Science.gov

Sample records for digestivo alto hospital

  1. Calar Alto Academy

    NASA Astrophysics Data System (ADS)

    Pedraz, Santos; Galadí, David

    Calar Alto Academy was initiated in 2007 with the aim to give students from different Spanish universities the chance to perform professional observational work at Calar Alto Observatory. The second edition of this innovative educational project has increased the number of participating universities and has almost doubled the quantity of visiting students, in a significant step towards the consolidation of this undergraduate and graduate school of observational astronomy.

  2. Construction of a manual of work processes and techniques from Centro de Dispensação de Medicamentos de Alto Custo (CEDMAC), Hospital de Clínicas, Unicamp.

    PubMed

    Bertolo, Manoel Barros; Ferreira, Bruno Silva de Araújo; Marchiore, Adriana G Mucke; Carvalho, Glaucia Pereira do Amaral; de Souza, Débora Pessoa; Psaltikidis, Eliane Molina

    2014-01-01

    The Centers for High Cost Medication (Centros de Medicação de Alto Custo, CEDMAC), Health Department, São Paulo were instituted by project in partnership with the Clinical Hospital of the Faculty of Medicine, USP, sponsored by the Foundation for Research Support of the State of São Paulo (Fundação de Amparo à Pesquisa do Estado de São Paulo, FAPESP) aimed at the formation of a statewide network for comprehensive care of patients referred for use of immunobiological agents in rheumatological diseases. The CEDMAC of Hospital de Clínicas, Universidade Estadual de Campinas (HC-Unicamp), implemented by the Division of Rheumatology, Faculty of Medical Sciences, identified the need for standardization of the multidisciplinary team conducts, in face of the specificity of care conducts, verifying the importance of describing, in manual format, their operational and technical processes. The aim of this study is to present the methodology applied to the elaboration of the CEDMAC/HC-Unicamp Manual as an institutional tool, with the aim of offering the best assistance and administrative quality. In the methodology for preparing the manuals at HC-Unicamp since 2008, the premise was to obtain a document that is participatory, multidisciplinary, focused on work processes integrated with institutional rules, with objective and didactic descriptions, in a standardized format and with electronic dissemination. The CEDMAC/HC-Unicamp Manual was elaborated in 10 months, with involvement of the entire multidisciplinary team, with 19 chapters on work processes and techniques, in addition to those concerning the organizational structure and its annexes. Published in the electronic portal of HC Manuals in July 2012 as an e-Book (ISBN 978-85-63274-17-5), the manual has been a valuable instrument in guiding professionals in healthcare, teaching and research activities.

  3. 4. photocopy of an advertisement (from Penn Alto Hotel archives, ...

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

    4. photocopy of an advertisement (from Penn Alto Hotel archives, Altoona, Pennsylvania) ADVERTISEMENT TO SELL STOCK IN PENN ALTO HOTEL - Penn Alto Hotel, 1120-1130 Thirteenth Avenue, Altoona, Blair County, PA

  4. 3. photocopy of an advertisement (from Penn Alto Hotel archives, ...

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

    3. photocopy of an advertisement (from Penn Alto Hotel archives, Altoona, Pennsylvania) ADVERTISEMENT TO SELL STOCK IN PENN ALTO HOTEL - Penn Alto Hotel, 1120-1130 Thirteenth Avenue, Altoona, Blair County, PA

  5. The Alto Tandem and Isol Facility at IPN Orsay

    NASA Astrophysics Data System (ADS)

    Franchoo, Serge

    Alto is an infrastructure for experimental nuclear physics in France that comprises both an on-line isotope-separation facility based on the photofission of uranium and a stable-ion beam facility based on a 14.5-MV tandem accelerator. The isotope-separation on-line section of Alto is dedicated to the production of neutron-rich radioactive ion beams (RIB) from the interaction of the γ-flux induced by a 50-MeV 10-µA electron beam in a uranium-carbide target. It is dimensioned for 1011 fissions per second. The RIB facility is exploited in alternating mode with the tandem-based section of Alto, capable of accelerating both light ions for nuclear astrophysics and heavy ions for γ-spectroscopy. The facility thereby offers the opportunity to deliver beams to a large range of physics programmes from nuclear to interdisciplinary physics. In this article, we present the Alto facility as well as some of the highlights and prospects of the experimental programme.

  6. The Arctic Lower Troposphere Observed Structure (ALTOS) Campaign

    SciTech Connect

    Verlinde, J

    2010-10-18

    The ALTOS campaign focuses on operating a tethered observing system for routine in situ sampling of low-level (< 2 km) Arctic clouds. It has been a long-term hope to fly tethered systems at Barrow, Alaska, but it is clear that the Federal Aviation Administration (FAA) will not permit in-cloud tether systems at Barrow, even if unmanned aerial vehicle (UAV) operations are allowed in the future. We have provided the scientific rationale for long-term, routine in situ measurements of cloud and aerosol properties in the Arctic. The existing restricted air space at Oliktok offers an opportunity to do so.

  7. CAFE: Calar Alto Fiber-fed Échelle spectrograph

    NASA Astrophysics Data System (ADS)

    Aceituno, J.; Sánchez, S. F.; Grupp, F.; Lillo, J.; Hernán-Obispo, M.; Benitez, D.; Montoya, L. M.; Thiele, U.; Pedraz, S.; Barrado, D.; Dreizler, S.; Bean, J.

    2013-04-01

    We present here CAFE, the Calar Alto Fiber-fed Échelle spectrograph, a new instrument built at the Centro Astronomico Hispano Alemán (CAHA). CAFE is a single-fiber, high-resolution (R ~ 70 000) spectrograph, covering the wavelength range between 3650-9800 Å. It was built on the basis of the common design for Échelle spectrographs. Its main aim is to measure radial velocities of stellar objects up to V ~ 13-14 mag with a precision as good as a few tens of m s-1. To achieve this goal the design was simplified at maximum, removing all possible movable components, the central wavelength is fixed, as is the wavelength coverage; there is no filter wheel, etc. Particular care was taken with the thermal and mechanical stability. The instrument is fully operational and publically accessible at the 2.2 m telescope of the Calar Alto Observatory. In this article we describe (i) the design, summarizing its manufacturing phase; (ii) characterize the main properties of the instrument; (iii) describe the reduction pipeline; and (iv) show the results from the first light and commissioning runs. The preliminar results indicate that the instrument fulfills the specifications and can achieve the planned goals. In particular, the results show that the instrument is more efficient than anticipated, reaching a signal-to-noise of ~20 for a stellar object as faint as V ~ 14.5 mag in ~2700 s integration time. The instrument is a wonderful machine for exoplanetary research (by studying large samples of possible systems cotaining massive planets), galactic dynamics (highly precise radial velocities in moving groups or stellar associations), or astrochemistry.

  8. Bird diversity and conservation of Alto Balsas (southwestern Puebla), Mexico.

    PubMed

    Ramírez-Albores, Jorge E

    2007-03-01

    Knowledge of the composition of the bird community in Alto Balsas (southwestern Puebla, Central Mexico) is needed for management programs aiming at protection and conservation of bird species and their habitats I studied sites with tropical deciduous forest. Data were obtained during 1666 hours of field work in 238 days from March 1998 to September 2000. Six permanent transect (3.5 km long and 100 m wide; 30 to 40 ha in each transect) were used to determine species richness in the study sites. The Shannon-Wiener diversity index was calculated for each site and Sorensen's index was used to assess similarity between sites. One-way analysis of variance was used to test for differences between sites in species richness and diversity values. A total of 128 species were recorded, Tepexco (n=75, H' = 3.76) and Puente Márquez (n=61, H' = 3.62) were the sites that showed the greatest specific richness and diversity. However, species richness and diversity seasonally patterns were similar among sites (ANOVA p > 0.05), with highest diversity during the rainy season. Most species were resident; 42 were migrants. The avifauna was represented by 30 species associated with tropical deciduous forest and 12 from open habitats or heavily altered habitats. Insectivores were the best represented trophic category, followed by carnivores and omnivores.

  9. Busca de estruturas em grandes escalas em altos redshifts

    NASA Astrophysics Data System (ADS)

    Boris, N. V.; Sodrã©, L., Jr.; Cypriano, E.

    2003-08-01

    A busca por estruturas em grandes escalas (aglomerados de galáxias, por exemplo) é um ativo tópico de pesquisas hoje em dia, pois a detecção de um único aglomerado em altos redshifts pode por vínculos fortes sobre os modelos cosmológicos. Neste projeto estamos fazendo uma busca de estruturas distantes em campos contendo pares de quasares próximos entre si em z Â3 0.9. Os pares de quasares foram extraídos do catálogo de Véron-Cetty & Véron (2001) e estão sendo observados com os telescópios: 2,2m da University of Hawaii (UH), 2,5m do Observatório de Las Campanas e com o GEMINI. Apresentamos aqui a análise preliminar de um par de quasares observado nos filtros i'(7800 Å) e z'(9500 Å) com o GEMINI. A cor (i'-z') mostrou-se útil para detectar objetos "early-type" em redshifts menores que 1.1. No estudo do par 131046+0006/J131055+0008, com redshift ~ 0.9, o uso deste método possibilitou a detecção de sete objetos candidatos a galáxias "early-type". Num mapa da distribuição projetada dos objetos para 22 < i' < 25 observou-se que estas galáxias estão localizadas próximas a um dos quasares e há indícios de que estejam aglomeradas dentro de um área de ~ 6 arcmin2. Se esse for o caso, estes objetos seriam membros de uma estrutura em grande escala. Um outro argumento em favor dessa hipótese é que eles obedecem uma relação do tipo Kormendy (raio equivalente X brilho superficial dentro desse raio), como a apresentada pelas galáxias elípticas em z = 0.

  10. CAFE: Calar Alto Fiber-fed Echelle spectrograph

    NASA Astrophysics Data System (ADS)

    Sánchez, S. F.; Aceituno, J.; Thiele, U.; Grupp, F.; Dreizler, S.; Bean, J.; Benitez, D.

    2011-11-01

    The Calar Alto Fiber-fed Echelle spectrograph (CAFE) is an instrument underconstruction at CAHA to replace FOCES, the high-resolution echellespectrograph at the 2.2 m telescope of the observatory. FOCES is a property ofthe Observatory of the Munich University, and it was recalled it from Calar Altoin 2009. The instrument comprised a substantial fraction of thetelescope time during its operational life-time, and it is due to that it wastaken the decision to build a replacement.CAFE shares its basic characteristics with those of FOCES. However, significantimprovements have been introduced in the original design, the quality of thematerials, and the overall stability of the system. In particular: (i) a newcalibration Iodine cell is foreseen to operate together with the standard ThArlamps; (ii) the optical quality of all the components has been selected to belambda/20, instead of the original lambda/10; (iii) an isolated room hasbeen selected to place the instrument, termalized and stabilized againstvibrations (extensive tests have been performed to grant the stability); (iv)most of the mobile parts in FOCES has been substituted by fixed elements, toincrease the stability of the system; and finally (v) a new more efficientCCD, with a smaller pixel has been acquired. It is expected that the overallefficiency and the quality of the data will be significantly improved withrespect to its precesor. In particular, CAFE is design and built to achieveresolutions of R ˜ 70000, which will be kept in the final acquired data,allowing it to compete with current operational extrasolar planets hunters.After two years of work all the components are in place. The instrument is nowfinally assembled, and we are performing the the first alignment tests. It isexpected that the commissioning on the laboratory will finish at the end of2010, followed by the commissioning on telescope along the first semester of2011. If everything goes well, we will offer the instrument in a shared

  11. Norovirus - hospital

    MedlinePlus

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... Symptoms start within 24 to 48 hours of infection, and can last for 1 ... norovirus. Hospital patients who are very old, very young, or ...

  12. Schooling and Critical Citizenship: Pedagogies of Political Agency in El Alto, Bolivia

    ERIC Educational Resources Information Center

    Lazar, Sian

    2010-01-01

    This article explores the formation of citizenship as social practice in a school in El Alto, Bolivia. I examine interactions between "banking" forms of education, students' responses, and embodied practices of belonging and political agency, and argue that the seemingly passive forms of knowledge transmission so criticized by critical pedagogy…

  13. Hospital fundamentals.

    PubMed

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

    2014-07-01

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

  14. Hospital fundamentals.

    PubMed

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

    2014-07-01

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

  15. Hospital marketing.

    PubMed

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  16. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

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

  17. Hospital marketing.

    PubMed

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation. PMID:14753323

  18. Health assessment for Hewlett-Packard, Palo Alto, Palo Alto, Santa Clara County, California, Region 9. CERCLIS No. CAD009122532. Final report

    SciTech Connect

    Not Available

    1988-12-05

    The Hewlett-Packard, Palo Alto site is on the National Priorities List. The site is a gasoline station owned by the Hewlett-Packard Corporation which had five underground storage tanks. The environmental contamination (maximum concentrations reported) consists of trichloroethylene (520 ppb), benzene (110 ppb), xylenes (290 ppb), toluene (10 ppb), and chloroform (28 ppb) in ground water; benzene (36 ppm), toluene (290 ppm), xylenes (540 ppm), ethylbenzene (100 ppm), and total petroleum hydrocarbons (1,700 ppm) in subsurface soil beneath the site. The site is considered to be of potential public health concern because of the risk to human health caused by the possibility of exposure to hazardous substances via contaminated ground water. However, the potential appears to be minor at this time since there apparently are no ground water wells in use in the vicinity of the plume.

  19. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

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

  20. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

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

  1. CALIFA, the Calar Alto Legacy Integral Field Area survey. III. Second public data release

    NASA Astrophysics Data System (ADS)

    García-Benito, R.; Zibetti, S.; Sánchez, S. F.; Husemann, B.; de Amorim, A. L.; Castillo-Morales, A.; Cid Fernandes, R.; Ellis, S. C.; Falcón-Barroso, J.; Galbany, L.; Gil de Paz, A.; González Delgado, R. M.; Lacerda, E. A. D.; López-Fernandez, R.; de Lorenzo-Cáceres, A.; Lyubenova, M.; Marino, R. A.; Mast, D.; Mendoza, M. A.; Pérez, E.; Vale Asari, N.; Aguerri, J. A. L.; Ascasibar, Y.; Bekerait*error*ė, S.; Bland-Hawthorn, J.; Barrera-Ballesteros, J. K.; Bomans, D. J.; Cano-Díaz, M.; Catalán-Torrecilla, C.; Cortijo, C.; Delgado-Inglada, G.; Demleitner, M.; Dettmar, R.-J.; Díaz, A. I.; Florido, E.; Gallazzi, A.; García-Lorenzo, B.; Gomes, J. M.; Holmes, L.; Iglesias-Páramo, J.; Jahnke, K.; Kalinova, V.; Kehrig, C.; Kennicutt, R. C.; López-Sánchez, Á. R.; Márquez, I.; Masegosa, J.; Meidt, S. E.; Mendez-Abreu, J.; Mollá, M.; Monreal-Ibero, A.; Morisset, C.; del Olmo, A.; Papaderos, P.; Pérez, I.; Quirrenbach, A.; Rosales-Ortega, F. F.; Roth, M. M.; Ruiz-Lara, T.; Sánchez-Blázquez, P.; Sánchez-Menguiano, L.; Singh, R.; Spekkens, K.; Stanishev, V.; Torres-Papaqui, J. P.; van de Ven, G.; Vilchez, J. M.; Walcher, C. J.; Wild, V.; Wisotzki, L.; Ziegler, B.; Alves, J.; Barrado, D.; Quintana, J. M.; Aceituno, J.

    2015-04-01

    This paper describes the Second Public Data Release (DR2) of the Calar Alto Legacy Integral Field Area (CALIFA) survey. The data for 200 objects are made public, including the 100 galaxies of the First Public Data Release (DR1). Data were obtained with the integral-field spectrograph PMAS/PPak mounted on the 3.5 m telescope at the Calar Alto observatory. Two different spectral setups are available for each galaxy, (i) a low-resolution V500 setup covering the wavelength range 3745-7500 Å with a spectral resolution of 6.0 Å (FWHM); and (ii) a medium-resolution V1200 setup covering the wavelength range 3650-4840 Å with a spectral resolution of 2.3 Å (FWHM). The sample covers a redshift range between 0.005 and 0.03, with a wide range of properties in the color-magnitude diagram, stellar mass, ionization conditions, and morphological types. All the cubes in the data release were reduced with the latest pipeline, which includes improvedspectrophotometric calibration, spatial registration, and spatial resolution. The spectrophotometric calibration is better than 6% and the median spatial resolution is 2.̋4. In total, the second data release contains over 1.5 million spectra. Based on observations collected at the Centro Astronómico Hispano Alemán (CAHA) at Calar Alto, operated jointly by the Max-Planck-Institut für Astronomie (MPIA) and the Instituto de Astrofísica de Andalucía (CSIC).The second data release is available at http://califa.caha.es/DR2

  2. Petrology and geochemistry of Alto Peak, a vapor-cored hydrothermal system, Leyte Province, Philippines

    SciTech Connect

    Reyes, A.G. |; Giggenbach, W.F.; Saleras, J.R.M.; Salonga, N.D.; Vergara, M.C.

    1993-10-01

    Based on detailed petrological information on secondary mineral assemblages and the composition of fluids trapped in inclusions and discharged from five wells, the Alto Peak geothermal field was found to represent a combined vapor and liquid-dominated system. A central core or chimney, with a diameter of about 1 km, a height of some 3 km and occupied by a high gas vapor (1.1 to 5.6 molal CO{sub 2}), is surrounded by an envelope of intermediate salinity water (7,000 mg/kg Cl) with temperatures between 250 and 350 C. The transition from purely vapor-dominated to liquid-dominated zones takes place via two-phase zones occupied by fluid mixtures of highly variable compositions. Much of the lower temperature, mature neutral pH Cl water is likely to have formed during an earlier stage in the evolution of the system. High temperatures of > 300 C, and associated alteration, are limited to wells AP-1D and the lower parts of AP-2D and are ascribed to re-heating by recent magmatic intrusions. The isotopic composition of the well discharges suggests that they contain some 40 to 50% of magmatic water. Alto Peak is considered a typical example of hydrothermal systems associated with many dormant volcanoes.

  3. The 3He long-counter TETRA at the ALTO ISOL facility

    NASA Astrophysics Data System (ADS)

    Testov, D.; Verney, D.; Roussière, B.; Bettane, J.; Didierjean, F.; Flanagan, K.; Franchoo, S.; Ibrahim, F.; Kuznetsova, E.; Li, R.; Marsh, B.; Matea, I.; Penionzhkevich, Yu.; Pai, H.; Smirnov, V.; Sokol, E.; Stefan, I.; Suzuki, D.; Wilson, J. N.

    2016-04-01

    A new β-decay station (BEDO) has been installed behind the PARRNe mass separator operated on-line at the electron-driven ALTO ISOL facility. The station is equipped with a movable tape collector allowing the creation of the radioactive sources of interest at the very center of a modular detection system. The mechanical structure was designed to host various assemblies of detectors in compact geometry. We report here the first on-line use of this system equipped with the 4π 3He neutron counter TETRA built at JINR Dubna associated with HPGe and plastic 4π β detectors. The single neutron detection efficiency achieved is 53(2)% measured using the 252Cf source. For β-delayed neutron measurements the neutron detection efficiency was derived from the comparison of gated γ-spectra. The on-line commissioning of the TETRA setup was performed with laser-ionized gallium beams. β and neutron events were recorded as a function of time. From these data we report P1n(82Ga)=22(2)% and T1/2(82Ga)=0.604(11) s in good agreement with values available in the literature. The new detection system will be used in other experiments aimed at investigations of β-decay properties of neutron-rich isotopes produced at ALTO.

  4. Fuel dynamics by using Landscape Ecology Indices in the Alto Mijares, Spain

    NASA Astrophysics Data System (ADS)

    Iqbal, J.; Garcia, C. V.

    2009-04-01

    Land abandonment in Mediterranean regions has brought about a number of management problems, being an increased wildfire activity prevalent among them. Agricultural neglect in highlands resulted in reduced anthropogenic disturbances and greater landscape homogeneity in areas such as the Alto Mijares in Spain. It is widely accepted that processes like forest fires, influence structure of the landscape and vice versa. Fire-prone Mediterranean flora is well adapted to this disturbance, exhibiting excellent succession capabilities; but higher fuel loads and homogeneous conditions may ally to promote vegetation recession when the fire regime is altered by land abandonment. Both succession and recession make changes to the landscape structure and configuration. However, these changes are difficult to quantify and characterize. If landscape restoration of these forests is a management objective, then developing a quantitative knowledge base for landscape fuel dynamics is a prerequisite. Four classified LandsatTM satellite images were compared to quantify changes in landscape structure between 1984 and 1998. An attempt is made to define landscape level dynamics for fuel development after reduced disturbance and fuel accumulation that leads to catastrophic fires by using landscape ecology indices. By doing so, indices that best describe the fuel dynamics are pointed. The results indicate that low-level disturbance increases heterogeneity, thus lowers fire hazard. No disturbance or severe disturbance increases homogeneity because of vegetation succession and may lead to devastating fires. These fires could be avoided by human induced disturbance like controlled burning, harvesting, mechanical works for fuel reduction and other silviculture measures; thus bringing in more heterogeneity in the region. The Alto Mijares landscape appears to be in an unstable equilibrium where succession and recession are at tug of war. The effects are evident in the general absence of the climax

  5. CALIFA, the Calar Alto Legacy Integral Field Area survey. IV. Third public data release

    NASA Astrophysics Data System (ADS)

    Sánchez, S. F.; García-Benito, R.; Zibetti, S.; Walcher, C. J.; Husemann, B.; Mendoza, M. A.; Galbany, L.; Falcón-Barroso, J.; Mast, D.; Aceituno, J.; Aguerri, J. A. L.; Alves, J.; Amorim, A. L.; Ascasibar, Y.; Barrado-Navascues, D.; Barrera-Ballesteros, J.; Bekeraitè, S.; Bland-Hawthorn, J.; Cano Díaz, M.; Cid Fernandes, R.; Cavichia, O.; Cortijo, C.; Dannerbauer, H.; Demleitner, M.; Díaz, A.; Dettmar, R. J.; de Lorenzo-Cáceres, A.; del Olmo, A.; Galazzi, A.; García-Lorenzo, B.; Gil de Paz, A.; González Delgado, R.; Holmes, L.; Iglésias-Páramo, J.; Kehrig, C.; Kelz, A.; Kennicutt, R. C.; Kleemann, B.; Lacerda, E. A. D.; López Fernández, R.; López Sánchez, A. R.; Lyubenova, M.; Marino, R.; Márquez, I.; Mendez-Abreu, J.; Mollá, M.; Monreal-Ibero, A.; Ortega Minakata, R.; Torres-Papaqui, J. P.; Pérez, E.; Rosales-Ortega, F. F.; Roth, M. M.; Sánchez-Blázquez, P.; Schilling, U.; Spekkens, K.; Vale Asari, N.; van den Bosch, R. C. E.; van de Ven, G.; Vilchez, J. M.; Wild, V.; Wisotzki, L.; Yıldırım, A.; Ziegler, B.

    2016-10-01

    This paper describes the third public data release (DR3) of the Calar Alto Legacy Integral Field Area (CALIFA) survey. Science-grade quality data for 667 galaxies are made public, including the 200 galaxies of the second public data release (DR2). Data were obtained with the integral-field spectrograph PMAS/PPak mounted on the 3.5 m telescope at the Calar Alto Observatory. Three different spectral setups are available: i) a low-resolution V500 setup covering the wavelength range 3745-7500 Å (4240-7140 Å unvignetted) with a spectral resolution of 6.0 Å (FWHM) for 646 galaxies, ii) a medium-resolution V1200 setup covering the wavelength range 3650-4840 Å (3650-4620 Å unvignetted) with a spectral resolution of 2.3 Å (FWHM) for 484 galaxies, and iii) the combination of the cubes from both setups (called COMBO) with a spectral resolution of 6.0 Å and a wavelength range between 3700-7500 Å (3700-7140 Å unvignetted) for 446 galaxies. The Main Sample, selected and observed according to the CALIFA survey strategy covers a redshift range between 0.005 and 0.03, spans the color-magnitude diagram and probes a wide range of stellar masses, ionization conditions, and morphological types. The Extension Sample covers several types of galaxies that are rare in the overall galaxy population and are therefore not numerous or absent in the CALIFA Main Sample. All the cubes in the data release were processed using the latest pipeline, which includes improved versions of the calibration frames and an even further improved image reconstruction quality. In total, the third data release contains 1576 datacubes, including ~1.5 million independent spectra. Based on observations collected at the Centro Astronómico Hispano Alemán (CAHA) at Calar Alto, operated jointly by the Max-Planck-Institut für Astronomie (MPIA) and the Instituto de Astrofísica de Andalucía (CSIC).The spectra are available at http://califa.caha.es/DR3

  6. Brief Therapy Based on Interrupting Ironic Processes: The Palo Alto Model

    PubMed Central

    Rohrbaugh, Michael J.; Shoham, Varda

    2009-01-01

    The model of brief therapy developed by Fisch, Weakland, Watzlawick, and colleagues in Palo Alto is based on identifying and interrupting ironic processes that occur when repeated attempts to solve a problem keep the problem going or make it worse. Formulations of ironic problem-solution loops provide a template for assessment and strategic intervention, indicating where to look to understand what keeps a problem going (look for “more of the same” solution) and what needs to happen for the complaint to be resolved (someone must apply “less of the same” solution). Supporting research is preliminary but suggests this approach may be well suited for change-resistant clients. PMID:19997533

  7. Nutrient content of earthworms consumed by Ye'Kuana Amerindians of the Alto Orinoco of Venezuela.

    PubMed

    Paoletti, M G; Buscardo, E; VanderJagt, D J; Pastuszyn, A; Pizzoferrato, L; Huang, Y-S; Chuang, L-T; Millson, M; Cerda, H; Torres, F; Glew, R H

    2003-02-01

    For the Makiritare (Ye'Kuana) native people of the Alto Orinoco (Venezuela), earthworms (Anellida: Glossoscolecidae) are an important component of the diet. Two species in particular are widely consumed: 'kuru' (Andiorrhinus kuru n. sp.) and 'motto' (Andiorrhinus motto). We analysed eviscerated kuru body proper, and whole and smoked preparations of motto for their content of protein and amino acids, fatty acids and 20 minerals and trace elements. The samples contained large amounts of protein (64.5-72.9% of dry weight), essential amino acids, calcium and iron together with notable quantities of other important elements, indicating that these earthworms contain potentially useful quantities of many nutrients that are critical to the health of the humans who consume them. PMID:12614573

  8. Nutrient content of earthworms consumed by Ye'Kuana Amerindians of the Alto Orinoco of Venezuela.

    PubMed Central

    Paoletti, M G; Buscardo, E; VanderJagt, D J; Pastuszyn, A; Pizzoferrato, L; Huang, Y-S; Chuang, L-T; Millson, M; Cerda, H; Torres, F; Glew, R H

    2003-01-01

    For the Makiritare (Ye'Kuana) native people of the Alto Orinoco (Venezuela), earthworms (Anellida: Glossoscolecidae) are an important component of the diet. Two species in particular are widely consumed: 'kuru' (Andiorrhinus kuru n. sp.) and 'motto' (Andiorrhinus motto). We analysed eviscerated kuru body proper, and whole and smoked preparations of motto for their content of protein and amino acids, fatty acids and 20 minerals and trace elements. The samples contained large amounts of protein (64.5-72.9% of dry weight), essential amino acids, calcium and iron together with notable quantities of other important elements, indicating that these earthworms contain potentially useful quantities of many nutrients that are critical to the health of the humans who consume them. PMID:12614573

  9. Hospitals for sale.

    PubMed

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

    2011-01-01

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

  10. Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano, inland southern Italy

    PubMed Central

    Quave, Cassandra L; Pieroni, Andrea; Bennett, Bradley C

    2008-01-01

    Background Dermatological remedies make up at least one-third of the traditional pharmacopoeia in southern Italy. The identification of folk remedies for the skin is important both for the preservation of traditional medical knowledge and in the search for novel antimicrobial agents in the treatment of skin and soft tissue infection (SSTI). Our goal is to document traditional remedies from botanical, animal, mineral and industrial sources for the topical treatment of skin ailments. In addition to SSTI remedies for humans, we also discuss certain ethnoveterinary applications. Methods Field research was conducted in ten communities in the Vulture-Alto Bradano area of the Basilicata province, southern Italy. We randomly sampled 112 interviewees, stratified by age and gender. After obtaining prior informed consent, we collected data through semi-structured interviews, participant-observation, and small focus groups techniques. Voucher specimens of all cited botanic species were deposited at FTG and HLUC herbaria located in the US and Italy. Results We report the preparation and topical application of 116 remedies derived from 38 plant species. Remedies are used to treat laceration, burn wound, wart, inflammation, rash, dental abscess, furuncle, dermatitis, and other conditions. The pharmacopoeia also includes 49 animal remedies derived from sources such as pigs, slugs, and humans. Ethnoveterinary medicine, which incorporates both animal and plant derived remedies, is addressed. We also examine the recent decline in knowledge regarding the dermatological pharmacopoeia. Conclusion The traditional dermatological pharmacopoeia of Vulture-Alto Bradano is based on a dynamic folk medical construct of natural and spiritual illness and healing. Remedies are used to treat more than 45 skin and soft tissue conditions of both humans and animals. Of the total 165 remedies reported, 110 have never before been published in the mainland southern Italian ethnomedical literature. PMID

  11. Source characteristics of 2000 small earthquakes nucleating on the Alto Tiberina fault system (central Italy).

    NASA Astrophysics Data System (ADS)

    Munafo, I.; Malagnini, L.; Tinti, E.; Chiaraluce, L.; Di Stefano, R.; Valoroso, L.

    2014-12-01

    The Alto Tiberina Fault (ATF) is a 60 km long east-dipping low-angle normal fault, located in a sector of the Northern Apennines (Italy) undergoing active extension since the Quaternary. The ATF has been imaged by analyzing the active source seismic reflection profiles, and the instrumentally recorded persistent background seismicity. The present study is an attempt to separate the contributions of source, site, and crustal attenuation, in order to focus on the mechanics of the seismic sources on the ATF, as well on the synthetic and the antithetic structures within the ATF hanging-wall (i.e. Colfiorito fault, Gubbio fault and Umbria Valley fault). In order to compute source spectra, we perform a set of regressions over the seismograms of 2000 small earthquakes (-0.8 < ML< 4) recorded between 2010 and 2014 at 50 permanent seismic stations deployed in the framework of the Alto Tiberina Near Fault Observatory project (TABOO) and equipped with three-components seismometers, three of which located in shallow boreholes. Because we deal with some very small earthquakes, we maximize the signal to noise ratio (SNR) with a technique based on the analysis of peak values of bandpass-filtered time histories, in addition to the same processing performed on Fourier amplitudes. We rely on a tool called Random Vibration Theory (RVT) to completely switch from peak values in the time domain to Fourier spectral amplitudes. Low-frequency spectral plateau of the source terms are used to compute moment magnitudes (Mw) of all the events, whereas a source spectral ratio technique is used to estimate the corner frequencies (Brune spectral model) of a subset of events chosen over the analysis of the noise affecting the spectral ratios. So far, the described approach provides high accuracy over the spectral parameters of earthquakes of localized seismicity, and may be used to gain insights into the underlying mechanics of faulting and the earthquake processes.

  12. [Work condition of workers and recommended individual protective means in cyproconasol (alto) usage via surface and aviation methods].

    PubMed

    Nebytov, V G

    2014-01-01

    While using cyprokonasol via surface and aviation methods, workers are exposed to unfavorable microclimate, noise and pollution of overalls, skin and workplace air with the fungicide. Necessity for safe work of operators, pilots and signalmen, while using alto, is complex application of individual protective means.

  13. Hospital-acquired pneumonia

    MedlinePlus

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

  14. Hospital Charges of Potentially Preventable Pediatric Hospitalizations

    PubMed Central

    Lu, Sam; Kuo, Dennis Z.

    2014-01-01

    Objectives Reducing the number of preventable hospitalizations represents a possible source of healthcare savings. However, the current literature lacks a description of the extent of potentially preventable pediatric hospitalizations. The study objectives are to (1) identify the charges and (2) demographic characteristics associated with potentially preventable pediatric hospitalizations. Methods Secondary analysis of the 2006 Kids’ Inpatient Database (weighted N=7,558,812). ICD-9-CM codes for 16 previously validated pediatric ambulatory care-sensitive (ACS) conditions identified potentially preventable hospitalizations; seven additional conditions reflected updated care guidelines. Outcome variables included number of admissions, hospitalization days, and hospital charges. Demographic and diagnostic variables associated with an ACS condition were compared with regression analyses using appropriate person-level weights. Results Pediatric ACS hospitalizations totaled $4.05B in charges and 1,087,570 hospitalization days in 2006. Two respiratory conditions—asthma and bacterial pneumonia—comprised 48.4% of ACS hospital charges and 46.7% of ACS hospitalization days. In multivariate analysis, variables associated with an ACS condition included: male gender (OR: 1.10; 95% CI: 1.07–1.13); race/ethnicity of black (OR: 1.22; 95% CI: 1.16–1.27) or Hispanic (OR: 1.12; 95% CI: 1.06–1.18); and emergency department (ED) as admission source (OR: 1.37; 95% CI: 1.27–1.48). Conclusions Respiratory conditions comprised the largest proportion of potentially preventable pediatric hospitalizations, totaling as much as $1.96B in hospital charges. Children hospitalized with an ACS condition tend to be male, non-white, and admitted through the ED. Future research to prevent pediatric hospitalizations should examine targeted interventions in the primary care setting, specifically around respiratory conditions and minority populations. PMID:22922047

  15. The Early Triassic magmatism of the Alto Paraguay Province, Central South America: Paleomagnetic and ASM data

    NASA Astrophysics Data System (ADS)

    Ernesto, Marcia; Comin-Chiaramonti, Piero; Gomes, Celso de Barros

    2015-10-01

    A paleomagnetic studystudywork was carried out on the Alto Paraguay Province (APP), a belt of alkaline complexes that parallel the Paraguay river for more than 40 km at the border of Brazil and Paraguay. The province is well dated by 40Ar/39Ar method giving ages in the range 240-250 Ma with a preferred age of 241 Ma. Intrusive rocks are predominant but the stocks may be topped by lava flows and ignimbrites. Paleomagnetic work on stocks, dikes and flows of the APP identified normal and reversed magnetic components which are carried mainly by titanomagnetites. The calculated paleomagnetic pole located at 319ºE 78ºS (α95 = 6º; k = 23) is in agreement with other South American poles of Permo-Triassic age. Most of the sampling sites showed large variations in rock magnetization, but similar patterns in the variation of the within-site magnetizations, mainly in dikes, suggest geomagnetic polarity transition records. The magnetization data along with the anisotropy of magnetic susceptibility determinations suggested that the South and North areas of the province have different evolution characteristics.

  16. Instrumental social support and women's body composition in El Alto, Bolivia.

    PubMed

    Hicks, Kathryn

    2013-09-01

    Instrumental social support, or aid in the form of labor or money, may exert a positive influence on economic welfare and food security. Several investigators have found a positive relationship between social support and nutritional status, while others have found a negative association between social support and central adiposity. In the rural Andes, extra-household economic cooperation has long been an important adaptive strategy, and the breakdown of these relationships is one reason for high rates of rural-to-urban migration, including to the Bolivian city of El Alto. This research investigates the influence of instrumental support on women's body composition. Information was collected on individual perception of instrumental support and anthropometric indicators of nutritional status including percent body fat (bioelectrical impedance analysis (BIA)), BMI, and distribution of fat on trunk relative to limbs (Ratio of subscapular to triceps skinfold (STR)), and multiple linear regression analysis used to test the prediction that instrumental social support is positively related to body fat stores. Controlling for age and household socioeconomic status, perceived access to one or more sources of instrumental support was positively and significantly related to overall levels of adiposity. There is no evidence that STR mediates the relationship between instrumental social support and body composition. This analysis offers support for the prediction that economic social support has direct effects on women's energy stores. The interpretation of these results is somewhat ambiguous given the high levels of overweight and obesity in this population.

  17. [Report of four clinical cases of filariasis in Alto Nanay, Loreto].

    PubMed

    Vargas-Herrera, Javier; Arróspide-Velasco, Nancy; Gutierrez-González, Sonia; Celis-Salinas, Juan C; Huamaní-Solano, Daniel; Loza-Hermenegildo, Luis; Elgegren-Lao, Julio; Armas-Montes, José; Baca-Pérez, Juan; Cabezas, César

    2013-07-01

    This study describes the clinical, parasitological and laboratory findings of four patients who lived in the district of Alto Nanay, Maynas, Loreto, Peru and were infected with Mansonella ozzardi microfilariae. Clinical examinations by ophthalmologists, cardiologists and nephrologists were performed. In case 1, the presence of 2 subcutaneous lumps was the most important finding, one at dorsal level and the other in the lower third of the left leg; in case 2, there was a sensation of tingling or coldness in the legs; in case 3, an associated chronic hepatitis B infection was found, and in case 4, a large lump was detected in the left lumbar region. All 4 patients were infected with Mansonella ozzardi and had eosinophilia, 3 of them in percentages of 20%. The lump found in case 4 was due to a herniation of bowel content. Further clinical studies and an evaluation of the actual pathogenic effect of microfilariae are to be performed. A study of the genetic diversity of filariae in the Peruvian Amazon would also be important. PMID:24100830

  18. An economic analysis of the EHAS telemedicine system in Alto Amazonas.

    PubMed

    Martínez, Andrés; Villarroel, Valentín; Puig-Junoy, Jaume; Seoane, Joaquín; del Pozo, Francisco

    2007-01-01

    Telemedicine systems providing voice communication and email by radio were installed at seven health centres (HCs) and 32 health posts (HPs) in the Alto Amazonas province of Peru during 2001. A cost analysis was performed to estimate the net effect on direct resource consumption from the perspective of society. Prior to the availability of the EHAS telemedicine system, there was a mean of 11.1 urgent patient referrals per year from the HPs and 14.0 referrals per year from the HCs. After the implementation of telemedicine, patient referrals fell to 2.5 per year from the HPs (P = 0.03) and to 8.4 per year from the HCs (P = 0.17). The net economic effect of the telemedicine programme over a four-year period was clearly positive, amounting to annual net savings of US$320,126 (using a 5% discounting rate). A one-way sensitivity analysis using a range of values for the discounting rate, and the number of urgent referrals, confirms that the programme was efficient (i.e. it made net financial savings) in all cases. From the restricted budgetary perspective of the health network, the results also demonstrate that the additional operational costs (telephone and maintenance) introduced by the telemedicine system were lower than the direct cost-savings produced for the health-care network.

  19. Hospital Library Administration.

    ERIC Educational Resources Information Center

    Cramer, Anne

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

  20. Hospital marketing revisited.

    PubMed

    Costello, M M

    1987-05-01

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

  1. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  2. [Risk prescription associated to treatment at home of the elderly patient when admitted to the hospital].

    PubMed

    Iniesta-Navalón, C; Urbieta-Sanz, E; Gascón-Cánovas, J J; Rentero-Redondo, L; Cabello Muriel, A; García-Molina, C

    2013-01-01

    Objetivo: Determinar la prevalencia, la incidencia de error y el daño potencial asociado a determinadas prescripciones señaladas como de riesgo de error de medicación en el tratamiento domiciliario de pacientes ancianos que ingresan en el hospital, así como los factores asociados a su aparición. Material y métodos: Estudio transversal descriptivo. Se incluyeron los pacientes de edad igual o mayor a 65 años que ingresaron en el hospital desde el servicio de urgencias durante el último trimestre de 2009.Para el análisis estadístico se utilizó el programa SPSSv15.0. Resultados: Se incluyeron en el estudio 324 pacientes. Se identificaron 1176 (47%) prescripciones de riesgo en el 91% de los pacientes. La prescripción de riesgo más relevante fue la prescripción de medicamentos de alto riesgo (51.5% pacientes) que presentó una incidencia de error de 88/100 pacientes con medicamentos de alto riesgo, de los cuales en 68 pacientes fue grave. Los factores asociados a la presencia de error grave/moderado ocasionado por prescripciones de riesgo fueron tener enfermedad respiratoria crónica o diabetes y la polimedicación. Conclusiones: Se deben priorizar actuaciones dirigidas a disminuir errores por medicamentos de alto riesgo.

  3. CALIFA, the Calar Alto Legacy Integral Field Area survey. I. Survey presentation

    NASA Astrophysics Data System (ADS)

    Sánchez, S. F.; Kennicutt, R. C.; Gil de Paz, A.; van de Ven, G.; Vílchez, J. M.; Wisotzki, L.; Walcher, C. J.; Mast, D.; Aguerri, J. A. L.; Albiol-Pérez, S.; Alonso-Herrero, A.; Alves, J.; Bakos, J.; Bartáková, T.; Bland-Hawthorn, J.; Boselli, A.; Bomans, D. J.; Castillo-Morales, A.; Cortijo-Ferrero, C.; de Lorenzo-Cáceres, A.; Del Olmo, A.; Dettmar, R.-J.; Díaz, A.; Ellis, S.; Falcón-Barroso, J.; Flores, H.; Gallazzi, A.; García-Lorenzo, B.; González Delgado, R.; Gruel, N.; Haines, T.; Hao, C.; Husemann, B.; Iglésias-Páramo, J.; Jahnke, K.; Johnson, B.; Jungwiert, B.; Kalinova, V.; Kehrig, C.; Kupko, D.; López-Sánchez, Á. R.; Lyubenova, M.; Marino, R. A.; Mármol-Queraltó, E.; Márquez, I.; Masegosa, J.; Meidt, S.; Mendez-Abreu, J.; Monreal-Ibero, A.; Montijo, C.; Mourão, A. M.; Palacios-Navarro, G.; Papaderos, P.; Pasquali, A.; Peletier, R.; Pérez, E.; Pérez, I.; Quirrenbach, A.; Relaño, M.; Rosales-Ortega, F. F.; Roth, M. M.; Ruiz-Lara, T.; Sánchez-Blázquez, P.; Sengupta, C.; Singh, R.; Stanishev, V.; Trager, S. C.; Vazdekis, A.; Viironen, K.; Wild, V.; Zibetti, S.; Ziegler, B.

    2012-02-01

    The final product of galaxy evolution through cosmic time is the population of galaxies in the local universe. These galaxies are also those that can be studied in most detail, thus providing a stringent benchmark for our understanding of galaxy evolution. Through the huge success of spectroscopic single-fiber, statistical surveys of the Local Universe in the last decade, it has become clear, however, that an authoritative observational description of galaxies will involve measuring their spatially resolved properties over their full optical extent for a statistically significant sample. We present here the Calar Alto Legacy Integral Field Area (CALIFA) survey, which has been designed to provide a first step in this direction. We summarize the survey goals and design, including sample selection and observational strategy. We also showcase the data taken during the first observing runs (June/July 2010) and outline the reduction pipeline, quality control schemes and general characteristics of the reduced data. This survey is obtaining spatially resolved spectroscopic information of a diameter selected sample of ~600 galaxies in the Local Universe (0.005 < z < 0.03). CALIFA has been designed to allow the building of two-dimensional maps of the following quantities: (a) stellar populations: ages and metallicities; (b) ionized gas: distribution, excitation mechanism and chemical abundances; and (c) kinematic properties: both from stellar and ionized gas components. CALIFA uses the PPAK integral field unit (IFU), with a hexagonal field-of-view of ~1.3⎕', with a 100% covering factor by adopting a three-pointing dithering scheme. The optical wavelength range is covered from 3700 to 7000 Å, using two overlapping setups (V500 and V1200), with different resolutions: R ~ 850 and R ~ 1650, respectively. CALIFA is a legacy survey, intended for the community. The reduced data will be released, once the quality has been guaranteed. The analyzed data fulfillthe expectations of

  4. Sedimentation survey of Lago Loíza, Trujillo Alto, Puerto Rico, July 2009

    USGS Publications Warehouse

    Soler-López, Luis R.; Licha-Soler, N.A.

    2014-01-01

    Lago Loíza is a reservoir formed at the confluence of Río Gurabo and Río Grande de Loíza in the municipality of Trujillo Alto in central Puerto Rico, about 10 kilometers (km) north of the town of Caguas, about 9 km northwest of Gurabo, and about 3 km south of Trujillo Alto (fig. 1). The Carraizo Dam is owned and operated by the Puerto Rico Aqueduct and Sewer Authority (PRASA), and was constructed in 1953 as a water-supply reservoir for the San Juan Metropolitan area. The dam is a concrete gravity structure that is located in a shallow valley and has a gently sloping left abutment and steep right abutment. Non-overflow sections flank the spillway section. Waterways include an intake structure for the pumping station and power plant, sluiceways, a trash sluice, and a spillway. The reservoir was built to provide a storage capacity of 26.8 million cubic meters (Mm3) of water at the maximum pool elevation of 41.14 meters (m) above mean sea level (msl) for the Sergio Cuevas Filtration Plant that serves the San Juan metropolitan area. The reservoir has a drainage area of 538 square kilometers (km2) and receives an annual mean rainfall that ranges from 1,600 to 5,000 millimeters per year (mm/yr). The principal streams that drain into Lago Loíza are the Río Grande de Loíza, Río Gurabo, and Río Cañas. Two other rivers, the Río Bairoa and Río Cagüitas, discharge into the Río Grande de Loíza just before it enters the reservoir. The combined mean annual runoff of the Río Grande de Loíza and the Río Gurabo for the 1960–2009 period of record is 323 Mm3. Flow from these streams constitutes about 89 percent of the total mean annual inflow of 364 Mm3 to the reservoir (U.S. Geological Survey, 2009). Detailed information about Lago Loíza reservoir structures, historical sediment accumulation, and a dredge conducted in 1999 are available in Soler-López and Gómez-Gómez (2005). During July 8–15, 2009, the U.S. Geological Survey (USGS) Caribbean Water Science

  5. Quantifying Mechanisms of Aquifer Salinization at the Alto Piura Valley, Northern Part of Peru

    NASA Astrophysics Data System (ADS)

    Rivera Villarreyes, C. A.; Weisbrod, N.; Yakirevich, A.; Benavent, I.; Chavez, A. M.

    2009-12-01

    The Alto Piura aquifer (Peruvian northern coastal area) supports the important agricultural activity in the region and provides water supply for 150,000 residents. Recent studies show a salinization process in the northwest area of the aquifer. Further groundwater degradation could create economic and social problems for the region. An infiltration-tracer test in a typical agricultural field of the Alto Piura region was carried out to explore water and solute transport mechanisms. The main objective was to mimic the mechanism of flood irrigation (25 cm head once a month) typically used by Peruvian farmers in banana plots. Soil and groundwater contaminations were monitored in a 3x3 m area and a calcium chloride solution (3.07 m3) was injected as a tracer during the irrigation event. The initial and final conditions of the soil profile were studied by drilling three boreholes inside and one outside the plot prior to, and 2, 4, 7 and 10 days following the irrigation event. In total, 289 soil samples were collected to follow the gravimetric water content (GWC) and electrical conductivity (EC) profiles during the experiment. Soil samples were extracted in 20 cm resolution from the upper 2 m and 50 cm resolution for the rest of soil profile to 4.5 m, the initial watertable depth. Likewise, thirty groundwater samples were taken and analyzed for major ions, EC, and total dissolved solids (TDS). Bulk density and soil texture were also measured along the soil profiles. The GWC profiles indicated faster water movement through the unsaturated zone with respect to the salt movement. An infiltration test using double ring infiltrometer estimated Ks value of 0.24 m day-1.The EC soil profiles indicated a clear salt accumulation in the first 1 m layer that did not manifest changes until the end of the 10 day measurement period. Groundwater salinity varied within the 3x3 m zone. It increased, decreased or changed with time in respect to the initial salinity. This variability within

  6. Ethnobotanical notes about some uses of medicinal plants in Alto Tirreno Cosentino area (Calabria, Southern Italy)

    PubMed Central

    Leporatti, Maria Lucia; Impieri, Massimo

    2007-01-01

    Background The present paper contributes to enrich the ethnobotanical knowledge of Calabria region (Southern Italy). Research was carried out in Alto Tirreno Cosentino, a small area lying between the Tyrrhenian coast and the Pollino National Park. In the area studied medicinal plants still play a small role among farmers, shepherds and other people who live far from villages and built-up areas. Methods Information was collected by interviewing native people, mainly elderly – engaged in farming and stock-raising activities – and housewives. The plants collected, indicated by the locals, have been identified according to "Flora d'Italia". The exsiccata vouchers are preserved in the authors' own herbaria. Results 52 medicinal species belonging to 35 families are listed in this article. The family, botanical and vernacular name, part of the plant used and respective manipulation are reported there and, when present, similar or identical uses in different parts of Calabria or other Italian regions are also indicated. Conclusion Labiatae, Rosaceae and Leguminosae are the families most frequently present, whilst Compositae and Brassicaceae are almost absent. The uses of the recorded species relate to minor ailments, mainly those of the skin (15 species), respiratory apparatus diseases (11), toothache, decay etc. (10) and rheumatic pains (8). The easy availability of these remedies provides a quick way of curing various minor complaints such as tooth-ache, belly and rheumatic pain and headaches and can also serve as first aid as cicatrizing, lenitive, haemostatic agents etc. The role in veterinary medicine is, on the contrary, more important: sores, ulcers, tinea, dermatitis, gangrenous wounds of cattle, and even respiratory ailments are usually cured by resort to plants. PMID:17983476

  7. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    ERIC Educational Resources Information Center

    Anderson, David W.

    2011-01-01

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

  8. The application of hospitality elements in hospitals.

    PubMed

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

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

  9. The application of hospitality elements in hospitals.

    PubMed

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

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

  10. Hospitals as health educators

    MedlinePlus

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

  11. Surviving Your Child's Hospitalization.

    ERIC Educational Resources Information Center

    Cohen, David A.

    1988-01-01

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

  12. University Hospitals for Sale.

    ERIC Educational Resources Information Center

    Culliton, Barbara J.

    1984-01-01

    Although faculty opposition stopped the sale of Harvard's McLean Hospital to the Hospital Corporation of America (HCA), a partnership remains a possibility. Issues related to the proposed sale as well as those affecting hospital economics are considered. Proposed terms of the sale are included. (JN)

  13. HOSPITALS FOR RURAL PEOPLE.

    ERIC Educational Resources Information Center

    MANNY, ELSIE S.; ROGERS, CHARLES E.

    MODERN ADVANCEMENTS IN MEDICAL SCIENCE HAVE PRECIPITATED THE NEED FOR ADEQUATE UP-TO-DATE HOSPITAL FACILITIES REASONABLY CLOSE TO ALL PEOPLE. RURAL COMMUNITIES HAVE UTILIZED FEDERAL AID, STATE AID, ASSISTANCE FROM FOUNDATIONS, CIVIC BONDS, AND VOLUNTEER CONTRIBUTIONS AND DRIVES TO ERECT AND EQUIP HOSPITALS. HOSPITAL CARE FOR RURAL PEOPLE USUALLY…

  14. Crustal Structure and Moho Geometry around the Alto Tiberina Fault (Northern Apennines) from Receiver Functions

    NASA Astrophysics Data System (ADS)

    Licciardi, A.; Chiaraluce, L.; Piana Agostinetti, N.; Amato, A.

    2013-12-01

    The Alto Tiberina Fault (ATF) is an unique example of active low angle normal fault (dip ≈ 15°), detected in the Northern Apennines from the interpretation of passive and active seismic data. This NW-SE striking structure has been mapped for a about 50 km along dip and is thought to have accumulated a total of 2 km of displacement in the last 2 Ma. In the last years, a dense, high resolution seismic network has been deployed in the area surrounding the ATF, with the aim of better understanding the physical mechanisms of earthquakes nucleation of such geological feature and assessing the potentially associated seismic hazard. In this context, a good knowledge of the elastic properties of rocks at depth is the starting points for building accurate and consistent physical models of ATF's style of deformation. We carried out a teleseismic receiver functions (RF) study on the 42 broadband seismic stations, using about 800 events from teleseismic distances, recorded from January 2010 to December 2011. We selected an average of about 70 high S/N ratio RFs per station, achieving a good azimuthal coverage for most of the stations. We separated the isotropic and the anisotropic component of the RF data-set through the harmonic decomposition. For each station, we performed a Monte Carlo inversion (using a reversible jump Markov chain Monte Carlo algorithm) of the isotropic component of the RF data-set, obtaining 1-D Vs profiles from the surface to 60km depth. This kind of inversion does not suffer of the problems related to the choice of a particular starting model, and has the advantage of inferring the degree of complexity (i.e. the number of layers) of the resulting model, directly from the data themselves. Preliminary results show an increasing level of structural complexity moving from west to east across the target area. A clear and shallow (~25 km) Moho is observed from the velocity profiles in the westernmost part of the region. Along the easternmost part, crustal

  15. Guanaco traces and hunting strategies at Alto Patache North Chilean fog oasis

    NASA Astrophysics Data System (ADS)

    Larrain, H.; Cereceda, P.; Pérez, L.

    2010-07-01

    1. In foregoing Fog Conferences, some of us have made explicit the rich botanic and faunistic inventory to be found at this Chilean Fog site. This was specially apparent under strong ENSO conditions, as it happened in 1997/98 in the area. Among the mammal biggest species represented, the guanaco (Lama guanicoe Müller) merits special mention. Clear traces of their presence and eventual hunting and slaughtering by primitive populations have survived until present times. Among them, the myriads of guanaco trails still covering practically all the slopes along the foggy area, close to the sea, and their wollowing and defecating places are found. Also, although less studied, plant eating traces left behind by roaming camelids can be seen. 2. Guanaco hunting traces still visible at Alto Patache can be portrayed differently through : A) Analysis of lithic artifacts used as arms in hunting operations; B) Botanic response to animal attack; C) Examination of topographic traits used by primitive man in guanaco hunting strategies. A. Hundreds of lithic instruments made of stone, were abandoned by hunters in situ, some of them were intact, some fragmented, which would demonstrate a direct relationship with hunting and slaughtering, and also their elaboration in workshops at place. Lithic points, scrapers and knives were found at places specially apt for hunting or slaughtering activities. Total isolation of the mountain fog site previous to our arrival in 1996, favoured their conservation at place. B. Careful observation of some local plants showed clear traces of guanaco feeding habits. As a proof thereof, old cactus of the species Eulychnia iquiquensis show in their basal portions clear signals in the forms of scars, caused by the eating by guanacos. Guanaco faeces were found at the foot of Ephedra plants. Many dead Stipa ichu plants (Gramineae), in different areas of the oasis provide evidence of cutting close to their basis, caused by sharp guanaco tooth under severe food

  16. 4D modelling of the Alto Tiberina Fault system (Northern Apennines, Italy)

    NASA Astrophysics Data System (ADS)

    De Donatis, Mauro; Susini, Sara; Mirabella, Francesco; Lupattelli, Andrea; Barchi, Massimiliano

    2014-05-01

    The Alto Tiberina Fault (ATF) in the Northern Apennines of Italy is a low-angle normal fault dipping to the East and accommodating up to 10 km of extension. The fault is ~70 km long and is the detachment for the SW-dipping Gubbio normal fault. The ATF fault system has been dramatically exhumed and the ATF footwall has evolved in a horst bounded to the east by ATF synthetic faults and to the west by the Corciano west-dipping normal fault. The fault has been widely studied over the last years in order to understand its mechanical behaviour, its present-day deformation rate and its seismological role. By using a wide data-set including subsurface data (seismic reflection profiles and boreholes) and surface geological data (new maps of the CARG project of Italy), we have reconstructed the 3D geometry of both the fault and of the main lithostratigraphic boundaries at the fault hanging-wall and foot-wall. The CARG map data were integrated by local observations and mapping using mobile GIS software (BeeGIS) and Android app (Geopaparazzi). Surface data were combined with seismic reflection profiles and wells interpretation and other data from available literature. The large amount of information were combined in MOVE software (Midland Valley Exploration ltd). Our reconstruction allows to i) build up a three-dimensional geological model of the subsurface including the main faults and lithostratigraphic boundaries; ii) identify a set of east-west trending faults the role of which was previously underestimated; iii) test a 3D-restoration of extension for the visualization of the time evolution and for the validation of the structural reconstruction. The restored structures are the main normal faults in the region. The sequential restoration was performed by taking into account the timing of deformation as derived from the literature. The model was sequentially restored according to the following chronological order from the latest to the oldest: 1a) last deformational event

  17. Low-Cost Sensor Network for Stream Flow Monitoring in the Alto Beni Region of Bolivia

    NASA Astrophysics Data System (ADS)

    Rowe, M. D.; Fry, L. M.; Mihelcic, J. R.

    2009-12-01

    Lack of data is a persistent problem in hydrology and other field work in developing countries. Low cost monitoring devices allow investigators to maximize spatial coverage on a limited budget, as well as to minimize the financial risk of loss of instruments placed in vulnerable locations. This work contributes to an ongoing project to evaluate the sustainability of discharge from springs supplying gravity-fed potable water systems in the Alto Beni region of Bolivia where land use is rapidly changing from forest to agriculture. The approach is to estimate ground water recharge as a function of land use variables using a water balance model in several representative watersheds. Monthly stream discharge is currently estimated using monthly manual measurements of water level by a local technician. Continuous water level measurements will allow an improved estimate of the cumulative discharge, and generate data on statistical distribution of daily flow that may be useful to estimate discharge in similar, ungaged watersheds. Continuous water level measurements, along with available precipitation data, will allow analysis and comparison of the response of watersheds to individual precipitation events as a function of land use variables. We assembled a low cost level logging system for stream flow monitoring that measures and records distance up to 6 m to the nearest 25 mm every ten minutes, and runs for a month on six rechargeable AA batteries. The system consists of a sonic range finder sensor (MaxSonar-EZ2, Maxbotix Inc., Baxter, MN, 30), a temperature sensor (MCP9701, Microchip Technology Inc., Chandler, AZ, 0.25), and a datalogger (Hobo U12, Onset Computer Corp., Pocasset, MA, 104) along with a weather-resistant enclosure and common items for a total cost of 230 per unit. The level loggers were attached to bridges over three subject streams. A local technician visits the sites monthly to download data, replace the rechargeable batteries, and take a manual water level

  18. Alto Patache fog oasis in the Atacama Desert: Geographical basis for a sustainable development program

    NASA Astrophysics Data System (ADS)

    Calderón, M.; Cereceda, P.; Larrain, H.; Osses, P.; Pérez, L.; Ibáñez, M.

    2010-07-01

    Alto Patache coastal fog oasis is a protected area located south of Iquique, Northern Chile, being presently in charge of the Atacama Desert Center (ADC) research group of the Pontificia Universidad Católica de Chile, since 1997. On 2007, the Chilean Government bestowed a piece of land stretch covering 1,114 hectares to ADC scientific group for scientific research, ecosystem protection and environmental education. This oasis has been recently studied from different points of view: climate, biogeography, fog collection, geomorphology, soil survey and land use planning, plant distribution, conservation and archaeology. During 2009, a study of the geographical basis to elaborate a general management plan was undertaken to collect information to fulfill our planned out objectives. Through this study, georreferenciated strategic information was compiled to evaluate future actions conducting to a sustainable development within the protected area. This information was translated into thematic maps showing the spatial distribution of variables like: climate, geology, geomorphology, soils, vegetation, fauna, archaeological sites and management zones. The methodology used is the analysis of satellite imagery, using GPS by creating a cartographic Data Base incorporated in GIS. Results show that the area starts at the littoral plain, ranging from 500 m to 2.000 m, being continued in parts by a piedmont intercepted by a very abrupt mega-cliff, or hectares of climbing sand dunes leading to a short high plateau limited by a soft hilly area to the East. Two soil types are characteristic: Entisols (Torriorthent) covering the coastal beach sediments, and Aridisols along the cliff and adjacent hills. Vegetation consists not only of a very rich lichen cover, but also of endangered vascular species associations constituting a very fragile sub-tropical coastal desert community, such as Eulychnia, Cumulopuntia, Eriosyce cacti, and Lycium - Nolana- Ephedra communities. Fog oasis

  19. Santa Barbara Cottage Hospital.

    PubMed

    1984-01-01

    The 465-bed Santa Barbara Cottage Hospital is the largest medical facility on the California coast between Los Angeles and the San Francisco bay area. The hospital dates back to 1888, when a group of local citizens began raising funds to build a "cottage-style" hospital for the growing community. Their original plans called for a complex in which each medical specialty would be housed in a separate bungalow. Even then, however, such a decentralized plan was too costly, so work began instead on a single cottage for all hospital departments. The first Cottage Hospital opened in 1891, with 25 beds housed in a two story Victorian building. Now a hugh medical complex employing some 1,500 people, the hospital continues to be called "Cottage" after the original home-like building. Rodney J. Lamb has been Hospital Administrator for the last 30 years.

  20. A biocultural perspective on fictive kinship in the Andes: social support and women's immune function in El Alto, Bolivia.

    PubMed

    Hicks, Kathryn

    2014-09-01

    This article examines the influence of emotional and instrumental support on women's immune function, a biomarker of stress, in the city of El Alto, Bolivia. It tests the prediction that instrumental support is protective of immune function for women living in this marginal environment. Qualitative and quantitative ethnographic methods were employed to assess perceived emotional and instrumental support and common sources of support; multiple linear regression analysis was used to model the relationship between social support and antibodies to the Epstein-Barr virus. These analyses provided no evidence that instrumental social support is related to women's health, but there is some evidence that emotional support from compadres helps protect immune function.

  1. Liquefaction Hazard Maps for Three Earthquake Scenarios for the Communities of San Jose, Campbell, Cupertino, Los Altos, Los Gatos, Milpitas, Mountain View, Palo Alto, Santa Clara, Saratoga, and Sunnyvale, Northern Santa Clara County, California

    USGS Publications Warehouse

    Holzer, Thomas L.; Noce, Thomas E.; Bennett, Michael J.

    2008-01-01

    Maps showing the probability of surface manifestations of liquefaction in the northern Santa Clara Valley were prepared with liquefaction probability curves. The area includes the communities of San Jose, Campbell, Cupertino, Los Altos, Los Gatos Milpitas, Mountain View, Palo Alto, Santa Clara, Saratoga, and Sunnyvale. The probability curves were based on complementary cumulative frequency distributions of the liquefaction potential index (LPI) for surficial geologic units in the study area. LPI values were computed with extensive cone penetration test soundings. Maps were developed for three earthquake scenarios, an M7.8 on the San Andreas Fault comparable to the 1906 event, an M6.7 on the Hayward Fault comparable to the 1868 event, and an M6.9 on the Calaveras Fault. Ground motions were estimated with the Boore and Atkinson (2008) attenuation relation. Liquefaction is predicted for all three events in young Holocene levee deposits along the major creeks. Liquefaction probabilities are highest for the M7.8 earthquake, ranging from 0.33 to 0.37 if a 1.5-m deep water table is assumed, and 0.10 to 0.14 if a 5-m deep water table is assumed. Liquefaction probabilities of the other surficial geologic units are less than 0.05. Probabilities for the scenario earthquakes are generally consistent with observations during historical earthquakes.

  2. Evidence for active creep on the Alto Tiberina low angle normal fault inferred using GPS geodesy

    NASA Astrophysics Data System (ADS)

    Rick, Bennett; Jackson, Lily; Mencin, David; Casale, Gabriele

    2014-05-01

    The Alto Tiberina fault (ATF) in central Italy is an upper crustal discontinuity dipping ~20° to the east-northeast. This structure is imaged by seismic reflection lines constrained by deep boreholes, and highlighted by intense microseismicity between latitudes ~43.2ºN and 43.5ºN. Outside of this latitude range, a more regional continuation of the structure is hypothesized, but is not well imaged by geophysical data. Balanced restored geological cross sections show that the structure represents a major fault accommodating up to 10 km of regional extension in central Italy since 3 Ma. However, no large earthquakes have been attributed to the ATF. Instead, large earthquakes in the area occur on high angle west dipping normal faults that cut the ATF hanging wall. Several lines of evidence, including fine grained foliations composed of velocity strengthening phyllosilicate minerals in exhumed fault rocks, high fault fluid over-pressures observed in footwall boreholes (~85% lithostatic pressure at 3.7-4.8 km depth), persistent microseismicity coincident with the ATF fault plane, and pattern of geodetically observed crustal motions suggest that the ATF may accommodate slip primarily by aseismic creep below ~4 km depth in the crust. Previous studies comparing GPS velocity data with a simple fault model consisting of an infinitely long edge dislocation buried in an elastic halfspace supported the shallow creeping hypothesis. But a newer more precise set of crustal motion data obtained from long-running campaign and continuous GPS stations is not adequately explained by an infinitely long creeping-fault model. To investigate whether the finite along-strike length of the ATF fault may help reconcile models for a shallow creeping ATF fault with the current GPS velocity data set, we used the TDEFNODE software to parameterize the ATF fault using the available high-resolution constraints on fault geometry provided by seismic reflection data and seismicity in the latitude

  3. Hospital diversification strategy.

    PubMed

    Eastaugh, Steven R

    2014-01-01

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

  4. Hospital diversification strategy.

    PubMed

    Eastaugh, Steven R

    2014-01-01

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

  5. Measuring Hospital Productivity

    PubMed Central

    Ruchlin, Hirsch S.; Leveson, Irving

    1974-01-01

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

  6. Central line infections - hospitals

    MedlinePlus

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

  7. Hospital benefit segmentation.

    PubMed

    Finn, D W; Lamb, C W

    1986-12-01

    Market segmentation is an important topic to both health care practitioners and researchers. The authors explore the relative importance that health care consumers attach to various benefits available in a major metropolitan area hospital. The purposes of the study are to test, and provide data to illustrate, the efficacy of one approach to hospital benefit segmentation analysis.

  8. [Music in the hospital].

    PubMed

    Bouteloup, Philippe

    2010-01-01

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

  9. Hospitality Occupations. Curriculum Guide.

    ERIC Educational Resources Information Center

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

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

  10. 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…

  11. Library Services in Hospitals.

    ERIC Educational Resources Information Center

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

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

  12. Hospitals are dangerous places.

    PubMed

    de Richemond, Albert L

    2010-01-01

    Hospital fire dangers are real, widespread, and ever present, the article demonstrates, spelling out the locations, conditions, and ignition potentials which exist in such a setting. Knowledge of codes and standards, good maintenance practices, and frequent drills in fire prevention and suppression are among the practices recommended for keeping a hospital fire from becoming a disaster, the author says. PMID:20873506

  13. Smaller hospitals accept advertising.

    PubMed

    Mackesy, R

    1988-07-01

    Administrators at small- and medium-sized hospitals gradually have accepted the role of marketing in their organizations, albeit at a much slower rate than larger institutions. This update of a 1983 survey tracks the increasing competitiveness, complexity and specialization of providing health care and of advertising a small hospital's services. PMID:10288550

  14. Hospitality services generate revenue.

    PubMed

    Bizouati, S

    1993-01-01

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

  15. 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…

  16. Hospital 360°.

    PubMed

    Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia

    2015-01-01

    There are forces that are greater than the individual performance of each hospital institution and of the health system structural of each country. The world is changing and to face up to the future in the best possible way, we need to understand how contexts and emerging trends link up and how they affect the hospital sector. The Columbian Association of Hospitals and Clinics, ACHC, has thus come up with the Hospital 360° concept which uses hospitals capable of anticipating changing contexts by means of the transition between present and future and takes on board the experience of global, socio-economic, demographic, political, environmental and technological fields as its model. Hospital 360° is an invitation to reinvent processes and institution themselves allowing them to adapt and incorporate a high degree of functional flexibility. Hospital 360° purses goals of efficiency, effectiveness and relevance, but also of impact and sustainability, and is coherent with the internal needs of hospital institutions and society for long-term benefits. PMID:26521380

  17. Mental hospitals in India.

    PubMed

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

    2000-04-01

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

  18. [Music in the hospital].

    PubMed

    Bouteloup, Philippe

    2010-01-01

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

  19. Handbook on Hospital Television.

    ERIC Educational Resources Information Center

    Prynne, T. A.

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

  20. Designing sustainable acute hospitals.

    PubMed

    Cory, Alistair

    2008-01-01

    The need to provide sustainable hospitals lies in the fact that we have an obligation to act responsibly towards good stewardship of our environment and the world's precious resources, ensuring a healthy future for coming generations. As such, a sustainable hospital must sit squarely in a sustainable society, and the global and local context should be considered when designing a sustainable health facility.

  1. Hospitality services generate revenue.

    PubMed

    Bizouati, S

    1993-01-01

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

  2. [Hospital medicine in Chile].

    PubMed

    Eymin, Gonzalo; Jaffer, Amir K

    2013-03-01

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

  3. Hospitality as an Environmental Metaphor.

    ERIC Educational Resources Information Center

    Horwood, Bert

    1991-01-01

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

  4. Radial velocity confirmation of Kepler-91 b. Additional evidence of its planetary nature using the Calar Alto/CAFE instrument

    NASA Astrophysics Data System (ADS)

    Lillo-Box, J.; Barrado, D.; Henning, Th.; Mancini, L.; Ciceri, S.; Figueira, P.; Santos, N. C.; Aceituno, J.; Sánchez, S. F.

    2014-08-01

    The object transiting the star Kepler-91 was recently assessed as being of planetary nature. The confirmation was achieved by analysing the light-curve modulations observed in the Kepler data. However, quasi-simultaneous studies claimed a self-luminous nature for this object, thus rejecting it as a planet. In this work, we apply anindependent approach to confirm the planetary mass of Kepler-91b by using multi-epoch high-resolution spectroscopy obtained with the Calar Alto Fiber-fed Echelle spectrograph (CAFE). We obtain the physical and orbital parameters with the radial velocity technique. In particular, we derive a value of 1.09 ± 0.20 MJup for the mass of Kepler-91b, in excellent agreement with our previous estimate that was based on the orbital brightness modulation.

  5. Health assessment for Hewlett-Packard, Palo Alto, Santa Clara County, California, Region 9. CERCLIS No. CAD009122532. Preliminary report

    SciTech Connect

    Not Available

    1988-12-05

    The Hewlett-Packard, Palo Alto, site is listed by the U.S. Environmental Protection Agency (EPA) on the National Priorities List (NPL). The site is a gasoline station owned by the Hewlett-Packard Corporation which had five underground storage tanks. By approximately 1985, the principally responsible party voluntarily removed the tanks. A plume of hazardous chemicals has been detected in groundwater beneath this area and is believed to be associated with the former underground tanks. The environmental pathway of concern is migration of contaminated groundwater. The human exposure pathways of concern are potential ingestion and dermal contact with contaminated groundwater, and inhalation of the volatile components of the contamination from domestic uses such as cooking, showering, and bathing. Based on the available information, the site is considered to be of potential public health concern because of the risk to human health caused by the possibility of exposure to hazardous substances via contaminated groundwater.

  6. Coma imaging of comet P/Brorsen-Metcalf at Calar Alto in late July to mid August 1989

    NASA Technical Reports Server (NTRS)

    Boehnhardt, Hermann; Vanysek, Vladimir; Birkle, K.; Hopp, U.

    1992-01-01

    Comet P/Brorsen-Metcalf was observed on 1989/07/28+30 and on 1989/08/04+12(+14) with the 3.5 m telescope and the 0.8 m Schmidt camera at Calar Alto/Spain. The images exhibit a narrow plasma tail pointing into anti-solar direction. On 1989/07/30 a triple tail was found which can be interpreted as tail ray event. The coma isophotes show prominent asymmetries with the nucleus located on the tailward side of the isophote foci and with a slightly higher brightness in the Northern Hemisphere of the coma. A strong curved jet feature was detected in the coma on 1989/07/30. The jet extended at least 30,000 km into the sunward coma hemisphere. The rotation period of about 1.3 days, estimated from the curvature of the coma jet, needs verification by other observations.

  7. Hospital diversification: evaluating alternatives.

    PubMed

    Hammer, L

    1987-05-01

    The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival. PMID:3300300

  8. Philanthropy and hospital financing.

    PubMed Central

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

    1995-01-01

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

  9. Hospitals' Internal Accountability

    PubMed Central

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

    2014-01-01

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

  10. Hospital diversification: evaluating alternatives.

    PubMed

    Hammer, L

    1987-05-01

    The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival.

  11. Hospitals' internal accountability.

    PubMed

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

    2014-09-01

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

  12. Hospitalized Patients and Fungal Infections

    MedlinePlus

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

  13. Hospital free cash flow.

    PubMed

    Kauer, R T; Silvers, J B

    1991-01-01

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

  14. Critical Access Hospitals (CAH)

    MedlinePlus

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

  15. Objections to hospital philosophers.

    PubMed Central

    Ruddick, W; Finn, W

    1985-01-01

    Like morally sensitive hospital staff, philosophers resist routine simplification of morally complex cases. Like hospital clergy, they favour reflective and principled decision-making. Like hospital lawyers, they refine and extend the language we use to formulate and defend our complex decisions. But hospital philosophers are not redundant: they have a wider range of principles and categories and a sharper eye for self-serving presuppositions and implicit contradictions within our practices. As semi-outsiders, they are often best able to take an 'external point of view,' unburdened by routine, details, and departmental loyalties. Their clarifications can temporarily disrupt routine, but can eventually improve staff morale, hence team practice and patient welfare. PMID:3981573

  16. Practice Hospital Bed Safety

    MedlinePlus

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

  17. Hospital free cash flow.

    PubMed

    Kauer, R T; Silvers, J B

    1991-01-01

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

  18. Home versus hospital confinement

    PubMed Central

    Barry, C. N.

    1980-01-01

    The case for hospital rather than home delivery has been powerfully argued, especially in and since the Report of the Peel Committee. Nevertheless, evidence of comparison with other countries, notably the Netherlands, suggests the choice is not necessarily simple. Some general practitioner units are now reporting perinatal mortality rates which are consistently lower than those of specialist units, and recent statistical analyses suggest that the presence of more high risk cases in consultant units does not explain this. The only big controlled home-versus-hospital trial did not lead to a significantly lower perinatal mortality rate in the hospital group. The onus of proof now seems to lie with those who advocate 100 per cent hospital confinement. PMID:7373581

  19. A Review. The Use of the Alto, Bass and Contrabass Clarinets in Selected Wind Band Compositions Written Between 1951 and 1972.

    ERIC Educational Resources Information Center

    Heim, Norman M.

    1987-01-01

    Reviews a dissertation which examined the scoring practices for alto, bass, and contrabass clarinets in selected compositions written between 1951-1972. The study identified new practices for scoring low clarinets in wind band compositions. The study is recommended to readers seeking a good understanding of the use of clarinets in these…

  20. Managing diversity in hospitals.

    PubMed

    Schwartz, R H; Sullivan, D B

    1993-01-01

    Hospital work force diversity, although potentially a source of creativity and improved problem solving, is often a source of political strife and the mistreatment of people based on their identification with one or another of the diverse groups that are employed in hospitals. Factors linked to these phenomena are discussed and are the basis for suggestions about how administrators can deal with the organizational pathologies that are often associated with unmanaged work force diversity.

  1. [Hospital organizational structure].

    PubMed

    Bittar, O J

    1994-01-01

    The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.

  2. Organizational leadership in hospitals.

    PubMed

    Longest, B B; Darr, K; Rakich, J S

    1993-01-01

    Hospitals face very dynamic environments and must meet diverse needs in the communities they serve and respond to multiple expectations imposed by their stakeholders. Coupled with these variables, the fact that leadership in these organizations is a shared phenomenon makes organizational leadership in them very complicated. An integrative overview of the organizational leadership role of CEOs in hospitals is presented, and determinants of success in playing this role are discussed.

  3. Cogeneration for hospitals

    SciTech Connect

    Not Available

    1985-01-01

    With health care costs on the rise, hospitals are looking for ways to reduce operating expenses-especially utility bills. But hospitals, more than anyone else, need a continuous source of electricity, heating and air conditioning. They cannot turn off medical equipment or climate control systems in the name of energy conservation. Hospital Corporation of America (HCA), with the help of the Gas Research Institute (GRI), has found a way to supply affordable and efficient power to a mid-size hospital in Houston, Texas. A 500-kilowatt (kw) gasfired cogeneration system, sold as a package, is now being field-tested at the Medical Center Del Oro, a 258-bed hospital facility. The cogeneration system, which began operating last month, will supply the medical center with 145 tons of cooling (or 2.3 MMBtu/hour space heating) and 500,000 Btu/hour for water heating, in addition to the 500 kw of electricity. A Caterpillar continuous-duty turbocharged gas-fueled engine serves as the prime mover, and heat is recovered from its exhaust and from water used to cool the engine. A Trane single-effect absorption chiller supplies chilled water for air conditioning the hospital.

  4. Financing hospital disaster preparedness.

    PubMed

    De Lorenzo, Robert A

    2007-01-01

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

  5. Sisters in Dutch hospitals.

    PubMed

    van den Bergh-Braam, A H

    1985-11-01

    This study focuses on hospital sisters in 30 Dutch hospitals. The so-called role-set approach has been adopted. In this approach the sisters are the focal persons. Direct superiors, specialists, registered nurses and student nurses acted as role-senders. The possible number of respondents is 600 (120 of each group). The response of hospital sisters is 100%, that of role-senders 88%. The study started out as an attempt to collect background information on the causes of wastage of sisters. High wastage rates are generally regarded as an indication of an unfavourable working environment. Since hospital sisters occupy a key position in hospitals, the ward problems will be studied from their angle. Although wastage rates have dropped recently, it does not necessarily follow that the working environment has improved. Wastage is known to act as a safety valve, thus allowing tensions to resolve. The threat of unemployment clogs this outlet, which increases the tensions on the hospital ward. Data from the study show that work overload is one of the major stress factors for sisters. Analyses demonstrated that there exists a relationship between work overload and tensions with the management and direct superiors, tensions in job execution, irritableness on the ward, low self-esteem, health complaints and psychological condition. Sisters with an excessive job involvement refer to work overload more often than their moderate colleagues. There is a relationship between an unfavourable working environment and irritableness of sisters.

  6. Simwe model application on susceptibility analysis to linear erosion: a case study in Alto Douro wine region.

    NASA Astrophysics Data System (ADS)

    Fernandes, Joana; Bateira, Carlos; Soares, Laura; Faria, Ana; Moura, Rui; Gonçalves, José

    2016-04-01

    The wine production in Alto Douro Wine Region - one of the world's oldest regulated and demarcated wine region - is based on a slope system organized in agricultural terraces once supported exclusively by dry stone walls. It has been undergoing the necessary changes for the introduction of technological innovations partially associated to the mechanization of vineyards work. In this sense, different forms of terrain framing have been implemented, namely the substitution of stone walls by earth embankments. This evolution raises a group of problems related to the hydric soil erosion and landscape preservation, since Alto Douro Wine Region is classified as UNESCO World Heritage Site since 2001. The study area is mostly occupied by vineyards planted in the agriculture terraces without continuous vegetation, the flow proceeds superficially influenced by the weak infiltration capacity and hydraulic conductivity. So, because of this conditioning factor the erosive features present non-significant depth, and the length thereof is limited essentially by the slope of the land, where was registered 64 gullies and 78 rills This paper focuses on the evaluation of susceptibility to linear erosion, through the application of SIMWE (SIMulated Water Erosion), (Mitas and Mitasova, 1998), using a digital elevation model, with pixel of one square meter of spatial resolution, created through detail aerial photographs, (side pixel of 50 cm), submitted to automatic stereo-correlation procedures in Agisoft PhotoScan software. The results provided by the model are compared with hydrological characteristics of the soil, (infiltration capacity, and hydraulic conductivity), soil texture, and soil structure parameters (identified by electrical resistivity measurement) where obtained from field monitoring. This approach demonstrates an association between the spatial distribution of erosive features with high values of soil saturation, and reduced water discharge (10-110 cm3/s), that are

  7. [Communication among hospital leaders].

    PubMed

    Haberey-Knuessi, Véronique; Heeb, Jean-Luc; De Morgan, Paula Emilie

    2013-12-01

    New management styles imposed on hospital institutions in recent years, have fundamentally changed the organization of the latter. Many texts discuss the consequences, specifically on the field of communication. The aim of this study was to understand the real impact of new management methods on communication by managers in hospital, but also on care teams in termes of satisfaction and/or stress. This two-year study was conducted among 900 executives in hospitals in Western Switzerland using a mixed methodology. A first phase of questionnaires highlighted the problematic areas, while a second phase in the form of organized group interviews in each hospital, had the objective of achieving a better understanding of the relationship between management and communication. The latter proved to be particularly significant in terms of results, and this is the one we focused on in this article.These results indeed show that a crucial role is given to communication by carers, and, at the same time a lessening of the time devoted to relationships, both among peers and with patients. Frustration then arises, which is not without consequences both for the management of patients and the institutions themselves. It is by means of these results that awareness is raised of the omnipresence of communication at all levels and the major advantages that positive dynamic supports. And, on the contrary, of the serious problems which may arise from management practice that do not give due importance to the dimension of communication, present in all sectors of the hospital. PMID:24490450

  8. Utilization of hospital resources.

    PubMed

    Black, C D; Roos, N P; Burchill, C A

    1995-12-01

    A population-based approach was used to analyze the utilization patterns of hospital care by Manitoba residents during the fiscal year 1991/1992. Patterns were analyzed for eight administrative regions, with use assigned to the patient's region of residence, regardless of the location of the hospitalization. Regional boundaries consistent with those used for presentation of data on health status and socioeconomic risk permitted integration of findings across the Population Health Information System. Marked differences in acute hospital use were found. Residents of the urban Winnipeg ("good health") region had the lowest rates of use of acute care overall, and northern rural ("poor health") regions had significantly higher rates of use. However, almost one half of hospital days by Winnipeg residents were used in long-stay care (60+ days), while rural residents were more likely to use short-stay hospital care. Despite a concentration of surgical specialists in Winnipeg, there were only small regional differences in overall rates of surgery. PMID:7500670

  9. Eclipsing binaries and fast rotators in the Kepler sample. Characterization via radial velocity analysis from Calar Alto

    NASA Astrophysics Data System (ADS)

    Lillo-Box, J.; Barrado, D.; Mancini, L.; Henning, Th.; Figueira, P.; Ciceri, S.; Santos, N.

    2015-04-01

    Context. The Kepler mission has searched for planetary transits in more than two hundred thousand stars by obtaining very accurate photometric data over a long period of time. Among the thousands of detected candidates, the planetary nature of around 15% has been established or validated by different techniques. But additional data are needed to characterize the rest of the candidates and reject other possible configurations. Aims: We started a follow-up program to validate, confirm, and characterize some of the planet candidates. In this paper we present the radial velocity analysis of those that present large variations, which are compatible with being eclipsing binaries. We also study those showing high rotational velocities, which prevents us from reaching the necessary precision to detect planetary-like objects. Methods: We present new radial velocity results for 13 Kepler objects of interest (KOIs) obtained with the CAFE spectrograph at the Calar Alto Observatory and analyze their high-spatial resolution (lucky) images obtained with AstraLux and the Kepler light curves of some interesting cases. Results: We have found five spectroscopic and eclipsing binaries (group A). Among them, the case of KOI-3853 is of particular interest. This system is a new example of the so-called heartbeat stars, showing dynamic tidal distortions in the Kepler light curve. We have also detected duration and depth variations of the eclipse. We suggest possible scenarios to explain such an effect, including the presence of a third substellar body possibly detected in our radial velocity analysis. We also provide upper mass limits to the transiting companions of six other KOIs with high rotational velocities (group B). This property prevents the radial velocity method from achieving the necessary precision to detect planetary-like masses. Finally, we analyze the large radial velocity variations of two other KOIs, which are incompatible with the presence of planetary-mass objects

  10. Hospitals as interpretation systems.

    PubMed Central

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

    1991-01-01

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

  11. Internal auditing in hospitals.

    PubMed

    Edwards, Don; Kusel, Jim; Oxner, Tom

    2003-01-01

    The authors analyzed two national surveys to determine answers for two basic questions: How do the roles of internal auditors compare with those of their counterparts in other industries and to what extent over the past 6 years have the activities of internal auditors changed? Internal auditors in hospitals allocate their time primarily to financial/compliance and operational types of audits, as do their counterparts. The current trend is toward more operational types of audits. In the early years of employment, staff turnover in hospitals is significantly higher than in all combined industries, often leading to internal auditors' filling other positions in the organization. Hospital staff salaries are higher than are salaries in other industries combined. Staff composition continues to reflect the growing presence of women in the field. The majority of internal auditing directors believe that their salaries are fair, would recommend internal auditing as a career position, and are treated as valued consultants in the organization.

  12. Chemical and mineralogical characterization of elbaites from the Alto Quixaba pegmatite, Seridó province, NE Brazil.

    PubMed

    Ferreira, Ana C M; Ferreira, Valderez P; Soares, Dwight R; Vilarroel-Leo, Hugo S

    2005-12-01

    The Alto Quixaba pegmatite, Seridó region, northeastern Brazil, is a 60 degrees/80 degrees SW-trending subvertical dike discordantly intruded into biotite schists of the Upper Neoproterozoic Seridó Formation. It has three distinct mineralogical and textural zones, besides a replacement body that cuts the pegmatite at its central portion and in which occur, among other gem minerals, colored elbaites. Elbaites usually occur as prismatic crystals, elongate according to the c-axis, with rounded faces and striations parallel to this axis. Optically, crystals are uniaxial negative with strong pleochroism; refractive index extraordinary axis = 1.619-1.622 and ordinary axis = 1.639-1.643, birefringence between 0.019 and 0.021, average relative density of 3.07, and the following unit cell parameters: ao = 15.845 A, co = 7.085 A and V = 1540.476 A. There is alkali deficiency in the X site of 12-17%. The elbaites are relatively enriched in MnO (1.69 to 2.87%) and ZnO (up to 2.98%).

  13. Chemical and mineralogical characterization of elbaites from the Alto Quixaba pegmatite, Seridó province, NE Brazil.

    PubMed

    Ferreira, Ana C M; Ferreira, Valderez P; Soares, Dwight R; Vilarroel-Leo, Hugo S

    2005-12-01

    The Alto Quixaba pegmatite, Seridó region, northeastern Brazil, is a 60 degrees/80 degrees SW-trending subvertical dike discordantly intruded into biotite schists of the Upper Neoproterozoic Seridó Formation. It has three distinct mineralogical and textural zones, besides a replacement body that cuts the pegmatite at its central portion and in which occur, among other gem minerals, colored elbaites. Elbaites usually occur as prismatic crystals, elongate according to the c-axis, with rounded faces and striations parallel to this axis. Optically, crystals are uniaxial negative with strong pleochroism; refractive index extraordinary axis = 1.619-1.622 and ordinary axis = 1.639-1.643, birefringence between 0.019 and 0.021, average relative density of 3.07, and the following unit cell parameters: ao = 15.845 A, co = 7.085 A and V = 1540.476 A. There is alkali deficiency in the X site of 12-17%. The elbaites are relatively enriched in MnO (1.69 to 2.87%) and ZnO (up to 2.98%). PMID:16341446

  14. Pasture evapotranspiration as indicators of degradation in the Brazilian Savanna: a case study for Alto Tocantins watershed

    NASA Astrophysics Data System (ADS)

    Andrade, Ricardo G.; de C. Teixeira, Antônio H.; Sano, Edson E.; Leivas, Janice F.; Victoria, Daniel C.; Nogueira, Sandra F.

    2014-10-01

    The Alto Tocantins watershed, located in the Brazilian Savanna (Cerrado biome), is under an intense land use and occupation process, causing increased pressure on natural resources. Pasture areas in the region are highly relevant to the rational use of natural resources in order to achieve economic and environmental sustainability. In this context, remote sensing techniques have been essential for obtaining information relevant to the assessment of vegetation conditions on a large scale. This study aimed to apply this tool in conjunction with field measurements to evaluate evapotranspiration (ET) against pasture degradation indicators. The SAFER algorithm was applied to estimate ET using MODIS images and weather station data from year 2012. Results showed that ET was lower in degraded pastures. It is noteworthy that during low rainfall period, ET values were 22.2% lower in relation to non-degraded pastures. This difference in ET indicates changes in the partition of the energy balance and may impact the microclimate. These results may contribute to public policies that aim to reduce the loss of the productive potential of pastures.

  15. Hospital structure and consumer satisfaction.

    PubMed Central

    Fleming, G V

    1981-01-01

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

  16. Responsible Hospitality. Prevention Updates

    ERIC Educational Resources Information Center

    Colthurst, Tom

    2004-01-01

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

  17. Hospital perceived value.

    PubMed

    Moliner, Miguel A

    2006-01-01

    The creation, distribution and communication of value have been considered to be the key element of marketing (American Marketing Association, 2004, www.marketingpower.com). The aim of this article is to identify the indicators of perceived value in a hospital context. The results show that perceived quality and emotions are key dimensions of perceived value.

  18. Hospital restructuring and burnout.

    PubMed

    Greenglass, Esther R; Burke, Ronald J

    2002-01-01

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

  19. Planning Australia's hospital workforce.

    PubMed

    Harris, Mary; Gavel, Paul; Conn, Warwick

    2002-01-01

    Growing government support has been evident during the past decade for macro-level workforce planning to ensure that future populations have access to appropriate health care services. Population ageing is impacting on workforce requirements and on workforce supply within Australia and internationally. Changes in financing and the organisation of health services are impacting on the availability of training and on the quality of working life. The age and gender profile and career expectations of young Australians are changing. These factors are all adding to the importance and complexity of workforce planning. This paper draws on data from various sources to describe Australia's hospital workforce, to explore supply-side workforce trends and to discuss some contemporary issues of concern to policy makers and workforce planners. The paper finds that in recent years there has been a 3 per cent decline in the number of full time equivalent staff in public hospitals, while the number in the private hospital workforce has increased by 28 per cent. The paper concludes that, nationally, there are serious limitations in the data available to describe and monitor the hospital workforce and that there is a need to remedy this situation.

  20. Hospital Library Development.

    ERIC Educational Resources Information Center

    Cramer, Anne

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

  1. In-hospital resuscitation.

    PubMed

    Mason, Christine

    2016-09-21

    What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article outlined the response sequence required for cardiac arrest in an in-hospital environment and discussed effective cardiopulmonary resuscitation (CPR) and defibrillation. PMID:27654563

  2. Incarceration and hospital care.

    PubMed

    Prince, Jonathan D

    2006-01-01

    Risk for jail or prison recidivism is well documented among incarcerated individuals with schizophrenia. However, it is less clear that risk is also high for psychiatric hospital readmission after accounting for mediating influences such as psychopathology severity, functioning level, substance misuse, and demographic characteristics. Relative to counterparts without prior time in jail, this study therefore assessed whether formerly incarcerated individuals with schizophrenia were more likely to repeatedly use hospital care after controlling for level of functioning and symptomatology. Among 315 inpatients, former inmates had a greater mean number of previous hospital stays than other patients (t = -2.13; df = 305; p = 0.03) and were more likely to visit the emergency room or be rehospitalized within 3 months of discharge (chi2 = 8.83; df = 1; p = 0.003). They were twice as likely to be readmitted, moreover, even after accounting in logistic regression for age, sex, race, global functioning, psychopathology severity, alcohol abuse or dependence, and drug abuse or dependence (OR = .49; CI = .26-.95). Implications for community care are discussed, and the suggestion is made that jail diversion programs should be renamed and refocused as "jail and hospital diversion." PMID:16462553

  3. Hospital perceived value.

    PubMed

    Moliner, Miguel A

    2006-01-01

    The creation, distribution and communication of value have been considered to be the key element of marketing (American Marketing Association, 2004, www.marketingpower.com). The aim of this article is to identify the indicators of perceived value in a hospital context. The results show that perceived quality and emotions are key dimensions of perceived value. PMID:17077707

  4. Cost characteristics of hospitals.

    PubMed

    Smet, Mike

    2002-09-01

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

  5. Speech intelligibility in hospitals.

    PubMed

    Ryherd, Erica E; Moeller, Michael; Hsu, Timothy

    2013-07-01

    Effective communication between staff members is key to patient safety in hospitals. A variety of patient care activities including admittance, evaluation, and treatment rely on oral communication. Surprisingly, published information on speech intelligibility in hospitals is extremely limited. In this study, speech intelligibility measurements and occupant evaluations were conducted in 20 units of five different U.S. hospitals. A variety of unit types and locations were studied. Results show that overall, no unit had "good" intelligibility based on the speech intelligibility index (SII > 0.75) and several locations found to have "poor" intelligibility (SII < 0.45). Further, occupied spaces were found to have 10%-15% lower SII than unoccupied spaces on average. Additionally, staff perception of communication problems at nurse stations was significantly correlated with SII ratings. In a targeted second phase, a unit treated with sound absorption had higher SII ratings for a larger percentage of time as compared to an identical untreated unit. Taken as a whole, the study provides an extensive baseline evaluation of speech intelligibility across a variety of hospitals and unit types, offers some evidence of the positive impact of absorption on intelligibility, and identifies areas for future research.

  6. Peptic ulcer in hospital

    PubMed Central

    Johnson, H. Daintree

    1962-01-01

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

  7. [Leadership in the hospital].

    PubMed

    Schrappe, Matthias

    2009-01-01

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

  8. Improving Hospital Discharge Time

    PubMed Central

    El-Eid, Ghada R.; Kaddoum, Roland; Tamim, Hani; Hitti, Eveline A.

    2015-01-01

    Abstract Delays in discharging patients can impact hospital and emergency department (ED) throughput. The discharge process is complex and involves setting specific challenges that limit generalizability of solutions. The aim of this study was to assess the effectiveness of using Six Sigma methods to improve the patient discharge process. This is a quantitative pre and post-intervention study. Three hundred and eighty-six bed tertiary care hospital. A series of Six Sigma driven interventions over a 10-month period. The primary outcome was discharge time (time from discharge order to patient leaving the room). Secondary outcome measures included percent of patients whose discharge order was written before noon, percent of patients leaving the room by noon, hospital length of stay (LOS), and LOS of admitted ED patients. Discharge time decreased by 22.7% from 2.2 hours during the preintervention period to 1.7 hours post-intervention (P < 0.001). A greater proportion of patients left their room before noon in the postintervention period (P < 0.001), though there was no statistical difference in before noon discharge. Hospital LOS dropped from 3.4 to 3.1 days postintervention (P < 0.001). ED mean LOS of patients admitted to the hospital was significantly lower in the postintervention period (6.9 ± 7.8 vs 5.9 ± 7.7 hours; P < 0.001). Six Sigma methodology can be an effective change management tool to improve discharge time. The focus of institutions aspiring to tackle delays in the discharge process should be on adopting the core principles of Six Sigma rather than specific interventions that may be institution-specific. PMID:25816029

  9. [Leadership in the hospital].

    PubMed

    Schrappe, Matthias

    2009-01-01

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

  10. Direct admission to the hospital: An alternative approach to hospitalization.

    PubMed

    Leyenaar, JoAnna K; Lagu, Tara; Lindenauer, Peter K

    2016-04-01

    Appropriate use of emergency departments (EDs) is a focus of national healthcare reform efforts, and patients requiring hospital admission account for a substantial proportion of ED utilization. Despite this, little attention has been paid to evaluating direct admission to the hospital as an alternative to hospital admissions beginning in the ED. In this Perspective, we discuss the role of hospital medicine in the changing epidemiology of hospital admissions, the potential risks and benefits of direct admission to the hospital, and the need for research to evaluate the safety and effectiveness of this admission approach. We propose that transitions of care research and quality improvement, historically focused on hospital-to-home transitions, be expanded to address transitions into the hospital. PMID:26588666

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

    PubMed

    McQuoid-Mason, David

    2012-04-12

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

  12. Superfund record of decision (EPA Region 9): Hewlett-Packard, 620-640 Page Mill Road, Palo Alto, CA, March 24, 1995

    SciTech Connect

    1995-07-01

    The Record of Decision (ROD) presents the selected remedial action for the Hewlett-Packard 640 Page Mill Road Superfund site (HP-640 PMR) in Palo Alto, California. Leaks from an underground waste solvent storage tank resulted in soil and groundwater contamination at the HP-640 PMR site. These interim response actions addressed the principal threats at the HP-640 PMR site, soil and groundwater contamination. The final remedy addresses threats remaining after the interim measures.

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

    ERIC Educational Resources Information Center

    Cramer, Anne

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

  14. [Hospital clinical ethics committees].

    PubMed

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

    The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of

  15. An ethnobotanical survey of medicinal plants commercialized in the markets of La Paz and El Alto, Bolivia.

    PubMed

    Macía, Manuel J; García, Emilia; Vidaurre, Prem Jai

    2005-02-28

    An ethnobotanical study of medicinal plants marketed in La Paz and El Alto cities in the Bolivian Andes, reported medicinal information for about 129 species, belonging to 55 vascular plant families and one uncertain lichen family. The most important family was Asteraceae with 22 species, followed by Fabaceae s.l. with 11, and Solanaceae with eight. More than 90 general medicinal indications were recorded to treat a wide range of illnesses and ailments. The highest number of species and applications were reported for digestive system disorders (stomach ailments and liver problems), musculoskeletal body system (rheumatism and the complex of contusions, luxations, sprains, and swellings), kidney and other urological problems, and gynecological disorders. Some medicinal species had magic connotations, e.g. for cleaning and protection against ailments, to bring good luck, or for Andean offerings to Pachamama, 'Mother Nature'. In some indications, the separation between medicinal and magic plants was very narrow. Most remedies were prepared from a single species, however some applications were always prepared with a mixture of plants, e.g. for abortion, and the complex of luxations and swellings. The part of the plant most frequently used was the aerial part (29.3%) and the leaves (20.7%). The remedies were mainly prepared as a decoction (47.5%) and an infusion (28.6%). Most of species were native from Bolivia, but an important 36.4% of them were introduced from different origins. There exists a high informant consensus for species and their medicinal indications. The present urban phytotherapy represents a medicinal alternative to treat main health problems and remains closer to the cultural and social context of this society. PMID:15707774

  16. A Community in Life and Death: The Late Neolithic Megalithic Tomb at Alto de Reinoso (Burgos, Spain).

    PubMed

    Alt, Kurt W; Zesch, Stephanie; Garrido-Pena, Rafael; Knipper, Corina; Szécsényi-Nagy, Anna; Roth, Christina; Tejedor-Rodríguez, Cristina; Held, Petra; García-Martínez-de-Lagrán, Íñigo; Navitainuck, Denise; Arcusa Magallón, Héctor; Rojo-Guerra, Manuel A

    2016-01-01

    The analysis of the human remains from the megalithic tomb at Alto de Reinoso represents the widest integrative study of a Neolithic collective burial in Spain. Combining archaeology, osteology, molecular genetics and stable isotope analysis (87Sr/86Sr, δ15N, δ13C) it provides a wealth of information on the minimum number of individuals, age, sex, body height, pathologies, mitochondrial DNA profiles, kinship relations, mobility, and diet. The grave was in use for approximately one hundred years around 3700 cal BC, thus dating from the Late Neolithic of the Iberian chronology. At the bottom of the collective tomb, six complete and six partial skeletons lay in anatomically correct positions. Above them, further bodies represented a subsequent and different use of the tomb, with almost all of the skeletons exhibiting signs of manipulation such as missing skeletal parts, especially skulls. The megalithic monument comprised at least 47 individuals, including males, females, and subadults, although children aged 0-6 years were underrepresented. The skeletal remains exhibited a moderate number of pathologies, such as degenerative joint diseases, healed fractures, cranial trauma, and a low intensity of caries. The mitochondrial DNA profiles revealed a pattern pointing to a closely related local community with matrilineal kinship patterns. In some cases adjacent individuals in the bottom layer showed familial relationships. According to their strontium isotope ratios, only a few individuals were likely to have spent their early childhood in a different geological environment, whilst the majority of individuals grew up locally. Carbon and nitrogen isotope analysis, which was undertaken to reconstruct the dietary habits, indicated that this was a homogeneous group with egalitarian access to food. Cereals and small ruminants were the principal sources of nutrition. These data fit in well with a lifestyle typical of sedentary farming populations in the Spanish Meseta during

  17. A Community in Life and Death: The Late Neolithic Megalithic Tomb at Alto de Reinoso (Burgos, Spain)

    PubMed Central

    Garrido-Pena, Rafael; Knipper, Corina; Szécsényi-Nagy, Anna; Roth, Christina; Tejedor-Rodríguez, Cristina; Held, Petra; García-Martínez-de-Lagrán, Íñigo; Navitainuck, Denise; Arcusa Magallón, Héctor; Rojo-Guerra, Manuel A.

    2016-01-01

    The analysis of the human remains from the megalithic tomb at Alto de Reinoso represents the widest integrative study of a Neolithic collective burial in Spain. Combining archaeology, osteology, molecular genetics and stable isotope analysis (87Sr/86Sr, δ15N, δ13C) it provides a wealth of information on the minimum number of individuals, age, sex, body height, pathologies, mitochondrial DNA profiles, kinship relations, mobility, and diet. The grave was in use for approximately one hundred years around 3700 cal BC, thus dating from the Late Neolithic of the Iberian chronology. At the bottom of the collective tomb, six complete and six partial skeletons lay in anatomically correct positions. Above them, further bodies represented a subsequent and different use of the tomb, with almost all of the skeletons exhibiting signs of manipulation such as missing skeletal parts, especially skulls. The megalithic monument comprised at least 47 individuals, including males, females, and subadults, although children aged 0–6 years were underrepresented. The skeletal remains exhibited a moderate number of pathologies, such as degenerative joint diseases, healed fractures, cranial trauma, and a low intensity of caries. The mitochondrial DNA profiles revealed a pattern pointing to a closely related local community with matrilineal kinship patterns. In some cases adjacent individuals in the bottom layer showed familial relationships. According to their strontium isotope ratios, only a few individuals were likely to have spent their early childhood in a different geological environment, whilst the majority of individuals grew up locally. Carbon and nitrogen isotope analysis, which was undertaken to reconstruct the dietary habits, indicated that this was a homogeneous group with egalitarian access to food. Cereals and small ruminants were the principal sources of nutrition. These data fit in well with a lifestyle typical of sedentary farming populations in the Spanish Meseta during

  18. Environmental evaluation of fluoride in drinking water at "Los Altos de Jalisco," in the central Mexico region.

    PubMed

    Hurtado, Roberto; Gardea-Torresdey, Jorge

    Naturally occurring fluoride has been detected and quantified in drinking water in several cities of the "Los Altos de Jalisco" (LAJ) region. LAJ is located in the northeastern part of the state of Jalisco-Mexico, covering an area of 16,410 km2 with a population of 696,318 in 20 municipalities. Drinking water comes mainly from groundwater aquifers, located in the Trans-Mexican Volcanic Belt, which is a volcanic region characterized by hydrothermal activity. Results indicated that water supply from 42% of the municipalities had a fluoride concentration over the Mexican standards of 1.5 mg/L. It is important to notice that there are three cities, Lagos de Moreno (1.66-5.88 mg/L F(-)), Teocaltiche (3.82-18.58 mg/L F(-)), and Encarnación de Díaz (2.58-4.40 mg/L F(-)) where all water samples resulted in fluoride concentration over the maximum contaminant level. The total population from these three cities is over 122,000 inhabitants. Another important city with high levels of fluoride in the water supply was Tepatitlán de Morelos (2 wells with 6.54 and 13.47 mg/L F(-)). In addition to water supply, 30 samples of brand-name bottled water were tested. Surprisingly, 8 samples (27%) demonstrated fluoride level over the standards, mainly Agua de Lagos with 5.27 mg/L. Fluoridated table salt (200-300 mg/kg F(-)) is another important source of fluoride. A large number of people living in the region, mainly school children, might be under adverse health risk because they are consuming contaminated drinking water. It is well known that long-term exposure to water with high levels of fluoride produces severe health problems.

  19. [Volgograd military hospital--70 years].

    PubMed

    Novikov, V Ia; Alborov, Z Ts

    2012-01-01

    History of the Volgograd military hospital dates back to July 24, 1941, when on the basis of the regional children's bone tuberculosis sanatorium in Krasnodar was transformed into 2150th military hospital consisted of 240 beds. Since May 1944 relocated in the city of Stalingrad became a garrison hospital. Today the hospital is a multidisciplinary health centre of the Russian Defense Ministry. Annually, the hospital performed at least 3000 surgical procedures, including more than 37%--are complex. In surgery, improved endovideosurgical direction, over 31% of emergency operations performed using this method. Since December 2009 the hospital became a structural division of the District Hospital in 1602 in Rostov on Don. The close connection between the branch and district hospital allows for complex diagnostic situations to consult leading experts, including consultation, thus ensuring the most effective treatment results.

  20. Hanging on the hospital telephone.

    PubMed

    Bates, Jane

    2016-09-21

    When someone dear to you is admitted to hospital in an emergency, you are not in a calm frame of mind. You want news, and fast. But when you call the hospital, the phone just keeps ringing. PMID:27654550

  1. E-procurement in hospitals.

    PubMed

    Hidalgo, Julio Villalobos; Orrit, Joan; Villalobos, Juan Pablo

    2011-01-01

    This article describes the history, current status, advantages of and opposition to the implementation of e-procurement in hospitals and examines the results of its implementation in a psychiatric hospital.

  2. Guide to Choosing a Hospital

    MedlinePlus

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

  3. Hospital Preparedness and SARS

    PubMed Central

    Wallington, Tamara; Rutledge, Tim; Mederski, Barbara; Rose, Keith; Kwolek, Sue; McRitchie, Donna; Ali, Azra; Wolff, Bryan; White, Diane; Glassman, Edward; Ofner, Marianna; Low, Don E.; Berger, Lisa; McGeer, Allison; Wong, Tom; Baron, David; Berall, Glenn

    2004-01-01

    On May 23, 2003, Toronto experienced the second phase of a severe acute respiratory syndrome (SARS) outbreak. Ninety cases were confirmed, and >620 potential cases were managed. More than 9,000 persons had contact with confirmed or potential case-patients; many required quarantine. The main hospital involved during the second outbreak was North York General Hospital. We review this hospital’s response to, and management of, this outbreak, including such factors as building preparation and engineering, personnel, departmental workload, policies and documentation, infection control, personal protective equipment, training and education, public health, management and administration, follow-up of SARS patients, and psychological and psychosocial management and research. We also make recommendations for other institutions to prepare for future outbreaks, regardless of their origin. PMID:15200807

  4. How hospitals approach price transparency.

    PubMed

    Houk, Scott; Cleverley, James O

    2014-09-01

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

  5. Analysis of the medication reconciliation process conducted at hospital admission.

    PubMed

    Contreras Rey, María Beatriz; Arco Prados, Yolanda; Sánchez Gómez, Ernesto

    2016-06-01

    fueron y en 93 (29,8%) la aceptación no procedía por un cambio en la situación del paciente. Las mayores oportunidades de mejora se identificaron en los servicios de Digestivo, Medicina Interna y Cirugía General y en los grupos terapéuticos: sangre y órganos hematopoyéticos, sistema cardiovascular y sistema nervioso. Conclusiones: En nuestro hospital solo una tercera parte de las intervenciones fueron aceptadas y reconocidas como errores de conciliación. No obstante, la conciliación de la medicación al ingreso realizada por un farmacéutico mostró ser útil en la identificación y prevención de errores de medicación. Un mejor entendimiento de los casos en los que las intervenciones no fueron aceptadas podría mejorar el resultado en el futuro.

  6. Childrens Hospital Inservice Education Curriculum.

    ERIC Educational Resources Information Center

    Lutz, Joan

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

  7. 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…

  8. Strategic market planning for hospitals.

    PubMed

    Zallocco, R L; Joseph, W B; Doremus, H

    1984-01-01

    The application of strategic market planning to hospital management is discussed, along with features of the strategic marketing management process. A portfolio analysis tool, the McKinsey/G.E. Business Screen, is presented and, using a large urban hospital as an example, discussed in detail relative to hospital administration. Finally, strategic implications of the portfolio analysis are examined.

  9. Before Hospitalization: A Preparation Program

    ERIC Educational Resources Information Center

    Johnson, Beverly H.

    1974-01-01

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

  10. Hospitality Studies: Escaping the Tyranny?

    ERIC Educational Resources Information Center

    Lashley, Conrad

    2015-01-01

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

  11. Library Hospitality: Some Preliminary Considerations

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  12. Hospital mergers and market overlap.

    PubMed Central

    Brooks, G R; Jones, V G

    1997-01-01

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

  13. [Refuse disposal at the hospital].

    PubMed

    Knoll, K H

    1990-02-01

    For the classification of hospital-wastes in the categories infectious-contaminate or special waste are only significant views of the prevention by nosocomial infection in the hospital. Solely infectious waste become removed hospital-intern and -extern on conditions of hygienic prevention, namely through secure packing during the transport, combustion or desinfection. Special wastes to be defeated by special-conditions. The hygienist of the hospital is only competent for the classification of the wastes in the hospital as well as for their refuse.

  14. Simulation in hospitals.

    PubMed

    Proctor, T

    1996-01-01

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

  15. Characteristics of the Earth's Magnetic Field Prior to the Cretaceous Normal Superchron: New Paleomagnetic Results from Alto Paraguay Formation

    NASA Astrophysics Data System (ADS)

    Cervantes Solano, M.; Goguitchaichrili, A.

    2011-12-01

    We report a detailed paleomagnetic investigation from 28 lava flows (221 standard paleomagnetic cores) collected in the Paraguayan part of the Paraná Flood Basalts (Alto Paraguay Formation) in order to (i) document the variability of the Earth's magnetic field during the early Cretaceous, (ii) estimate the extrusion rate of Paraná magma and (iii) obtain a new Cretaceous paleomagnetic pole for stable South America. The paleofield direction is precisely determined for 26 sites for which, the remanent magnetization is characterized by a small within-site dispersion and a high directional stability. Nine sites give normal polarity magnetization and other 9 are reversely magnetized while 8 remaining sites show intermediate paleodirections. The mean paleomagnetic direction of normal polarity sites is I=-41.8, D=4.9, k=112, a95=4.9 while reversely magnetized sites give I=37.1, D=181.4, k=23, a95=11.1. These results point to almost antipodal mean directions, since the reversal test is positive. The mean paleomagnetic pole position obtained from 18 sites is Plong= 179.2E, Plat= 86.2S, R=17.74, k=64.56, A95=4.3. The positions of Virtual Geomagnetic Poles show a reasonably good fit with a Fisherian distribution when probability plots as well as formal testing procedures are used. The pole obtained in this study agrees reasonably well with coeval pole positions, in particular with those obtained from CPMP (Central Paraná), Los Adobes, Misiones and SAMC. However, some other similar age paleomagnetic poles show significant departure that may be attributed to local tectonic rotations or insufficient sampling to overcome the paleosecular variation. The paleosecular variation parameters are in agreement with the selected data reported for the Cretaceous Normal Superchron. In contrast, VGP angular dispersions found here are lower with respect to the Jurassic and Plio-Pleistocene data. The intermediate VGPs show a cluster in southern hemisphere of 6 VGPs located near the pacific

  16. Biodiversity of Archaea and floral of two inland saltern ecosystems in the Alto Vinalopó Valley, Spain

    PubMed Central

    2010-01-01

    Background The extraction of salt from seawater by means of coastal solar salterns is a very well-described process. Moreover, the characterization of these environments from ecological, biochemical and microbiological perspectives has become a key focus for many research groups all over the world over the last 20 years. In countries such as Spain, there are several examples of coastal solar salterns (mainly on the Mediterranean coast) and inland solar salterns, from which sodium chloride is obtained for human consumption. However, studies focused on the characterization of inland solar salterns are scarce and both the archaeal diversity and the plant communities inhabiting these environments remain poorly described. Results Two of the inland solar salterns (termed Redonda and Penalva), located in the Alto Vinalopó Valley (Alicante, Spain), were characterized regarding their geological and physico-chemical characteristics and their archaeal and botanical biodiversity. A preliminary eukaryotic diversity survey was also performed using saline water. The chemical characterization of the brine has revealed that the salted groundwater extracted to fill these inland solar salterns is thalassohaline. The plant communities living in this environment are dominated by Sarcocornia fruticosa (L.) A.J. Scott, Arthrocnemum macrostachyum (Moris) K. Koch, Suaeda vera Forsk. ex Gmelin (Amaranthaceae) and several species of Limonium (Mill) and Tamarix (L). Archaeal diversity was analyzed and compared by polymerase chain reaction (PCR)-based molecular phylogenetic techniques. Most of the sequences recovered from environmental DNA samples are affiliated with haloarchaeal genera such as Haloarcula, Halorubrum, Haloquadratum and Halobacterium, and with an unclassified member of the Halobacteriaceae. The eukaryote Dunaliella was also present in the samples. Conclusions To our knowledge, this study constitutes the first analysis centered on inland solar salterns located in the

  17. Trends analysis of precipitation and temperature in the Alto Genil basin (Southeast Spain) from 1970 to 2010

    NASA Astrophysics Data System (ADS)

    Fernández-Chacón, Francisca; Pulido-Velázquez, David; Jiménez-Sánchez, Jorge; Jimeno-Sáez, Patricia; Juan Collados-Lara, Antonio; Luque-Espinar, Juan Antonio

    2016-04-01

    The last studies of climate change predict a trend to more arid conditions in most of Spain. These studies show a significant increment in seasonal and annual air temperature, a reduction in mean precipitation and a raising number of extreme events of both variables. The historic data analysis is essential for identifying cycles, recent weather trends and to calibrate predictive models. In this work we analyses the recent historical climate in Alto Genil Basin. The system is located at SE Iberian Peninsula and includes an important part of the Sierra Nevada catchment. A high-resolution Spain02 dataset (~11 km) have been employed in this study. In accordance with the available data we have analyzed the period from 1970 to 2010 for daily precipitation and from 1970 to 2007 for daily temperature. In order to detect cycles and climate trends we have analyzed the temporal, seasonal and spatial distribution of the precipitation and temperature variables. We have calculated and analyzed the accumulated deviations from the mean daily precipitation. This analysis has been also performed with monthly and annual series. A non-parametric Mann Kendall method has been applied to study trends. In the period 1971-2007, the temperature has increased. The strongest trends appear since 1994. Between of 1971-1993 the average temperature observed was 13.6 °C, however from 1994 to 2007 the average temperature observed was 14.84 °C. Seasonally, during the study period, the spring has been the season with biggest increment in temperature. These temperature increments are more significant during March, April, May, June, July and October. In the period 1971-2010 the Mann Kendall test does not show a clear trend for precipitation. It is mainly due to the series culminates in three exceptional hydrological years that mask the overall trend of the study period. For this reason, we have also performed a sensitivity analysis of the Mann Kendall analysis to the period of data considered. On the

  18. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    PubMed

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department. PMID:26338391

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

    PubMed

    de Mello, Rita Mello; Schneider, Jacó Fernando

    2011-06-01

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

  20. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    PubMed

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

  1. Opportunistic immunisation in hospital

    PubMed Central

    Conway, S

    1999-01-01

    AIM—To assess the potential for administering catch up and scheduled immunisations during hospital admission.
METHODS—Immunisation status according to the child's principal carer was checked against official records for 1000 consecutively admitted preschool age children. Junior doctors were instructed to offer appropriate vaccination before discharge, and consultants were asked to reinforce this proactive policy on ward rounds.
RESULTS—Excluding those children who were not fully immunised against pertussis through parental choice, 142 children (14.2%) had missed an age appropriate immunisation and 41 were due a scheduled immunisation. None had a valid contraindication. Only 43 children were offered vaccination on the ward but uptake was 65% in this group.
CONCLUSIONS—Admission to hospital provides opportunities for catch up and routine immunisations and can contribute to the health care of an often disadvantaged group of children. These opportunities are frequently missed. Junior doctors must be encouraged to see opportunistic immunisation as an important part of their routine work.
 PMID:10519717

  2. Hospital-Associated Infections.

    PubMed

    Babady, N Esther

    2016-06-01

    Hospital-associated infection (HAI) in immunocompromised patients can result in high rates of morbidity and mortality. Infections caused by multidrug-resistant organisms (MDROs) are especially worrisome because of the limited choice of remaining antibiotics available when a patient becomes colonized or infected with an MDRO. It is therefore important that immunocompromised patients be cared for in an environment that limits the risk for acquiring infections. However, with healthcare being increasingly delivered in settings other than the traditional inpatient hospital wards, a bigger effort will need to be set forth to prevent or rapidly diagnose HAI. The last few years have seen a significant increase in the number of singleplex and multiplex molecular assays for the detection of many of the organisms responsible for HAI, but more is needed as infections caused by organisms like Legionella pneumophila and Aspergillus species are still diagnosed with methods that have relatively low yield and are slow to provide actionable results. Finally, the use of novel techniques for outbreak investigations will provide new information on transmission of infectious agents in healthcare settings and allow stronger, evidence-based recommendations to be developed for prevention of HAIs in the immunocompromised host. PMID:27337459

  3. Design of paediatric hospitals.

    PubMed

    Lambert, Veronica

    2016-05-01

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

  4. Electronic Cigarettes on Hospital Campuses

    PubMed Central

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

    2015-01-01

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

  5. Electronic Cigarettes on Hospital Campuses.

    PubMed

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

    2015-12-29

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

  6. Structural determinants of hospital closure.

    PubMed

    Longo, D R; Chase, G A

    1984-05-01

    In a retrospective case-control study, structural characteristics of hospitals that closed during the years 1976-1980 were contrasted with three comparison groups: hospitals that were acquired in a merger; hospitals that joined a multihospital system; and hospitals that remained autonomously opened, to investigate these characteristics as predictors of closure. Characteristics investigated included environmental, structural, and process variables. The independent variables were measured 5 years prior to outcome. Findings indicate that closed hospitals resemble hospitals acquired in a merger ("failure"), and likewise autonomous hospitals resemble hospitals that join a multihospital system ("success"). The most important predictors of hospital failure were the physician-to-population ratio, the East North Central and West North Central census regions, the level of diversification, low occupancy rate, location in a standard metropolitan statistical area, the chief executive officer's lack of affiliation in the American College of Hospital Administrators, profit status, bed size of less than 50, and presence in a state with a rate-setting agency. Surprisingly, this study shows the bed-to-population ratio to be unrelated to closure. In addition, the findings strongly support the open-system perspective, which, unlike the closed-system perspective, is concerned with the vulnerability of the organization to the uncontrollable and often unpredictable influences of the environment.

  7. Hospital service offerings: does Catholic ownership matter?

    PubMed

    White, Kenneth R; Begun, James W; Tian, Wenqiang

    2006-01-01

    Controlling for market and organizational characteristics, Catholic hospitals in 2001 offered more stigmatized and compassionate care services than investor-owned hospitals, and more stigmatized services than public hospitals. There were no differences between Catholic hospitals and other nonprofit hospitals, however, in the number of compassionate, stigmatized, and access services offered. This may reflect growing isomorphism in the nonprofit hospital sector.

  8. [Prevalence of gastrointestinal disorders in adults with common variable immunodeficiency at Specialty Hospital Dr. Bernardo Sepulveda].

    PubMed

    Rodríguez-Negrete, Elda Victoria; Mayoral-Zavala, Arturo; Rodríguez-Mireles, Karen Alicia; Díaz de León-Salazar, Oscar Edmundo; Hernández-Mondragón, Oscar; Gómez-Jiménez, Luz María; Moreno-Alcántar, R; González-Virla, Baldomero

    2015-01-01

    Antecedentes: la incidencia de la inmunodeficiencia común variable (IDCV) es de 1 por cada 15,000 a 117,000 casos, sin predominio de género. La incidencia de manifestaciones gastrointestinales en estos pacientes es de 20 a 60% y pueden ser la primera y única manifestación clínica de IDCV. En México existe escasa información en relación con el tipo y frecuencia de alteraciones gastrointestinales que padecen los pacientes adultos con IDCV. Objetivo: determinar la prevalencia de alteraciones gastrointestinales en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio descriptivo, observacional y transversal en el que participaron pacientes con inmunodeficiencia común variable de la Clínica de Inmunodeficiencias del Servicio de Alergia e Inmunología Clínica del Hospital de Especialidades, Centro Médico Nacional Siglo XXI. A todos los pacientes se les aplicó un cuestionario de síntomas gastrointestinales y se les realizaron estudios de laboratorio, gabinete, endoscopia y prueba de aliento para determinar sobrepoblación bacteriana. Resultados: evaluamos 17 pacientes, 8 hombres y 9 mujeres, con edad promedio de 36 años y diagnóstico definitivo de inmunodeficiencia común variable de acuerdo con criterios internacionales. El 59% refirió dolor abdominal, 53% distensión abdominal y 17.6% estreñimiento. El 47% tenía diarrea crónica, en dos de ellos (11.8%) acompañada de pujo rectal. Las enfermedades gastrointestinales de esta población fueron: 18% diarrea crónica, enfermedad celiaca y sobrepoblación bacteriana, 24% trastorno funcional digestivo, 12% estreñimiento, 6% dispepsia. Sólo un paciente (6%) no tenía síntomas gastrointestinales. Conclusión: la prevalencia de las enfermedades gastrointestinales en pacientes adultos con inmunodeficiencia común variable fue de 94%, sin predominio de género. Debido a la frecuencia de manifestaciones gastrointestinales, es importante realizar protocolos de estudio al respecto

  9. Total quality in acute care hospitals: guidelines for hospital managers.

    PubMed

    Holthof, B

    1991-08-01

    Quality improvement can not focus exclusively on peer review and the scientific evaluation of medical care processes. These essential elements have to be complemented with a focus on individual patient needs and preferences. Only then will hospitals create the competitive advantage needed to survive in an increasingly market-driven hospital industry. Hospital managers can identify these patients' needs by 'living the patient experience' and should then set the hospital's quality objectives according to its target patients and their needs. Excellent quality program design, however, is not sufficient. Successful implementation of a quality improvement program further requires fundamental changes in pivotal jobholders' behavior and mindset and in the supporting organizational design elements.

  10. Has competition increased hospital technical efficiency?

    PubMed

    Lee, Keon-Hyung; Park, Jungwon; Lim, Seunghoo; Park, Sang-Chul

    2015-01-01

    Hospital competition and managed care have affected the hospital industry in various ways including technical efficiency. Hospital efficiency has become an important topic, and it is important to properly measure hospital efficiency in order to evaluate the impact of policies on the hospital industry. The primary independent variable is hospital competition. By using the 2001-2004 inpatient discharge data from Florida, we calculate the degree of hospital competition in Florida for 4 years. Hospital efficiency scores are developed using the Data Envelopment Analysis and by using the selected input and output variables from the American Hospital Association's Annual Survey of Hospitals for those acute care general hospitals in Florida. By using the hospital efficiency score as a dependent variable, we analyze the effects of hospital competition on hospital efficiency from 2001 to 2004 and find that when a hospital was located in a less competitive market in 2003, its technical efficiency score was lower than those in a more competitive market.

  11. Does outsourcing affect hospital profitability?

    PubMed

    Danvers, Kreag; Nikolov, Pavel

    2010-01-01

    Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.

  12. Union Density and Hospital Outcomes.

    PubMed

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

    2015-01-01

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

  13. Lower Mortality in Magnet Hospitals

    PubMed Central

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

    2014-01-01

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

  14. Lower Mortality in Magnet Hospitals

    PubMed Central

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

    2012-01-01

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

  15. IK Brunel's Crimean war hospital.

    PubMed

    Merridew, C G

    2014-07-01

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

  16. RFID solution benefits Cambridge hospital.

    PubMed

    James, Andrew

    2013-10-01

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

  17. Wearing gloves in the hospital

    MedlinePlus

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

  18. The physician exodus from hospitals.

    PubMed

    Royce, P C

    1997-04-01

    Physicians are spending increasingly less of their work week in the hospital. This is true of surgeons because they are performing more ambulatory surgery, often off the hospital premises, and for primary care physicians because they are delegating hospital care of their patients to others. What are the effects of this physician exodus on hospitals, patients, physicians, and medical education? Some of these consequences are explored, from disruptions in the continuity of care, to increase in practice productivity, to preparing undergraduates for the realities of medical practice.

  19. Psychiatric hospitalization in Poland.

    PubMed

    Frydman, L

    1983-01-01

    An overview of psychiatric hospitalization in Poland is presented in the context of Polish political and socio-cultural developments. The areas addressed include: the characteristics of the patient population; the organization of Polish mental health service; the nature of psychiatric treatment; psychiatric legislation; patients' rights; and the training and social status of the various mental health professionals. In spite of the meager resources allocated to mental health services, and the consequent staff shortages and overcrowded, drab living conditions in psychiatric facilities, the care afforded patients is generally humane and nonoppressive. Polish psychiatry has succeeded in maintaining its professional autonomy and has assumed a leadership role in the modernization of its service delivery system.

  20. Controlling hospital library theft

    PubMed Central

    Cuddy, Theresa M.; Marchok, Catherine

    2003-01-01

    At Capital Health System/Fuld Campus (formerly Helene Fuld Medical Center), the Health Sciences Library lost many books and videocassettes. These materials were listed in the catalog but were missing when staff went to the shelves. The hospital had experienced a downsizing of staff, a reorganization, and a merger. When the library staff did an inventory, $10,000 worth of materials were found to be missing. We corrected the situation through a series of steps that we believe will help other libraries control their theft. Through regularly scheduling inventories, monitoring items, advertising, and using specific security measures, we have successfully controlled the library theft. The January 2002 inventory resulted in meeting our goal of zero missing books and videocassettes. We work to maintain that goal. PMID:12883573

  1. Controlling hospital library theft.

    PubMed

    Cuddy, Theresa M; Marchok, Catherine

    2003-04-01

    At Capital Health System/Fuld Campus (formerly Helene Fuld Medical Center), the Health Sciences Library lost many books and videocassettes. These materials were listed in the catalog but were missing when staff went to the shelves. The hospital had experienced a downsizing of staff, a reorganization, and a merger. When the library staff did an inventory, $10,000 worth of materials were found to be missing. We corrected the situation through a series of steps that we believe will help other libraries control their theft. Through regularly scheduling inventories, monitoring items, advertising, and using specific security measures, we have successfully controlled the library theft. The January 2002 inventory resulted in meeting our goal of zero missing books and videocassettes. We work to maintain that goal.

  2. Along strike variation in fault creep on the active Alto Tiberina low angle normal fault inferred from GPS geodesy

    NASA Astrophysics Data System (ADS)

    Bennett, R. A.; Jackson, L. J.; Mencin, D.; Casale, G.

    2013-12-01

    The Alto Tiberina fault (ATF) in central Italy is a low angle normal fault (LANF) dipping ~20° to the east-northeast. The fault is inferred from surface geology, deep boreholes, seismic reflection lines, abundant microseismicity, and crustal motion data. Balanced cross sections show that the fault plays a major role in accommodating regional extension in central Italy, having accommodated up to 10 km of extension over the past 3 Ma. However, no large earthquakes have been attributed to the ATF. Instead, large earthquakes in the area occur on high angle west dipping normal faults that cut the ATF hanging wall. Several lines of evidence, including fine grained foliations composed of velocity strengthening phyllosilicate minerals in exhumed fault rocks, high fault fluid over-pressures observed in footwall boreholes (~85% lithostatic pressure at 3.7-4.8 km depth), persistent microseismicity coincident with the ATF fault plane, and pattern of geodetically observed crustal motions suggest that the ATF accommodates slip primarily by aseismic creep up to shallow (~4 km) depth in the crust. Previous studies using a simple fault model consisting of an edge dislocation buried in and elastic halfspace supported the shallow creeping hypothesis. But newer realizations of the crustal motion field, imaged with more precision and higher spatial resolution than previously reported, are not adequately explained by this 1-D creeping-fault model. Moreover, significant variations in the occurrence of large hanging wall earthquakes are observed along the strike of the ATF and may be indicative of along-strike variation in ATF fault mechanics. To test whether the along-strike variation in earthquake occurrence is accompanied by similar variation in the rate of fault creep on the ATF, we analyzed crustal motion data derived from more than a decade of continuous GPS measurements in central Italy. We used the TDEFNODE software to parameterize the ATF using the available high

  3. Pre-hospital emergency medicine.

    PubMed

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

    2015-12-19

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

  4. Health assessment for Hewlett-Packard (620-640 Page Mill Road), Palo Alto, Santa Clara County, California, Region 9. CERCLIS No. CAD980884209. Preliminary report

    SciTech Connect

    Not Available

    1990-07-18

    The Hewlett-Packard (620-640 Page Mill Road) site was proposed for the National Priorities List on Update 7. The site is located on Page Mill Road in Palo Alto, California. Until 1986, the site was used as the location of an optoelectronic manufacturing operation. The site is currently vacant and will be converted into an office park complex. In 1981, waste solvents leaked out of an underground storage tank and contaminated the underlying soil and groundwater. The storage tank and some of the contaminated soil were excavated and disposed of off-site. An air stripping tower was constructed on-site to aid in the groundwater cleanup. The city of Palo Alto maintains several emergency water supply wells downgradient of the site. No site-related contamination has been reported in these public supply wells. The area surrounding the site is serviced by the public water system. However, there may be some private wells downgradient of the site. It is not known if these wells are currently being used for potable or nonpotable purposes or if they have been impacted by site-related contamination. In the absence of this information, it cannot be determined if the site poses a potential public health risk.

  5. Segmentation in local hospital markets.

    PubMed

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

    1993-01-01

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

  6. Faculty Internships for Hospitality Instructors

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  7. Practicing Hospitality in the Classroom

    ERIC Educational Resources Information Center

    Burwell, Rebecca; Huyser, Mackenzi

    2013-01-01

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

  8. Management of the Hospital Environment

    ERIC Educational Resources Information Center

    Turner, Alvis G.

    1976-01-01

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

  9. Comparing Candidate Hospital Report Cards

    SciTech Connect

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

    1997-12-31

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

  10. Latex in the Hospital Environment

    MedlinePlus

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

  11. Hospitality Management Education and Training.

    ERIC Educational Resources Information Center

    Brotherton, Bob, Ed.; And Others

    1995-01-01

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

  12. Hospital transformation and organisational learning.

    PubMed

    Ho, W

    1999-12-01

    Kwong Wah Hospital was founded by the charity organisation Tung Wah Group of Hospitals some 88 years ago, with management transfer to the Hong Kong Hospital Authority in 1991. Capitalizing both from the traditional caring culture of its founder, as well as opportunities in the new management environment, the hospital has scored remarkable successes in service quality, community partnership, organisational effectiveness, and staff development. Underpinning these transformations were Structure, Process, People, and Culture strategies. The learning imperative is heavily mandated or the success of each of these strands of development. Indeed, the embodiment of a learning organisation culture provides the impetus in sustaining the change momentum, towards achieving the Vision of becoming a 'Most Preferred Hospital' in Hong Kong. PMID:10673847

  13. New directions in hospital governance.

    PubMed

    Shortell, S M

    1989-01-01

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

  14. Physicians and foundation hospitals.

    PubMed

    Cooper, John; Black, Carol

    2003-01-01

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

  15. Genotoxicity evaluation of hospital wastewaters.

    PubMed

    Gupta, Preeti; Mathur, N; Bhatnagar, P; Nagar, P; Srivastava, S

    2009-10-01

    In hospitals a large variety of substances are in use for medical purposes such as diagnostics and research. After application, diagnostic agents, disinfectants and excreted non-metabolized pharmaceuticals by patients reach the wastewater. Indeed, some of the substances found in wastewaters are genotoxic and are suspected to be a possible cause of the cancers observed in the last decades. Genotoxicity tests are an excellent means to study the toxicity and the risk associated with these releases. This paper points out the areas of concern for hospital wastewater disposal and reports the findings of genotoxicity tests for hospital effluents from 3 major hospitals in Delhi, namely All India Institute of Medical Sciences, Apollo and Escorts. Mutagenicity of hospital wastewaters from effluent treatment plants (before and after treatment) was studied. The results of this study show that the genotoxicity of hospital wastewaters is highly reduced after the treatment process. This study calls for establishment of advanced and effective effluent treatment plants in the hospitals, which are merely dumping the wastewaters in the municipal sewerage system. The results of this study call for further detailed study in this area.

  16. [Hospitals' evolution through the ages].

    PubMed

    de Micheli, Alfredo

    2005-01-01

    The predecessor institutions of modern hospitals--Byzantine nosocómeion, European hospitale and Islamic maristan--were dissimilar both in their patients and their aims. The first charitable organizations in West Europe (Rome) and in the East (Cesarea in Cappadocia) were rather hospices. After the collapse of the Western Roman Empire (476 A.D.), some monastic centers were prepared to provide medical assistance to religious and secular patients. Since the XI and XII Centuries in all of Christian Europe the charitable institutions, designated as hospitale, multiplied. Among the Italian ones, the Roman Santo Spirito (Holy Ghost) Hospital, built in the 1201-1204 period, reached a preeminet position. This one soon became the most important of the entire Christendom (archihospital), with a lot of affiliated hospitals in Europe and later in America. The first American hospital, Saint Nicholas Hospital, opened on December 29, 1503 in Santo Domingo, obtained in 1541 its affiliation to the Santo Spirito archihospital. Regarding continental America, the first health centers were established in Mexico: the Immaculate Conception Hospital and the Saint Lazarus Hospital, both established by Hernán Cortés. For its part, clinical teaching was systematized at the Saint Francis Hospital in Padua and by there moved to Leyden. In Mexico, the chair of medical clinics or practical medicine was established in 1806 at the Saint Andrew Hospital. During the XX century, Dr. Ignacio Chávez was the driving force behind the creation of the modern Mexican Health Institutes. These ones are dedicated to the treatment of poor patients, as well as to medical teaching and research.

  17. The Status of Hospital Information Systems in Iranian Hospitals

    PubMed Central

    Jahanbakhsh, Maryam; Sharifi, Mohammed; Ayat, Masar

    2014-01-01

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

  18. Why urban voluntary hospitals close.

    PubMed Central

    Sager, A

    1983-01-01

    In this paper, we argue for the importance of understanding hospital closings and relocations. Broad descriptive data on closings, relocations, and other reconfigurations of beds in 52 large and mid-size U.S. cities are presented. The period covered is 1937 to 1980. Two contrasting outlooks on hospital closings and relocations are offered. As hypothesized, smaller and less specialized nonteaching hospitals and those located in minority neighborhoods or serving above-average proportions of minority or Medicaid-funded patients were more likely to close. A potentially more effective but more costly and less accessible system of urban health care appears to result. PMID:6360956

  19. A computerized hospital maintenance system.

    PubMed

    Kresch, E; Katz, P; Schwartz, H; Hamarman, H

    1985-01-01

    The Biomedical Instrumentation Department at Thomas Jefferson University Hospital maintains most of the clinical equipment owned by the hospital and provides support to six other hospitals, as well. In order to document these services, a computerized support system has been developed. This system maintains the inventory of equipment, documents the occurrence of repair and preventive maintenance procedures, generates lists of items due for maintenance and inspection, and prints reports and summaries of all activities performed by department staff. The system was designed for ease of use and requires a minimum of training for personnel who use it. PMID:10271514

  20. Preventable hospitalizations and socioeconomic status.

    PubMed

    Blustein, J; Hanson, K; Shea, S

    1998-01-01

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

  1. Energy audits at 48 hospitals

    NASA Astrophysics Data System (ADS)

    Hirst, E.

    1981-11-01

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

  2. Trends affecting hospitals' human resources.

    PubMed

    Neudeck, M M

    1985-01-01

    Hospital workers at every level--from administrators to housekeepers--will be affected by the interaction of changes already underway in the healthcare industry. Societal forces that will affect the hospital workforce include demographic change, the rise of the participatory ethic and decentralization, a growing philosophy of job entitlement, and new pressures for unionization. At the same time, the industry is faced with changing manpower requirements, cost containment, and the oversupply of physicians. This article identifies some of the likely effects of these changes on hospital human resources and suggests ways that administrators can prepare for them.

  3. Assessing Greek Public Hospitals' Websites.

    PubMed

    Tsirintani, Maria; Binioris, Spyros

    2015-01-01

    Following a previous (2011) survey, this study assesses the web pages of Greek public hospitals according to specific criteria, which are included in the same web page evaluation model. Our purpose is to demonstrate the evolution of hospitals' web pages and document e-health applications trends. Using descriptive methods we found that public hospitals have made significant steps towards establishing and improving their web presence but there is still a lot of work that needs to be carried out in order to take advantage of the benefits of new technologies in the e-health ecosystem.

  4. [Management or strategy within hospitals].

    PubMed

    Branciard, A; Mosse, P

    1992-01-01

    A study was conducted on certain number of hospital departments to identify the kind of variables which determine decision-making and decision-implementation as concerns innovations, both in medical process and hospital organization. Among the internal variables, one can quote the size of the hospital, its ownership type, its main field of activity, its situation in the local health structure, its resources ... Among the external variables one can quote the supply of care at the local level, the local health networking, the state of technological development, interrelationship of the health sector, the manufacturing sector and the research sector, the presence of managerial tools and skills...

  5. CDC Vital Signs: Hospital Actions Affect Breastfeeding

    MedlinePlus

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

  6. Lack of identification of Flaviviruses in oral and cloacal swabs from long- and short-distance migratory birds in Trentino-Alto Adige (North-eastern Italy)

    PubMed Central

    2013-01-01

    Background West Nile virus (WNV) and Usutu virus (USUV), both belonging to the genus Flavivirus, are emerging in Italy as important human and animal pathogens. Migratory birds are involved in the spread of Flaviviruses over long distances, particularly from Africa to Europe. Once introduced, these viruses can be further be dispersed by short-distance migratory and resident bird species. Thus far, there is still a considerable knowledge gap on the role played by different bird species in the ecology and transmission mechanisms of these viruses. The Region of Trentino-Alto Adige (north-eastern Italy) is located on the migratory route of many of the short- and long-distance migratory birds that cross the Alps, connecting northern Europe and western Asia with southern Europe and Africa. Until now, only a silent circulation of WNV and USUV within the territory of the Province of Trento has been confirmed by serological screening, whilst no cases of infected humans or animals have so far been reported. However, continuous spillover events of both viruses have been reported in neighbouring Regions. The aim of this study was to monitor the circulation of WNV and USUV in Trentino-Alto Adige, in order to detect if active virus shedding occurs in migratory birds captured during their seasonal movements and to evaluate the role that different bird species could play in the spreading of these viruses. Methods We carried out a biomolecular survey on oral and cloacal swabs collected from migratory birds during seasonal migrations. Birds belonging to 18 transaharian and 21 intrapaleartic species were examined during spring (n = 176) and autumn (n = 146), and were tested using a generic nested-PCR. Results All samples tested negative for Flaviviruses. The possible causes of unapparent shedding, along with ecological and epidemiological implications are discussed. Conclusions The lack of detection of active virus shedding in these bird species does not exclude the

  7. Crisp clustering of airborne geophysical data from the Alto Ligonha pegmatite field, northeastern Mozambique, to predict zones of increased rare earth element potential

    NASA Astrophysics Data System (ADS)

    Eberle, Detlef G.; Daudi, Elias X. F.; Muiuane, Elônio A.; Nyabeze, Peter; Pontavida, Alfredo M.

    2012-01-01

    The National Geology Directorate of Mozambique (DNG) and Maputo-based Eduardo-Mondlane University (UEM) entered a joint venture with the South African Council for Geoscience (CGS) to conduct a case study over the meso-Proterozoic Alto Ligonha pegmatite field in the Zambézia Province of northeastern Mozambique to support the local exploration and mining sectors. Rare-metal minerals, i.e. tantalum and niobium, as well as rare-earth minerals have been mined in the Alto Ligonha pegmatite field since decades, but due to the civil war (1977-1992) production nearly ceased. The Government now strives to promote mining in the region as contribution to poverty alleviation. This study was undertaken to facilitate the extraction of geological information from the high resolution airborne magnetic and radiometric data sets recently acquired through a World Bank funded survey and mapping project. The aim was to generate a value-added map from the airborne geophysical data that is easier to read and use by the exploration and mining industries than mere airborne geophysical grid data or maps. As a first step towards clustering, thorium (Th) and potassium (K) concentrations were determined from the airborne geophysical data as well as apparent magnetic susceptibility and first vertical magnetic gradient data. These four datasets were projected onto a 100 m spaced regular grid to assemble 850,000 four-element (multivariate) sample vectors over the study area. Classification of the sample vectors using crisp clustering based upon the Euclidian distance between sample and class centre provided a (pseudo-) geology map or value-added map, respectively, displaying the spatial distribution of six different classes in the study area. To learn the quality of sample allocation, the degree of membership of each sample vector was determined using a-posterior discriminant analysis. Geophysical ground truth control was essential to allocate geology/geophysical attributes to the six classes

  8. In-hospital Cardiac Arrest at Cork University Hospital.

    PubMed

    O'Sullivan, E; Deasy, C

    2016-01-01

    We describe the incidence and outcomes of in-hospital cardiac arrest (IHCA) at Cork University Hospital over a one year time period (2011), prior to the implementation of national early warning scoring (NEWS) systems. There were 43 217 coded CUH admissions, in 2011, to 518 in-patient beds. The Hospital In-Patient Enquiry Database was used to identify adults (>/= 18 years) who sustained IHCA. Available Utstein variables were collected. Fifty-two patients were found to be incorrectly coded IHCA. 17 of 63 (27.0%) IHCA survived to discharge. IHCA with shockable rhythm had significantly higher survival. IHCA survival was significantly lower on wards versus any other hospital location. Median days of stay prior to arrest were significantly different between survivors and non-survivors. All survivors (n = 17) had intact neurological outcome post-event. Our outcomes from IHCA are poorest on hospital wards when compared to other areas of the hospital. Those that survive have excellent function and one-year survival.

  9. 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.... ACTION: Notice. SUMMARY: This notice announces the inpatient hospital deductible and the hospital...

  10. What is your hospitality quotient?

    PubMed

    DeSilets, Lyn

    2015-03-01

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

  11. When hospitals limit organizing activity.

    PubMed

    Gilmore, C B

    1988-01-01

    Since 1974, when the NLRA was extended to cover nonprofit medical institutions, hospitals have been faced with the challenge of accommodating their employees' right to engage in organizing and concerted activities while preventing such activities from disrupting patient care. Some hospitals have sought to protect the interests of patients by prohibiting solicitation and distribution in all areas to which patients and visitors have access. The Board and the courts have generally found such rules overly broad and violative of employee rights under the NLRA. In the following survey of cases involving solicitation/distribution rules, the author points out that the courts have consistently evaluated these rules on the basis of the special nature of the hospital setting. Accordingly, advises the author, hospital administrators who are promulgating distributions and solicitation rules covering a given location must consider the individual characteristics of that location, namely, its physical layout, the type of work performed there, and the availability of alternate space.

  12. Latex allergies - for hospital patients

    MedlinePlus

    ... hospital; Contact dermatitis - latex allergy; Allergy - latex; Allergic reaction - latex ... You can have a reaction to latex if your skin, mucous membranes (eyes, mouth, or other moist areas), or bloodstream (during surgery) come into contact ...

  13. Play for Children in Hospital

    ERIC Educational Resources Information Center

    Hardgrove, Carol; And Others

    1976-01-01

    Contains six short articles on therapeutic play. Each article is an edited version of a paper delivered at the XIV World Congress of Pediatrics in Buenos Aires on the subject of children in the hospital. (JMB)

  14. Standards for hospital libraries 2002

    PubMed Central

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

    2002-01-01

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

  15. Hospitalization length of insanity acquittees.

    PubMed

    Steadman, H J; Pasewark, R A; Hawkins, M; Kiser, M; Bieber, S

    1983-07-01

    Used step-wise multiple regression procedures to predict length of hospitalization of 225 defendants acquitted by reason of insanity in New York state. Of the 21 variables considered, only 9 (severity of offense, sex, marital status, days prior imprisonment, homicide offense, days previous civil hospitalization, educational level, race, number of victims) contributed to the significance of the regression equation. However, these accounted for but 11% of the observed variance.

  16. Turning hospital data into dollars.

    PubMed

    Bradley, Paul; Kaplan, Jeff

    2010-02-01

    Predictive analytics is an advanced business intelligence tool that can help healthcare financial executives mine data resulting in high-value, actionable improvements for their revenue cycle. Predictive analytic solutions can help hospitals increase revenues and improve their decision-making ability to increase revenue and staff productivity. Automation technology can help hospital business offices eliminate manual work on claims, saving time and costly labor while increasing accuracy.

  17. Facility management in German hospitals.

    PubMed

    Gudat, H

    2000-04-01

    Facility management and optimum building management offer for hospitals a chance to reduce costs and to increase quality, process sequences, employee motivation and customer satisfaction. Some years ago simple services such as cleaning, catering or laundry were outsourced. Now, German hospitals progress to more complex fields such as building and medical technology, clinical support processes such as pharmacy, central laboratory and sterilization, goods and logistics services. PMID:11066999

  18. Hospital diversification and financial management.

    PubMed

    Eastaugh, S R

    1984-08-01

    Hospital diversification and its impact on the operating ratio are studied for 62 New York hospitals during the period 1974-1979. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as being jointly dependent. Institutional diversification is found to yield better financial position, and the better operating ratio allows the institution the wherewithal to diversify. The impact of external government planning and hospital competition are also measured. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification and divestiture, occasionally leading to closure or merger. These results should not be generalized beyond the New York State context. Restructuring of the organization, unrelated business ventures, and transactions with related organizations were not a problem in this sample. However, in 1983, many a new corporation is set up whose revenues do not become part of the hospital's and whose complex transactions conceal unallowable costs and maximize reimbursement. A number of hypotheses are advanced concerning hospital administrator's attitude toward risk.

  19. Standards for hospital libraries 2002.

    PubMed

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

    2002-10-01

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

  20. Random output and hospital performance.

    PubMed

    Barros, Pedro Pita

    2003-11-01

    Many countries are under pressure to reform health care financing and delivery. Hospital care is one part of the health system that is under scrutiny. Private management initiatives are a possible way to increase efficiency in health care delivery. This motivates the interest in developing methodologies to assess hospital performance, recognizing hospitals as a different sort of firm. We present a simple way to describe hospital production: hospital output as a change in the distribution of survival probabilities. This output definition allows us to separate hospital production from patients' characteristics. The notion of "better performance" has a precise meaning: (first-order) stochastic dominance of a distribution of survival probabilities over another distribution. As an illustration, we compare, for an important DRG, private and public management and find that private management performs better, mainly in the range of high-survival probabilities. The measured performance difference cannot be attributed to input prices or to economies of scale and/or scope. It reflects pure technological and organisational differences.

  1. Hospital network performance: a survey of hospital stakeholders' perspectives.

    PubMed

    Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P

    2013-02-01

    Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance.

  2. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  3. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  4. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  5. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  6. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...

  7. Ethics issues in security hospitals.

    PubMed

    Weinstein, Henry C

    2002-01-01

    The term 'security hospital' is used for a variety of facilities including forensic hospitals and prison hospitals, which, because of their mission, the nature of their work, and the populations they serve-or because of the authority under which they operate-place the staff at considerable risk of ethical violations related to either clinical care or to forensic activities. The problem of divided loyalties is of special concern in security hospitals. Ethics principles particularly at risk are confidentiality and informed consent. Where there are cultural disparities between the staff and the patients, differences in background, socioeconomic class, education, and other types of diversity, cultural awareness is required and must be reflected in appropriate treatment and evaluation. To counteract the risks of ethical violations, a security hospital should create an ethical climate and develop means to anticipate, prevent, and deal with ethical violations. These might include detailed and specific policies and procedures, programs of orientation, education, consultation, and liaison as well as its own ethics committee.

  8. Enterprise resource planning for hospitals.

    PubMed

    van Merode, Godefridus G; Groothuis, Siebren; Hasman, Arie

    2004-06-30

    Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the potential of enterprise resource planning (ERP) systems for healthcare delivery organizations. First ERP systems are explained. An overview is then presented of the characteristics of the planning process in hospital environments. Problems with ERP that are due to the special characteristics of healthcare are presented. The situations in which ERP can or cannot be used are discussed. It is suggested to divide hospitals in a part that is concerned only with deterministic processes and a part that is concerned with non-deterministic processes. ERP can be very useful for planning and controlling the deterministic processes. PMID:15171978

  9. Light Therapy in Mental Hospitals.

    PubMed

    Cormac, H D

    1929-02-01

    The position of actinotherapy in Mental Hospitals in this country is reviewed. An investigation of the results of ultra-violet irradiation in mental disorders at Parkside Mental Hospital is described and it is shown that certain types of the psychoses appear to benefit. The physiological action of actinic rays in relation to mental disorders is discussed and their mode of action on the nervous system suggested. Reference is made to substances which sensitize the body tissues to sunlight and ultra-violet radiation. An allusion is made to glass, penetrable by a portion of the actinic rays, and its uses. The need for ultra-violet ray apparatus in every mental hospital is urged both for treatment of mental and physical conditions and for the study of its action.

  10. Unsafe driving behaviors and hospitalization.

    PubMed

    Van Tuinen, M

    1994-04-01

    The medical costs associated with motor vehicle crashes are difficult to measure. Most attempts have used crash data and cost data that are only indirectly related to each other or have followed patients in a few hospitals or trauma centers. These studies produce localized estimates or rough national estimates of limited use to policy makers. The result has been a dependence on more readily available mortality data, such as the Fatal Accident Reporting System, to guide automotive safety efforts. The limitations of mortality data and the increasing sophistication of medical care data bases have resulted in a strong interest in obtaining crash-linked morbidity data. Hence, in 1993, the National Highway Traffic Safety Administration (NHTSA) awarded the Missouri Department of Health and six other applicants grants to link automotive crash records to statewide ambulance trip, outpatient care, hospitalization and mortality records. By identifying an individual across multiple data sets, states would be able to determine directly the relationship of driver behaviors and crash characteristics to hospitalization rates and other medical outcomes. Examination of hospital pay source information would expose the toll of automotive crashes on public tax dollars. Having recently completed the record linkage phase of this project, Missouri Department of Health staff are beginning to analyze the impact of automotive crashes on health care costs in Missouri. In this report, three unsafe driving behaviors, failure to use a safety device (seatbelts and motorcycle helmets), driving under the influence of alcohol, and speeding, are related to the risk of hospitalization or death, hospital costs, and expected pay source. PMID:8202067

  11. [The future of hospitals and the hospitals in the future].

    PubMed

    Illés, S Tamás

    2016-07-01

    By the end of the 20th century the vertically organized hospitals formed into a closed hierarchical system, in which the healthcare supply significantly fragmented. The existing hospitals in the current organization are not prepared for the increase in longevity, nor for the high growth in the number of chronic and long-term illnesses and the multi-morbidity since they were not designed for extended carry treatments. The fast incorporation of high-tech and very expensive technologies into healthcare generates an economic crisis. Solving the supply and economic crisis at the same time cannot be achieved without changing the structure of hospitals. Future hospitals will be organized in a network, conducting special treatments according to disease profiles. According to present knowledge, this is the only structure that allows for economies in scale, the proper spending of the ever-shrinking resources, and to ensure the effective patient care required after the changing of disorder structures and patient corporate identities. Orv. Hetil., 2016, 157(28), 1099-1104. PMID:27397421

  12. Hospital-integrated PACS at the University Hospital of Geneva

    NASA Astrophysics Data System (ADS)

    Ratib, Osman M.; Ligier, Yves; Hochstrasser, Denis; Scherrer, Jean-Raoul

    1991-07-01

    The PACS under development at the University Hospital of Geneva is a hospital-wide image management system for radiological as well as non-radiological medical images which is part of one of the widest hospital information systems (HIS) in Switzerland (Diogene system). It is based on a multi-vendor open architecture and a set of widely available industry standards, namely: Unix as the operating system, TCP-IP as network protocol and an SQL-based distributed database (INGRES) that handles both the PACS and the HIS. The PACS is based on a distributed architecture of servers of two types: the archive servers connected to the sources of images and equipped with large optical disk libraries (jukeboxes) and display servers distributed over the hospital. A standard image storage format was developed based on the ACR-NEMA standard. This file format (the PAPYRUS format) allows storage of sets of images as a sequence of ACR-NEMA messages in an 'encapsulated' file structure. In order to provide a more uniform user interface on a variety of different workstations, a common platform for image display and manipulation called OSIRIS is developed based on X-11 windowing system and OSF/Motif extension. Such a platform is designed to be portable to any computer running Unix and equipped with a graphic display system running X-11. Because this software is written in the object-oriented language C++, it is easily expandable and easily adaptable to different needs and requirements.

  13. 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 hospitals). 447.280 Section 447.280 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Inpatient Hospital and Long-Term Care Facility Services Swing-Bed Hospitals § 447.280 Hospital providers...

  14. 76 FR 25550 - Medicare and Medicaid Programs: Changes Affecting Hospital and Critical Access Hospital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-05

    ... May 26, 2010 (75 FR 29479). In that rule, we proposed to revise both the hospital and CAH... and Medicaid Programs: Changes Affecting Hospital and Critical Access Hospital Conditions of...) for both hospitals and critical access hospitals (CAHs). The final rule will implement a...

  15. 77 FR 69848 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

    ... 2013 Rates and to the Long Term Care Hospital PPS and FY 2013 Rates'' (77 FR 53257). Therefore, the... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2013 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for...

  16. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-09

    ... 2011 LTCH PPS) (75 FR 50042-50677).'' Therefore, the percentage increase for hospitals paid under the... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for...

  17. What's new in tent hospitals?

    PubMed

    Laufman, H

    1989-06-01

    There will always be a need for some kind of rapidly deployable, easy to assemble, temporary shelter for use in military conflicts, large-scale military disasters, industrial accidents, major construction projects in remote areas, refugee relocation centers, military hospitals, and any temporary outdoor event requiring cover. The history of tenting is essentially a history of man's ingenuity in creating portable, rapidly erected, temporary shelter. This article will be limited to the stages of development of the latest in military tent hospitals. PMID:2498765

  18. Virtual hospitalization: reality or utopia?

    PubMed

    Maceratini, R; Rafanelli, M; Ricci, F L

    1995-01-01

    In this paper the problem regarding the way in which the increasing capacity and facilities of the telemedicine to link points of care, supporting services and health care sectors, is described. The virtual hospitalization is discussed, as well as its insertion in a new health care system, whose services will provide everyone with effective health care in their homes or in isolated places or in their working places or in emergencies, and which will permit remote consultations between professionals in specialized centers, hospitals and other peripheral points of care.

  19. Hospital readmission and parent perceptions of their child's hospital discharge

    PubMed Central

    Berry, Jay G.; Ziniel, Sonja I.; Freeman, Linda; Kaplan, William; Antonelli, Richard; Gay, James; Coleman, Eric A.; Porter, Stephanie; Goldmann, Don

    2013-01-01

    Objective To describe parent perceptions of their child's hospital discharge and assess the relationship between these perceptions and hospital readmission. Design A prospective study of parents surveyed with questions adapted from the care transitions measure, an adult survey that assesses components of discharge care. Participant answers, scored on a 5-point Likert scale, were compared between children who did and did not experience a readmission using a Fisher's exact test and logistic regression that accounted for patient characteristics associated with increased readmission risk, including complex chronic condition and assistance with medical technology. Setting A tertiary-care children's hospital. Participants: A total of 348 parents surveyed following their child's hospital discharge between March and October 2010. Intervention None. Main Outcome Measure Unplanned readmission within 30 days of discharge. Results There were 28 children (8.1%) who experienced a readmission. Children had a lower readmission rate (4.4 vs. 11.3%, P = 0.004) and lower adjusted readmission likelihood [odds ratio 0.2 (95% confidence interval 0.1, 0.6)] when their parents strongly agreed (n = 206) with the statement, ‘I felt that my child was healthy enough to leave the hospital’ from the index admission. Parent perceptions relating to care management responsibilities, medications, written discharge plan, warning signs and symptoms to watch for and primary care follow-up were not associated with readmission risk in multivariate analysis. Conclusions Parent perception of their child's health at discharge was associated with the risk of a subsequent, unplanned readmission. Addressing concerns with this perception prior to hospital discharge may help mitigate readmission risk in children. PMID:23962990

  20. Fluid evolution in a volcanic-hosted epithermal carbonate-base metal-gold vein system: Alto de la Blenda, Farallón Negro, Argentina

    NASA Astrophysics Data System (ADS)

    Márquez-Zavalía, M. Florencia; Heinrich, Christoph A.

    2016-10-01

    Alto de la Blenda is a ˜6.6-Ma intermediate-sulphidation epithermal vein system in the Farallón Negro Volcanic Complex, which also hosts the 7.1-Ma porphyry-Cu-Au deposit of Bajo de la Alumbrera. The epithermal vein system is characterised by a large extent and continuity (2 km × 400 m open to depth × 6 m maximum width) and an average gold grade of ˜8 g/t. The vein is best developed within an intrusion of a fine-grained equigranular monzonite, interpreted as the central conduit of a stratovolcano whose extrusive activity ended prior to porphyry-Cu-Au emplacement at Bajo de la Alumbrera, which is in turn cut by minor epithermal veins. The Alto de la Blenda vein consists predominantly of variably Mn-rich carbonates and quartz, with a few percent of pyrite, sphalerite, galena and other sulphide and sulphosalt minerals. Four phases of vein opening, hydrothermal mineralisation and repeated brecciation can be correlated between different vein segments. Stages 2 and 3 contain the greatest fraction of sulphide and gold. They are separated by the emplacement of a polymictic breccia containing clasts of quartz feldspar porphyry as well as basement rocks. Fluid inclusions in quartz related to stages 2 to 4 are liquid rich with 2-4 wt% NaCl(eq). They homogenise between 160 and 300 °C, with very consistent values within each assemblage. Vapour inclusions are practically absent in the epithermal vein. Quartz fragments in the polymictic breccia contain inclusions of intermediate to vapour-like density and similar low salinity (˜3 wt% NaCl(eq)), besides rare brine inclusions containing halite. Laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) analyses of epithermal inclusions indicate high concentrations of K, Fe, As, Sb, Cs, and Pb that significantly vary within and through subsequent vein stages. Careful consideration of detection limits for individual inclusions shows high gold concentrations of ˜0.5 to 3 ppm dissolved in the ore fluid, which

  1. Fluid evolution in a volcanic-hosted epithermal carbonate-base metal-gold vein system: Alto de la Blenda, Farallón Negro, Argentina

    NASA Astrophysics Data System (ADS)

    Márquez-Zavalía, M. Florencia; Heinrich, Christoph A.

    2016-03-01

    Alto de la Blenda is a ˜6.6-Ma intermediate-sulphidation epithermal vein system in the Farallón Negro Volcanic Complex, which also hosts the 7.1-Ma porphyry-Cu-Au deposit of Bajo de la Alumbrera. The epithermal vein system is characterised by a large extent and continuity (2 km × 400 m open to depth × 6 m maximum width) and an average gold grade of ˜8 g/t. The vein is best developed within an intrusion of a fine-grained equigranular monzonite, interpreted as the central conduit of a stratovolcano whose extrusive activity ended prior to porphyry-Cu-Au emplacement at Bajo de la Alumbrera, which is in turn cut by minor epithermal veins. The Alto de la Blenda vein consists predominantly of variably Mn-rich carbonates and quartz, with a few percent of pyrite, sphalerite, galena and other sulphide and sulphosalt minerals. Four phases of vein opening, hydrothermal mineralisation and repeated brecciation can be correlated between different vein segments. Stages 2 and 3 contain the greatest fraction of sulphide and gold. They are separated by the emplacement of a polymictic breccia containing clasts of quartz feldspar porphyry as well as basement rocks. Fluid inclusions in quartz related to stages 2 to 4 are liquid rich with 2-4 wt% NaCl(eq). They homogenise between 160 and 300 °C, with very consistent values within each assemblage. Vapour inclusions are practically absent in the epithermal vein. Quartz fragments in the polymictic breccia contain inclusions of intermediate to vapour-like density and similar low salinity (˜3 wt% NaCl(eq)), besides rare brine inclusions containing halite. Laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) analyses of epithermal inclusions indicate high concentrations of K, Fe, As, Sb, Cs, and Pb that significantly vary within and through subsequent vein stages. Careful consideration of detection limits for individual inclusions shows high gold concentrations of ˜0.5 to 3 ppm dissolved in the ore fluid, which

  2. An automatic modular procedure to generate high-resolution earthquake catalogues: application to the Alto Tiberina Near Fault Observatory (TABOO), Italy.

    NASA Astrophysics Data System (ADS)

    Di Stefano, R.; Chiaraluce, L.; Valoroso, L.; Waldhauser, F.; Latorre, D.; Piccinini, D.; Tinti, E.

    2014-12-01

    The Alto Tiberina Near Fault Observatory (TABOO) in the upper Tiber Valley (northern Appennines) is a INGV research infrastructure devoted to the study of preparatory processes and deformation characteristics of the Alto Tiberina Fault (ATF), a 60 km long, low-angle normal fault active since the Quaternary. The TABOO seismic network, covering an area of 120 × 120 km, consists of 60 permanent surface and 250 m deep borehole stations equipped with 3-components, 0.5s to 120s velocimeters, and strong motion sensors. Continuous seismic recordings are transmitted in real-time to the INGV, where we set up an automatic procedure that produces high-resolution earthquakes catalogues (location, magnitudes, 1st motion polarities) in near-real-time. A sensitive event detection engine running on the continuous data stream is followed by advanced phase identification, arrival-time picking, and quality assessment algorithms (MPX). Pick weights are determined from a statistical analysis of a set of predictors designed to correctly apply an a-priori chosen weighting scheme. The MPX results are used to routinely update earthquakes catalogues based on a variety of (1D and 3D) velocity models and location techniques. We are also applying the DD-RT procedure which uses cross-correlation and double-difference methods in real-time to relocate events with high precision relative to a high-resolution background catalog. P- and S-onset and location information are used to automatically compute focal mechanisms, VP/VS variations in space and time, and periodically update 3D VP and VP/VS tomographic models. We present results from four years of operation, during which this monitoring system analyzed over 1.2 million detections and recovered ~60,000 earthquakes at a detection threshold of ML 0.5. The high-resolution information is being used to study changes in seismicity patterns and fault and rock properties along the ATF in space and time, and to elaborate ground shaking scenarios adopting

  3. Hospital contract management: a descriptive profile.

    PubMed Central

    Alexander, J A; Lewis, B L

    1984-01-01

    Despite the dramatic growth in hospital contract management in the last decade, research only recently has begun to provide insights into the structure, operation, and effectiveness of these arrangements. Two descriptive questions regarding hospital contract management are addressed in an effort to increase correspondence between theoretical and evaluative research in this area: (1) how do contract-managed hospitals differ from traditionally managed hospitals? and (2) how do contract-managed hospitals differ from each other? Principal discriminating variables in the analyses are hospital size, control, urban-rural location, region, management organization control, and management organization size. Results of the analysis on a sample of 406 contract-managed hospitals and 401 unaffiliated hospitals reveal important differences between contract-managed and traditionally managed hospitals as well as among contract management organizations. These findings are discussed in terms of their implications for future research and performance evaluations on contract management arrangements. PMID:6490376

  4. The Hospital as a Hotel

    ERIC Educational Resources Information Center

    Goldstein, Mark Kane; And Others

    1976-01-01

    A rehabilitation unit was established in which patients could develop work skills by day and return to the hospital for recreation, reinforcement, and rest at night. In a three-month follow-up about 50 percent of the discharged patients were working at paid jobs. (Author)

  5. Social Group Work in Hospitals.

    ERIC Educational Resources Information Center

    Stambler, Moses

    This literature review focuses on social group work in the hospital setting. The first section addresses the need for a holistic approach within a typology of illness, and discusses the social work role and intervention tasks required at different stages of illness, i.e., diagnosis, adaptation to long-term illness, and the ending of the illness…

  6. Hospital autopsy: Endangered or extinct?

    PubMed Central

    Turnbull, Angus; Osborn, Michael; Nicholas, Nick

    2015-01-01

    Aim To determine the hospital autopsy rate for the UK in 2013. Methods A study of data from a ‘Freedom of Information’ request to all (n=186) acute NHS Trusts within England (n=160), NHS Boards in Scotland (n=14) and Wales (n=7) and Social Care Trusts in Northern Ireland (n=5). Hospital autopsy rates were calculated from the number of hospital autopsies performed in 2013 as a percentage of total inpatient deaths in the Trust that year. Results The UK response rate was 99% (n=184), yielding a mean autopsy rate of 0.69%. The mean rates were 0.51% (England), 2.13% (Scotland), 0.65% (Wales) and 0.46% (Northern Ireland). 23% (n=38) of all included respondents had a rate of 0% and 86% (n=143) a rate less than 1%. Conclusions The decline in hospital autopsy has continued relentlessly and, for better or for worse, the practice is on the verge of extinction in the UK. The study highlights to health professionals and policy makers the magnitude of this decline. Further research should investigate the impact of this on patient safety, clinical audit, public health and medical education. PMID:26076965

  7. Magnet hospitals: insights and issues.

    PubMed

    McClure, Margaret L

    2005-01-01

    This article explores some of the major lessons that have been learned over more than 2 decades of experience with the Magnet Hospital recognition program. Both the background for the work and some of the issues related to the effort are discussed. PMID:16056153

  8. National hospital input price index.

    PubMed

    Freeland, M S; Anderson, G; Schendler, C E

    1979-01-01

    The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 per cent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies. PMID:10309052

  9. Hospital Libraries in Patient's Education.

    ERIC Educational Resources Information Center

    Iroka, Luke A.

    1988-01-01

    Reviews the positive effects of patient education, including the physician patient relationship, improvements in health status, and cost effectiveness. The status of hospital libraries in Nigeria is described, and suggestions for the implementation of patient education programs are made. (5 references) (CLB)

  10. The Johns Hopkins Hospital Network

    PubMed Central

    Tolchin, Stephen G.; Barta, Wendy; Harkness, Kenneth

    1985-01-01

    The Johns Hopkins Hospital has initiated an ambitious program to apply modern technologies to the development of a new, comprehensive clinical information system. One component of this system is a networking technology for supporting the integration of diverse and functionally distinct information systems. This paper discusses the selection of the networking technology implemented at JHH, issues and problems, networking concepts, protocols and reliability.

  11. Hospital engineering on 'tightrope walk'.

    PubMed

    Marshall, Nicholas

    2007-11-01

    The way forward for hospital engineering in Europe will clearly require a balance between meeting new expectations and adhering to somewhat restrictive budgets. This was a point reinforced at ECHE 2007, the 2nd European Conference on Healthcare Engineeing, which was held recently in Vienna, Austria. Nicholas Marshall reports.

  12. Employee Incentive System for Hospitals.

    ERIC Educational Resources Information Center

    Community Health Service (DHEW/PHS), Arlington, VA. Div. of Health Resources.

    The purpose of this monograph is to discuss employee incentive plans with a potential for cost containment in order to assist hospitals in providing efficient and effective delivery of health care. Based on an examination of employee incentive systems both in and outside the health care field, the information is intended to aid the administrative…

  13. National hospital input price index.

    PubMed

    Freeland, M S; Anderson, G; Schendler, C E

    1979-01-01

    The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 per cent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies.

  14. [Hospital activities of surgery undergraduates].

    PubMed

    Díez Miralles, M; Medrano Heredia, J; Pardo Correcher, J M; Calpena Rico, R; González Santos, J; Rodríguez Hidalgo, J M; Compañ Rosique, A

    1990-04-01

    A teaching-learning system of practices in Surgery named "Hospital Activity of undergraduates in surgery" has been performed over the last five academic courses in Alicante's Medical School. It is based on the stay and participation of 10 students over a 4 weeks period in the assistance tasks of one of the Teaching Hospital Surgery Department in the areas of: hospitalization, external visits and operating rooms. In order to fulfill the proposed teaching objectives a series of clinical sessions and special practices are performed. The hospital activity of 4 academic courses has been evaluated through the performance of a test addressed to the students and a evaluation using a multiple choice test. This educative method is accepted by the students although there are some aspects susceptible to be modified. A significant increase of knowledge between a pretest and a posttest (p less than 0.05) is observed and a significant absence of lacking of knowledge regarding the cognitive objectives fulfilled. Thus, this model of teaching-learning is valid and applicable in our environment.

  15. What is your hospitality quotient?

    PubMed

    DeSilets, Lyn

    2015-03-01

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

  16. Measuring efficiency among US federal hospitals.

    PubMed

    Harrison, Jeffrey P; Meyer, Sean

    2014-01-01

    This study evaluates the efficiency of federal hospitals, specifically those hospitals administered by the US Department of Veterans Affairs and the US Department of Defense. Hospital executives, health care policymakers, taxpayers, and federal hospital beneficiaries benefit from studies that improve hospital efficiency. This study uses data envelopment analysis to evaluate a panel of 165 federal hospitals in 2007 and 157 of the same hospitals again in 2011. Results indicate that overall efficiency in federal hospitals improved from 81% in 2007 to 86% in 2011. The number of federal hospitals operating on the efficiency frontier decreased slightly from 25 in 2007 to 21 in 2011. The higher efficiency score clearly documents that federal hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the health care industry. This research examines benchmarking strategies to improve the efficiency of hospital services to federal beneficiaries. Through the use of strategies such as integrated information systems, consolidation of services, transaction-cost economics, and focusing on preventative health care, these organizations have been able to provide quality service while maintaining fiscal responsibility. In addition, the research documented the characteristics of those federal hospitals that were found to be on the Efficiency Frontier. These hospitals serve as benchmarks for less efficient federal hospitals as they develop strategies for improvement.

  17. Measuring efficiency among US federal hospitals.

    PubMed

    Harrison, Jeffrey P; Meyer, Sean

    2014-01-01

    This study evaluates the efficiency of federal hospitals, specifically those hospitals administered by the US Department of Veterans Affairs and the US Department of Defense. Hospital executives, health care policymakers, taxpayers, and federal hospital beneficiaries benefit from studies that improve hospital efficiency. This study uses data envelopment analysis to evaluate a panel of 165 federal hospitals in 2007 and 157 of the same hospitals again in 2011. Results indicate that overall efficiency in federal hospitals improved from 81% in 2007 to 86% in 2011. The number of federal hospitals operating on the efficiency frontier decreased slightly from 25 in 2007 to 21 in 2011. The higher efficiency score clearly documents that federal hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the health care industry. This research examines benchmarking strategies to improve the efficiency of hospital services to federal beneficiaries. Through the use of strategies such as integrated information systems, consolidation of services, transaction-cost economics, and focusing on preventative health care, these organizations have been able to provide quality service while maintaining fiscal responsibility. In addition, the research documented the characteristics of those federal hospitals that were found to be on the Efficiency Frontier. These hospitals serve as benchmarks for less efficient federal hospitals as they develop strategies for improvement. PMID:24776830

  18. Trends in Inpatient Hospital Deaths: National Hospital Discharge Survey, 2000-2010

    MedlinePlus

    ... Has the inpatient hospital death rate decreased for all patients and for those with selected first-listed ... 2010 differ from the length of stay for all hospitalizations? Inpatients who died in the hospital stayed ...

  19. Hospitalization Type and Subsequent Severe Sepsis

    PubMed Central

    Dickson, Robert P.; Rogers, Mary A. M.; Langa, Kenneth M.; Iwashyna, Theodore J.

    2015-01-01

    Rationale: Hospitalization is associated with microbiome perturbation (dysbiosis), and this perturbation is more severe in patients treated with antimicrobials. Objectives: To evaluate whether hospitalizations known to be associated with periods of microbiome perturbation are associated with increased risk of severe sepsis after hospital discharge. Methods: We studied participants in the U.S. Health and Retirement Study with linked Medicare claims (1998–2010). We measured whether three hospitalization types associated with increasing severity of probable dysbiosis (non–infection-related hospitalization, infection-related hospitalization, and hospitalization with Clostridium difficile infection [CDI]) were associated with increasing risk for severe sepsis in the 90 days after hospital discharge. We used two study designs: the first was a longitudinal design with between-person comparisons and the second was a self-controlled case series design using within-person comparison. Measurements and Main Results: We identified 43,095 hospitalizations among 10,996 Health and Retirement Study–Medicare participants. In the 90 days following non–infection-related hospitalization, infection-related hospitalization, and hospitalization with CDI, adjusted probabilities of subsequent admission for severe sepsis were 4.1% (95% confidence interval [CI], 3.8–4.4%), 7.1% (95% CI, 6.6–7.6%), and 10.7% (95% CI, 7.7–13.8%), respectively. The incidence rate ratio (IRR) of severe sepsis was 3.3-fold greater during the 90 days after hospitalizations than during other observation periods. The IRR was 30% greater after an infection-related hospitalization versus a non–infection-related hospitalization. The IRR was 70% greater after a hospitalization with CDI than an infection-related hospitalization without CDI. Conclusions: There is a strong dose–response relationship between events known to result in dysbiosis and subsequent severe sepsis hospitalization that is not present

  20. Nursing: the hospital's competitive edge.

    PubMed

    Shaffer, F A; Preziosi, P

    1988-09-01

    The health care marketplace is becoming increasingly competitive. The hospital has a built-in marketing force with the nursing department, because nurses are in constant, direct contact with the customer. Nursing must identify the case mix profile of the community and focus the hospital product lines to meet community needs. The nursing department should decentralize, change, measure, and innovate the staff mix needed to operationalize these product lines. The development of nursing practice standards for the case mix will help to identify the staff mix needed and create systems to efficiently manage the product lines. Nursing management must become aware of cross-subsidization and downward skill substitution of nursing personnel. Nursing information systems must generate quality reports that invoke cost consciousness on the part of nursing staff. Quality assurance programs must become unit based and complete with frequent audits to correlate length of stay with nursing quality. Correlations must be determined between nursing productivity and case mix to determine the hospital's niche in the marketplace. The transformation of health care into a competitive business industry has created many opportunities for nursing. The health care industry's incentives for efficiency along with the decreasing demand for inpatient hospital services will be the forces driving health care toward a competitive marketplace. The hospital's nursing department should be strategically positioned to become accountable for increasing market share and enhancing quality patient outcomes. The focus has shifted from the theoretical to the tactical, which is a step in the right direction, particularly for nursing. Nursing, if strategically positioned, will not only thrive but will also excel in this chaotic environment by capturing the opportunities and being innovative.

  1. Peptic ulcers: mortality and hospitalization.

    PubMed

    Riley, R

    1991-01-01

    This study analyzes data on peptic ulcer disease based on deaths for 1951-1988 and hospital separations for 1969-1988. The source of the data are mortality and morbidity statistics provided to Statistics Canada by the provinces. The age-standardized mortality rates (ASMR) for peptic ulcer disease decreased from 1951 to 1988 by 69.4% for men (8.5 to 2.6 per 100,000 population), and 31.8% for women (2.2 to 1.5). Separation rates from hospitals during 1969-1988 for peptic ulcer disease also decreased by 59.8% for men (242.7 to 97.6 per 100,000 population) and 35.6% for women (103.2 to 66.5). Age-specific rates for both mortality and hospital separations increased with age. Epidemiological studies indicate that the incidence of peptic ulcer disease is declining in the general population. The downward trends in mortality and hospitalization rates for peptic ulcer disease reflect this change in incidence, but additional factors probably contribute as well to this decline. Male rates for both mortality and hospital separations were much higher than female rates at the beginning of the study period; but toward the end, the gap between the sexes narrowed considerably, mainly because the male rates declined substantially while the female rates decline moderately. The slower decline in the rates for women may be related to such factors as the increasing labour force participation among women and the slower decline in the population of female smokers. PMID:1801957

  2. Nursing: the hospital's competitive edge.

    PubMed

    Shaffer, F A; Preziosi, P

    1988-09-01

    The health care marketplace is becoming increasingly competitive. The hospital has a built-in marketing force with the nursing department, because nurses are in constant, direct contact with the customer. Nursing must identify the case mix profile of the community and focus the hospital product lines to meet community needs. The nursing department should decentralize, change, measure, and innovate the staff mix needed to operationalize these product lines. The development of nursing practice standards for the case mix will help to identify the staff mix needed and create systems to efficiently manage the product lines. Nursing management must become aware of cross-subsidization and downward skill substitution of nursing personnel. Nursing information systems must generate quality reports that invoke cost consciousness on the part of nursing staff. Quality assurance programs must become unit based and complete with frequent audits to correlate length of stay with nursing quality. Correlations must be determined between nursing productivity and case mix to determine the hospital's niche in the marketplace. The transformation of health care into a competitive business industry has created many opportunities for nursing. The health care industry's incentives for efficiency along with the decreasing demand for inpatient hospital services will be the forces driving health care toward a competitive marketplace. The hospital's nursing department should be strategically positioned to become accountable for increasing market share and enhancing quality patient outcomes. The focus has shifted from the theoretical to the tactical, which is a step in the right direction, particularly for nursing. Nursing, if strategically positioned, will not only thrive but will also excel in this chaotic environment by capturing the opportunities and being innovative. PMID:3047695

  3. Peptic ulcers: mortality and hospitalization.

    PubMed

    Riley, R

    1991-01-01

    This study analyzes data on peptic ulcer disease based on deaths for 1951-1988 and hospital separations for 1969-1988. The source of the data are mortality and morbidity statistics provided to Statistics Canada by the provinces. The age-standardized mortality rates (ASMR) for peptic ulcer disease decreased from 1951 to 1988 by 69.4% for men (8.5 to 2.6 per 100,000 population), and 31.8% for women (2.2 to 1.5). Separation rates from hospitals during 1969-1988 for peptic ulcer disease also decreased by 59.8% for men (242.7 to 97.6 per 100,000 population) and 35.6% for women (103.2 to 66.5). Age-specific rates for both mortality and hospital separations increased with age. Epidemiological studies indicate that the incidence of peptic ulcer disease is declining in the general population. The downward trends in mortality and hospitalization rates for peptic ulcer disease reflect this change in incidence, but additional factors probably contribute as well to this decline. Male rates for both mortality and hospital separations were much higher than female rates at the beginning of the study period; but toward the end, the gap between the sexes narrowed considerably, mainly because the male rates declined substantially while the female rates decline moderately. The slower decline in the rates for women may be related to such factors as the increasing labour force participation among women and the slower decline in the population of female smokers.

  4. Strategies for survival in the hospital industry.

    PubMed

    Coddington, D C; Palmquist, L E; Trollinger, W V

    1985-01-01

    Hospitals, besieged by new competitors and pressured to cut costs, are entering a new and unfamiliar environment. As usage declines and the government's new prospective payment system makes itself felt, hospitals are feeling the pinch. Nonprofit hospitals face competition from newer, for-profit providers of health care. These authors discuss the factors that have led some hospitals to close and forced most others to consider how they can lower costs while maintaining high-quality care. Several strategies exist to help hospitals cope with their new problems. The authors point out the advantages and disadvantages of downsizing, diversification, and joint ventures, among other practical measures that hospitals can take.

  5. Study of a population of Biomphalaria tenagophila (Orbigny, 1835) and of schistosomiasis transmission in "Alto da Boa Vista", Rio de Janeiro.

    PubMed

    Baptista, D F; Vasconcelos, M C; Schall, V T

    1989-01-01

    The present study was performed using data from a Biomphalaria tenagophila population located in a watercress garden in the Alto da Boa Vista region representing an isolated focal point of schistosomiasis in the city of Rio de Janeiro. The density and age structure of this B. tenagophila population and its rate of infection by Schistosoma mansoni were studied for a period of 15 months. The snail population showed seasonal variation in density, with a decrease in number of individuals at the beginning of the rainy season. At the end of this season, the population consisted mainly of adults (92.8% in May 1985 and 82.8% in April 1986). The population growth curve was logistic and of sigmoidal configuration. Schistosoma mansoni cercariae were eliminated over a short period of time (March, April and May 1986). The release of cercariae of S. mansoni and of birds seems to depend on environmental temperature, which during certain months would show a daily variation of up to 13 degrees C, with the lower thermal limit approaching the limit value for sporocyte development.

  6. An investigation of ground-water recharge by injection in the Palo Alto Baylands, California : hydraulic and chemical interactions; final report

    USGS Publications Warehouse

    Hamlin, S.N.

    1985-01-01

    The U.S. Geological Survey, in cooperation with the Santa Clara Valley Water District, has completed a study of ground-water recharge by injection in the Palo Alto baylands along San Francisco Bay, California. Selected wells within the Water District 's injection-extraction network were monitored to determine hydraulic and chemical interactions affecting well-field operation. The well field was installed to prevent and eliminate saline contamination in the local shallow aquifer system. The primary focus of this study is on factors that affect injection efficiency, specifically well and aquifer clogging. Mixing and break-through curves for major chemical constituents indicate ion exchange, adsorption, and dissolution reactions. Freshwater breakthrough was detected in water-level data, which reflected fluid-density change as well as head buildup. Dissolution of calcium carbonate caused by dilution of saline ground water probably accounts for an apparent increase in specific capacity possibly related to improved aquifer permeability. Adsorption evidently removed trace elements during passage of injected water through the aquifer. In terms of hydraulic and chemical compatibility, the well field is a viable system for ground-water recharge. Aquifer heterogeneity and operational constraints reduce the efficiency of the system. Efficiency may be maximized by careful attention to extraction distribution and quantity and to injection distribution, quantity, and water quality. (USGS)

  7. Injection of treated wastewater for ground-water recharge in the Palo Alto Baylands, California, hydraulic and chemical interactions; preliminary report

    USGS Publications Warehouse

    Hamlin, S.N.

    1983-01-01

    An injection-extraction well network in the Palo Alto Baylands along the San Francisco Bay, California, was designed to flush the shallow aquifer system of saline water and prevent further inland saline contamination. Clogging processes and solution migration in the vicinity of one injection well were studied. Cyclic evaporative concentration of bay water and infiltration have generated a concentrated ground-water brine. Montmorillonite and illite are the primary clay minerals present in the shallow aquifer system. X-ray diffraction analysis of these clays showed a marked increase in the d-spacing of the crystal lattice when native hypersaline pure water was replaced by injection water. Chloride:magnesium and chloride:potassium ratios in the aquifer system changed during injection, most likely due to ionic exchange reaction. Similar variations in chloride:boron, chloride:iron, and chloride:manganese ratios probably resulted from reduction-oxidation reactions. Ground-water quality appears to have been chiefly affected by the processes of dilution and dispersion. Extraction pump test data yielded a transmissivity value of 960 feet squared per day and a storage coefficient of 0.0005. Vertical permeability of the upper confining layer is 0.08 feet per day. (USGS)

  8. The risk of Ascaris lumbricoides infection in children as an environmental health indicator to guide preventive activities in Caparaó and Alto Caparaó, Brazil.

    PubMed Central

    Carneiro, Fernando Ferreira; Cifuentes, Enrique; Tellez-Rojo, Martha Maria; Romieu, Isabelle

    2002-01-01

    OBJECTIVE: To develop an environmental health indicator for use as a basis for developing preventive measures against Ascaris lumbricoides infection in children from the rural municipalities of Caparaó and Alto Caparaó, in Minas Gerais, Brazil. METHODS: A cross-sectional survey was conducted between May and September 1998 among 1171 children under 14 years of age living in 588 dwellings selected from 11 communities. Trained interviewers used a questionnaire to identify risk factors for infection (socioeconomic, sanitation and hygiene variables) and collected stool samples from each child for parasitological tests. RESULTS: The overall prevalence of A. lumbricoides infection was 12.2%. The results showed the protective effects of availability of water in the washbasin and better hygiene, sanitation and socioeconomic status; the interactive effect of crowding was five times larger in households without water in the washbasin than in those having water. There was a statistically significant association between infection and children's age. CONCLUSION: The environmental health indicator, which incorporated the most significant biological, environmental and social factors associated with the risk of A. lumbricoides infection in children from these communities, should contribute to the development of surveillance tools and health protection measures in this population. PMID:11884972

  9. Curie surface of the alkaline provinces of Goiás (GAP) and Alto Paranaíba (APAP), central Brazil

    NASA Astrophysics Data System (ADS)

    Moraes Rocha, Loiane Gomes de; Pires, Augusto César Bittencourt; Carmelo, Adriana Chatack; Oksum, Erdinc

    2015-05-01

    The study area includes the most important carbonatite and kimberlite complexes in Brazil, located in the Brazilian states of Goiás and Minas Gerais. The central portion of this area involves the Azimuth 125° lineament (Az 125°) that consists of an extensive set of faults (oriented in the NW-SE direction) that served as a conduit for magma ascent. This lineament is the main structural feature associated with these complexes. The Goiás (GAP) and Alto Paranaíba (APAP) Alkaline Provinces occur along the Az 125° and include highly economically valuable mineralizations. In this study, we aim to map the depth to the curie isotherm (or Curie Point Depths: CPD) of the study area (mainly the Gap and APAP regions) based on spectral analysis of aeromagnetic data. The CPD estimations were achieved from a spectral approach known as the centroid method, providing the relationship between the spectra of magnetic anomalies and the depths of the magnetic source of a 2-D magnetic data. The CPD estimates from approximately 500 overlapping blocks vary from 7 km to 40 km deep. The shallower depths are related to the GAP and APAP regions, and the deeper ones are related to the São Franciscana Plate. The Curie depths related to the Az 125° are between 30 km and 15.7 km deep. According to the results, the GAP and APAP intrusive bodies have shallower roots the major faults of the Az 125°.

  10. Mathiasite-loveringite and priderite in mantle xenoliths from the Alto Paranaíba Igneous Province, Brazil: genesis and constraints on mantle metasomatism

    NASA Astrophysics Data System (ADS)

    Almeida, Vidyã; Janasi, Valdecir; Svisero, Darcy; Nannini, Felix

    2014-12-01

    Alkali-bearing Ti oxides were identified in mantle xenoliths enclosed in kimberlite-like rocks from Limeira 1 alkaline intrusion from the Alto Paranaíba Igneous Province, southeastern Brazil. The metasomatic mineral assemblages include mathiasite-loveringite and priderite associated with clinopyroxene, phlogopite, ilmenite and rutile. Mathiasite-loveringite (55-60 wt.% TiO2; 5.2-6.7 wt.% ZrO2) occurs in peridotite xenoliths rimming chromite (˜50 wt.% Cr2O3) and subordinate ilmenite (12-13.4 wt.% MgO) in double reaction rim coronas. Priderite (Ba/(K+Ba)< 0.05) occurs in phlogopite-rich xenoliths as lamellae within Mg-ilmenite (8.4-9.8 wt.% MgO) or as intergrowths in rutile crystals that may be included in sagenitic phlogopite. Mathiasite-loveringite was formed by reaction of peridotite primary minerals with alkaline melts. The priderite was formed by reaction of peridotite minerals with ultrapotassic melts. Disequilibrium textures and chemical zoning of associated minerals suggest that the metasomatic reactions responsible for the formation of the alkali-bearing Ti oxides took place shortly prior the entrainment of the xenoliths in the host magma, and is not connected to old (Proterozoic) mantle enrichment events.

  11. [Historical exploration of Acapulco hospitals, Guerrero, Mexico].

    PubMed

    Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo

    2006-01-01

    This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Señora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care.

  12. Mold remediation in a hospital.

    PubMed

    Lee, Tang G

    2009-01-01

    As occupants in a hospital, patients are susceptible to air contaminants that can include biological agents dispersed throughout the premise. An exposed patient can become ill and require medical intervention. A consideration for patients is that they may have become environmentally sensitive and require placement in an environment that does not compromise their health. Unfortunately, the hospital environment often contains more biological substances than can be expected in an office or home environment. When a hospital also experiences water intrusion such as flooding or water leaks, resulting mold growth can seriously compromise the health of patients and others such as nursing staff and physicians (Burge, Indoor Air and Infectious Disease. Occupational Medicine: State of the Art Reviews, 1980; Lutz et al., Clinical Infectious Diseases 37: 786-793, 2003). Micro-organism growth can propagate if the water is not addressed quickly and effectively. Immunocompromised patients are particularly at risk when subjected to fungal infection such that the US Center for Disease Control issued guideline for building mold in health care facilities (Centers for Disease and Control [CDC], Centers for Disease and Control: Questions and Answers on Stachybotrys chartarum and Other Molds, 2000). This paper is based on mold remediation of one portion of a hospital unit due to water from construction activity and inadequate maintenance, resulting in mold growth. A large proportion of the hospital staff, primarily nurses in the dialysis unit, exhibited health symptoms consistent with mold exposure. Unfortunately, the hospital administrators did not consider the mold risk to be serious and refused an independent consultant retained by the nurse's union to examine the premise (Canadian Broadcasting Corporation [CBC], Nurses file complaints over mold at Foothills. Canadian Broadcasting Corporation, 2003). The nurse's union managed to have the premise examined by submitting a court order of

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

    PubMed

    Hall, John

    2012-01-01

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

  14. Learning to speak up about hospital failures.

    PubMed

    Garrett, Dawne

    2016-08-17

    The recent Public Accounts Committee (PAC) report on discharging older people from acute hospitals in England revealed that rising numbers of patients are remaining in hospital when they are clinically ready to go home.

  15. Improve Hospital-to-Home Transitions

    MedlinePlus

    ... rehabilitation in the home. The result is often readmission to the hospital. One study found that seniors ... medical conditions, and they have the highest hospital readmission rate of all adult patient groups. This indicates ...

  16. Critical Care in Critical Access Hospitals.

    PubMed

    Seright, Teresa J; Winters, Charlene A

    2015-10-01

    What began as a grant-funded demonstration project, as a means of bridging the gap in rural health care, has developed into a critical access hospital system comprising 1328 facilities across 45 states. A critical access hospital is not just a safety net for health care in a rural community. Such hospitals may also provide specialized services such as same-day surgery, infusion therapy, and intensive care. For hospitals located near the required minimum of 35 miles from a tertiary care center, management of critically ill patients may be a matter of stabilization and transfer. Critical access hospitals in more rural areas are often much farther from tertiary care; some of these hospitals are situated within frontier areas of the United States. This article describes the development of critical access hospitals, provision of care and services, challenges to critical care in critical access hospitals, and suggestions to address gaps in research and collaborative care.

  17. Formal and informal authority of hospital directors.

    PubMed

    Nirel, N; Schmid, H; Stern, Z

    1994-01-01

    Describes and contrasts the perceptions of formal and informal authority of hospital directors of two different kinds of organizations: hospitals that are part of public multi-hospital organizations (PMOs) and independent hospitals. Indicates that all the directors perceive their formal authority to be greater than their formal authority. However, there is a gap in the perception of formal and informal authority by directors of the two types of hospital. Directors of independent hospitals perceive themselves to have more formal and informal authority than do their colleagues at hospitals that are part of PMOs. Both structural and personal explanations for these findings are given. In addition, discusses the implications for policy making of the source of authority, informal, and formal authority in the transition to autonomous semi-independent hospitals in a changing environment.

  18. Introduction to pediatric hospital medicine.

    PubMed

    Rauch, Daniel A; Percelay, Jack M; Zipes, David

    2005-08-01

    This article provides a brief summary of the past, present, and future of pediatric hospital medicine. In its short history, it already has made an impact on the way pediatrics is practiced and taught. There is no denying Dr. Menna's prescience when he wrote his opinion in 1990. As the field continues to emerge and mature, the current leadership is cognizant of the obstacles ahead and the need to maintain the goal of the well-being of all children. Maintaining that goal means redoubling efforts to maintain contact with primary care providers for continuity of care in and out of the hospital. Only by promoting patient- and family-centered care, inclusive of all providers, can children's health best be served.

  19. Critical strategies for successful rural hospitals.

    PubMed

    Cleverley, W O; Harvey, R K

    1992-01-01

    Not all rural hospitals are in a depressed financial situation. Many can and have achieved financial performance levels which match their urban counterparts. Cost control is the single most important management strategy which differentiates the successful from the unsuccessful rural hospital. Labor productivity is much higher in the financially successful rural hospital than in the unsuccessful hospitals. Reduced length of stay is also especially critical in the overall cost containment program. PMID:1548117

  20. [Pericarditis in a general hospital].

    PubMed

    Faintuch, J J; Friedmann, A A

    1996-01-01

    The authors studied 57 patients with pericarditis in the Ward of Internal Medicine of the University of São Paulo from January 1993 through May 1995. A comparison was made with the results of a similar study performed in the same hospital in 1989. Increasing frequency of pericarditis was verified. Tuberculosis, formerly the most frequent etiologic agent, decreased while neoplastic diseases became more common.

  1. Hospital safety: not child's play.

    PubMed

    Gips, Michael A

    2007-01-01

    With a main campus and other satellite facilities, Children's Mercy Hospitals & Clinics set out to revamp its access control program after 9-11. The revised program includes sign-in requirements, protocols for special restrictions, and attention to situations that might create a risk of contamination. It also employs additional controls at internal doors and uses CCTV for remote surveillance throughout. Last, the program included staff increases. PMID:17970452

  2. Business Intelligence in Hospital Management.

    PubMed

    Escher, Achim; Hainc, Nicolin; Boll, Daniel

    2016-01-01

    Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting.

  3. [Enteral nutrition in the hospital].

    PubMed

    Pérez-Portabella, C

    1999-05-01

    The author presents an interesting historical journey documenting the search for solutions to feed patients who were not capable of feeding themselves by conventional means. Patients deemed at risk nutritionally are analyzed, along with the means of detecting them. The characteristics of enteral nutrition plus its most important indications and counterindications are discussed. Mention is also made of the important role of nurses in hospital care, in the types of feeding patients receive, and in the form of administering this feeding.

  4. Hospitalization costs associated with leiomyoma.

    PubMed

    Zhao, S Z; Wong, J M; Arguelles, L M

    1999-03-01

    The objective of this study was to determine the prevalence and cost of leiomyoma-related hospitalizations based on the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP-3). Data for 1991 and 1992 were obtained from the HCUP-NIS database, which includes an approximate 20% sample of US hospital discharges. ICD-9 (International Classification of Diseases, Ninth Revision) codes 218.0-218.2 and 218.9 were used to identify women between the ages of 15 and 64 years with the diagnosis of leiomyoma. The distribution of leiomyoma was described using demographic characteristics, admission type, length of stay (LOS), mean total charge, specific leiomyoma diagnosis, principal procedure, and other diagnosed diseases. Among hospital admissions of women between the ages of 15 and 64 years during 1991 and 1992, 26 to 28 admissions per 1000 included a diagnosis of leiomyoma. The highest rates of leiomyoma diagnosis were seen in women aged >40 years (65% and 70% for 1991 and 1992, respectively) and black women (26% and 27%, respectively). Approximately 90% of hospitalizations for leiomyoma were routine admissions, with the most common specific diagnosis being intramural leiomyoma of the uterus. In 1992, patients with leiomyoma as the first diagnosis (vs other diagnoses) had significantly lower mean LOS (3.1 vs. 4.4 days; P<0.001) and mean total charge ($5919 vs. $6810; P<0.001). Total abdominal hysterectomy was performed on three quarters of the women admitted for leiomyoma, and these patients had longer mean LOS and higher total charges than those undergoing other procedures. Although not as costly as other conditions, this common disorder among women of reproductive years requires expensive treatment and is a major burden on the health care system.

  5. Hospital inquiries. The listening blank.

    PubMed

    Higgins, J

    2001-09-13

    The major failures reported in the Bristol inquiry have been highlighted in most hospital inquiry reports over the past 30 years. The tendency to victimise the whistleblower has characterised virtually all inquiries. Inadequate leadership, isolation, system failures, poor communication and disempowerment of staff and service users are the common themes. While organisational reform is essential, the real challenge is to change behaviour. And this depends on the example of senior staff.

  6. Welfare standards in hospital mergers.

    PubMed

    Katona, Katalin; Canoy, Marcel

    2013-08-01

    There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control.

  7. Epsom General Hospital orthopaedic theatre.

    PubMed

    1992-11-01

    The Surrey Section of the London Branch held a very successful meeting on Wednesday 9th September 1992 at which Mr Stephen Kirby BSc, CEng, Director of Estates, gave a talk and tour of the new Private Ward Unit and Ultra Clean Ventilation Theatre at Epsom General Hospital. The new Northey Ward, is a result of the refurbishment of what was a 31 bed section of the Hospital Surgical Block on the 5th floor. The new Ward provides a total of 18 single bed Wards, each complete with bathroom/WC, the Unit also accommodates a 5 bed Day Ward. All the facilities provided are of extremely high standard, which given the very tight building programme, detailed elsewhere, is indicative of the dedication of both the Designers and Contractors who are congratulated on their achievement. With regard to the UCV Theatre the following information was prepared by Aidan Hardy who is a Project Engineer with Epsom General Hospital. We are delighted to be able to print this report for our readers. PMID:10122458

  8. [Hospital organization of cardiopulmonary resuscitation].

    PubMed

    Gómez-Arnau, J; Lacoma, F; García del Valle, S; Núñez, A; González, A; Burgos, E

    1999-05-01

    That hospital cardiopulmonary resuscitation (CPR) should be supported by an organized plan rather than on the skills of individual health care personnel is a universally agreed-upon principle. Such a plan should guarantee that needed materials are available and in working order in all departments and that the team assigned to carry out CPR arrives promptly. Personnel other than the specialized team should also receive CPR training appropriate to their posts. The main features of a CPR plan are related to the five steps in the chain of survival: a) identification of a patient to be resuscitated, a matter that has important ethical ramifications; b) early recognition of cardiac arrest; c) early defibrillation; d) basic CPR, and e) advanced CPR. The CPR plan should incorporate the automatic recording of system, population, event and outcome variables. Task forces responsible for establishing and maintaining the plan and its quality control will periodically review the data with the aim of detecting errors, correcting them or introducing improvements. Various international societies and CPR committees have recently suggested a uniform way (the Utstein style) of recording and presenting data to allow comparisons either from hospital to hospital or over time within a single center.

  9. Strategies to Reduce Hospital Readmissions.

    PubMed

    Chirapongsathorn, Sakkarin; Talwalkar, Jayant A; Kamath, Patrick S

    2016-05-01

    After the Patient Protection and Affordable Care Act or "Obamacare" was signed into law in 2010, the problem of readmission has taken on a new sense of urgency. Hospitals with excess readmissions receive reduced reimbursement because readmission is considered to represent a poor quality measure in the healthcare delivery system. Cirrhosis places a major burden on the healthcare economy. Patients with cirrhosis frequently require hospitalization, and annual admission rates have doubled within 10 years. The costs of hospitalization associated with cirrhosis have also markedly increased. Readmissions create negative consequences for the patient and the family. Several strategies have been proposed to reduce the number of readmissions, but the efficacy of these strategies is questionable. Although the Model for End-Stage of Liver Disease (MELD) score can be a tool for risk stratification, many other factors are also independent risks for readmission. Studies aimed at the reduction of readmission in patients with cirrhosis are very limited, and much research is required before specific recommendations can be made to reduce readmissions.

  10. Hospital treatment of HIV patients.

    PubMed

    Ola, Samuel Olawale

    2006-12-01

    Treatment of patients with HIV/AIDS in Nigeria has progressed from the stage of inactivity, unconcern, abandonment and neglect to the present stage of holistic care involving treatment of the infection with Highly Active Anti Retroviral Agents, complications of the disease and side effects of antiretroviral therapy as well as that of human behavioural responses towards the disease with hope and promising outcome. The goal of the treatment is to prolong the patient's life while maintaining the best possible quality of health and life. It is now a continuum of care between the hospital and the different sectors of the community. Hospital treatment of patients with HIV-AIDS is complex and yet a simple task if there is healthy interaction of the patients and health care providers in a milieu of well equipped hospital setting with available treatment facilities for proper management of diseases. Similarly, for the care to achieve its goal, it requires a joint participation of the community and the commitment of the government not only on curtailment of the reservoir of HIV infection by antiretroviral therapy but total eradication of diseases, poverty and ignorance in all its entirety. PMID:18050774

  11. Legionella in hospitals: a review.

    PubMed

    Hart, C A; Makin, T

    1991-06-01

    Although epidemics of nosocomial Legionnaires' disease attract great attention, up to 30% of sporadic cases of hospital-acquired pneumonia are caused by legionellae. Legionellae are ubiquitous contaminants of potable water and can achieve high numbers in the hot-water systems of large buildings such as hospitals. They are present in the mains water supply in small numbers but are amplified considerably in the hospital's hot-water system. This is encouraged by water temperatures below 50 degrees C, areas of stagnation and sludge formation, the presence of amoebae and other bacteria and the materials used in the piping. Formation of aerosols from contaminated water is a major mode of spread of legionellae, but there is evidence to suggest that aspiration is also a mode of entry. Safe levels of legionellae in cooling towers have been defined, but not for hot-water systems. A combination of culture and antigen detection by immunofluorescence offer the best method for enumerating legionellae in environmental samples. Control involves a mixture of physical (heat, UV irradiation, sanitation) and chemical (hypochlorite, ozone) methods combined with good plumbing practice (e.g. arrangement of pumps and calorifiers, elimination of dead-legs). Adequate control can be costly and requires considerable attention to detail. PMID:1679819

  12. 27 CFR 31.54 - Hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Hospitals. 31.54 Section 31.54 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF... Registration And/or Recordkeeping § 31.54 Hospitals. Hospitals and similar institutions furnishing liquors...

  13. The visual arts in Northern Ireland hospitals.

    PubMed Central

    Cromie, H.

    1995-01-01

    Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals. Images Fig 1 Fig 2 Fig 3 PMID:8533183

  14. Financial Indicators for Critical Access Hospitals

    ERIC Educational Resources Information Center

    Pink, George H.; Holmes, G. Mark; D'Alpe, Cameron; Strunk, Lindsay A.; McGee, Patrick; Slifkin, Rebecca T.

    2006-01-01

    Context: There is a growing recognition of the need to measure and report hospital financial performance. However, there exists little comparative financial indicator data specifically for critical access hospitals (CAHs). CAHs differ from other hospitals on a number of dimensions that might affect appropriate indicators of performance, including…

  15. Future looks bleak for many Ontario hospitals

    PubMed Central

    Gray, Charlotte

    1995-01-01

    Ontario will soon begin to experience some of the hospital closures that are already well known in many other provinces. A recent report called for the closure of 12 hospitals in Metropolitan Toronto and a 13% cut in the number of hospital beds. Strong campaigns against some of the proposed closures are already being mounted.

  16. CEOs: Gulf crisis hits hospitals' bottom line.

    PubMed

    Johnsson, J

    1990-12-01

    Hospital CEOs say the Persian Gulf crisis could hit them hard where it counts. In fact, hospitals are already seeing some adverse impact from events in the Middle East. From fundraising to plant management to strategic planning, the confrontations in the Gulf are having an impact on the hospital's bottom line.

  17. 2 CFR 200.52 - Hospital.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Hospital. 200.52 Section 200.52 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET... AWARDS Acronyms and Definitions Acronyms § 200.52 Hospital. Hospital means a facility licensed as...

  18. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and...

  19. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  20. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  1. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  2. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... hospitals within hospitals and satellites of long-term care hospitals. 412.534 Section 412.534 Public Health... Hospitals § 412.534 Special payment provisions for long-term care hospitals within hospitals and satellites... § 412.22(e)(2), or satellite facilities of long-term care hospitals that meet the criteria in §...

  3. 42 CFR 419.20 - Hospitals subject to the hospital outpatient prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospitals subject to the hospital outpatient..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services Subject to and Excluded From the...

  4. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. 419.22 Section 419.22 Public Health CENTERS... PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and...

  5. 75 FR 29479 - Medicare and Medicaid Programs: Proposed Changes Affecting Hospital and Critical Access Hospital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ... and Medicaid Programs: Proposed Changes Affecting Hospital and Critical Access Hospital (CAH... proposed rule would revise the conditions of participation (CoPs) for both hospitals and critical access hospitals (CAHs). These revisions would allow for a new credentialing and privileging process for...

  6. 42 CFR 486.322 - Condition: Relationships with hospitals, critical access hospitals, and tissue banks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Relationships with hospitals, critical access hospitals, and tissue banks. 486.322 Section 486.322 Public Health CENTERS FOR MEDICARE & MEDICAID... Measures § 486.322 Condition: Relationships with hospitals, critical access hospitals, and tissue banks....

  7. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ...; Payment Policies Related to Patient Status '' (78 FR 50608). Therefore, the percentage increase for... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2014 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for...

  8. Nursing Home Residents at Risk of Hospitalization and the Characteristics of Their Hospital Stays.

    ERIC Educational Resources Information Center

    Murtaugh, Christopher M.; Freiman, Marc P.

    1995-01-01

    Analysis of national medical data identified elderly nursing home residents with an elevated risk of hospitalization and the characteristics of their hospital stays. Findings indicate an elevated risk of hospitalization for residents diagnosed with one of several different primary diagnoses. Infections accounted for over 25% of hospital stays.…

  9. Comparison between a multi-pavilion hospital and a single pavilion hospital

    PubMed Central

    MLEŞNIŞE, MIHAI; BOCŞAN, IOAN STELIAN

    2016-01-01

    Background and aim Defining and measuring hospital efficiency is a hard task, in spite of the agreement that hospitals need to be efficient. Thus, while research might focus on the relationship between costs and outcomes, measurements differ significantly across studies. The aim of the present study is to compare a multi-pavilion hospital with a single hospital from Cluj-Napoca, Romania. Methods Statistical and financial (effective expenses, salaries, drugs, materials, reagents, food) indicators were used to compare two hospitals from Cluj-Napoca: the Adults’ Clinical Hospital in Cluj-Napoca, and the Rehabilitation Hospital from Cluj-Napoca respectively. Data related to these indicators were collected at each hospital level, between 2004 and 2010. Results When investigating the expenses on medicine, data showed the two hospitals had similar values in 2004, 13.09% and 14.43% for the multi-pavilion hospital and single hospital, respectively. After 2004, the expenses started to drop simultaneously, being around 11% in 2006 and 2007 for both hospitals. The mortality rate was significantly different for the two hospitals. The multi-pavilion had a much higher mortality rate, when compared to the single hospital. From 2004 until 2007 a steady increase was observed for the multi-pavilion hospital, from 1.09 to 2.57 respectively. Conclusion The significant differences found between the two hospitals look being unavoidable, as long as they seem to stem from the hospitals’ ownership, their addressability and their targeted diseases and associated procedures. PMID:27547061

  10. A Computerized Hospital Patient Information Management System

    PubMed Central

    Wig, Eldon D.

    1982-01-01

    The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

  11. Cost of Information Handling in Hospitals

    PubMed Central

    Jydstrup, Ronald A.; Gross, Malvern J.

    1966-01-01

    Cost of information handling (noncomputerized) in hospitals was studied in detail from an industrial engineering point of view at Rochester General, Highland, and Geneva General hospitals. Activities were observed, personnel questioned, and time studies carried out. It was found that information handling comprises about one fourth of the hospitals' operating cost—a finding strongly recommending revision and streamlining of both forms and inefficient operations. In an Appendix to this study are presented 15 items that would improve information handling in one area of the hospital, nursing units, where this activity is greater than in any other in a hospital. PMID:5971636

  12. Corporate visual identity: a case in hospitals.

    PubMed

    Alkibay, Sanem; Ozdogan, F Bahar; Ermec, Aysegul

    2007-01-01

    This paper aims to present a perspective to better understand corporate identity through examining the perceptions of Turkish patients and develop a corporate visual identity scale. While there is no study related to corporate identity research on hospitals in Turkey as a developing country, understanding consumer's perceptions about corporate identity efforts of hospitals could provide different perspectives for recruiters. When the hospitals are considered in two different groups as university and state hospitals, the priority of the characteristics of corporate visual identity may change, whereas the top five characteristics remain the same for all the hospitals.

  13. Strategic management of Public Hospitals' medical services.

    PubMed

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

    2016-01-01

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

  14. 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.

  15. Profit efficiency and ownership of German hospitals.

    PubMed

    Herr, Annika; Schmitz, Hendrik; Augurzky, Boris

    2011-06-01

    This paper investigates the cost and profit efficiency of German hospitals and their variation with ownership type. It is motivated by the empirical finding that private (for-profit) hospitals - having been shown to be less cost efficient in the past - on average earn higher profits than public hospitals. We conduct a Stochastic Frontier Analysis on a multifaceted administrative German data set combined with the balance sheets of 541 hospitals of the years 2002-2006. The results show no significant differences in cost efficiency but higher profit efficiency of private than of publicly owned hospitals.

  16. South San Francisco Bay tidal marsh vegetation and elevation surveys-Corkscrew Marsh, Bird Island, and Palo Alto Baylands, California, 1983

    USGS Publications Warehouse

    Orlando, James L.; Drexler, Judy Z.; Dedrick, Kent G.

    2005-01-01

    Changes in the topography and ecology of the San Francisco Bay Estuary ('Estuary') during the past 200 years have resulted in the loss of nearly 80 percent of the historical salt marsh in the region. Currently, numerous projects are being undertaken by federal, state, and local governments in an attempt to restore wetland habitat and ecosystem function at a number of locations within the Estuary. Much information is needed concerning the historical topographic and ecologic characteristics of the Estuary to facilitate these restoration efforts. This report presents previously unpublished vegetation and elevation data collected in 1983 by the California State Lands Commission at Corkscrew marsh, Bird Island, and Palo Alto Baylands, all located in South San Francisco Bay. These precise and detailed elevation and plant surveys represent a snapshot of South Bay flora before invasion by the Atlantic smooth cordgrass, Spartina alterniflora. Such precise elevation data are rare for relatively undisturbed marshes in the San Francisco Bay; publication of these historical data may facilitate wetland restoration efforts. Marsh-surface and tidal-channel elevations were determined at a total of 962 stations by differential leveling to established tidal benchmark stations at each site and referenced to Mean Lower Low Water (MLLW) relative to the National Tidal Datum Epoch (1960-78). In addition, presence or absence of nine salt marsh species, percentage plant cover, and percentage bare soil were recorded for 1-square meter quadrats at 648 stations where elevations were determined. Collectively, over the three sites, salt marsh vegetation ranged in elevation from 0.98 to 2.94 m above MLLW. S. foliosa and Salicornia virginica were the most frequently observed plant species. Atriplex patula, Deschampsia cespitosa, and Limonium californicum were each recorded at only one of the three sites.

  17. [From admission team to hospital bed management].

    PubMed

    Pochini, Angelo; Augellone, Elisa; Enei, Rosanna; Gaetani, Laura; Paolucci, Simona; Ursumando, Diana; Mitello, Lucia

    2013-01-01

    Reduction on number of hospital beds i.e. on patients' admission among hospitals in Lazio has lead to a reformulation of health service framework within Lazio indentifying hospital as the only place to go to treat acute and urgent diseases. San Camillo-Forlanini, the largest hospital in Rome, according to the regional health plan, the recovery plan and the redevelopment of network hospital has had a significant reduction of hospital beds leading, as consequence, to the need of an internal reorganization. In order to correctly address this issue, the management of the Hospital started in February 2008 a project, setting up a group made up by nursing coordinators which had as a main aim to manage the number of hospital beds needed for emergencies. This group has been called "Admission Team" and nurses within the group are familiar with hospital policies and organization. The team collaborates daily with physicians and nurses in  emergency room, in order to decide the most appropriate health care protocol for each patient. The project follows a specific methodology i.e. Systemic Analysis. Over the years this project has contributed to the improvement to a number of indicators and more generally to the health care within the hospital together with the enhancement of education of new managerial roles among health professional. In 2009, the Regional Council of Lazio has recognized this project as strategic within private and public hospitals.

  18. Hospital Closure and Insights into Patient Dispersion

    PubMed Central

    Garg, N.; Husk, G.; Nguyen, T.; Onyile, A.; Echezona, S.; Kuperman, G.

    2015-01-01

    Summary Background Hospital closures are becoming increasingly common in the United States. Patients who received care at the closing hospitals must travel to different, often farther hospitals for care, and nearby remaining hospitals may have difficulty coping with a sudden influx of patients. Objectives Our objectives are to analyze the dispersion patterns of patients from a closing hospital and to correlate that with distance from the closing hospital for three specific visit types: emergency, inpatient, and ambulatory. Methods In this study, we used data from a health information exchange to track patients from Saint Vincent’s Medical Center, a hospital in New York City that closed in 2010, to determine where they received emergency, inpatient, and ambulatory care following the closure. Results We found that patients went to the next nearest hospital for their emergency and inpatient care, but ambulatory encounters did not correlate with distance. Discussion It is likely that patients followed their ambulatory providers as they transitioned to another hospital system. Additional work should be done to determine predictors of impact on nearby hospitals when another hospital in the community closes in order to better prepare for patient dispersion. PMID:25848422

  19. Management of infectious waste by US hospitals.

    PubMed

    Rutala, W A; Odette, R L; Samsa, G P

    In July 1987 and January 1988, forty-six percent (441/955) of randomly selected US hospitals responded to a questionnaire intended to identify their waste disposal practices. Survey responses were received from hospitals in 48 states. United States hospitals generated a median of 6.93 kg of hospital waste per patient per day and infectious waste made up 15% of the total hospital waste. Most hospitals (greater than 90%) considered blood, microbiology, "sharps," communicable disease isolation, pathology, autopsy, and contaminated animal carcass waste as infectious. Other sources of hospital waste that were commonly (greater than 80%) designated infectious were surgical, dialysis, and miscellaneous laboratory waste. The infectious waste was normally (80%) treated via incineration or steam sterilization before disposal, whereas noninfectious waste was discarded directly in a sanitary landfill. Eight-two percent of these US hospitals are discarding blood, microbiology, sharps, pathology, and contaminated animal carcass waste in accordance with the Centers for Disease Control's recommendations, while the compliance rate for the Environmental Protection Agency's recommendations (excluding optional waste) is 75%. No hospital could identify an infection problem (excluding needle-stick injuries) that was attributable to the disposal of infectious waste. While the management of infectious waste by US hospitals is generally consistent with the Centers for Disease Control's guidelines, many hospitals employ overly inclusive definitions of infectious waste.

  20. Costs of Physician-Hospital Integration.

    PubMed

    Cho, Na-Eun

    2015-10-01

    Given that the enactment of the Patient Protection and Affordable Care Act of 2010 is expected to generate forces toward physician-hospital integration, this study examined an understudied, albeit important, area of costs incurred in physician-hospital integration. Such costs were analyzed through 24 semi-structured interviews with physicians and hospital administrators in a multiple-case, inductive study. Two extreme types of physician-hospital arrangements were examined: an employed model (ie, integrated salary model, a group of physicians integrated by a hospital system) and a private practice (ie, a physician or group of physicians who are independent of economic or policy control). Interviews noted that integration leads to 3 evident costs, namely, monitoring, coordination, and cooperation costs. Improving our understanding of the kinds of costs that are incurred after physician-hospital integration will help hospitals and physicians to avoid common failures after integration. PMID:26496300

  1. The cost of hospitalization for firearm injuries.

    PubMed

    Martin, M J; Hunt, T K; Hulley, S B

    1988-11-25

    The hospital records for all patients (N = 131) admitted during 1984 to San Francisco General Hospital because of firearm injuries were studied to determine the hospital costs and sources of payment for these injuries. Because San Francisco General Hospital is the regional trauma center, the sample is population based, representing all firearm victims hospitalized in San Francisco during 1984. Only hospital costs (excluding professional fees) for the first hospitalization were studied. The total costs for the year were $905,809, an average cost per patient of $6915. Public sources paid 85.6% of this cost, while private sources paid only 14.4%. These findings have important implications for legislators considering bills to restrict the availability of firearms. These legislators must be aware that the issue is not simply one of individual rights, since taxpayers pay most of the costs (estimated to be more than $1 billion per year for the United States) associated with firearm injuries. PMID:3184369

  2. Virtual reality in a children's hospital.

    PubMed

    Nihei, K; Shirakawa, K; Isshiki, N; Hirose, M; Iwata, H; Kobayashi, N

    1999-01-01

    We used virtual reality technology to improve the quality of life and amenity of in-patients in a children's hospital. Children in the hospital could enjoy a zoo, amusement park, and aquarium, in virtual. They played soccer, skiing and horse riding in virtual. They could communicate with persons who were out of the hospital and attend the school which they had gone to before entering hospital. They played music with children who had been admitted to other children's hospitals. By using this virtual technology, the quality of life of children who suffered from psychological and physiological stress in the hospital greatly improved. It is not only useful for their QOL but also for the healing of illness. However, these methods are very rare. Our systemic in our children's hospital is the first to be reported in Japan both software and hardware of virtual reality technology to increase the QOL of sick children need further development.

  3. Hospital union election activity, 1974-85

    PubMed Central

    Becker, Edmund R.; Rakich, Jonathon S.

    1988-01-01

    This study, using National Labor Relations Board data and American Hospital Association data, reports on the status of union election activity in the hospital industry for a 65-month period, January 1980-May 1985, and contrasts it with earlier data for a similar 65-month time period (1974-79). Together these data provide a comprehensive overview of union election activity in non-Federal, nongovernment hospitals since the passage of the 1974 Nonprofit Hospital Amendments to the Taft-Hartley Act. The study analyzes union, election, hospital, and environmental characteristics. Comparisons over the two time periods show that, while union victory rates in hospital elections have remained constant, the total number of elections has declined dramatically in the hospital industry. PMID:10312518

  4. [Historical analysis of the hospital bed].

    PubMed

    Fajardo-Ortiz, Guillermo; Fajardo-Dolci, Germán

    2010-01-01

    Until now the bed has been the basic physical resource in hospitals. This type of furniture has served to study and treat patients, through out the centuries it has undergone changes in the materials they are made of dimensions, functionality, accessories, aesthetic, and design. The hospital bed history is not well known, there are thousands of documents about the evolution of hospitals, but not enough is known about hospital beds, a link between the past and the present. The medical, anthropological, technological, social, and economic dynamics and knowledge have produced a variety of beds in general and hospital beds in particular. From instinctive, rustic, poor and irregular "sites" that have differed in shape and size they had evolved into ergonomic equipment. The history of the hospital bed reflects the culture, techniques and human thinking. Current hospital beds include several types: for adults, for children, for labor, for intensive therapy, emergency purposes, census and non census beds etc.

  5. Costs of Physician-Hospital Integration

    PubMed Central

    Cho, Na-Eun

    2015-01-01

    Abstract Given that the enactment of the Patient Protection and Affordable Care Act of 2010 is expected to generate forces toward physician-hospital integration, this study examined an understudied, albeit important, area of costs incurred in physician-hospital integration. Such costs were analyzed through 24 semi-structured interviews with physicians and hospital administrators in a multiple-case, inductive study. Two extreme types of physician-hospital arrangements were examined: an employed model (ie, integrated salary model, a group of physicians integrated by a hospital system) and a private practice (ie, a physician or group of physicians who are independent of economic or policy control). Interviews noted that integration leads to 3 evident costs, namely, monitoring, coordination, and cooperation costs. Improving our understanding of the kinds of costs that are incurred after physician-hospital integration will help hospitals and physicians to avoid common failures after integration. PMID:26496300

  6. [Medical clowns at hospitals and their effect on hospitalized children].

    PubMed

    Bornstein, Yossi

    2008-01-01

    Healing by the use of humor has become popular over the last few years and it is used not only in alternative medicine but also in conventional medicine in hospitals all over the world, particularly in the USA and Europe. This practice has been well implemented in pediatric wards. It is easier to make a child laugh than an adult. In the framework of healing by humor, use is made of a medical clown who is in fact a person who has undergone special training in acting and clowning, combined with medical knowledge and an understanding of patient behavior. Some medical clowns come from the world of entertainment, and are actors, clowns, and magicians. Some have a paramedical or medical background. Medical research demonstrates that medical clowns and humor have a positive effect on patients. The implementation of medical clowning has been increasing throughout the world from year to year and has, slowly but surely, started a movement to integrate it into formal frameworks in both pediatric and adult wards in hospitals. However, there is still a necessity to conduct larger, well controlled clinical trials regarding the influence of the different programs. Maybe the growing awareness in the world will fill the void that demands resources of both personnel and budgets, both of which are often missing from health budgets. PMID:18300620

  7. [Medical clowns at hospitals and their effect on hospitalized children].

    PubMed

    Bornstein, Yossi

    2008-01-01

    Healing by the use of humor has become popular over the last few years and it is used not only in alternative medicine but also in conventional medicine in hospitals all over the world, particularly in the USA and Europe. This practice has been well implemented in pediatric wards. It is easier to make a child laugh than an adult. In the framework of healing by humor, use is made of a medical clown who is in fact a person who has undergone special training in acting and clowning, combined with medical knowledge and an understanding of patient behavior. Some medical clowns come from the world of entertainment, and are actors, clowns, and magicians. Some have a paramedical or medical background. Medical research demonstrates that medical clowns and humor have a positive effect on patients. The implementation of medical clowning has been increasing throughout the world from year to year and has, slowly but surely, started a movement to integrate it into formal frameworks in both pediatric and adult wards in hospitals. However, there is still a necessity to conduct larger, well controlled clinical trials regarding the influence of the different programs. Maybe the growing awareness in the world will fill the void that demands resources of both personnel and budgets, both of which are often missing from health budgets.

  8. HOSPITAL NUTRITIONAL CARE: PROPOSITIONS ENDORSED BY THE SCIENTIFIC COMMUNITY.

    PubMed

    Diez-Garcia, Rosa Wanda; Zangiacomi Martinez, Edson; Penaforte, Fernanda Rodrigues de Oliveira; Japur, Camila Cremonezi

    2015-09-01

    Antecedentes/objetivos: la incidencia de desnutrición hospitalaria y sus consecuencias tanto para el paciente como para el hospital ha exigido procedimientos que aseguren un servicio de atención nutricional hospitalaria de buena calidad. Basado en los informes de la literatura, este estudio tuvo como objetivo construir proposiciones sobre los cuidados nutricionales hospitalarios, que después fueran evaluados y aprobados por la comunidad científica. Métodos: fueron desarrolladas cuarenta y una proposiciones relativas a la atención nutricional clínica del paciente y a la gestión del servicio de alimentación por el Servicio de Alimentación y Nutrición Hospitalaria. Un total de cien profesionales, investigadores y profesores evaluaron las proposiciones. Para analizar si los evaluadores estaban de acuerdo con las proposiciones se utilizó una escala Likert de cinco puntos (estoy en total desacuerdo, estoy parcialmente en desacuerdo, no tengo opinión, estoy parcialmente de acuerdo, estoy totalmente de acuerdo) asociada a cada proposición. Fue considerada concordancia cuando el 70% o más de los evaluadores estaban de acuerdo (totalmente o parcialmente) con la proposición. Para el análisis estadístico fue utilizado el procedimiento Proc Corresp del software SAS 10, versión 8, estadística descriptiva y análisis de correspondencias. Resultados: más del 90% de los entrevistados estaban total o parcialmente de acuerdo con el 85% (35) de las 41 proposiciones; entre el 80 y 90% de los entrevistados estaban total o parcialmente de acuerdo con el 15% (6) de las 41 proposiciones. Todos los criterios propuestos tuvieron más del 70% de concordancia (total y parcial). El menor valor de concordancia total fue del 70%, atribuido a la proposición que sugiere la participación del paciente en la intervención nutricional. Conclusiones: la comunidad científica presentó alto nivel de concordancia con las proposiciones para la atención nutricional hospitalaria, lo

  9. The Impact of Hospital Pay-for-Performance on Hospital and Medicare Costs

    PubMed Central

    Kruse, Gregory B; Polsky, Daniel; Stuart, Elizabeth A; Werner, Rachel M

    2012-01-01

    Objective To evaluate the effects of Medicare's hospital pay-for-performance demonstration project on hospital revenues, costs, and margins and on Medicare costs. Data Sources/Study Setting All health care utilization for Medicare beneficiaries hospitalized for acute myocardial infarction (AMI; ICD-9-CM code 410.x1) in fiscal years 2002–2005 from Medicare claims, containing 420,211 admissions with AMI. Study Design We test for changes in hospital costs and revenues and Medicare payments among 260 hospitals participating in the Medicare hospital pay-for-performance demonstration project and a group of 780 propensity-score-matched comparison hospitals. Effects were estimated using a difference-in-difference model with hospital fixed effects, testing for changes in costs among pay-for-performance hospitals above and beyond changes in comparison hospitals. Principal Findings We found no significant effect of pay-for-performance on hospital financials (revenues, costs, and margins) or Medicare payments (index hospitalization and 1 year after admission) for AMI patients. Conclusions Pay-for-performance in the CMS hospital demonstration project had minimal impact on hospital financials and Medicare payments to providers. As P4P extends to all hospitals under the Affordable Care Act, these results provide some estimates of the impact of P4P and emphasize our need for a better understanding of the financial implications of P4P on providers and payers if we want to create sustainable and effective programs to improve health care value. PMID:23088391

  10. Managing hospitals in turbulent times: do organizational changes improve hospital survival?

    PubMed Central

    Lee, S Y; Alexander, J A

    1999-01-01

    OBJECTIVE: To examine (1) the degree to which organizational changes affected hospital survival; (2) whether core and peripheral organizational changes affected hospital survival differently; and (3) how simultaneous organizational changes affected hospital survival. DATA SOURCES: AHA Hospital Surveys, the Area Resource File, and the AHA Hospital Guides, Part B: Multihospital Systems. STUDY DESIGN: The study employed a longitudinal panel design. We followed changes in all community hospitals in the continental United States from 1981 through 1994. The dependent variable, hospital closure, was examined as a function of multiple changes in a hospital's core and peripheral structures as well as the hospital's organizational and environmental characteristics. Cox regression models were used to test the expectations that core changes increased closure risk while peripheral changes decreased such risk, and that simultaneous core and peripheral changes would lead to higher risk of closure. PRINCIPAL FINDINGS: Results indicated more peripheral than core changes in community hospitals. Overall, findings contradicted our expectations. Change in specialty, a core change, was beneficial for hospitals, because it reduced closure risk. The two most frequent peripheral changes, downsizing and leadership change, were positively associated with closure. Simultaneous organizational changes displayed a similar pattern: multiple core changes reduced closure risk, while multiple peripheral changes increased the risk. These patterns held regardless of the level of uncertainty in hospital environments. CONCLUSIONS: Organizational changes are not all beneficial for hospitals, suggesting that hospital leaders should be both cautious and selective in their efforts to turn their hospitals around. PMID:10536977

  11. 1. Oblique view of Portsmouth Naval Hospital Building looking north ...

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

    1. Oblique view of Portsmouth Naval Hospital Building looking north from roof of 1960 high-rise hospital - Portsmouth Naval Hospital, Hospital Building, Rixey Place, bounded by Williamson Drive, Holcomb Road, & The Circle, Portsmouth, Portsmouth, VA

  12. Rural and Urban Hospitals' Role in Providing Inpatient Care, 2010

    MedlinePlus

    ... CDC/NCHS, National Hospital Discharge Survey, 2010. How did rural hospital inpatients differ from urban hospital inpatients ... CDC/NCHS, National Hospital Discharge Survey, 2010. How did patients' first-listed diagnoses differ in rural and ...

  13. How to choose the best hospital for surgery

    MedlinePlus

    ... give you an idea of how your hospital compares to other hospitals. Find out if your hospital ... information to them, and some publish reports that compare hospitals in the state. Nonprofit groups in some ...

  14. Business Intelligence in Hospital Management.

    PubMed

    Escher, Achim; Hainc, Nicolin; Boll, Daniel

    2016-01-01

    Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting. PMID:27514111

  15. Salisbury hospital's steam trap success.

    PubMed

    Baillie, Jonathan

    2011-03-01

    With the Carbon Reduction Commitment now fully in force, and the NHS tasked with achieving tough carbon emission reduction targets in line with both UK and EU mandates, healthcare estates teams across the country are seeking cost-effective ways to reduce energy consumption. Against this backdrop, Salisbury District Hospital has implemented a concerted energy-saving programme, key elements of which include replacing existing bucket steam traps with higher performing, lower maintenance, and more effective GEM venturi steam traps from Thermal Energy International (TEI), installing a new gas CHP engine, and looking into fitting a TEI condensate economiser system. PMID:21485315

  16. [Out-of-hospital births].

    PubMed

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

    2016-01-01

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

  17. Salisbury hospital's steam trap success.

    PubMed

    Baillie, Jonathan

    2011-03-01

    With the Carbon Reduction Commitment now fully in force, and the NHS tasked with achieving tough carbon emission reduction targets in line with both UK and EU mandates, healthcare estates teams across the country are seeking cost-effective ways to reduce energy consumption. Against this backdrop, Salisbury District Hospital has implemented a concerted energy-saving programme, key elements of which include replacing existing bucket steam traps with higher performing, lower maintenance, and more effective GEM venturi steam traps from Thermal Energy International (TEI), installing a new gas CHP engine, and looking into fitting a TEI condensate economiser system.

  18. [Dialogical leadership in hospitals institutions].

    PubMed

    Amestoy, Simone Coelho; Trindade, Letícia de Lima; Waterkemper, Roberta; Heidman, Ivonete Teresinha Schülter; Boehs, Astrid Egged; Backes, Vânia Marli Schubert

    2010-01-01

    The aim of this study is make a theorical-reflection about the importance of using dialogical leadership in hospital institutions through Freirean referencial. The dialogical leadership pattern differs from the coercive and autocratic methods, for being reasoned on the establishment of an efficient communicational process, able to stimulate autonomy, co-responsibility and appreciation of each member from nurse team. The dialogical leadership, unlike the directive one, is a management instrument, that pursuits to minimize the conflicts and stimulate the formation of healthy interpersonal relationships, which can contribute to the improvement of organizational atmosphere and quality care provided to health services users.

  19. Operating private hospitals in Mexico.

    PubMed

    Barcie, Joseph S

    2015-01-01

    Mexico is one of the richest countries in Latin America and over the last several decades there have been many changes in the healthcare delivery systems, from universal healthcare coverage for all Mexicans to the fast paced expansion of private healthcare. Like many countries, Mexico has both private and public health systems and hospital administrators are facing challenges on multiple fronts in addition to facing exciting new opportunities. In this article you will get a bird's eye view of this ever changing panorama. How the new growing middle class consumerism has impacted physicians, health insurance and private healthcare industry. PMID:26521381

  20. Hubble Systems Optimize Hospital Schedules

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Don Rosenthal, a former Ames Research Center computer scientist who helped design the Hubble Space Telescope's scheduling software, co-founded Allocade Inc. of Menlo Park, California, in 2004. Allocade's OnCue software helps hospitals reclaim unused capacity and optimize constantly changing schedules for imaging procedures. After starting to use the software, one medical center soon reported noticeable improvements in efficiency, including a 12 percent increase in procedure volume, 35 percent reduction in staff overtime, and significant reductions in backlog and technician phone time. Allocade now offers versions for outpatient and inpatient magnetic resonance imaging (MRI), ultrasound, interventional radiology, nuclear medicine, Positron Emission Tomography (PET), radiography, radiography-fluoroscopy, and mammography.

  1. [Out-of-hospital births].

    PubMed

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

    2016-01-01

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

  2. Providing family care in hospital.

    PubMed

    Bridgman, H; Carr, E

    Using the delphi technique, this study aimed to identify supportive nursing behaviours and some factors that inhibit the effective provision of family-centred palliative care in a hospital. Supportive nursing behaviours were identified and priority was given to the issues of symptom control, privacy, time and communication. Factors that hinder effective provision of family care focused mainly on the problems involved in balancing priorities, issues of disclosure and managing family conflict. The findings identified key areas of family-centred palliative care that warrant further investigation.

  3. Hospital Emergency Readiness Overview study.

    PubMed

    Kollek, Daniel; Cwinn, A Adam

    2011-06-01

    In 2001, a survey of Canadian emergency departments indicated significant deficiencies in disaster preparedness. Since then, there have been efforts on the part of Provincial governments to remedy this situation. This survey repeats the original study with minor modifications to determine if there has been improvement. The Hospital Emergency Readiness Overview study demonstrates that despite improvements, there remain gaps in Canadian healthcare facility readiness for disaster, specifically one involving contaminated patients. It also highlights the lack of any standardized assessment of healthcare facilities' chemical, biological, radiological, or nuclear readiness. PMID:22107765

  4. Physician-owned Surgical Hospitals Outperform Other Hospitals in the Medicare Value-based Purchasing Program

    PubMed Central

    Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott

    2016-01-01

    Background The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals while creating financial incentives for quality improvement and fostering increased transparency. Limited information is available comparing hospital performance across healthcare business models. Study Design 2015 hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Results Of 3089 hospitals with Total Performance Scores (TPS), categories of representative healthcare business models included 104 Physician-owned Surgical Hospitals (POSH), 111 University HealthSystem Consortium (UHC), 14 US News & World Report Honor Roll (USNWR) Hospitals, 33 Kaiser Permanente, and 124 Pioneer Accountable Care Organization affiliated hospitals. Estimated mean TPS for POSH (64.4, 95% CI 61.83, 66.38) and Kaiser (60.79, 95% CI 56.56, 65.03) were significantly higher compared to all remaining hospitals while UHC members (36.8, 95% CI 34.51, 39.17) performed below the mean (p < 0.0001). Significant differences in mean hospital case mix index included POSH (mean 2.32, p<0.0001), USNWR honorees (mean 2.24, p 0.0140) and UHC members (mean =1.99, p<0.0001) while Kaiser Permanente hospitals had lower case mix value (mean =1.54, p<0.0001). Re-estimation of TPS did not change the original results after adjustment for differences in hospital case mix index. Conclusions The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals may guide value improvement and policy-making decisions for all Medicare Value-Based Purchasing Program Hospitals. PMID:27502368

  5. Diversification strategies for hospital pharmacies.

    PubMed

    Smith, J E; Phillips, D J; Meyer, G E

    1984-09-01

    Several ways used by the pharmacy department of a large university hospital to generate revenue through diversification are described. The department offers its facilities and staff as a resource in training medical service representatives for several pharmaceutical manufacturers, which is projected to provide $85,000 in net income for fiscal year (FY) 1983-84. The pharmacy department also conducts a six-month program for training pharmacy technicians, which yields a small net profit. The pharmacy department actively participates in educational programs such as college courses and clerkships earning extra income. An apothecary-style outpatient pharmacy was set up under a for-profit corporation. Services have been expanded to include the preparation of i.v. solutions that support home care. A durable medical equipment (DME) business is planned. The ambulatory and home-care programs are expected to generate approximately $165,000 in net profit next year. Contract pharmaceutical services are provided to another hospital. The net income generated through diversification in this pharmacy department will exceed $250,000 in FY 1983-84.

  6. Technical Efficiency of Hospitals in Tehran, Iran

    PubMed Central

    KAKEMAN, Edris; RAHIMI FORUSHANI, Abbas; DARGAHI, Hossein

    2016-01-01

    Background: Nowadays, restriction on access and optimum use of resources is the main challenge of development in all organizations. Therefore, the aim of this study was to determine the technical efficiency and its factors, influencing hospitals of Tehran. Methods: This research was a descriptive-analytical and retrospective study conducted in 2014–2015. Fifty two hospitals with public, private, and social security ownership type were selected for this study. The required data was collected by a researcher-made check list in 3 sections of background data, inputs and outputs. The data was analyzed by DEAP 1.0.2, and STATA-13 technique. Results: Seventeen (31/48) of hospitals had the efficiency score of 1 as the highest technical efficiency. The highest average score of efficiency was related to social security hospitals as 84.32, and then the public and private hospitals with the average of 84.29 and 79.64 respectively. Tobit regression results showed that the size, type of practice, and ownership of hospitals were effective on the degree of their technical efficiency. However, there was no significant correlation between teaching / non-teaching hospitals with technical efficiency. Conclusion: Establishment of competition system among hospitals, constitution of medium size hospitals and allocation of budget to hospitals based on national accreditation system are recommended. PMID:27252919

  7. The effect of hospital control strategies on physician satisfaction and physician-hospital conflict.

    PubMed Central

    Burns, L R; Andersen, R M; Shortell, S M

    1990-01-01

    This article examines several strategies that hospitals use to control their medical staffs. Such strategies include placing physicians on salary, developing exclusive hospital affiliations with physicians, and involving physicians in decision-making bodies. Using regression techniques, we investigate which hospitals are more likely to utilize these strategies and whether such strategies are effective in promoting physician-hospital integration. Contrary to our expectations, corporate hospital structures (e.g., for-profit hospitals, membership in multihospital systems) generally do not employ these strategies more often and oftentimes employ them less. There is also little evidence that control strategies are effective levers for increasing physician satisfaction or decreasing physician-hospital conflict. We suggest that control strategies are useful for purposes other than promoting physician-hospital integration. Finally, hospital ownership appears to exert the biggest effect on physician satisfaction and conflict. PMID:2380074

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

    PubMed Central

    2009-01-01

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

  9. [Burnout syndrome in medical residents at the General Hospital of Durango, México].

    PubMed

    Terrones-Rodríguez, Jovany Francisco; Cisneros-Pérez, Vicente; Arreola-Rocha, José Jesús

    2016-01-01

    Introducción: el síndrome de burnout es frecuente en los trabajadores de la salud y educación debido a que se sienten presionados por las excesivas demandas en su espacio de trabajo. Se evalúan tres esferas: despersonalización, agotamiento emocional y realización personal. Métodos: para determinar la prevalencia del síndrome de burnout en los médicos residentes del Hospital General de Durango SSD, se diseñó un estudio descriptivo, transversal, prolectivo y se aplicó el cuestionario Maslach Burnout Inventory a los residentes de las diferentes especialidades del Hospital General de Durango SSD que aceptaron participar. Resultados: se encuestó a 116 residentes, el 43.1 % (50) mujeres y el 56.89 % (66) hombres. La prevalencia general fue de 89.66 % (IC 95 %: 82.63-94.54). Afectados en una esfera el 48.28 % (IC 95 %: 38.90-57.74), en dos esferas el 35.34 % (IC 95 %: 26.69-44.76) y en las tres esferas el 6.03 % (IC 95 %: 2.46-12.04). En las tres esferas, el agotamiento emocional alto fue del 41.38 % (IC 95 %: 32.31-50.90), alta despersonalización en el 54.31 % (IC 95 %: 44.81-63.59) y baja realización personal en el 41.38 % (IC 95 %: 32.31-50.90). Conclusiones: la prevalencia se encuentra por arriba de la reportada. La mayor frecuencia de afectados fue la de despersonalización, seguida por agotamiento emocional y al final la de realización personal. En las especialidades de ginecología y obstetricia, medicina interna, pediatría y ortopedia los residentes se encuentran afectados en el 100 % de su población.

  10. Hospital library foreign language labs: the experiences of two hospital libraries.

    PubMed

    Whelan, Julia S; Schneider, Elizabeth; Woodworth, Karl; Markwell, Linda Garr

    2006-01-01

    Increasingly, hospital-based physicians, residents, and medical students are welcoming into their care foreign-born patients, who do not speak English. Most hospitals today have an Interpretive Services Department, but many of the physicians, residents, and medical students want to become more proficient in the most frequently spoken foreign languages in their respective locales. To help recruit and retain a diverse workforce, some hospitals sponsor English programs for staff. The Treadwell Library at Massachusetts General Hospital in Boston, Massachusetts, and the Grady Branch Library at Grady Memorial Hospital in Atlanta, Georgia, have developed a special collection and hospital library-based language laboratories in order to meet this need. PMID:16782669

  11. Evaluation of Nigerian hospital meal carts

    NASA Astrophysics Data System (ADS)

    Ayodeji, Sesan P.; Adeyeri, Michael K.; Omoniyi, Olaoluwa

    2015-03-01

    Hospital meal carts are used to deliver meals, drugs and some other materials to patients in the hospital environment. These carts which are moved manually by operators, the health workers, mostly do not comply with ergonomics guidelines and physical requirements of the equipment users in terms of anthropometry data of the region thus increasing the risk of musculoskeletal disorder among the meal cart users. This study carried out ergonomic evaluation of the available meal carts in some western Nigeria hospitals. A well-structured questionnaire has two major segments: Operational survey and biomechanical survey, which were administered to the health workers using hospital meal carts in some hospitals in southwestern Nigeria, and physical assessment, which was undertaken to collect data for the ergonomic evaluation. The responses from the questionnaires show that some areas on the existing hospital meal carts are of concern to the users which need to be improved upon.

  12. Medicare's fee schedule for hospital outpatient care.

    PubMed

    Grimaldi, Paul L

    2002-01-01

    Medicare's hospital outpatient prospective payment system (OPPS) went live on August 1, 2000, after a decade of developmental work. The new system introduced a fee schedule that replaced the cost-related methods that Medicare previously used to reimburse various hospital outpatient services. Hospitals are now paid predetermined rates or fees based on the Ambulatory Patient Classification (APC) groups assigned to the services that Medicare patients receive during outpatient encounters. The new system aims to simplify Medicare's intricate cost-based reimbursement policies, improve hospital efficiency, ensure that payments are sufficient to compensate hospitals for reasonable Medicare costs, and reduce Medicare coinsurance amounts for beneficiaries. Implementation of OPPS-related administrative and operational changes has been a major challenge for hospitals. PMID:12079149

  13. CEO compensation and hospital financial performance.

    PubMed

    Reiter, Kristin L; Sandoval, Guillermo A; Brown, Adalsteinn D; Pink, George H

    2009-12-01

    Growing interest in pay-for-performance and the level of chief executive officers' (CEOs') pay raises questions about the link between performance and compensation in the health sector. This study compares the compensation of nonprofit hospital CEOs in Ontario, Canada to the three longest reported and most used measures of hospital financial performance. Our sample consisted of 132 CEOs from 92 hospitals between 1999 and 2006. Unbalanced panel data were analyzed using fixed effects regression. Results suggest that CEO compensation was largely unrelated to hospital financial performance. Inflation-adjusted salaries appeared to increase over time independent of hospital performance, and hospital size was positively correlated with CEO compensation. The apparent upward trend in salary despite some declines in financial performance challenges the fundamental assumption underlying this article, that is, financial performance is likely linked to CEO compensation in Ontario. Further research is needed to understand long-term performance related to compensation incentives. PMID:19605619

  14. The architecture of enterprise hospital information system.

    PubMed

    Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye

    2005-01-01

    Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described.

  15. [Development of green hospitals home and abroad].

    PubMed

    Yang, Yiju; Zeng, Na; Shen, Minxue; Sun, Zhenqiu

    2013-09-01

    Green hospital construction is a new challenge for medical industry after global sustainable development strategy was put forward. The core connotation of green hospital includes green building, green healthcare, patient safety, and doctor-patient harmony. Many countries have established green building evaluation system to deal with energy crisis. Leadership in Energy and Environmental Design (LEED), Green Guide for Health Care (GGHC) in the U.S., and Evaluation System for Green Hospital Building (CSUS/GBC 2-2011) in China have guiding significance for the development of green hospitals in China. The evaluation system of green hospitals home and abroad still focuses on green building, and establishment of suitable synthesis evaluation system of green hospitals in China needs further research. PMID:24071694

  16. [Development of green hospitals home and abroad].

    PubMed

    Yang, Yiju; Zeng, Na; Shen, Minxue; Sun, Zhenqiu

    2013-09-01

    Green hospital construction is a new challenge for medical industry after global sustainable development strategy was put forward. The core connotation of green hospital includes green building, green healthcare, patient safety, and doctor-patient harmony. Many countries have established green building evaluation system to deal with energy crisis. Leadership in Energy and Environmental Design (LEED), Green Guide for Health Care (GGHC) in the U.S., and Evaluation System for Green Hospital Building (CSUS/GBC 2-2011) in China have guiding significance for the development of green hospitals in China. The evaluation system of green hospitals home and abroad still focuses on green building, and establishment of suitable synthesis evaluation system of green hospitals in China needs further research.

  17. Hospital management contracts: institutional and community perspectives.

    PubMed Central

    Wheeler, J R; Zuckerman, H S

    1984-01-01

    Previous studies have shown that external management by contract can improve the performance of managed hospitals. This article presents a conceptual framework which develops specific hypotheses concerning improved hospital operating efficiency, increased ability to meet hospital objectives, and increased ability to meet community objectives. Next, changes in the process and structure of management under contractual arrangements, based on observations from two not-for-profit hospital systems, are described. Finally, the effects of these management changes over time on hospital and community objectives are presented. These effects suggest progressive stages in the development of management contracts. The first stage focuses on stabilizing hospital financial performance. Stage two involves recruitment and retention efforts to secure necessary personnel. In the third stage, attention shifts to strategic planning and marketing. PMID:6490378

  18. CEO Compensation and Hospital Financial Performance

    PubMed Central

    Reiter, Kristin L.; Sandoval, Guillermo A.; Brown, Adalsteinn D.; Pink, George H.

    2010-01-01

    Growing interest in pay-for-performance and the level of CEO pay raises questions about the link between performance and compensation in the health sector. This study compares the compensation of non-profit hospital Chief Executive Officers (CEOs) in Ontario, Canada to the three longest reported and most used measures of hospital financial performance. Our sample consisted of 132 CEOs from 92 hospitals between 1999 and 2006. Unbalanced panel data were analyzed using fixed effects regression. Results suggest that CEO compensation was largely unrelated to hospital financial performance. Inflation-adjusted salaries appeared to increase over time independent of hospital performance, and hospital size was positively correlated with CEO compensation. The apparent upward trend in salary despite some declines in financial performance challenges the fundamental assumption underlying this paper, that is, financial performance is likely linked to CEO compensation in Ontario. Further research is needed to understand long-term performance related to compensation incentives. PMID:19605619

  19. Magma associations in Ediacaran granitoids of the Cachoeirinha‒Salgueiro and Alto Pajeú terranes, northeastern Brazil: Forty years of studies

    NASA Astrophysics Data System (ADS)

    Sial, Alcides N.; Ferreira, Valderez P.

    2016-07-01

    Granitic magmatism in the Cachoeirinha‒Salgueiro and Alto Pajeú terranes in the Transversal Zone Domain of the Borborema Province, northeastern Brazil, occurred in three main time intervals: 650-620 Ma, 590-560 Ma and 545-520 Ma. The oldest one is characterized by intrusions of magmatic-epidote (mEp) bearing calc-alkalic (some with trondhjemitic affinities) and high-K calc-alkalic plutons, synkinematic to the main regional foliation, under contractional tectonic regime, and exhibits TDM < 2.0 Ga and ƐNd (0.6 Ga) from -1 to -4, and δ18O (zircon) values from 7.1 to 10‰VSMOW. O- and Nd-isotope data for the 650‒620 Ma group of plutons is compatible with partial fusion of subducted oceanic basaltic crust (mEp-bearing calc-alkalic tonalites/granodiorites, equivalent to adakites). Voluminous intrusions in the 590-560 Ma interval are represented by abundant mEp-free high-K calc-alkalic, peralkalic, ultrapotassic, mEp-bearing high-K calc-alkalic, and less abundant shoshonitic magmas. Nd-model ages for this group of plutons vary from 1.5 to 2.5 Ga and ƐNd (0.6 Ga) ranges from -8 to -20; δ18O (zircon) varies from 6.4 to 7.9‰VSMOW. Values of δ18O (zircon) for the 590‒560 Ma old group of plutons coupled with Nd isotope data are compatible with remelting of crustal (negative ƐNd, 1.6 to 2.0 Ga old) source rocks. O- and Nd-isotope data for this group of plutons are compatible with underplating of basaltic magma in the base of the lower crust for the high-K calc-alkalic granitoids, coeval to transcurrent movements along sigmoidal shear zones. Intrusion of one shoshonitic (Serrote do Arapuá), one calc-alkalic (Riacho do Icó) plutons besides the peralkalic Manaíra-Princeza Isabel dike set have witnessed this transition from contractional to transcurrent movements along shear zones, around 610‒600 Ma.

  20. A biogeochemical and isotopic view of Nitrogen and Carbon in rivers of the Alto Paraíba do Sul basin, São Paulo State, Brazil

    NASA Astrophysics Data System (ADS)

    Ravagnani, E. D. C.; Coletta, L. D.; Lins, S. R. M.; Antonio, J.; Mazzi, E. A.; Rossete, A. L. M.; Andrade, T. M. B.; Martinelli, L. A.

    2014-12-01

    The magnitude of potential flows of elements in tropical ecosystems is not well represented in the literature, even being very important. The Paraíba do Sul River drains the three more economically developed states in Brazil: São Paulo, Minas Gerais and Rio de Janeiro and its basin is considered extremely altered. Despite its economic and social importance (~ 5.3 mi inhabitants), we don't know much about carbon and nitrogen transport into its rivers and how these are affected by soil use changes. This work aimed to investigate these nutrients, using an isotopic and a biogeochemical approach, at some third order (Paraibuna, Paraitinga and Paraíba do Sul), second and first order rivers, all inserted at the Alto Paraíba do Sul Basin. In general, the low dissolved organic carbon, dissolved inorganic carbon, total dissolved nitrogen and inorganic N concentrations found in the first order rivers, showed the lower variation, despite changes in the soil use. Forested rivers presented higher DOC (3.3 mg.L-1) and TDN (14.2 mM) concentrations than the pasture rivers (2.6 mg.L-1 and 13.8 mM), while these presented higher DIC concentrations than those ones (90.2 mM and 71.2 mM). In third order rivers, the concentrations were also very low. Both carbon and nitrogen contents at the fine and coarse fractions of the suspended particulate material (SPM) were lower at Paraitinga and Paraiba do Sul Rivers. At the Paraibuna River, the fine fraction of SPM presented 25% of C concentration. The concentrations found at the coarse fraction were also higher at this river. The N concentrations were higher at the fine fraction and, consequently, this fraction presented higher C:N ratio. These observations allow us to say that the coarse fraction might be related to plant material, while the fine fraction is probably related to the soils. The δ13C in the SPM was lower in the Paraibuna River, probably due to the predominance of forest, while in the other ones pasture was the main soil use

  1. Palaeoproterozoic tectonic evolution of the Alto Tererê Group, southernmost Amazonian Craton, based on field mapping, zircon dating and rock geochemistry

    NASA Astrophysics Data System (ADS)

    Lacerda Filho, J. V.; Fuck, R. A.; Ruiz, A. S.; Dantas, E. L.; Scandolara, J. E.; Rodrigues, J. B.; Nascimento, N. D. C.

    2016-01-01

    New geochemical and geochronological U-Pb and Sm-Nd data from amphibolites of the Alto Tererê Group, which are of Palaeoproterozoic age, are presented. The amphibolites are exposed in the central-eastern portion of the Rio Apa Block, southern Amazonian Craton, Mato Grosso do Sul, Brazil, and are composed of hornblende, plagioclase, quartz, biotite, cummingtonite and epidote. The amphibolites are subdivided into three lithofacies: (i) thinly banded amphibolites (metabasalts), (ii) coarse- and medium-grained amphibolites with relic subophitic texture (metagabbros), and (iii) amphibolites with relic cumulate texture (metapyroxenites). Chemical data also suggest the subdivision of the amphibolites into three different types. These rocks yield a U-Pb zircon age of 1768 ± 6 Ma and are therefore older than rocks of part of the Rio Apa Complex. Their Sm-Nd model ages range between 2.89 and 1.88 Ga, and their ɛNd (T) values range between -3.40 and + 3.74. Chemical analyses of these rocks indicate SiO2 concentrations between 45.23 and 50.65 wt.%, MgO concentrations between 4.34 and 8.01 wt.%, TiO2 concentrations between 0.91 and 1.74 wt.%, weakly fractionated rare-earth element (REE) patterns with mild depletion in heavy REEs, enrichment in large-ion lithophile elements (LILEs) and high-field-strength element (HFSEs), negative Nb, Ta and Co anomalies, positive Ba and Pb anomalies, low Ce concentrations, high Rb/Y ratios and low Th/La and Hf/Sm ratios. These features reflect metasomatism of the mantle wedge produced by sediments from the subducted plate. Various degrees of melting mark the evolution of the parent basic magmas, although subordinate crustal contamination may also have occurred. The geochemical signature of the amphibolites corresponds to that of tholeiitic basalts generated in an extensional back-arc-basin environment. The deposition in the basin apparently ceased during the first episode of compression and deformation at approximately 1.68 Ga, and the main

  2. Evaluation of the MMF (Morgan-Morgan-Finney) model based on soil loss experimental data from vineyards in Alto Monferrato area (NW Italy)

    NASA Astrophysics Data System (ADS)

    Biddoccu, Marcella; Cavallo, Eugenio

    2010-05-01

    Soil erosion in sloping vineyards is a serious threat, made worse by climate change and mechanisation. Machinery traffic influences soil physical properties resulting in lower water infiltration capacity, higher runoff and soil losses. Between 2000 and 2008 measurements have been conducted at an experimental vineyard with rows along the slope in the 'Alto Monferrato' area (Piedmont, NW Italy) in order to evaluate runoff and soil losses. Three plots are monitored to compare different inter-rows management practices: controlled grass cover, conventional and reduced tillage. Agriculture soil management practices affect soil losses. Each plot is 1200 m2 wide and its average slope is about 25 %. Rainfall was recorded and runoff and sediments were collected at the bottom of each plot by a drain connected with a tipping bucket device. This was designed to measure total runoff and to sample a portion of the runoff-sediment mixture. Collected sediments were then ovendried and weighed. Collected data show that runoff generally increased with the rainfall amount and was lower from the grass covered plot than others, especially when the event rainfall was higher than 60 mm. Soil loss increased with the maximum rainfall intensity registered during the event. Mean annual soil losses measured over the 9 years period are 16.1 Mg ha-1in the reduced tilled plot, 13.4 Mg ha-1 in the traditionally tilled plot and 3.2 Mg ha-1 with the controlled grass cover. A single summer storm caused the highest soil losses, which were higher than 18 Mg ha-1 in the tilled plots. The maintenance of controlled grass cover inter-rows allows protecting soil from erosion: the total soil loss was up to 80% lower than in the tilled plots. The protective action of the grass cover is effective also during storms and intense rainfalls, which are more erosiveness. Soil physical properties were also measured. Field data about percentage of clay, silt and sand, soil moisture at field capacity, bulk density and

  3. Active tectonic extension across the Alto Tiberina normal fault system from GPS data modeling and InSAR velocity maps: new perspectives within TABOO Near Fault Observatory

    NASA Astrophysics Data System (ADS)

    Vadacca, Luigi; Anderlini, Letizia; Casarotti, Emanuele; Serpelloni, Enrico; Chiaraluce, Lauro; Polcari, Marco; Albano, Matteo; Stramondo, Salvatore

    2014-05-01

    The Alto Tiberina fault (ATF) is a low-angle (east-dipping at 15°) normal fault (LANF) 70 km long placed in the Umbria-Marche Apennines (central Italy), characterized by SW-NE oriented extension occurring at rates of 2-3 mm/yr. These rates were measured by continuous GPS stations belonging to several networks, which are denser in the study area thanks to additional sites recently installed in the framework of the INGV national RING network and of the ATF observatory. In this area historical and instrumental earthquakes mainly occur on west-dipping high-angle normal faults. Within this context the ATF has accumulated 2 km of displacement over the past 2 Ma, but at the same time the deformation processes active along this misoriented fault, as well as its mechanical behavior, are still unknown. We tackle this issue by solving for interseismic deformation models obtained by two different methods. At first, through the 2D and 3D finite element modeling, we define the effects of locking depth, synthetic and antithetic fault activity and lithology on the velocity gradient measured along the ATF system. Subsequently through a block modeling approach, we model the GPS velocities by considering the major fault systems as bounds of rotating blocks, while estimating the corresponding geodetic fault slip-rates and maps of heterogeneous fault coupling. Thanks to the latest imaging of the ATF deep structure obtained from seismic profiles, we improve the proposed models by modeling the fault as a complex rough surface to understand where the stress accumulations are located and the interseismic coupling changes. The preliminary results obtained show firstly that the observed extension is mainly accommodated by interseismic deformation on both the ATF and antithetic faults, highlighting the important role of this LANF inside an active tectonic contest. Secondarily, using the ATF surface "topography", we find an interesting correlation between microseismicty and creeping portions

  4. Advanced InSAR and GPS measurements for the detection of surface movements along the Alto Tiberina (Italy) normal fault system: data modeling and future perspectives

    NASA Astrophysics Data System (ADS)

    Anderlini, L.; Polcari, M.; Bignami, C.; Pepe, A.; Solaro, G.; Serpelloni, E.; Moro, M.; Albano, M.; Chiaraluce, L.; Stramondo, S.

    2014-12-01

    The Alto Tiberina fault (ATF) is a low-angle (east-dipping at 15°), 70 km long normal fault (LANF) located in the Umbria-Marche Apennines (central Italy), an area characterized by a SW-NE oriented extension occurring at rates of ~2 mm/yr. Active extension is precisely measured by a dense distribution of GPS stations belonging to several networks, thanks also to additional sites recently installed in the framework of the INGV national RING network and of the ATF observatory. Advanced Interferometry SAR (A-InSAR) techniques play today a key role in Earth Sciences thanks to their capability to detect and monitor slow surface movements over wide areas. A-InSAR techniques, along with in-situ ground measurements, can provide suitable information on the causes of interseismic (seismic, creep) movements. Large datasets of SAR images of European (ERS 1-2 and ENVISAT) and Italian (COSMO-SKyMed) satellites have been used to retrieve surface velocity maps and relevant time series from 1992 to 2014, along both ascending and descending orbits. A network of artificial Corner Reflectors has also been deployed in the proximity of some GPS sites in order to calibrate the processing results of the COSMO-SkyMed SAR data-set and to derive velocity maps. We use an elastic Block Modeling (BM) approach in order to model GPS data by considering the major fault systems as bounds of rotating blocks, while estimating geodetic fault slip-rates.,Thanks to the latest imaging of its deep structure obtained from seismic profiles, the ATF is represented as a complex rough surface with the goal of evaluating the distribution of interseismic fault coupling. The preliminary results obtained show firstly that the observed extension is partially accommodated by interseismic deformation on the ATF, highlighting the important role of this LANF inside an active tectonic contest. Secondarily, using the ATF surface "topography", we found for the resolved areas an interesting correlation between

  5. Surgeon Contribution to Hospital Bottom Line

    PubMed Central

    Resnick, Andrew S.; Corrigan, Diane; Mullen, James L.; Kaiser, Larry R.

    2005-01-01

    Objective: We hypothesized that surgeon productivity is directly related to hospital operating margin, but significant variation in margin contribution exists between specialties. Summary Background Data: As the independent practitioner becomes an endangered species, it is critical to better understand the surgeon's importance to a hospital's bottom line. An appreciation of surgeon contribution to hospital profitability may prove useful in negotiations relating to full-time employment or other models. Methods: Surgeon total relative value units (RVUs), a measure of productivity, were collected from operating room (OR) logs. Annual hospital margin per specialty was provided by hospital finance. Hospital margin data were normalized by dividing by a constant such that the highest relative hospital margin (RHM) in fiscal year 2004 expressed as margin units (mu) was 1 million mu. For each specialty, data analyzed included RHM/OR HR, RHM/case, and RHM/RVU. Results: Thoracic (34.55 mu/RVU) and transplant (25.13 mu/RVU) were the biggest contributors to hospital margin. Plastics (−0.57 mu/RVU), maxillofacial (1.41 mu/RVU), and gynecology (1.66 mu/RVU) contributed least to hospital margin. Relative hospital margin per OR HR for transplant slightly exceeded thoracic (275.74 mu vs 233.94 mu) at the top and plastics and maxillofacial contributed the least (−3.83 mu/OR HR vs 9.36 mu/OR HR). Conclusions: Surgeons contribute significantly to hospital margin with certain specialties being more profitable than others. Payer mix, the penetration of managed care, and negotiated contracts as well as a number of other factors all have an impact on an individual hospital's margin. Surgeons should be fully cognizant of their significant influence in the marketplace. PMID:16192813

  6. Organizational diversification in the American hospital.

    PubMed

    Snail, T S; Robinson, J C

    1998-01-01

    This paper outlines a conceptual framework of organizational diversification and assesses the state of empirical research on hospital organizational change. The literature on economic organization of hospitals, one of the most developed branches of health services research, still has only weak ties to economic theory. Evolving physician-hospital organizations do not fit into existing frameworks based on horizontal integration, vertical integration, or diversification. Empirical research has primarily focused on horizontal integration, and cause-effect relationships are often obscured by models that depart from economic theory and lack controls for self-selection bias. Recent empirical studies indicate that hospital mergers had moderate, rather than dramatic, effects on the rate of change in operating costs, staffing, and scale. Mergers rarely resulted in hospital closure, but were as likely to result in acute care consolidation and restructuring as in conversion to non-acute inpatient uses. While administrative costs were higher in for-profit than non-profit system hospitals, total costs were similar. System hospitals had lower marginal and average costs per stay than independent hospitals. Hospital vertical integration into subacute care was largely an artifact of the governmental uniform pricing system, which encouraged vertical integration. Hospitals that shared governance or financial risks with physicians outperformed those with high levels of physician governance and financial integration (e.g. stock ownership). Formal physician-hospital organizational arrangements often served to coordinate managed care contracting or to forge links with primary care group practices. Hospital diversification into related services improved short-term financial performance over unrelated diversification, although long-term performance was similar.

  7. Freestanding heart hospitals is the end near?

    PubMed

    Ronning, Philip L; Nugent, Michael

    2004-09-01

    Freestanding heart hospitals are not enjoying the same competitive advantages they have in recent years for several reasons: Regulatory policy seems to be turning against them. They no longer enjoy the same cost structure advantage. Technology shifts mean lower payment rates and higher costs for cardiac services. Their access to capital is diminished. Traditional hospitals are mounting more effective competitive responses, while entrepreneurial physician practice executives are pursuing alternative strategies that may lead to more competition for heart hospitals.

  8. Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects--United States, 2003.

    PubMed

    2007-01-19

    Birth defects (BDs) are conditions that 1) result from a malformation, deformation, or disruption in one or more parts of the body; 2) are present at birth; and 3) have a serious, adverse effect on health, development, or functional ability. BDs are leading causes of pediatric hospitalizations, medical expenditures, and infant mortality. To estimate national hospital charges and rates of in-hospital deaths for a greater number of specific BDs than estimated in previous reports, investigators at the University of Arkansas for Medical Sciences and CDC used the Healthcare Cost and Utilization Project 2003 Kids' Inpatient Database (KID), developed and distributed by the Agency for Healthcare Research and Quality. KID is a 10% sample of hospital discharges after uncomplicated births and an 80% sample of all other pediatric discharges from 36 participating states. Data are weighted to represent all pediatric hospitalizations in the United States. The investigators analyzed hospital stays during 2003 for newborn infants with any of 35 BDs. This report describes the results of that analysis, which indicated substantial variation among BDs regarding average length of stay, average hospital charge, and the incidence of in-hospital deaths. Average length of stay was greatest for infants with surgically repaired gastroschisis or omphalocele. Average hospital charges were highest for infants with hypoplastic left heart syndrome and common truncus arteriosus. Although anencephaly, trisomy 13, and trisomy 18 were associated with the highest rates of in-hospital death, the largest total numbers of deaths associated with neonatal hospitalizations occurred in infants with diaphragmatic hernia and renal agenesis. Further studies are needed to distinguish outcomes for infants with isolated and multiple defects and to assess longer-term outcomes. PMID:17230142

  9. Recommendations for Using Barcode in Hospital Process

    PubMed Central

    Hachesu, Peyman Rezaei; Zyaei, Leila; Hassankhani, Hadi

    2016-01-01

    Background: Lack of attention to the proper barcode using leads to lack of use or misuse in the hospitals. The present research aimed to investigate the requirements and barrier for using barcode technology and presenting suggestions to use it. Methods: The research is observational-descriptive. The data was collected using the designed checklist which its validity was assessed. This check list consists of two parts: “Requirements” and “barrier” of using the barcodes. Research community included 10 teaching hospitals and a class of 65 participants included people in the hospitals. The collected data was analyzed using descriptive statistics. Results: Required changes of workflow processes in the hospital and compliance them with the hospital policy are such requirements that had been infringed in the 90 % of hospitals. Prioritization of some hospital processes for barcoding, system integration with Hospital Information system (HIS), training of staff and budgeting are requirements for the successful implementation which had been infringed in the 80% of hospitals. Dissatisfaction with the quality of barcode labels and lacks of adequate scanners both whit the rate of 100 %, and the lack of understanding of the necessary requirements for implementation of barcodes as 80% were the most important barrier. Conclusion: Integrate bar code system with clinical workflow should be considered. Lack of knowledge and understanding toward the infrastructure, inadequate staff training and technologic problems are considered as the greatest barriers. PMID:27482137

  10. Hospital strategic preparedness planning: the new imperative.

    PubMed

    Ginter, Peter M; Duncan, W Jack; Abdolrasulnia, Maziar

    2007-01-01

    Strategic preparedness planning is an important new imperative for many hospitals. Strategic preparedness planning goes beyond traditional product/market strategic planning by focusing on disaster prevention, containment, and response roles. Hospitals, because of their unique mission, size, complexity, the types of materials they handle, and the types of patients they encounter, are especially vulnerable to natural and human-initiated disasters. In addition, when disasters occur, hospitals must develop well-conceived first responder (receiver) strategies. This paper argues the case for strategic preparedness planning for hospitals and proposes a process for this relatively new and much needed type of planning.

  11. [The Polish Paderewski Hospital in Edinburgh].

    PubMed

    Tomaszewski, W

    1995-01-01

    On 22 March 1941 the Polish School of Medicine was established at the University of Edinburgh for soldier students in the Polish Forces. Six months later the Polish Paderewski Hospital was opened at the Western General Hospital in a building offered by the Edinburgh City Council. It was meant for Polish soldiers and civilians for the time of war. The moving force behind these events was Professor Jurasz, the organiser and dean of the Polish School of Medicine. He was made the superintendant of the Paderewski Hospital. The hospital was also a teaching hospital for the Polish students. The Hospital was very well equipped thanks to the financial aid coming from the Paderewski Fund in New York. The peak activity of the hospital was in 1944/45 with the invasion of Europe and still more after the end of the war when tens of thousands of Polish soldiers arrived from Italy and the Middle East to Gr. Britain for demobilisation. The hospital was closed down at the end of 1947. It had been planned that a new Medical School would be set up in Poland after the war, based on the Polish School of Medicine in Edinburgh and the Paderewski Hospital. The post-war political changes in Eastern Europe with enforced communism in Poland prevented the realisation of these plans.

  12. Effects of publicity on a forensic hospital.

    PubMed

    Reichlin, S M; Bloom, J D

    1993-01-01

    Oregon's forensic psychiatry hospital experienced a convulsing chain of events that began with the escape of an insanity acquittee who had been hospitalized following two murders. Although the patient was arrested without reoffending, there were major repercussions in the hospital. This event and related state hospital topics became the subject of intense publicity in the local newspaper. Articles ran almost daily for over a month, the majority of which were on page one. We give here an account of the episode and examine the meaning of the media coverage in the light of administration of public mental health systems, particularly where forensic psychiatry is involved.

  13. Recognition of dementia in hospitalized older adults.

    PubMed

    Maslow, Katie; Mezey, Mathy

    2008-01-01

    Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216. PMID:18156858

  14. Developing a strategic marketing plan for hospitals.

    PubMed

    Dychtwald, K; Zitter, M

    1988-09-01

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

  15. A Theory of Hospital Financial Analysis

    PubMed Central

    Elnicki, Richard A.

    1969-01-01

    The problem of determining the financial status of a group of hospitals was posed by the Connecticut Regional Medical Program in 1967 with the question: Are Connecticut's general hospitals financially healthy? The economist assigned to explore the question here describes the economic concepts and the methodology from which models applicable to voluntary hospitals were developed, utilizing the accepted modes of analysis and standards of for-profit business. The basic index of financial health investigated is self-sufficiency, with plant liquidation, revenue control and the role of private payors, and cost control studied as factors affecting the financial status of hospitals. PMID:5799485

  16. Swing beds: an approach to hospital utilization.

    PubMed

    Henderson, D R; Moomaw, A

    1986-11-01

    The need to use every available space for productive purposes is becoming a major concern for hospitals, especially rural hospitals. This need, coupled with the decline in the building of nursing homes, has given rise to the concept of the swing bed, a hospital bed that can be used to provide care to either acute or long-term care patients. This ability allows an acute care hospital to provide care to patients who might traditionally receive care in a nursing home. PMID:10301065

  17. Pediatric hospitalizations for bicycle‐related injuries

    PubMed Central

    Shah, Summit; Sinclair, Sara A; Smith, Gary A; Xiang, Huiyun

    2007-01-01

    Objectives To determine the incidence of bicycle‐related injury hospitalizations among children and adolescents 20 years of age and younger and to examine the associated use of healthcare resources. Design Nationally representative data from the 2003 Healthcare Cost and Utilization Project's Kids' Inpatient Database (KID). Outcome measures National estimates of hospitalization for bicycle‐related injuries according to patient demographics, type of injury, total hospital charges, and length of hospital stay. Results In 2003, an estimated 10 700 children were hospitalized for a bicycle‐related injury in the USA. Inpatient charges totaled nearly $200 million with a mean charge of $18 654 per hospitalization. The national rate was 12.7 hospitalizations per 100 000 children. Young adolescents aged 10–13 years accounted for the highest percentage of cases (36.6%) followed by children aged 6–9 years (25.1%). Most patients were male (76.7%) and resided in an urban area (94.4%). A head injury was diagnosed in one out of three hospitalized bicyclists; 30% were due to a motor vehicle collision. Conclusions Pediatric bicycle‐related hospitalizations are a significant public health problem. The morbidity and mortality among children and the economic costs to society are large. The patient characteristics and injury types identified by this study should be used to develop targeted prevention strategies. PMID:17916888

  18. Benchmarking hospital laboratory financial and operational performance.

    PubMed

    Portugal, B

    1993-12-01

    The movement toward more integrated delivery systems requires hospital administrators, medical staffs, and health care network organizations to consider strategies that will meet the future challenges facing laboratory services. Many health care experts predict that the number of hospital inpatient days, staffed acute care beds, and length of stay will continue their precipitous decline, and then stabilize during the next four to five years. Hospitals should carefully evaluate how their laboratories might be affected as a result of the decline in inpatient services and the integration of health care services at all levels. Hospital executive management must find a way to manage staffing levels and technical resources in order to maintain quality patient services in the face of declining test volume. This Special Report discusses relevant benchmarks intended to help hospital administrators and laboratory directors identify "best practices" in hospital laboratories so that comparisons of patterns of care and financial operations can be made. Benchmarking the relative financial and operational performance of hospital laboratories allows health care planners to design the most appropriate laboratory services delivery system for future hospital inpatient and outpatient market demands. Factors influencing financial and operation performance will be investigated, including utilization, testing costs, staffing mix, productivity, and organizational structure. This will be followed by a discussion on the future of laboratories and the trend toward regional laboratories owned by hospital consortiums.

  19. Hospital Contracts: Important Issues for Medical Groups.

    PubMed

    Rosolio, Charles E

    2016-01-01

    Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important.

  20. The changing power equation in hospitals.

    PubMed

    Rayburn, J M; Rayburn, L G

    1997-01-01

    This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur. PMID:10163913

  1. Image acquisition system for a hospital enterprise

    NASA Astrophysics Data System (ADS)

    Moore, Stephen M.; Beecher, David E.

    1998-07-01

    Hospital enterprises are being created through mergers and acquisitions of existing hospitals. One area of interest in the PACS literature has been the integration of information systems and imaging systems. Hospital enterprises with multiple information and imaging systems provide new challenges to the integration task. This paper describes the requirements at the BJC Health System and a testbed system that is designed to acquire images from a number of different modalities and hospitals. This testbed system is integrated with Project Spectrum at BJC which is designed to provide a centralized clinical repository and a single desktop application for physician review of the patient chart (text, lab values, images).

  2. [Hospital detention in tuberculosis control].

    PubMed

    Villalbí, Joan R; Rodríguez-Campos, Mònica; Orcau, Àngels; Espachs, M Àngels; Salamero, Marta; Maldonado, José; Caylà, Joan A

    2016-01-01

    This article describes the actions of public health services of the city of Barcelona to prevent tuberculosis transmission by noncompliant smear-positive patients by using the possibilities of Spanish Law 3/1986. The actions were based on a resolution of the health authorities on the need to locate such patients and to detain them in hospitals to provide treatment. This involved police cooperation, informing noncompliant patients, and requesting ratification from the Administrative Court. The article describes the process and the characteristics of the cases involved. Over nine years, from July 2006 to June 2015, the law was used in only twelve cases. The authors conclude that the criteria of prudence and proportionality were used in the application of the law, which resulted in the treatment of patients who posed a risk to their environment, reducing the transmission of infection. PMID:26832855

  3. [Hospital detention in tuberculosis control].

    PubMed

    Villalbí, Joan R; Rodríguez-Campos, Mònica; Orcau, Àngels; Espachs, M Àngels; Salamero, Marta; Maldonado, José; Caylà, Joan A

    2016-01-01

    This article describes the actions of public health services of the city of Barcelona to prevent tuberculosis transmission by noncompliant smear-positive patients by using the possibilities of Spanish Law 3/1986. The actions were based on a resolution of the health authorities on the need to locate such patients and to detain them in hospitals to provide treatment. This involved police cooperation, informing noncompliant patients, and requesting ratification from the Administrative Court. The article describes the process and the characteristics of the cases involved. Over nine years, from July 2006 to June 2015, the law was used in only twelve cases. The authors conclude that the criteria of prudence and proportionality were used in the application of the law, which resulted in the treatment of patients who posed a risk to their environment, reducing the transmission of infection.

  4. Depression among hospitalized and non-hospitalized gonadal cancer patients in tertiary care public hospitals in Karachi.

    PubMed

    Yousaf, Tahira; Zadeh, Zainab Fotowwat

    2015-03-01

    The study aimed at determining the differences in the levels of depression between hospitalized and non-hospitalized Gonadal cancer patients in tertiary care public hospitals in Karachi. The present study was conducted at the Jinnah Postgraduate Medical Centre and Civil Hospital, Karachi, from July to October 2009. One hundred adult patients diagnosed with Gonadal cancer volunteered for the study. Cases with any other co-morbidity were excluded. Urdu version of Siddiqui Shah Depression Scale (SSDS) was administered. Purposive and snowball sampling methods were used for data collection. The ages of participants in the sample ranged from 20 to 27 years with the mean age of 23.85 years. The participants belonged to the lower and middle classes. Out of the 30 hospitalized gonadal cancer patients 40% were moderately depressed and 60% were severely depressed, whereas out of 70 non-hospitalized gonadal cancer patients 74.3% were mildly depressed, 24.3% were moderately depressed and only 1.4% were severely depressed, which clearly indicated that the depression level of hospitalized gonadal cancer patients was high as compared to non-hospitalized gonadal cancer patients.

  5. Hospital prices and market structure in the hospital and insurance industries.

    PubMed

    Moriya, Asako S; Vogt, William B; Gaynor, Martin

    2010-10-01

    There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%.

  6. Sex Differences in Clinical Characteristics, Hospital Management Practices, and In-Hospital Outcomes in Patients Hospitalized in a Vietnamese Hospital with a First Acute Myocardial Infarction

    PubMed Central

    Nguyen, Hoa L.; Ha, Duc Anh; Phan, Dat Tuan; Nguyen, Quang Ngoc; Nguyen, Viet Lan; Nguyen, Nguyen Hanh; Nguyen, Ha; Goldberg, Robert J.

    2014-01-01

    Background Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI) at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. Methods The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. Results The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years) and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%). During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI) compared with men (57% vs. 74%), and women were more likely to have developed heart failure compared with men (19% vs. 10%). Women experienced higher in-hospital case-fatality rates (CFRs) than men (13% vs. 4%) and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89), and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09). Conclusions Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted. PMID:24752383

  7. Costs of surgical procedures in Indian hospitals

    PubMed Central

    Chatterjee, Susmita; Laxminarayan, Ramanan

    2013-01-01

    Objective Despite a growing volume of surgical procedures in low-income and middle-income countries, the costs of these procedures are not well understood. We estimated the costs of 12 surgical procedures commonly conducted in five different types of hospitals in India from the provider perspective, using a microcosting method. Design Cost and utilisation data were collected retrospectively from April 2010 to March 2011 to avoid seasonal variability. Setting For this study, we chose five hospitals of different types: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed district hospital, a 655-bed private teaching hospital and a 778-bed tertiary care teaching hospital based on their willingness to cooperate and data accessibility. The hospitals were from four states in India. The private, charitable and tertiary care hospitals serve urban populations, the district hospital serves a semiurban area and the private teaching hospital serves a rural population. Results Costs of conducting lower section caesarean section ranged from rupees 2469 to 41 087; hysterectomy rupees 4124 to 57 622 and appendectomy rupees 2421 to 3616 (US$1=rupees 52). We computed the costs of conducting lap and open cholecystectomy (rupees 27 732 and 44 142, respectively); hernia repair (rupees 13 204); external fixation (rupees 8406); intestinal obstruction (rupees 6406); amputation (rupees 5158); coronary artery bypass graft (rupees 177 141); craniotomy (rupees 75 982) and functional endoscopic sinus surgery (rupees 53 398). Conclusions Estimated costs are roughly comparable with rates of reimbursement provided by the Rashtriya Swasthya Bima Yojana (RSBY)—India's government-financed health insurance scheme that covers 32.4 million poor families. Results from this type of study can be used to set and revise the reimbursement rates. PMID:23794591

  8. The Hospital Information Planning Study at Groote Schuur Hospital, Cape Town.

    PubMed

    Davis, C K; Kane-Berman, J; van der Poel, K G

    1983-01-01

    Information is an increasingly important resource in an academic hospital. Effective planning and control of this resource are essential in order to maximize its usefulness. The Hospital Information Planning Study (HIPS) undertaken at Groote Schuur Hospital, and based on the Business Systems Planning (BSP) methodology, is outlined, as are the results of the study. The recommendations arising from the study, which are of considerable significance to the hospital, are mentioned briefly.

  9. Hospital board effectiveness: relationships between board training and hospital financial viability.

    PubMed

    Molinari, C; Morlock, L; Alexander, J; Lyles, C A

    1992-01-01

    This study examined whether hospital governing boards that invest in board education and training are more informed and effective decision-making bodies. Measures of hospital financial viability (i.e., selected financial ratios and outcomes) are used as indicators of hospital board effectiveness. Board participation in educational programs was significantly associated with improved profitability, liquidity, and occupancy levels, suggesting that investment in the education of directors is likely to enhance hospital viability and thus increase board effectiveness.

  10. Key operating and financial ratios for Alberta hospitals.

    PubMed

    Jacobs, P; Hall, E M

    1994-01-01

    Comparative financial and operating ratios in Canadian hospitals are examined to reveal sources of increased efficiency. The study involved 70 Alberta hospitals, which were divided into three groups: teaching hospitals, regional hospitals and smaller rural hospitals. Data were obtained from HS-1 and HS-2 reports. Hospitals across Canada can calculate their own ratios to give them a general idea of how they compare with the hospitals in this report.

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

    PubMed

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

    2004-01-01

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

  12. 77 FR 4908 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... INFORMATION: I. Background In FR Doc. 2011-19719 of August 18, 2011 (76 FR 51476), the final rule entitled... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates; Corrections AGENCY: Centers...

  13. 42 CFR 412.101 - Special treatment: Inpatient hospital payment adjustment for low-volume hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Inpatient hospital payment adjustment for low-volume hospitals. 412.101 Section 412.101 Public Health CENTERS FOR MEDICARE & MEDICAID... INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System...

  14. 77 FR 27869 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... Web page at: http://www.gpo.gov/fdsys/browse/collection.action?collectionCode=FR . Free public access... CFR Parts 412, 413, 424, et. al Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year...

  15. 77 FR 53257 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-31

    ... Printing Office Web page at: http://www.gpo.gov/fdsys/browse/collection.action?collectionCode=FR . Free... 42 CFR Parts 412, 413, 424, et al. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal...

  16. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Register citations affecting § 412.22, see the List of CFR Sections Affected, which appears in the Finding... 42 Public Health 2 2010-10-01 2010-10-01 false Excluded hospitals and hospital units: General... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL...

  17. Physician participation in hospital strategic decision making: the effect of hospital strategy and decision content.

    PubMed Central

    Ashmos, D P; McDaniel, R R

    1991-01-01

    An exploratory study examined variation in the participation of physicians in hospital strategic decision making as a function of (1) strategic decision content or (2) hospital strategy, or both. The findings revealed that who participates is a function of decision content while how physicians participate is a function of decision content and the interaction of decision content and hospital strategy. PMID:1869445

  18. 42 CFR 412.101 - Special treatment: Inpatient hospital payment adjustment for low-volume hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... adjustment for low-volume hospitals. 412.101 Section 412.101 Public Health CENTERS FOR MEDICARE & MEDICAID... Inpatient Operating Costs § 412.101 Special treatment: Inpatient hospital payment adjustment for low-volume... payment to a qualifying hospital for the higher incremental costs associated with a low volume...

  19. 42 CFR 412.101 - Special treatment: Inpatient hospital payment adjustment for low-volume hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... adjustment for low-volume hospitals. 412.101 Section 412.101 Public Health CENTERS FOR MEDICARE & MEDICAID... Inpatient Operating Costs § 412.101 Special treatment: Inpatient hospital payment adjustment for low-volume... payment to a qualifying hospital for the higher incremental costs associated with a low volume...

  20. 42 CFR 412.101 - Special treatment: Inpatient hospital payment adjustment for low-volume hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... adjustment for low-volume hospitals. 412.101 Section 412.101 Public Health CENTERS FOR MEDICARE & MEDICAID... Inpatient Operating Costs § 412.101 Special treatment: Inpatient hospital payment adjustment for low-volume... payment to a qualifying hospital for the higher incremental costs associated with a low volume...

  1. 42 CFR 412.101 - Special treatment: Inpatient hospital payment adjustment for low-volume hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... adjustment for low-volume hospitals. 412.101 Section 412.101 Public Health CENTERS FOR MEDICARE & MEDICAID... Inpatient Operating Costs § 412.101 Special treatment: Inpatient hospital payment adjustment for low-volume... payment to a qualifying hospital for the higher incremental costs associated with a low volume...

  2. Is leadership compatible with hospitals? Lessons from 10 years of teaching leadership to hospital managers.

    PubMed

    Georges, Patrick M; Samson, Julien

    2012-01-01

    Leadership methods can be understood and applied by hospital managers in the same way teachers and the seminar's participants respect certain conventions. Each method should be discussed and adapted, recognizing its limitations for use within hospitals. This article first presents what is taught in a traditional leadership course and then, discusses ways the course can be adapted for use by hospital managers. PMID:23342760

  3. Community-, Healthcare- and Hospital-Acquired Severe Sepsis Hospitalizations in the University HealthSystem Consortium

    PubMed Central

    Page, David B.; Donnelly, John P.; Wang, Henry E.

    2015-01-01

    Objectives Severe sepsis poses a major burden on the U.S. healthcare system. Previous epidemiologic studies have not differentiated community-acquired severe sepsis from healthcare-associated severe sepsis or hospital-acquired severe sepsis hospitalizations. We sought to compare and contrast community-acquired severe sepsis, healthcare-associated severe sepsis, and hospital-acquired severe sepsis hospitalizations in a national hospital sample. Setting United States Interventions None Measurements & Main Results Prevalence of community-acquired severe sepsis, healthcare-associated severe sepsis, and hospital-acquired severe sepsis, adjusted hospital mortality, length of hospitalization, length of stay in an ICU, and hospital costs. Among 3,355,753 hospital discharges, there were 307,491 with severe sepsis, including 193,081 (62.8%) community-acquired severe sepsis, 79,581 (25.9%) healthcare-associated severe sepsis, and 34,829 (11.3%) hospital-acquired severe sepsis. Hospital-acquired severe sepsis and healthcare-associated severe sepsis exhibited higher in-hospital mortality than community-acquired severe sepsis (hospital-acquired [19.2%] vs healthcare-associated [12.8%] vs community-acquired [8.6%]). Hospital-acquired severe sepsis had greater resource utilization than both healthcare-associated severe sepsis and community-acquired severe sepsis, with higher median length of hospital stay (hospital acquired [17 d] vs healthcare associated [7 d] vs community-acquired [6 d]), median length of ICU stay (hospital-acquired [8 d] vs healthcare-associated [3 d] vs community-acquired [3 d]), and median hospital costs (hospital-acquired [$38,369] vs healthcare-associated [$8,796] vs community-acquired [$7,024]). Conclusions In this series, severe sepsis hospitalizations included CA-SS (62.8%), HCA-SS (25.9%) and HA-SS (11.3%) cases. HA-SS was associated with both higher mortality and resource utilization than CA-SS and HCA-SS. PMID:26110490

  4. Hospital cost accounting: finding the software solution.

    PubMed

    Burik, D; Duvall, T J

    1985-04-01

    If hospital managers can clearly define the functions, features, and techniques required of a software package, carefully evaluate the capabilities of the various packages available, and use an organized approach for selecting a software package, they can more effectively choose cost accounting software that best fits the hospital's individual needs.

  5. Examining General Hospitals' Smoke-Free Policies

    ERIC Educational Resources Information Center

    Whitman, Marilyn V.; Harbison, Phillip Adam

    2010-01-01

    Purpose: This paper aims to examine the level of smoke-free policies in general hospitals and the barriers faced in implementing restrictive policies banning smoking inside buildings and on surrounding grounds. Design/methodology/approach; A survey was developed to gather data on hospitals' current smoke-free policies, including the challenges…

  6. Contribution of general practitioner hospitals in Scotland.

    PubMed

    Grant, J A

    1984-05-01

    The results of a survey of 64 Scottish general practitioner hospitals showed that in 1980 these hospitals contained 3.3% of available staffed beds in Scotland; 13.6% of the resident population had access for initial hospital care, and 14.5% of Scottish general practitioners were on their staffs. During the year of the survey they discharged 1.8% of all non-surgical patients, treated almost 100 000 patients for accidents and emergencies and 140 000 outpatients, and 4.4% of all deliveries in Scotland were carried out in the hospitals surveyed. Most communities which are served by general practitioner hospitals in Scotland are rural and on average are more than 30 miles from their nearest district general hospital. The contribution that these small hospitals make to the overall hospital workload has not previously been estimated. It has been shown nationally to be small but not inconsiderable . In terms of the contribution to the health care of the communities they serve it cannot and should not be underestimated.

  7. Hospitals as Centers for Consumer Health Information

    ERIC Educational Resources Information Center

    Topper, Judith M.

    1978-01-01

    Hospitals are trying to make health information available to lay persons to increase their knowledge of the processes of health and disease. Specific programs cited include those based in hospital libraries. Findings of several studies evaluating program effectiveness are indicated, as well as directions for future research. (MBR)

  8. Managing constipation in older people in hospital.

    PubMed

    Wessel-Cessieux, Elizabeth

    Constipation is a distressing disorder that is common among older patients in hospital. It is often underdiagnosed and undertreated, and can lead to increased morbidity and prolonged hospital stays. In most cases this common problem can be treated successfully if the correct management plan is adopted. This article reviews the prevention and management strategies available to address the issue.

  9. Neighborhood Transition and Mental Hospitalization Patterns.

    ERIC Educational Resources Information Center

    Muhlin, Gregory L.

    1979-01-01

    Assesses the relationship of change in neighborhood ethnic composition and 1970 psychiatric hospitalization rates for persons born in Ireland, Germany, Poland, Austria, Hungary, the U.S.S.R., and Italy. Concludes that such neighborhood change was unrelated to psychiatric hospitalization rates of the foreign born. Discusses policy implications and…

  10. The Canadian Hospital Executive Simulation System (CHESS).

    PubMed

    Pink, G H; Knotts, U A; Parrish, L G; Shields, C A

    1991-01-01

    The Canadian Hospital Executive Simulation System (CHESS) is a computer-based management decision-making game designed specifically for Canadian hospital managers. The paper begins with an introduction on the development of business and health services industry-specific simulation games. An overview of CHESS is provided, along with a description of its development and a discussion of its educational benefits. PMID:10109530

  11. Geothermal conversion at Veterans Hospital, Boise, Idaho

    NASA Astrophysics Data System (ADS)

    Engen, I. A.; Metzger, S. W.

    1982-02-01

    A geothermal resource near the Veterans Administration Hospital facilities in Boise, Idaho, has been used since the turn of the century for space heating of homes. A plan for using this resource in some of the Veterans Hospital facilities is discussed. Preliminary cost estimates are presented, economic evaluation criteria are given, and heating system alternatives for the facilities are compared.

  12. Anaesthesia at the District Hospital. Second Edition.

    ERIC Educational Resources Information Center

    Dobson, Michael B.

    This practical manual is designed to help medical officers in small hospitals provide safe and effective anesthesia for patients. Intended for doctors with at least one year of postgraduate clinical experience, it describes anesthetic techniques suitable for use in hospitals with limited resources. Chapter 2 describes fundamental principles and…

  13. Particulate air pollution and hospitalization for asthma

    SciTech Connect

    Tseng, R.Y.; Li, C.K.; Spinks, J.A. )

    1992-05-01

    Age-specific quarterly asthmatic hospital discharge rates in Hong Kong during 1983 to 1989 were examined in relation to mean levels of six pollutants: sulfur dioxide (SO2), ozone (O3), total suspended particles (TSP), respiratory suspended particles (RSP), nitrogen dioxide (NO2), and nitrogen oxides (NOX). Discharges from the hospital of children under 14 years of age represented 56% of 33,952 discharges recorded in all age groups. Trends of adult hospitalization rates over time remained stable during the study period. In children, however, there was an increase in these rates, particularly marked in the age group of 1 to 4 years. Univariate analysis revealed a strong correlation between quarterly mean TSP and hospital discharge rate for the 1 to 4-year-old children (r = .62, P less than .001). In the 5 to 14-year-old age group, there was an inverse relationship between hospital discharge rate and sulfur dioxide level (r = -.38, P less than .05). Stepwise multiple regression analysis, controlling for confounding variables (seasonal and annual trends of asthma hospitalizations) confirmed these relationships. A highly significant linear regression equation was derived between hospitalization rate for ages 1 to 4 years and total suspended particles (P less than .001). The highly significant correlation between pollution and asthmatic hospitalization rate for the 1 to 4-year-old group suggests that young children are vulnerable to the adverse environmental effects of pollution. Auditing these relationships offers a logical basis for approaching control.

  14. The Rehabilitation Hospital of the Pacific

    ERIC Educational Resources Information Center

    Yarbrough, Charles R.

    1976-01-01

    The Rehabilitation Hospital of the Pacific (REHAB) is a highly-specialized medical hospital dedicated to the rehabilitation of the handicapped. Its primary concern is with the care of neurological, orthopedic, or cardiovascular conditions which result in physical impairment. Discusses its personnel, goals, and services. (Author/RK)

  15. Strategic hospital marketing responses to prospective payment.

    PubMed

    Rosko, M D; Broyles, R W

    1987-01-01

    Hospitals may respond to the revenue constraints of prospective payment by altering their patient mix. This article provided a brief overview of marketing management and suggested that hospitals might change their patient mix by employing marketing strategies designed to attract patients to its services or to attract physicians who specialize in the appropriate medical disciplines.

  16. Environmental Risk Factors in Hospital Suicide

    ERIC Educational Resources Information Center

    Lieberman, Daniel Z.; Resnik, Harvey L.P.; Holder-Perkins, Vicenzio

    2004-01-01

    Suicide of hospitalized patients is the most common sentinel event reviewed by The Joint Commission on Accreditation of Healthcare Organizations. Shorter lengths of stay, sicker patients, and higher patient to staff ratios challenge the ability of the hospital to maintain safety. Risk factors associated with the physical environment of the…

  17. Psychiatric Hospitalization after Deliberate Self-Poisoning

    ERIC Educational Resources Information Center

    Carter, Gregory L.; Safranko, Ivan; Lewin, Terry J.; Whyte, Ian M.; Bryant, Jennifer L.

    2006-01-01

    The decision for psychiatric hospitalization after deliberate self-poisoning (DSP) is not well understood. This study, a longitudinal cohort study of 3,148 consecutive DSP patients found 920 (29.2%) subjects were referred for psychiatric hospitalization, 576 (18.3%) on involuntary basis. A logistic regression analysis showed increased risk for:…

  18. Conditions influencing the marketing efforts of hospitals.

    PubMed

    Myrtle, R C; Martinez, C F

    1990-01-01

    This research assesses the degree to which environmental change, competitive conditions and position, hospital characteristics, and organizational performance influence the extensiveness of a hospital's marketing activities. Changes in occupancy, revenue, and patient mix did not predict the level of marketing activities. Instead, the perceptions of marketing decision makers about changing environmental conditions were found to predict these activities.

  19. Promoting Regional Disaster Preparedness among Rural Hospitals

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  20. Introduction to Hospitality and Tourism. Teacher Edition.

    ERIC Educational Resources Information Center

    Walker, Susan S.

    This teacher's guide is the core publication of a series of instructional materials developed for the hospitality and tourism industry. It includes the entry-level competencies students will need to enter any of the occupational areas identified in the four cluster areas of the hospitality and tourism industry: lodging, food service, travel and…

  1. Youth Employment in the Hospitality Sector.

    ERIC Educational Resources Information Center

    Schiller, Bradley R.

    A study used data from the National Longitudinal Surveys of Youth to analyze the long-term effects of hospitality industry employment on youth. The subsample extracted for the study included all youth who were aged 16-24 in 1980 and employed in the civilian sector for pay at any time in the year. Statistics indicated the hospitality sector was…

  2. [Incorporation of the hospital into modern technology].

    PubMed

    Foucault, M

    1978-01-01

    This address traces the emergence of the hospital in the 18th century as a facility for combating disease and tending to the sick. Reference is made to the reports of Tenon and Howard on hospitals in several European countries, which instead of considering the hospital as a mere architectural object make recommendations based on the numbers of beds of an institution, its usable space, the dimensions of wards, mortaility rates, etc.; the result is a new functional concept of the medical and physical organization of the hospital. The author delves into the characteristics of the hospital and medical practice in the Middle Ages, the 17th and 18th centuries, and since the middle of the 18th. He brings out the direct relationship of hospital organization to the economic regulations that emerged with mercantilism. He stresses the importance of man for social and military development on the one hand, and, on the other hand, to the application of a technology that could be described as political: the discipline. He is of the view that the introduction of disciplinary mechanisms in the confused environment of the hospital permitted its "medicalization" and the development of the medical-therapeutic hospital.

  3. Day Hospitals' Cost and Effectiveness: A Summary.

    ERIC Educational Resources Information Center

    Eagle, D. Joan; And Others

    1987-01-01

    Review of literature concerning effectiveness and cost of geriatric day hospitals revealed many descriptive studies and four randomized control studies. Of four studies, one demonstrated credible improvement in physical and emotional function in day hospital versus conventional care control group. Three randomized studies in which costs were…

  4. Hospital closure: Phoenix, Hydra or Titanic?

    PubMed

    Dunne, T; Davis, S

    1996-01-01

    Very little has been published about the effects of hospital closure in terms of the service, financial or management issues of the process. Attempts through a case-study format to redress the balance and as such represents the reflections of practitioners who have recently undergone the experience of hospital closure and the often neglected issues arising both during and after the process.

  5. Future pension accounting changes: implications for hospitals.

    PubMed

    Weld, Tim; Klein, Gina

    2011-05-01

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

  6. Key financial ratios can foretell hospital closures.

    PubMed

    Lynn, M L; Wertheim, P

    1993-11-01

    An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent.

  7. Implementing Patient Safety Initiatives in Rural Hospitals

    ERIC Educational Resources Information Center

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  8. Future pension accounting changes: implications for hospitals.

    PubMed

    Weld, Tim; Klein, Gina

    2011-05-01

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

  9. Hospital pricing: cost shifting and competition.

    PubMed

    Morrisey, M A

    1993-05-01

    The issue of cost shifting has taken on enormous policy implications. It is estimated that unsponsored and undercompensated hospital costs--one measure of cost shifting--has totaled $21.5 billion in 1991. The health services research literature indicates that hospitals set different prices for different payers. However, the empirical evidence on hospitals' ability to raise prices to one payer to make up for unsponsored care or lower payments by other payers is mixed at best. No study has concluded that hospitals have raised prices to fully adjust for such actions. The extent of cost shifting is limited by the market. When a hospital has market power, it is able to set prices above marginal costs. However, when a buyer has enough patient/subscribers and a willingness to direct them to particular providers based on price considerations, hospitals have less flexibility in raising prices above costs. Thus, the extent of cost shifting is limited by the market. Cost shifting is not as easy as it may have been in the past because the nature of hospital and insurer competition has changed radically in the last decade. While hospital quality, services, and amenities still matter, some buyers are increasingly concerned about the price they pay. Evidence from studies of PPO and HMO negotiations with hospitals suggests that hospitals' market power is eroding, at least in some areas. In areas with relatively few hospital competitors and little PPO or HMO activity, Medicaid and Medicare price reductions and uncompensated care burdens will be partially absorbed by higher prices paid by private payers. In more price sensitive markets and in markets in which prices to private payers have risen to those commensurate with the market power of local hospitals, such cost shifting will not occur. A market-based approach in hospital pricing requires an explicit policy for the uninsured. In a competitive market, a hospital that traditionally cared for the uninsured by spending some of its

  10. The dangers of planned hospital births.

    PubMed

    Cohain, Judy Slome

    2010-01-01

    Hospital birth* has not undergone rigorous scientific scrutiny, yet is commonly believed to be safer than planned homebirth, even for low-risk women. A commonly promoted notion is that there are rare complications, which can arise at birth, making a hospital birth safer for low-risk women. There is no published research to support this notion. Where trained and equipped birth attendants are available, and hospital transfer is closer than 30-45 minutes, a planned, attended homebirth is safer for low-risk women than a planned hospital birth. Currently available published research suggests planning a hospital birth is not safer than planning an attended homebirth for women with one head-down fetus, between 37-42 weeks, no high blood pressure, no previous cesareans and no serious medical conditions that affect pregnancy outcome.

  11. Patient Engagement in Hospital Fall Prevention.

    PubMed

    Tzeng, Huey-Ming; Yin, Chang-Yi

    2015-01-01

    Injurious falls are the most prevalent in-hospital adverse event, and hospitalized patients are at a greater risk of falling than the general population. Patient engagement in hospital fall prevention could be a possible approach to reducing falls and fall-related injuries. To engage patients, bedside nursing staff must first understand the concept of patient centeredness and then incorporate patient centeredness in clinical practice. Clinicians should move from being experts to being enablers. To conceptualize the knowledge gaps identified, a conceptual model was developed to guide future research and quality improvement efforts in hospital settings. This model could be used as a guide to advance nursing leadership in hospital fall prevention via promoting patient engagement (e.g., developing patient-centered fall prevention interventions with patients' input).

  12. Socioeconomic Disparities and Influenza Hospitalizations, Tennessee, USA.

    PubMed

    Sloan, Chantel; Chandrasekhar, Rameela; Mitchel, Edward; Schaffner, William; Lindegren, Mary Lou

    2015-09-01

    We examined population-based surveillance data from the Tennessee Emerging Infections Program to determine whether neighborhood socioeconomic status was associated with influenza hospitalization rates. Hospitalization data collected during October 2007-April 2014 were geocoded (N = 1,743) and linked to neighborhood socioeconomic data. We calculated age-standardized annual incidence rates, relative index of inequality, and concentration curves for socioeconomic variables. Influenza hospitalizations increased with increased percentages of persons who lived in poverty, had female-headed households, lived in crowded households, and lived in population-dense areas. Influenza hospitalizations decreased with increased percentages of persons who were college educated, were employed, and had health insurance. Higher incidence of influenza hospitalization was also associated with lower neighborhood socioeconomic status when data were stratified by race. PMID:26292106

  13. Ancon Hospital: an American Hospital during the construction of the Panama Canal, 1904-1914.

    PubMed

    Chaves-Carballo, E

    1999-10-01

    The control of yellow fever, malaria, and other tropical diseases was essential for the successful completion of the Panama Canal. COL William C. Gorgas, Chief Sanitary Officer, found Ancon Hospital quite satisfactory as a site from which to direct his sanitation efforts. Ancon Hospital played an important role during the period of the excavation of the canal (1904-1914). In 1928, Ancon Hospital was renamed Gorgas Hospital to commemorate this achievement. After more than a century of clinical and research activities in Panama, Ancon Hospital closed its doors in 1997. PMID:10544628

  14. Blastocystis hominis in hospital employees.

    PubMed

    Grossman, I; Weiss, L M; Simon, D; Tanowitz, H B; Wittner, M

    1992-06-01

    Several reports have appeared that either support or deny the importance of the protozoan Blastocystis hominis as an intestinal pathogen in humans. In this report, we describe the clinical characteristics of B. hominis and its response to therapy in hospital employees found to have the parasite on routine screening of stools. During the study, 49 patients with B. hominis were identified, and 413 stools were examined from these patients. Twenty-nine patients were asymptomatic (59%), and 20 had symptoms of bloating, flatulence, soft/loose stools, or constipation. Of these 20 patients, 10 had symptoms that correlated with the presence or absence of B. hominis, four had symptoms that were independent of B. homonis, and six had other intestinal parasites that could account for their symptoms. Nineteen percent of patients without treatment had eradication of B. hominis from stool on follow-up examination. Metronidazole did not increase this rate. Iodoquinol treatment eradicated the organism in 41% of patients (p less than 0.05), and resulted in the reduction or eradication of the parasite in 62%, as determined by follow-up examination. PMID:1590309

  15. Use of Smartphones in Hospitals.

    PubMed

    Thomairy, Noora Al; Mummaneni, Mounica; Alsalamah, Sami; Moussa, Nicole; Coustasse, Alberto

    2015-01-01

    Mobile technology has begun to change the landscape of the medical profession, with more than two-thirds of physicians regularly using smartphones. Smartphones have allowed health care professionals and the general public to communicate more efficiently, collect data, and facilitate clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of smartphone use among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into 7 categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology, which were chosen based on the documented use of smartphone application in different health care practices. A last section of patient safety and issues with confidentiality is also described. This study suggests that smartphones have been playing an increasingly important role in health care. Medical professionals have become more dependent upon medical smartphone applications. However, concerns of patient safety and confidentiality will likely lead to increased oversight of mobile device use by regulatory agencies and accrediting bodies.

  16. [Understanding nursing care in hospitals].

    PubMed

    Seferdjeli, Laurence; Terraneo, Fabienne

    2015-03-01

    In a context in which sanitary institutions have transparency obligations toward authorities and patients, quality management and best practices--defined according to scientific standards--have become major concerns with respect to in-house management. While protocols and prescriptions are necessary for orienting work, they don't apply by themselves. Given that these various documents provide standardized and stabilized work descriptions, they contribute to hide what workers effectively do in unstable and variable situations in which numerous, sometimes contradictory, elements need to be simultaneously considered. In the present work, we follow this claim held by the French ergonomics stream and we consider the serious and irreducible gap between "prescribed work" and "real effective work". Such an understanding based on research evidence appears more adapted to professional realities and provides (valued) resources in nursing education. Based on information collected in three work analysis studies conducted by our team in hospital settings, we deepen these notions and their implication for practice and education. PMID:26510343

  17. [Visa at a tertiary hospital].

    PubMed

    Martínez-Jiménez, S; Lluch-Colomer, A; Desongles-Corrales, T; Bernal-González, D; Santos-Rubio, M D; Alfaro-Lara, E R; Galván-Banqueri, M

    2013-01-01

    Objetivo: Analizar el procedimiento de visado y su actividad en un hospital de tercer nivel. Material y métodos: Estudio descriptivo del procedimiento de visado durante el período abril 2011-abril 2012. Se diseñó una base de datos y se definieron categorías relativas a las variables de estudio: pacientes y recetas. Para los pacientes atendidos en la Unidad de Visado se registraron las incidencias detectadas en base a una clasificación previamente establecida. Resultados: Se incluyeron 6.738 pacientes (8.465 recetas visadas). Se visaron 170 medicamentos y productos de nutrición diferentes, siendo el mayoritario Tacrolimus. Se detectaron un total de 420 incidencias, siendo las más frecuentes la «Ausencia de documento clínico» (46,67 %) y los «Errores formales de cumplimentación» (28,57%). Conclusiones: El presente trabajo ha permitido un conocimiento más pormenorizado de la actividad, los tipos de incidencias y la identificación de áreas de mejora.

  18. Acoustic pollution in hospital environments

    NASA Astrophysics Data System (ADS)

    Olivera, J. M.; Rocha, L. A.; Rotger, V. I.; Herrera, M. C.

    2011-12-01

    There are many different services within a hospital. This means different types of noise which can be considered as acoustic pollution. Knowing that preterm infants exposed to high amounts of noise in the NICU are at a much higher risk because of their neurologic immaturity and physiologic instability, that excessive levels of noise also affect the persons and it can also impede some studies on patients, it was proposed to evaluate the Sound Pressure Level in some services of the Instituto de Maternidad, Tucumán, Argentina. There were evaluated the Level III NICU, the laundry service, a physical space destined for a service of evoked potential and a neonatal incubator under working conditions. The measurements were performed with a type II sonometer (CENTER 322) and it was also used an incubator analyzer (FLUKE INCU) for the incubator. The average values obtained were of 63.6 dBA for the NICU, 82.5dBA for the laundry room, 52.7 dBA for the evoked potential room and 62.8 dBA in the inside of the incubator under 64 dBA in the outside. The reports were documented in compliance with the appropriate standards.

  19. Advanced interpretation of ground motion using Persistent Scatterer Interferometry technique: the Alto Guadalentín Basin (Spain) case of study

    NASA Astrophysics Data System (ADS)

    Bonì, Roberta; Herrera, Gerardo; Meisina, Claudia; Notti, Davide; Zucca, Francesco; Bejar, Marta; González, Pablo; Palano, Mimmo; Tomás, Roberto; Fernandez, José; Fernández-Merodo, José; Mulas, Joaquín; Aragón, Ramón; Mora, Oscar

    2014-05-01

    Subsidence related to fluid withdrawal has occurred in numerous regions of the world. The phenomena is an important hazard closely related to the development of urban areas. The analysis of the deformations requires an extensive and continuous spatial and temporal monitoring to prevent the negative effects of such risks on structures and infrastructures. Deformation measurements are fundamental in order to identify the affected area extension, to evaluate the temporal evolution of deformation velocities and to identify the main control mechanisms. Differential SAR interferometry represents an advanced remote sensing tool, which can map displacements at very high spatial resolution. The Persistent Scatterer Interferometry (PSI) technique is a class of SAR interferometry that uses point-wise radar targets (PS) on the ground whose phase is not interested by temporal and geometrical decorrelation. This technique generates starting from a set of images two main products: the displacement rate along line of sight (LOS) of single PS; and the LOS displacement time series of individual PS. In this work SAR data with different spatio-temporal resolution were used to study the displacements that occur from 1992 to 2012 in the Alto Guadalentin Basin (southern Spain), where is located the city of Lorca The area is affected by the highest rate of subsidence measured in Europe (>10 cm/yr-1) related to long-term exploitation of the aquifer (González et al. 2011). The objectives of the work were 1) to analyse land subsidence evolution over a 20-year period with PSI technique; 2) to compare the spatial and temporal resolution of SAR data acquired by different sensors, 3) to investigate the causes that could explain this land motion. The SAR data have been obtained with ERS-1/2 & ENVISAT (1992-2007), ALOS PALSAR (2007-2010) and COSMO-SkyMed (2011-2012) images, processed with the Stable Point Network (SPN) technique. The PSI data obtained from different satellite from 1992 to 2012

  20. Magnetic fabric of Pleistocene continental clays from the hanging-wall of a low-angle normal fault (Alto Tiberina Fault, Italy)

    NASA Astrophysics Data System (ADS)

    Pucci, S.; Maffione, M.; Sagnotti, L.; Speranza, F.

    2010-12-01

    Anisotropy of magnetic susceptibility (AMS) represents a valuable strain proxy able to detect subtle strain effects in very weakly deformed sediments, since the AMS ellipsoid compares to the strain ellipsoid (Hrouda 1982; Borradaile 1988; Tarling & Hrouda 1993; Borradaile & Henry, 1997; Borradaile & Jackson, 2004). During the last decades a large number of AMS studies have documented that in compressive tectonic setting the maximum susceptibility axes (i.e. the magnetic lineations) are parallel to fold axes (and thrust faults) and local bedding strikes, while in extensional regimes (Sagnotti et al., 1994; Mattei et al., 1999; Cifelli et al., 2004) they are perpendicular to the normal faults and, thus, parallel to the strata dip directions. One of the most striking active structures of the northern Apennines is represented by the Alto Tiberina Fault (ATF), a NE-dipping low-angle normal fault bounding the High Tiber Valley. The ATF is largely documented to represent a primary detachment of the Plio-Quaternary extensional tectonics affecting the Apennine belt. The long-lasting activity of the ATF produced 5 km of total displacement and up to 1200-m-thick basin infill of syntectonic, sandy-clayey continental succession. Thus, the AMS analysis of the sediments lying above the ATF represents a unique opportunity to document the strain field affecting the hanging-wall of low-angle normal faults. We collected 133 oriented cores at 13 different localities within the High Tiber Valley, and the AMS was measured in the paleomagnetic laboratory at the INGV (Rome, Italy) with a spinner Multi-Function Kappabridge. The AMS ellipsoids and their parameters resulted well defined at 12 sites. Most of the sites show a predominantly sedimentary fabric, while prolate ellipsoids at two sites are suggestive of a pervasive tectonic deformation. The magnetic lineation is well-developed and has a prevailing NNE direction. At seven sites the magnetic lineations are sub-parallel to local bed

  1. 42 CFR 424.52 - Payment to a nonparticipating hospital.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to a nonparticipating hospital. 424.52... § 424.52 Payment to a nonparticipating hospital. Medicare pays a nonparticipating hospital for the... services furnished by a U.S. hospital, if the hospital has in effect an election to claim payment...

  2. 21 CFR 880.5140 - Pediatric hospital bed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5140 Pediatric hospital bed. (a) Identification. A pediatric hospital bed is a...

  3. 42 CFR 419.42 - Hospital election to reduce coinsurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital election to reduce coinsurance. 419.42... SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Payments to Hospitals § 419.42 Hospital election to reduce coinsurance. (a) A hospital may...

  4. 42 CFR 409.82 - Inpatient hospital deductible.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Inpatient hospital deductible. 409.82 Section 409... MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Deductibles and Coinsurance § 409.82 Inpatient hospital deductible. (a) General provisions—(1) The inpatient hospital deductible is a...

  5. 24 CFR 242.72 - Leasing of hospital.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Leasing of hospital. 242.72 Section... INSURANCE FOR HOSPITALS Miscellaneous Requirements § 242.72 Leasing of hospital. Leasing of a hospital in... facilities by state entities shall be considered on a case-by-case basis. Also, leasing of a hospital...

  6. 42 CFR 409.83 - Inpatient hospital coinsurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Inpatient hospital coinsurance. 409.83 Section 409... MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Hospital Insurance Deductibles and Coinsurance § 409.83 Inpatient hospital coinsurance. (a) General provisions—(1) Inpatient hospital coinsurance is the...

  7. Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital

    PubMed Central

    2010-01-01

    Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental) health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania). We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals. PMID:21067580

  8. Simulation shows hospitals that cooperate on infection control obtain better results than hospitals acting alone.

    PubMed

    Lee, Bruce Y; Bartsch, Sarah M; Wong, Kim F; Yilmaz, S Levent; Avery, Taliser R; Singh, Ashima; Song, Yeohan; Kim, Diane S; Brown, Shawn T; Potter, Margaret A; Platt, Richard; Huang, Susan S

    2012-10-01

    Efforts to control life-threatening infections, such as with methicillin-resistant Staphylococcus aureus (MRSA), can be complicated when patients are transferred from one hospital to another. Using a detailed computer simulation model of all hospitals in Orange County, California, we explored the effects when combinations of hospitals tested all patients at admission for MRSA and adopted procedures to limit transmission among patients who tested positive. Called "contact isolation," these procedures specify precautions for health care workers interacting with an infected patient, such as wearing gloves and gowns. Our simulation demonstrated that each hospital's decision to test for MRSA and implement contact isolation procedures could affect the MRSA prevalence in all other hospitals. Thus, our study makes the case that further cooperation among hospitals--which is already reflected in a few limited collaborative infection control efforts under way--could help individual hospitals achieve better infection control than they could achieve on their own.

  9. Hospital Value-Based Purchasing And 30-Day Readmissions: Are Hospitals Ready?

    PubMed

    Haley, D Rob; Zhao, Mei; Spaulding, Aaron

    2016-01-01

    To better understand the relationship between a hospital's Total Performance Score (TPS) and unplanned readmissions, a multivariate linear regression analysis was used to examine the relationship between hospital TPS and readmission rates for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PN). Hospital TPS was significantly and inversely related to AMI, HF, and PN readmission rates. The higher the hospital TPS, the lower the readmission rates for patients with AMI, HF, and PN. Hospitals with higher Medicare and Medicaid patients had higher readmission rates for all three conditions. The TPS methodology will likely evolve to include additional measures or dimensions to assess hospital quality and payment. Policymakers and hospital administrators should consider other structure elements and process measures to assess and improve patient safety and quality.

  10. Hospital Value-Based Purchasing And 30-Day Readmissions: Are Hospitals Ready?

    PubMed

    Haley, D Rob; Zhao, Mei; Spaulding, Aaron

    2016-01-01

    To better understand the relationship between a hospital's Total Performance Score (TPS) and unplanned readmissions, a multivariate linear regression analysis was used to examine the relationship between hospital TPS and readmission rates for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PN). Hospital TPS was significantly and inversely related to AMI, HF, and PN readmission rates. The higher the hospital TPS, the lower the readmission rates for patients with AMI, HF, and PN. Hospitals with higher Medicare and Medicaid patients had higher readmission rates for all three conditions. The TPS methodology will likely evolve to include additional measures or dimensions to assess hospital quality and payment. Policymakers and hospital administrators should consider other structure elements and process measures to assess and improve patient safety and quality. PMID:27439247

  11. Differences among hospitals in Medicare patient mortality.

    PubMed Central

    Chassin, M R; Park, R E; Lohr, K N; Keesey, J; Brook, R H

    1989-01-01

    Using hospital discharge abstract data for fiscal year 1984 for all acute care hospitals treating Medicare patients (age greater than or equal to 65), we measured four mortality rates: inpatient deaths, deaths within 30 days after discharge, and deaths within two fixed periods following admission (30 days, and the 95th percentile length of stay for each condition). The metric of interest was the probability that a hospital would have as many deaths as it did (taking age, race, and sex into account). Differences among hospitals in inpatient death rates were large and significant (p less than .05) for 22 of 48 specific conditions studied and for all conditions together; among these 22 "high-variation" conditions, medical conditions accounted for far more deaths than did surgical conditions. We compared pairs of conditions in terms of hospital rankings by probability of observed numbers of inpatient deaths; we found relatively low correlations (Spearman correlation coefficients of 0.3 or lower) for most comparisons except between a few surgical conditions. When we compared different pairs of the four death measures on their rankings of hospitals by probabilities of the observed numbers of deaths, the correlations were moderate to high (Spearman correlation coefficients of 0.54 to 0.99). Hospitals with low probabilities of the number of observed deaths were not distributed randomly geographically; a small number of states had significantly more than their share of these hospitals (p less than .01). Information from hospital discharge abstract data is insufficient to determine the extent to which differences in severity of illness or quality of care account for this marked variability, so data on hospital death rates cannot now be used to draw inferences about quality of care. The magnitude of variability in death rates and the geographic clustering of facilities with low probabilities, however, both argue for further study of hospital death rates. These data may prove

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

    PubMed Central

    Lakbala, Parvin

    2016-01-01

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

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

    PubMed Central

    Boscarino, J A; Steiber, S R

    1995-01-01

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

  14. The effects of hospital-physician integration strategies on hospital financial performance.

    PubMed Central

    Goes, J B; Zhan, C

    1995-01-01

    STUDY QUESTION. This study investigated the longitudinal relations between hospital financial performance outcomes and three hospital-physician integration strategies: physician involvement in hospital governance, hospital ownership by physicians, and the integration of hospital-physician financial relationships. DATA SOURCES AND STUDY SETTING. Using secondary data from the State of California, integration strategies in approximately 300 California short-term acute care hospitals were tracked over a ten-year period (1981-1990). STUDY DESIGN. The study used an archival design. Hospital performance was measured on three dimensions: operational profitability, occupancy, and costs. Thirteen control variables were used in the analyses: market competition, affluence, and rurality; hospital ownership; teaching costs and intensity; multihospital system membership; hospital size; outpatient service mix; patient volume case mix; Medicare and Medicaid intensity; and managed care intensity. DATA COLLECTION/EXTRACTION. Financial and utilization data were obtained from the State of California, which requires annual hospital reports. A series of longitudinal regressions tested the hypotheses. PRINCIPAL FINDINGS. Considerable variation was found in the popularity of the three strategies and their ability to predict hospital performance outcomes. Physician involvement in hospital governance increased modestly from 1981-1990, while ownership and financial integration declined significantly. Physician governance was associated with greater occupancy and higher operating margins, while financial integration was related to lower hospital operating costs. Direct physician ownership, particularly in small hospitals, was associated with lower operating margins and higher costs. Subsample analyses indicate that implementation of the Medicare prospective payment system in 1983 had a major impact on these relationships, especially on the benefits of financial integration. CONCLUSIONS. The

  15. Trends and initiatives in hospital ambulatory care.

    PubMed

    Burns, L A

    1982-05-01

    Changes in the financing and delivery of hospital ambulatory care are discussed. Ambulatory care encompasses a wide spectrum of clinical services provided to patients who are not confined overnight to an institutional bed as inpatients. There are a large and growing number of ways hospitals and physicians cooperate to provide ambulatory-care services. Technological advancements, which have spurred changes in other sectors of medicine, have also changed patterns of medical practice in ambulatory care. Some of the reasons why hospitals develop and expand ambulatory-care programs relate to the changing demand for health services, the shifting preferences of third-party payers and regulators, competitive influences, diversification of risk, and use of such programs as feeders for inpatient services and as teaching and research settings. Although outpatient revenues are a small portion of total hospital revenues, they are growing more rapidly than inpatient revenues. Changes in the health industry that offer opportunities to hospitals are described, such as the increasing physician supply and the formation of group practices, the climate of cost consciousness and price competition, and the trend toward new corporate structures for hospitals. These changes portend changes for hospital pharmacists and give them the opportunity to increase their clinical roles in providing ambulatory care. PMID:7081250

  16. Impact of PACS in hospital management

    NASA Astrophysics Data System (ADS)

    Hur, Gham; Cha, Soon-Joo; Kim, Yong H.; Hwang, Yoon J.; Kim, Soo Y.

    2002-05-01

    Since the low-cost, NT-based, full PACS was successfully implemented in a large-scale hospital at the end of 1999, many hospital administrators have rushed to purchase the system competitively. It is now a worldwide trend to implement the technology, but Korea has several unique environments for the fast spread of the full PACS. Since hospitals in Korea operate inpatient and outpatient clinics in the same building and use identical OCS, full integration of PACS with the OCS was relatively easy and highly efficient. The simple governing structures of the hospitals also made the decision-making process short and effective. In addition, the national health insurance reimbursement policy that started pay in the beginning of 2000 has also played a catalytic role for the swift propagation of PACS. The recent appearance of the affordable PACS gave hospital administrators the opportunity to learn and understand the role of digital imaging in the areas that are directly related to the efficiency and quality of medical services, as well as cost containment. Furthermore, PACS provided them with windows to the 'all-digital hospital,' which will lead them to realign policies in the management of the hospitals in order to compete successfully in the fast-changing world of health care.

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

    PubMed

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

    2005-07-01

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

  18. Tailoring hospital marketing efforts to physicians' needs.

    PubMed

    Mackay, J M; Lamb, C W

    1988-12-01

    Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.

  19. Management of medical waste in Tanzanian hospitals.

    PubMed

    Manyele, S V; Anicetus, H

    2006-09-01

    A survey was conducted to study the existing medical waste management (MWM) systems in Tanzanian hospitals during a nationwide health-care waste management-training programme conducted from 2003 to 2005. The aim of the programme was to enable health workers to establish MWM systems in their health facilities aimed at improving infection prevention and control and occupational health aspects. During the training sessions, a questionnaire was prepared and circulated to collect information on the MWM practices existing in hospitals in eight regions of the Tanzania. The analysis showed that increased population and poor MWM systems as well as expanded use of disposables were the main reasons for increased medical wastes in hospitals. The main disposal methods comprised of open pit burning (50%) and burying (30%) of the waste. A large proportion (71%) of the hospitals used dust bins for transporting waste from generation points to incinerator without plastic bags. Most hospitals had low incineration capacity, with few of them having fire brick incinerators. Most of the respondents preferred on-site versus off-site waste incineration. Some hospitals were using untrained casual labourers in medical waste management and general cleanliness. The knowledge level in MWM issues was low among the health workers. It is concluded that hospital waste management in Tanzania is poor. There is need for proper training and management regarding awareness and practices of medical waste management to cover all carders of health workers in the country.

  20. Disposable products in the hospital waste stream.

    PubMed Central

    Gilden, D. J.; Scissors, K. N.; Reuler, J. B.

    1992-01-01

    Use of disposable products in hospitals continues to increase despite limited landfill space and dwindling natural resources. We analyzed the use and disposal patterns of disposable hospital products to identify means of reducing noninfectious, nonhazardous hospital waste. In a 385-bed private teaching hospital, the 20 disposable products of which the greatest amounts (by weight) were purchased, were identified, and total hospital waste was tabulated. Samples of trash from three areas were sorted and weighed, and potential waste reductions from recycling and substituting reusable items were calculated. Business paper, trash liners, diapers, custom surgical packs, paper gowns, plastic suction bottles, and egg-crate pads were among the 20 top items and were analyzed individually. Data from sorted trash documented potential waste reductions through recycling and substitution of 78, 41, and 18 tonnes per year (1 tonne = 1,000 kg = 1.1 tons) from administration, the operating room, and adult wards, respectively (total hospital waste was 939 tonnes per year). We offer specific measures to substantially reduce nonhazardous hospital waste through substitution, minimization, and recycling of select disposable products. Images PMID:1595242

  1. [The hospital: reality and proposable future].

    PubMed

    Cardinale, A E; Torregrossa, M V

    2008-01-01

    In this work we run over hospital history from Middle ages to the present time. Hospitals were charitable institutions in fact they rise inside monasterys, churches or castles with an architecture in modum crucis as a symbolic expression of Christ crucifix. During Renaissance, new scientific Knowledges and the need of technical assistance in a suitable place, lead to a new kind of hospital included into the functional centres of the city were medical practice takes the places of spiritual assistance. In XVIII century hospital is like a "human diseases botanical garden" divided into departments with a circular structure in conformity with a functional model of control. To exceed the isolation of single room, rectangular rooms born with a radially arrangement. At the end of 700's born the pavilions structures typical of hospitals until half 900's when the "monobloc" take place. Today hospital becomes horizontal, include in the context of the city, with hall as a big hotel and with trading centres in accordance with Renzo Piano model and with a new vision of hospital as a welcome place were the patient is a guest to treat as a person of consequence. PMID:18590044

  2. Remote Antimicrobial Stewardship in Community Hospitals.

    PubMed

    Wood, Zachary H; Nicolsen, Nicole C; Allen, Nichole; Cook, Paul P

    2015-11-13

    Antimicrobial stewardship has become standard practice at university medical centers, but the practice is more difficult to implement in remote community hospitals that lack infectious diseases trained practitioners. Starting in 2011, six community hospitals within the Vidant Health system began an antimicrobial stewardship program utilizing pharmacists who reviewed charts remotely from Vidant Medical Center. Pharmacists made recommendations within the electronic medical record (EMR) to streamline, discontinue, or switch antimicrobial agents. Totals of charts reviewed, recommendations made, recommendations accepted, and categories of intervention were recorded. Linear regression was utilized to measure changes in antimicrobial use over time. For the four larger hospitals, recommendations for changes were made in an average of 45 charts per month per hospital and physician acceptance of the pharmacists' recommendations varied between 83% and 88%. There was no significant decrease in total antimicrobial use, but much of the use was outside of the stewardship program's review. Quinolone use decreased by more than 50% in two of the four larger hospitals. Remote antimicrobial stewardship utilizing an EMR is feasible in community hospitals and is generally received favorably by physicians. As more community hospitals adopt EMRs, there is an opportunity to expand antimicrobial stewardship beyond the academic medical center.

  3. Shift in power to hospital accountants.

    PubMed

    Rayburn, L G; Rayburn, J M

    1996-01-01

    With the introduction of the Prospective Payment System, hospital accountants' role changed from reimbursement maximizers to an important role in decision making. Faced with increased competition, many hospitals are installing financial controls. Many hospitals are engaging in promotion and health awareness campaigns and expanding their services to stabilize income and reduce the effects of a changing environment. Thus, hospitals operate in a more competitive environment with much uncertainty. When faced with uncertainty, organizations often believe that they must convince society that their existence is legitimate. Increasing specialization and organizational complexity in healthcare professions have made the expert important. Experts, such as the role assumed by hospital accountants, maintain power because the organization depends on them for their special skills and information. Scarce resources coupled with uncertainty move hospital accountants as experts into the power equation in the changing control of the U.S. healthcare system. Since accountants often serve as monitors of scarce resources, information about the resource allocation directly affects the distribution of power. This places hospital accountants in a critical role of assisting their institutions in adapting to a new environment.

  4. Near field receiving water monitoring of trace metals in clams (macoma balthica) and sediments near the Palo Alto Water Quality Control Plant in South San Francisco Bay, California: 2000

    USGS Publications Warehouse

    Moon, Edward; Luoma, Samuel N.; Cain, Daniel J.; Hornberger, Michelle I.; David, Carlos Primo C.

    2004-01-01

    Trace element concentrations were analyzed on samples of fine-grained sediments and clams (Macoma balthica) collected from a mudflat one kilometer south of the discharge of the Palo Alto Regional Water Quality Control Plant in South San Francisco Bay. This report serves as a continuation of the Near Field Receiving Water Monitoring Study, which was started in 1994. The data for 2003, herein, are interpreted within that context. Metal concentrations in both sediments and clam tissue samples have been within the range of values produced by seasonal variability; however, copper and zinc, display continued decreases over the last decade. In 2003, copper in sediment was observed to drop below the ERL (Effects Range-Low) concentration for the third consecutive year and zinc concentrations never exceeded the ERL. Yearly average concentrations of copper, zinc and silver in Macoma balthica for 2003 are some of the lowest recorded since monitoring began in 1975. Mercury and selenium concentrations in sediments and clams at Palo Alto were similar to concentrations observed elsewhere in the San Francisco Bay.

  5. Near field receiving water monitoring of trace metals in clams (Macoma balthica) and sediments near the Palo Alto water quality control plant in south San Francisco Bay, California : 2002

    USGS Publications Warehouse

    Moon, Edward; David, Carlos Primo C.; Luoma, Samuel N.; Cain, Daniel J.; Hornberger, Michelle I.; Lavigne, Irene R.

    2003-01-01

    This report presents trace element concentrations analyzed on samples of fine-grained sediments and clams (Macoma balthica) collected from a mudflat one kilometer south of the discharge of the Palo Alto Regional Water Quality Control Plant in South San Francisco Bay. This report serves as a continuation of the Near Field Receiving Water Monitoring Study, which was started in 1994. The data for 2002, herein, are interpreted within that context. Metal concentrations in both sediments and clam tissue samples have been within the range of values produced by seasonal variability. However, copper and zinc, display continued decreases. Copper in sediment was observed to drop below the ERL (Effects Range-Low) concentration for the third consecutive year and zinc concentrations never exceeded the ERL. Yearly average concentrations of copper, zinc and silver in Macoma balthica for 2002 are some of the lowest recorded since monitoring began in 1975. Mercury and selenium concentrations in sediments and clams at Palo Alto were similar concentrations observed elsewhere in the San Francisco Bay.

  6. Factors influencing warfarin response in hospitalized patients

    PubMed Central

    Abdel-Aziz, Mahmoud I.; Ali, Mostafa A. Sayed; Hassan, Ayman K.M.; Elfaham, Tahani H.

    2015-01-01

    The objective of this study was to investigate the influence of simultaneous factors that potentially keep patients far from achieving target INR range at discharge in hospitalized patients. Prospective cross-sectional observational study conducted at the Cardiology Department and Intensive Care Unit (ICU) of the Assiut University Hospitals. One-hundred and twenty patients were enrolled in the study from July 2013 to January 2014. Outcome measures were discharge INRs, bleeding and thromboembolic episodes. Bivariate analysis and multinomial logistic regression were conducted to determine independent risk factors that can keep patients outside target INR range. Patients who were newly initiated warfarin on hospital admission were given low initiation dose (2.8 mg ± 0.9). They were more likely to have INR values below 1.5 during hospital stay, 13 (27.7%) patients compared with 9 (12.3%) previously treated patients, respectively (p = .034). We found that the best predictors of achieving below target INR range relative to within target INR range were; shorter hospital stay periods (OR, 0.82 for every day increase [95% CI, 0.72–0.94]), being a male patient (OR, 2.86 [95% CI, 1.05–7.69]), concurrent infection (OR, 0.21 [95% CI, 0.07–0.59]) and new initiation of warfarin therapy on hospital admission (OR, 3.73 [95% CI, 1.28–10.9]). Gender, new initiation of warfarin therapy on hospital admission, shorter hospital stay periods and concurrent infection can have a significant effect on discharge INRs. Initiation of warfarin without giving loading doses increases the risk of having INRs below 1.5 during hospital stay and increases the likelihood of a patient to be discharged with INR below target range. Following warfarin dosing nomograms and careful monitoring of the effect of various factors on warfarin response should be greatly considered. PMID:26702259

  7. Hospital Quality, Efficiency, and Input Slack Differentials

    PubMed Central

    Valdmanis, Vivian G; Rosko, Michael D; Mutter, Ryan L

    2008-01-01

    Objective To use an advance in data envelopment analysis (DEA) called congestion analysis to assess the trade-offs between quality and efficiency in U.S. hospitals. Study Setting Urban U.S. hospitals in 34 states operating in 2004. Study Design and Data Collection Input and output data from 1,377 urban hospitals were taken from the American Hospital Association Annual Survey and the Medicare Cost Reports. Nurse-sensitive measures of quality came from the application of the Patient Safety Indicator (PSI) module of the Agency for Healthcare Research and Quality (AHRQ) Quality Indicator software to State Inpatient Databases (SID) provided by the Healthcare Cost and Utilization Project (HCUP). Data Analysis In the first step of the study, hospitals’ relative output-based efficiency was determined in order to obtain a measure of congestion (i.e., the productivity loss due to the occurrence of patient safety events). The outputs were adjusted to account for this productivity loss, and a second DEA was performed to obtain input slack values. Differences in slack values between unadjusted and adjusted outputs were used to measure either relative inefficiency or a need for quality improvement. Principal Findings Overall, the hospitals in our sample could increase the total amount of outputs produced by an average of 26 percent by eliminating inefficiency. About 3 percent of this inefficiency can be attributed to congestion. Analysis of subsamples showed that teaching hospitals experienced no congestion loss. We found that quality of care could be improved by increasing the number of labor inputs in low-quality hospitals, whereas high-quality hospitals tended to have slack on personnel. Conclusions Results suggest that reallocation of resources could increase the relative quality among hospitals in our sample. Further, higher quality in some dimensions of care need not be achieved as a result of higher costs or through reduced access to health care. PMID:18783457

  8. Hyperkalaemia in patients in hospital.

    PubMed

    Moore, M L; Bailey, R R

    1989-10-25

    A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.

  9. Understanding and implementing hospital information systems.

    PubMed

    1995-02-01

    One of a hospital's greatest resources is its information. The hospital's information system, whether computerized or manual, is the means by which data is collected, integrated, and retrieved. However, because optimal patient treatment, financial management, and hospital operation require that decisions be based on current, accurate, complete, and well-organized data, a computerized hospital information system (HIS), when correctly implemented, can be the most effective means of disseminating valuable information to decision makers. Although the systems currently in place in most hospitals are used primarily to manage finances, an integrated HIS is much more than a financial system; it can, in fact, coordinate all of a hospital's information needs. An integrated HIS develops over time, typically several years. Merely automating existing procedures may not provide many of the potential benefits of a new system and may even carry forward most of the drawbacks of the old system. Determining how information is currently processed in the hospital and putting together an effective team to carry out acquisition and implementation of an HIS must precede the purchase of computers, networks, and software applications. In Part 1 of this article, we describe hospitals' general information needs and provide an overview of the current state of HISs and what hospitals can expect to gain from implementing a new system; in Part 2, we describe the steps hospitals can take when putting the system in place. We caution readers that, although we will be discussing many benefits of successful HISs, little documented or quantified evidence exists to show that these benefits are being realized; most evidence is subjective and qualitative, and claims are not thoroughly substantiated. Few, if any, hospitals have achieved the completely integrated system model--or even come close. Nevertheless, this article provides the groundwork for hospitals to make a thoughtful beginning. In upcoming

  10. Hospital design to support greater operating efficiency.

    PubMed

    Skaggs, R L

    1984-12-01

    With the new imperative on cost containment and particular emphasis on prospective payment, hospital design must support greater productivity. It is incumbent on architects and engineers to reduce construction costs; but more importantly, to design facilities that improve personnel productivity. Several approaches to designing for efficiency are discussed including improving the development process; systems building, ease of maintenance, and conserving energy; developing the model hospital; minimizing travel throughout the hospital; centralization vs. decentralization; automating support systems; designing for growth and change; analyzing workflow; utilizing swing space; and emphasizing consumer centered care.

  11. Does hospital financial performance measure up?

    PubMed

    Cleverley, W O; Harvey, R K

    1992-05-01

    Comparisons are continuously being made between the financial performance, products and services, of the healthcare industry and those of non-healthcare industries. Several useful measures of financial performance--profitability, liquidity, financial risk, asset management and replacement, and debt capacity, are used by the authors to compare the financial performance of the hospital industry with that of the industrial, transportation and utility sectors. Hospitals exhibit weaknesses in several areas. Goals are suggested for each measure to bring hospitals closer to competitive levels. PMID:10145625

  12. Hospital response during the Red Dragon drill.

    PubMed

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

    2011-05-01

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

  13. The financial performance of diversified hospital subsidiaries.

    PubMed Central

    Clement, J P; D'Aunno, T; Poyzer, B L

    1993-01-01

    Despite its proliferation, we know relatively little about the impact of hospital restructuring to offer new services. This exploratory study examines the relationship between types of services offered and financial performance among separately incorporated subsidiaries of acute care hospitals. We draw data from the subsidiaries of all hospital firms operating in one state (Virginia) that requires reporting by all such firms. Results from multiple regression analyses of 1987 data indicate that units that existed longer, produced health care or related products, or were nonprofit subsidiaries of nonprofit firms tended to be more profitable than the other subsidiaries. PMID:8428811

  14. Hospital industry pushes back against the RACs.

    PubMed

    2013-01-01

    Groups ranging from the American Hospital Association to the U.S. Congress have taken up the issues posed by the Recovery Audit Contractors and other Medicare and Medicaid auditors. The high percentage of denials overturned upon appeal and large number of records requests are getting attention. Hospitals may get relief, but it's not likely to be immediate so they should continue preparing for the audits. Meanwhile, in addition to the Recovery Audit Contractors (RACs), hospitals are facing scrutiny from the Zoned Program Integrity Contractors (ZPICs), Medicare Prepayment Reviews, and Medicare Administrative Contractor (MAC) on-site audits. PMID:23339269

  15. [The national union for private hospital oncology].

    PubMed

    Parmentier, Gérard

    2013-06-01

    In the French health system, social security is the same for both public and private hospitals regardless of their status. In terms of number of patients screened, diagnosed, or treated, independant medicine is the most important sector in the French oncology. The multitude of organizations representing private hospitals or independant oncologists, physicians, radiologists or pathologists have a common organization, the National Union for Private Hospital Oncology (UNHPC). It bases its action on two founding postulates to ensure the quality of the oncology practice : the medical and managerial cultures are complementary and should be articulated ; the quality of organizations is as important as professional competence.

  16. Acute care hospitals' accountability to provincial funders.

    PubMed

    Kromm, Seija K; Ross Baker, G; Wodchis, Walter P; Deber, Raisa B

    2014-09-01

    Ontario's acute care hospitals are subject to a number of tools, including legislation and performance measurement for fiscal accountability and accountability for quality. Examination of accountability documents used in Ontario at the government, regional and acute care hospital levels reveals three trends: (a) the number of performance measures being used in the acute care hospital sector has increased significantly; (b) the focus of the health system has expanded from accountability for funding and service volumes to include accountability for quality and patient safety; and (c) the accountability requirements are misaligned at the different levels. These trends may affect the success of the accountability approach currently being used.

  17. Acute care hospitals' accountability to provincial funders.

    PubMed

    Kromm, Seija K; Ross Baker, G; Wodchis, Walter P; Deber, Raisa B

    2014-09-01

    Ontario's acute care hospitals are subject to a number of tools, including legislation and performance measurement for fiscal accountability and accountability for quality. Examination of accountability documents used in Ontario at the government, regional and acute care hospital levels reveals three trends: (a) the number of performance measures being used in the acute care hospital sector has increased significantly; (b) the focus of the health system has expanded from accountability for funding and service volumes to include accountability for quality and patient safety; and (c) the accountability requirements are misaligned at the different levels. These trends may affect the success of the accountability approach currently being used. PMID:25305386

  18. Tax-exempt challenges warrant hospitals' attention.

    PubMed

    Henry, W

    1991-01-01

    The tax-exempt status of not-for-profit healthcare organizations is being questioned and sometimes challenged on Federal, state, and local fronts. While the Internal Revenue Service (IRS) has created a special program for randomly auditing not-for-profit organizations, Congress is expected to consider legislation that would mandate the amount of charity care and community benefits a tax-exempt hospital must provide in relation to its tax-exemption value. Familiarity with IRS and Congressional activity, as well as with cases in which a hospital's tax-exempt status has been challenged in court, may provide guidelines for hospitals to assess their vulnerability.

  19. [Training concepts for in-hospital emergencies].

    PubMed

    Fritzsche, Katrin; Jantzen, Tanja; Rüsseler, Miriam; Müller, Michael P

    2013-06-01

    In this manuscript training concepts, which help us to manage in-hospital emergency situations adequately, are described. International courses such as the Basic Life Support Course and the Advanced Life Support Course of the ERC are introduced. Recently the European Trauma Course has been established; technical and non-technical skills, which are necessary to treat traumatised patients, are taught in this course. The quality of the medical emergency team in the hospital should be monitored to find deficits and to improve teaching. The use of the new in-hospital emergency chart and participation in the new emergency register of the DGAI may be helpful. PMID:23828084

  20. Internal fixation in a combat theater hospital.

    PubMed

    Large, Thomas M; Bonds, Cale; Howard, Michael

    2013-08-01

    Limited data are available on the use of internal fixation in combat zone hospitals. The authors performed a retrospective review of 713 surgical cases during 2 Operation Enduring Freedom deployments to a Level III theater hospital in 2007 and 2009 to 2010. The epidemiology and short- to intermediate-term outcomes of patients treated with internal fixation devices were studied. The authors found that, with judicious use, internal fixation under a damage control protocol in a combat theater hospital can be performed with acceptable complication rates. PMID:23937739

  1. Caveat emptor: joint ventures with specialty hospitals.

    PubMed

    Kahn, Charles N

    2006-06-01

    A specialty hospital joint venture between a health system and physician investors may implicate anti-kickback and tax laws when physicians self-refer patients to the hospital, raising the issue of conflict of interest. Physician self-referral can motivate behavior, such as cherry-picking patients and increased utilization, which in turn leads to windfall profits for physician owners and weakens classic community hospitals. Hopitals can best serve the interests of patients and improve performance by building enduring partnerships with physicians.

  2. The Burgholzli Hospital: Its history and legacy

    PubMed Central

    Kallivayalil, Roy Abraham

    2016-01-01

    The Burgholzli Hospital Zurich has a very important place in history, as part of of modern era in Psychiatry. Founded in 1870 by the efforts of Griesinger, it was here many eminent path breakers in Psychiatry like Bleuler, Jung, Adolf Meyer and others once worked. From here, Bleuler coined the term “Schizophrenia”. Now the University Hospital of Zurich, Burgholzli's transformation from a mental hospital to a centre of excellence speaks of a rich legacy. It is a model worth emulating in many parts of the world. PMID:27385861

  3. 12. 1960 highrise hospital, front (south) facade, view to northwest ...

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

    12. 1960 high-rise hospital, front (south) facade, view to northwest - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  4. Hospital to Home: Plan for a Smooth Transition

    MedlinePlus

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

  5. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  6. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  7. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  8. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  9. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  10. Hospital choice by rural medicare beneficiaries: does hospital ownership matter?--a Colorado case.

    PubMed

    Roh, Chul-Young; Lee, Keon-Hyung

    2006-01-01

    About 45 percent of rural patients in Colorado bypassed their local rural hospitals during the 1990s. The effect of this phenomenon is a reduction in occupancy rates and a decrease in the competitiveness of rural hospitals, thereby ultimately causing rural hospitals to close and adversely affecting the communities that they were designed to serve. This study tests whether hospital ownership affects hospital choice by patients after controlling for institutional and individual dimensions. A conditional logistic regression is used to analyze Colorado Inpatient Discharge Data (CIDD) on 85,529 patients in addition to hospital data. Rural Medicare beneficiaries are influenced to choose a particular hospital by a combination of hospital characteristics (the number of beds, the number of services, accreditation, ownership type, and distance from patient residence) and patient characteristics (medical condition, age, gender, race, and total charge for services). Increasing rural hospitals' survivability, collaborating with other rural hospitals, expanding the number of available services, making strategic alliance with other providers are possible strategies that may help ward off encroachment by urban competitors. PMID:16583743

  11. Nosocomial infection indicators in Australian hospitals: assessment according to hospital characteristics.

    PubMed

    Ansari, M Z; Collopy, B T

    1997-06-01

    The relationship of bed size and hospital type (private or public) was studied using Hospital-Wide Medical Indicator data on nosocomial infections submitted to the Australian Council on Healthcare Standards Care Evaluation Program by hospitals presenting voluntarily for accreditation in 1993. The aim was to determine if this process could simplify the establishment of hospital peer groups for comparison of risk in the absence of knowledge of patient illness severity indices. After adjusting for potential confounders in a logistic model, hospital type was found to be a significant predictor for the occurrence of infection in clean and contaminated wounds. Bed size was a significant predictor for the occurrence of hospital-acquired bacteraemia in private and public hospitals. The increase in the risk of developing hospital acquired bacteraemia with increasing number of beds was significant as a trend (P < 0.0001) in private as well as public hospitals. The results suggest that hospital type and bed size are initial indices for 'flagging' peer group variation and prompting a more detailed internal review.

  12. 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

  13. Demand uncertainty and hospital costs: an application to Portuguese public hospitals.

    PubMed

    Almeida, Alvaro Santos; Cima, Joana Ferreira

    2015-01-01

    In this paper, we evaluate the effect of demand uncertainty on hospital costs. Since hospital managers want to minimize the probability of not having enough capacity to satisfy demand, and since demand is uncertain, hospitals have to build excess capacity and incur the associated costs. Using panel data comprising information for 43 Portuguese public hospitals for the period 2007-2009, we estimate a translog cost function that relates total variable costs to the usual variables (outputs, the price of inputs, some of the hospitals' organizational characteristics) and an additional term measuring the excess capacity related to the uncertainty of demand. Demand uncertainty is measured as the difference between actual and projected demand for emergency services. Our results indicate that the cost function term associated with the uncertainty of demand is significant, which means that cost functions that do not include this type of term may be misspecified. For most of our sample, hospitals that face higher demand uncertainty have higher excess capacity and higher costs. Furthermore, we identify economies of scale in hospital costs, at least for smaller hospitals, suggesting that a policy of merging smaller hospitals would contribute to reducing hospital costs. PMID:24310509

  14. Hospital board and management practices are strongly related to hospital performance on clinical quality metrics.

    PubMed

    Tsai, Thomas C; Jha, Ashish K; Gawande, Atul A; Huckman, Robert S; Bloom, Nicholas; Sadun, Raffaella

    2015-08-01

    National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored in depth. We collected data from surveys of nationally representative groups of hospitals in the United States and England to examine the relationships among hospital boards, management practices of front-line managers, and the quality of care delivered. First, we found that hospitals with more effective management practices provided higher-quality care. Second, higher-rated hospital boards had superior performance by hospital management staff. Finally, we identified two signatures of high-performing hospital boards and management practice. Hospitals with boards that paid greater attention to clinical quality had management that better monitored quality performance. Similarly, we found that hospitals with boards that used clinical quality metrics more effectively had higher performance by hospital management staff on target setting and operations. These findings help increase understanding of the dynamics among boards, front-line management, and quality of care and could provide new targets for improving care delivery.

  15. Demand uncertainty and hospital costs: an application to Portuguese public hospitals.

    PubMed

    Almeida, Alvaro Santos; Cima, Joana Ferreira

    2015-01-01

    In this paper, we evaluate the effect of demand uncertainty on hospital costs. Since hospital managers want to minimize the probability of not having enough capacity to satisfy demand, and since demand is uncertain, hospitals have to build excess capacity and incur the associated costs. Using panel data comprising information for 43 Portuguese public hospitals for the period 2007-2009, we estimate a translog cost function that relates total variable costs to the usual variables (outputs, the price of inputs, some of the hospitals' organizational characteristics) and an additional term measuring the excess capacity related to the uncertainty of demand. Demand uncertainty is measured as the difference between actual and projected demand for emergency services. Our results indicate that the cost function term associated with the uncertainty of demand is significant, which means that cost functions that do not include this type of term may be misspecified. For most of our sample, hospitals that face higher demand uncertainty have higher excess capacity and higher costs. Furthermore, we identify economies of scale in hospital costs, at least for smaller hospitals, suggesting that a policy of merging smaller hospitals would contribute to reducing hospital costs.

  16. The concentration of hospital care for black veterans in Veterans Affairs hospitals: implications for clinical outcomes.

    PubMed

    Jha, Ashish K; Stone, Roslyn; Lave, Judith; Chen, Huanyu; Klusaritz, Heather; Volpp, Kevin

    2010-01-01

    Where minorities receive their care may contribute to disparities in care, yet, the racial concentration of care in the Veterans Health Administration is largely unknown. We sought to better understand which Veterans Affairs (VA) hospitals treat Black veterans and whether location of care impacted disparities. We assessed differences in mortality rates between Black and White veterans across 150 VA hospitals for any of six conditions (acute myocardial infarction, hip fracture, stroke, congestive heart failure, gastrointestinal hemorrhage, and pneumonia) between 1996 and 2002. Just 9 out of 150 VA hospitals (6% of all VA hospitals) cared for nearly 30% of Black veterans, and 42 hospitals (28% of all VA hospitals) cared for more than 75% of Black veterans. While our findings show that overall mortality rates were comparable between minority-serving and non-minority-serving hospitals for four conditions, mortality rates were higher in minority-serving hospitals for acute myocardial infarction (AMI) and pneumonia. The ratio of mortality rates for Blacks compared with Whites was comparable across all VA hospitals. In contrast to the private sector, there is little variation in the degree of racial disparities in 30-day mortality across VA hospitals, although higher mortality among patients with AMI and pneumonia requires further investigation.

  17. Hospital board and management practices are strongly related to hospital performance on clinical quality metrics.

    PubMed

    Tsai, Thomas C; Jha, Ashish K; Gawande, Atul A; Huckman, Robert S; Bloom, Nicholas; Sadun, Raffaella

    2015-08-01

    National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored in depth. We collected data from surveys of nationally representative groups of hospitals in the United States and England to examine the relationships among hospital boards, management practices of front-line managers, and the quality of care delivered. First, we found that hospitals with more effective management practices provided higher-quality care. Second, higher-rated hospital boards had superior performance by hospital management staff. Finally, we identified two signatures of high-performing hospital boards and management practice. Hospitals with boards that paid greater attention to clinical quality had management that better monitored quality performance. Similarly, we found that hospitals with boards that used clinical quality metrics more effectively had higher performance by hospital management staff on target setting and operations. These findings help increase understanding of the dynamics among boards, front-line management, and quality of care and could provide new targets for improving care delivery. PMID:26240243

  18. The concentration of hospital care for black veterans in Veterans Affairs hospitals: implications for clinical outcomes.

    PubMed

    Jha, Ashish K; Stone, Roslyn; Lave, Judith; Chen, Huanyu; Klusaritz, Heather; Volpp, Kevin

    2010-01-01

    Where minorities receive their care may contribute to disparities in care, yet, the racial concentration of care in the Veterans Health Administration is largely unknown. We sought to better understand which Veterans Affairs (VA) hospitals treat Black veterans and whether location of care impacted disparities. We assessed differences in mortality rates between Black and White veterans across 150 VA hospitals for any of six conditions (acute myocardial infarction, hip fracture, stroke, congestive heart failure, gastrointestinal hemorrhage, and pneumonia) between 1996 and 2002. Just 9 out of 150 VA hospitals (6% of all VA hospitals) cared for nearly 30% of Black veterans, and 42 hospitals (28% of all VA hospitals) cared for more than 75% of Black veterans. While our findings show that overall mortality rates were comparable between minority-serving and non-minority-serving hospitals for four conditions, mortality rates were higher in minority-serving hospitals for acute myocardial infarction (AMI) and pneumonia. The ratio of mortality rates for Blacks compared with Whites was comparable across all VA hospitals. In contrast to the private sector, there is little variation in the degree of racial disparities in 30-day mortality across VA hospitals, although higher mortality among patients with AMI and pneumonia requires further investigation. PMID:20946426

  19. The Relationship Between Hospital Value-Based Purchasing Program Scores and Hospital Bond Ratings.

    PubMed

    Rangnekar, Anooja; Johnson, Tricia; Garman, Andrew; O'Neil, Patricia

    2015-01-01

    Tax-exempt hospitals and health systems often borrow long-term debt to fund capital investments. Lenders use bond ratings as a standard metric to assess whether to lend funds to a hospital. Credit rating agencies have historically relied on financial performance measures and a hospital's ability to service debt obligations to determine bond ratings. With the growth in pay-for-performance-based reimbursement models, rating agencies are expanding their hospital bond rating criteria to include hospital utilization and value-based purchasing (VBP) measures. In this study, we evaluated the relationship between the Hospital VBP domains--Clinical Process of Care, Patient Experience of Care, Outcome, and Medicare Spending per Beneficiary (MSPB)--and hospital bond ratings. Given the historical focus on financial performance, we hypothesized that hospital bond ratings are not associated with any of the Hospital VBP domains. This was a retrospective, cross-sectional study of all hospitals that were rated by Moody's for fiscal year 2012 and participated in the Centers for Medicare & Medicaid Services' VBP program as of January 2014 (N = 285). Of the 285 hospitals in the study, 15% had been assigned a bond rating of Aa, and 46% had been assigned an A rating. Using a binary logistic regression model, we found an association between MSPB only and bond ratings, after controlling for other VBP and financial performance scores; however, MSPB did not improve the overall predictive accuracy of the model. Inclusion of VBP scores in the methodology used to determine hospital bond ratings is likely to affect hospital bond ratings in the near term. PMID:26554267

  20. Why most private hospitals are nonprofit.

    PubMed

    Bays, C W

    1983-01-01

    In recent decades, restrictions that have been imposed on hospitals organized for profit have served to restructure the industry, generating a constant trend toward nonprofit organizations. Small proprietary hospitals in particular have disappeared while corporate chains have come to dominate what is left of the for-profit hospital sector. The trend toward nonprofit hospitals is not explained by the failure of the health service markets and is not the result of a desire to serve the public interest more effectively. Although a number of arguments have been advanced to explain the shift, the hypothesis that seems most consistent with the existing evidence is that the nonprofit form of organization serves most effectively to strengthen the restrictive character of the market for physicians' services and thereby to serve the individual economic interests of the physicians. PMID:10261067