately by the lead author. Data was synthesised qualitatively. Results Twelve papers were eligible for inclusion (five randomised controlled trials, four before and after studies and three controlled trials), involving a total of 8440 older adults (>65 years). These papers reported on a range of interventions. During data synthesis, descriptors were assigned to four emergent discharge methods: Virtual Interface Model, In-reach Interface Model, Out-reach Interface Model and Independent Interface Model. In each model, the findings were mixed in terms of health care and patient and carer outcomes. Conclusions It is plausible that each model identified in this systematic review has a role to play in successfully discharging different cohorts of older adults from hospital. Further research is required to identify appropriate population groups for various discharge models and to select suitable outcome measures to determine the effectiveness of these models, considering all stakeholders' involved. PMID:24179455

  11. Comparison between two mobile pre-hospital care services for trauma patients

    PubMed Central

    2012-01-01

    Objectives Pre-hospital care (PH) in Brazil is currently in the phase of implementation and expansion, and there are few studies on the impacts of this public health service. The purpose of this study is to assess the quality of care and severity of trauma among the population served, using trauma scores, attendance response times, and mortality rates. This work compares two pre-hospital systems: the Mobile Emergency Care Service, or SAMU 192, and the Fire Brigade Group, or CB. Method Descriptive study evaluating all patients transported by both systems in Catanduva, SP, admitted to a single hospital. Results 850 patients were included, most of whom were men (67.5%); the mean age was 38.5 ± 18.5 years. Regarding the use of PH systems, most patients were transported by SAMU (62.1%). The trauma mechanisms involved motorcycle accidents in 32.7% of cases, transferred predominantly by SAMU, followed by falls (25.8%). Regarding the response time, CB showed the lowest rates. In relation to patient outcome, only 15.5% required hospitalization. The average score on the Glasgow Coma Scale was 14.7 ± 1.3; average RTS was 7.7 ± 0.7; ISS 3.8 ± 5.9; and average TRISS 97.6 ± 9.3. The data analysis showed no statistical differences in mortality between the groups studied (SAMU - 1.5%; CB - 2.5%). The trauma scores showed a higher severity of trauma among the fatal victims. Conclusion Trauma victims are predominantly young and male; the trauma mechanism that accounted for the majority of PH cases was motorcycle accidents; CB responded more quickly than SAMU; and there was no statistical difference between the services of SAMU and CB in terms of severity of the trauma and mortality rates. PMID:23531089

  12. 42 CFR 419.22 - Hospital services excluded from payment under the hospital outpatient prospective payment system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Clinical social worker services as defined in section 1861(hh)(2) of the Act. (h) Physical therapy services, speech-language pathology services, and occupational therapy services described in section 1833(a)(8)...

  13. Patients’ Expectations and Perceptions of Service Quality in the Selected Hospitals

    PubMed Central

    Nadi, Aliasghar; Shojaee, Jalil; Abedi, Ghassem; Siamian, Hasan; Abedini, Ehsan; Rostami, Farideh

    2016-01-01

    Background: Hospital’s success depends on patients’ expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients’ perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. Materials and Methods: This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive – analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. Results: The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients’ perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal–Wallis test, the difference observed in these three hospitals were significant. Conclusion: The results showed that patients’ expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed

  14. Safety of labour and delivery following closures of obstetric services in small community hospitals

    PubMed Central

    Hutcheon, Jennifer A.; Riddell, Corinne A.; Strumpf, Erin C.; Lee, Lily; Harper, Sam

    2017-01-01

    BACKGROUND: In recent decades, many smaller hospitals in British Columbia, Canada, have stopped providing planned obstetric services. We examined the effect of these service closures on the labour and delivery outcomes of pregnant women living in affected communities. METHODS: We used maternal postal codes to identify delivery records (1998–2014) of women residing in a community affected by service closure. The records were obtained from the British Columbia Perinatal Data Registry. We examined the effect of the closures using a within-communities fixed-effects framework and included similar-sized communities without service closures to control for underlying time trends. The primary outcome was a previously published composite measure of labour and delivery safety, the Adverse Outcome Index, which includes adverse events such as birth injury and unanticipated operative procedures, and includes weights for severity of adverse events. Secondary outcomes included maternal or newborn transfer, and use of obstetric interventions. RESULTS: We found little evidence that closure of planned obstetric services affected the risk of composite adverse maternal–newborn outcome (−0.4 excess adverse events per 100 deliveries, 95% confidence interval [CI] −2.0 to 1.1), or most other secondary outcomes. The severity of composite outcome events decreased following the closures (rate ratio 0.58, 95% CI 0.36 to 0.89). Closures were associated with increases in use of epidural analgesia (3.4 excess events per 100 deliveries, 95% CI 0.4 to 6.3) and length of antepartum stay (0.6 h, 95% CI 0.1 to 1.0 h). INTERPRETATION: Closure of planned obstetric services in low-volume hospitals was not associated with an increase or decrease in frequency of adverse events during labour and delivery. PMID:27821464

  15. An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

    PubMed

    Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

    2015-02-01

    Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

  16. [A guide to successful public relations for hospitals and emergency medical services].

    PubMed

    Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V

    2014-04-01

    Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you

  17. Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up.

    PubMed

    Castells-Aulet, Laura; Hernández-Viadel, Miguel; Jiménez-Martos, Jesús; Cañete-Nicolás, Carlos; Bellido-Rodríguez, Carmen; Calabuig-Crespo, Roman; Asensio-Pascual, Pedro; Lera-Calatayud, Guillem

    2015-08-01

    Aims and method To evaluate whether involuntary out-patient commitment (OPC) in patients with severe mental disorder reduces their use of hospital services. This is a retrospective case-control study comparing a group of patients on OPC (n = 75) and a control group (n = 75) which was composed of patients whose sociodemographic variables and clinical characteristics were similar to those of the OPC group. Each control case is paired with an OPC case, so the control case must have an involuntary admission in the month that the index OPC case admission occurred. Emergency room visits, admissions and average length of hospital stay over a 2-year follow-up after the initiation of OPC were compared. Results No statistically significant evidence was found in the use of mental healthcare services between the two groups. Different reasons for admission found between the groups limit similarity when comparing the two. Clinical implications The findings cast doubt over the effectiveness of this legal measure to reduce emergency visits, the number of admissions and the length of stay in the hospital.

  18. Measurement of Quality of Educational Hospital Services by the SERVQUAL Model: The Iranian Patients’ Perspective

    PubMed Central

    Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid

    2016-01-01

    Introduction The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. Methods In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. Results There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (−0.88) and responsiveness (−0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. Conclusion There were gaps between the patients’ perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time. PMID:27123218

  19. Higher Education Crossing Borders. A Guide to the Implications of the General Agreement on Trade in Services (GATS) for Cross-Border Education

    ERIC Educational Resources Information Center

    Knight, Jane

    2006-01-01

    This Guide examines the different dimensions of cross-border education within the context of General Agreement on Trade in Services (GATS): the present landscape, opportunities and challenges and the implications for policy and practice in higher education. It is meant for a range of stakeholders: policymakers, senior academic leaders, faculty…

  20. System-level factors affecting clinicians' perceptions and use of interpreter services in California public hospitals.

    PubMed

    Baurer, Danielle; Yonek, Julie C; Cohen, Alan B; Restuccia, Joseph D; Hasnain-Wynia, Romana

    2014-04-01

    Professional language interpreters are skilled in the nuances of interpretation and are less likely to make errors of clinical significance but clinicians infrequently use them. We examine system-level factors that may shape clinicians' perceptions and use of professional interpreters. Exploratory qualitative study in 12 California public hospitals. We conducted in-person key informant interviews with hospital leadership, clinical staff, and administrative staff. Five emergent themes highlight system-level factors that may influence clinicians' perceptions and use of professional interpreters in hospitals: (1) organization-wide commitment to improving language access for LEP patients; (2) organizational investment in remote interpreter technologies to increase language access; (3)training clinicians on how to access and work with interpreters; (4) hospital supports the training and certification of bilingual staff to serve as interpreters to expand in-person, on-site, interpreter capacity; and (5)organizational investment in readily accessible telephonic interpretation. Multiple system-level factors underlie clinicians' use of professional interpreters. Interventions that target these factors could improve language services for patients with limited English proficiency.