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Sample records for facultad al hospital

  1. Bacterial Contamination in Intensive Care Unit at Al-Imam Al-Hussein Hospital in Thi-qar Province in Iraq

    PubMed Central

    Nasser, Nazar Edward; Abbas, Ali Taher; Hamed, Saad L.

    2013-01-01

    Cross- infection from patient to patient or from hospital personnel to patients represents constant hazards. It is one of the most important causes of morbidity and mortality especially in Intensive Care Unit all over the world. To identify the types and the source of bacterial contamination in ICU and to study the sensitivity of bacterial isolates to commonly used antibiotics in hospitals this study had been conducted in Al-Imam Al-Hussein hospital in Thi-qar province for the period from the 1st of September to the end of December 2011. A total of 320 swabs and samples were collected from 17 different sites of Intensive Care Unit environment and inoculated on a normal cultural media, then incubated at 37°C for 24 hour. The obtained growth revealed different bacterial colonies which had been tested for their morphological and biochemical characteristics. Sixty eight of pure isolates were obtained including 24 (35.29%) Gram positive bacterial isolates, and 44(64.71%) of Gram negative bacterial isolates, the highest rates (19.11%) of bacterial contamination had been found on the walls and the floor. Sensitivity tests for all isolates were done using 25 types of commonly used antibiotics in Iraq, among Gram negative bacteria and gram positive bacteria the genus Enterobacter spp and Staphylococcus spp respectively, showed the highest resistance to most of the tested antibiotics, MIC tests for 5 types of antibiotics being applied for the most resistant and the most sensitive isolates had identified that all isolates have a low rate of MIC against Ciprofloxacine. Bacillus spp and Enterobacter spp were the most prevalent bacterial contaminants of Intensive Care Unit environment. such contamination could be managed mostly by strict application of sterilization measures. PMID:23283046

  2. Discrepancies between dental and medical records of cardiac patients in AlHada Armed Forces Hospital, Taif, Saudi Arabia

    PubMed Central

    Al Hibshi, Sana M.; Al-Raddadi, Rajaa M.; Assery, Mansour K.

    2016-01-01

    Aims and Objectives: This study aims to estimate the prevalence of medical information discrepancies between dental and medical records of cardiac patients at AlHada Armed Forces Hospital in Taif and to identify the factors contributing to these information discrepancies. Materials and Methods: The study applied a descriptive retrospective medical and dental records review of a stratified proportional sample of 289 cardiac patients, which was extracted from 1154 cardiac patients who visited both the cardiology and dental clinics at the AlHada Armed Forces Hospital between 2007 and June 2012. Data were analyzed using the Statistical Package for the Social Sciences version 19. Results: The main results of this study are the following: The mean and standard deviation of patient's age was 56 ± 16.9, female patients represented 47.8% of the study population. A total of 78.5% of dental records were documented by dental residents whereas 48.4% of the dentists had more than 6 years of experience. Two hundred and seventy-nine (96.5%) of the 289 dental records had medical information discrepancies compared to the corresponding medical records. One hundred percent of systemic lupus erythematosus and rheumatic fever cases were not documented in the dental records followed by 93% of medications, 92% of stroke, and 88.5% of hyperlipidemia, whereas the least prevalent were cardiac disease (26%) and diabetes mellitus (22.2%). Conclusion: Approximately 75% of the patients who directly or indirectly accessed the dental services showed discrepancies. The researcher concludes that critical information gaps exist between dental and medical records that mostly attributed to system level problems. A well-established model for efficient communication among medical and dental care providers caring for cardiac patients does not appear to exist. The absence of such a model can threaten the overall health of patients. PMID:28032050

  3. Frequency of anti-Chlamydia trachomatis antibodies in infertile women referred to Tabriz Al-Zahra hospital

    PubMed Central

    Sattari, Mahtab; Ghiami Rad, Mehdi; Ghasemzadeh, Aaliye; Mohammadoghli Reihan, Zahra

    2017-01-01

    Background: Infertility is one of the major issues in society and its incidence is estimated to be almost 10-15%. Chlamydia trachomatis (C. trachomatis) is an important cause of sexually transmitted diseases leading to infertility. Objective: This study was designed to determine the frequency of anti-C. trachomatis antibodies in infertile women at Al-zahra hospital, Tabriz, Iran. Materials and Methods: In this cross-sectional study, the blood samples were collected randomly from 184 infertile women (case group) and 100 pregnant women (control group). The frequency of specific IgG and IgM anti-C. trachomatis antibodies were evaluated using ELISA method. Results: The frequency of IgG anti-C. trachomatis antibody in the control and case groups was 18% and 35.88%, respectively. IgM anti-C. trachomatis antibody was found in 2% of controls and 5.44% of infertile women. Our results showed the significant differences between the case and control groups in anti-C. trachomatis antibodies (IgG, p=0.035 and IgM, p=0.004). Also, no significant relation was seen between the frequency of anti-C. trachomatis antibodies and age, location, and tubal factor infertility in our two study groups. Conclusion: According to high frequency of antibody anti-C. trachomatis among infertile women in competition to the control group, evaluation and treatment of Chlamydia infections is necessary in these patients. PMID:28280796

  4. Comparison of sexual dysfunction in women with infertility and without infertility referred to Al-Zahra Hospital in 2013-2014

    PubMed Central

    Mirblouk, Fariba; Asgharnia, Dr.Maryam; Solimani, Robabeh; Fakor, Fereshteh; Salamat, Fatemeh; Mansoori, Samaneh

    2016-01-01

    Background: One of the affected aspects in infertile women that have not been given sufficient attention is sexual function. Sexual function is a key factor in physical and marital health, and sexual dysfunction could significantly lower the quality of life. Aim of this study was to assess the comparison sexual dysfunction in women with infertility and without infertility, admitted to Al- Zahra Hospital. Objective: We decided to assess the prevalence of women sexual disorders in fertile and infertile subjects, admitted to Al-Zahra Hospital. Materials and Methods: 149 fertile and 147 infertile women who referred to infertility clinic of Al-Zahra Hospital during 2013-2014 were entered this cross-sectional study and Female Sexual Function Index questionnaire (FSFI) had been filled by all the cases. Most of women were married for 6-10 years (35.5%) and mean marriage time in participants was 9.55±6.07 years. Data were analyzed using SPSS software Ver. 18 and 2 test and logistic regression model has been used for analysis. Results: Results showed significant differences between desire (p=0.004), arousal (p=0.001), satisfaction (p=0.022) and total sexual dysfunction (p=0.011) in both groups but in lubrication (p=0.266), orgasm (p=0.61) and pain (p=0.793) difference were not significant. Conclusion: Some of sexual dysfunction indices are high in all infertile women. Our findings suggest that infertility impacts on women’s sexual function in desire, arousal, satisfaction and total sexual dysfunction. Health care professional should be sensitive to impact that diagnosis of infertility can have on women’s sexuality. PMID:27200426

  5. HISTORICAL SERIES OF PATIENTS WITH VISCERAL LEISHMANIASIS TREATED WITH MEGLUMINE ANTIMONIATE IN A HOSPITAL FOR TROPICAL DISEASES, MACEIÓ-AL, BRAZIL

    PubMed Central

    Silveira, Lindon Johoson Diniz; Rocha, Thiago José Matos; Ribeiro, Sandra Aparecida; Pedrosa, Célia Maria Silva

    2015-01-01

    Introduction: Visceral leishmaniasis is an endemic protozoan found in Brazil. It is characterized by fever, pallor, hepatosplenomegaly, lymphadenopathy, and progressive weakness in the patient. It may lead to death if untreated. The drug of choice for treatment is meglumine antimoniate (Glucantime®). The aim of this study was to evaluate patients with visceral leishmaniasis according to criteria used for diagnosis, possible reactions to Glucantime® and blood pressure measured before and after treatment. Methods: 89 patients admitted to the Teaching Hospital Dr. Hélvio Auto (HEHA) in Maceió-AL, in the period from May 2006 to December 2009 were evaluated. Data were collected on age, sex, origin, method of diagnosis, adverse effects of drugs, duration of hospitalization, duration of treatment and dosage up to the onset of adverse effects. Results: There was a predominance of child male patients, aged between one and five years old, from the interior of the State of Alagoas. Parasitological diagnosis was made by bone marrow aspirate; three (3.37%) patients died, 12 (13.48%) had adverse reactions and treatment was changed to amphotericin B, and 74 (83.14%) were cured. Changes that led to replacing Glucantime® were persistent fever, jaundice, rash, bleeding and cyanosis. Conclusion: During the study, 89 patients hospitalized for VL were analyzed: 74 were healed, 12 were replaced by amphotericin B treatment and three died. Most of them were under five years old, male and came from the interior. The dosage and duration of treatment with Glucantime® were consistent with that advocated by the Ministry of Health. Persistence of fever, jaundice, rash, cyanosis and bleeding were the reactions that led the physician to modify treatment. No change was observed in blood pressure before and after treatment. This study demonstrated the work of a hospital, a reference in the treatment of leishmaniasis, which has many patients demanding its services in this area. It demonstrates

  6. Drug Dependence and Psychotic Symptoms: A Retrospective Study of Adolescents Who Abuse Drugs at Al-Amal Hospital in Jeddah, Saudi Arabia

    PubMed Central

    Elawad, Nagi; Misau, Yusuf A.; Shaikh, Tarteel M.; Allam, Nedal

    2012-01-01

    Drug abuse is reported to be on the increase among young persons using illicit substances but little is known about the frequency with which they occur, the symptoms on presentation to health institutions, and the different substances abused. To establish this, we reviewed patient data collected at Al-Amal Hospital in Jeddah Kingdom of Saudi Arabia on young persons who are refered to the hospital for problems related to drug abuse. Data on 69 adolescent drug users were reviewed and analyzed using the Composite International Diagnostic Interview - Substance Abuse Model (CIDI-SAM) to assess dependence on substances including amphetamines, cannabis, cocaine, and opioids. Furthermore, we assessed the adolescents’ data on history of delusions and hallucinations in the context of use of, or withdrawal from, these specific substances. Our analysis shows that 10 to 79.6% of users of amphetamines, cannabis, cocaine, and opiates met DSM-III-R dependence criteria for each specific substance. The prevalence of psychotic symptoms associated with each specific substance ranged from users with no diagnosis to users with severe dependence as follows: amphetamines (3-100%), cannabis (7-60.0%), cocaine (5-70.7%), and opiates (4-88%). The risk of psychotic symptoms increased for respondents who abused (OR=7.2) or had mild (OR=8.1), moderate (OR=20.0), or severe dependence (OR=14.0) on cocaine when compared to those who were users with no diagnosis. A similar pattern was evident in cannabis, opiate, and amphetamine users. In conclusion, most adolescent drug users in Saudi Arabia who are dependent on illicit substances experience psychotic symptoms in the context of use of, or withdrawal from, these substances. Psychotic symptoms increased with the severity of the disorders associated with use of all four substances. These findings underscore the importance of developing services to target this population; a population at risk of developing psychotic symptoms. PMID:28299079

  7. Epidemiology of Suicide and its Associated Socio-demographic Factors in Patients Admitted to Emergency Department of Zahedan Khatam-Al-Anbia Hospital

    PubMed Central

    Behmanehsh Poor, Fatemeh; Tabatabaei, Seyed Mehdi; Bakhshani, Nour-Mohammad

    2014-01-01

    Background: Suicide is a growing public health problem all over the world. Understanding the prevalence of suicide and its correlates is of great importance in planning programs to reduce the risk in different societies. Objectives: The present study was conducted to assess the epidemiology of suicide and its associated risk factors in Sistan and Balouchestan Province, southeast of Iran. Patients and Methods: We investigated a total of 369 suicide cases admitted to the emergency department of Zahedan Khatam- Al- Anbia hospital between March 2010 and February 2012. Data was collected from the hospital information system (HIS) using a semi-structured questionnaire. Descriptive statistics and chi-square tests were used to identify the factors associated with suicidal behaviors. Results: A greater proportion of the study subjects (65%) were female. They were more likely to be young (43.5% in the age group of 16 to 25 years) and illiterate or have a primary school education (20.9% and 48.8%, respectively). Housewives and self-employed individuals and those with a low or medium income dominated the suicide cases. The most common method of suicide was burning (53.4%) followed by drug ingestion (23.8%). One third of the suicide cases occurred during spring. The case fatality rate was 49.6% and it was significantly associated with low income, summer time suicides, burning as a method of suicide. Conclusions: This study highlights the burden of suicide and itspotential socio-demographic risk factors in Sistan and Blouchestan Province. This information has an implication for planning the preventive measures, policy making and future research. PMID:25741486

  8. Conceptuaciones de los estudiantes de las facultades de educacion y ciencias naturales de la Universidad de Puerto Rico, recinto de Rio Piedras, acerca de la ciencia y la pseudociencia

    NASA Astrophysics Data System (ADS)

    Reyes Medina, Hector A.

    Esta investigacion describe las conceptuaciones de los estudiantes de tercer ano o mas a nivel de bachillerato de los programas de Educacion en Ciencia y Ciencias Naturales de la Universidad de Puerto Rico, Recinto de Rio Piedras, acerca de lo establecido en la literatura para distinguir el conocimiento cientifico de las creencias pseudocientificas. Este estudio se guio por un diseno tipo encuesta transversal que permitio conocer de manera consistente las conceptuaciones de los estudiantes encuestados acerca de la Ciencia y la Pseudociencia. Ademas, permitio desarrollar inferencias estadisticas relacionadas a la poblacion de estudio, sus conceptuaciones y su inclinacion teorica en torno al Realismo y al Racionalismo cientifico moderados. El instrumento utilizado fue el Cuestionario acerca de las concepciones de la ciencia y la pseudocienca en estudiantes universitarios, Reyes (2015). Este cuestionario fue validado mediante la recopilacion de diversas fuentes de evidencias, entre estas se encuentran las evidencias basadas en el contenido, el proceso de respuesta, la estructura interna y de constructo. Tambien, se calculo el Alfa de Crombach para la escala total y para cada componente y se realizo un analisis de factores que demostro la presencia de seis componentes claramente definidos de acuerdo a lo esperado sobre las caracteristicas originales del instrumento. Las estadisticas utilizadas fueron descriptivas. Participaron 302 alumnos, de las facultades de educacion y ciencias naturales. Se encontro que las conceptuaciones de los estudiantes de ambas facultades se inclinan en un 66.2% a favor con lo establecido en el modelo teorico en torno al Realismo y al Racionalismo cientifico moderados. Sin embargo, aun hay un 33.8% de los estudiantes de ambas facultades que poseen conceptuaciones distintas al modelo teorico propuesto.

  9. Clinical evaluation of BIOXTRA in relieving signs and symptoms of dry mouth after head and neck radiotherapy of cancer patients at Seyed-al-Shohada Hospital, Isfahan, Iran

    PubMed Central

    Gookizadeh, Abbas; Emami, Hamid; Najafizadeh, Nadia; Roayaei, Mahnaz

    2012-01-01

    Background: Radiotherapy of head and neck cancers causes acute and chronic xerostomia and acute mucositis. Xerostomia increases risk of radiation caries and affects on oral comfort, fit of prostheses, speech, swallowing, and the growth of caries-producing organisms. Salivary flow rate can be measured by asking patients some questions. There are different types of commercial synthetic saliva such as BIOXTRA, but until now, no one can effectively relieve xerostomia. We tried to design a clinical research on BIOXTRA efficacy for treating xerostomia. Materials and Methods: In this research, 58 patients with head and neck cancer (except salivary gland cancers) treated in Seyed-al-Shohada Hospital. The patients received at least 40-50 GY; and after 2 months of compilation treatment, they were evaluated by asking about having xerostomia. Before and after treatment with the BIOXTRA, the PH of the oral cavity, candida albicans, and lactobacillus counts measured and documented in laboratory. We used BIOXTRA for 2 weeks, 3 times daily, and then re-evaluated patients with some questions. Results: The counts of candida albicans and lactobacilli statistically significant decreased. Conclusion: Xerostomia for most patients improved clinically during the day and night while PH of the oral cavity increased. PMID:23326802

  10. The Relationship between Self-esteem and Quality of Life of Patients with Idiopathic Thrombocytopenic Purpura at Isfahan's Sayed Al-Shohada Hospital, Iran, in 2013

    PubMed Central

    Hemati, Zeinab; Kiani, Davood

    2016-01-01

    Background: Idiopathic thrombocytopenic purpura (ITP) is a chronic disease which is accompanied with hopelessness and loss of the sense of well-being due to its symptoms and treatment. It also affects patients' sense of social and spiritual well-being. This disorder decreases patients' self-esteem and their quality of life by changing their mental image and self-confidence. This study was performed to find the relationship between self-esteem and quality of life of patients with ITP. Subjects and Methods: This was a descriptive-analytical study on 64 patients with ITP who referred to Isfahan's Sayed Al-Shohada Hospital, Iran. In this study, patients with ITP were selected randomly using a random number chart. The data collection tools consisted of the World Health Organization Quality of Life (WHOQOL)-BREF and Coopersmith Self-esteem Inventory (CSEI). Data were analyzed using SPSS and chi-square and Mann-Whitney tests and the Pearson and Spearman’s rank correlation coefficients. Results: In total, 64 patients completed the questionnaires. Results showed that 32% of subjects were over 36 years of age and 59% were women. In addition, 29.7% of ITP patients had low self-esteem and quality of life. Chi-square test showed a significant relationship between self-esteem and quality of life of patients with ITP. Conclusions: The results of the present study showed that considerable attention must be paid to self-esteem, as one of the most important factors influencing the promotion of quality of life. Therefore, it is suggested that patient’s self-esteem be improved by the implementation of educational and psychological programs in order to decrease the consequences of poor quality of life. PMID:27252807

  11. Polyclonal Outbreak of KPC-3-Producing Enterobacter cloacae at a Single Hospital in Montréal, Québec, Canada

    PubMed Central

    Lévesque, Simon; Lefebvre, Brigitte; Blanchette, Ruth; Tomkinson, Melissa; Mataseje, Laura; Mulvey, Michael R.; Miller, Mark A.

    2013-01-01

    From September 2010 to December 2011, 26 KPC-3-producing Enterobacter cloacae isolates were identified from 16 patients at a single hospital. Analyses revealed the blaKPC gene to be localized on multiple plasmids in a diverse nonclonal E. cloacae genetic background. These findings highlight the potential complexity of a KPC outbreak at a single hospital. PMID:23637289

  12. Norovirus - hospital

    MedlinePlus

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

  13. Understanding hospitality.

    PubMed

    Patten, C S

    1994-03-01

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

  14. Diagnosing ALS

    MedlinePlus

    ... that a person diagnosed with ALS seek a second opinion from an ALS "expert" - someone who diagnoses and treats many ALS patients and has training in this medical specialty. The ALS Association maintains a list of recognized experts in the field of ALS. See ALS Association Certified Centers of ...

  15. Validating the use of Hospital Episode Statistics data and comparison of costing methodologies for economic evaluation: an end-of-life case study from the Cluster randomised triAl of PSA testing for Prostate cancer (CAP)

    PubMed Central

    Thorn, Joanna C; Turner, Emma L; Hounsome, Luke; Walsh, Eleanor; Down, Liz; Verne, Julia; Donovan, Jenny L; Neal, David E; Hamdy, Freddie C; Martin, Richard M; Noble, Sian M

    2016-01-01

    Objectives To evaluate the accuracy of routine data for costing inpatient resource use in a large clinical trial and to investigate costing methodologies. Design Final-year inpatient cost profiles were derived using (1) data extracted from medical records mapped to the National Health Service (NHS) reference costs via service codes and (2) Hospital Episode Statistics (HES) data using NHS reference costs. Trust finance departments were consulted to obtain costs for comparison purposes. Setting 7 UK secondary care centres. Population A subsample of 292 men identified as having died at least a year after being diagnosed with prostate cancer in Cluster randomised triAl of PSA testing for Prostate cancer (CAP), a long-running trial to evaluate the effectiveness and cost-effectiveness of prostate-specific antigen (PSA) testing. Results Both inpatient cost profiles showed a rise in costs in the months leading up to death, and were broadly similar. The difference in mean inpatient costs was £899, with HES data yielding ∼8% lower costs than medical record data (differences compatible with chance, p=0.3). Events were missing from both data sets. 11 men (3.8%) had events identified in HES that were all missing from medical record review, while 7 men (2.4%) had events identified in medical record review that were all missing from HES. The response from finance departments to requests for cost data was poor: only 3 of 7 departments returned adequate data sets within 6 months. Conclusions Using HES routine data coupled with NHS reference costs resulted in mean annual inpatient costs that were very similar to those derived via medical record review; therefore, routinely available data can be used as the primary method of costing resource use in large clinical trials. Neither HES nor medical record review represent gold standards of data collection. Requesting cost data from finance departments is impractical for large clinical trials. Trial registration number ISRCTN92187251

  16. ALS Association

    MedlinePlus

    ... toward a world without ALS! Walk to Defeat ALS® Walk to Defeat ALS® draws people of all ... We need your help. I Will Advocate National ALS Registry The National ALS Registry is a congressionally ...

  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.

  18. 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.

  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. Hospital finance.

    PubMed

    Herman, M J

    1998-01-01

    This article summarizes key areas of focus for the analysis of risk in the hospital segment of the health care industry. The article is written from a commercial bank lending perspective. Both for-profit (C-corporations) and 501 (c)(3) not-for-profit segments are addressed.

  1. 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…

  2. ALS - resources

    MedlinePlus

    Resources - ALS ... The following organizations are good resources for information on amyotrophic lateral sclerosis : Muscular Dystrophy Association -- www.mda.org/disease/amyotrophic-lateral-sclerosis National Amyotrophic Lateral Sclerosis (ALS) ...

  3. Can hospitals compete on quality? Hospital competition.

    PubMed

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

  4. 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.

  5. Changing hospital payments: implications for teaching hospitals.

    PubMed

    Bentley, J D

    1983-09-01

    Hospitals cannot continue to view themselves only as social institutions whose performance will be assessed on the good they do. Teaching hospitals, in particular, cannot view themselves simply as distinctive combinations of social and educational institutions. Under Medicare's prospective pricing system, the hospital's role as production system is enhanced, and all hospitals must learn to balance the new economic realities as they work with their medical staff to adapt to a changed future.

  6. Going to the Hospital

    MedlinePlus

    ... Happens in the Operating Room? Going to the Hospital KidsHealth > For Kids > Going to the Hospital Print ... you flowers, balloons, or other treats! previous continue Hospital People You'll meet lots of people in ...

  7. Critical Access Hospitals (CAH)

    MedlinePlus

    ... use requirements for Critical Access Hospitals related to Electronic Health Records (EHRs)? Critical Access Hospital (CAH) are eligible for Electronic Health Record (EHR) incentive payments and can receive ...

  8. Specialty hospitals: can general hospitals compete?

    PubMed

    Dummit, Laura A

    2005-07-13

    The rapid increase in specialty cardiac, surgical, and orthopedic hospitals has captured the attention of general hospitals and policymakers. Although the number of specialty hospitals remains small in absolute terms, their entry into certain health care markets has fueled arguments about the rules of "fair" competition among health care providers. To allow the smoke to clear, Congress effectively stalled the growth in new specialty hospitals by temporarily prohibiting physicians from referring Medicare or Medicaid patients to specialty hospitals in which they had an ownership interest. During this 18-month moratorium, which expired June 8, 2005, two mandated studies of specialty hospitals provided information to help assess their potential effect on health care delivery. This issue brief discusses the research on specialty hospitals, including their payments under Medicare's hospital inpatient payment system, the quality and cost of care they deliver, their effect on general hospitals and on overall health care delivery, and the regulatory and legal environment in which they have proliferated. It concludes with open issues concerning physician self-referral and the role of general hospitals in providing a range of health care services.

  9. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  10. Hospital marketing revisited.

    PubMed

    Costello, M M

    1987-05-01

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

  11. AL Amyloidosis

    PubMed Central

    2012-01-01

    Definition of the disease AL amyloidosis results from extra-cellular deposition of fibril-forming monoclonal immunoglobulin (Ig) light chains (LC) (most commonly of lambda isotype) usually secreted by a small plasma cell clone. Most patients have evidence of isolated monoclonal gammopathy or smoldering myeloma, and the occurrence of AL amyloidosis in patients with symptomatic multiple myeloma or other B-cell lymphoproliferative disorders is unusual. The key event in the development of AL amyloidosis is the change in the secondary or tertiary structure of an abnormal monoclonal LC, which results in instable conformation. This conformational change is responsible for abnormal folding of the LC, rich in β leaves, which assemble into monomers that stack together to form amyloid fibrils. Epidemiology AL amyloidosis is the most common type of systemic amyloidois in developed countries with an estimated incidence of 9 cases/million inhabitant/year. The average age of diagnosed patients is 65 years and less than 10% of patients are under 50. Clinical description The clinical presentation is protean, because of the wide number of tissues or organs that may be affected. The most common presenting symptoms are asthenia and dyspnoea, which are poorly specific and may account for delayed diagnosis. Renal manifestations are the most frequent, affecting two thirds of patients at presentation. They are characterized by heavy proteinuria, with nephrotic syndrome and impaired renal function in half of the patients. Heart involvement, which is present at diagnosis in more than 50% of patients, leading to restrictive cardiopathy, is the most serious complication and engages prognosis. Diagnostic methods The diagnosis relies on pathological examination of an involved site showing Congo red-positive amyloid deposits, with typical apple-green birefringence under polarized light, that stain positive with an anti-LC antibody by immunohistochemistry and/or immunofluorescence. Due to the

  12. Competition among hospitals.

    PubMed

    Noether, M

    1988-09-01

    The traditional view of hospital competition has posited that hospitals compete primarily along 'quality' dimensions, in the form of fancy equipment to attract admitting physicians and pleasant surroundings to entice patients. Price competition among hospitals is thought to be non-existent. This paper estimates the effects of various hospital market characteristics on hospital prices and expenses in an attempt to determine the form of hospital competition. The results suggest that both price and quality competition are greater in markets that are less concentrated, although the net effect of the two on prices is insignificant. It appears, therefore, that, despite important distortions, hospital markets are not immune to standard competitive forces.

  13. Guide to Choosing a Hospital

    MedlinePlus

    ... your condition? Should you consider a specialty hospital, teaching hospital (usually part of a university), community hospital, ... been approved by Medicare. Hospitals may choose either method of evaluation. You can check with a hospital ...

  14. 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.

  15. Help prevent hospital errors

    MedlinePlus

    ... www.ncbi.nlm.nih.gov/pubmed/23330698 . The Joint Commission. Hospital: 2014 National Patient Safety Goals. www.jointcommission. ... October 24, 2014. Accessed October 27, 2016. The Joint Commission. Hospital: 2016 National Patient Safety Goals. Updated January ...

  16. 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 ...

  17. 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)

  18. Hospital Dermatology, Introduction.

    PubMed

    Fox, Lindy P

    2017-03-01

    Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success.

  19. Positioning hospitals: a model for regional hospitals.

    PubMed

    Reddy, A C; Campbell, D P

    1993-01-01

    In an age of marketing warfare in the health care industry, hospitals need creative strategies to compete successfully. Lately, positioning concepts have been added to the health care marketer's arsenal of strategies. To blend theory with practice, the authors review basic positioning theory and present a framework for developing positioning strategies. They also evaluate the marketing strategies of a regional hospital to provide a case example.

  20. Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay

    PubMed Central

    Bentancor, Ana; Hernández, Ana Laura; Godoy, Yamile; Dapueto, Juan J

    2016-01-01

    ABSTRACT OBJECTIVE To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. METHODS In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: structure, process, and results. RESULTS Between December 2012 and November 2013, a total of 6,676 voluntary interruptions of pregnancy were reported in Uruguay; out of these, 80 were conducted at the Hospital de Clínicas. The patients’ demographic data agreed with those reported at the national level: Of the total patients, 81.0% were aged over 19 years; 6.2% decided to continue with the pregnancy; and only 70.0% attended the subsequent control and received advice on contraception. CONCLUSIONS In its implementation year in Uruguay, we can assess the experience as positive from the point of view of women’s health. Our experience as a mental health team at the Hospital de Clínicas, inserted into the multidisciplinary voluntary interruption of pregnancy team, is in the process of assessment and reformulation of practices. PMID:27384969

  1. 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

  2. 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 ...

  3. Measuring hospital competition.

    PubMed

    White, S L; Chirikos, T N

    1988-03-01

    This paper appraises the use of the Herfindahl market share index as an exogenous competition variable in empirical studies of the hospital sector. An analysis of cross-sectional Florida data shows that this index itself is significantly influenced by the demand and supply factors commonly included in econometric models of hospital performance. The analysis then illustrates that biased inferences about the effects of market competition on the costs of hospital care may result unless the values of the Herfindahl Index are treated endogenously in hospital cost models.

  4. Teaching of Astronomy at Teresa Martin College. (Breton Title: Ensino de Astronomia Nas Faculdades Teresa Martin.) Enseñanza de la Astronomia en la Facultad Teresa Martin

    NASA Astrophysics Data System (ADS)

    Azevedo Sobreira, Paulo Henrique

    2005-12-01

    Courses with exclusive Astronomy contents did not exist at (FATEMA) Teresa Martin College's program until the end of 2002. In 2001, a series of educational experiments started in courses and classes of Astronomy at Mathematics and Geography departments. This actions culminated with the insertion of Teaching of Astronomy as a study theme in the course of Independent Studies for Mathematics professors in 2005. Até o final de 2002 inexistiam na grade curricular das Faculdades Integradas Teresa Martin (FATEMA) cadeiras com conteúdos exclusivos de Astronomia. A partir do ano de 2001 iniciou-se uma série de experiências educacionais através de modelos de cursos e de aulas de Astronomia nos Departamentos de Matemática e de Geografia, o que culminou com a inserção do Ensino de Astronomia como temática da disciplina de Estudos Independentes para o curso de Licenciatura em Matemática, em 2005. Hasta el final de 2002 no había en el currículo dela Facultad TeresaMartín (FATEMA) en San Pablo - SP, Brasil, disciplinas con contenidos exclusivos de Astronomía. A partir del año 2001 comenzó una secuencia de experimentos educacionales de carrera y de clases de Astronomía en los Departamentos de Matemática y Geografía, culminando en la implantación de clases de Enseñanza dela Astronomíaenla Licenciaturaen Matemática, en el año de 2003, y de la cátedra de extensión en Cosmografía parala Licenciaturaen Geografía.

  5. 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…

  6. Hospitality, Tourism, and Recreation.

    ERIC Educational Resources Information Center

    Novachek, James

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

  7. 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…

  8. 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…

  9. 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…

  10. Virtual Pediatric Hospital

    MedlinePlus

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  11. 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.

  12. Leading a hospital closure.

    PubMed

    Lucey, Paula A

    2002-01-01

    Hospital closures have become more common. The challenges facing a nursing leader in this situation are complex and difficult. This author suggests that looking for new beginnings rather than focusing on endings created an approach to closing a public hospital. The article includes approaches to employee morale, staffing, and patient care.

  13. Competition among hospitals.

    PubMed

    Gaynor, Martin; Vogt, William B

    2003-01-01

    We examine competition in the hospital industry, in particular the effect of ownership type (for-profit, not-for-profit, government). We estimate a structural model of demand and pricing in the hospital industry in California, then use the estimates to simulate the effect of a merger. California hospitals in 1995 face an average price elasticity of demand of -4.85. Not-for-profit hospitals face less elastic demand and act as if they have lower marginal costs. Their prices are lower than those of for-profits, but markups are higher. We simulate the effects of the 1997 merger of two hospital chains. In San Luis Obispo County, where the merger creates a near monopoly, prices rise by up to 53%, and the predicted price increase would not be substantially smaller were the chains not-for-profit.

  14. What Is ALS?

    MedlinePlus

    ... Javits, actor David Niven, “Sesame Street” creator Jon Stone, boxing champion Ezzard Charles, NBA Hall of Fame ... Help for People with ALS and Caregivers Read stories from families living with ALS Forms of ALS ...

  15. Development and Implementation of a Comprehensive Risk Management Program at the USAF Academy Hospital.

    DTIC Science & Technology

    1980-04-01

    31, 1979. USAFA Hospital Regulation 161-7, Hospital Employee Health Program, Jul 14, 1978. USAFA Hospital Regulation 168-1, Patient Questionaires , Oct...Al87 344 DEVELOPMENT AND IMPLEMENTATION OF A COMPREHENSIVE RISK 1 MANAGEMENT PROGRAM AT THE USAF ACADEMY HOSPITAL(U) ARMY HEALTH CARE STUDIES AND...Baylor University In Partial Fulfillment of the Requirements for the Degree of Master of Health Administration By Captain Charles W. Boone, USAF, MSC

  16. 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

  17. Disrupting Emerging Networks: Analyzing and Evaluating Jamaat al-Muslimeen (JAM) and the Development of an Extremist Threat in the Caribbean

    DTIC Science & Technology

    2012-06-01

    Jamaat al-Muslimeen JFK John F. Kennedy NNV New National Vision Labor Party PKK Kurdistan Workers Party PNM People’s National Movement PPM...known as the New National Vision (NNV) Labor Party states its common goal to establish “a free, fair and secure society where Trinbagonians can thrive...Política y Relaciones Internacionales, Facultad de Derecho , Universidad Autónoma de Madrid, 2005, 9. 94 UTv, “Results Summary,” 2011, http://www.u.tv

  18. Hospital service recovery.

    PubMed

    Gutbezahl, Cary; Haan, Perry

    2006-01-01

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

  19. Predicting hospital accounting costs

    PubMed Central

    Newhouse, Joseph P.; Cretin, Shan; Witsberger, Christina J.

    1989-01-01

    Two alternative methods to Medicare Cost Reports that provide information about hospital costs more promptly but less accurately are investigated. Both employ utilization data from current-year bills. The first attaches costs to utilization data using cost-charge ratios from the previous year's cost report; the second uses charges from current year's bills. The first method is the more accurate of the two, but even using it, only 40 percent of hospitals had predicted costs within plus or minus 5 percent of actual costs. The feasibility and cost of obtaining cost reports from a small, fast-track sample of hospitals should be investigated. PMID:10313352

  20. Abu al-Layth al-Libi

    DTIC Science & Technology

    2015-02-01

    Introduction In the tradition of post-9/11 senior Arab militant figures operating in Khurasan (the Afghanistan-Pakistan region), there is little doubt as to...the standing of Libyan jihadi commander Abu al-Layth al-Libi. If Usama bin Ladin and Ayman al-Zawahiri came to be the most prominent Arab -Afghan...Libi, a longtime leader of the Libyan Islamic Fighting Group (LIFG), who rapidly established himself as the champion of the Arab -Afghan milieu after

  1. Hospital-acquired thrombocytopenia.

    PubMed

    McMahon, Christine M; Cuker, Adam

    2014-10-01

    The development of thrombocytopenia is common in hospitalized patients and is associated with increased mortality. Frequent and important causes of thrombocytopenia in hospitalized patients include etiologies related to the underlying illness for which the patient is admitted, such as infection and disseminated intravascular coagulation, and iatrogenic etiologies such as drug-induced immune thrombocytopenia, heparin-induced thrombocytopenia, posttransfusion purpura, hemodilution, major surgery, and extracorporeal circuitry. This review presents a brief discussion of the pathophysiology, distinguishing clinical features, and management of these etiologies, and provides a diagnostic approach to hospital-acquired thrombocytopenia that considers the timing and severity of the platelet count fall, the presence of hemorrhage or thrombosis, the clinical context, and the peripheral blood smear. This approach may offer guidance to clinicians in distinguishing among the various causes of hospital-acquired thrombocytopenia and providing management appropriate to the etiology.

  2. Surgery, Hospitals, and Medications

    MedlinePlus

    ... products that are not commonly stocked in hospital pharmacies. Examples include: Salagen ® , Evoxac ® , and Restasis ® Eye drops, ... prescription and OTC medications/products in their labeled pharmacy container or packaging. This is important in case ...

  3. 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

  4. 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

  5. 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.

  6. American Hospital Association

    MedlinePlus

    ... Hospitals & Health Networks H & HN Daily Trustee Research & Trends AHA Policy Research Health Research & Educational Trust AHA ... Associations unless otherwise indicated. AHA does not claim ownership of any content, including content incorporated by permission ...

  7. Hospital Ship Replacement

    DTIC Science & Technology

    2011-08-01

    designed to operate primarily when anchored to reduce the effects of roll. Quantum markets two separate zero speed active roll fin models for small ...ships. Feasibility of scaling fins to the size of the hospital ship requires validation. 3.12 Lifeboats and Liferafts The safety appliances designated ...for Innovation in Ship Design Technical Report Hospital Ship Replacement By Hannah Allison, Christopher Mehrvarzi, Rebecca Piks, Beau Lovdahl

  8. Fast tracking hospital construction.

    PubMed

    Quirk, Andrew

    2013-03-01

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

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

    PubMed

    Hard, R

    1992-05-20

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

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

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

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

  11. The impact of hospital discharge on inappropriate hospital stay.

    PubMed

    Panis, Lambert J G G; Verheggen, Frank W S M; Pop, Peter; Prins, Martin H

    2004-01-01

    Appropriate hospital stay should be effective, efficient and tailored to patient needs. Previous studies have found that on average 20 per cent of hospital stay is inappropriate. Within obstetrics, inappropriate hospital stay consists mostly of delays in hospital discharge. The specific goals of this study were to reduce inappropriate hospital stay by fine-tuning patient logistics, increasing efficiency and providing more comfortable surroundings. New policies using strict discharge criteria were implemented. Total inappropriate hospital stay decreased from 13.3 to 7.2 per cent. The delay in discharge procedures halved. P-charts showed a decrease in inappropriate hospital stay, indicating the current process to be stable. Concludes that a significant reduction in inappropriate hospital stay was found following the implementation of innovative hospital discharge policies, indicating greater efficiency and accessibility of hospital services.

  12. Market structure and hospital-insurer bargaining in the Netherlands.

    PubMed

    Halbersma, R S; Mikkers, M C; Motchenkova, E; Seinen, I

    2011-12-01

    In 2005, competition was introduced in part of the hospital market in the Netherlands. Using a unique dataset of transactions and list prices between hospitals and insurers in the years 2005 and 2006, we estimate the influence of buyer and seller concentration on the negotiated prices. First, we use a traditional structure-conduct-performance model (SCP-model) along the lines of Melnick et al. (J Health Econ 11(3): 217-233, 1992) to estimate the effects of buyer and seller concentration on price-cost margins. Second, we model the interaction between hospitals and insurers in the context of a generalized bargaining model similar to Brooks et al. (J Health Econ 16: 417-434, 1997). In the SCP-model, we find that the market shares of hospitals (insurers) have a significantly positive (negative) impact on the hospital price-cost margin. In the bargaining model, we find a significant negative effect of insurer concentration, but no significant effect of hospital concentration. In both models, we find a significant impact of idiosyncratic effects on the market outcomes. This is consistent with the fact that the Dutch hospital sector is not yet in a long-run equilibrium.

  13. /Cu-Al System

    NASA Astrophysics Data System (ADS)

    Kish, Orel; Froumin, Natalya; Aizenshtein, Michael; Frage, Nachum

    2014-05-01

    Wettability and interfacial interaction of the Ta2O5/Cu-Al system were studied. Pure Cu does not wet the Ta2O5 substrate, and improved spreading is achieved when relatively a high fraction of the active element (~40 at.% Al) was added. The Al2O3 and AlTaO4 phases were observed at the Ta2O5/Cu-Al interface. A thermodynamic evaluation allowed us to suggest that the lack of wetting bellow 40 at.% Al is due to the presence of a native oxide, which covers the drop. The conditions of the native oxide decomposition and the formation of the volatile Al2O suboxide strongly depend on the vacuum level during sessile drop experiments and the composition of the Cu-Al alloy. In our case, Al contents greater than 40% provides thermodynamic conditions for the formation of Al2O (as a result of Al reaction with Al2O3) and the drop spreading. It was suggested that the final contact angle in the Ta2O5/Cu-Al system (50°) is determined by Ta adsorption on the newly formed alumina interlayer.

  14. Marketing the hospital library.

    PubMed

    Bridges, Jane

    2005-01-01

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

  15. Tiered hospital networks.

    PubMed

    Yegian, Jill M

    2003-01-01

    As a result of rising health care costs, health plans are experimenting with insurance products that shift greater financial responsibility for medical care to consumers and create incentives for consumers to consider cost differences when choosing among providers. Based on an October 2002 roundtable discussion, this paper discusses insurance product trends, particularly tiered hospital networks. Issues addressed include these product features' potential to reduce system costs, the effect on the hospital-health plan relationship, consumers' ability to consider cost and quality in decision making, and financial barriers to care for the chronically ill.

  16. Initial Symptoms of ALS

    MedlinePlus

    ... Chapters Certified Centers and Clinics Support Groups About ALS About Us Our Research In Your Community Advocate ... Diagnosis En español Symptoms The initial symptoms of ALS can be quite varied in different people. One ...

  17. Lou Gehrig's Disease (ALS)

    MedlinePlus

    ... 1930s. People in England and Australia call ALS motor neurone disease (MND). The French refer to it ... about ALS in 1869. Lou Gehrig's disease damages motor neurons in the brain and spinal cord. Motor ...

  18. Toilet privacy in hospital.

    PubMed

    Logan, Karen

    Good practice in toilet management and continence promotion can help hospital patients to maintain their dignity. This article reports on an audit that highlighted the issues important to patients and nurses in terms of improving privacy and dignity for inpatients using the toilet.

  19. Drama Therapies in Hospitals

    ERIC Educational Resources Information Center

    Goodman, Judith; Prosperi, Mario

    1976-01-01

    Explores the use of drama as a therapeutic tool at various hospitals and records specific therapy groups dialogues. Available from: The Drama Review, 51 West 4th Street, Room 300, New York, N.Y. 10012. Subscription Rates: $12.50 per year. (MH)

  20. Mechanical engineering in hospitals.

    PubMed

    Wallington, J W

    1980-10-01

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

  1. 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.

  2. Innovations in Hospitality Industry

    ERIC Educational Resources Information Center

    Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.

    2016-01-01

    The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…

  3. Going to the Hospital

    MedlinePlus

    ... taking care of you — to explain. continue Your Room Once you're in the hospital, you may have a room all to yourself or you might share one with another kid. Your room will have a bed, usually with buttons to ...

  4. 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…

  5. 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.

  6. 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.

  7. Reengineering hospital materiel management.

    PubMed

    Giunipero, L C

    1995-08-01

    Reengineering involves significant change and dramatic rethinking of the business process. The expected result of these changed processes is dramatic improvement. Hospital cost pressures and technological change necessitate review or reengineering the process to enhance customer service at a lower cost. Three areas that yield significant results include reducing the cost of purchasing, implementing new technologies, and empowering teams to accomplish customer driven goals.

  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.

  10. The frontline hospital.

    PubMed

    Mein, P

    1983-01-01

    This brief description of the planning process for a frontline hospital is intended as a guide only: there will be a variety of approaches depending on local conditions. However, certain of the principles raised have universal relevance for the construction of health facilities where resources are limited. In brief, these: - The changing role of the frontline hospital should not be allowed to obscure the fact that the small hospital still has a significant role to play and that future, as yet undefined, functional changes will take place necessitating generalized designs that can accommodate those changes. - The erection of new buildings is not always the appropriate solution to apparent problems with facilities. Often a more relevant course is to adapt existing buildings or to provide community-level primary health care services not based on facilities. - The development of standardized, though flexible, briefs for hospitals of different sizes is essential, since ther will, for some years to come, be a shortage of the professional manpower needed to enable completely individual designs to be produced for each facility. Standardized briefs are infinitely preferable to standard or type plans, which tend to be inflexible and lead to overbuilding. - Local involvement in the planning process is essential, not only because it provides useful knowledge but primarily because local commitment is the only way of avoiding the construction of inappropriate facilities. - Architectural expertise must be available within the health system, since very often outside consultants are unable or unwilling, because of the system of payment, to design suitable hospital buildings. - The type of construction used should be the simplest and most economical that will provide an effective environment for the health tasks to be carried out so that the limited resources available can be stretched to serve as many people as possible. - Local building materials should always be preferred- to

  11. How consumers view hospital advertising.

    PubMed

    Johns, H E; Moser, H R

    1988-01-01

    The purposes of this study were to determine: (a) consumers' attitudes toward advertising by hospitals; (b) which media consumers feel are appropriate for hospital advertising; and (c) whether consumers are seeing hospital advertisements, and if so, through which media. It was found that consumers indeed have a favorable attitude toward hospitals that advertise. It was also found that consumers feel that most media are appropriate for hospital advertising. Finally, it was found that most consumers have seen hospitals advertise their services, especially on television and radio and in the newspaper.

  12. The politics of hospital payment.

    PubMed

    Feder, J; Spitz, B

    1979-01-01

    This paper analyzes the politics of hospital payment over the last decade. The authors explain how provider interests and judgments became a standard for appropriate hospital payment: the impact of that standard on hospital costs; and the political obstacles to imposing an alternative standard and controlling hospital costs. The authors draw lessons from this experience, here and in other countries, to propose an alternative approach to hospital payment that would allow policymakers, accountable to the public, to make explicit choices about the level and nature of hospital expenditures.

  13. 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.

  14. Hospital malnutrition: a 33-hospital screening study.

    PubMed

    Kamath, S K; Lawler, M; Smith, A E; Kalat, T; Olson, R

    1986-02-01

    A collaborative study involving nutrition screening of 3,047 patients (excluding 125 pregnant women) at admission to 33 hospitals in and around the greater Chicago area was carried out to identify patients at nutritional risk. Information on sex, age, admitting diagnosis, serum albumin, hemoglobin, total lymphocyte count, and height and weight was collected from the medical chart within 48 hours of admission. Nutrition screening could not be completed for a larger number of patients (60%) because data at admission were not available. Of the remaining 40% of patients, more than 50% had below normal values for one or more of the variables studied: serum albumin, hemoglobin, and total lymphocyte count. A large number of the patients (40%) also were considered at nutritional risk as judged by the criteria of weight/height (measured only). Early nutrition intervention for high-risk patients cannot be implemented, nor can the efficacy of nutrition services be evaluated, unless nutrition screening is carried out on patients at admission.

  15. [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

  16. 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,…

  17. Hospitals report on cancer centers.

    PubMed

    Rees, T

    2001-01-01

    Woman's Hospital, Baton Rouge, La., is first-place winner among cancer centers. Holy Cross Hospital's Michael and Dianne Bienes Comprehensive Cancer Center, Ft. Lauderdale, Fla., is named second; and, Cardinal Health System's Ball Cancer Center, Muncie, Ind., third.

  18. Community Hospital Telehealth Consortium

    DTIC Science & Technology

    2007-04-01

    project involving the purchase of a neonatal retinal camera . This clinic transmits images from Lake Charles Memorial Hospital to a neonatal...ophthalmologist in New Orleans and assists in diagnosing Retinopathy of prematurity ( ROP ), a potentially blinding eye disorder that primarily affects...weeks). The smaller a baby is at birth, the more likely that baby is to develop ROP . This disorder—which usually develops in both eyes—is one of

  19. [Homicide crimes in hospitals].

    PubMed

    Dürwald, W

    1993-02-01

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

  20. Desarrollo de una Interfaz de Control para un Observatorio Astronómico Robotizado con fines educativos en la Facultad de Ciencias Exactas; Físicas y Naturales de la UNSJ

    NASA Astrophysics Data System (ADS)

    Pogrebinsky, L.; Francile, C.

    We report the development and the construction of an Interface to Control a robotized Astronomical Observatory (ICOA), which allows to control the operation of an observatory based on a Meade LX200 telescope. The interface operates together with a computer to control and supervise all the local variables of the observatory, and can take the control of it in risky situations. It serves as a link among the control computer and all the necessary devices for the astronomical observation such as the telescope, the dome, the weather station, the CCD camera, the calibration devices and the security devices. The computer receives orders from an operator who can be or not at the site of observation. The goal of this robotized observatory is the operation in a secure, autonomous and unattended way, with the purpose of to be used remotely by the students of the "Facultad de Ciencias Exactas, Físicas y Naturales" of the UNSJ. FULL TEXT IN SPANISH

  1. Relationships between in-hospital and 30-day standardized hospital mortality: implications for profiling hospitals.

    PubMed Central

    Rosenthal, G. E.; Baker, D. W.; Norris, D. G.; Way, L. E.; Harper, D. L.; Snow, R. J.

    2000-01-01

    OBJECTIVE: To examine the relationship of in-hospital and 30-day mortality rates and the association between in-hospital mortality and hospital discharge practices. DATA SOURCES/STUDY SETTING: A secondary analysis of data for 13,834 patients with congestive heart failure who were admitted to 30 hospitals in northeast Ohio in 1992-1994. DESIGN: A retrospective cohort study was conducted. DATA COLLECTION: Demographic and clinical data were collected from patients' medical records and were used to develop multivariable models that estimated the risk of in-hospital and 30-day (post-admission) mortality. Standardized mortality ratios (SMRs) for in-hospital and 30-day mortality were determined by dividing observed death rates by predicted death rates. PRINCIPAL FINDINGS: In-hospital SMRs ranged from 0.54 to 1.42, and six hospitals were classified as statistical outliers (p <.05); 30-day SMRs ranged from 0.63 to 1.73, and seven hospitals were outliers. Although the correlation between in-hospital SMRs and 30-day SMRs was substantial (R = 0.78, p < .001), outlier status changed for seven of the 30 hospitals. Nonetheless, changes in outlier status reflected relatively small differences between in-hospital and 30-day SMRs. Rates of discharge to nursing homes or other inpatient facilities varied from 5.4 percent to 34.2 percent across hospitals. However, relationships between discharge rates to such facilities and in-hospital SMRs (R = 0.08; p = .65) and early post-discharge mortality rates (R = 0.23; p = .21) were not significant. CONCLUSIONS: SMRs based on in-hospital and 30-day mortality were relatively similar, although classification of hospitals as statistical outliers often differed. However, there was no evidence that in-hospital SMRs were biased by differences in post-discharge mortality or discharge practices. PMID:10737447

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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

  7. Mother-baby friendly hospital.

    PubMed

    Aragon-choudhury, P

    1996-01-01

    In Manila, the Philippines, the Dr. Jose Fabella Memorial Hospital has been a maternity hospital for 75 years. It averages 90 deliveries a day. Its fees are P200-P500 for a normal delivery and P800-P2000 for a cesarean section. Patients pay what they can and pay the balance when they can. The hospital provides a safe motherhood package that encompasses teaching responsible parenthood, prenatal care, labor, delivery, postpartum care, breast feeding, family planning, and child survival. In 1986, the hospital introduced innovative policies and procedures that promote, protect, and support breast feeding. It has a rooming-in policy that has saved the hospital P6.5 million so far. In the prenatal stage, hospital staff inform pregnant women that colostrum protects the newborn against infections, that suckling stimulates milk production, and that there is no basis to the claim of having insufficient breast milk. Sales representatives of milk substitutes are banned from the hospital. Staff confiscate milk bottles or formula. A lactation management team demonstrates breast feeding procedures. Mothers also receive support on the correct way of breast feeding from hospital staff, volunteers from the Catholic Women's League, consumer groups, and women lawyers. The hospital's policy is no breast milk, no discharge. This encourages mothers to motivate each other to express milk immediately after birth. The hospital has received numerous awards for its breast feeding promotion efforts. UNICEF has designated Fabella Hospital as a model of the Baby-Friendly Hospital Initiative. The hospital serves as the National Lactation Management Education Training Center. People from other developing countries have received training in lactation management here. The First Lady of the Philippines, the First Lady of the US, and the Queen of Spain have all visited the hospital. The hospital has also integrated its existing services into a women's health care center.

  8. Hospital closure and economic efficiency.

    PubMed

    Capps, Cory; Dranove, David; Lindrooth, Richard C

    2010-01-01

    We present a new framework for assessing the effects of hospital closures on social welfare and the local economy. While patient welfare necessarily declines when patients lose access to a hospital, closures also tend to reduce costs. We study five hospital closures in two states and find that urban hospital bailouts reduce aggregate social welfare: on balance, the cost savings from closures more than offset the reduction in patient welfare. However, because some of the cost savings are shared nationally, total surplus in the local community may decline following a hospital closure.

  9. [Success factors in hospital management].

    PubMed

    Heberer, M

    1998-12-01

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

  10. Hospital clowning: a paediatrician's view.

    PubMed

    van Venrooij, Lennard T; Barnhoorn, Pieter C

    2017-02-01

    This study investigates the current position of hospital clowns from the perspective of paediatricians and paediatric residents. A total of 14 attending paediatricians and paediatric residents participated in two focus group sessions. Data were analysed using Atlas.ti 5.0. In general, physicians reported positive experiences regarding the interaction between hospital clowns and paediatric patients on the ward. Physicians were more interested in research on children's perception of hospital clowns than in research on the clinical efficacy of hospital clowning. No direct collaboration between physicians and hospital clowns was reported. However, physicians proposed conditions which may streamline their encounters with hospital clowns such as clear communication prior to hospital clown visits, and the condition that visits do not impede medical interventions.

  11. Genetic testing in ALS

    PubMed Central

    McLaughlin, Russell L.; Heverin, Mark; Thorpe, Owen; Abrahams, Sharon; Al-Chalabi, Ammar; Hardiman, Orla

    2017-01-01

    Objective: To determine the degree of consensus among clinicians on the clinical use of genetic testing in amyotrophic lateral sclerosis (ALS) and the factors that determine decision-making. Methods: ALS researchers worldwide were invited to participate in a detailed online survey to determine their attitudes and practices relating to genetic testing. Results: Responses from 167 clinicians from 21 different countries were analyzed. The majority of respondents (73.3%) do not consider that there is a consensus definition of familial ALS (FALS). Fifty-seven percent consider a family history of frontotemporal dementia and 48.5% the presence of a known ALS genetic mutation as sufficient for a diagnosis of FALS. Most respondents (90.2%) offer genetic testing to patients they define as having FALS and 49.4% to patients with sporadic ALS. Four main genes (SOD1, C9orf72, TARDBP, and FUS) are commonly tested. A total of 55.2% of respondents would seek genetic testing if they had personally received a diagnosis of ALS. Forty-two percent never offer presymptomatic testing to family members of patients with FALS. Responses varied between ALS specialists and nonspecialists and based on the number of new patients seen per year. Conclusions: There is a lack of consensus among clinicians as to the definition of FALS. Substantial variation exists in attitude and practices related to genetic testing of patients and presymptomatic testing of their relatives across geographic regions and between experienced specialists in ALS and nonspecialists. PMID:28159885

  12. Ventilatory Control in ALS

    PubMed Central

    Nichols, Nicole L.; Van Dyke, J.; Nashold, L.; Satriotomo, I.; Suzuki, M.; Mitchell, G.S.

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a fatal, progressive neurodegenerative disease. ALS selectively causes degeneration in upper and lower (spinal) motor neurons, leading to muscle weakness, paralysis and death by ventilatory failure. Although ventilatory failure is generally the cause of death in ALS, little is known concerning the impact of this disorder on respiratory motor neurons, the consequences of respiratory motor neuron cell death, or the ability of the respiratory control system to “fight back” via mechanisms of compensatory respiratory plasticity. Here we review known effects of ALS on breathing, including possible effects on rhythm generation, respiratory motor neurons, and their target organs: the respiratory muscles. We consider evidence for spontaneous compensatory plasticity, preserving breathing well into disease progression despite dramatic loss of spinal respiratory motor neurons. Finally, we review current and potential therapeutic approaches directed toward preserving the capacity to breathe in ALS patients. PMID:23692930

  13. Hospitality and Collegial Community: An Essay.

    ERIC Educational Resources Information Center

    Bennett, John B.

    2000-01-01

    Explains a collegial ethic of hospitality as a cardinal academic virtue and suggests a way of building a "collegium," the covenantal community of academe. Discusses how academicians can develop hospitable teaching, hospitable scholarship, and hospitable service. (Author/SLD)

  14. [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.

  15. 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

  16. 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.

  17. ALS2 mutations

    PubMed Central

    Schneider, Susanne A.; Carr, Lucinda; Deuschl, Guenther; Hopfner, Franziska; Stamelou, Maria; Wood, Nicholas W.; Bhatia, Kailash P.

    2014-01-01

    Objective: To determine the genetic etiology in 2 consanguineous families who presented a novel phenotype of autosomal recessive juvenile amyotrophic lateral sclerosis associated with generalized dystonia. Methods: A combination of homozygosity mapping and whole-exome sequencing in the first family and Sanger sequencing of candidate genes in the second family were used. Results: Both families were found to have homozygous loss-of-function mutations in the amyotrophic lateral sclerosis 2 (juvenile) (ALS2) gene. Conclusions: We report generalized dystonia and cerebellar signs in association with ALS2-related disease. We suggest that the ALS2 gene should be screened for mutations in patients who present with a similar phenotype. PMID:24562058

  18. 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.

  19. Strategies and performance in hospitals.

    PubMed

    Madorrán García, Cristina; de Val Pardo, Isabel

    2004-01-01

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

  20. 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.

  1. Lou Gehrig's Disease (ALS)

    MedlinePlus

    ... when it becomes necessary. For instance, a power wheelchair can enable a paralyzed person with ALS to ... done these things despite being confined to a wheelchair for many years, being able to move only ...

  2. Genetic Testing for ALS

    MedlinePlus

    ... Involved Donate Familial Amyotrophic Lateral Sclerosis (FALS) and Genetic Testing By Deborah Hartzfeld, MS, CGC, Certified Genetic ... guarantee a person will develop symptoms of ALS. Genetic Counseling If there is more than one person ...

  3. Cross hospital bed management system.

    PubMed

    Abedian, S; Kazemi, H; Riazi, H; Bitaraf, E

    2014-01-01

    The lack of adequate numbers of hospital beds to accommodate the injured is a main problem in public hospitals. For control of occupancy of bed, we design a dynamic system that announces status of bed when it change with admission or discharge of a patient. This system provide a wide network in country for bed management, especially for ICU and CCU beds that help us to distribute injured patient in the hospitals.

  4. 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.

  5. 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

  6. Ag-Al-Ca

    NASA Astrophysics Data System (ADS)

    Carow-Watamura, U.; Louzguine, D. V.; Takeuchi, A.

    This document is part of Part 1 http://dx.doi.org/10.1007/97.etType="URL"/> 'Systems from Ag-Al-Ca to Au-Pd-Si' of Subvolume B 'Physical Properties of Ternary Amorphous Alloys' of Volume 37 'Phase Diagrams and Physical Properties of Nonequilibrium Alloys' of Landolt-Börnstein - Group III 'Condensed Matter'. It contains the Chapter 'Ag-Al-Ca' with the content:

  7. Hospital Ethics Committees in Poland.

    PubMed

    Czarkowski, Marek; Kaczmarczyk, Katarzyna; Szymańska, Beata

    2015-12-01

    According to UNESCO guidelines, one of the four forms of bioethics committees in medicine are the Hospital Ethics Committees (HECs). The purpose of this study was to evaluate how the above guidelines are implemented in real practice. There were 111 hospitals selected out of 176 Polish clinical hospitals and hospitals accredited by Center of Monitoring Quality in Health System. The study was conducted by the survey method. There were 56 (50%) hospitals that responded to the survey. The number of HECs members fluctuated between 3 and 16 members, where usually 5 (22% of HECs) members were part of the board committee. The composition of the HECs for professions other than physicians was diverse and non-standardized (nurses-in 86% of HECs, clergy-42%, lawyers-38%, psychologists-28%, hospital management-23%, rehab staff-7 %, patient representatives-3%, ethicists-2%). Only 55% of HECs had a professional set of standards. 98% of HECs had specific tasks. 62% of HECs were asked for their expertise, and 55% prepared <6.88% of the opinions were related to interpersonal relations between hospital personnel, patients and their families with emphasis on the interactions between superiors and their inferiors or hospital staff and patients and their families. Only 12% of the opinions were reported by the respondents as related to ethical dilemmas. In conclusion, few Polish hospitals have HECs, and the structure, services and workload are not always adequate. To ensure a reliable operation of HECs requires the development of relevant legislation, standard operating procedures and well trained members.

  8. 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

  9. [Hospitals and surgeons: Madrid 1940].

    PubMed

    de Quevedo, Francisco Vázquez

    2007-01-01

    The history of the hospitals and general surgeons that best represent the centres in Madrid are here in reviewed, comprising the period between 1940 and the closure of the Hospital Clinico (1957) as well as the Hospital General (General Hospital) (1967), both in Atocha. Other hospitals which are reviewed and highlighted are: the H. de la Princesa (the Princess Hospital), the H. del Nifio Jesus (Hospital of the Child Jesus), the H. Militar (Military Hospital) and the Cruz Roja (Red Cross). Data is provided on the permanent surgeons in the following centres: H. General: J. Goyanes, J. Die, J. de la Villa, T. Rodriguez, E. Diaz, G. Bueno e H. Huerta; H. Clinico: L. de la Peña, L. Cardenal, L. Olivares, R. Argüelles, J. Estella y M. F. Zumel; H. Militar: M. G. Ulla, M. Bastos, M. G. Durán, J. S. Galindo, y A. G. Durán; Hospital de la Cruz Roja: V. M. Noguera, L. Serrada, F. Luque y L. L. Durán; H. de la Princesa: P. Cifuentes, P. G. Duarte, L. Estella y R. Aiguabella; H. del Niño Jesús: J. Garrido Lestache; H. Clinico, last time, Atocha: F. M. Lagos, R. Vara y A. de la Fuente.

  10. Closure of a home hospital program: impact on hospitalization rates.

    PubMed

    Jacobs, Jeremy M; Cohen, Aaron; Rozengarten, Ora; Meiller, Ludmila; Azoulay, Daniel; Hammerman-Rozenberg, Robert; Stessman, Jochanan

    2007-01-01

    Home hospitalization (HH), as a substitute to in-patient care, is an area of growing interest, particularly amongst the elderly. Debate nonetheless exists concerning its economic justification. This study describes a natural experiment that arose following spending cuts and closure of the 400 patient Jerusalem HH program. It examines the hypothesis that HH closure would cause increasing geriatric and general medical hospital utilization amongst the 45,000 beneficiaries of the Jerusalem Clalit Health Fund (HMO) aged 65 years and over. Hospitalization rates were measured prior to and following HH closure, and analysis of variance confirmed the significance of the differences in both geriatric (p<0.0001) and general medical hospitalization rates (p=0.02) over the study period. Linear regression analyses of the hospitalization rates prior to HH closure were performed to determine the expected trajectory of hospitalization rates following HH closure. The observed hospital utilization in the year following HH closure cost 6.2 million US dollars in excess of predicted expenditure; closure of the HH resulted in the saving of 1.3 million USdollars. The ratio of direct increased costs to savings was 5:1 thus confirming the hypothesis that HH closure would result in increased hospital utilization rates among the local elderly population.

  11. Hathaway v. Worcester City Hospital. 22 Mar 1973.

    PubMed

    1973-01-01

    The arguments and findings in the case of Robbie Mae Hathaway, Plaintiff, Appellant, versus Worcester City Hospital et al., (Worcester, Massachusetts), Defendants, Appellees, are presented. The case was heard January 3, 1973 by the United States Court of Appeals, First Circuit, and was decided March 22, 1973. Hathaway's action challenged the city hospital policy barring the use of facilities in connection with consensual sterilization. The appellant, Hathaway, had 12 pregnancies resulting in 8 live children and maintained that her life would be jeopardized by future pregnancies. She challenged as unconstitutional the policy of the Worcester City Hospital barring the use of its facilities in connection with any consensual sterilization. Appellee administrator specifically refused appellant's request that the hospital allow her physicians to perform a tubal ligation at the time of the delivery of her 8th child in April 1971. Despite further requests, the operation was not performed after the delivery. In the interim, the instant suit was filed in the district court seeking declaratory and injunctive relief and damages. Th district court twice dismissed the complaint. The Assistant solicitor's opinion, on which the hospital's policy is based, was that the legality of sterilization procedures was "highly doubtful" in view of the Massachusetts statutes concerning birth control assistance. The U.S. Court of Appeals, First Circuit, reverses and remands for entry of an order declaring the Worceste City Hospital's policy against the use of its facilities in conjunction with sterilization operations unconstitutional and enjoining the individual appellees from enforcing the policy in the future.

  12. 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.

  13. 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…

  14. Suicidal Behavior in Hospitalized Schizophrenics.

    ERIC Educational Resources Information Center

    Prasad, Ashoka Jahnavi; Kumar, Nirmal

    1988-01-01

    Compared 131 hospitalized schizophrenics who had attempted suicide within past year to 70 hospitalized schizophrenics who had not attempted suicide, using the Present State Examination depressive symptoms. Found that schizophrenics who had attempted suicide had significantly higher number of symptoms indicative of a depressive disorder. (Author/NB)

  15. 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…

  16. 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…

  17. 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.

  18. Occupational hazards to hospital personnel

    SciTech Connect

    Patterson, W.B.; Craven, D.E.; Schwartz, D.A.; Nardell, E.A.; Kasmer, J.; Noble, J.

    1985-05-01

    Hospital personnel are subject to various occupational hazards. Awareness of these risks, compliance with basic preventive measures, and adequate resources for interventions are essential components of an occupational health program. Physical, chemical, and radiation hazards; important infectious risks; and psychosocial problems prevalent in hospital workers are reviewed. A rational approach to managing and preventing these problems is offered. 370 references.

  19. [Obstetric analgesia in Norwegian hospitals].

    PubMed

    Dahl, V; Hagen, I E; Raeder, J C

    1998-04-30

    We report the results of a questionnaire sent to anaesthetists and midwives on the use of obstetric analgesia and anaesthesia in Norwegian hospitals in 1996. 95% of the 49 hospitals involved responded to the questionnaire, representing a total of 56,884 births. The use of epidural analgesia in labour varied from 0 to 25% in the different hospitals with a mean value of 15%. Epidural analgesia was much more widely used in university and regional hospitals than in local hospitals (p < 0.001). Five of the local hospitals did not offer epidural analgesia during labour at all. The combination of low-dose local anaesthetic and an opioid (either sufentanil or fentanyl) had not been introduced in nine of the hospitals (20%). The optimal use of epidural analgesia to relieve labour pain was judged to be more frequent by the anaesthetists than by the midwives (19% versus 11%, p < 0.01). In response to what factors limited the frequency of epidural analgesia, the anaesthetists specified factors related to the attitude of the midwife, and the midwives specified factors related to the anaesthetist. Only five of the hospitals provided written information on the various analgesic methods that could be employed during labour. The majority of midwives considered the analgesic methods employed on their maternity ward to be good or excellent. The frequency of Caesarean section was 12%; spinal anaesthesia was used in 55%, epidural anaesthesia in 17%, and general anaesthesia in 28% of the cases.

  20. 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.

  1. 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…

  2. Statins: Do They Cause ALS?

    MedlinePlus

    Statins: Do they cause ALS? Do statins cause amyotrophic lateral sclerosis (ALS)? Answers from Francisco Lopez-Jimenez, M.D. ... D. References Sorensen HT, et al. Statins and amyotrophic lateral sclerosis: The level of evidence for an association. Journal ...

  3. [Hospitals as vital links].

    PubMed

    Klink, A

    2013-01-01

    The reform of the system in 2006 aimed at reducing waiting lists in an efficient manner. Performance-linked funding and regulated competition did indeed lead to improved efficiency. The other side of the coin is overtreatment, and expensive and not infrequently damaging growth in volume. In order to control costs, three strategies have been determined: agreements with an annual cap on volume; (b) collaboration of regional health-care providers with the mission of improving results in health care (with profit-sharing if costs fall); and (c) fusions reducing the number of hospitals which reduces the burden of injuries (supply no longer creates its own demand). This article comments on these strategies. The author argues for a fourth approach: if the quality of health care improves, the number of complications will fall, overtreatment will decline and the outcome will be a decrease in burden of injuries. This requires the health care insurers to modify the way they manage their contracts and methods of payment, and stimulates competition based on quality.

  4. The single-hospital county: is its hospital at risk?

    PubMed

    Chang, C F; Tuckman, H P

    1991-06-01

    This article focuses on a hospital group that has not received adequate attention in the literature: the sole provider of short-term, acute hospital care located in a county. In Tennessee, SPHs (single provider hospitals) are fewer in number but are present in more counties than multiprovider hospitals (MPHs). They are smaller in size, less labor and capital intensive, more likely to be a government hospital, and more likely to be in a rural area with low income and limited health care resources. SPHs operate with lower costs, charge patients less, and have lower revenue write-offs than MPHs. As a result, their cash flow is sufficient to fund their depreciation and they consistently earn modest returns. Between 1982 and 1988, a total of 16 hospitals failed in Tennessee but only 3 were SPHs. While SPHs have not been profitable enough to make them ideal candidates for takeover by major hospital systems, they are not a population that is unduly at risk.

  5. Rapidly solidified NiAl and FeAl

    NASA Technical Reports Server (NTRS)

    Gaydosh, D. J.; Crimp, M. A.

    1984-01-01

    Melt spinning was used to produce rapidly solidified ribbons of the B2 intermetallics NiAl and FeAl. Both Fe-40Al and Fe-45Al possessed some bend ductility in the as spun condition. The bend ductility of Fe-40Al, Fe-45Al, and equiatomic NiAl increased with subsequent heat treatment. Heat treatment at approximately 0.85 T (sub m) resulted in significant grain growth in equiatomic FeAl and in all the NiAl compositions. Low bend ductility in both FeAl and NiAl generally coincided with intergranular failure, while increased bend ductility was characterized by increasing amounts of transgranular cleavage fracture.

  6. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened

  7. Hospitals: Soft Target for Terrorism?

    PubMed

    De Cauwer, Harald; Somville, Francis; Sabbe, Marc; Mortelmans, Luc J

    2017-02-01

    In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning

  8. ALS superbend magnet system

    SciTech Connect

    Zbasnik, J.; Wang, S.T.; Chen, J.Y.; DeVries, G.J.; DeMarco, R.; Fahmie, M.; Geyer, A.; Green, M.A.; Harkins, J.; Henderson, T.; Hinkson, J.; Hoyer, E.H.; Krupnick, J.; Marks, S.; Ottens, F.; Paterson, J.A.; Pipersky, P.; Portmann, G.; Robin, D.A.; Schlueter, R.D.; Steier, C.; Taylor, C.E.; Wahrer, R.

    2000-09-15

    The Lawrence Berkeley National Laboratory is preparing to upgrade the Advanced Light Source (ALS) with three superconducting dipoles (Superbends). In this paper we present the final magnet system design which incorporates R&D test results and addresses the ALS operational concerns of alignment, availability, and economy. The design incorporates conduction-cooled Nb-Ti windings and HTS current leads, epoxy-glass suspension straps, and a Gifford-McMahon cryocooler to supply steady state refrigeration. We also present the current status of fabrication and testing.

  9. Fosetyl-al

    Integrated Risk Information System (IRIS)

    Fosetyl - al ; CASRN 39148 - 24 - 8 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncarcinogenic Ef

  10. Al Shanker Remembers.

    ERIC Educational Resources Information Center

    American Educator, 2000

    2000-01-01

    In a 1996 interview shortly before his death, Al Shanker, longtime president of the American Federation of Teachers, discussed such topics as: his own educational experiences; how he learned about political fighting in the Boy Scouts; the appeal of socialism; multinational corporations and the nation state; teaching tough students; and John Dewey…

  11. [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.

  12. 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

  13. Al Partitioning Patterns and Root Growth as Related to Al Sensitivity and Al Tolerance in Wheat.

    PubMed Central

    Samuels, T. D.; Kucukakyuz, K.; Rincon-Zachary, M.

    1997-01-01

    Studies of Al partitioning and accumulation and of the effect of Al on the growth of intact wheat (Triticum aestivum L.) roots of cultivars that show differential Al sensitivity were conducted. The effects of various Al concentrations on root growth and Al accumulation in the tissue were followed for 24 h. At low external Al concentrations, Al accumulation in the root tips was low and root growth was either unaffected or stimulated. Calculations based on regression analysis of growth and Al accumulation in the root tips predicted that 50% root growth inhibition in the Al-tolerant cv Atlas 66 would be attained when the Al concentrations were 105 [mu]M in the nutrient solution and 376.7 [mu]g Al g-1 dry weight in the tissue. In contrast, in the Al-sensitive cv Tam 105, 50% root growth inhibition would be attained when the Al concentrations were 11 [mu]M in the nutrient solution and 546.2 [mu]g Al g-1 dry weight in the tissue. The data support the hypotheses that differential Al sensitivity correlates with differential Al accumulation in the growing root tissue, and that mechanisms of Al tolerance may be based on strategies to exclude Al from the root meristems. PMID:12223623

  14. Potential for Hospital Based Corneal Retreival in Hassan District Hospital

    PubMed Central

    Melsakkare, Suresh Ramappa; Manipur, Sahana R.; Acharya, Pavana; Ramamurthy, Lakshmi Bomalapura

    2015-01-01

    Context In developing countries, corneal diseases are the second leading cause of blindness. This corneal blindness can be treated through corneal transplantation. Though the present infrastructure is strong enough to increase keratoplasty numbers at a required rate, India has largest corneal blind population in the world. So a constant supply of high quality donor corneal tissue is the key factor for reduction of prevalence of corneal blindness. Considering the magnitude of corneal blindness and shortage of donor cornea, there is a huge gap in the demand and supply. Aim To study the potential for hospital based retrieval of donor corneal tissue in Hassan district hospital after analysing the indicated and contraindicated causes of deaths, so that hospital corneal retrieval program in Hassan district hospital can be planned. Materials and Methods The cross-sectional, retrospective and record-based study included all hospital deaths with age group more than two years occurred during one year period (January 2014 to December 2014). Data regarding demographic profile, cause of death, treatment given and presence of any systemic diseases were collected. The causes of deaths which are contraindicated for the retrieval of corneas were analysed and noted. The contraindications were based on the NPCB guidelines for standard of eye banking in India 2009. Results Out of 855 deaths, number of deaths in males (565) was greater than females (290). Numbers of deaths were highest between 41-60 years age group (343). Deaths due to HIV, septicaemia, meningitis, encephalitis, disseminated malignancies were contraindicated for corneal retrieval. Corneas could be retrieved from 736 deaths out of 855. Potential for corneal retrieval in a period of one year in Hassan District hospital was 86%. Conclusion Hospital corneal retrieval program has got a great potential to bridge the gap between the need for the cornea and actually collected corneas which will contribute enormously in

  15. Internet connectivity for hospitals and hospital libraries: strategies.

    PubMed

    Fuller, S S

    1995-01-01

    Access to Internet resources and communications has rapidly become a necessity in many hospitals nationally. The results of a Pacific Northwest pilot Intenet connections project provides important evidence of the value of librarians in establishing such connections in their institutions The pilot project has resulted in a wealth of information regarding approaches to promoting the utility of the Internet to health professionals in hospitals. Roles that librarians are playing in support of such connections include facilitator, negotiator, provider, publisher, integrator, and educator.

  16. 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.

  17. Al Sumelat Water Network. Village of Al Sumelat, Iraq

    DTIC Science & Technology

    2006-03-15

    OFFICE OF THE SPECIAL INSPECTOR GENERAL FOR IRAQ RECONSTRUCTION AL SUMELAT WATER NETWORK VILLAGE OF AL SUMELAT, IRAQ...Sumelat Water Network Village of Al Sumelat, Iraq 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...Al Sumelat Water Network Village of Al Sumelat, Iraq Synopsis Introduction. This report was previously provided on a limited distribution basis

  18. Hospital Room Floors May Harbor 'Superbugs'

    MedlinePlus

    ... fullstory_163886.html Hospital Room Floors May Harbor 'Superbugs' But that area often overlooked when it comes ... Hospital room floors may be more of a "superbug" threat than many hospital staffers realize, new research ...

  19. Improve Hospital-to-Home Transitions

    MedlinePlus

    ... to the hospital. One study found that seniors hospitalized with heart failure often have multiple medical conditions, and they have the highest hospital readmission rate of all adult patient groups. This indicates a serious breakdown during the ...

  20. 77 FR 34326 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-11

    ... 0938-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident... Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term...

  1. Hospital financial performance trends to watch.

    PubMed

    Schuhmann, Thomas M

    2008-07-01

    Hospitals may wish to compare their performance with that of their peers to identify areas for possible improvement. Comparing financial indicators over five years shows directional trends and the influence of environmental factors such as regulatory change. For-profit hospitals appear to outperform their not-for-profit counterparts. Rural hospitals generally exhibit better financial performance than urban hospitals. Nonteaching hospitals show more desirable operating margins than teaching hospitals.

  2. Preventing Infections in the Hospital

    MedlinePlus

    ... and your doctor discuss the best way to control your blood sugar before, during, and after your hospital stay. High blood sugar increases the risk of infection noticeably. If you are overweight, losing weight will ...

  3. Public policy regarding specialty hospitals.

    PubMed

    Dowd, Bryan E

    2008-10-01

    Why do we need "public policy" regarding specialty hospitals? What is the rationale for government involvement in decisions by the private sector to invest in specialty hospitals? Two possibilities are reduced access to services primarily by the uninsured (a fairness concern) and changes in the types of patients receiving care resulting from poor consumer information (an efficiency concern). The fairness argument faces logical and empirical difficulties, and even if it proved to be true, it is not clear that limiting the growth of specialty hospitals would be an efficient way to address the problem. However, there is some empirical evidence to support the efficiency concern, and if specialty hospitals result in the treatment of patients with lower expected net benefits from treatment, then it is possible that physician-owned facilities could result in an increasingly inefficient allocation of health care resources, higher insurance premiums, and higher rates of uninsurance.

  4. Facts about Hospital Worker Safety

    MedlinePlus

    ... discount. Many hospitals are self-insured, so they bear the entire cost of workers’ compensation losses directly. ... satisfied patients or their families. All of society bears the cost of workplace injuries. All of society ...

  5. Health Hazards of Hospital Personnel

    PubMed Central

    Clever, Linda Hawes

    1981-01-01

    Health care workers historically have faced serious health problems, such as exposure to patients with tuberculosis. For hospital personnel today, a number of hazards exist. These range from toxic substance exposure to safety hazards presented by patients themselves. PMID:7281652

  6. Recommendations for managing hospital closure.

    PubMed

    van der Wal, R; Bouthillette, F; Havlovic, S J

    1998-01-01

    An acute care hospital was closed by the British Columbia Ministry of Health in 1993. A research study was conducted to investigate the ways closure of the hospital affected hospital employees and to identify ways to facilitate the closure/reorganization process. Unstructured interviews were conducted with 25 employees around the time of closure and six months after the closure. In the category Living with Closure, six themes arose from the qualitative analysis. They related to (1) provision of information; (2) effect of closure on the working environment and colleagues; (3) perceived stress; (4) recognition of one's worth; (5) provision of support services; and (6) the process of having a new job. The authors offer recommendations stemming from the analysis, which are intended to assist others planning for future hospital reorganizations or closures.

  7. Air handling units for hospitals.

    PubMed

    Amoroso, V; Gjestvang, R

    1989-10-01

    Air handling units should provide proper quality and conditioned air to various hospital areas. Unit capacity should be able to meet limited space functionality or load changes as well as any smoke control requirements. System components should be readily accessible and appropriate for spaces served. In summary, engineers should consider the following: Environmental design criteria for area being served Components desired Unit type required Economic issues affecting design. Using this approach, design engineers can design hospital air handling units methodically and logically.

  8. 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.

  9. ALS insertion devices

    NASA Astrophysics Data System (ADS)

    Hoyer, E.; Chin, J.; Halbach, K.; Hassenzahl, W. V.; Humphries, D.; Kincaid, B.; Lancaster, H.; Plate, D.

    1991-08-01

    The Advanced Light Source (ALS), the first US third generation synchrotron radiation source, is currently under construction at the Lawrence Berkeley Laboratory. The low-emittance, 1.5 GeV electron storage ring and the insertion devices are specifically designed to produce high brightness beams in the UV to soft X-Ray range. The planned initial complement of insertion devices includes four 4.6 m long undulators, with period lengths of 3.9 cm, 5.0 cm (2) and 8.0 cm, and a 2.9 m long wiggler of 16 cm period length. Undulator design is well advanced and fabrication has begun on the 5.0 cm and 8.0 cm period length undulators. This paper discusses ALS insertion device requirements; general design philosophy; and design of the magnetic structure, support structure/drive systems, control system and vacuum system.

  10. Foodborne listeriosis acquired in hospitals.

    PubMed

    Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M

    2014-08-15

    Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods.

  11. [Evaluation of satisfaction of patients hospitalized at the Kairouan Hospital].

    PubMed

    Mtiraoui, Ali; Alouini, Borhane

    2002-03-01

    The patients' satisfaction studies are more and more utilized to underline the health centers' deficiencies and consequently set improvement action plans. Our survey aims to measure inpatients' satisfaction in its different dimensions. A survey centered around a transversal inquiry has been conducted during a period going from February to April 2000 and reached a total number of 817 patients hospitalized in six service units at kairouan hospital. The data has been gathered by structured interviews led by a previously trained social worker. The investigation tool was a standardized questionnaire prepared by a group of experts from WHO in the Oriental Mediterranean region. The main results are as follow: High satisfaction level concerning the global evaluation of the hospital service units was recorded (score = 70%). The patient who are more satisfied are those who have the feeling that their health situation has considerably improved, and who will probably recommend this hospital to their surroundings. Big proportion of the patients (77%) was expecting better services. The main reason behind their unhappiness is the information emanated whether from the nurses or the doctors, the comfort and the cleanness of waiting room, linen, room comfort, food and the emergency. These results showed that the quality of care improvements priorities, according to patient expectations are especially in relation with the quality of information, the relational aspects and the hospital stay conditions.

  12. Reporting hospital adverse events using the Alfred Hospital's morbidity data.

    PubMed

    Carroll, Rhonda; McLean, Jenny; Walsh, Michael

    2003-01-01

    Hospital morbidity data were analysed to determine their usefulness for reporting adverse events. The entire ICD-10-AM classification system was reviewed in conjunction with the Australian Coding Standards to identify external cause codes and code prefixes associated with adverse events. For the 50,712 separations registered at The Alfred from July 2000-June 2001, 4,740 external cause codes were associated with adverse events. Place of occurrence code CY92.22 was considered the best indicator of the number of separations associated with adverse events. Approximately 4% of all separations were associated with adverse events occurring during an episode of care. Results suggest that hospital morbidity data are useful for monitoring adverse events at hospital level. Reliable reporting across the health care industry requires consistent reporting requirements at state and national levels and the adoption of standard code prefixes nationally.

  13. Frequently Asked Questions about ALS and the ALS Registry

    MedlinePlus

    ... Why is it necessary to provide my Social Security Number (SSN) when registering in the National ALS ... Why is it necessary to provide my Social Security Number (SSN) when registering in the National ALS ...

  14. Internet connectivity for hospitals and hospital libraries: strategies.

    PubMed Central

    Fuller, S S

    1995-01-01

    Access to Internet resources and communications has rapidly become a necessity in many hospitals nationally. The results of a Pacific Northwest pilot Intenet connections project provides important evidence of the value of librarians in establishing such connections in their institutions The pilot project has resulted in a wealth of information regarding approaches to promoting the utility of the Internet to health professionals in hospitals. Roles that librarians are playing in support of such connections include facilitator, negotiator, provider, publisher, integrator, and educator. PMID:7703936

  15. Measuring nutritional risk in hospitals

    PubMed Central

    Rasmussen, Henrik H; Holst, Mette; Kondrup, Jens

    2010-01-01

    About 20%–50% of patients in hospitals are undernourished. The number varies depending on the screening tool amended and clinical setting. A large number of these patients are undernourished when admitted to the hospital, and in most of these patients, undernutrition develops further during hospital stay. The nutrition course of the patient starts by nutritional screening and is linked to the prescription of a nutrition plan and monitoring. The purpose of nutritional screening is to predict the probability of a better or worse outcome due to nutritional factors and whether nutritional treatment is likely to influence this. Most screening tools address four basic questions: recent weight loss, recent food intake, current body mass index, and disease severity. Some screening tools, moreover, include other measurements for predicting the risk of malnutrition. The usefulness of screening methods recommended is based on the aspects of predictive validity, content validity, reliability, and practicability. Various tools are recommended depending on the setting, ie, in the community, in the hospital, and among elderly in institutions. The Nutrition Risk Screening (NRS) 2002 seems to be the best validated screening tool, in terms of predictive validity ie, the clinical outcome improves when patients identified to be at risk are treated. For adult patients in hospital, thus, the NRS 2002 is recommended. PMID:21042553

  16. Technical Support Document: Development of the Advanced Energy Design Guide for Large Hospitals - 50% Energy Savings

    SciTech Connect

    Bonnema, E.; Leach, M.; Pless, S.

    2013-06-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Large Hospitals: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-LH) ASHRAE et al. (2011b). The AEDG-LH is intended to provide recommendations for achieving 50% whole-building energy savings in large hospitals over levels achieved by following Standard 90.1-2004. The AEDG-LH was created for a 'standard' mid- to large-size hospital, typically at least 100,000 ft2, but the strategies apply to all sizes and classifications of new construction hospital buildings. Its primary focus is new construction, but recommendations may be applicable to facilities undergoing total renovation, and in part to many other hospital renovation, addition, remodeling, and modernization projects (including changes to one or more systems in existing buildings).

  17. 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...

  18. 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...

  19. 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...

  20. Hospital pricing policies: the simple economics.

    PubMed

    Robison, G A; Robison, H D

    1986-10-01

    Changes in hospital reimbursement structures and the shrinking inpatient service market are forcing hospitals to reexamine their pricing strategies. This article examines historical hospital pricing, the effect of pricing in a competitive market and considerations for hospitals moving toward competitive pricing for services.

  1. A conflict of interest policy for hospitals.

    PubMed

    McClure, A E

    1993-01-01

    As the environment in which community hospitals operate becomes ever more complex, the opportunity for conflict of interest between the hospital and members of its governing board increases. This article examines the duties and responsibilities of hospital trustees and the ways in which hospitals can identify and manage conflict of interest.

  2. Report: hospitals need more sophisticated planning efforts.

    PubMed

    Anderson, H J

    1990-09-20

    Sophisticated planning efforts are increasing among hospitals. However, hospital planners and marketers still have far to go before they can match their counterparts in industry. This is according to a report on hospital planning recently released by the Society for Healthcare Planning and Marketing of the American Hospital Association, Chicago.

  3. 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...

  4. 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...

  5. Appropriate measures of hospital market areas.

    PubMed Central

    Garnick, D W; Luft, H S; Robinson, J C; Tetreault, J

    1987-01-01

    As public and private policymakers turn to market-oriented strategies to control hospital prices, it is necessary to understand the conceptual underpinnings of hospital market area measurement. This article provides a framework for evaluating which definitions of hospital market areas are suitable for various types of analyses. Hospital market areas can be defined from two perspectives: an individual hospital perspective and that of the overall market. From each perspective, empirical definitions can be based on geopolitical boundaries, distance between hospitals, and patient-origin data. In this article, market areas are compared based on various descriptions using data on California hospitals and patient discharge abstracts. PMID:3570813

  6. Al Jazirah, Sudan

    NASA Technical Reports Server (NTRS)

    2008-01-01

    Al Jazirah (also Gezira) is one of the 26 states of Sudan. The state lies between the Blue Nile and the White Nile in the east-central region of the country. It is a well populated area suitable for agriculture. The area was at the southern end of Nubia and little is known about its ancient history and only limited archaeological work has been conducted in this area. The region has benefited from the Gezira Scheme, a program to foster cotton farming begun in 1925. At that time the Sennar Dam and numerous irrigation canals were built. Al Jazirah became the Sudan's major agricultural region with more than 2.5 million acres (10,000 km) under cultivation. The initial development project was semi-private, but the government nationalized it in 1950. Cotton production increased in the 1970s but by the 1990s increased wheat production has supplanted a third of the land formerly seeded with cotton.

    The image was acquired December 25, 2006, covers an area of 56 x 36.4 km, and is located near 14.5 degrees north latitude, 33.1 degrees east longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  7. AL Amyloidosis and Agent Orange

    MedlinePlus

    ... for survivors' benefits . Research on AL amyloidosis and herbicides The Health and Medicine Division (formally known as ... to the compounds of interest found in the herbicide Agent Orange and AL amyloidosis." VA made a ...

  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.

  9. SARS in Hospital Emergency Room

    PubMed Central

    Chen, Yee-Chun; Huang, Li-Min; Chan, Chang-Chuan; Su, Chan-Ping; Chang, Ying-Ying; Chen, Mei-Ling; Hung, Chien-Ching; Chen, Wen-Jone; Lin, Fang-Yue; Lee, Yuan-Teh

    2004-01-01

    Thirty-one cases of severe acute respiratory syndrome (SARS) occurred after exposure in the emergency room at the National Taiwan University Hospital. The index patient was linked to an outbreak at a nearby municipal hospital. Three clusters were identified over a 3-week period. The first cluster (5 patients) and the second cluster (14 patients) occurred among patients, family members, and nursing aids. The third cluster (12 patients) occurred exclusively among healthcare workers. Six healthcare workers had close contact with SARS patients. Six others, with different working patterns, indicated that they did not have contact with a SARS patient. Environmental surveys found 9 of 119 samples of inanimate objects to be positive for SARS coronavirus RNA. These observations indicate that although transmission by direct contact with known SARS patients was responsible for most cases, environmental contamination with the SARS coronavirus may have lead to infection among healthcare workers without documented contact with known hospitalized SARS patients. PMID:15200809

  10. Al Qaeda as a System

    DTIC Science & Technology

    2006-03-15

    either as welcome guests or parasites . As welcome guests, Al Qaeda members take sanctuary in sponsor states. Sponsor states provide Al Qaeda with...sponsorship, Al Qaeda takes sanctuary as parasites either overtly or covertly. They take overt sanctuary in countries that publicly claim a policy...39 Yehudit Barsky, “Al Qa’ida, Iran, and Hezbollah: A Continuing Symbiosis ,” The American Jewish Committee Series on Terrorism , February 2004, 2-3

  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.

  12. Field guide to hospital cafeterias.

    PubMed

    Smith, R P

    1986-09-01

    We have all faced the problem of whether or not to venture into that gastronomic wasteland known as the hospital cafeteria. Hospital cafeterias have developed a reputation, deserved or otherwise, as less than ideal places to eat. Many people overlook the fact that this is a direct result of trying to provide patient meals that are salt-free, sugar-free, fiber-free, and taste-free. (Some faint traces of color may, occasionally, be found.) How then does one go about choosing whether to venture in, and how does one survive the encounter once there? The following guide has been assembled to help the reader through this difficult process.

  13. Pricing objectives in nonprofit hospitals.

    PubMed Central

    Bauerschmidt, A D; Jacobs, P

    1985-01-01

    This article reports on a survey of 60 financial managers of nonprofit hospitals in the eastern United States relating to the importance of a number of factors which influence their pricing decisions and the pricing objectives which they pursue. Among the results uncovered by the responses: that trustees are the single most important body in the price-setting process (doctors play a relatively unimportant role); that hospital pricing goals are more related to target net revenue than profit maximizing; and that regional factors seem to play an important role in management differences. PMID:4008272

  14. Evaluation methods for hospital projects.

    PubMed

    Buelow, Janet R; Zuckweiler, Kathryn M; Rosacker, Kirsten M

    2010-01-01

    The authors report the findings of a survey of hospital managers on the utilization of various project selection and evaluation methodologies. The focus of the analysis was the empirical relationship between a portfolio of project evaluation(1) methods actually utilized for a given project and several measures of perceived project success. The analysis revealed that cost-benefit analysis and top management support were the two project evaluation methods used most often by the hospital managers. The authors' empirical assessment provides evidence that top management support is associated with overall project success.

  15. 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... Measures § 486.322 Condition: Relationships with hospitals, critical access hospitals, and tissue banks. (a... Medicaid participating hospitals and critical access hospitals in its service area that have both...

  16. 42 CFR 447.280 - Hospital providers of NF services (swing-bed hospitals).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  17. 42 CFR 447.280 - Hospital providers of NF services (swing-bed hospitals).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  18. Bibliography for the Hospitality Industry.

    ERIC Educational Resources Information Center

    Nelson, Elizabeth A.

    This annotated bibliography is a sample collection of reference materials in the hospitality industry suitable for a small academic library. It is assumed that the library has a general reference collection. Publication dates range from 1992-96, with two publication dates in the 1980s. No periodicals are included. The 41 reference materials are…

  19. Antidepressants in the general hospital.

    PubMed Central

    Gelenberg, A. J.

    1979-01-01

    An approach to the use of antidepressant medication in the general hospital is presented. The type of depression most likely to respond to chemotherapy is described, categories of available antidepressant agents are discussed, and relevant pharmacologic aspects are outlined. This paper suggests clinical guidelines for the use of these drugs, particularly in medical and surgical patients. PMID:455184

  20. Emergency contraception and Catholic hospitals.

    PubMed

    Bucar, L; Nolan, D

    1999-01-01

    The "Ethical and Religious Directives for Catholic Health Care," which outline policies for Catholic hospitals in the US, are ambiguous on the topic of emergency contraception. Recent evidence suggests that, in the absence of definitive guidelines, Catholic hospitals are erring on the side of not providing emergency contraception. A survey of 589 US Catholic hospitals conducted by Catholics for a Free Choice found that 82% refused to supply emergency contraception--even to rape victims. Directive 36, which governs cases of sexual assault, could be argued to sanction the provision of emergency contraception. It states, "A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum." Because the process of conception takes approximately 2 days, it would be consistent with the Catholic Church's position to offer emergency contraception within 24 hours of a rape. Since no currently available test can confirm or deny conception as early as 72 hours after unprotected intercourse, the timetable for emergency contraception, Catholic hospitals should be able to provide this service to all women and still abide by the directives.

  1. 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.

  2. The PSRO hospital review system.

    PubMed

    Goran, M J; Roberts, J S; Kellogg, M A; Fielding, J; Jessee, W

    1975-04-01

    The 1972 Social Security amendments contained the landmark Professional Standards Review Organization (PSRO) provisions as well as several sections upgrading existing utilization review (UR) requirements under Medicare and Medicaid. With issuance of the PSRO Program Manual and the recent publication of the new UR regulations, HEW for the first time has brought Medicare and Medicaid hospital review requirements into conformity and made them compatible with and supportive of the PSRO program. This article defines the PSRO hospital review system, describes how the three major components-concurrent review, medical care evaluation studies, and profile analysis-interrelate and provides examples of each of these components. Under utilization review requirements or PSRO, hospitals will be required to implement an integrated system of review designed to assure appropriate utilization practices and improve the quality of care. These aims are to be accomplished through the application of concepts of peer review, the use of norms, criteria, and standards, the identification of deficiencies in the quality, administration, or appropriateness of health care services, and their correction through linkage with programs of continuing medical education. Although PSROs are initially responsible for review in hospitals, they will likely provide the locus for a community-wide system of peer review for all services provided under National Health Insurance.

  3. 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…

  4. 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

  5. Hospital mutual aid evacuation plan.

    PubMed

    Phillips, R

    1997-02-01

    Health care facilities need to be prepared for disasters such as floods, tornadoes and earthquakes. Rochester, NY, and its surrounding communities devised a hospital mutual aid evacuation plan in the event a disaster occurs and also to comply with the Joint Commission. This document discusses the plan's development process and also provides the end result.

  6. Hospital hygiene in Great Britain.

    PubMed

    Emmerson, A M

    1996-12-01

    ICT's in the UK are experienced, well trained and are enthusiastic. However, their efforts are frustrated through lack of resources. Infection Control is now a quality issue and defined separate budgets are being established and hospital contracts now contain elements of infection control as part of the service. Infection control is coming of age in the UK after 25 years of earnest effort.

  7. 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.

  8. Antidepressant adherence after psychiatric hospitalization

    PubMed Central

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

    2010-01-01

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

  9. Growth and Optical Properties of Al rich AlN/AlGaN Quantum Wells

    NASA Astrophysics Data System (ADS)

    Tahtamouni, T. M. Al; Nepal, N.; Nakarmi, M. L.; Lin, J. Y.; Jiang, H. X.

    2006-03-01

    Al rich AlGaN alloys are promising materials for the applications in the optoelectronic devices such as deep ultraviolet (UV) emitters and detectors in the spectral range down to 200 nm. AlGaN based UV emitters (λ<340nm) has applications in bio-chemical agent detection and medical research/ health care. To realize deep UV emission (λ< 280 nm) Al rich AlGaN based quantum wells (QWs) are required. We report here the growth of AlN/AlxGa1-xNQWs (x>0.65) on AlN/sapphire templates by metalorganic chemical vapor deposition (MOCVD). Deep UV photoluminescence (PL) was employed to study the optical properties of the QWs. Well width (Al composition) dependence was studied by varying the QW thickness (Al composition) with fixed x ˜ 0.65 (well width at 3 nm). Optical properties of these QWs such as the effects of alloy fluctuation, temperature, strain and piezoelectric field, carrier and exciton localizations on the quantum efficiency have been studied. Carrier and exciton dynamics were probed. Implications of our findings on the applications of Al rich AlN/AlGaN QWs for UV emitters and detectors will also be discussed.

  10. Studies of 27Al NMR in SrAl4

    NASA Astrophysics Data System (ADS)

    Niki, Haruo; Higa, Nonoka; Kuroshima, Hiroko; Toji, Tatsuki; Morishima, Mach; Minei, Motofumi; Yogi, Mamoru; Nakamura, Ai; Hedo, Masato; Nakama, Takao; Ōnuki, Yoshichika; Harima, Hisatomo

    A charge density wave (CDW) transition at TCDW = 243 K and a structural phase (SP) transition at approximately 100 K occur in SrAl4 with the BaAl4-type body center tetragonal structure, which is the divalent and non-4f electron reference compound of EuAl4. To understand the behaviors of the CDW and SP transitions, the 27Al NMR measurements using a single crystal and a powder sample of SrAl4 have been carried out. The line width below TCDW is modulated by an electrical quadruple interaction between 27Al nucleus and CDW charge modulation. The incommensurate CDW state below TCDW changes into a different structure below TSP. The temperature dependences of Knight shifts of 27Al(I) and 27Al(II) show the different behaviors. The temperature variation of 27Al(I) Knight shift shows anomalies at the CDW and SP transition temperatures, revealing the shift to negative side below TCDW, which is attributable to the core polarization of the d-electrons. However, 27Al(II) Knight shift keeps almost constant except for the small shift due to the SP transition. The 1/T1T of 27Al(I) indicates the obvious changes due to the CDW and SP transitions, while that of 27Al(II) takes a constant value. The density of state at the Fermi level at Al(I) site below 60 K would be about 0.9 times less than that above TCDW.

  11. Markets for hospital services in Zambia.

    PubMed

    Nakamba, Pamela; Hanson, Kara; McPake, Barbara

    2002-01-01

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

  12. 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.

  13. 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.

  14. 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.

  15. Contributions of Muhadhdhab Al-Deen Al-Baghdadi to the progress of medicine and urology. A study and translations from his book Al-Mukhtar.

    PubMed

    Abdel-Halim, Rabie E

    2006-11-01

    This study of the Arabic 4-volume book of Al-Mukhtar Fi Al-Tibb (Choice Book on Medicine) written by the Muslim physician Muhadhdhab Al-Deen Al-Baghdadi (515-610 H, 1117-1213 AD) aimed at evaluating his contributions to the progress of medicine and urology along with providing English translations of relevant excerpts. Al-Baghdadi laid emphasis on the morals of medical practice and the principles of medical education describing how to select medical students and how to evaluate graduates. He stressed on the need for a long training program directly supervised by skilled expert doctors both in hospitals (Al-Bimaristanat) and during home visits. A good part of volume 1 was allocated to preventive medicine and the whole of volume 2 was devoted to the pharmacy section, which he restricted to what was proven by the experience of his teacher and by his own experiments. Same as all his predecessors in the Islamic era, Al-Baghdadi stressed the importance of clinical medicine and gave more details related to history taking, physical examination, differential diagnosis and prognosis. Similar to them, he also, emphasized that a doctor should be quite knowledgeable in anatomy. Furthermore, the presence of anatomical drawings in Kitab Al-Mukhtar Fi Al-Tibb is a further step forward in illustrating medical text books; a trend that flourished in the Islamic era reflecting the role of direct observations and experience. The detailed description of the functional anatomy of the uretero-vesical junction and the antireflux and micturition mechanisms given by Al-Baghdadi is contrary to that of Galen (130-200 AD) but conforms well to our contemporary understanding. In the conservative management of urinary stones, he described 70 simple and 13 compound drugs while those described by Pulus of Aegina (625-690 AD) were only 20 simple and 3 compound drugs. Furthermore, Al-Baghdadi's description of the instruments and techniques of urethral catheterization, perineal cystolithotomy and

  16. Hospital advertising in California, 1991-1997.

    PubMed

    Town, Robert J; Currim, Imran

    2002-01-01

    This paper examines the advertising behavior of California hospitals from 1991 to 1997. Using highly detailed hospital-level information, we found that hospital advertising in California increased dramatically: annual spending on advertising grew (inflation adjusted) more than sixfold over the period. In addition, advertising expenditures varied significantly across hospitals. We found that hospital advertising increased with market concentration; with the number of nearby potential patients; with the percentage of nearby patients insured through Medicare, health maintenance organizations (HMOs), and indemnity insurance; and with chain affiliation. For-profit hospitals were not found to advertise more than their not-for-profit counterparts.

  17. Malnutrition among hospitalized patients in King Khalid University Hospital, Riyadh.

    PubMed

    Bani, I A; Al-Kanhal, M A

    1998-09-01

    The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM). Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, serum albumin and total lymphocyte count. Anthropometric measurements, weight for height and midarm circumference reflected malnutrition (PCM) of 33.8% and 30% respectively. The overall prevalence of obesity was 21%. A higher proportion (23.9%) of medical cases were found to be obese compared to surgical cases (19.7%). If malnutrition can be documented on hospital admission, attempts can be made to reverse malnutrition in the high risk patients.

  18. Rub' al Khali, Arabia

    NASA Technical Reports Server (NTRS)

    2008-01-01

    The Rub' al Khali is one of the largest sand deserts in the world, encompassing most of the southern third of the Arabian Peninsula. It includes parts of Oman, United Arab Emirates, and Yemen. The desert covers 650,000 square kilometers, more than the area of France. Largely unexplored until recently, the desert is 1000 km long and 500 km wide. The first documented journeys made by Westerners were those of Bertram Thomas in 1931 and St. John Philby in 1932. With daytime temperatures reaching 55 degrees Celsius, and dunes taller than 330 meters, the desert may be one of the most forbidding places on Earth.

    The image was acquired December 2, 2005, covers an area of 54.8 x 61.9 km, and is located near 20.7 degrees north latitude, 53.6 degrees east longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  19. Morton et al. Reply

    NASA Technical Reports Server (NTRS)

    Morton, Douglas C.; Nagol, Jyoteshwar; Carabajal, Claudia C.; Rosette, Jacqueline; Palace, Michael; Cook, Bruce D.; Vermote, Eric F.; Harding, David J.; North, Peter R. J.

    2016-01-01

    Multiple mechanisms could lead to up-regulation of dry-season photosynthesis in Amazon forests, including canopy phenology and illumination geometry. We specifically tested two mechanisms for phenology-driven changes in Amazon forests during dry-season months, and the combined evidence from passive optical and lidar satellite data was incompatible with large net changes in canopy leaf area or leaf reflectance suggested by previous studies. We therefore hypothesized that seasonal changes in the fraction of sunlit and shaded canopies, one aspect of bidirectional reflectance effects in Moderate Resolution Imaging Spectroradiometer (MODIS) data, could alter light availability for dry-season photosynthesis and the photosynthetic capacity of Amazon forests without large net changes in canopy composition. Subsequent work supports the hypothesis that seasonal changes in illumination geometry and diffuse light regulate light saturation in Amazon forests. These studies clarify the physical mechanisms that govern light availability in Amazon forests from seasonal variability in direct and diffuse illumination. Previously, in the debate over light limitation of Amazon forest productivity, seasonal changes in the distribution of light within complex Amazon forest canopies were confounded with dry-season increases in total incoming photosynthetically active radiation. In the accompanying Comment, Saleska et al. do not fully account for this confounding effect of forest structure on photosynthetic capacity.

  20. [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.

  1. Demand Management: The Primary Care Role at Ireland Army Community Hospital (IACH)

    DTIC Science & Technology

    2005-04-29

    internal medicine, and pediatrics (Kongstvedt, 2001). The principal role of primary care physicians is an inevitable evolution of managed care (Fox... Moron , Bacchetti, Baker & Bindman, 2001; Zhan, Miller, Wong, & Myer, 2004). A study examining the correlation of preventable hospitalizations and...effectiveness of primary care (Gill & Mainous, 1998; Backus, Moron , Bacchetti, Baker & Bindman, 2001; Bindman, et al., 1995; Zhan, Miller, Wong, & Myer, 2004

  2. A profile of out-of-hospital cardiac arrests in Northern Emirates, United Arab Emirates

    PubMed Central

    Batt, Alan M.; Al-Hajeri, Ahmed S.; Cummins, Fergal H.

    2016-01-01

    Objectives: To report the characteristics of out-of-hospital cardiac arrest patients and their outcomes in the emirates of Sharjah, Ras-al-Khaimah, Umm Al-Quwain, Fujairah, and Ajman in the United Arab Emirates (collectively known as the Northern Emirates). Methods: This is a prospective descriptive cohort study of out-of-hospital cardiac arrest incidents transported by the national ambulance crews between February 2014 and March 2015 in the Northern Emirates. Results: A total of 384 patients were enrolled in this study. Male victims of out-of-hospital cardiac arrest represented 76% of the participants. The mean age of the study population was 50.9 years. An over-all prehospital return of spontaneous circulation rate of 3.1% was documented, as well as a 30% rate of bystander cardiopulmonary resuscitation being performed. Public access defibrillators were applied in 0.5% of cases. Data is presented according to Utstein reporting criteria. Conclusion: Baseline data for out-of-hospital cardiac arrest was established for the first time in the Northern Emirates of the United Arab Emirates. A low survival rate for out-of-hospital cardiac arrest, low rates of bystander cardiopulmonary resuscitation, and low public access defibrillator use were discovered. Although low by comparison to established western systems results are similar to other systems in the region. Determining the baseline data presented in this study is essential in recommending and implementing strategies to reduce mortality from out-of-hospital cardiac arrest. PMID:27761558

  3. Prospective study of cost of care at multidisciplinary ALS centers adhering to American Academy of Neurology (AAN) ALS practice parameters.

    PubMed

    Boylan, Kevin; Levine, Todd; Lomen-Hoerth, Catherine; Lyon, Mary; Maginnis, Kimberly; Callas, Peter; Gaspari, Celeste; Tandan, Rup

    2015-01-01

    Multidisciplinary care in ALS is associated with longer survival, improved quality of life, and reduced hospital admissions, but there are no published data on institutional costs associated with multidisciplinary ALS care at U.S. centers. We prospectively examined institutional costs, adherence to AAN Practice Parameters and patient satisfaction in multidisciplinary ALS clinics at 18 U.S. ALS centers. Centers reported patient volumes; direct costs for staff salary/benefits, supplies and equipment; and institutional non-salary and overhead costs over a three-month period. In 1117 patients seen during this period, mean age was 61.5 years (range 25-91 years), 56% were male, and mean ALSFRS-R score was 29. Mean total salary/benefit cost per clinic day for all providers was $2964 (range $1692-$5236 across centers). Mean salary/benefit cost per patient per clinic was $507 (range $258-$806 across centers). Differences among centers in reporting non-salary costs prevented meaningful analysis. Practice parameter adherence and patient satisfaction were high. This prospective collaborative study demonstrates the direct financial burden of evidence-based multidisciplinary ALS care in the U.S.; more refined non-salary and overhead cost data are needed to evaluate the full cost impact of care. These data may be useful in supporting evidence-based models of patient centered care for ALS.

  4. Alexandria (Al Iskandariya), Egypt

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This image of Alexandria was taken by astronauts on board the International Space Station in December 2000 using an Electronic Still Camera. A wider-angle view (STS088-739-90) taken from the Space Shuttle in December 1998 is available for context. Alexandria (Al Iskandariya) occupies a T-shaped peninsula and strip of land separating the Mediterranean from Lake Mariout. Originally the town was built upon a mole (stone breakwater) called Heptastadium, which joined the island of Pharos (see referenced website, below) to the mainland. Since then sedimentary deposits have widened the mole. Since 1905, when the 370,000 Alexandrians lived in an area of about 4 sq km between the two harbors, the city (population 4 million; see referenced website, below) has grown beyond its medieval walls and now occupies an area of about 300 sq km. The Mahmudiya Canal, connecting Alexandria with the Nile, runs to the south of the city and, by a series of locks, enters the harbor of the principal port of Egypt (note ships). The reddish and ochre polygons west of Lake Mariout are salt-evaporation, chemical-storage, and water-treatment ponds within the coastal lagoon. Reference Youssef Halim and Fatma Abou Shouk, 2000, Human impacts on Alexandria's marine environment: UNESCO, Coastal Regions and Small Islands Unit (CSI), Coastal Management Sourcebooks 2 (accessed December 20, 2000) Additional photographs taken by astronauts can be viewed at NASA-JSC's Gateway to Astronaut Photography of Earth. Image ISS001-ESC-5025 provided by the Earth Sciences and Image Analysis Laboratory, Johnson Space Center.

  5. Shingles Vaccine Cuts Chronic Pain, Hospitalizations

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_164156.html Shingles Vaccine Cuts Chronic Pain, Hospitalizations Protection lasts years after ... age, researchers said. The new study showed the vaccine was 74 percent effective in preventing hospitalizations for ...

  6. Hospital demand for licensed practical nurses.

    PubMed

    Spetz, Joanne; Dyer, Wendy T; Chapman, Susan; Seago, Jean Ann

    2006-10-01

    Despite evidence that hospital use of licensed practical nurses (LPNs) declined in the 1990s, the current registered nurse (RN) shortage has prompted interest in LPNs as substitutes for RNs. Hospitals, being the dominant employer of RNs, have an economic incentive to use less expensive LPNs as substitutes. Beside wages, there are several forces underlying hospital demand for LPNs. In this article, the authors model and estimate hospital demand for LPNs as a function of nurse wages and hospital, market, and patient characteristics using a longitudinal data set of short-term general hospitals in the United States. The authors find evidence that higher RN wages increase hospital demand for LPNs, both in levels and relative to RNs, suggesting that hospitals at least partially substitute RNs with LPNs.

  7. 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.

  8. Hospital Sinks May Be Awash in 'Superbugs'

    MedlinePlus

    ... 163800.html Hospital Sinks May Be Awash in 'Superbugs' Study finds drug-resistant bacteria can colonize in ... News) -- New research suggests that the battle against "superbugs" -- multidrug-resistant bacteria -- should begin in hospital sinks. ...

  9. Metadata - National Hospital Discharge Survey (NHDS)

    EPA Pesticide Factsheets

    The National Hospital Discharge Survey (NHDS) is an annual probability survey that collects information on the characteristics of inpatients discharged from non-federal short-stay hospitals in the United States.

  10. Getting your home ready - after the hospital

    MedlinePlus

    ... 000432.htm Getting your home ready - after the hospital To use the sharing features on this page, ... home ready after you have been in the hospital often requires much preparation. Set up your home ...

  11. Observations on Hospitalized Dengue Patients

    DTIC Science & Technology

    1987-01-01

    DENGUE PATIENTS IN MANILA Carman. R. Min oto* be" S. Siqpo Ommon D. Leus** Curds G. Ibyes* INTRODUCION to the Hospital of Infant Jesus between October...31, 1983 and March 31, 1984: Criteria for the diagnosis of dengue Dengue hemorrhagic fever (DHF) has been recognized infection were based on the...titer of later sample < 1:640. DHF epidemic.4𔃿 Since that time, there have only been a few- was differentiated from dengue fever (DF), and DHF was

  12. Salmonella isolation from hospital areas.

    PubMed Central

    Harvey, R. W.; Price, T. H.; Joynson, D. H.

    1979-01-01

    Evidence of the presence of salmonellas in a paediatric ward, a special care baby unit, a maternity unit and a hospital kitchen was obtained by culture of sewer swabs, faeces and food samples. The survey was designed to cause as little administrative interference as possible. The technical aspects of the survey did not strain laboratory facilities. Minimal secondary spread of salmonella infection was experienced. PMID:390044

  13. [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.

  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.

  15. Is there a paraneoplastic ALS?

    PubMed

    Corcia, Philippe; Gordon, Paul H; Camdessanche, Jean-Philippe

    2015-06-01

    Our objective was to examine the strength of evidence in support of the paraneoplastic syndrome (PNS) as one cause of ALS and, if the association appears more likely than chance, determine which features of ALS imply concurrent malignancy. We reviewed the literature on concurrent ALS and neoplasia assessing the strength of evidence for the association. Most accounts of ALS and neoplasm are case reports or small uncontrolled series. In order of strength of evidence, three clinical situations that support a paraneoplastic aetiology for ALS are: 1) laboratory evidence of well-characterized onconeuronal antibodies, most often anti-Hu, anti-Yo or anti-Ri; 2) co-occurrence of ALS and a neoplasm known to cause PNS, usually lymphoma or cancer of the breast; and 3) combined ALS and a neoplasm not classically associated with PNS, without detectable onconeuronal antibodies. Clinical features that warrant evaluation of neoplasm include upper motor neuron disease in elderly females, rapid progression, non-motor signs, and young onset. In conclusion, most examples of ALS and neoplasm do not constitute a classically established PNS. Rare instances of elevated onconeuronal antibody titres or typical neoplasm, implies that, albeit rare, the PNS is one of a multitude of causes of ALS.

  16. Sociodemographic and Clinical Characteristics of Psychiatric Inpatients Hospitalized Involuntarily and Voluntarily in a Mental Health Hospital

    PubMed Central

    GÜLTEKİN, Bülent Kadri; ÇELİK, Seda; TİHAN, Aysu; BEŞKARDEŞ, Ali Fuat; SEZER, Umut

    2013-01-01

    Introduction In this study, we aimed to investigate and compare the sociodemographic and clinical characteristics of psychiatric inpatients hospitalized involuntarily and voluntarily. To our knowledge, there is no study analyzing involuntary psychiatric hospitalization in our country. Method In this retrospective study, we included a total of 504 patients who were involuntarily or voluntarily hospitalized in Bolu Izzet Baysal Mental Health Hospital between 1st of May and 31st October 2010. The data were obtained from the hospital records. Result In the 6-month period, 13.1% of 504 inpatients were hospitalized involuntarily. The number of male patients who were involuntarily hospitalized was higher than the number of female patients. Most of the patients in the involuntary hospitalized group were graduates of primary school, were not married and were not working at the time of hospitalization. Schizophrenia was the most common diagnosis in the involuntarily hospitalized psychiatric patients and these patients needed longer stay in the hospital. The next hospitalization of the involuntarily hospitalized patients was mostly involuntary. Conclusion Most of the involuntarily hospitalized psychiatric inpatients were male, were not working and had the diagnosis of schizophrenia. These general psychiatric risk factors were more important in involuntary hospitalization compared to voluntary hospitalization. We concluded that the high prevalence of involuntary hospitalizations deserved further studies.

  17. 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.

  18. Prognosis after Hospitalization for Erythroderma.

    PubMed

    Egeberg, Alexander; Thyssen, Jacob P; Gislason, Gunnar H; Skov, Lone

    2016-11-02

    Erythrodermic psoriasis (EP) and erythroderma exfoliativa (EE) are acute and potentially life-threatening inflammatory reactions. We estimated hazard ratios (HRs) of 3-year mortality following hospitalization for EP or EE compared with general population controls, patients hospitalized for psoriasis vulgaris, and toxic epidermal necrolysis (TEN), respectively. We identified 26 and 48 patients with a first-time hospitalization (1997-2010) for EP and EE, respectively (10 matched population-controls for each patient), 1,998 patients with psoriasis vulgaris, and 60 patients with TEN. During follow-up, 8 (30.8%) patients with EP, 19 (39.6%) patients with EE, and 34 (56.7%) patients with TEN died. Compared with population-controls, adjusted HRs were 4.40 (95% CI 1.66-11.70) for EP and 2.16 (1.21-3.82) for EE. Compared with psoriasis vulgaris, adjusted HRs were 1.83 (0.90-3.73) for EP, and 1.28 (1.01-1.63) for EE. The risk was significantly lower in EP (0.38 (0.16-0.91)) and in EE (0.50 (0.36-0.71)), compared with TEN. Mortality in EP and EE is high, and close follow-up is advised.

  19. Functional seismic evaluation of hospitals

    NASA Astrophysics Data System (ADS)

    Guevara, L. T.

    2003-04-01

    Functional collapse of hospitals (FCH) occurs when a medical complex, or part of it, although with neither structural nor nonstructural damage, is unable to provide required services for immediate attention to earthquake victims and for the recovery of the affected community. As it is known, FCH during and after an earthquake, is produced, not only by the damage to nonstructural components, but by an inappropriate or deficient distribution of essential and supporting medical spaces. This paper presents some conclusions on the analysis of the traditional architectural schemes for the design and construction of hospitals in the 20th Century and some recommendations for the establishment of evaluation parameters for the remodeling and seismic upgrade of existing hospitals in seismic zones based on the new concepts of: a) the relative location of each essential service (ES) into the medical complex, b) the capacity of each of these spaces for housing temporary activities required for the attention of a massive emergency (ME); c) the relationship between ES and the supporting services (SS); d) the flexibility of transformation of nonessential services into complementary spaces for the attention of extraordinary number of victims; e) the dimensions and appropriateness of evacuation routes; and d) the appropriate supply and maintenance of water, electricity and vital gases emergency installations.

  20. 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.

  1. Current trends in hospital mergers and acquisitions.

    PubMed

    Brown, Thomas C; Werling, Krist A; Walker, Barton C; Burgdorfer, Rex J; Shields, J Jordan

    2012-03-01

    Healthcare reform will impact hospital consolidation in three key areas: Payment rates will decrease, indirectly encouraging consolidation by forcing hospitals to find new ways to reduce costs and increase negotiating clout with suppliers and payers. The cost of doing business will increase as hospitals spend more on compliance, technology, and physician employment. The ACO model will encourage hospital network formation by rewarding integrated healthcare systems that can reduce costs and improve quality.

  2. Management control literature and French public hospitals.

    PubMed

    Georgescu, Irène

    2013-08-01

    The introduction of activity based pricing in combination with hospitals' reorganizations has created a new financial logic in French public hospitals. The organization has an obligation to produce certain levels of activity, since hospitals' resources are directly dependent on the activity level. These changes also imply the implementation of financial results controls in these organizations. The purpose of this answer is to demonstrate how the literature on management control can help to understand what has been happening within the French public hospitals.

  3. Marketing issues for the hospital industry.

    PubMed

    Godiwalla, Yezdi H; Godiwalla, Shirley Y

    2002-01-01

    The controls on payments by insurance companies and governmental agencies (Medicare, Medicaid, Title 19) to hospitals have led to restricted hospital services for patients. This situation has caused over-capacity in hospitals. Also, there is a surplus of both hospital capacity and doctors. However, there are frequent shortages of nurses and many other trained technical personnel. This situation has behavioral implications which are discussed in this paper.

  4. Market orientation and organizational culture in hospitals.

    PubMed

    Proenca, E J

    1996-01-01

    Hospitals have been advised to respond to environmental pressures by changing from a product to a market orientation. Such changes are difficult to accomplish because of the entrenched behaviors and attitudes of hospitals employees. This article proposes organizational cultures as the avenue to a market orientation. It describes the role of hospital culture as an antecedent to market orientation. It also suggests ways to develop and maintain a market-oriented culture in hospitals.

  5. Impurity Enhancement of Al_2O_3/Al Adhesion

    NASA Astrophysics Data System (ADS)

    Wang, Xiao-Gang; Smith, John R.; Zhang, Wenqing; Evans, Anthony

    2003-03-01

    Our first-principles computations indicate that the clean Al_2O_3/Al interface is relatively weak - weaker than bulk Al. Fracture experiments reveal that the interface is relatively strong with observed failure in bulk Al, however. This paradox is resolved via doping effects of the common impurity C. We have found that only 1/3 of a monolayer of carbon segregated to the interface can increase the work of separation by a factor of 3. The resulting strong interface is consistent with fracture experiments. It arises due to void formation in the interface, which provides low-strain sites for the carbon to segregate to. The degree of void formation is consistent with the relatively high heat of oxide formation of Al.

  6. Hospital Library Standards: An Administrator's View

    ERIC Educational Resources Information Center

    Koughan, William P.

    1975-01-01

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

  7. Developing Marketing Strategies for University Teaching Hospitals.

    ERIC Educational Resources Information Center

    Fink, Daniel J.

    1980-01-01

    University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, consumerism, and a declining urban population base. New marketing strategies are seen as ways in which teaching hospitals can achieve better relationships with institutions, practitioners, and surrounding communities and…

  8. The risks of getting hospital discharge wrong.

    PubMed

    2016-08-01

    Hospital discharge remains a hot topic for all of us who work with older people. As the recent National Audit Office (NAO) 2016 report on discharging older patients from hospital rather bluntly put it: 'There are currently far too many older people in hospitals who do not need to be there.'

  9. [Psychiatric and psychosomatic day hospitals in Austria].

    PubMed

    Evans, Janet; Dummer, Verena; Kinzl, Johann

    2016-12-01

    This paper on psychiatric and psychosomatic day hospitals in Austria first looks at the overall situation of Austrian day clinics then, in a second step, compares psychiatric and psychosomatic day hospitals. For this purpose, a questionnaire was developed and sent to all psychiatric and psychosomatic day hospitals in Austria. The first part consisted of closed questions and was used to gather and evaluate the categories: general conditions for treatment in day hospitals, tasks of day hospitals, therapeutic paradigms, indication and contraindication, diagnostics, day hospital organisation, interdisciplinary cooperation and the offering in day hospitals. The second section consisted of open questions which were used to gather and evaluate active factors, difficulties, specifics and requests for future treatment in day hospitals. The results show that there is a trend towards more day hospitals. Psychosomatic day hospitals are a rather new phenomenon. Furthermore, the distinction between psychiatric and psychosomatic day hospitals is important in order to offer patients distinguishable treatment options in future. The results show that psychiatric and psychosomatic day hospitals both have a strong focus on psychotherapy and both fulfill the active factors for psychotherapy by Grawe.

  10. 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…

  11. 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... 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 §...

  12. 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 §...

  13. 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 §...

  14. 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 §...

  15. 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 §...

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

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

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

  17. Thermal Modeling of Al-Al and Al-Steel Friction Stir Spot Welding

    NASA Astrophysics Data System (ADS)

    Jedrasiak, P.; Shercliff, H. R.; Reilly, A.; McShane, G. J.; Chen, Y. C.; Wang, L.; Robson, J.; Prangnell, P.

    2016-09-01

    This paper presents a finite element thermal model for similar and dissimilar alloy friction stir spot welding (FSSW). The model is calibrated and validated using instrumented lap joints in Al-Al and Al-Fe automotive sheet alloys. The model successfully predicts the thermal histories for a range of process conditions. The resulting temperature histories are used to predict the growth of intermetallic phases at the interface in Al-Fe welds. Temperature predictions were used to study the evolution of hardness of a precipitation-hardened aluminum alloy during post-weld aging after FSSW.

  18. 76 FR 67567 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

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

  19. 75 FR 60640 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ... Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY... Rehabilitation and Respiratory Care Services; Medicaid Program: Accreditation for Providers of Inpatient... ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

  20. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... status. A satellite of a long-term care hospital that occupies space in a building used by another..., a hospital that occupies space in a building also used by another hospital, or in one or more... from the governing body of the hospital occupying space in the same building or on the same campus....

  1. 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.…

  2. 77 FR 60315 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ...-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific...

  3. 78 FR 15882 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ...-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific...

  4. 77 FR 63751 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-17

    ...; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory...

  5. Philosophieren als Unterrichtsprinzip im Mathematikunterricht

    NASA Astrophysics Data System (ADS)

    Meerwaldt, Diana

    Philosophieren und Mathematik scheinen zunächst gegensätzliche Bereiche zu sein, die sich kaum vereinbaren lassen. Dies trifft für eine Auffassung zu, die Philosophieren als "Gerede" disqualifiziert und Mathematik als eine reine "Formelwissenschaft" begreift. Beide Auffassungen werden den Gegenständen nicht gerecht.

  6. The Evolution of Al Qaeda

    DTIC Science & Technology

    2007-06-15

    Al Qaeda is a product of the forces of globalization. Increasing access to global finances , international travel, and sophisticated technology is...evolution. Al Qaeda is a product of the forces of globalization. Increasing access to global finances , international travel, and sophisticated technology...75 Finance

  7. Factors Influencing Fourth-Year Pharmacy Students’ Decisions to Pursue a Hospital Pharmacy Residency

    PubMed Central

    Dupuis, Sébastien; Martel, Alexis; Arfa, Taha; Valma, Joannah; Williamson, David R; Perreault, Marc M

    2016-01-01

    Background: The Canadian Society of Hospital Pharmacists promotes the recruitment of residency-trained pharmacists for work in hospitals and related health care settings. However, Quebec hospitals are still hiring non–residency trained pharmacists, in part because of a severe shortage of hospital pharmacists. To date, no studies have examined the factors influencing the career choices of fourth-year pharmacy students in Canada. Objectives: To identify motivating factors and barriers influencing students’ decision to pursue a hospital pharmacy residency. Methods: All 186 fourth-year students in the Faculty of Pharmacy, Université de Montréal, were invited by e-mail to participate in a validated and institutionally approved survey that was available online between March and May 2014. Results: Of the 138 respondents who returned a completed survey (74% response rate), 36 (26%) planned to apply for a hospital pharmacy residency. Those planning to apply for a residency were older (p = 0.037) and had more hospital work experience (36% versus 3%, p < 0.001) than those not planning to apply. The most important motivators for pursuing a residency were potential gains in knowledge (reported by 88% of respondents, whether or not they were planning to pursue a residency), experience (80%), and self-confidence (62%). The most frequently reported barriers were recognition that a hospital pharmacy residency is a highly demanding program (65%), having work available upon graduation from the undergraduate program (43%), and financial obligations (34%). Hospital experiential rotations influenced, either positively or negatively, 23 (72%) of the 32 students who changed their decision to pursue or not pursue residency training over the course of their studies. Conclusions: The potential gain in knowledge and experience acquired through residency, the fact that it is considered a highly demanding program, and having work available upon graduation from undergraduate studies were

  8. Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants.

    PubMed

    Azzeh, Firas S; Alazzeh, Awfa Y; Dabbour, Ibrahim R; Jazar, Abdelelah S; Obeidat, Ahmed A

    2014-10-01

    Introducción: Los bebés con bajo peso al nacer reciben asistencia nutricional hospitalaria para reforzar su supervivencia y peso corporal. Sin embargo, cada hospital tiene su propia fórmula de asistencia nutricional. Por lo tanto, la efectividad de esta asistencia nutricional debería ser investigada. Objetivo: Evaluar el efecto de la asistencia nutricional hospitalaria sobre la velocidad del crecimiento velocidad del crecimiento y el estado nutricional de bebés con bajo peso al nacer en el hospital Al-Noor, Arabia Saudita. Métodos: Se llevó a cabo un estudio interseccional entre octubre de 2010 y diciembre de 2012. Se seleccionó a trescientos recién nacidos del hospital Al-Noor de la ciudad de Makkah, Arabia Saudita. Los bebés fueron seleccionados según su peso al nacer y fueron separados en tres grupos iguales: (i) Bajo peso al nacer (BPN) (peso de nacimiento 1501- 2500 g), (ii) Muy Bajo peso al nacer (MBPN) (peso de nacimiento 1001-1500 g) y (iii) Peso extremadamente bajo al nacer (PEBN) (peso de nacimiento < 1000 g). Los datos fueron recopilados en el momento del nacimiento y en el momento del alta. Los pesos fueron registrados y se calculó la velocidad del crecimiento. Se hizo la medición de algunos tests bioquímicos y niveles minerales. Resultados: los valores de índice de masa corporal del VBPN y EBPN fueron menores (p < 0.05) que los del grupo BPN. La velocidad de crecimiento de los niños de todos los grupos osciló entre 8.7 y 10.2 g/kg/d sin diferencias (p > 0.05) observadas entre grupos. Los niveles de suero, calcio, fósforo y potasio en el momento del alta fueron superiores (p < 0.05) que los del momento del nacimiento para los grupos de EBPN y VBPN, mientras que los niveles de sodio descendieron en el grupo de EBPN hasta un rango normal. El nivel de albúmina mejoró (p < 0.05) en el grupo de EBPN. Conclusión: La gestión de la atención sanitaria para bebés con bajo peso al nacer en el hospital Al-Noor no fue suficiente para alcanzar

  9. 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.

  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. Organ donation: the role of hospitals.

    PubMed

    Land, W; Schulz, C

    1990-11-01

    Three models of cooperation between hospitals and transplant centres are: (1) performance of brain death diagnosis, organ removal and preservation at the peripheral hospital; (2) performance of brain death diagnosis at the peripheral hospital and transportation of the dead body under ICU modalities to the transplant centre; (3) transport of a potential organ donor to the transplant centre. The key issues for success in cooperation between peripheral hospitals and transplant centres are: positive attitudes of hospital representatives; motivation and acceptance of ICU staff, supported by the whole community; and availability of adequate facilities to perform organ recovery in practice.

  12. 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

  13. [A future path toward cooperation: hospital partnership].

    PubMed

    de Roodenbeke, E

    1994-01-01

    Development agencies have been promoting hospital programs in developing countries for several years. Although they have placed the accent on reorganising the management of these hospitals, most funds have been used for investment in buildings and equipment. This policy has failed, for several reasons. In many cases the field of intervention is too narrow, and involved too few professionals. There is also an erroneous belief that management restructuring can solve all the problems of running an hospital. Indeed, practitioners themselves, who are the cutting edge, are often ignored. Many projects are started without evaluating the resources of the hospital team. And a training program is not always the best solution when there is a lack of motivation or poor basic knowledge. Development agencies are often simply regarded a funding sources, yet money is not the answer to all hospital problems. Clearly development agencies cannot enter partnerships directly with hospitals in developing countries, but the solution may be to get these hospital more involved. For example, French hospitals are legally authorized to undertake international cooperation programs, free from time limits and political pressures, contrary to development agencies. What is more, hospitals in the developed countries can learn much about cost rationalization from their counterparts in the developing countries. Development agencies should thus encourage this sort of hospital "twinning" initiative and provide financial support, but it is important that the hospitals involved should be fully independent to avoid excessive bureaucracy.

  14. [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.

  15. Characteristics of CeCoIn5/Al/AlOx/Nb and CeCoIn5/Al/AlOx/Al Tunnel Junctions

    SciTech Connect

    Petrovic, C.; Nevirkovets, I.P.; Chernyashevskyy, O.; Hu, R.; Ketterson, J.B.; Sarma, B.K.

    2009-03-03

    We report characteristics of CeCoIn{sub 5}/Al/AlO{sub x}/Nb and CeCoIn{sub 5}/Al/AlO{sub x}/Al tunnel junctions fabricated on the (0 0 1) surface of CeCoIn{sub 5} crystal platelets. The main result of this work is the observation of a low Josephson current (as compared with that expected from the Ambegaokar-Baratoff formula), which is consistent with idea that the order parameter in the heavy-fermion superconductor CeCoIn{sub 5} has unconventional pairing symmetry.

  16. 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.

  17. 'Patient satisfaction' in hospitalized cancer patients.

    PubMed

    Skarstein, Jon; Dahl, Alv A; Laading, Jacob; Fosså, Sophie D

    2002-01-01

    Predictors of 'patient satisfaction' with hospitalization at a specialized cancer hospital in Norway are examined in this study. Two weeks after their last hospitalization, 2021 consecutive cancer patients were invited to rate their satisfaction with hospitalization, quality of life, anxiety and depression. Compliance rate was 72% (n = 1453). Cut-off levels separating dissatisfied from satisfied patients were defined. It was found that 92% of the patients were satisfied with their stay in hospital, independent of cancer type and number of previous admissions. Performance of nurses and physicians, level of information perceived, outcome of health status, reception at the hospital and anxiety independently predicted 'patient satisfaction'. The model explained 35% of the variance with an area under the curve of 0.76 of the Receiver Operator Curve. Cancer patients' satisfaction with their hospital stay was high, and predicted by four independently predictive variables related to the performance of caregivers. These suggest areas for further improvement in the healthcare service.

  18. 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.

  19. [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.

  20. 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.

  1. 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

  2. Co-circulation of Dengue and Chikungunya Viruses, Al Hudaydah, Yemen, 2012.

    PubMed

    Rezza, Giovanni; El-Sawaf, Gamal; Faggioni, Giovanni; Vescio, Fenicia; Al Ameri, Ranya; De Santis, Riccardo; Helaly, Ghada; Pomponi, Alice; Metwally, Dalia; Fantini, Massimo; Qadi, Hussein; Ciccozzi, Massimo; Lista, Florigio

    2014-08-01

    We investigated 400 cases of dengue-like illness in persons hospitalized during an outbreak in Al Hudaydah, Yemen, in 2012. Overall, 116 dengue and 49 chikungunya cases were diagnosed. Dengue virus type 2 was the predominant serotype. The co-circulation of these viruses indicates that mosquitoborne infections represent a public health threat in Yemen.

  3. Medical application of 26Al

    NASA Astrophysics Data System (ADS)

    Steinhausen, C.; Gerisch, P.; Heisinger, B.; Hohl, Ch.; Kislinger, G.; Korschinek, G.; Niedermayer, M.; Nolte, E.; Dumitru, M.; Alvarez-Brückmann, M.; Schneider, M.; Ittel, T. H.

    1996-06-01

    Accelerator mass spectrometry (AMS) measurements with 26Al as tracer were performed in order to study the aluminium metabolism and anomalies in the human body and in rats. In particular, the differences between healthy volunteers and patients with renal failure were investigated. The obtained data points of 26Al in blood and urine were described by an open compartment model with three peripheral compartments. It was found that the minimum of peripheral compartments needed to describe 26Al concentrations in blood and urine over a time period of three years is at least three.

  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. Missan Surgical Hospital Under the Economic Support Fund Al Amarah, Iraq

    DTIC Science & Technology

    2009-07-16

    the province along with numerous branches originating from the eastern side of the province. The lands of Missan are known for their high fertility ...m (18 inches) above grade. It is unclear how the sludge cake will be removed from the filter press room or how large equipment maintenance will be...reinforcement requirements of section 10.6 may be waived where tests and structural analysis show that adequate strength and feasibility of construction can

  6. [Procedure optimization in hospital management].

    PubMed

    Bauer, M; Hanss, R; Schleppers, A; Steinfath, M; Tonner, P H; Martin, J

    2004-05-01

    Starting January 1st 2004 the German diagnosis-related group (DRG) system was established for in-patient cases. Consequently, the detection and realization of cost-saving potentials are becoming more and more important. For a successful future, efficient allocation of resources is essential. Economically, anaesthesia-related time delays during perioperative work-flow should be minimized. Since numerous entities contribute to perioperative care, it is extremely complex to analyze and optimize this process flow. In this publication single steps leading to an optimized perioperative process flow will be presented: documentation of predefined time points, calculation of relevant time intervals and analysis of key numbers for complex settings. Single steps of the given process analysis will be demonstrated using data from surgical patients at the University Hospital Schleswig-Holstein, Campus Kiel. The attached data collection sheets can be used by interested hospital departments and are meant to serve as a template for further process analyses. Based on the shown analysis, an example will be given to develop an optimized work-flow as a standard operating procedure (SOP). The implementation of the SOP module in an interdisciplinary clinical pathway (CP), which defines efficient medical care from admission to discharge, is mainly responsible for decreased process costs but increased quality of care.

  7. Utilization of Facilities of a University Hospital

    PubMed Central

    McCorkle, Lois P.

    1966-01-01

    The lengths of hospital stay among adult inpatients discharged during 1962 from the medical and surgical specialty departments of a large urban university-affiliated general hospital have been examined. Data are shown comparing the durations of hospitalization of patients who had a private physician directly responsible for their hospital care (private patients) and of those who did not (staff patients). The relation between the lengths of stay of private patients and those of staff patients varied considerably from one hospital department to another. On the medical services, staff patients had longer hospital stays than did private patients, a discrepancy that could not be accounted for by differences between the two groups in age, race, sex, or source of payment for hospitalization and it is being studied further. A major cause of the apparent difference in lengths of hospitalization between private and staff surgical patients proved to be inconsistencies in the criteria used to define the terms “hospital admission” and “inpatient” among various patient groups. Some of the possible effects of variations in the definition of these terms and of the terms “medical patients” and “surgical patients” in hospital-use studies are discussed. Images Fig. 1 PMID:5915337

  8. Hospitals' marketing challenge: influencing physician behavior.

    PubMed

    MacStravic, R C

    1985-05-01

    Physicians' referring and admitting behavior as well as their clinical management practices are major determinants of hospitals' profitability under prospective payment. Four techniques are available to hospitals that seek to increase market share: Recruitment and retention strategies. In planning the mix of specialties represented on staff, hospitals should consider the effects of a physician's practice on the hospital's case mix. Peer pressure. Peer review programs in hospitals as well as through medical or specialty societies may help persuade physicians to alter their use of services. Education and information programs. Hospitals can assist physicians in patient management by conducting economic grand rounds, developing committees to study and communicate cost data to physicians, and providing information on alternatives to hospitalization. Incentives. Putting physicians at risk by linking planned expenditures to hospital financial performance can influence practice patterns. Other techniques include offering limited partnerships to medical staff members and merging the hospital and medical staff into one corporation. Hospitals may also need to influence physicians away from ventures that compete directly with the institution, such as ambulatory surgery centers.

  9. The Transformation of the Fleet Hospital Program from a Platform-Based Hospital to a Modular, Capability-Based Hospital

    DTIC Science & Technology

    2007-11-02

    dental services and facilities maintained by the Department of the Navy. BUMED is responsible for active duty fleet hospital staffing decisions and...exception of dental -oral surgery. 10 Assembly of this facility requires three-to-five days and eleven acres of clear land (Fleet Hospitals 2001, 2-3...utilize digital radiography , each service has adopted the use of these systems. These systems allow the hospitals to copy x-ray images to a CD that is

  10. Price adjustment in the hospital sector: how should the NHS discriminate between providers. A comment on Miraldo, Siciliani and Street.

    PubMed

    Mougeot, Michel; Naegelen, Florence

    2012-01-01

    Miraldo et al. (2011) have analyzed the price adjustment policy of a payer implementing a Prospective Payment System in the hospital sector in the presence of exogenous cost differences when no lump-sum transfers are allowed. They focus on deriving conditions for the price adjustment being positive. In this paper, using a result of Miraldo et al., we emphasize whether the price adjustment is larger or smaller than the marginal cost. We show how the discrimination operates against either the low-cost or the high-cost hospitals according to the value of the elasticity of the additional marginal cost with respect to the quantity of services.

  11. The Impact of Setting the Standards of Health Promoting Hospitals on Hospital Indicators in Iran

    PubMed Central

    Amiri, Mohammad; Khosravi, Ahmad; Riyahi, Leila

    2016-01-01

    Hospitals play a critical role in the health promotion of the society. This study aimed to determine the impact of establishing standards of health promoting hospitals on hospital indicators in Shahroud. This applied study was a quasi-experimental one which was conducted in 2013. Standards of health promoting hospitals were established as an intervention procedure in the Fatemiyeh hospital. Parameters of health promoting hospitals were compared in intervention and control hospitals before and after of intervention (6 months). The data were analyzed using chi-square and t-test. With the establishment of standards for health promotion hospitals, standard scores in intervention and control hospitals were found to be 72.26 ± 4.1 and 16.26 ± 7.5, respectively. T-test showed a significant difference between the mean scores of the hospitals under study (P = 0.001).The chi-square test also showed a significant relationship between patient satisfaction before and after the intervention so that patients’ satisfaction was higher after the intervention (P = 0.001). Commenting on the short-term or long-term positive impacts of establishing standards of health promoting hospitals on all hospital indicators is a bit difficult but preliminary results show the positive impact of the implementation of standards in case hospitals which has led to the improvement of many indicators in the hospital. PMID:27959930

  12. Reply to Gopalswamy et al.

    NASA Technical Reports Server (NTRS)

    Cane, H. V.; Richardson, I. G.

    2003-01-01

    The comment of Gopalswamy et al. (thereafter GMY) relates to a letter discussing coronal mass ejections (CMEs), interplanetary ejecta and geomagnetic storms. GMY contend that Cane et al. incorrectly identified ejecta (interplanetary CMEs) and hypothesize that this is because Cane et al. fail to understand how to separate ejecta from "shock sheaths" when interpreting solar wind and energetic particle data sets. They (GMY) are wrong be cause the relevant section of the paper was concerned with the propagation time to 1 AU of any potentially geoeffective structures caused by CMEs, i.e. upstream compression regions with or without shocks, or ejecta. In other words, the travel times used by Cane et al. were purposefully and deliberately distinct from ejecta travel times (except for those slow ejecta, approx. 30% of their events, which generated no upstream features), and no error in identification was involved. The confusion of GMY stems from the description did not characterize the observations sufficiently clearly.

  13. In memory of Al Cameron

    NASA Astrophysics Data System (ADS)

    Cowan, John; Truran, James W.

    Al Cameron, who died recently (October 3, 2005) at 80, was one of the giants in astrophysics. His insights were profound and his interests were wide-ranging. Originally trained as a nuclear physicist, he made major contributions in a number of fields, including nuclear reactions in stars, nucleosynthesis, the abundances of the elements in the Solar System, and the origin of the Solar System and the Moon. In 1957, Cameron and, independently, Burbidge, Burbidge, Fowler and Hoyle, wrote seminal papers on nuclear astrophysics. Most of our current ideas concerning ele- ment formation in stars have followed from those two pioneering and historical works. Al also made many contributions in the field of Solar System physics. Particularly noteworthy in this regard was Cameron's work on the formation of the Moon. Al was also a good friend and mentor of young people. Al Cameron will be missed by many in the community both for his scientific contributions and for his friendship.

  14. Al-Co-Fe (030)

    NASA Astrophysics Data System (ADS)

    Carow-Watamura, U.; Louzguine, D. V.; Takeuchi, A.

    This document is part of Part 1 http://dx.doi.org/10.1007/9getType="URL"/> 'Systems from Ag-Al-Ca to Au-Pd-Si' of Subvolume B 'Physical Properties of Ternary Amorphous Alloys' of Volume 37 'Phase Diagrams and Physical Properties of Nonequilibrium Alloys' of Landolt-Börnstein - Group III 'Condensed Matter'. It contains the Chapter 'Al-Co-Fe (030)' with the content:

  15. Al-La-Nb (068)

    NASA Astrophysics Data System (ADS)

    Carow-Watamura, U.; Louzguine, D. V.; Takeuchi, A.

    This document is part of Part 1 http://dx.doi.org/10.1007/97.etType="URL"/> 'Systems from Ag-Al-Ca to Au-Pd-Si' of Subvolume B 'Physical Properties of Ternary Amorphous Alloys' of Volume 37 'Phase Diagrams and Physical Properties of Nonequilibrium Alloys' of Landolt-Börnstein - Group III 'Condensed Matter'. It contains the Chapter 'Al-La-Nb (068)' with the content:

  16. Al-Cu-Zr (050)

    NASA Astrophysics Data System (ADS)

    Carow-Watamura, U.; Louzguine, D. V.; Takeuchi, A.

    This document is part of Part 1 http://dx.doi.org/10.1007/9getType="URL"/> 'Systems from Ag-Al-Ca to Au-Pd-Si' of Subvolume B 'Physical Properties of Ternary Amorphous Alloys' of Volume 37 'Phase Diagrams and Physical Properties of Nonequilibrium Alloys' of Landolt-Börnstein - Group III 'Condensed Matter'. It contains the Chapter 'Al-Cu-Zr (050)' with the content:

  17. Al-La-Ni (069)

    NASA Astrophysics Data System (ADS)

    Carow-Watamura, U.; Louzguine, D. V.; Takeuchi, A.

    This document is part of Part 1 http://dx.doi.org/10.1007/9getType="URL"/> 'Systems from Ag-Al-Ca to Au-Pd-Si' of Subvolume B 'Physical Properties of Ternary Amorphous Alloys' of Volume 37 'Phase Diagrams and Physical Properties of Nonequilibrium Alloys' of Landolt-Börnstein - Group III 'Condensed Matter'. It contains the Chapter 'Al-La-Ni (069)' with the content:

  18. Al-Au-La (010)

    NASA Astrophysics Data System (ADS)

    Carow-Watamura, U.; Louzguine, D. V.; Takeuchi, A.

    This document is part of Part 1 http://dx.doi.org/10.1007/9getType="URL"/> 'Systems from Ag-Al-Ca to Au-Pd-Si' of Subvolume B 'Physical Properties of Ternary Amorphous Alloys' of Volume 37 'Phase Diagrams and Physical Properties of Nonequilibrium Alloys' of Landolt-Börnstein - Group III 'Condensed Matter'. It contains the Chapter 'Al-Au-La (010)' with the content:

  19. Al-Ce-V (029)

    NASA Astrophysics Data System (ADS)

    Carow-Watamura, U.; Louzguine, D. V.; Takeuchi, A.

    This document is part of Part 1 http://dx.doi.org/10.1007/97.etType="URL"/> 'Systems from Ag-Al-Ca to Au-Pd-Si' of Subvolume B 'Physical Properties of Ternary Amorphous Alloys' of Volume 37 'Phase Diagrams and Physical Properties of Nonequilibrium Alloys' of Landolt-Börnstein - Group III 'Condensed Matter'. It contains the Chapter 'Al-Ce-V (029)' with the content:

  20. Soft Budget Constraints in Public Hospitals.

    PubMed

    Wright, Donald J

    2016-05-01

    A soft budget constraint arises when a government is unable to commit to not 'bailout' a public hospital if the public hospital exhausts its budget before the end of the budget period. It is shown that if the political costs of a 'bailout' are relatively small, then the public hospital exhausts the welfare-maximising budget before the end of the budget period and a 'bailout' occurs. In anticipation, the government offers a budget to the public hospital that may be greater than or less than the welfare-maximising budget. In either case, the public hospital treats 'too many' elective patients before the 'bailout' and 'too few' after. The introduction of a private hospital reduces the size of any 'bailout' and increases welfare.

  1. 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.

  2. 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

  3. All-Round Marketing Increases Hospital Popularity.

    PubMed

    Ziqi, Tao

    2015-06-01

    Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

  4. [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.

  5. 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.

  6. What determines hospital sponsorship of an HMO?

    PubMed

    McCue, M J

    2000-01-01

    Using a strategic adaptation framework, this study evaluates the underlying institutional, market, organizational, and financial factors leading to hospital sponsorship of a health maintenance organization (HMO) insurance product. Analyzing hospitals in Metropolitan Statistical Areas (MSAs) in 1995 and 1996, the study found that a hospital is more likely to sponsor an HMO in markets that see a combined interaction effect of a large number of competing HMOs and high HMO penetration. HMO sponsorship also is more likely among hospitals with relatively low market share. Only in small MSA markets do hospitals with greater liquidity sponsor an HMO. Finally, hospitals that are affiliated with a multihospital system and under public ownership are more likely to sponsor HMOs.

  7. Medical tourism private hospitals: focus India.

    PubMed

    Brotman, Billie Ann

    2010-01-01

    This article examines demand factors for sophisticated medical treatments offered by private hospitals operating in India. Three types of medical tourism exist: Outbound, Inbound, and Intrabound. Increased profitability and positive growth trends by private hospital chains can be attributed to rising domestic income levels within India. Not all of the chains examined were financially solvent. Some of the hospital groups in this sample that advertised directly to potential Inbound medical tourists appear to be experiencing negative cash flows.

  8. Market orientation in the hospital industry.

    PubMed

    Bhuian, S N; Abdul-Gader, A

    1997-01-01

    Using the more recent methodological developments in the assessment of the unidemensionality, reliability, and validity, the authors developed and examined a scale of market orientation for the hospital industry. The scale is based on a clear definition of the content of the construct of market orientation in the hospital industry. To this end, a national random sample of 237 hospital administrators was used. In addition to the support for the reliability and validity, the scale promises parsimony, pragmatism, and wide-ranging applicability.

  9. 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.

  10. Internationalization of multi hospital systems.

    PubMed

    Jayachandran, C; Chandran, R; O'Hara, L

    1992-01-01

    Much like the manufacturing multinationals of yore, professional service establishments are now going abroad in large numbers. Two factors drive their expansion overseas--the increasing restrictions on their operations domestically, and the inviting opportunities in some of the global markets. A survey of multi hospital corporations both with and without experience in foreign markets was conducted regarding the expansion of their operations overseas. Examined were factors central to the decision-making process including: the various types of foreign health care systems; the entry strategies in penetrating foreign markets (fully owned, joint ventures, etc.); favorable factors and barriers considered in choosing foreign markets; the ability to transfer standardized systems from operations in the U.S.; and the profits from such operations. Respondents provided information regarding the above factors that are critical in determining an overseas expansion strategy.

  11. Comparing the Thermodynamic Behaviour of Al(1)+ZrO2(s) to Al(1)+Al2O3(s)

    NASA Technical Reports Server (NTRS)

    Copland, Evan

    2004-01-01

    In an effort to better determine the thermodynamic properties of Al(g) and Al2O(g). the vapor in equilibrium with Al(l)+ZrO2(s) was compared to the vapor in equilibrium with Al(l)+Al2O3(s) over temperature range 1197-to-1509K. The comparison was made directly by Knudsen effusion-cell mass spectrometry with an instrument configured for a multiple effusion-cell vapor source (multi-cell KEMS). Second law enthalpies of vaporization of Al(g) and Al2O(g) together with activity measurements show that Al(l)+ZrO2(s) is thermodynamically equivalent to Al(l)+Al2O3(s), indicating Al(l) remained pure and Al2O3(s) was present in the ZrO2-cell. Subsequent observation of the Al(l)/ZrO2 and vapor/ZrO2 interfaces revealed a thin Al2O3-layer had formed, separating the ZrO2-cell from Al(l) and Al(g)+Al2O(g), effectively transforming it into an Al2O3 effusion-cell. This behavior agrees with recent observations made for Beta-NiAl(Pt) alloys measured in ZrO2 effusion-cell.

  12. 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

  13. 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.

  14. 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.

  15. The funding of private hospitals in Australia.

    PubMed

    Bloom, Abby L

    2002-01-01

    Private hospitals are an essential component of Australia's complex mix of public and private health funding and provision. Private hospitals account for 34.3 per cent of all hospital separations, and over half (56.2%) of all same-day separations. The revenue (funding) of the sector approached $4 billion by 1998/99, and as a result of its recent rapid growth capital expenditure in the sector was nearly $550 million in the same year. Private casemix of private hospitals is distinctive, and characterised by a high proportion of surgical procedures in general (48.1 per cent), and more than a majority of all services in such areas as rehabilitation, orthopaedics (shoulder, knee, spinal fusion, and hand surgery), alcohol disorders, same day colonoscopy and sleep disorders. This chapter synthesizes data from a multitude of sources to produce a comprehensive picture of Australia's private hospital sector and its funding. It examines the funding (revenue) sources of private hospitals, and considers how and why private hospitals approach the issue of funding from a different perspective than their public sector colleagues. To illustrate how Australian private hospitals approach revenue (funding) strategically, a series of indicative types of hospitals is explored.

  16. An inquiry - aesthetics of art in hospitals.

    PubMed

    Gates, Jillian

    2008-09-01

    Historically, art has served a significant purpose within hospital waiting rooms. However, in recent times we have experienced cuts in funding and less interest in improving the aesthetic of art displayed in Australian hospitals. This article briefly discusses the history of art in hospitals and explores a methodology for researching the preference of Australian patients today. Potentially, Australians waiting in hospitals and medical clinics could benefit from art works that reflect their preferences; this may help to ease the pain, anxiety, and boredom of waiting.

  17. 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.

  18. 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.

  19. 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).

  20. Analysis on antimicrobial resistance of clinical bacteria isolated from county hospitals and a teaching hospital.

    PubMed

    Sun, Ziyong; Li, Li; Zhu, Xuhui; Ma, Yue; Li, Jingyun; Shen, Zhengyi; Jin, Shaohong

    2006-01-01

    The distinction of antimicrobial resistance of clinical bacteria isolated from county hospitals and a teaching hospital was investigated. Disc diffusion test was used to study the antimicrobial resistance of isolates collected from county hospitals and a teaching hospital. The data was analyzed by WHONET5 and SPSS statistic software. A total of 655 strains and 1682 strains were collected from county hospitals and a teaching hospital, respectively, in the year of 2003. The top ten pathogens were Coagulase negative staphylococci (CNS), E. coli, Klebsiella spp., S. areus, P. aeruginosa, Enterococcus spp., Enterobacter spp., otherwise Salmonella spp., Proteus spp., Shigella spp. in county hospitals and Streptococcus spp., Acinetobacter spp., X. maltophilia in the teaching hospital. The prevalence of multi-drug resistant bacteria was 5% (4/86) of methicillin-resistant S. areus (MRSA), 12% (16/133) and 15.8% (9/57) of extended-spectrum beta-lactamases producing strains of E. coli and Klebsiella spp., respectively, in county hospitals. All of the three rates were lower than that in the teaching hospital and the difference was statistically significant (P < 0. 01). However, the incidence of methicillin-resistant CNS (MRCNS) reached to 70% (109/156) in the two classes of hospitals. Generally, the antimicrobial resistant rates in the county hospitals were lower than those in the teaching hospital, except the resistant rates of ciprofloxacin, erythromycin, clindamycin, SMZco which were similar in the two classes of hospitals. There were differences between county hospitals and the teaching hospital in the distribution of clinical isolates and prevalence of antimicrobial resistance. It was the basis of rational use of antimicrobial agents to monitor antimicrobial resistance by each hospital.

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

    PubMed

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

    2008-07-01

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

  2. Hospital volume, hospital teaching status, patient socioeconomic status, and outcomes in patients hospitalized with sickle cell disease

    PubMed Central

    McCavit, Timothy L.; Lin, Hua; Zhang, Song; Ahn, Chul; Quinn, Charles T.; Flores, Glenn

    2014-01-01

    Sickle cell disease (SCD) accounts for ~100,000 hospitalizations in the US annually. Quality of care for hospitalized SCD patients has been insufficiently studied. Therefore, we aimed to examine whether four potential determinants of quality care, [1] hospital volume, [2] hospital teaching status, [3] patient socioeconomic status (SES), and [4] patient insurance status are associated with three quality indicators for patients with SCD: [1] mortality, [2] length of stay (LOS), and [3] hospitalization costs. We conducted an analysis of the 2003–2005 Nationwide Inpatient Sample (NIS) datasets. We identified cases using all ICD-9CM codes for SCD. Both overall and SCD-specific hospital volumes were examined. Multivariable analyses included mixed linear models to examine LOS and costs, and logistic regression to examine mortality. About 71,481 SCD discharges occurred from 2003 to 2005. Four hundred and twenty five patients died, yielding a mortality rate of 0.6%. Multivariable analyses revealed that SCD patients admitted to lower SCD-specific volume hospitals had [1] increased adjusted odds of mortality (quintiles 1–4 vs. quintile 5: OR, 1.36; 95% CI, 1.05, 1.76) and [2] decreased LOS (quintiles 1–4 vs. quintile 5, effect estimate −0.08; 95% CI, −0.12, −0.04). These are the first data describing associations between lower SCD-specific hospital volumes and poorer outcomes. PMID:21442644

  3. Rural Residents Who Are Hospitalized in Rural and Urban Hospitals: United States, 2010

    MedlinePlus

    ... the factors influencing hospital choice, merit continued study. Definitions Urban and rural residents and hospitals : Using ZIP ... categories reported here are very broad using this definition, analysis of more refined categories would not be ...

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

    PubMed

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

    2013-01-01

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

  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. 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

  7. 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.

  8. Revoking hospital privileges: new directions in Ontario. Dr. N. v. Brantford General Hospital.

    PubMed

    Liswood, J; McClure, A E

    1993-01-01

    Recent decisions by the Ontario Hospital Appeal Board have helped hospital boards understand the importance of due process when revoking a physician's hospital privileges. The authors illustrate the need to have a mechanism to suspend privileges immediately but which also provides physicians with the opportunity to respond to allegations. The article outlines 11 clauses that serve as a practical guide to due process and can be added to hospital by-laws.

  9. Hospital autopsy performance and reporting.

    PubMed

    Benjamin, Jacqueline

    2014-01-01

    Postmortem examinations have been performed for centuries (King and Meehan, Am J Pathol 73(2): 514-541, 1973; Burton, The history of the autopsy. Hodder Arnold, Hachette UK, London, pp 1-10, 2010) and have a long and venerable tradition, one which is sadly on the decline worldwide (Underwood, The future of the autopsy. Hodder Arnold, Hachette UK, London, pp 11-17, 2010; Nemetz et al., Mayo Clin Proc 64:1065-2076, 1989; Kaplan, Hum Pathol 9(2):127-129, 1978; Roberts, N Engl J Med 299:332-337, 1978; Haber, Arch Pathol Lab Med 120:714-717, 1996; AMA Council on Scientific Affairs, Arch Pathol Lab Med 120:721-726, 1996; Sanner, Arch Pathol Lab Med 118:878-883, 1994; Robinson, Hum Pathol 14(7):566-568, 1983). One of the reasons cited for the decline in postmortem examinations is new imaging techniques such as computerized tomography and magnetic resonance imaging. The advent of these new diagnostic procedures has not resulted in obsolescence of the relatively low-cost, high-yield autopsy examination (Goldman et al., N Engl J Med 308:1000-1005, 1983). The procedure for performance of an autopsy, using the Zenker method (Volmar, History of autopsy technique. College of American Pathologists, Northfield, IL, pp 18-19, 2003), is described, in addition to the content and format of the written report.

  10. Modeling of the ALS linac

    SciTech Connect

    Kim, C.H.

    1996-08-01

    The ALS injector linac is used for the Beam Test Facility (BTF) and the Damping Experiments when it is available in between the ALS filings. These experiments usually require higher quality beams and a better characterization than is normally required for ALS operations. This paper focuses on the beam emittance, energy tilt, and especially the longitudinal variation of the beam parameters. For instance, the authors want to avoid longitudinal variations at the low beta section of the BTF. On the other hand, a large energy tilt is required for post-acceleration compression of the bunch using an alpha magnet. The PARMELA code was modified to calculate and display longitudinal variations of the emittance ellipse. Using the Microsoft Development Studio under Windows NT environment the code can handle a much larger number of particles than was previously possible.

  11. Superconductivity in Al/Al2O3 interface

    NASA Astrophysics Data System (ADS)

    Palnichenko, A. V.; Vyaselev, O. M.; Mazilkin, A. A.; Khasanov, S. S.

    2016-06-01

    Metastable superconductivity at Tc ≈ 65 K has been observed in Al foil subjected to special oxidation process, according to the ac magnetic susceptibility and electrical resistance measurements. Comparison of the ac susceptibility and the dc magnetization measurements infers that the superconductivity arises within the interfacial granular layer formed during the oxidation process between metallic aluminum and its oxide.

  12. Baumard et al.'s moral markets lack market dynamics.

    PubMed

    Fessler, Daniel M T; Holbrook, Colin

    2013-02-01

    Market models are indeed indispensable to understanding the evolution of cooperation and its emotional substrates. Unfortunately, Baumard et al. eschew market thinking in stressing the supposed invariance of moral/cooperative behavior across circumstances. To the contrary, humans display contingent morality/cooperation, and these shifts are best accounted for by market models of partner choice for mutually beneficial collaboration.

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 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...

  14. 75 FR 31118 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-02

    ...This notice contains the final wage indices, hospital reclassifications, payment rates, impacts, and other related tables effective for the fiscal year (FY) 2010 hospital inpatient prospective payment systems (IPPS) and rate year 2010 long-term care hospital (LTCH) prospective payment system (PPS). The rates, tables, and impacts included in this notice reflect changes required by or resulting......

  15. 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

  16. 78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... 106-554 BLS Bureau of Labor Statistics CAH Critical access hospital CARE Continuity Assessment Record... Disproportionate share hospital ECI Employment cost index EDB Enrollment Database EHR Electronic health record EMR Electronic medical record FAH Federation of American Hospitals FDA Food and Drug Administration FFY...

  17. FTD and ALS: genetic ties that bind.

    PubMed

    Orr, Harry T

    2011-10-20

    Curiously, amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), seemingly disparate neurodegenerative disorders, can be inherited together. Two groups (DeJesus-Hernandez et al. and Renton et al.) show that the long sought after ALS/FTD mutation on chromosomal region 9p is a hexanucleotide expansion in C90RF72. These studies, plus a study on X-linked ALS/FTD, provide molecular starting points for identifying pathways that link ALS and FTD pathogenesis.

  18. ALS - A unique design approach

    NASA Astrophysics Data System (ADS)

    Chamberlain, Roger A.

    1990-09-01

    An advanced launch system (ALS), which is intended to be flexible and to deliver a wide range of payloads at a reduced cost, is discussed. The ALS concept also features total quality management, modular subsystems, standardized interfaces, standardized missions, and off-line payload encapsulation. The technological improvements include manufacturing of dry structures, use of composite materials, adaptive guidance and control systems, and laser-initiated radar systems. The operational improvements range from paperless management, to rocket engine leak detection devices and automated ground operations.

  19. FPs lower hospital readmission rates and costs.

    PubMed

    Chetty, Veerappa K; Culpepper, Larry; Phillips, Robert L; Rankin, Jennifer; Xierali, Imam; Finnegan, Sean; Jack, Brian

    2011-05-01

    Hospital readmission after discharge is often a costly failing of the U.S. health care system to adequately manage patients who are ill. Increasing the numbers of family physicians (FPs) is associated with significant reductions in hospital readmissions and substantial cost savings.

  20. Continuing Education for Rural Hospital Nurses.

    ERIC Educational Resources Information Center

    Burns, Nancy; Pickard, Myrna R.

    1979-01-01

    Describes a rural outreach program to provide continuing education in nursing practice to all levels of nursing personnel in rural hospitals. Covers difficulties in planning and implementing the programs and the steps taken to explain the program philosophy and gain the trust of hospital adminstration and staff. (MF)

  1. Cost of hospital-acquired infection.

    PubMed

    Hassan, Mahmud; Tuckman, Howard P; Patrick, Robert H; Kountz, David S; Kohn, Jennifer L

    2010-01-01

    The authors assessed the costs of hospital-acquired infections using rigorous econometric methods on publicly available data, controlling for the interdependency of length of stay and the incidence of hospital acquired infection, and estimated the cost shares of different payers. They developed a system of equations involving length of stay, incidence of infection, and the total hospital care cost to be estimated using simultaneous equations system. The main data came from the State of New Jersey UB 92 for 2004, complimented with data from the Annual Survey of Hospitals by the American Hospital Association and the Medicare Cost Report of 2004. The authors estimated that an incidence of hospital acquired infection increases the hospital care cost of a patient by $10,375 and it increases the length of stay by 3.30 days, and that a disproportionately higher portion of the cost is attributable to Medicare. They conclude that reliable cost estimates of hospital-acquired infections can be made using publicly available data. Their estimate shows a much larger aggregate cost of $16.6 billion as opposed to $5 billion reported by the Centers for Disease Control and Prevention but much less than $29 billion as reported elsewhere in the literature.

  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. 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…

  4. Quality Assurance in a Children's Psychiatric Hospital.

    ERIC Educational Resources Information Center

    Baggish, Rosemary C.; And Others

    1981-01-01

    Examined the use of short-term isolation (STI) in a children's psychiatric hospital. The Joint Commission on Accreditation of Hospitals quality assurance mode was used. Studied the quality use of STI and its documentation. Data gathered served as the basis for recommendations that led to planned, informed program changes. (Author)

  5. Rubicon crossed in acute hospital design?

    PubMed

    Baillie, Jonathan

    2008-06-01

    With construction work now underway on the new pound sterling 227 million PFI-funded Pembury Hospital near Tunbridge Wells in Kent, Jonathan Baillie talks to John Cooper of architects Anshen + Allen, who is convinced that this exciting new acute facility will become the first of a new generation of 100% single-bedroom hospitals in the UK.

  6. [Proximity and breastfeeding at the maternity hospital].

    PubMed

    Fradin-Charrier, Anne-Claire

    2015-01-01

    The establishment of breastfeeding, as well as its duration, are facilitated through the proximity of the mother with her new baby. However, in maternity hospitals, breastfeeding mothers very often leave their baby in the nursery at night time. A study carried out in 2014 in several maternity hospitals put forward suggestions and highlighted areas to improve in everyday practice.

  7. Daptomycin Use in United States Children's Hospitals.

    PubMed

    Larru, Beatriz; Cowden, Carter L; Zaoutis, Theoklis E; Gerber, Jeffrey S

    2015-03-01

    We described 1035 pediatric hospitalizations with daptomycin use in 794 patients since 2004. Daptomycin use was uncommon but increased over time. A minority of hospitals accounted for the majority of use. This variability of daptomycin use highlights the need for future studies to assess the efficacy and safety of daptomycin in children.

  8. Community perceptions of rural hospital closure.

    PubMed

    Muus, K J; Ludtke, R L; Gibbens, B

    1995-02-01

    Hospital closure, a devastating event in the life of small communities, can have long-lasting medical, economic, and psychological consequences. This study focuses on a 1991 closure that occurred in the rural North Dakota town of Beach that left local residents 40 and 61 miles away from the nearest hospitals. Two hundred residents of the hospital's former service area were selected via systematic random sampling to share their perceptions on the causes and effects of closing their local hospital. According to respondents, this hospital closure was caused by a number of influences, with the most commonly cited being under-utilization of services by local residents, exacting government rules and regulations, doleful economic climate, dwindling population, poor and unstable local physician care, and poor management of hospital matters. Findings further indicated that Beach area residents were most concerned with poor access to emergency medical care as a result of the closing. Area dwellers perceived that the hospital closure's aftermath would include the loss of local jobs, further declines in the local economy, the suffering of elderly and children, transportation problems, and out-migration of some area residents. These concerns, coupled with the notable decrease in hospital care access, motivated many area residents to think of solutions to these problems rather than to place blame on others for the closure.

  9. 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.

  10. 45 CFR 211.8 - Continuing hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES CARE AND TREATMENT OF MENTALLY ILL NATIONALS OF THE UNITED STATES, RETURNED FROM FOREIGN COUNTRIES § 211.8 Continuing hospitalization... in need of continuing care and treatment in a hospital cannot be accomplished under § 211.7, or...

  11. 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…

  12. 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.

  13. 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:…

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. Measures of performance in Scottish maternity hospitals.

    PubMed Central

    Leyland, A H; Pritchard, C W; McLoone, P; Boddy, F A

    1991-01-01

    OBJECTIVE--To develop measures of hospital performance over time with particular reference to maternal and neonatal care by controlling for case mix. DESIGN--Analysis of computerised records of births. SETTING--Scotland, 1980-7. SUBJECTS--Over half a million singleton live births and stillbirths. MAIN OUTCOME MEASURES--Numbers of perinatal deaths and caesarean sections. RESULTS--Scottish maternity hospitals perform more or less equally with regard to perinatal mortality. When caesarean sections are considered, there is evidence that hospitals differ in their treatment of different groups of women; in two examples one hospital had an increased rate among women of parity 2 or more and another had a reduced rate of repeat caesarean section. CONCLUSIONS--Developing measures of performance over time by controlling for case mix is a valid system for monitoring hospital outcomes and activity, and allows comparison either between hospitals or with data for all Scottish maternity hospitals. Hospital profiles permit identification of differences for particular patient groups after allowance is made for other case mix variables. PMID:1912806

  19. Educational Facilities in the Hospital for Teaching.

    ERIC Educational Resources Information Center

    Green, Alan C.

    1965-01-01

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

  20. 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…

  1. 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

  2. [Possibilities for rehabilitation in a county hospital].

    PubMed

    Mohr, P

    1981-01-01

    A county hospital with an infirmary surely offers the possibilities for rehabilitation as much as any other institution. Due to its manageable size, the county hospital can probably guarantee deeper personal care. The following possibilities are discussed: activating care, mental stimulation in a reality orientation program, dance and music therapy, plus the opening of the infirmary outwards, which remains a very important aspect. The rehabilitation in a county hospital can be guaranteed only by the complete cooperation between hospital internal and external medicine. An outpatient ward such as the day- and night-clinic is also a useful institution. In the future, the employment of volunteers in and outside the hospital will be of greater importance. Already now, greater efforts should be made on behalf of continued training and greater social prestige for these volunteers.

  3. Hospital finances and patient safety outcomes.

    PubMed

    Encinosa, William E; Bernard, Didem M

    2005-01-01

    Hospitals recently have experienced greater financial pressures. Whether these financial pressures have led to more patient safety problems is unknown. Using the Healthcare Cost and Utilization Project (HCUP) State Inpatient Data for Florida from 1996 to 2000, this study examines whether financial pressure at hospitals is associated with increases in the rate of patient safety events (e.g., medical errors) for major surgeries. Findings show that patients have significantly higher odds of having adverse patient safety events (nursing-related patient safety events, surgery-related patient safety events, and all likely preventable patient safety events) when hospital profit margins decline over time. The finding that a within-hospital erosion of hospital operating profits increases the rate of adverse patient safety events suggests that any cost-cutting efforts be carefully designed and managed.

  4. 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.

  5. [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.

  6. Hospital mergers and reproductive health care.

    PubMed

    Donovan, P

    1996-01-01

    In the US, when one of the two hospitals involved in a merger is a Catholic hospital, comprehensive reproductive health care tends to suffer. The Catholic Church forbids its hospitals from providing and making direct referrals for many reproductive health services (i.e., reversible contraception, infertility treatments, male and female sterilization, abortion, condoms for HIV prevention, and emergency contraception). These mergers are especially severe in small towns and rural areas. Several groups have formed to address this hidden crisis. In Troy, New York, a settlement was reached about 12 months after a law suit was filed against the conditions of a merger between a Catholic hospital and a nonsectarian hospital. After a long fight, the settlement essentially guaranteed that patients who are dependent on religious institutions obtain the contraceptive and sterilization services they need and want, but abortion services and referrals continued to be denied. The state of Montana considered the impact of a merger of a Catholic institution and a nonsectarian institution, yet continued availability of all reproductive health services was not guaranteed. The American Civil Liberties Union asked the Federal Trade Commission (FTC) to investigate the merger's impact on reproductive health care, since the merger created a monopoly on acute care in Great Falls. FTC took no action. Key factors to provision of reproductive health services other than abortion in cases of mergers between a Catholic hospital and a nonsectarian hospital include the type of association the two hospitals enter into, the local bishop's willingness to accept a creative solution, and the willingness of the state to consider the implications of such a merger and take steps to guarantee the continued availability of services. State reproductive health care advocacy groups (e.g., MergerWatch in New York) are increasing public awareness of the risks these mergers pose and helping residents ensure that

  7. [Hospital solid waste: quantification. Bacteriological analyses--case of hospital Ibn Sina].

    PubMed

    Bahri, Meriem; Belkhadir, Rachid; Benzakour, Mohammed; Idrissi, Larbi; Khadri, Abdelhamid

    2006-01-01

    Hospital waste represent, by their nature and their constitution, a big threat to health in the intra and extra hospital area. and a source of pollution for the environment. A 12-day campaign of weighing of the waste produced by the hospital Ibn Sina of Rabat-Morocco should an average of 1.75 kg/bed/day. In order to identify the hospital pathogenic germs as well as their sensitivities to antibiotics, some bacteriological analyses have been done on the percolat waste of this hospital. The results of these analyses put in evidence the presence of Pseudomonas aeruginosa and Staphylococcus aureus and their resistance to some antibiotics.

  8. 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.

  9. Dynamic Modeling of ALS Systems

    NASA Technical Reports Server (NTRS)

    Jones, Harry

    2002-01-01

    The purpose of dynamic modeling and simulation of Advanced Life Support (ALS) systems is to help design them. Static steady state systems analysis provides basic information and is necessary to guide dynamic modeling, but static analysis is not sufficient to design and compare systems. ALS systems must respond to external input variations and internal off-nominal behavior. Buffer sizing, resupply scheduling, failure response, and control system design are aspects of dynamic system design. We develop two dynamic mass flow models and use them in simulations to evaluate systems issues, optimize designs, and make system design trades. One model is of nitrogen leakage in the space station, the other is of a waste processor failure in a regenerative life support system. Most systems analyses are concerned with optimizing the cost/benefit of a system at its nominal steady-state operating point. ALS analysis must go beyond the static steady state to include dynamic system design. All life support systems exhibit behavior that varies over time. ALS systems must respond to equipment operating cycles, repair schedules, and occasional off-nominal behavior or malfunctions. Biological components, such as bioreactors, composters, and food plant growth chambers, usually have operating cycles or other complex time behavior. Buffer sizes, material stocks, and resupply rates determine dynamic system behavior and directly affect system mass and cost. Dynamic simulation is needed to avoid the extremes of costly over-design of buffers and material reserves or system failure due to insufficient buffers and lack of stored material.

  10. Hospitalization for ambulatory care sensitive conditions at health insurance organization hospitals in Alexandria, Egypt.

    PubMed

    Mosallam, Rasha A; Guirguis, Wafaa W; Hassan, Mona Ha

    2014-01-01

    This study aimed at estimating the percentage of hospital discharges and days of care accounted for by Ambulatory Care Sensitive Conditions (ACSCs) at Health Insurance Organization (HIO) hospitals in Alexandria, calculating hospitalization rates for ACSCs among HIO population and identifying determinants of hospitalization for those conditions. A sample of 8300 medical records of patients discharged from three hospitals affiliated to HIO at Alexandria was reviewed. The rate of monthly discharges for ACSCs was estimated on the basis of counting number of combined ACSCs detected in the three hospitals and the hospitals' average monthly discharges. ACSCs accounted for about one-fifth of hospitalizations and days of care at HIO hospitals (21.8% and 20.8%, respectively). Annual hospitalization rates for ACSCs were 152.5 per 10,000 insured population. The highest rates were attributed to cellulitis/abscess (47.3 per 10,000 population), followed by diabetes complications and asthma (42.8 and 20.8 per 10,00 population). Logistic regression indicated that age, number of previous admissions, and admission department are significant predictors for hospitalization for an ACSC.

  11. 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

  12. Coagulopathy and Shock on Admission is Associated with Mortality for Children with Traumatic Injuries at Combat Support Hospitals

    DTIC Science & Technology

    2012-01-01

    to US military combat support hospitals in Afghanistan and Iraq: Learning from the first 2000 admissions. J Trauma 2009; 67:762–768 7. Niles SE...25:579–581 11. Hindy -Francois C, Meyer P, Blanot S, et al: Admission base deficit as a long-term prognostic factor in severe pediatric trau- ma

  13. 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.

  14. 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.

  15. 42 CFR 412.92 - Special treatment: Sole community hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Sole community hospitals. 412.92... treatment: Sole community hospitals. (a) Criteria for classification as a sole community hospital. CMS classifies a hospital as a sole community hospital if it is located more than 35 miles from other...

  16. [Prevalence and associated factors of hospital malnutrition in a general hospital; Perú, 2012].

    PubMed

    Veramendi-Espinoza, L E; Zafra-Tanaka, J H; Salazar-Saavedra, O; Basilio-Flores, J E; Millones-Sánchez, E; Pérez-Casquino, G A; Quispe-Moore, L M; Tapia-Vicente, M E; Ticona-Rebagliati, D I; Asato N, B; Quispe-Calderón, L; Ruiz García, H J; Chia-Gil, A; Rey-Rodríguez, D E; Surichaqui B, T; Whittembury, Á

    2013-01-01

    Introducción: La desnutrición hospitalaria es un problema prevalente que genera mayor morbi-mortalidad, peor respuesta al tratamiento, mayor estancia y costo hospitalario. Objetivos: Determinar la prevalencia y factores asociados a desnutrición hospitalaria en un hospital general peruano. Métodos: Estudio analítico transversal de 211 pacientes en servicios de Medicina y Cirugía. Se analizó variables demográficas, clínicas e indicadores antropométricos. El análisis multivariado fue de regresión logística binaria. El nivel de significancia fue 5% (p < 0,05). Resultados: La prevalencia de desnutrición hospitalaria fue 46.9% y las de desnutrición calórica y proteica fueron 21,3% y 37,5% respectivamente. En el análisis bivariado, estar hospitalizado en el servicio de Cirugía se asoció a un mayor riesgo de desnutrición calórica (OR = 4,41, IC 95% [1,65-11,78]) y proteica (OR = 2,52, IC 95% [1,30-4,90]). Hubo asociación significativa entre el número de comorbilidades del paciente y desnutrición calórica (p = 0,031), y el tiempo de cambio de ingesta alimentaria y presencia de desnutrición proteica (p = 0,031). El análisis multivariado mostró asociación significativa entre el diagnóstico de neoplasia y la presencia de desnutrición calórica (OR = 5,22, IC 95% [1,43-19,13]). Conclusiones: La prevalencia de desnutrición hospitalaria fue cerca del 50%, coincidiendo con estudios similares. Las prevalencias de desnutrición calórica/proteica halladas difieren de las de un estudio anterior en este hospital, explicándose por parámetros de diagnóstico diferentes y características particulares de las poblaciones, como el servicio de procedencia y comorbilidades. Se encontró asociación entre desnutrición proteica/calórica y estar hospitalizado en el servicio de Cirugía; las razones deben investigarse en estudios posteriores.

  17. Large rectification magnetoresistance in nonmagnetic Al/Ge/Al heterojunctions

    NASA Astrophysics Data System (ADS)

    Zhang, Kun; Li, Huan-Huan; Grünberg, Peter; Li, Qiang; Ye, Sheng-Tao; Tian, Yu-Feng; Yan, Shi-Shen; Lin, Zhao-Jun; Kang, Shi-Shou; Chen, Yan-Xue; Liu, Guo-Lei; Mei, Liang-Mo

    2015-09-01

    Magnetoresistance and rectification are two fundamental physical properties of heterojunctions and respectively have wide applications in spintronics devices. Being different from the well known various magnetoresistance effects, here we report a brand new large magnetoresistance that can be regarded as rectification magnetoresistance: the application of a pure small sinusoidal alternating-current to the nonmagnetic Al/Ge Schottky heterojunctions can generate a significant direct-current voltage, and this rectification voltage strongly varies with the external magnetic field. We find that the rectification magnetoresistance in Al/Ge Schottky heterojunctions is as large as 250% at room temperature, which is greatly enhanced as compared with the conventional magnetoresistance of 70%. The findings of rectification magnetoresistance open the way to the new nonmagnetic Ge-based spintronics devices of large rectification magnetoresistance at ambient temperature under the alternating-current due to the simultaneous implementation of the rectification and magnetoresistance in the same devices.

  18. Large rectification magnetoresistance in nonmagnetic Al/Ge/Al heterojunctions

    PubMed Central

    Zhang, Kun; Li, Huan-huan; Grünberg, Peter; Li, Qiang; Ye, Sheng-tao; Tian, Yu-feng; Yan, Shi-shen; Lin, Zhao-jun; Kang, Shi-shou; Chen, Yan-xue; Liu, Guo-lei; Mei, Liang-mo

    2015-01-01

    Magnetoresistance and rectification are two fundamental physical properties of heterojunctions and respectively have wide applications in spintronics devices. Being different from the well known various magnetoresistance effects, here we report a brand new large magnetoresistance that can be regarded as rectification magnetoresistance: the application of a pure small sinusoidal alternating-current to the nonmagnetic Al/Ge Schottky heterojunctions can generate a significant direct-current voltage, and this rectification voltage strongly varies with the external magnetic field. We find that the rectification magnetoresistance in Al/Ge Schottky heterojunctions is as large as 250% at room temperature, which is greatly enhanced as compared with the conventional magnetoresistance of 70%. The findings of rectification magnetoresistance open the way to the new nonmagnetic Ge-based spintronics devices of large rectification magnetoresistance at ambient temperature under the alternating-current due to the simultaneous implementation of the rectification and magnetoresistance in the same devices. PMID:26387967

  19. 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

  20. Epidemiology of systemic inflammatory response syndrome and sepsis in cats hospitalized in a veterinary teaching hospital.

    PubMed

    Babyak, Jonathan M; Sharp, Claire R

    2016-07-01

    OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.

  1. AlSb/InAs/AlSb quantum wells

    NASA Technical Reports Server (NTRS)

    Kroemer, Herbert

    1990-01-01

    Researchers studied the InAs/AlSb system recently, obtaining 12nm wide quantum wells with room temperature mobilities up to 28,000 cm(exp 2)/V center dot S and low-temperature mobilities up to 325,000 cm(exp 2)/V center dot S, both at high electron sheet concentrations in the 10(exp 12)/cm(exp 2) range (corresponding to volume concentrations in the 10(exp 18)/cm(exp 2) range). These wells were not intentionally doped; the combination of high carrier concentrations and high mobilities suggest that the electrons are due to not-intentional modulation doping by an unknown donor in the AlSb barriers, presumably a stoichiometric defect, like an antisite donor. Inasmuch as not intentionally doped bulk AlSb is semi-insulating, the donor must be a deep one, being ionized only by draining into the even deeper InAs quantum well. The excellent transport properties are confirmed by other observations, like excellent quantum Hall effect data, and the successful use of the quantum wells as superconductive weak links between Nb electrodes, with unprecendentedly high critical current densities. The system is promising for future field effect transistors (FETs), but many processing problems must first be solved. Although the researchers have achieved FETs, the results so far have not been competitive with GaAs FETs.

  2. [Computerization of hospital blood banks in France].

    PubMed

    Daurat, G; Py, J-Y

    2012-11-01

    In France, most blood products are delivered by the établissement francais du sang, directly to the recipients, and hospital blood banks deliver a minor part, but are independent from it. However that may be, hospital blood banks are hazardous activities regarding to recipients, blood products, blood supply of the hospital and regional blood supply. Because of the high risk level, a computerized information system is compulsory for all hospital blood banks, except for those only devoted to vital emergency transfusion. On the field, the integration of computerization in the different processes is very heterogeneous. So, it has been decided to publish guidelines for computerizing hospital blood banks information systems and production management. They have been built according to risk assessment and are intended to minimize those risks. The principle is that all acquisition and processing of data about recipients or blood products and tracking, must be fully computerized and that the result of all manual processes must be checked by computer before proceeding to the next step. The guidelines list the different processes and, for each of them, the functions the software must play. All together, they form the basic level all hospital blood banks should reach. Optional functions are listed. Moreover, the guidelines are also aimed to be a common tool for regional health authorities who supervise hospital blood banks.

  3. [Computerization of hospital blood banks in France].

    PubMed

    Daurat, G; Py, J-Y

    2011-04-01

    In France, most blood products are delivered by the Établissement français du sang, directly to the recipients, and hospital blood banks deliver a minor part, but are independent from it. However that may be, hospital blood banks are hazardous activities regarding recipients, blood products, blood supply for the hospital and regional blood supply. Because of the high risk level, a computerized information system is compulsory for all hospital blood banks, except for those only devoted to vital emergency transfusion. On the field, integration of computerization in the different processes is very heterogeneous. So it has been decided to publish guidelines for computerizing hospital blood banks information systems and production management. They have been built according to risk assessment and are intended to minimize those risks. The principle is that all acquisition and processing of data about recipients or blood products and tracking, must be fully computerized and that the result of all manual processes must be checked by computer before proceeding to the next step. The guidelines list the different processes and, for each of them, the functions the software must play. All together, they form the basic level all hospital blood banks should reach. Optional functions are listed. Moreover, the guidelines are also aimed at being a common tool for regional health authorities who supervise hospital blood banks.

  4. 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.

  5. 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.

  6. [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.

  7. Approaching hospital administration about adopting cooling technologies.

    PubMed

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

    2009-07-01

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

  8. 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.

  9. [Experience of the Baby Friendly Hospital initiative].

    PubMed

    Lamounier, J A

    1998-01-01

    In the study is analyzed and described the initiative called "Initiative Baby Friendly Hospitals", a program which started in Brazil, 1992. This initiative intends to support, to protect and to promote the breastfeeding as proposed in a meeting in 1990 in Florence, Italy, which was promoted by WHO and UNICEF. The basic goal of this initiative is to mobilize health professionals and hospital or maternity workers for changing their routines and conducts aiming to prevent the early wean. The health establishments are evaluated based on the "ten steps for success of breastfeeding, a group of goals created in the same meeting. In Brazil, the evaluation is coordinated by the Federal Government through the PNIAM (Programa Nacional de Incentivo ao Aleitamento Materno). A baby friendly hospital, if approved, receives from the Minister of Health, a Federal Governmental Agency (SUS) a differential payment for childbirth assistance and prenatal accompaniment, 10% and 40%, more respectively. Until 1998 year there were 103 baby friendly hospitals in Brazil, with the majority of them located in the northeast area (68.1%). However, taking in accounting the number of 5650 hospitals linked to SUS in the country, less than 2.0% are baby friendly hospitals. On the basis of the experience and according with PNIAM data the implementation of the ten steps and the incentive to breastfeeding through baby friendly hospitals have resulted in a significant increase of breastfeeding incidence and duration in Brazil.

  10. Marketing healthcare: lessons for smaller hospitals.

    PubMed

    Chowdhary, N R

    2000-02-01

    Recently, I have noted ubiquitous trends that lead me to conclude that we are on the brink of a fundamental change in the structure of healthcare delivery. Hospitals are changing. The hospital, that enduring and pervasive organization, which for decades has delivered the vast majority of acute care services is being re-conceptualized. Administrators and executives in today's hospitals are beginning to recognize the disaffection of constituents and the necessity to change from placing their own agenda or that of their profession over the needs of the customer. A lesson that is increasingly being heeded, particularly by the leading hospitals, is that a belief in one's own importance or a feeling of invulnerability represents an anachronistic stance. No hospital today can afford to retain a view that it is more important than the patients it serves, or that it is invulnerable. The external pressures are already clear--the actors, factors and forces in the external environment are forcing hospitals to re-evaluate efficiency, effectiveness and delivery arrangements. The rise to prominence of the outcomes movement is part of this trend. The present study was an attempt to assess the practices and trends in the modern smaller hospitals as a part of their strategy to match the competitive pressures.

  11. [Neurological health care activity in a recently created district hospital: model of high efficiency].

    PubMed

    Jiménez-Jiménez, Félix J; Plaza-Nieto, José F; Navacerrada, Francisco; Alonso-Navarro, Hortensia; Pilo-de-la-Fuente, Belén; Arroyo-Solera, Margarita; Guillán, Marta; Calleja, Marisol; Moreno-Puertas, Dolores

    2015-03-01

    Objetivo. Analizar la actividad asistencial de un hospital comarcal de reciente creacion, con especial enfasis en los indicadores asistenciales en consultas externas y en actos medicos de pacientes ingresados. Pacientes y metodos. Describimos la actividad asistencial realizada por nuestra seccion de neurologia durante los años 2008-2013. Se comparan nuestros indicadores asistenciales de los años 2012 y 2013 (quinto y sexto año de actividad), tanto en consultas externas como en pacientes ingresados, con los de otros dos hospitales de caracteristicas similares, otros tres de nivel secundario y otros cuatro de nivel terciario. Resultados. La seccion de neurologia de nuestro hospital fue la que realizo mayor numero de primeras consultas por facultativo, tuvo el mejor indice de consultas sucesivas/primeras y el mayor porcentaje de consultas de alta resolucion, tuvo la menor estancia media en los dos grupos relacionados por el diagnostico (GRD) mas frecuentes en nuestra especialidad, y fue la segunda en ingresos por facultativo del GRD 'ictus con infarto' y la tercera en ingresos por facultativo del GRD 'otros trastornos del sistema nervioso'. Conclusiones. Los indicadores asistenciales de la seccion de neurologia de nuestro hospital muestran un modelo de muy alta eficiencia, al cual solo se aproximan los de otros dos de caracteristicas y desarrollo similares al nuestro. La implantacion gradual de modelos similares al de estos tres hospitales en los niveles secundario y terciario podria ser de utilidad en la mejora de su eficiencia asistencial.

  12. Effect of interface geometry on electron tunnelling in Al/Al2O3/Al junctions

    NASA Astrophysics Data System (ADS)

    Koberidze, M.; Feshchenko, A. V.; Puska, M. J.; Nieminen, R. M.; Pekola, J. P.

    2016-04-01

    We investigate how different interface geometries of an Al/Al2O3 junction, a common component of modern tunnel devices, affect electron transport through the tunnel barrier. We study six distinct Al/Al2O3 interfaces which differ in stacking sequences of the metal and the oxide surface atoms and the oxide termination. To construct model potential barrier profiles for each examined geometry, we rely on first-principles density-functional theory (DFT) calculations for the barrier heights and the shapes of the interface regions as well as on experimental data for the barrier widths. We show that even tiny variations in the atomic arrangement at the interface cause significant changes in the tunnel barrier parameters and, consequently, in electron transport properties. Especially, we find that variations in the crucial barrier heights and widths can be as large as 2 eV and 5 Å, respectively. Finally, to gain information about the average properties of the measured junction, we fit the conductance calculated within the Wentzel-Kramers-Brillouin approximation to the experimental data and interpret the fit parameters with the help of the DFT results.

  13. 42 CFR 412.331 - Determining hospital-specific rates in cases of hospital merger, consolidation, or dissolution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... hospital merger, consolidation, or dissolution. 412.331 Section 412.331 Public Health CENTERS FOR MEDICARE... cases of hospital merger, consolidation, or dissolution. (a) New hospital merger or consolidation. If... dissolution. If a hospital separates into two or more hospitals that are subject to capital payments...

  14. 42 CFR 412.331 - Determining hospital-specific rates in cases of hospital merger, consolidation, or dissolution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... hospital merger, consolidation, or dissolution. 412.331 Section 412.331 Public Health CENTERS FOR MEDICARE... cases of hospital merger, consolidation, or dissolution. (a) New hospital merger or consolidation. If... dissolution. If a hospital separates into two or more hospitals that are subject to capital payments...

  15. 42 CFR 412.331 - Determining hospital-specific rates in cases of hospital merger, consolidation, or dissolution.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hospital merger, consolidation, or dissolution. 412.331 Section 412.331 Public Health CENTERS FOR MEDICARE... cases of hospital merger, consolidation, or dissolution. (a) New hospital merger or consolidation. If... dissolution. If a hospital separates into two or more hospitals that are subject to capital payments...

  16. 42 CFR 412.331 - Determining hospital-specific rates in cases of hospital merger, consolidation, or dissolution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... hospital merger, consolidation, or dissolution. 412.331 Section 412.331 Public Health CENTERS FOR MEDICARE... cases of hospital merger, consolidation, or dissolution. (a) New hospital merger or consolidation. If... dissolution. If a hospital separates into two or more hospitals that are subject to capital payments...

  17. Hospital keeps cool and cuts its costs.

    PubMed

    Pitman, Russ

    2013-09-01

    Energy usage--particularly electricity--in hospitals is a hot topic, and the sector is under increasing pressure to reduce load and carbon emissions. The cost of 'going green' can, however, be high, and many hospitals shy away from more costly energy-efficient solutions, instead selecting cheaper options to suit the short term. One Hampshire healthcare facility, however, bucked the trend when selecting new chilled water plant, thanks to the advice and expertise of chartered consulting engineers, Henderson Green. Examining whether other hospitals should follow suit, managing director, Russ Pitman, explains 'why considering the bigger picture perspective does pay off'.

  18. Segmenting hospitals for improved management strategy.

    PubMed

    Malhotra, N K

    1989-09-01

    The author presents a conceptual framework for the a priori and clustering-based approaches to segmentation and evaluates them in the context of segmenting institutional health care markets. An empirical study is reported in which the hospital market is segmented on three state-of-being variables. The segmentation approach also takes into account important organizational decision-making variables. The sophisticated Thurstone Case V procedure is employed. Several marketing implications for hospitals, other health care organizations, hospital suppliers, and donor publics are identified.

  19. Hospital characteristics: can an audit be predicted?

    PubMed

    Chang, C F; Tuckman, H P

    1993-01-01

    Each year Medicare-participant hospitals submit a cost report to the Health Care Financing Administration (HCFA) to settle their reimbursement claims. These reports are subject to audit, and a decision by HCFA to audit can be costly to the auditee. This article uses data from 6,270 cost reports filed in 1986 to explore the factors related to the probability of an audit. Logistic regression equations are estimated to examine how hospital characteristics influence the chance of audit. The results suggest that audit probability can be predicted with reasonable accuracy by a hospital's bed size, ownership type, teaching status, function, proportion of Medicare inpatient days, and geographic location.

  20. [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.

  1. 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

  2. [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.

  3. Nursing administration in small rural hospitals.

    PubMed

    Henry, B M; Moody, L E

    1986-01-01

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

  4. Hospital auditors--friend or foe?

    PubMed

    Okamoto, C L

    1987-05-01

    Now, with the direct linkage to the hospital's financial position, medical record departments are sharing part of the internal review process which hospital financial areas have historically undergone. Without a good financial background, most medical record managers lack the basic understanding of the purpose and usefulness of financial auditors. It is critical that medical record managers understand that purpose so that they can better serve their institutions. This article discusses the process undertaken and the results produced by hospital financial auditors, so that record managers gain benefits from financial auditor reviews, and see them as friends, rather than foes.

  5. [Hospital readmissions: A reliable quality indicator?].

    PubMed

    van Galen, Louise S; Nanayakkara, Prabath W B

    2016-01-01

    The percentage of readmissions within 30 days after discharge is an official quality indicator for Dutch hospitals in 2016. In this commentary the authors argue why readmissions cannot be regarded as a reliable way of assessing quality of healthcare in a hospital. To date, policy makers have been struggling with its precise definition and the indicator has not been properly formulated yet. It does not distinguish between planned and unplanned readmissions and does not take into account the 'preventability'. Therefore the authors believe that the indicator in its current form might falsely interpret the quality of care of a hospital and it is questionable to use readmissions as a quality indicator.

  6. 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

  7. The ecological footprint of Lions Gate Hospital.

    PubMed

    Germain, S

    The first-ever Ecological Footprint of a hospital was carried out in the summer of 2001 in North Vancouver, British Columbia. Although there has been growing concern that the healthcare system in Canada might be adversely affecting the environment, there have been few analyses of its environmental impact. Lions Gate Hospital bravely agreed to participate in this study and have its footprint calculated. This displays real leadership, reflecting very positively on the hospital's commitment to becoming more environmentally responsible and its willingness to open up to scrutiny.

  8. A new methodology for hospital design.

    PubMed

    Mejia, Ana Maria Silva

    2013-08-01

    According to architect, Ana Maria Silva Mejia, 'a new era for the design of hospitals in Guatemala has arrived', with a considerable growth in interest around good healthcare facility design. Here, in a slightly adapted version of an article, 'A new methodology for design', first published in the IFHE (International Federation of Hospital Engineering) Digest 2012, she reports on the application of a new methodology designed to optimise efficient use of space, and clinical and other adjacencies, in a district hospital in the City of Zacapa. The system has subsequently been successfully applied to a number of other Guatemalan healthcare facilities.

  9. [Information use in public hospital management].

    PubMed

    Escrivão Junior, Alvaro

    2007-01-01

    This study investigates managerial perceptions of the use of information in health management and planning in 24 Public Hospitals in the São Paulo Metropolitan Region, analyzing its usefulness for the decision-making process. In addition, some characteristics of the existing information system are studied. The findings show that ample amounts of information and data are available in the hospitals covered by this study, despite some gaps, and that managers do not know about the existing data and do not use this information to guide hospital management.

  10. Leveraging hospital formularies for improved prescribing.

    PubMed

    Karas, Albert; Kuehl, Bonnie

    2014-01-01

    Hospital formularies, guided by the Pharmacy and Therapeutics Committee, exist to optimize medication use by identifying and designating drugs of choice to guide rational prescribing, ultimately reducing patient risk and costs and improving patient outcomes. Guidelines and a framework exist to guide critical evaluations of medications for formulary listing; however, there may be opportunities to improve and standardize how a formulary change could be instituted in Canadian hospitals. A formulary change at an Ontario hospital revealed that there are some key challenges to the formulary change process including the importance of a robust project plan, appropriate resources, healthcare staff education, and acceptance.

  11. Lunar phases and psychiatric hospital admissions.

    PubMed

    Gorvin, J J; Roberts, M S

    1994-12-01

    To assess the lunar hypothesis as predictive of mental health emergencies and antisocial behavior, the relation of the lunar hypothesis and the occurrence of psychiatric hospital admissions of developmentally disabled adults was examined. The full moon phase of the lunar cycle did not explain a higher rate of hospital admission and accounted for only .007% of the variance. A critique of the methodology in prior research led to the suggestion that more immediate stressors and environmental factors are more plausible contributing factors to hospital admission.

  12. Reforming the Medicaid Disproportionate Share Hospital Program

    PubMed Central

    Coughlin, Teresa A.; Ku, Leighton; Kim, Johnny

    2000-01-01

    Since 1991, three Federal laws have sought to reform the Medicaid disproportionate share hospital (DSH) program, which is designed to help safety net hospitals. This article provides findings from a 40-State survey about Medicaid DSH and supplemental payment programs in 1997. Results indicate that the overall size of the DSH program did not grow from 1993 to 1997, but the composition of DSH revenues and expenditures changed substantially: A much higher share of the DSH funds were being paid to local hospitals and relatively less was being retained by the States. The study also revealed that large differences in States' use of DSH still persist. PMID:12500325

  13. What happens in hospitals does not stay in hospitals: antibiotic-resistant bacteria in hospital wastewater systems.

    PubMed

    Hocquet, D; Muller, A; Bertrand, X

    2016-08-01

    Hospitals are hotspots for antimicrobial-resistant bacteria (ARB) and play a major role in both their emergence and spread. Large numbers of these ARB will be ejected from hospitals via wastewater systems. In this review, we present quantitative and qualitative data of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, vancomycin-resistant enterococci and Pseudomonas aeruginosa in hospital wastewaters compared to community wastewaters. We also discuss the fate of these ARB in wastewater treatment plants and in the downstream environment. Published studies have shown that hospital effluents contain ARB, the burden of these bacteria being dependent on their local prevalence. The large amounts of antimicrobials rejected in wastewater exert a continuous selective pressure. Only a few countries recommend the primary treatment of hospital effluents before their discharge into the main wastewater flow for treatment in municipal wastewater treatment plants. Despite the lack of conclusive data, some studies suggest that treatment could favour the ARB, notably ESBL-producing E. coli. Moreover, treatment plants are described as hotspots for the transfer of antibiotic resistance genes between bacterial species. Consequently, large amounts of ARB are released in the environment, but it is unclear whether this release contributes to the global epidemiology of these pathogens. It is reasonable, nevertheless, to postulate that it plays a role in the worldwide progression of antibiotic resistance. Antimicrobial resistance should now be seen as an 'environmental pollutant', and new wastewater treatment processes must be assessed for their capability in eliminating ARB, especially from hospital effluents.

  14. Relativity and Al^+ Optical Clocks

    NASA Astrophysics Data System (ADS)

    Chou, Chin-Wen; Hume, David B.; Wineland, David J.; Rosenband, Till

    2010-03-01

    We have constructed an optical clock based on quantum logic spectroscopy of an Al+ ion that has a fractional frequency inaccuracy of 8.6x10-18. The frequency of the ^1S0<->^3P0 clock transition is compared to that of a previously constructed Al^+ optical clock with a statistical measurement uncertainty of 7.0x10-18. The two clocks exhibit a relative stability of 2.8x10-15&-1/2circ;, and a fractional frequency difference of -1.8x10-17, consistent with the accuracy limit of the older clock. By comparing the frequencies of the clocks, we have observed relativistic effects, such as time dilation due to velocities less than 10 m/s and the gravitational red shift from a 0.33 m height change of one of the clocks.

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. Patient and hospital characteristics associated with average length of stay.

    PubMed

    Shi, L

    1996-01-01

    This article examines the relationship between patient, hospital characteristics, and hospital average length of stay controlling for major disease categories. A constellation of patient and physician factors were found to be significantly associated with average hospital length of stay.

  1. Organizational Culture and Its Relationship with Hospital Performance in Public Hospitals in China

    PubMed Central

    Zhou, Ping; Bundorf, Kate; Chang, Ji; Huang, Jin Xin; Xue, Di

    2011-01-01

    Objective To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Data Sources Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Study Design Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Principal Findings Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Conclusions Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. PMID:22092228

  2. 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

  3. 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.

  4. [Hospital efficiency measured by bed space use in a secondary care hospital].

    PubMed

    Moreno-Martínez, Roberto; Martínez-Cruz, Rocío Alejandra

    2015-01-01

    Introducción: reconociendo que los recursos disponibles en las unidades médicas forman parte de los factores que condicionan la atención médica de calidad, resulta de importancia medir su aprovechamiento. El objetivo de este estudio fue determinar la eficiencia hospitalaria a través del recurso cama en un hospital de segundo nivel. Métodos: del Sistema de Información Médico Operativo, se examinaron los cuadros de salida mensuales de julio 2012 a junio 2013 que incluyen variables como egresos, días paciente, porcentaje de ocupación y promedio de días de estancia por especialidad y división, se obtuvieron los resultados por cada indicador estratégico y se relacionaron dichos resultados proponiendo supuestos para valorar la eficiencia hospitalaria. Resultados: de manera global, se identifica una óptima eficiencia hospitalaria, sin embargo el análisis por servicio y división señala una eficiencia deteriorada y baja. El resultado global de los cinco indicadores aplicados ignora la saturación de los servicios al interior de la unidad médica. Sin embargo, el análisis en conjunto revela dicha problemática, demostrando la ventaja de evaluar un mismo escenario desde diferentes perspectivas. Conclusiones: incluir indicadores que midan la eficiencia hospitalaria partiendo del recurso cama, permite considerar deficiencias no identificadas, con lo que se fortalece la toma de decisiones en salud.

  5. Discharging patients from acute care hospitals.

    PubMed

    Goodman, Helen

    2016-02-10

    Planning for patient discharge is an essential element of any admission to an acute setting, but may often be left until the patient is almost ready to leave hospital. This article emphasises why discharge planning is important and lists the essential principles that should be addressed to ensure that patients leave at an optimum time, feeling confident and safe to do so. Early assessment, early planning and co-ordination of all the teams involved in the patient's care are essential. Effective communication between the various teams and with the patient and their family or carer(s) is necessary. Patients should leave hospital with all the information, medications and equipment they require. Appropriate plans should have been developed and communicated to the receiving community or non-acute team. When patient discharge is effective, complications as a result of extended lengths of hospital stay are prevented, hospital beds are used efficiently and readmissions are reduced.

  6. [The oldest children's hospital in the Americas].

    PubMed

    Ferrero, Fernando

    2012-01-01

    Considering the history of medicine, pediatrics is relatively a recent discipline and so are the institutions devoted to it. The "Spedale degli Innocenti" (Florence, 1419) was the first institution devoted to child care; and is not by chance that it was an orphanage, because the "hospital" concept was then more related to hosting and careing than to health. It was in the 19th century when the pediatric hospitals, as we know them today, appear in Europe (L'Hôpital Des Enfants-Malades, Paris, 1802) and North America (Children's Hospital of Philadelphia, 1855); surprisingly "Casa Cuna" (Hospital de Niños Pedro de Elizalde, Buenos Aires, 1779) was already there, witnessing the foundation of both institutions.

  7. Hospital design for better infection control

    PubMed Central

    Lateef, Fatimah

    2009-01-01

    The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges PMID:20009307

  8. Quality Outcomes of Hospital Supplemental Nurse Staffing

    PubMed Central

    Xue, Ying; Aiken, Linda H.; Freund, Deborah A.; Noyes, Katia

    2017-01-01

    Background Use of supplemental registered nurses (SRNs) is common practice among U.S. hospitals to fill gaps in nurse staffing. Objective To examine the relationship between use of SRNs and patient outcomes. Methods Multilevel modeling was performed to analyze hospital administrative data from 19 hospital units in a large tertiary medical center for the years 2003–2006. Patient outcomes included in-hospital mortality, medication errors, falls, pressure ulcers, and patient satisfaction with nurses. Results SRN use ranged from 0–30.4% of total RN hours per unit quarter. Among 188 of the 304 unit quarters in which SRNs were used, the average SRN use was 9.8% in non-ICUs and 6.4% in ICUs. All observed effects of SRN use on patient outcomes were non-significant. Conclusions SRN use was substantial and varied widely by unit. No evidence was found that links SRN use to either adverse or positive patient outcomes. PMID:23151931

  9. ERP implementation in hospitals: a case study.

    PubMed

    Agarwal, Divya; Garg, Poonam

    2012-01-01

    In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital.

  10. Child psychiatric hospitalization: the last resort.

    PubMed

    Scharer, Kathleen; Jones, Debbie Singleton

    2004-01-01

    The purpose of this study was to describe how parents manage the experience of hospitalizing their school-aged child in a psychiatric unit. Grounded theory methodology was used. Thirty-eight parents participated. Data were collected by interviews. Analysis was done using the constant comparative method. The basic social problem identified was the escalating behavior of the child. The child's behavior included self-injurious behavior or violence toward others. The core concept was "hospitalization, the last resort." Parents' management of the experience varied based on many factors including whether this was the child's first psychiatric hospitalization, the distance from the hospital to their home, their trust of staff members, sources of support, and their definition of the situation.

  11. Stimulating cost effective behavior in hospitals.

    PubMed

    Neuhauser, D

    1987-04-01

    Types of influence on the delivery of medical care are divided into monetary and other. These incentives effect care at the system, hospital, care team, physician and patient levels. Selected examples, primarily from the USA, are discussed.

  12. Alternative indicators for measuring hospital productivity.

    PubMed

    Serway, G D; Strum, D W; Haug, W F

    1987-08-01

    This article explores the premise that the appropriateness and usefulness of typical hospital productivity measures have been affected by three changes in delivery: Organizational restructuring and other definition and data source changes that make full-time equivalent employee (FTE) measurements ambiguous. Transition to prospective payment (diagnosis-related groups). Increase in capitation (prepaid, at risk) programs. The effects of these changes on productivity management indicate the need for alternative productivity indicators. Several productivity measures that complement these changes in internal operations and the external hospital business environment are presented. These are based on an analysis of four hospitals within a multihospital system, and an illustration and interpretation of an array of measures, based on ten months of actual data, is provided. In conclusion, the recommendation is made for hospital management to collect an expanded set of productivity measures and review them in light of changing expense and revenue management schemes inherent in new payment modes.

  13. Green 'heart' for new community hospital.

    PubMed

    Baillie, Jonathan

    2013-06-01

    Replacing a healthcare facility first opened in 1908 as a 20-bed cottage hospital, the recently opened 'new' Finchley Memorial Hospital in north-west London was designed by architects, Murphy Philipps, 'to be at the heart of a health campus', surrounded by green space for use by both the hospital itself, and the local community. The 28 million pounds hospital, which has achieved a BREAAM Excellent rating - with an annual energy target of just 35 GJ/100 m3 set by SHINE, the Department of Health-backed learning network for sustainable healthcare buildings - has also featured as one of only 20 projects in the RIBA Health Buildings Exhibition. HEJ editor, Jonathan Baillie, met with lead architect, Marc Levinson, to find out more about the key elements, and the thinking, that went into the design.

  14. Medication safety during your hospital stay

    MedlinePlus

    Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... Medication safety means you get the right medicine, the right dose, at the right times. During your ...

  15. [Patients' perception about privacy in the hospital].

    PubMed

    Pupulim, Jussara Simone Lenzi; Sawada, Namie Okino

    2012-01-01

    This qualitative study aimed to describe the hospitalized patient's perception on privacy, using the content analysis. Thirty-four patients, who have been at least three days hospitalized, participated in the study. The analysis of the information was based on the theoretical reference framework of privacy, and evidenced three thematic categories: dignity and respect, autonomy, personal and territorial space. The subjects pointed out behavioral factors, which contribute or not for the protection and maintenance of the privacy in the hospital, highlighting respect as the most important aspect, followed by personal control over situations that violate privacy. Patients believe that privacy is linked to dignity and respect, depends on the demarcation of the personal/territorial space and the autonomy's security; and that these concepts and attitudes are connected and essential to protect privacy in the hospital context.

  16. The Old Library of the Pennsylvania Hospital *

    PubMed Central

    Bell, Whitfield J.

    1972-01-01

    The first medical book acquired by the Pennsylvania Hospital was William Lewis's Experimental History of the Materia Medica. Dr. John Fothergill of London donated it in 1762. The next year the Managers resolved to establish a library, and the physicians assigned their fees from hospital students for the purchase of books. Books were regularly ordered from William Strahan in London, and gifts and bequests added still more volumes. From 1790 to 1810 Dr. John Coakley Lettsom of London was the hospital's principal adviser on purchases. As the library grew, it expanded beyond purely medical works to include some in natural history, many purchased in 1817 from the estate of Dr. Benjamin Smith Barton. Catalogues were printed in the years 1790-94, 1806, 1829, and 1857. At midcentury the hospital library numbered about 9,000 volumes. At that time it was the largest medical library in the United States. PMID:4563538

  17. Massachusetts General Hospital starts own degree programs.

    PubMed

    1979-01-01

    Massachusetts General Hospital has established a new Education Division that administers various degree programs in seven professional fields. Major emphasis is on interdisciplinary study and integration of the academic and the clinical components of training.

  18. [Epilepsy treatment in Serbian medieval monastery hospitals].

    PubMed

    Ilić-Tasić, Slobodanka; Pantović, Mihailo; Jović, Nebojsa; Ravanić, Dragan; Obradović, Dejan; Sretenović, Srdjan; Pantović, Maja; Pantović, Vesna

    2009-01-01

    Emperor John III Ducas Vatatzes (ruled from 1222-1254) and his son Theodore II Lascaris (ruled from 1254-1258) both suffered from epilepsy. On his journeys to Nicaea, St Sava visited emperors Theodore I Lascaris (ruled from 1204-1222) and John II Vatatzes, who richly rewarded him, which was probably of crucial importance for the foundation of hospitals in the Monastery of Hilandar and the Monastery of Studenica These hospitals had special departments for the treatment of patints with epilepsy. According to researches conducted up-to-date, these departments are considered to be the oldest institutions for epilepsy treatment. Monastery hospitals in the West served primarily as a shelter for the poor and patients with chronic incurable diseases. The development of Serbian monastery hospitals was a long process and it included institutions that lasted for a long time (for over two centuries) in which, among others, those affected by epilepsy were cured.

  19. ORD Studies of Water Quality in Hospitals

    EPA Science Inventory

    Presentation descibes results from two studies of water quality and pathogen occurrence in water and biofilm samples from two area hospitals. Includes data on the effectiveness of copper/silver ionization as a disinfectant.

  20. A new "P" for hospital marketing?

    PubMed

    Hill, R C

    1988-01-01

    The rather abrupt introduction of payors to hospitals and vice versa that started a few years ago has now settled down into a learning situation. To be price competitive in the health insurance marketplace, the payor must obtain full contractual performance in price, administrative and utilization review areas. Hospitals need the patients that payors can refer, but there is only a minimal understanding of how the health insurance industry operates both internally and in the marketplace. By selecting payors and soliciting those selected, hospitals have an excellent chance to accomplish their patient and revenue goals while payors have the opportunity to determine the effectiveness of their various programs to help meet their goals. By making a little effort, hospitals can accomplish a lot by adding this new "P" to their marketing mix.

  1. Wireless technologies and patient safety in hospitals.

    PubMed

    Boyle, Justin

    2006-06-01

    In the development of policies for wireless technologies, it is important for healthcare organizations to reduce risks to patients from use of wireless devices. Policy should be devised for instructing hospital staff, visitors, and patients, avoiding unwarranted restrictions but not ignoring evidence regarding potential interference problems, and allowing comparison with other clinical facilities of benefits of policy. To inform policy developers and a general audience of hospital personnel, a review was conducted on the safety of wireless devices for communication within hospitals. This review targeted electromagnetic interference effects of devices on medical devices and summarises key recommendations from published reports and international standards. There is consensus that the highest risk of interference occurs with two-way radios used by emergency crews, followed by mobile phones, while radio local area networks produce negligible interference. Wireless technologies are deemed suitable for use throughout hospital areas including intensive care units and operating rooms, given that recommended separation distances from medical equipment are observed.

  2. [Hospitality as an expression of nursing care].

    PubMed

    Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera

    2010-01-01

    Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care.

  3. [Civil hospital of Zamora de Hidalgo].

    PubMed

    Gómez de Lara, José Luis

    2015-01-01

    The city of Zamora de Hidalgo is home to one of the most important hospitals in the region, built in 1841 and named the Civil Hospital of Zamora. Built following demand for municipal health needs and with the support of the City Council of Zamora and private donations, it functioned as a hostel for pilgrims, the destitute and the sick. It was administered and maintained by residents, subsequently by the mothers of the Sacred Heart of Jesus, and finally by the federal Government. It currently gives the Zamorano community services, and admits sick people from other locations such as Jacona, Jiquilpan, Patamban Ocumicho, Chavinda, Tangancicuaro, Chilchota, and Tangamandapio, among others. It was called the Civil hospital because as the only hospital that operated in Zamora, it ceased to be administered by the Ecclesiastic Chapter, and passed into the hands of the State.

  4. Nontherapeutic areas and their role in hospital surge capacity in facing disasters

    PubMed Central

    Shirani, Mehrdad; Salehnia, Mohammad Hossein; Esmailian, Mehrdad

    2016-01-01

    Background: Unexpected events, accidents, wars, other natural, and unnatural disasters threaten human life. Hospitals especially emergency departments are the first line dealing with the disaster victims and on the other hand, are often full of patients. The purpose of this study is evaluating surge capacity of Isfahan Al-Zahra Hospital in facing disasters with the usage of nontherapeutic areas potential in a time of crisis. Materials and Methods: First, nontherapeutic areas having the conversional potential to be used as therapeutic areas were defined and then with applying standard formulas, and patient admission capacity was calculated. Results: After calculating, it was determined that there is a potential of hospitalization of 240 patients at the stadium next to the hospital, 100 patients in clinics, 1,000 patients in the indoor parking, and 3–4 thousand patients in the open space area. Conclusion: Hospital current capacity could be increased significantly in case of facing disasters through providing instructions, and pre-prepared plans. PMID:27169105

  5. Relationship marketing in a hospital library.

    PubMed

    Enyeart, Amanda L; Weaver, Debbie

    2005-01-01

    This article explores relationship marketing as adopted by staff of the Forbes Medical Library at The Children's Hospital in Denver. It provides a broad overview of relationship marketing along with its applications in libraries, and a description of how the library staff has used specific relationships with different hospital groups to enhance library service. The examples illustrate the importance of persistence, patience, and flexibility when consciously developing relationships between a library and individuals or groups.

  6. Assessing the performance of freestanding hospitals.

    PubMed

    McCue, Michael J; Diana, Mark L

    2007-01-01

    Freestanding hospitals are becoming less common as more hospitals are joining or establishing relationships with multihospital systems. These associations are driven by factors, such as unrelenting competition in local markets, aging physical plants, increasing labor costs, and higher physician fees, that place a high demand on financial assets. Despite these factors, many freestanding hospitals continue to do well financially, showing increases in total profit margins and total cash flow margins. This article examines which market, management, financial, and mission factors are associated with freestanding hospitals with consistently positive cash flows, relative to those without consistently positive cash flows. The study sample consisted of freestanding, nonfederal, short-term, acute care general hospitals with more than 50 beds and three years of annual cash flow data. Data were taken from the annual surveys of the American Hospital Association, the cost reports of the Centers for Medicare and Medicaid Services, and the Area Resource File of the Health Resources and Services Administration. The data were analyzed using logistic regression to identify those factors associated with a consistently positive cash flow. Freestanding hospitals with positive cash flows were found to have a greater market share and to be located in markets with a higher number of physicians and fewer acute care beds; to have fewer unoccupied beds, higher net revenues, greater liquidity, and less debt on hand; and to treat fewer Medicare patients than those without a positive cash flow. The findings suggest that these hospitals are located in resource-rich environments and that they have strong management teams.

  7. Coding productivity in Sydney public hospitals.

    PubMed

    Dimitropoulos, Vera; Bennett, Adam; McIntosh, Jean

    2002-01-01

    The aims of this study were to compare Sydney public hospitals regarding medical record coding times to compare observed coding times with coding times necessary to avoid backlog and to evaluate the impact on coding time of casemix complexity, coder age, experience, job satisfaction, employment status, and salary. Coding time (in minutes) for each medical record over a two-week period was documented by 61 coders employed in 13 hospitals: six principal referral (PR), six major metropolitan (MM), and one paediatric specialist (PS) hospitals. The mean coding time for each coder was estimated by averaging across coding times for all records during the two-week period. In order to compare hospital mean coding times, the hospitals were grouped into PR and MM/PS groups. The mean coding time necessary to avoid coding backlog (expected coding time) for each hospital group was based on the total number of annual separations and filled full-time equivalent coding positions. The observed mean coding time was longer in the PR group than in the MM/PS group (p = 0.019); however, the observed coding time was within the expected coding time limit in both the PR and MM/PS groups. Casemix complexity tended to influence coding time, but neither age, experience, job satisfaction, employment status nor salary had any impact. In conclusion, the expected coding times, if reliable, indicate that coders in the two hospital groups were keeping coding up-to-date. Thus, the variation between hospital groups in coding time is of little importance, given that the main objective in coding productivity is to maintain the coding workload.

  8. Jackson Park Hospital Green Building Medical Center

    SciTech Connect

    Dorsey, William; Vasquez, Nelson

    2010-05-01

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

  9. [The Bauhaus style in hospitals of Saxony].

    PubMed

    Klimpel, Volker

    2011-01-01

    In the first half of 20th century the architecture of hospitals in Germany changed considerable. Essential impulses for "The new construct" get out from the school of "Bauhaus" in Weimar, Dessau and Berlin. Clear lines and the principle of light, air and sun were characteristic of this style. Buildings of such hospitals and her creators in Chemnitz, Dresden, Freiberg and Zwenkau, all in Saxony, are described and illustrated exemplary.

  10. Hospitals pile junk high, but fervor subsiding.

    PubMed

    Lutz, S

    1992-11-30

    While the junk bond market has been good to hospital companies this year--feeding them $2 billion through the sale of high-yield bonds--some say a post-election chill has cooled the junk bond fervor. One healthcare system, citing a "collapse" in the junk market, called off a $200 million hospital acquisition deal. However, many analysts say a recent slump in junk bond prices represents an oversupply of issues, not a market collapse.

  11. [Research on SOA for hospital information system].

    PubMed

    Chen, Wei; Liu, Min

    2010-09-01

    Integration of heterogeneous systems in hospital is an important subject. The loose-coupling and efficient data interaction can be realized with SOA, the complexity of cross-point can be avoided with ESB and Service-Oriented when system integration, the unified control can come for information management. Finally it will meet a variety of needs related with management and business in hospital, adapting quickly to changes.

  12. An approach toward public hospital performance assessment

    PubMed Central

    Nwagbara, Vitalis Chukwudi; Rasiah, Rajah; Aslam, Md. Mia

    2016-01-01

    Abstract Background: Public hospitals have come under heavy scrutiny across the world owing to rising expenditures. However, much of the focus has been on cutting down costs to raise efficiency levels. Although not denying the importance of efficiency measures, this article targets a performance issue that is relevant to address the quality of services rendered in public hospitals. Thus, it is important to focus on the effectiveness of resource utilization in these hospitals. Consequently, this article seeks to examine the impact of average length of stay (ALOS) and bed turnover rates (BTR) on bed occupancy rates (BOR). Methods: Public hospital inpatient utilization records during the period 2006 to 2013 were gathered from the Ministry of Health, Malaysia. A 2-step generalized method of moments (GMM) statistical method was used to analyze the data. BOR was adopted as the dependent variable, whereas BTR and ALOS were used as the explanatory variables. The logarithm of total bed count (BED), admission (ADM), and patient days (PD) was deployed as control variables. Three regression models were developed to explore the correlates of BOR as a hospital performance measure. Ethics committee approval was waived because no patients were identified in the study. Results: The statistical analyses show that ALOS and BTR are inversely correlated with BOR, with both coefficients significant at 1%. The control variables of BED, ADM, and PD had the right positive signs and they were significant in both sets of equations. Hence, reducing ALOS and BTR can help raise performance of public hospitals in Malaysia. Conclusion: In light of the robust results obtained, this study offers implications for improving public hospital performance. It shows a need to reduce ALOS and BTR in public hospitals to improve BOR. PMID:27603363

  13. Geriatric Prescription in a Nigerian Tertiary Hospital

    PubMed Central

    Osemeke, Nwani Paul; Hart, Onwukwe Chikezie; Cosmas, Nwosu Maduaburochukwu; Ohumagho, Isah Ambrose

    2016-01-01

    Objectives: To assess the medications prescribed for elderly inpatients on specific days during hospital admission with a view to detecting areas of irrational prescription. Methods: It was a prospective study of all patients aged 65 years and above admitted to the medical wards of a Nigerian tertiary hospital over a 12-month period. The World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators were used to assess drug prescriptions on various days of admission. Results: A total of 1513 patient encounters involving 345 patients aged between 65 and 92 years were assessed on hospital days 1, 3, 5, 7, 14, and 28. The average number of medicines per encounter ranged from 6.1 ± 2.5 on hospital day 1 to 7.8 ± 2.4 on hospital day 28. This difference was statistically significant (F = 14.42; P < 0.05). The percentage of encounters with an antibiotic prescribed ranged from 50.4% on hospital day 1 to 62.9% on hospital day 28 while the percentage of encounters with an injection prescribed decreased from 72.8% on hospital day 1 to 50.0% on day 28. Conclusions: This study suggests some degree of irrational prescribing as evident by the high average number of medicine per encounter and the high percentages of encounters with an antibiotic or injection prescribed. However, there is a need to develop standard values for the WHO/INRUD indicators based on the recently published national treatment guidelines for common elderly diseases which will serve as yardsticks to assess elderly inpatients prescriptions using WHO/INRUD core indicators in future studies. PMID:28104970

  14. Hospital, system boards adjust to changing roles.

    PubMed

    Greene, J

    1991-09-02

    A growing number of multihospital systems are flexing their centralized power over individual hospital boards in an attempt to realize the competitive edge that systems were supposed to provide. As a result, governance at the hospital level is becoming more and more advisory. Obviously, trustees in a lot of locales aren't coming quietly into the new relationship. But experts say healthcare's financial climate makes such change just a matter of time.

  15. Metadata - National Hospital Ambulatory Medical Care Survey (NHAMCS)

    EPA Pesticide Factsheets

    The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect information on the services provided in hospital emergency and outpatient departments and in ambulatory surgery centers.

  16. Chronic obstructive pulmonary disease: hospital and intensive care unit outcomes in the Kingdom of Saudi Arabia

    PubMed Central

    Alaithan, Abdulsalam M; Memon, Javed I; Rehmani, Rifat S; Qureshi, Arif A; Salam, Abdul

    2012-01-01

    Background There is little data surrounding the survival of patients with chronic obstructive pulmonary disease (COPD) who are admitted to the critical care unit with exacerbation of symptoms. We conducted a study to measure the in-hospital and intensive care unit (ICU) outcomes of patients admitted with COPD exacerbation, and identified the related prognostic factors. Method We performed a retrospective cohort study of patients who were admitted to the adult ICU between January 2006 and July 2011 for COPD exacerbation in King Abdulaziz National Guard Hospital, Al-Hasa, Saudi Arabia. Results During the study period, a total of 119 patients were admitted to the ICU with acute respiratory failure attributed to COPD exacerbation. The mean age was 72 ± 13 years, and 44 (37%) were females. The main cause of respiratory failure was infection, which occurred in 102 (86%) patients. Thirty-nine (33%) of the admitted patients were mechanically ventilated, and the median duration was 2.6 (1–42) days. The median lengths of the ICU and hospital stays were 3 (1–40) and 9 (2–43) days, respectively. The ICU mortality was 6%, and hospital mortality was 11%. Low Glasgow Coma Scale on admission, intubation, duration of mechanical ventilation, current smoking, tracheostomy, cardiopulmonary arrest, and the development of acute renal failure were associated with higher hospital mortality. Conclusion Early ICU and hospital mortality is low for COPD patients who have been admitted to the ICU with exacerbation. Low Glasgow Coma Scale scores on admission, intubation, prolonged use of mechanical ventilation, and the development of acute renal failure were identified as risk factors associated with increased hospital mortality. PMID:23269866

  17. In Hospital We Trust: Experiences of older peoples' decision to seek hospital care.

    PubMed

    Hallgren, Jenny; Ernsth Bravell, Marie; Dahl Aslan, Anna K; Josephson, Iréne

    2015-01-01

    The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People's Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples' arguments for seeking hospital care may have implications for how home care staff address individuals' perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life.

  18. Herpes Zoster Associated Hospital Admissions in Italy: Review of the Hospital Discharge Forms

    PubMed Central

    Gabutti, Giovanni; Serenelli, Carlotta; Cavallaro, Alessandra; Ragni, Pietro

    2009-01-01

    In Italy a specific surveillance system for zoster does not exist, and thus updated and complete epidemiological data are lacking. The objective of this study was to retrospectively review the national hospital discharge forms database for the period 1999–2005 using the code ICD9-CM053. In the period 1999–2005, 35,328 hospital admissions have been registered with annual means of 4,503 hospitalizations and 543 day-hospital admissions. The great part of hospitalizations (61.9%) involved subjects older than 65 years; the mean duration of stay was 8 days. These data, even if restricted to hospitalizations registered at national level, confirm the epidemiological impact of shingles and of its complications. PMID:19826547

  19. The impact of policy on hospital productivity: a time series analysis of Dutch hospitals.

    PubMed

    Blank, Jos L T; Eggink, Evelien

    2014-06-01

    The health care industry, in particular the hospital industry, is under an increasing degree of pressure, by an ageing population, advancing expensive medical technology a shrinking labor. The pressure on hospitals is further increased by the planned budget cuts in public spending by many current administrations as a result of the economic and financial crises. However, productivity increases may alleviate these problems. Therefore we study whether productivity in the hospital sector is growing, and whether this productivity growth can be influenced by government policy. Using an econometric time series analysis of the hospital sector in the Netherlands, productivity is estimated for the period 1972-2010. Then, productivity is linked to the different regulation regimes during that period, ranging from output funding in the 1970s to the current liberalized hospital market. The results indicate that the average productivity of the hospital sector in different periods differs and that these differences are related to the structure of regulation in those periods.

  20. Community Factors and Hospital Readmission Rates

    PubMed Central

    Herrin, Jeph; St Andre, Justin; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen C

    2015-01-01

    Objective To examine the relationship between community factors and hospital readmission rates. Data Sources/Study Setting We examined all hospitals with publicly reported 30-day readmission rates for patients discharged during July 1, 2007, to June 30, 2010, with acute myocardial infarction (AMI), heart failure (HF), or pneumonia (PN). We linked these to publicly available county data from the Area Resource File, the Census, Nursing Home Compare, and the Neilsen PopFacts datasets. Study Design We used hierarchical linear models to assess the effect of county demographic, access to care, and nursing home quality characteristics on the pooled 30-day risk-standardized readmission rate. Data Collection/Extraction Methods Not applicable. Principal Findings The study sample included 4,073 hospitals. Fifty-eight percent of national variation in hospital readmission rates was explained by the county in which the hospital was located. In multivariable analysis, a number of county characteristics were found to be independently associated with higher readmission rates, the strongest associations being for measures of access to care. These county characteristics explained almost half of the total variation across counties. Conclusions Community factors, as measured by county characteristics, explain a substantial amount of variation in hospital readmission rates. PMID:24712374

  1. Hospital Readmission Through the Emergency Department

    PubMed Central

    Mahmoudi, Sadrollah; Taghipour, Hamid Reza; Javadzadeh, Hamid Reza; Ghane, Mohammad Reza; Goodarzi, Hassan; Kalantar Motamedi, Mohammad Hosein

    2016-01-01

    Background Hospital readmission places a high burden on both health care systems and patients. Most readmissions are thought to be related to the quality of the health care system. Objectives The aim of this study was to examine the causes and rates of early readmission in emergency department in a Tehran hospital. Patients and Methods A cross-sectional investigation was performed to study readmission of inpatients at a large academic hospital in Tehran, Iran. Patients admitted to hospital from July 1, 2014 to December 30, 2014 via the emergency department were enrolled. Descriptive statistics were used to summarize the distribution demographics in the sample. Data was analyzed by chi2 test using SPSS 20 software. Results The main cause of readmission was complications related to surgical procedures (31.0%). Discharge from hospital based on patient request at the patient's own risk was a risk factor for emergency readmission in 8.5%, a very small number were readmitted after complete treatment (0.6%). The only direct complication of treatment was infection (17%). Conclusions Postoperative complications increase the probability of patients returning to hospital. Physicians, nurses, etc., should focus on these specific patient populations to minimize the risk of postoperative complications. Future studies should assess the relative connections of various types of patient information (e.g., social and psychosocial factors) to readmission risk prediction by comparing the performance of models with and without this information in a specific population. PMID:27626018

  2. [Problems of modernization of historic hospitals].

    PubMed

    Gerber, Piotr

    Adapting buildings and the technical infrastructure of hospitals to the requirements of modern technology, workflow and legal regulations is a difficult and costly process. A proper plan, taking into account the necessary changes, has a significant influence on the future functioning of the hospital. The assumptions and priorities of the project determine the quality of services provided in the future. The modernization process is more complicated when it concerns hospital complexes with a historic pedigree. Combining functionality, modernity and efficiency while retaining historical features is a difficult undertaking: Decisions must be made basing on a thorough analysis. Of the 70 hospitals in Lower Silesia, 23 are historic structures. The majority of them do not meet the demands of modern medical technology and workflow, or the requirements of the Ministry of Health. The subject of modernization of historic hospital facilities is a very important contemporary topic, but is subjected to very little research. The work presented is one phase of a larger study intending to develop model solutions for the optimization of design processes in the modernization of a historic hospital.

  3. Management changes resulting from hospital accreditation 1

    PubMed Central

    de Oliveira, João Lucas Campos; Gabriel, Carmen Silvia; Fertonani, Hosanna Pattrig; Matsuda, Laura Misue

    2017-01-01

    ABSTRACT Objective: to analyze managers and professionals' perceptions on the changes in hospital management deriving from accreditation. Method: descriptive study with qualitative approach. The participants were five hospital quality managers and 91 other professionals from a wide range of professional categories, hierarchical levels and activity areas at four hospitals in the South of Brazil certified at different levels in the Brazilian accreditation system. They answered the question "Tell me about the management of this hospital before and after the Accreditation". The data were recorded, fully transcribed and transported to the software ATLAS.ti, version 7.1 for access and management. Then, thematic content analysis was applied within the reference framework of Avedis Donabedian's Evaluation in Health. Results: one large family was apprehended, called "Management Changes Resulting from the Accreditation: perspectives of managers and professionals" and five codes, related to the management changes in the operational, structural, financial and cost; top hospital management and quality management domains. Conclusion: the management changes in the hospital organizations resulting from the Accreditation were broad, multifaceted and in line with the improvements of the service quality. PMID:28301031

  4. Local public hospitals: changing with the times.

    PubMed

    Felland, Laurie E; Stark, Lucy

    2012-11-01

    Over the last 15 years, public hospitals have pursued multiple strategies to help maintain financial viability without abandoning their mission to care for low-income people, according to findings from the Center for Studying Health System Change's (HSC) site visits to 12 nationally representative metropolitan communities. Local public hospitals serve as core safety net providers in five of these communities--Boston, Cleveland, Indianapolis, Miami and Phoenix--weathering increased demand for care from growing numbers of uninsured and Medicaid patients and fluctuations in public funding over the past 15 years. Generally, these public hospitals have adopted six key strategies to respond to growing capacity and financial pressures: establishing independent governance structures; securing predictable local funding sources; shoring up Medicaid revenues; increasing attention to revenue collection; attracting privately insured patients; and expanding access to community-based primary care. These strategies demonstrate how public hospitals often benefit from functioning somewhat independently from local government, while at the same time, relying heavily on policy decisions and funding from local, state and federal governments. While public hospitals appear poised for changes under national health reform, they will need to adapt to changing payment sources and reduced federal subsidies and compete for newly insured people. Moreover, public hospitals in states that do not expand Medicaid eligibility to most low-income people as envisioned under health reform will likely face significant demand from uninsured patients with less federal Medicaid funding.

  5. [Suggestions for buying medical equipment in hospitals].

    PubMed

    Trontzos, Christos

    2004-01-01

    TO THE EDITOR: Both in Greece and in other European countries there are plans to buy more medical equipment. If the whole procedure is not effective, it may result to a large deficit in the hospital budget. The total hospital deficit now in Greece is about 2.5 billion euros. It is suggested that in every hospital, the Authorized Committee for Medical Equipment Purchasing, should include the following: One Director of a Medical Department related to the equipment to be bought and another Director of a Medical Department, unrelated. One accountant. One legal advisor specialized in hospital affairs. One economical advisor specialized in banking who will be able to suggest leasing or other means of financing the purchase of the relevant equipment. A cost accounting analysis described by a detailed report, should be provided to secure that the equipment to be bought should be cost-effective and leaving a reasonable surplus after not more than 10 years from the time it is installed. Finally, the possibility of using one expensive equipment to cover the needs of more than one hospitals either by moving the equipment (i.e. the PET/CT camera by a large vehicle) or by transferring the patients to a central hospital, may be provided by the above Authorized Committee.

  6. Acceptability of identification bracelets for hospital inpatients

    PubMed Central

    Cleopas, A; Kolly, V; Bovier, P; Garnerin, P; Perneger, T

    2004-01-01

    Objective: To evaluate whether hospitalised patients would agree to wear an identification bracelet and whether patient acceptability is improved by more detailed explanations or by using a code instead of a name on the bracelet. Design: Patient survey that tested two variables in a randomised factorial design. Explanations about identification bracelets were given (a) with or without examples of situations where patient identification may be important, and (b) with the patient name or an anonymous code appearing on the bracelet. Setting: Swiss teaching hospital where wearing of identification bracelets was not systematic. Participants: Adult patients discharged from hospital (n = 1411). Main outcome measures: Patients' responses to the questions: (a) should the hospital introduce a compulsory identification bracelet? and (b) would the patient agree to wear such a bracelet? Results: Globally, 83.9% of patients thought that the hospital should introduce bracelets and 90.2% stated that they would agree to wear one. Providing examples increased support for both the hospital policy (87.9% v 79.2%, p<0.001) and personal acceptance (92.2% v 88.1%, p = 0.015). Whether or not the bracelet carried the patient's name or an anonymous code did not influence patient choice. Conclusions: The majority of patients were in favour of wearing an identification bracelet during their hospital stay. This proportion increased significantly when an explanation based on examples of the consequences of incorrect patient identification had been provided. PMID:15465937

  7. [Hospital-acquired urinary tract infections].

    PubMed

    Adukauskiene, Dalia; Cicinskaite, Ilona; Vitkauskiene, Astra; Macas, Andrius; Tamosiūnas, Ramūnas; Kinderyte, Aida

    2006-01-01

    Urinary tract infections are responsible for 40-60% of all hospital-acquired infections. Increased age of patients and comorbid diseases render hospitalized patients more susceptible to infection. Almost 80% of hospital-acquired urinary tract infections are associated with urinary catheters, and only 5-10% of urinary infections are caused by invasive manipulations in the urogenital tract. Pathogens of hospital-acquired urinary tract infections are frequently multi-resistant, and antibiotic therapy can only be successful when the complicating factors are eliminated or urodynamic function is restored. For treatment of complicated hospital-acquired urinary tract infections, the antibiotics must exhibit adequate pharmacodynamic and pharmacokinetic properties: high renal clearance of unmetabolized form with good antimicrobial activity in both acidic and alkaline urine. For selection of empirical treatment of hospital-acquired urinary tract infections, it is necessary to evaluate localization of infection, its severity, possible isolates, and the most frequent pathogens in the department where patient is treated. The best choice for the starting the antimicrobial therapy is the cheapest narrow-spectrum effective antibiotic in the treatment of urinary tract infection until microbiological evaluation of pathogens will be received. Adequate management of urinary tract infections lowers the rate of complications, requirements for antibacterial treatment, selection of multi-resistant isolates and is cost effective.

  8. Factor structure of the SOCRATES questionnaire in hospitalized medical patients

    PubMed Central

    Bertholet, Nicolas; Dukes, Kim; Horton, Nicholas J.; Palfai, Tibor P.; Pedley, Alison; Saitz, Richard

    2009-01-01

    The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), a 19-item instrument developed to assess readiness to change alcohol use among individuals presenting for specialized alcohol treatment, has been used in various populations and settings. Its factor structure and concurrent validity has been described for specialized alcohol treatment settings and primary care. The purpose of this study was to determine the factor structure and concurrent validity of the SOCRATES among medical inpatients with unhealthy alcohol use not seeking help for specialized alcohol treatment. The subjects were 337 medical inpatients with unhealthy alcohol use, identified during their hospital stay. Most of them had alcohol dependence (76%). We performed an Alpha Factor Analysis (AFA) and Principal Component Analysis (PCA) of the 19 SOCRATES items, and forced 3 factors and 2 components, in order to replicate findings from Miller & Tonigan (1996) and Maisto et al (1999). Our analysis supported the view that the 2 component solution proposed by Maisto et al (1999) is more appropriate for our data than the 3 factor solution proposed by Miller & Tonigan (1996). The first component measured Perception of Problems and was more strongly correlated with severity of alcohol related consequences, presence of alcohol dependence, and alcohol consumption levels (average number of drinks per day and total number of binge drinking days over the past 30 days)compared to the second component measuring Taking Action. Our findings support the view that the SOCRATES is comprised of two important readiness constructs in general medical patients identified by screening PMID:19395177

  9. [Drugs having latex and therapeutic alternatives in hospital formulary].

    PubMed

    Damas Fuentes, Rosa María; Pérez León, Moisés; Piñero González, Marta; Sangil Monroy, Nayra; Molero Gómez, Rafael; Domínguez Lantigua, Pablo

    2015-01-01

    Objetivo: Analizar el contenido en látex de los medicamentos en la guía farmacoterapéutica y establecer alternativas en un hospital de tercer nivel. Método: Se seleccionaron los medicamentos susceptibles de contener látex en su material de acondicionamiento, se solicitó al laboratorio fabricante información y se buscaron posibles alternativas incluidas en guía farmacoterapéutica. Resultados: De las 618 especialidades seleccionadas se obtuvo información escrita del laboratorio para 605 (97.9%) y en ficha técnica para 8. De las 57 (9,2%) especialidades con riesgo en pacientes con alergia al látex se encontró una alternativa en guía para el 43,9%. Conclusiones: Conocer las especialidades con látex aumenta la seguridad en la prescripción, mientras que la disponibilidad de una tabla de equivalencias terapéuticas facilita la validación. Los datos publicados vienen a actualizar la información del contenido en látex de los medicamentos para pacientes y personal sanitario, generalmente escasa y variable.

  10. [Effectiveness and adequacy of tolvaptan prescription in hospitalized patients].

    PubMed

    Edo Solsona, Ma D; Ruiz Ramos, J; Montero Hernández, M; Font Noguera, I; Poveda Andrés, J L

    2013-01-01

    Objetivo: Analizar la efectividad del uso de tolvaptán y la adecuación de su prescripción en un hospital de tercer nivel. Método: Estudio observacional prospectivo de las prescripciones de tolvaptán desde octubre de 2010 hasta diciembre de 2011. Resultados: Se incluyeron 30 pacientes (60,0% varones), 50,0% diagnosticados de insuficiencia cardíaca y 30,0% de SIADH. Tolvaptán permitió alcanzar niveles de sodio superiores a 135 mEq/L en el 53,3% de los pacientes que partían con una media de 125,3±7,3 mEq/L. La mediana de días de tratamiento fue de 5,0 (rango intercuartílico = 3-45). Se observó un incremento significativo de los niveles de ácido úrico asociado al tratamiento con tolvaptán. La prescripción se adecuó a lo establecido en la GFT en el 63,3% de los casos. Conclusiones: Tolvaptán incrementa un 7,5 mEq/L los niveles de sodio tanto en hiponatremia secundaria al SIADH como en insuficiencia cardiaca.

  11. [Coagulation behavior of Al13 species].

    PubMed

    Hu, Cheng-zhi; Liu, Hui-juan; Qu, Jiu-hui

    2006-12-01

    Coagulation behavior of Al13 species was examined in synthetic water with high alkalinity and high humic acid concentration from viewpoint of the transformation of Al hydrolysis products during the coagulation process. The results indicated that coagulation efficiency of Al coagulants positively correlated with the content of Al13 in the coagulation process. Aluminum chloride (AlCl3) was more effective than polyaluminum chloride (PACI) in removing turbidity and dissolved organic matter in the synthetic water because AlCl3 could not only generate Al13 species but also function as pH control agent in the coagulation process. During coagulation process pH control can improve coagulation process through regulating Al speciation, and AlCl3 benefited most from pH control.

  12. Economic evaluation of hospital at home versus hospital care: cost minimisation analysis of data from randomised controlled trial

    PubMed Central

    Jones, Jeremy; Wilson, Andrew; Parker, Hilda; Wynn, Alison; Jagger, Carol; Spiers, Nicky; Parker, Gillian

    1999-01-01

    Objectives To compare the costs of admission to a hospital at home scheme with those of acute hospital admission. Design Cost minimisation analysis within a pragmatic randomised controlled trial. Setting Hospital at home scheme in Leicester and the city's three acute hospitals. Participants 199 consecutive patients assessed as being suitable for admission to hospital at home for acute care during the 18 month trial period (median age 84 years). Intervention Hospital at home or hospital inpatient care. Main outcome measures Costs to NHS, social services, patients, and families during the initial episode of treatment and the three months after admission. Results Mean (median) costs per episode (including any transfer from hospital at home to hospital) were similar when analysed by intention to treat—hospital at home £2569 (£1655), hospital ward £2881 (£2031), bootstrap mean difference −305 (95% confidence interval −1112 to 448). When analysis was restricted to those who accepted their allocated place of care, hospital at home was significantly cheaper—hospital at home £2557 (£1710), hospital ward £3660 (£2903), bootstrap mean difference −1071 (−1843 to −246). At three months the cost differences were sustained. Costs with all cases included were hospital at home £3671 (£2491), hospital ward £3877 (£3405), bootstrap mean difference −210 (−1025 to 635). When only those accepting allocated care were included the costs were hospital at home £3698 (£2493), hospital ward £4761 (£3940), bootstrap mean difference −1063 (−2044 to −163); P=0.009. About 25% of the costs for episodes of hospital at home were incurred through transfer to hospital. Costs per day of care were higher in the hospital at home arm (mean £207 v £134 in the hospital arm, excluding refusers, P<0.001). Conclusions Hospital at home can deliver care at similar or lower cost than an equivalent admission to an acute hospital. PMID:10591720

  13. Cost estimate of hospital stays for premature newborns in a public tertiary hospital in Brazil

    PubMed Central

    Desgualdo, Claudia Maria; Riera, Rachel; Zucchi, Paola

    2011-01-01

    OBJECTIVES: To estimate the direct costs of hospital stays for premature newborns in the Interlagos Hospital and Maternity Center in São Paulo, Brazil and to assess the difference between the amount reimbursed to the hospital by the Unified Health System and the real cost of care for each premature newborn. METHODS: A cost-estimate study in which hospital and professional costs were estimated for premature infants born at 22 to 36 weeks gestation during the calendar year of 2004 and surviving beyond one hour of age. Direct costs included hospital services, professional care, diagnoses and therapy, orthotics, prosthetics, special materials, and blood products. Costs were estimated using tables published by the Unified Health System and the Brasíndice as well as the list of medical procedures provided by the Brazilian Classification of Medical Procedures. RESULTS: The average direct cost of care for initial hospitalization of a premature newborn in 2004 was $2,386 USD. Total hospital expenses and professional services for all premature infants in this hospital were $227,000 and $69,500 USD, respectively. The costs for diagnostic testing and blood products for all premature infants totaled $22,440 and $1,833 USD. The daily average cost of a premature newborn weighing less than 1,000 g was $115 USD, and the daily average cost of a premature newborn weighing more than 2,500 g was $89 USD. Amounts reimbursed to the hospital by the Unified Health System corresponded to only 27.42% of the real cost of care. CONCLUSIONS: The cost of hospital stays for premature newborns was much greater than the amount reimbursed to the hospital by the Unified Health System. The highest costs corresponded to newborns with lower birth weight. Hospital costs progressively and discretely decreased as the newborns' weight increased. PMID:22012050

  14. The effect of hospital volume on the in-hospital complication rate in knee replacement patients.

    PubMed Central

    Norton, E C; Garfinkel, S A; McQuay, L J; Heck, D A; Wright, J G; Dittus, R; Lubitz, R M

    1998-01-01

    OBJECTIVE: To examine the effect of hospital volume on in-hospital surgical outcomes for knee replacement using six years of Medicare claims data. DATA SOURCES/STUDY SETTING: The data include inpatient claims for a 100 percent sample of Medicare patients who underwent primary knee replacement during 1985-1990. We supplemented these data with information from HCFA's denominator files, the Area Resource File, and the American Hospital Association survey files. STUDY DESIGN: We estimated the probability that a patient has an in-hospital complication in the initial hospitalization for the first primary knee replacement, using a Logit model, for three definitions of complication. The models controlled for hospital volume, other hospital characteristics, patient demographics, and patient health status. We tested for the endogeneity of hospital volume. DATA COLLECTION/EXTRACTION METHODS: A panel of two orthopaedic surgeons and two internists reviewed diagnosis codes to determine whether a complication was likely, possible, or due to anemia. After removing the few observations with bad or missing data, the final population has 295,473 observations. PRINCIPAL FINDINGS: The probability of a likely in-hospital complication declines rapidly from 53 through 107 operations per year, then levels off. Statistical tests imply that hospital volume is exogenous in this patient-level data. Complication rates increased steadily through the study period. Although obesity appeared to lower the probability of a complication, a counterintuitive result, further investigation revealed this to be an artifact of the claims data limit of listing no more than five diagnoses. Controlling for this restriction reversed the effect of obesity. CONCLUSIONS: Rather than uncontrolled expansion of knee surgery to small hospitals, decentralization to regional centers where at least about 50, and preferably about 100, operations per year are assured appears to be the optimal policy to reduce in-hospital

  15. Synthesis of AlN/Al Polycrystals along with Al Nanoparticles Using Thermal Plasma Route

    SciTech Connect

    Kanhe, Nilesh S.; Nawale, A. B.; Kulkarni, N. V.; Bhoraskar, S. V.; Mathe, V. L.; Das, A. K.

    2011-07-15

    This paper for the first time reports the (200) oriented growth of hexagonal Aluminum nitride crystals during synthesis of aluminum nanoparticles in dc transferred arc thermal plasma reactor by gas phase condensation in nitrogen plasma. The structural and morphological study of as synthesized AlN crystal and aluminium nanoparticles was done by using the x-ray diffraction method, scanning electron microscopy and transmission electron microscopy.

  16. Investigations of Al-Dalang and Al-Hawashat meteorites

    NASA Astrophysics Data System (ADS)

    Gismelseed, A. M.; Abdallah, S. B.; Al-Rawas, A. D.; Al-Mabsali, F. N.; Widatallah, H. M.; Elzain, M. E.; Yousif, A. A.; Ericsson, T.; Annersten, H.

    2016-12-01

    Mössbauer spectroscopy, X-ray diffraction (XRD) measurements, and electron microprobe analysis (EMPA) have been performed on two meteorites named Al-Dalang and Al-Hawashat after identifying their falling sites in the Western region of Sudan. These two meteorites are ordinary chondrites with similar mineralogy. XRD and EMPA show that the two specimens consist of primary olivine, ortho-pyroxene and later crystallising clino-pyroxene as reaction rims against plagioclase. Fe-metal phases are dominated by kamacite (≈6 wt.% Ni) and minor amounts of tetrataenite (≈52 wt.% Ni). Troilite (FeS) and alabandite (MnS) are optically observed as sulphide phases. The Mössbauer measurements at 295 and 78 K are in agreement with the above characterizations, showing at least two paramagnetic doublets which are assigned to olivine and pyroxene and magnetic sextets assigned to kamacite (hyperfine field ≈33.5 T) and troilite FeS (hyperfine field ≈31 T).

  17. Al-Al2O3-Pd junction hydrogen sensor

    NASA Astrophysics Data System (ADS)

    Okuyama, K.; Takinami, N.; Chiba, Y.; Ohshima, S.; Kambe, S.

    1994-07-01

    Al-Al2O3-Pd MIM (metal insulator metal) junctions fabricated on a glass substrate were tested as hydrogen sensors. The I-V (current versus voltage) characteristics of the junctions were measured at room temperature in a vacuum of 10-5 Torr and in H2 gas of 10-2-100 Torr. A significant increase in the current was observed upon introduction of H2 gas. This phenomenon is believed to occur due to the work function lowering of the hydrogen-absorbed Pd top electrode. The rise time was on the order of minutes, while the recovery time when hydrogen was purged was more than 20 h. However, when the junction was placed in an oxidizing ambient such as air, the recovery time was drastically reduced to the order of minutes, indicating that the device is operative as a hydrogen sensor in the atmospheric ambient. Hydrogen adsorption and desorption behavior of the Pd film was also investigated using a Pd coated quartz microbalance, and the results explained the current response of the Pd MIM junction to hydrogen in the presence of oxygen.

  18. Rural Hospital Mergers and Acquisitions: Which Hospitals Are Being Acquired and How Are They Performing Afterward?.

    PubMed

    Noles, Marissa J; Reiter, Kristin L; Boortz-Marx, Jonathan; Pink, George

    2015-01-01

    The number of stand-alone rural hospitals has been shrinking as larger health systems target these hospitals for mergers and acquisitions (M and As). However, little research has focused specifically on rural hospital M and A transactions. Using data from Irving Levin Associates' Healthcare M and A Report and Medicare Cost Reports from 2005 to 2012, we examined two research questions: (1) What were the characteristics of rural hospitals that merged or were acquired, and (2) were there changes in rural hospital financial performance, staffing, or services after an M and A transaction? We used logistic regression to identify factors predictive of merger, and we used multiple regression to examine various hospital measures after an M or A. Study results showed that hospitals with weaker financial performance but lower staffing levels and staffing costs were more likely to merge or be acquired. Statistically weak evidence suggested that operating margins declined after the merger; stronger evidence suggested reductions in salary expense. There was no statistically significant evidence of changes to the number of full-time equivalent (FTE) employees, the service lines that were included in the study, capital expenditures, or the amount of debt financing among the hospitals that merged or were acquired. M and A may not result in a rapid influx of capital, a relief of debt burden, or an improvement in bottom-line profitability. However, M and A may be a viable option for maintaining the hospital and the access to care it provides.

  19. Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals.

    PubMed

    Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra

    2016-11-01

    The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS.

  20. [The psychiatric emergency in the general hospital: an analysis of the indications for hospitalization].

    PubMed

    Lozano, M; O'Neill, A; Jorda, L; Vázquez, A

    1992-01-01

    The following is a study of psychiatric emergencies in a General Hospital in Madrid (Spain). The Psychiatric Emergency Service of the Ramón y Cajal Hospital in Madrid received a total of 3,693 patients in 1988. This was 3.4% of patients seen in the General Emergency Service. The study is based on an analysis of the variables that influence a recommendation of hospitalization and their statistical significance. Hospitalization was recommended more frequently in males and those with diagnoses of depression, alcoholism and schizophrenic or paranoid disorders.

  1. Does a hospital's quality depend on the quality of other hospitals? A spatial econometrics approach.

    PubMed

    Gravelle, Hugh; Santos, Rita; Siciliani, Luigi

    2014-11-01

    We examine whether a hospital's quality is affected by the quality provided by other hospitals in the same market. We first sketch a theoretical model with regulated prices and derive conditions on demand and cost functions which determine whether a hospital will increase its quality if its rivals increase their quality. We then apply spatial econometric methods to a sample of English hospitals in 2009-10 and a set of 16 quality measures including mortality rates, readmission, revision and redo rates, and three patient reported indicators, to examine the relationship between the quality of hospitals. We find that a hospital's quality is positively associated with the quality of its rivals for seven out of the sixteen quality measures. There are no statistically significant negative associations. In those cases where there is a significant positive association, an increase in rivals' quality by 10% increases a hospital's quality by 1.7% to 2.9%. The finding suggests that for some quality measures a policy which improves the quality in one hospital will have positive spillover effects on the quality in other hospitals.

  2. Estimating the effect of hospital closure on areawide inpatient hospital costs: a preliminary model and application.

    PubMed Central

    Shepard, D S

    1983-01-01

    A preliminary model is developed for estimating the extent of savings, if any, likely to result from discontinuing a specific inpatient service. By examining the sources of referral to the discontinued service, the model estimates potential demand and how cases will be redistributed among remaining hospitals. This redistribution determines average cost per day in hospitals that receive these cases, relative to average cost per day of the discontinued service. The outflow rate, which measures the proportion of cases not absorbed in other acute care hospitals, is estimated as 30 percent for the average discontinuation. The marginal cost ratio, which relates marginal costs of cases absorbed in surrounding hospitals to the average costs in those hospitals, is estimated as 87 percent in the base case. The model was applied to the discontinuation of all inpatient services in the 75-bed Chelsea Memorial Hospital, near Boston, Massachusetts, using 1976 data. As the precise value of key parameters is uncertain, sensitivity analysis was used to explore a range of values. The most likely result is a small increase ($120,000) in the area's annual inpatient hospital costs, because many patients are referred to more costly teaching hospitals. A similar situation may arise with other urban closures. For service discontinuations to generate savings, recipient hospitals must be low in costs, the outflow rate must be large, and the marginal cost ratio must be low. PMID:6668181

  3. Perceptions of the hospital ethical environment among hospital social workers in the United States.

    PubMed

    Pugh, Greg L

    2015-01-01

    Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.

  4. Campaign supports new name for TX hospital. Effort expands children's hospital's image and increases awareness.

    PubMed

    2007-01-01

    For years, the North Texas Hospital for Children at Medical City in Dallas struggled with its brand awareness. It's long-winded name was largely unknown among the city's 1.2 million residents. The hospital needed a new name and it needed one fast. The year 2005 proved to be both a burden and an opportunity for the 311-bed pediatric hospital. It survived a legal battle with a local competitor for the right to use the word "children's" in its name, created a new identity, and launched a three-year branding initiative to introduce its new name: Medical City Children's Hospital.

  5. [For an history of hospitals in Italy. The tipology and evolution of hospitals in XIX century].

    PubMed

    Cosmacini, G

    1997-01-01

    In XIX century the modern hospital develops because of and by means of the scientific revolution in medicine, and, in particular, in clinics. In the new hospital the hippocratic praxis and the models of experimental medicine combine, together with mechanistic epistemology and the new general theory of illness, health and disease. The new medicine, founding on an anthropological view of life and death, links with a renewed political attention towards social events; the new idea of health proposes a new model for hospitalization in which doctores and manuales (specialists in surgery) meet. In Italy, the evolution of the hospital tipology develops through the century.

  6. Inspiration of the functional localization of a US naval hospital ship on a Chinese hospital ship.

    PubMed

    Li, Da-Wei; Zhang, Zhi-Cheng; Zhu, Wen-Ya; Sun, Tao

    2016-01-01

    Through the experience of being stationed on the USS Mercy hospital ship (T-AH19) and a preliminary comprehension of the personnel and material arrangements, processing and functional formats, and the multi-platform contributions of US Navy hospital ships, we briefly introduce the characteristics of US hospital ships regarding medical support, emergency rescue exercises, communications and training, international humanitarian aid, etc. We discuss the function and responsibility of Chinese hospital ships, focusing on the investigation of the construction mode and positioning in the navy.

  7. Hospital Views of Factors Affecting Telemedicine Use.

    PubMed

    Merchant, Kimberly A S; Ward, Marcia M; Mueller, Keith J

    2015-04-01

    Telemedicine (also known as telehealth) is a means to increase access to care, one of the foundations of the Triple Aim. However, the expansion of telemedicine services in the United States has been relatively slow. We previously examined the extent of uptake of hospital based telemedicine using the 2013 HIMSS (Healthcare Information and Management Systems Society) Analytics national database of 4,727 non-specialty hospitals. Our analysis indicated that the largest percentage of operational telemedicine implementations (15.7 percent) was in radiology departments, with a substantial number in emergency/trauma care (7.5 percent) and cardiology/stroke/heart attack programs (6.8 percent). However, existing databases are limited because they do not identify whether a respondent hospital is a "hub" (providing telemedicine services) or a "spoke" (receiving telemedicine services). Therefore, we used data from interviews with hospital representatives to deepen the research and understanding of telemedicine use and the factors affecting that use. Interviews were conducted with key informants at 18 hub hospitals and 18 spoke hospitals to explore their perceptions of barriers and motivators to telemedicine adoption and expansion. Key Findings. (1) Respondents from both hub and spoke hospitals reported that telemedicine helps them meet their mission, enhances access, keeps lower-acuity patients closer to home, and helps head off competition. (2) Respondents from both hub and spoke hospitals reported licensing and credentialing to be significant barriers to telemedicine expansion. Thus, half of hubs provide services only within their state. (3) A variety of one-time funding sources have been used to initiate and grow telemedicine services among hubs and spokes. However, reimbursement issues have impeded the development of workable business models for sustainability. Hub hospitals shoulder the responsibility for identifying sustainable business models. (4) Although respondents

  8. Public employment and political pressure: the case of French hospitals.

    PubMed

    Clark, Andrew E; Milcent, Carine

    2011-09-01

    This paper uses an unusual administrative dataset covering the universe of French hospitals to consider hospital employment: this is consistently higher in public hospitals than in not-for-profit (NFP) or private hospitals, even controlling for a number of measures of hospital output. NFP hospitals serve as a benchmark, being very similar to public hospitals, but without political influence on their hiring. Public-hospital employment is positively correlated with the local unemployment rate, whereas no such relationship is found in other hospitals. This is consistent with public hospitals providing employment in depressed areas. We appeal to the Political Science literature and calculate local political allegiance, using expert evaluations on various parties' political positions and local election results. The relationship between public-hospital employment and local unemployment is stronger the more left-wing the local municipality. This latter result holds especially when electoral races are tight, consistent with a concern for re-election.

  9. [A brief history of hospital development in the West].

    PubMed

    Fang, Chongliang; Liu, Piyan; Jiang, Guiying

    2002-04-01

    Origin and development of hospital in the West was related closely with religions and wars. Before the Medieval Ages, priests or physicians treated their patients mainly in temples, which may be regarded as the earliest type of hospital. The military hospital first appeared in the ancient Rome due to war. During the Medieval Ages, most hospitals were attached to monasteries. The Crusades prompted the development of hospitals and hospices along the route taken by the Crusaders. After the Medieval Ages, as the Protestantism rose, the monastic hospitals suffered a major setback and secular hospitals developed. From the 16th century, hospitals of Europe were spread gradually into North America. During the 18th and 19th centuries, function of hospital in medical treatment, education and research was strengthened gradually. In the 20th century, hospital facilities were matured technically and management of hospital became an important problem to which people devoted themselves to resolve it.

  10. Ab initio modeling of zincblende AlN layer in Al-AlN-TiN multilayers

    DOE PAGES

    Yadav, S. K.; Wang, J.; Liu, X. -Y.

    2016-06-13

    An unusual growth mechanism of metastable zincblende AlN thin film by diffusion of nitrogen atoms into Al lattice is established. Using first-principles density functional theory, we studied the possibility of thermodynamic stability of AlN as a zincblende phase due to epitaxial strains and interface effect, which fails to explain the formation of zincblende AlN. We then compared the formation energetics of rocksalt and zincblende AlN in fcc Al through direct diffusion of nitrogen atoms to Al octahedral and tetrahedral interstitials. Furthermore, the formation of a zincblende AlN thin film is determined to be a kinetically driven process, not a thermodynamicallymore » driven process.« less

  11. [Medicines reconciliation at hospital admission into an electronic prescribing program].

    PubMed

    Villamayor-Blanco, Lucía; Herrero-Poch, Leticia; De-Miguel-Bouzas, Jose Carlos; Freire Vazquez, M Carmen

    2016-09-01

    Objetivo: Describir y analizar los resultados obtenidos durante un año con un nuevo procedimiento de conciliación de la medicación al ingreso hospitalario basado en un programa de prescripción electrónica asistida. Método: Estudio observacional, prospectivo, no aleatorizado y no controlado de 12 meses de duración, en el que se incluyeron todos los pacientes que ingresaron, durante ese año, en un hospital general concertado de 450 camas. Para la conciliación de la medicación se utilizó el programa de prescripción electrónica como medio para el abordaje multidisciplinar (enfermería, médicos y farmacéuticos). La conciliación se realizó al ingreso hospitalario y se midieron los errores de conciliación. Resultados: Se incluyeron 23.701 pacientes, conciliándose 53.920 medicamentos, de los cuales no tenían discrepancias 48.744 (90,4%) y 5.176 (9,6%) presentaban discrepancias: 4.731 (8,8 % de los fármacos) justificadas y 445 (0,8% de los fármacos) no justificadas. La mayor parte de las discrepancias no justificadas, (n = 310; 69,7%) se debieron a errores en el registro de la medicación domiciliaria al ingreso: medicación no registrada o errores de medicamentos, dosis, frecuencia o vía de administración, omisiones de prescripción, 23,6% (n = 105) y duplicidades, 6,7% (n = 30). En ningún caso el error de conciliación llegó al paciente. Conclusiones: Mediante las ayudas informáticas incluidas en el programa de prescripción electrónica asistida y el abordaje multidisciplinar del proceso de conciliación se consigue realizar la conciliación de la medicación al ingreso en el 98% de los pacientes en el momento del ingreso, evidenciando errores de conciliación solo en el 1,3% de los pacientes.

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

    PubMed Central

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

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

  13. Hospital-Admitted Injury Attributable to Alcohol

    PubMed Central

    Miller, Ted R.; Spicer, Rebecca S.

    2013-01-01

    Background Primary data collection has established that alcohol causes injuries treated in the emergency department. No comparable data exist for injuries admitted to hospital. Data on the injury risks of heavy drinkers relative to other drinkers also are sparse. Methods We estimated (1) whether regular heavy drinkers have higher hospitalized injury risks than other people when alcohol negative and (2) how much hospitalized injury risk of regular heavy drinkers and other drinkers rises when alcohol positive. We combined national alcohol consumption data with alcohol metabolism rates to estimate hours spent alcohol positive versus alcohol negative during a year for heavy drinkers versus other people. A literature review provided hospitalized non-fatal injury rates for these groups by alcohol involvement. Results Relative to other alcohol-negative people aged 18 and older, heavy drinkers have an estimated relative risk of hospitalized injury of 1.4 when alcohol negative and 4.3 when alcohol positive. Others have an estimated relative risk of 1.0 when alcohol negative and 6.8 when alcohol positive. Thus alcohol greatly raises injury risk. The excess risk patterns persist for a wide range of sensitivity analysis values. Of hospitalized injuries, an estimated 21% are alcohol attributable including 36% of assaults. Conclusions Drinking alcohol is a major cause of hospitalized injury. Heavy drinkers lead risky lifestyles. They tolerate alcohol better than most drinkers but their injury risks still triple when they drink. Our approach to attribution is a valuable complement to more costly, more precise approaches that rely heavily on primary data collection. It works for any severity of injury. Applying it only requires an existing alcohol consumption survey plus data on alcohol involvement in targeted injuries. PMID:22004026

  14. [Convent nursing in Polish hospitals from 1939].

    PubMed

    Halat, M

    2000-01-01

    The author, Sister of Charity and Mother Superior of the Children's Home in Tarnów, describes the attitude of the authorities of the Polish People's Republic towards convent nursing in hospitals. The problem is exemplified by the situation of the Cracow Province of the Order of the Sisters of Charity. Apart from this main theme, Sister Mirosława Hałat says a little about the establishment of the Order and the role it played in Polish hospital care. Before presenting the fundamental problems related to the topic of the article, the author presents numerical data showing the Sisters of Charity's involvement in hospital care between World War I and World War II. This facilitates a comparison of the possibilities of providing hospital care by the Sisters of Charity at a later time. The author also describes the persecutions of the Sister of Charity by the German occupiers. Her main reflections are divided into several parts. The period from 1945 to 1949 covers the time when the Sisters of Charity tried to engage actively in the reconstruction of the ruined Polish hospital system. This involved leaving the former Polish eastern borderland and taking up duties in the so-called Regained Territories. The period from 1950 to 1989 describes the conscious, planned and ideologically directed policies of the authorities of the Polish People's Republic to nullify or at least diminish the role of the Sisters of Charity in Polish hospitals. Quoting numerous accounts and documents, the author tries to recreate the atmosphere of those times. She also writes about the Sisters of Charity's preparation for work in hospitals as well as the possibilities of their education after the war. The article presents the Sisters of Charity's activity under very difficult political conditions and is complemented by a great number of figures, graphs and source documents.

  15. Epidemiology of hospitalized burns patients in Taiwan.

    PubMed

    Chien, Wu-Chien; Pai, Lu; Lin, Chao-Cheng; Chen, Heng-Chang

    2003-09-01

    Previous studies based on either single hospital data or sampling of specific groups of hospitalized burns victims in Taiwan have provided only minimal epidemiological information. The study is designed to provide additional data on the epidemiology of hospitalized burns patients in Taiwan. Data were obtained from the Burn Injury Information System (BIIS), which brings together information supplied by 34 contracted hospitals. The study time course spanned a 2-year period from July 1997 to June 1999. Patient characteristics (age, sex, education level, etc.), causes and severity of injuries, and medical care measures were explored. A total of 4741 patients were registered with BIIS over the study period. The majority of hospitalized patients (67%) were male. The age distribution of burns patients showed peaks occurring at the age groups of 0-5 and 35-44 years. Over the time course of a day, burn injuries occurred more frequently from 10:00 to 12:00 h and 16:00 to 18:00 h. Injuries suspected as the result of suicide, homicide or child abuse accounted for 4.8% of hospitalized cases. More than 48% of the burns occurred in the home. The leading type of burn injury was scalding, followed by naked flame, explosion, electrical burns, and chemical burns due to caustic or corrosive substances. The mean percent total body surface area (%TBSA) for adults was 19%, and for young children was 12%. The average length of hospital stay was 18 days. In conclusion, children under 5 years and adults between 35 and 44 years of age are two high-risk groups for burn injuries. Corresponding to meal preparation time, hot substances such as boiling water, hot soup, etc. are the most common agents responsible for scalds. Prevention programs for reducing the risk of burn injuries during cooking and eating are required, especially for parents with young children.

  16. Bifurcation analysis and global dynamics of a mathematical model of antibiotic resistance in hospitals.

    PubMed

    Cen, Xiuli; Feng, Zhilan; Zheng, Yiqiang; Zhao, Yulin

    2017-04-10

    Antibiotic-resistant bacteria have posed a grave threat to public health by causing a number of nosocomial infections in hospitals. Mathematical models have been used to study transmission dynamics of antibiotic-resistant bacteria within a hospital and the measures to control antibiotic resistance in nosocomial pathogens. Studies presented in Lipstich et al. (Proc Natl Acad Sci 97(4):1938-1943, 2000) and Lipstich and Bergstrom (Infection control in the ICU environment. Kluwer, Boston, 2002) have provided valuable insights in understanding the transmission of antibiotic-resistant bacteria in a hospital. However, their results are limited to numerical simulations of a few different scenarios without analytical analyses of the models in broader parameter regions that are biologically feasible. Bifurcation analysis and identification of the global stability conditions can be very helpful for assessing interventions that are aimed at limiting nosocomial infections and stemming the spread of antibiotic-resistant bacteria. In this paper we study the global dynamics of the mathematical model of antibiotic resistance in hospitals considered in Lipstich et al. (2000) and Lipstich and Bergstrom (2002). The invasion reproduction number [Formula: see text] of antibiotic-resistant bacteria is derived, and the relationship between [Formula: see text] and two control reproduction numbers of sensitive bacteria and resistant bacteria ([Formula: see text] and [Formula: see text]) is established. More importantly, we prove that a backward bifurcation may occur at [Formula: see text] when the model includes superinfection, which is not mentioned in Lipstich and Bergstrom (2002). More specifically, there exists a new threshold [Formula: see text], such that if [Formula: see text], then the system can have two positive interior equilibria, which leads to an interesting bistable phenomenon. This may have critical implications for controlling the antibiotic-resistance in a hospital.

  17. NiAl-base composite containing high volume fraction of AlN for advanced engines

    NASA Technical Reports Server (NTRS)

    Hebsur, Mohan (Inventor); Whittenbeger, John D. (Inventor); Lowell, Carl F. (Inventor)

    1994-01-01

    A particulate reinforced NiAl-AlN composite alloy has a NiAl matrix and greater than about 13 volume percent fine particles of AlN within the matrix. The particles preferably have a diameter from about 15 nanometers to about 50 nanometers. The particulate reinforced NiAl-AlN composite alloy may be prepared by cryomilling prealloyed NiAl in liquid nitrogen using grinding media having a diameter of from about 2 to 6 mm at an impeller speed of from about 450 RPM to about 800 RPM. The cryomilling may be done for a duration of from about 4 hours to about 20 hours to obtain a cryomilled powder. The cryomilled powder may be consolidated to form the particulate reinforced NiAl-AlN composite alloy. The particulate reinforced alloy can further include a toughening alloy. The toughening alloy may include NiCrAlY, FeCrAlY, and FeAl.

  18. Hospital sector choice and support for public hospital care in New Zealand: Results from a labeled discrete choice survey.

    PubMed

    Brown, Paul; Panattoni, Laura; Cameron, Linda; Knox, Stephanie; Ashton, Toni; Tenbensel, Tim; Windsor, John

    2015-09-01

    This study uses a discrete choice experiment (DCE) to measure patients' preferences for public and private hospital care in New Zealand. A labeled DCE was administered to 583 members of the general public, with the choice between a public and private hospital for a non-urgent surgery. The results suggest that cost of surgery, waiting times for surgery, option to select a surgeon, convenience, and conditions of the hospital ward are important considerations for patients. The most important determinant of hospital choice was whether it was a public or private hospital, with respondents far more likely to choose a public hospital than a private hospital. The results have implications for government policy toward using private hospitals to clear waiting lists in public hospitals, with these results suggesting the public might not be indifferent to policies that treat private hospitals as substitutes for public hospitals.

  19. Benefits for Military Veterans with ALS

    MedlinePlus

    ... Advocate Get Involved Donate Military Veterans Resources for Military Veterans, Families & Survivors The ALS Association is working everyday to ... and Caregivers Newly Diagnosed Clinical Trials Familial ALS Military Veterans For Caregivers Resources Read stories ... Site ...

  20. Motor neuron diseases in the university hospital of Fortaleza (Northeastern Brazil): a clinico-demographic analysis of 87 cases.

    PubMed

    Castro-Costa, C M; Oriá, R B; Vale, O C; Arruda, J A; Horta, W G; D'Almeida, J A; Santos, T J; Ramos, R S; Gifoni, M A

    2000-12-01

    In this retrospective (1980-1998) study, we have analyzed clinico-demographically, from the records of the University Hospital of Fortaleza (Brazil), a group of 87 patients showing signs and symptoms of motor neuron diseases (MNDs). Their diagnosis was determined clinically and laboratorially. The WFN criteria were used for amyotrophic lateral sclerosis (ALS) diagnosis. The clinico-demographic analysis of the 87 cases of MNDs showed that 4 were diagnosed as spinal muscular atrophy (SMA), 5 cases as ALS subsets: 2 as progressive bulbar paralysis (PBP), 2 as progressive muscular atrophy (PMA) and 1 as monomelic amyotrophy (MA), and 78 cases of ALS. The latter comprised 51 males and 27 females, with a mean age of 42.02 years. They were sub-divided into 4 groups according to age: from 15 to 29 years (n= 17), 30 to 39 years (n= 18), 40 to 69 years (n= 39) and 70 to 78 years (n= 4). From the 78 ALS patients, 76 were of the classic sporadic form whilst only 2 were of the familial form. The analysis of the 87 patients with MNDs from the University Hospital of Fortaleza showed a predominance of ALS patients, with a high number of cases of juvenile and early onset adult sporadic ALS.