Science.gov

Sample records for hospital service department

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

    PubMed

    Shreve, R B

    1987-01-01

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

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

    PubMed Central

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

    1995-01-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  6. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  7. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  8. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  9. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  10. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  11. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  12. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51 Pensions... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... the Public Health Service (or any other agency of the U.S. Government) which do not have...

  13. 42 CFR 447.54 - Cost sharing for services furnished in a hospital emergency department.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the application of a prudent-layperson standard for payment or coverage of emergency medical services... emergency department. 447.54 Section 447.54 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR...

  14. Department of Health and Human Services Changes: Implications for Hospital Social Workers

    ERIC Educational Resources Information Center

    Conlon, Annemarie; Aldredge, Patti A.

    2013-01-01

    In April 2010, President Obama issued a directive to the Secretary of Health and Human Services (HHS) regarding patient visitation, advance directives, and other initiatives to improve the lives of lesbian, gay, bisexual, and transgender people and their families. The HHS response to this directive has implications for hospital social workers. The…

  15. Institutional Effectiveness Assessment Process, 1993-94. Executive Summary. Hospitality and Service Occupations Division, Cosmetology Department.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    A study was conducted to evaluate student and student employer satisfaction with the services provided by the South Seattle Community College (SSCC) Cosmetology Department. Specifically, the study gathered data related to four outcomes: that students receive an educational experience allowing them to meet their goals; that former and current…

  16. Institutional Effectiveness Assessment Process, 1993-94. Executive Summary. Hospitality and Service Occupations Division, Floristry Department.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    A study was conducted to determine current and former students' and local employers' satisfaction with South Seattle Community College's (SSCC's) Floristry Department. Specifically, the study gathered data related to four outcomes: that students receive an education allowing them to meet goals; that students be satisfied with facilities,…

  17. 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.

  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. 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…

  20. 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…

  1. Institutional Effectiveness Assessment Process, 1993-94 Executive Summary. Hospitality and Service Occupations Division, Landscape and Environmental Horticulture Department.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    A study was conducted to determine current and former students' and local employers' satisfaction with South Seattle Community College's (SSCC's) Landscape and Environmental Horticulture Department. Specifically, the study gathered data on four outcomes: that students receive an education allowing them to meet goals; that students be satisfied…

  2. Focus on: Southern Baptist Hospital Biomedical Electronics Department.

    PubMed

    Newton, L M

    1987-01-01

    This paper describes the Biomedical Electronics Department at Southern Baptist Hospital, New Orleans, LA. The department, organized in January 1986, was established to replace an existing department which was operated under contractual agreement with a clinical equipment management company. The Biomedical Electronics Department is responsible for the preventive maintenance and repair of over 3,500 pieces of equipment, in areas ranging from dialysis to radiology and from communications to computers. The management and approval of all service contracts are handled by the department. Additional responsibilities include equipment inventory control, radio paging and nurse call system maintenance, and control of all time-and-materials services provided by biomedical equipment vendors.

  3. 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…

  4. 42 CFR 447.321 - Outpatient hospital and clinic services: Application of upper payment limits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  5. 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

  6. Focus on: Washington Hospital Center, Biomedical Engineering Department.

    PubMed

    Hughes, J D

    1995-01-01

    The Biomedical Engineering Department of the Washington Hospital Center provides clinical engineering services to an urban 907-bed, tertiary care teaching hospital and a variety of associated healthcare facilities. With an annual budget of over $3,000,000, the 24-person department provides cradle-to-grave support for a host of sophisticated medical devices and imaging systems such as lasers, CT scanners, and linear accelerators as well as traditional patient care instrumentation. Hallmarks of the department include its commitment to customer service and patient care, close collaboration with clinicians and quality assurance teams throughout the hospital system, proactive involvement in all phases of the technology management process, and shared leadership in safety standards with the hospital's risk management group. Through this interactive process, the department has assisted the Center not only in the acquisition of 11,000 active devices with a value of more than $64 million, but also in becoming one of the leading providers of high technology healthcare in the Washington, DC metropolitan area.

  7. District nursing sister attached to hospital surgical department.

    PubMed

    Hockey, L

    1970-04-18

    An experiment of attaching a district nursing sister to the surgical department of a general hospital was designed to show the use of the district nursing service for the after-care of patients discharged from hospital after surgical treatment. In a 15-week period about 590 bed days were saved, and only six out of 126 patients discharged early had to be readmitted. Most of the patients and the general practitioners who replied to questionaries about the scheme were in favour of it.

  8. 26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department ...

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

    26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department of Public Finance, Real Estate Owned by the City of New York under Jurisdiction of the Department of Public Charities, 1909.) - Island Hospital, Roosevelt Island, New York County, NY

  9. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  10. Human resources management for a hospital pharmacy department.

    PubMed

    Chase, P A

    1989-06-01

    The concepts of human resources management (HRM) are presented, and the application of HRM concepts to a hospital pharmacy department is described. Low salaries and poor working conditions had precipitated a mass exodus of pharmacists from a 650-bed, tertiary-care medical center. The newly hired director of pharmacy sought to rebuild the department by developing a three-stage HRM model consisting of needs forecasting, performance management, and advanced management systems. In the needs-forecasting stage, the strengths and weaknesses of departmental programs were determined through analysis of existing standards of practice, situational analysis, and financial analyses; the strengths and weaknesses of departmental employees were determined through the use of talent inventories, turnover analysis, analysis of time and leave records, reevaluation of the department's job classifications, performance and productivity evaluations, and productivity evaluations, and development of a philosophy of practice and mission statement. Needs and problems were addressed by examining each existing program and developing new policies and procedures, performance standards, quality assurance mechanisms, and productivity expectations. Personnel needs and problems were addressed by designing a system of differentiated career ladders, contracting with pharmacists for career moves, developing the skills of currently employed pharmacists, and implementing a succession planning model. The model has been in place for approximately three years and is beginning to yield the desired results. Application of HRM concepts to a hospital pharmacy department appears to have been successful in improving employee morale and in helping the department to meet goals of expanded and improved services.

  11. Department of Health and Human Services

    MedlinePlus

    ... content HHS .gov Search U.S. Department of Health & Human Services Search Close A-Z Index About HHS ... below. Email HHS Headquarters U.S. Department of Health & Human Services 200 Independence Avenue, S.W. Washington, D.C. ...

  12. Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of ...

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

    Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of Building No. 516, East of corridor connecting Building No. 511 to Building No. 515, Aurora, Adams County, CO

  13. Optimizing Naval Hospital Camp Pendleton’s Primary Care Access by Managing Demand of the Emergency Department through a Health Services Center: A Marcus Welby Care Initiative

    DTIC Science & Technology

    2006-06-01

    source of care in order to receive continuous supervision and medical attention. A growing body of research demonstrates that physicians who closely...a General Medical Officer ( GMO ) at an outlying clinic that cannot provide the appropriate care, a patient with an eye injury, all complaints of...voluntary, not-for-profit accreditation body sponsored by the American College of Physicians, the American College of Surgeons, the American Hospital

  14. Focus on: Watsonville Community Hospital Biomedical Engineering Department.

    PubMed

    Shugart, B L

    1986-01-01

    The Journal of Clinical Engineering is pleased to present this FOCUS on the Biomedical Engineering Department of Watsonville Community Hospital (Watsonville, CA). Since the Department's inception in 1983, the growth of the hospital and the surrounding area has resulted in the expansion of the Department and its duties. This paper describes the responsibilities of the two-man Biomedical Engineering Department, which serves this 130-bed hospital and oversees the preventive maintenance and repair of approximately 800 pieces of equipment. In addition, the Department is involved with staff education, equipment inventory control, new equipment purchases, technical consultations, and special projects.

  15. 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.

  16. The Impact of Hospital Closures and Hospital and Population Characteristics on Increasing Emergency Department Volume: A Geographic Analysis

    PubMed Central

    Carr, Brendan G.; Smith, Tony E.; Tran, Van C.; Polsky, Daniel; Branas, Charles C.

    2015-01-01

    Abstract Emergency visits are rising nationally, whereas the number of emergency departments is shrinking. However, volume has not increased uniformly at all emergency departments. It is unclear what factors account for this variability in emergency volume growth rates. The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. The study team analyzed emergency department volume at New York State hospitals from 2004 to 2010 using data from cost reports and administrative databases. Multivariate regression was used to evaluate characteristics associated with emergency volume growth. Spatial analytics and distances between hospitals were used in calculating the predicted impact of hospital closures on emergency department use. Among the 192 New York hospitals open from 2004 to 2010, the mean annual increase in emergency department visits was 2.7%, but the range was wide (-5.5% to 11.3%). Emergency volume increased nearly twice as fast at tertiary referral centers (4.8%) and nonurban hospitals (3.7% versus urban at 2.1%) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth. Emergency volume is increasing faster at specific hospitals: tertiary referral centers, nonurban hospitals, and those near hospital closures. This study provides an understanding of how emergency volume varies among hospitals and predicts the effect of hospital closures in a statewide region. Understanding the impact of these factors on emergency department use is essential to ensure that these populations have access to critical emergency services. (Population Health Management 2015;18:459–466) PMID:25658768

  17. Markets for hospital services in Zambia.

    PubMed

    Nakamba, Pamela; Hanson, Kara; McPake, Barbara

    2002-01-01

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

  18. Bone bank service in Odense, Denmark. Audit of the first ten years with bone banking at the Department of Orthopaedics, Odense University Hospital.

    PubMed

    Nielsen, H T; Larsen, S; Andersen, M; Ovesen, O

    2001-01-01

    There has been an increase in the demand for allograft bone in recent years. The Odense University Hospital bone bank has been in function since 1990, and this paper outlines our results during the 10 year period 1990-1999. Potential donors were screened by contemporary banking techniques which include a social history, donor serum tests for HIV, hepatitis B and C, and graft microbiology. The bones were stored at -80 degrees C. No type of secondary sterilisation was made. 423 femoral heads were approved and donated to 300 patients,1-6 heads/operation. The allografts have been used mainly to reconstruct defects at revision hip arthroplasty (34%), and for fracture surgery (24%). 7 % of all transplanted patients were reoperated because of infection. In the hip revision group the infection rate was 4 %. There were no cases of disease transmission. During the 10 year period there was a change in the clinical use of the allografts. In the first years the allografts were mainly used for spinal fusion surgery, but today the majority are used in hip revision and fracture surgery. The clinical results correspond to those reported in larger international series.

  19. Patient satisfaction with services of the outpatient department

    PubMed Central

    Mohd, Athar; Chakravarty, Abhijit

    2014-01-01

    Background Patients' satisfaction is a useful measure to provide an indicator of quality in healthcare and thus needs to be measured frequently. The aim of the study was to analyse and compare the level of satisfaction of patients attending the Outpatient Department of a Hospital. Methods Study was conducted by using a pre-structured questionnaire with 120 samples. Samples were further stratified into sub-populations of Officers, Junior Commissioned Officers (JCOs) and Other Ranks (ORs) including dependents as study population. Results JCOs predominantly expressed lower satisfaction judgement with several attributes. Overall satisfaction judgement with Outpatient Department services were rated lower by JCOs (2.56) when compared with Officers and ORs (3.10), the difference being statistically significant. Conclusion Statistically significant differences have been identified by this study against various study attributes as well as overall impression towards OPD services among the study groups, which need to be addressed by the hospital leadership to achieve consumer delight. PMID:25378776

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

    PubMed

    Studnicki, J

    1991-01-01

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

  1. Evaluating Service Quality in Universities: A Service Department Perspective

    ERIC Educational Resources Information Center

    Smith, Gareth; Smith, Alison; Clarke, Alison

    2007-01-01

    Purpose: The purpose of the study is to report on an in-depth exploration of service quality in an Information Technology service department in a Higher Education Institute (HEI) and to evaluate the instrument used. Design/methodology/approach: The study surveys customers using the SERVQUAL instrument, which is one of the most widely used and…

  2. Institutional Effectiveness Assessment Process, 1992-93. Executive Summary. Hospitality and Service Occupations Division, Food Sciences Department, Food Production Program, Food Production Management Program, Pastry and Specialty Baking Program.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    In the 1992-93 academic year, the Hospitality and Food Sciences Department at South Seattle Community College conducted surveys of current and former students and local foodservice employers to determine the level of satisfaction with Department programs. Specifically, the surveys focused on four key outcomes: determining the extent to which…

  3. North side. Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department ...

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

    North side. - Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of Building No. 516, East of corridor connecting Building No. 511 to Building No. 515, Aurora, Adams County, CO

  4. Estimating Uncompensated Care Charges at Rural Hospital Emergency Departments

    ERIC Educational Resources Information Center

    Bennett, Kevin J.; Moore, Charity G.; Probst, Janice C.

    2007-01-01

    Context: Rural hospitals face multiple financial burdens. Due to federal law, emergency departments (ED) provide a gateway for uninsured and self-pay patients to gain access to treatment. It is unknown how much uncompensated care in rural hospitals is due to ED visits. Purpose: To develop a national estimate of uncompensated care from patients…

  5. Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates Under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital. Final rule with comment period and interim final rule with comment period.

    PubMed

    2016-11-14

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, in this final rule with comment period, we are making changes to tolerance thresholds for clinical outcomes for solid organ transplant programs; to Organ Procurement Organizations (OPOs) definitions, outcome measures, and organ transport documentation; and to the Medicare and Medicaid Electronic Health Record Incentive Programs. We also are removing the HCAHPS Pain Management dimension from the Hospital Value-Based Purchasing (VBP) Program. In addition, we are implementing section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by certain off-campus provider-based departments of a provider. In this document, we also are issuing an interim final rule with comment period to establish the Medicare Physician Fee Schedule payment rates for the nonexcepted items and services billed by a nonexcepted off-campus provider-based department of a hospital in accordance with the provisions of section 603.

  6. Planned Parenthood services in teaching hospitals.

    PubMed

    1973-06-01

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

  7. 77 FR 43369 - Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... Employment and Training Administration Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department...; Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department, Including..., 2012, applicable to workers of Lexisnexis, a subsidiary of Reed Elsevier, Inc., Customer...

  8. Hospital pharmacists' evaluation of drug wholesaler services.

    PubMed

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

    1983-10-01

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

  9. Hospital Department Cost and Employment Increases: 1980-92

    PubMed Central

    Cromwell, Jerry; Butrica, Barbara

    1995-01-01

    Hospital costs have continued to rise at rates well in excess of inflation generally, even after the introduction of Medicare's per case prospective payment system (PPS). This article uses a hospital subscriber microcost reporting system to show trends in costs, wages, labor hours, and outputs for more than 50 individual departments from 1980-92. Descriptive results show dramatic growth in the operating room, catheter lab, and other technologically driven cost centers. Administrative costs also increased rapidly through 1988, but slowed thereafter. The paperwork billing and collection burden of hospitals is estimated to be $6 billion in 1992, or approximately 4 percent of total expenses. PMID:10153468

  10. 7 CFR 652.6 - Department delivery of technical services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Department delivery of technical services. 652.6 Section 652.6 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE SUPPORT ACTIVITIES TECHNICAL SERVICE PROVIDER ASSISTANCE General Provisions § 652.6 Department delivery...

  11. Hospitalization and emergency department visits among seniors receiving homecare: a pilot study

    PubMed Central

    Smith, Andrew A; Carusone, Soo B Chan; Willison, Kathleen; Babineau, Tamara J; Smith, Stephanie D; Abernathy, Tom; Marrie, Tom; Loeb, Mark

    2005-01-01

    Background Despite the recent growth in home health services, data on clinical outcomes and acute health care utilization among older adults receiving homecare services are sparse. Obtaining such data is particularly relevant in Ontario where an increasing number of frail seniors receiving homecare are awaiting placement in long-term care facilities. In order to determine the feasibility of a large-scale study, we conducted a pilot study to assess utilization of acute health care services among seniors receiving homecare to determine associated clinical outcomes. Methods This prospective cohort study followed forty-seven seniors admitted to homecare by two homecare agencies in Hamilton, Ontario over a 12-month period. Demographic information and medical history were collected at baseline, and patients were followed until either termination of homecare services, death, or end of study. The primary outcome was hospitalization. Secondary outcomes included emergency department visits that did not result in hospitalization and death. Rates of hospitalization and emergency department visits without admission were calculated, and univariate analyses were performed to test for potential risk factors. Survival curves for accumulative rates of hospitalization and emergency department visits were created. Results 312 seniors were eligible for the study, of which 123 (39%) agreed to participate initially. After communicating with the research nurse, of the 123 who agreed to participate initially, 47 (38%) were enrolled in the study. Eleven seniors were hospitalized during 3,660 days of follow-up for a rate of 3.0 incident hospitalizations per 1,000 homecare-days. Eleven seniors had emergency department visits that did not result in hospitalization, for a rate of 3.3 incident emergency department visits per 1,000 homecare-days. There were no factors significantly associated with hospitalization or emergency department visits when adjustment was made for multiple comparisons

  12. Reorganizing departments of psychiatry, hospitals, and medical centers for the 21st century.

    PubMed

    Schreter, R K

    1998-11-01

    Market forces are reshaping health care, transforming it from a public service into a product that is sold in a highly competitive marketplace. This transformation has been particularly disruptive for hospital departments of psychiatry and medical centers that were the early targets for managed care efforts at cost containment. To survive, health care institutions have embarked on a clinical and administrative re-engineering process. The author describes a series of steps for reconfiguring departments, hospitals, and medical centers as they enter the 21st century. The steps include identifying the leadership team, formulating a mission statement and strategic plan, creating a legal entity capable of achieving the organization's goals, drawing up an organizational chart, and developing the provider network. Other steps in the process include enhancing the continuum of services offered, developing administrative capability, dealing with managed care, paying attention to fundamental business practices, integrating psychiatric services into the health care system, and marketing psychiatric services.

  13. 42 CFR 403.321 - State systems for hospital outpatient services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  14. 78 FR 21631 - Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... BUDGET Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Medical Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable Third... the cost of inpatient medical services furnished by military treatment facilities through...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  16. Emergency Department of a Rural Hospital in Ecuador

    PubMed Central

    Johnson, Tara; Gaus, David; Herrera, Diego

    2016-01-01

    Introduction There is a paucity of data studying patients and complaints presenting to emergency departments (EDs) in low- and middle-income countries. The town of Pedro Vicente Maldonado (PVM) is located in the northwestern highlands of Ecuador. Hospital PVM (HPVM) is a rural teaching hospital providing family medicine residency training. These physicians provide around-the-clock acute medical care in HPVM’s ED. This study provides a first look at a functioning ED in rural Latin America by reviewing one year of ED visits to HPVM. Methods All ED visits between April 14, 2013, and April 13, 2014, were included and analyzed, totaling 1,239 patient visits. Data were collected from their electronic medical record and exported into a de-identified Excel® database where it was sorted and categorized. Variables included age, gender, mode of arrival, insurance type, month and day of the week of the service, chief complaint, laboratory and imaging requests, and disposition. We performed descriptive statistics, and where possible, comparisons using Student’s T or chi-square, as appropriate. Results Of the 1239 total ED visits, 48% were males and 52% females; 93% of the visits were ambulatory, and 7% came by ambulance. Sixty-three percent of the patients had social security insurance. The top three chief complaints were abdominal pain (25.5%), fever (15.1%) and trauma (10.8%). Healthcare providers requested labs on 71.3% of patients and imaging on 43.2%. The most frequently requested imaging studies were chest radiograph (14.9%), upper extremity radiograph (9.4%), and electrocardiogram (9.0%). There was no seasonal or day-of-week variability to number of ED patients. The chief complaint of human or animal bite made it more likely the patient would be admitted, and the chief complaint of traumatic injury made it more likely the patient would be transferred. Conclusion Analysis of patients presenting to a rural ED in Ecuador contributes to the global study of acute care in

  17. 42 CFR 410.66 - Emergency outpatient services furnished by a nonparticipating hospital and services furnished in...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  18. 7 CFR 652.6 - Department delivery of technical services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Department delivery of technical services. 652.6... General Provisions § 652.6 Department delivery of technical services. (a) The Department may enter into a... technical assistance services that accelerate conservation program delivery. Related technical...

  19. Department of Health and Human Services Semiannual Regulatory Agenda

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... [The Regulatory Plan and Unified Agenda of Federal Regulatory and Deregulatory Actions] Part VIII Department of Health and Human Services Semiannual Regulatory Agenda ] DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary 21 CFR Ch. I 42 CFR Chs. I-V 45 CFR Subtitle A; Subtitle B, Chs....

  20. Security aspects of electronic data interchange between a state health department and a hospital emergency department.

    PubMed

    Magnuson, J A; Klockner, Rocke; Ladd-Wilson, Stephen; Zechnich, Andrew; Bangs, Christopher; Kohn, Melvin A

    2004-01-01

    Electronic emergency department reporting provides the potential for enhancing local and state surveillance capabilities for a wide variety of syndromes and reportable conditions. The task of protecting data confidentiality and integrity while developing electronic data interchange between a hospital emergency department and a state public health department proved more complex than expected. This case study reports on the significant challenges that had to be resolved to accomplish this goal; these included application restrictions and incompatibilities, technical malfunctions, changing standards, and insufficient dedicated resources. One of the key administrative challenges was that of coordinating project security with enterprise security. The original project has evolved into an ongoing pilot, with the health department currently receiving secure data from the emergency department at four-hour intervals. Currently, planning is underway to add more emergency departments to the project.

  1. Hospital Determinants of Emergency Department Left Without Being Seen Rates

    PubMed Central

    Hsia, Renee Y.; Asch, Steven M.; Weiss, Robert E.; Zingmond, David; Liang, Li-Jung; Han, Weijuan; McCreath, Heather; Sun, Benjamin C.

    2011-01-01

    Study objective The proportion of patients who leave without being seen in the emergency department (ED) is an outcome-oriented measure of impaired access to emergency care and represents the failure of an emergency care delivery system to meet its goals of providing care to those most in need. Little is known about variation in the amount of left without being seen or about hospital-level determinants. Such knowledge is necessary to target hospital-level interventions to improve access to emergency care. We seek to determine whether hospital-level socioeconomic status case mix or hospital structural characteristics are predictive of ED left without being seen rates. Methods We performed a cross-sectional study of all acute-care, nonfederal hospitals in California that operated an ED in 2007, using data from the California Office of Statewide Health Planning and Development database and the US census. Our outcome of interest was whether a visit to a given hospital ED resulted in left without being seen. The proportion of left without being seen was measured by the number of left without being seen cases out of the total number of visits. Results We studied 9.2 million ED visits to 262 hospitals in California. The percentage of left without being seen varied greatly over hospitals, ranging from 0% to 20.3%, with a median percentage of 2.6%. In multivariable analyses adjusting for hospital-level socioeconomic status case mix, visitors to EDs with a higher proportion of low-income and poorly insured patients experienced a higher risk of left without being seen. We found that the odds of an ED visit resulting in left without being seen increased by a factor of 1.15 for each 10-percentage-point increase in poorly insured patients, and odds of left without being seen decreased by a factor of 0.86 for each $10,000 increase in household income. When hospital structural characteristics were added to the model, county ownership, trauma center designation, and teaching

  2. 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...

  3. 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...

  4. [Hospitality for elderly patients in the emergency department].

    PubMed

    Boulet, Marie-Claude; Dami, Fabrice; Hugli, Olivier; Renard, Delphine; Foucault, Eliane; Carron, Pierre-Nicolas

    2015-12-09

    Demographic evolution results in a growing use of emergency department by elderly patients. They require special care to avoid any further degradation of cognitive and functional abilities already compromised by the disease or injury that led them to hospital in the first place. Through a clinical case, we list the risks related to the care of these particular patients in the emergency department. Early recognition of those risks and careful management of these patients' specific needs can significantly contribute to reduce lengths of stay, an important outcome from both the individual patient's and society's perspective.

  5. 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...

  6. Implementation of product-line management in a hospital pharmacy department.

    PubMed

    Del Vecchio-Feinberg, G J; Sheinman, C H

    1990-09-01

    The development and implementation of product-line management (PLM) in a pharmacy department is reviewed. The PLM system of hospital organization shifts the emphasis from function to product. The pharmacy department at a 737-bed nonprofit hospital adopted PLM in an effort to reach more directly the physician and patient markets, enhance the image of pharmacy, and help meet requirements of the Joint Commission on Accreditation of Healthcare Organizations. The department surveyed physicians and administrators to identify their product and service needs and surveyed pharmacy staff members to identify the perceived benefits and risks of a PLM system. A strategic-planning session was held to decide how best to match the pharmacy department's product lines with market needs. The team leaders were renamed clinical supervisors and were no longer responsible for defined physical areas but rather for clinical matters relating to patients in the product line assigned. Pharmacy's chosen product lines were oncology services, neuropsychiatry, maternal and child care, cardiovascular, operating room-anesthesia-pain clinic, and general medical. The transition is being accomplished one product line at a time; interested team leaders transfer into clinical supervisor positions by achieving clinical expertise within the relevant product lines. Despite some initial confusion, PLM contributed to job satisfaction and morale and allowed the pharmacy department to provide increased clinical consultation and intervention services. PLM enhanced the clinical pharmacy program and focused clinical services on the physician and ultimately the patient.

  7. Perspective: Hospital support for anesthesiology departments: aligning incentives and improving productivity.

    PubMed

    Hill, Laureen L; Evers, Alex S

    2012-03-01

    Anesthesiology groups, particularly academic departments, are increasingly dependent on hospital support for financial viability. Economic stresses are driven by higher patient acuity, by multiple subspecialty service and call demands, by high-risk obstetric services, and by long case durations attributable to both case complexity and time for teaching. An unfavorable payer mix, university taxation, and other costs associated with academic education and research missions further compound these stresses. In addition, the current economic climate and the uncertainty surrounding health care reform measures will continue to increase performance pressures on hospitals and anesthesiology departments.Although many researchers have published on the mechanics of operating room (OR) productivity, their investigations do not usually address the motivational forces that drive individual and group behaviors. Institutional tradition, surgical convenience, and parochial interests continue to play predominant roles in OR governance and scheduling practices. Efforts to redefine traditional relationships, to coordinate operational decision-making processes, and to craft incentives that align individual performance goals with those of the institution are all essential for creating greater economic stability. Using the principles of shared costs, department autonomy, hospital flexibility and control over institutional issues, and alignment between individual and institutional goals, the authors developed a template to redefine the hospital-anesthesiology department relationship. Here, they describe both this contractual template and the results that followed implementation (2007-2009) at one institution.

  8. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  9. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  10. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  11. Hospital service quality: a managerial challenge.

    PubMed

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

    2004-01-01

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

  12. Current State of Antimicrobial Stewardship in Children's Hospital Emergency Departments.

    PubMed

    Mistry, Rakesh D; Newland, Jason G; Gerber, Jeffrey S; Hersh, Adam L; May, Larissa; Perman, Sarah M; Kuppermann, Nathan; Dayan, Peter S

    2017-04-01

    BACKGROUND Antimicrobial stewardship programs (ASPs) effectively optimize antibiotic use for inpatients; however, the extent of emergency department (ED) involvement in ASPs has not been described. OBJECTIVE To determine current ED involvement in children's hospital ASPs and to assess beliefs and preferred methods of implementation for ED-based ASPs. METHODS A cross-sectional survey of 37 children's hospitals participating in the Sharing Antimicrobial Resistance Practices collaboration was conducted. Surveys were distributed to ASP leaders and ED medical directors at each institution. Items assessed included beliefs regarding ED antibiotic prescribing, ED prescribing resources, ASP methods used in the ED such as clinical decision support and clinical care guidelines, ED participation in ASP activities, and preferred methods for ED-based ASP implementation. RESULTS A total of 36 ASP leaders (97.3%) and 32 ED directors (86.5%) responded; the overall response rate was 91.9%. Most ASP leaders (97.8%) and ED directors (93.7%) agreed that creation of ED-based ASPs was necessary. ED resources for antibiotic prescribing were obtained via the Internet or electronic health records (EHRs) for 29 hospitals (81.3%). The main ASP activities for the ED included production of antibiograms (77.8%) and creation of clinical care guidelines for pneumonia (83.3%). The ED was represented on 3 hospital ASP committees (8.3%). No hospital ASPs actively monitored outpatient ED prescribing. Most ASP leaders (77.8%) and ED directors (81.3%) preferred implementation of ED-based ASPs using clinical decision support integrated into the EHR. CONCLUSIONS Although ED involvement in ASPs is limited, both ASP and ED leaders believe that ED-based ASPs are necessary. Many children's hospitals have the capability to implement ED-based ASPs via the preferred method: EHR clinical decision support. Infect Control Hosp Epidemiol 2017;38:469-475.

  13. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  14. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  15. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  16. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  17. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  18. Analyzing patient's waiting time in emergency & trauma department in public hospital - A case study

    NASA Astrophysics Data System (ADS)

    Roslan, Shazwa; Tahir, Herniza Md; Nordin, Noraimi Azlin Mohd; Zaharudin, Zati Aqmar

    2014-09-01

    Emergency and Trauma Department (ETD) is an important element for a hospital. It provides medical service, which operates 24 hours a day in most hospitals. However overcrowding is not exclusion for ETD. Overflowing occurs due to affordable services provided by public hospitals, since it is funded by the government. It is reported that a patient attending ETD must be treated within 90 minutes, in accordance to achieve the Key Performance Indicator (KPI). However, due to overcrowd situations, most patients have to wait longer than the KPI standard. In this paper, patient's average waiting time is analyzed. Using Chi-Square Test of Goodness, patient's inter arrival per hour is also investigated. As conclusion, Monday until Wednesday was identified as the days that exceed the KPI standard while Chi-Square Test of Goodness showed that the patient's inter arrival is independent and random.

  19. Embedding research culture and productivity in hospital physiotherapy departments: challenges and opportunities.

    PubMed

    Skinner, Elizabeth H; Williams, Cylie M; Haines, Terry P

    2015-06-01

    Few studies have investigated research culture in the Australian hospital system. Although physiotherapists working in tertiary hospital departments conduct and publish research, a conflict between service delivery and research productivity remains. Few departments record research achievements, which limits the accuracy of investigating factors associated with research productivity within allied health. The conduct and translation of research within acute physiotherapy and allied health departments is imperative to improve patient health outcomes, optimise health service efficiency and cost-effectiveness and to improve staff and patient satisfaction and staff retention. Allied health departments should institute a research register and consider implementing other strategies to improve research culture and productivity, such as dedicating equivalent full-time staff to research, supporting staff with joint clinical and academic appointments, ensuring a research register is available and used and having events available for the dissemination of research. Future research should focus on improving research productivity within acute allied health departments to provide Level 1 and 2 evidence of service effectiveness and cost-effectiveness to optimise health care delivery and to maximise the benefit of allied health staff to Australia's healthcare system.

  20. The interface of quality management and the hospital information department.

    PubMed

    Spath, P L

    1993-02-01

    Hospital leadership, the Joint Commission, third-party payors, health care researchers, and others are repeatedly recognizing the essential role of information management in their quality improvement objectives. The health information department must become more proactive in its acknowledgment of these responsibilities by instituting the continuous quality improvement model. This model will prevent proactiveness from turning into mere reactiveness. As suggested by Peter Senge in The Fifth Discipline, "all too often, 'proactiveness' is reactiveness in disguise. If we simply become more aggressive fighting the 'enemy out there,' we are reacting--regardless of what we call it. True proactiveness comes from seeing how we contribute to our own problems."

  1. Hospital Emergency Services for Children and Adolescents

    PubMed Central

    Robinson, Geoffrey C.; Klonoff, Harry

    1967-01-01

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

  2. Establishing a pharmacy department for a large pediatric hospital: managerial problems, opportunities, and lessons.

    PubMed

    Summerfield, M R; Gurwitch, K D; Scholz, R L; Bagby, L M

    1991-07-01

    The process of planning and establishing a pharmacy department in a pediatric hospital is described, and lessons learned from the experience are summarized. Since its founding in 1954, Texas Children's Hospital (TCH) had shared pharmacy services with St. Luke's Episcopal Hospital. The decision to terminate the shared-services agreement in the mid-1980s made it necessary for TCH to establish an independent pharmacy department. A director of pharmacy was hired in March 1988, and November 30 of that year was set as the target for implementation of the TCH pharmacy. It was decided that six services--a decentralized unit dose distribution system, an i.v. admixture service, delivery services, ambulatory-care services, a formulatory system, and a drug information service--would be offered initially. Decisions concerning department organizational structure and staffing, space allocations, and a computer system were made. A multidisciplinary advisory committee was appointed; one of its responsibilities was to oversee inservice staff training. The pharmacy areas were to be opened on a staggered basis, beginning with the hematology-oncology clinic pharmacy. A number of problems arose immediately following the opening of the central pharmacy, including inaccurate computer profiles, lower-than-estimated productivity resulting from staff members' unfamiliarity with the new system, higher-than-estimated patient census, and orders for nonformulary drugs. Delays in drug delivery times were unacceptably high. A crisis-management plan was implemented to cover both short- and long-term problems, and within a few months operations had stabilized. The opening of the intensive-care and sixth-floor satellite pharmacies enhanced decentralized operations and had an important role in improving response times.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  4. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  6. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  7. Uninterrupted service on the hospital menu.

    PubMed

    Vines, Lee

    2014-09-01

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

  8. 75 FR 24754 - Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Military...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... BUDGET Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Military Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable Third Persons AGENCY: Office... inpatient medical services furnished by military treatment facilities through the Department of Defense...

  9. Department of Health and Human Services, Office for Civil Rights

    MedlinePlus

    ... for Civil Rights Search U.S. Department of Health & Human Services Search Close HHS A-Z Index About ... opportunities to participate in certain health care and human services programs without unlawful discrimination. HIPAA - Health Information ...

  10. Independent component analysis decomposition of hospital emergency department throughput measures

    NASA Astrophysics Data System (ADS)

    He, Qiang; Chu, Henry

    2016-05-01

    We present a method adapted from medical sensor data analysis, viz. independent component analysis of electroencephalography data, to health system analysis. Timely and effective care in a hospital emergency department is measured by throughput measures such as median times patients spent before they were admitted as an inpatient, before they were sent home, before they were seen by a healthcare professional. We consider a set of five such measures collected at 3,086 hospitals distributed across the U.S. One model of the performance of an emergency department is that these correlated throughput measures are linear combinations of some underlying sources. The independent component analysis decomposition of the data set can thus be viewed as transforming a set of performance measures collected at a site to a collection of outputs of spatial filters applied to the whole multi-measure data. We compare the independent component sources with the output of the conventional principal component analysis to show that the independent components are more suitable for understanding the data sets through visualizations.

  11. 42 CFR 410.28 - Hospital or CAH diagnostic services furnished to outpatients: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  12. Design and implementation of GRID-based PACS in a hospital with multiple imaging departments

    NASA Astrophysics Data System (ADS)

    Yang, Yuanyuan; Jin, Jin; Sun, Jianyong; Zhang, Jianguo

    2008-03-01

    Usually, there were multiple clinical departments providing imaging-enabled healthcare services in enterprise healthcare environment, such as radiology, oncology, pathology, and cardiology, the picture archiving and communication system (PACS) is now required to support not only radiology-based image display, workflow and data flow management, but also to have more specific expertise imaging processing and management tools for other departments providing imaging-guided diagnosis and therapy, and there were urgent demand to integrate the multiple PACSs together to provide patient-oriented imaging services for enterprise collaborative healthcare. In this paper, we give the design method and implementation strategy of developing grid-based PACS (Grid-PACS) for a hospital with multiple imaging departments or centers. The Grid-PACS functions as a middleware between the traditional PACS archiving servers and workstations or image viewing clients and provide DICOM image communication and WADO services to the end users. The images can be stored in distributed multiple archiving servers, but can be managed with central mode. The grid-based PACS has auto image backup and disaster recovery services and can provide best image retrieval path to the image requesters based on the optimal algorithms. The designed grid-based PACS has been implemented in Shanghai Huadong Hospital and been running for two years smoothly.

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

    PubMed

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

    2015-01-01

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

  14. Who provides nursing services in Cambodian hospitals?

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  16. Department of Defense / General Services Administration / National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... (DoD), General Services Administration (GSA), and National Aeronautics and Space Administration (NASA...., Washington, DC 20405, (202) 501-4755. SUPPLEMENTARY INFORMATION: DoD, GSA, and NASA, under their several... Acquisition Policy. DOD/GSA/NASA (FAR)--Final Rule Stage Regulation Sequence Title Identifier Number...

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

    PubMed

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

    2009-01-01

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

  18. The hospital emergency department as a social welfare institution.

    PubMed

    Gordon, J A

    1999-03-01

    In an era of social welfare reform marked by the erosion of a societal safety net, few institutions remain that can guarantee assistance to those most in need. The hospital emergency department is perhaps the only local institution where professional help is mandated by law, with guaranteed availability for all persons, all the time, regardless of the problem. Although the ED serves as a true social safety net, its potential as a social welfare institution generally goes underestimated, hampering its full development as an effective societal resource. More of the disadvantaged may pass through the ED than through any other community institution, making it a logical site not only for the treatment of acute illness, but also for the identification of basic social needs and the extension of existing community resources. By helping more fully incorporate the ED into the total care of its community, emergency physicians can become leaders in the design and implementation of integrated sociomedical systems of care.

  19. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  5. Computerized system for hospital engineering service management

    NASA Astrophysics Data System (ADS)

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

    2007-11-01

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

  6. 12. Photocopy of photograph, National Park Service, US Department of ...

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

    12. Photocopy of photograph, National Park Service, US Department of Interior, Washington, DC. Photograph No. 9525-A, 15 December 1965 ARMILLARY SPHERE AT EXEDRA - Meridian Hill Park, Bounded by Fifteenth, Sixteenth, Euclid & W Streets, Northwest, Washington, District of Columbia, DC

  7. 20. Photocopy of National Park Service photograph, US Department of ...

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

    20. Photocopy of National Park Service photograph, US Department of Interior, Washington, DC. Photograph No. 8005.B, 4 July 1963. CASCADE FROM ABOVE - Meridian Hill Park, Bounded by Fifteenth, Sixteenth, Euclid & W Streets, Northwest, Washington, District of Columbia, DC

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Chen, Minya; Zheng, Konglin; Xia, Yong

    2012-01-01

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

  11. The Ohio Department of Youth Services Juvenile Prison Library System

    ERIC Educational Resources Information Center

    Herring, Deidra N.

    2009-01-01

    The article is an introduction to The Ohio Department of Youth Services librarians and the services they provide. Information about each juvenile prison facility is revealed and provides an explanation of guidelines and standards for prison libraries. Sixty-eight questions were asked in four in-person interviews to present a profile of the…

  12. MICRO-CARES: An Information Management System for Psychosocial Services in Hospital Settings

    PubMed Central

    Hammer, Jeffrey S.; Lyons, John S.; Strain, James J.

    1984-01-01

    This paper presents a flexible software system that is adaptable to a variety of information management uses across different psychosocial service departments in hospital settings. Initially developed for Consultation Liaison Psychiatry, the present system has now been adapted for a Social Work department and is being adapted to Hospice, Home Care, Patient Representative, and Pastoral Care departmental uses.

  13. 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

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

    ERIC Educational Resources Information Center

    Tan, Kar Way; Shankararaman, Venky

    2014-01-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

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

    PubMed

    Penkunas, Michael J; Hahn-Smith, Stephen

    2016-08-01

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

  17. Nurse Staffing and Hospital Characteristics Predictive of Time to Diagnostic Evaluation for Patients in the Emergency Department.

    PubMed

    Shindul-Rothschild, Judith; Read, Catherine Y; Stamp, Kelly D; Flanagan, Jane

    2016-10-20

    In the 2014 Emergency Department Benchmarking Alliance Summit, for the first time, participants recommended tracking nursing and advanced practice nurse hours. Performance data from the Centers for Medicare and Medicaid Services provides an opportunity to analyze factors associated with delays in emergency care. The purpose of this study was to investigate hospital characteristics associated with time to a diagnostic evaluation in 67 Massachusetts emergency departments from 2013 to 2014.

  18. 77 FR 69848 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

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

  19. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

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

  20. 76 FR 4725 - Apria Healthcare Customer Service Department; Fourteen Locations in Missouri Cameron, Cape...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... Employment and Training Administration Apria Healthcare Customer Service Department; Fourteen Locations in... Healthcare, Customer Service Department, Thirteen Locations in Missouri: Cameron, Cape Girardeau, Columbia... Healthcare, Customer Service Department. The Clinton, Missouri location provided data entry services in...

  1. The 500-bed hospital that isn't there: the Victorian Department of Health review of the Hospital in the Home program.

    PubMed

    Montalto, Michael

    2010-11-15

    The Victorian Department of Health reviewed its Hospital in the Home (HIH) program in 2009, for the first time in a decade. Annual reimbursements to all Victorian hospitals for HIH care had reached $110 million. Nearly all Victorian hospitals have an HIH program. Collectively, these units recorded 32,462 inpatient admissions in 2008-09, representing 2.5% of all inpatient admissions, 5.3% of multiday admissions and 5% of all bed-days in Victoria. If HIH were a single entity, it would be a 500-bed hospital. Treatment of many patients with acute community- and hospital-acquired infections or venous thromboembolism has moved into HIH. There is still capacity for growth in clinical conditions that can be appropriately managed at home. The review found evidence of gaming by hospitals through deliberate blurring of boundaries between acute HIH care and postacute care. The Victorian HIH program is a remarkable success that has significantly expanded the overall capacity of the hospital system, with lower capital resources. It suggests HIH with access to equivalent hospital remuneration is necessary for a successful HIH policy. Hospitals should invest in HIH medical leadership and supervision to expand their HIH services, including teaching. HIH is a challenge to the traditional vision of a hospital. Greater community awareness of HIH could assist in its continued growth.

  2. Population aging and emergency departments: visits will not increase, lengths-of-stay and hospitalizations will.

    PubMed

    Pallin, Daniel J; Allen, Matthew B; Espinola, Janice A; Camargo, Carlos A; Bohan, J Stephen

    2013-07-01

    With US emergency care characterized as "at the breaking point," we studied how the aging of the US population would affect demand for emergency department (ED) services and hospitalizations in the coming decades. We applied current age-specific ED visit rates to the population structure anticipated by the Census Bureau to exist through 2050. Our results indicate that the aging of the population will not cause the number of ED visits to increase any more than would be expected from population growth. However, the data do predict increases in visit lengths and the likelihood of hospitalization. As a result, the aggregate amount of time patients spend in EDs nationwide will increase 10 percent faster than population growth. This means that ED capacity will have to increase by 10 percent, even without an increase in the number of visits. Hospital admissions from the ED will increase 23 percent faster than population growth, which will require hospitals to expand capacity faster than required by raw population growth alone.

  3. A proposed simulation optimization model framework for emergency department problems in public hospital

    NASA Astrophysics Data System (ADS)

    Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

    2015-12-01

    The Emergency Department (ED) is a very complex system with limited resources to support increase in demand. ED services are considered as good quality if they can meet the patient's expectation. Long waiting times and length of stay is always the main problem faced by the management. The management of ED should give greater emphasis on their capacity of resources in order to increase the quality of services, which conforms to patient satisfaction. This paper is a review of work in progress of a study being conducted in a government hospital in Selangor, Malaysia. This paper proposed a simulation optimization model framework which is used to study ED operations and problems as well as to find an optimal solution to the problems. The integration of simulation and optimization is hoped can assist management in decision making process regarding their resource capacity planning in order to improve current and future ED operations.

  4. Performance improvement indicators of the Medical Records Department and Information Technology (IT) in hospitals

    PubMed Central

    Ajami, Sima; Ketabi, Saedeh; Torabiyan, Fatemeh

    2015-01-01

    Medical Record Department (MRD) has a vital role in making short and long term plans to improve health system services. The aim of this study was to describe performance improvement indicators of hospital MRD and information technology (IT). Collection of Data: A search was conducted in various databases, through related keywords in articles, books, and abstracts of conferences from 2001 to 2009. About 58 articles and books were available which were evaluated and finally 15 of them were selected based on their relevance to the study. MRD must be capable of supporting tasks such as patient care and continuity, institute management processes, medical education programs, medical research, communication between different wards of a hospital and administrative and medical staff. The use of IT in MRD can facilitate access to department, expedite communication within and outside department, reduce space with electronic medical records, reduce costs, accelerate activities such as coding by use of coding guide software and facilitate retrieval of records that will ultimately improve the performance of MRD. PMID:26150874

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

    PubMed

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

    2011-10-01

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

  6. Hospital emergency department utilisation rates among the immigrant population in Barcelona, Spain

    PubMed Central

    Buron, Andrea; Cots, Francesc; Garcia, Oscar; Vall, Oriol; Castells, Xavier

    2008-01-01

    Background The recent increase in the number of immigrants of Barcelona represents a challenge for the public healthcare system, the emergency department being the most used healthcare service by this group. However, utilisation rates in our environment have not yet been studied. We aimed to compare emergency department utilisation rates between Spanish-born and foreign-born residents in a public hospital of Barcelona. Methods The study population included all adults residing in the area of study and visiting the emergency department of Hospital del Mar in 2004. The emergency care episodes were selected from the Emergency Department register, and the population figures from the Statistics Department of Barcelona. Emergency care episodes were classified into five large clinical categories. Adjusted rate ratios (RR) of utilisation among foreign-born vs. Spanish-born residents were assessed through negative binomial regression. Results The overall utilisation rate was 382 emergency contacts per 1,000 persons-years. The RR for foreign-born versus Spanish-born residents was 0.62 (95% CI: 0.52; 0.74%). The RR was also significantly below one in surgery (0.51, 95% CI: 0.42; 0.63), traumatology (0.47, 95% CI: 0.38; 0.59), medicine (0.48, 95% CI: 0.38; 0.59) and psychiatry (0.42, 95% CI: 0.18; 0.97). No differences were found in utilisation of gynaecology and minor emergency services. Conclusion The overall lower utilisation rates obtained for foreign-born residents is consistent with previous studies and is probably due to the "healthy immigrant effect". Thus, the population increase due to immigration does not translate directly into a corresponding increase in the number of emergency contacts. The lack of differences in minor and gynaecological emergency care supports the hypothesis that immigrants overcome certain barriers by using the emergency department to access to health services. The issue of healthcare barriers should therefore be addressed, especially among

  7. Genetic counseling, a health department service to physicians.

    PubMed

    Jolly, E; Blum, H L

    1965-11-01

    Questions about inheritance in all kinds of diseases and defects are commonly asked of nearly all physicians. In attempting to answer these questions, however, the physician is often hampered by lack of formal instruction in clinical genetics. Since the health department, if it is to carry out its epidemiologic function, must be as concerned over the increasing identification of genetic agents in disease as it is and has been over environmental disease agents, it should come to represent a source of assistance not now generally available to the physician. In short, as it carries out those activities by which its store of general genetic information is increased, and until other sources of genetic consultation become reasonably available, the health department can be of real service to physicians as a resource to which they may turn for help when dealing with families wanting genetic information. Such a service has been provided experimentally for the last two years by the Contra Costa County Health Department. This program calls for the taking of family pedigrees by public health nurses on families with questions of a genetic nature who are health department clients and on families who are referred by their private physicians for this service. An interpretation of each pedigree is made by the department's physician in charge of the program and submitted to the family's physician for his use in counseling the family. Evidence to date suggests the process can be a highly useful service to the practitioner and his patient.

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

    PubMed

    Fukunaga, Hisanori; Momonoi, Toshiyuki; Kumakawa, Hiromi

    2016-01-01

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

  9. Analysis of blood tests in the emergency department of a tertiary care hospital

    PubMed Central

    Rehmani, R.; Amanullah, S.

    1999-01-01

    There is ample evidence that many investigations sent from the accident and emergency department are inappropriate, thus affecting the quality of patient care. A study was designed to address this issue in the emergency department of a tertiary care hospital of a large city. A prospective cross-sectional study was carried out during the 3-month period 1 December 1996 to 28 February 1997. A set of guidelines was used to assess the appropriateness of different blood tests for the initial assessment of the patients presenting with common clinical conditions, although any investigation could be done if considered important for patient management. All other blood tests were considered inappropriate. A total of 6401 patients were seen in the emergency department and 14 300 blood tests were done on 3529 patients with diagnoses covered by the guidelines. Of these 62.2% were found to be inappropriate. Of the total 22 655 investigations done on all the 6401 patients seen, only 3.8% influenced the diagnosis, 3.0% influenced patient care in the emergency department, and 4.0% influenced the decision to admit or not. Amylase and arterial blood gases were found to be the most appropriate investigations. Analysis of reasons for unnecessary use of emergency tests suggested that improving supervision, decreasing the utilization of the emergency department as a phlebotomy service for the hospital, and abolition of routine blood tests would help to improve patient care.


Keywords: blood tests; accident and emergency medicine PMID:10621876

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

    PubMed

    Emery, A C

    1975-05-01

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

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

    PubMed

    Rao, Vijay M; Levin, David C

    2011-09-01

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

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

    PubMed Central

    Thibodeau, Patricia L.; Funk, Carla J.

    2009-01-01

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

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

    PubMed

    1998-09-08

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

  14. 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.

  15. Provision of Personal Healthcare Services by Local Health Departments

    PubMed Central

    Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

    2016-01-01

    Introduction The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008–2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Methods Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. Results The mean number of personal healthcare services provided by LHDs did not change significantly in 2008–2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services’ share of revenue and per capita expenditures (b=0.57, p<0.001). Conclusions A lower share of revenue from personal healthcare services is associated with lower per capita expenditures. LHDs, especially those serving <25,000 people, are highly dependent on personal healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. PMID:25997902

  16. Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

    PubMed

    Linggi, A; Pelham, L D

    1986-09-01

    A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

  17. Factors Affecting Patient Satisfaction With Emergency Department Care: An Italian Rural Hospital

    PubMed Central

    Messina, Gabriele; Vencia, Francesco; Mecheroni, Silvana; Dionisi, Susanna; Baragatti, Lorenzo; Nante, Nicola

    2015-01-01

    Background: In the emergency department satisfaction is strictly linked to the role of the nurses, namely the first interface between patients and hospital services. Objectives: The purpose of the study was to identify areas of emergency nursing activity associated with minor or major patient satisfaction. Methods: A descriptive cross-sectional study was conducted from December 2010 - May 2011, in the rural hospital of Orbetello, Tuscany (Italy). Convenience sampling was used to select patients, namely patients presenting at the emergency unit in the study period. The Consumer Emergency Care Satisfaction Scale was used to collect information on two structured subscale (Caring and Teaching). Results: 259 questionnaire were collected. Analysis indicated that only two characteristics significantly influenced overall satisfaction: “receiving continuous information from personnel about delay” positively effect (OR=7.98; p=0.022) while “waiting time for examination” had a negative effect (OR 0.42; p=0.026) Conclusions: The study was the first conduced in Italy using this instrument that enabled to obtain much important information about patient satisfaction with nursing care received in the emergency department. The results showing improvements must be related to educational aspects, such as explaining patients the colour waiting list, and communication towards patients, such as informing about emergences that cause queue. PMID:25946915

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

    PubMed

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

    2017-02-13

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

  19. 75 FR 67998 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Chattahoochee...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... Completion: U.S. Department of Agriculture, Forest Service, Chattahoochee-Oconee National Forests.... Department of Agriculture, Forest Service, Chattahoochee-Oconee National Forests, Gainesville, GA. The...

  20. Postdeployment Hospitalizations among Service Members Deployed in Support of the Operations in Iraq and Afghanistan

    DTIC Science & Technology

    2009-09-01

    10 ICD-9-CM diagnoses. For these analyses, only the first hospitalization for the targeted diagnosis or group of diagnoses was included.Outcomes To...injuries or illnesses that may be found after deploy- ment. Other categories such as neoplasms, found the most frequent diagnosis of uterine leiomyoma...phic lateral sclerosis, or fibromyalgia associated with Persian Gulf War service? An examination of Department of Defense hospitalization data. Am J

  1. Improving door-to-physician times in 2 community hospital emergency departments.

    PubMed

    Welch, Shari; Dalto, Joseph

    2011-01-01

    Door-to-physician time in the emergency department (ED) correlates with patient satisfaction and clinical quality and outcomes. Delays in seeing a provider result in a 3% nationwide rate of patients leaving without being seen (LWBS) after presenting for ED care. Two community hospitals had door-to-physician times of 51 and 47 minutes. The LWBS rates were 3% and 2%. A quality improvement project was initiated with a change package, including prompts, training, and feedback. Door-to-physician times decreased to 31 and 27 minutes. The change occurred in less than a month and was sustained for 6 months after the study. In addition, the LWBS rates at each facility fell by one third. Basic process improvement strategies borrowed from service industries were used in 2 EDs to improve the door-to-physician process.

  2. Integration of a psychoanalytic liaison department at a public hospital.

    PubMed

    Neuburger, R P

    2000-08-01

    A general overview of liaison-psychoanalysis in a general hospital is presented. The team's trajectory is revisited, as generating a presence in the inpatient units: a demand which changes from a purely psychiatric, scarcely operative level to an acknowledgment of subjectivity. Generally, this appears disruptively in medical proceedings. Two case histories are presented: (i) 'the tenant' and (ii) 'the nail-polishing file'. With regard to the first case history, the transference in its double aspect, with the patient as well as with the unit's staff, is examined. The analyst's intervention seeks to untangle the impasse, which prevents the physicians from helping the patient. With regard to the second case history, in which the de-mystification aspects of liaison work are shown, the horror that the so-called 'mental illness' can produce in the medical institution is explored. The aim of narrating this experience is to preserve a psy-space in the hospital where the overwhelming technological developments menace with its disappearance.

  3. 42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Method of payment for preadmission services under the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

  4. Factors associated with the hospital admission of consumer product-related injuries treated in U.S. hospital emergency departments.

    PubMed

    Schroeder, Thomas J; Rodgers, Gregory B

    2013-10-01

    While unintentional injuries and hazard patterns involving consumer products have been studied extensively in recent years, little attention has focused on the characteristics of those who are hospitalized after treatment in emergency departments, as opposed to those treated and released. This study quantifies the impact of the age and sex of the injury victims, and other factors, on the likelihood of hospitalization. The analysis focuses on consumer product injuries, and was based on approximately 400,000 injury cases reported through the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System, a national probability sample of U.S. hospital emergency departments. Logistic regression was used to quantify the factors associated with the likelihood of hospitalization. The analysis suggests a smooth U-shaped relationship between the age of the victim and the likelihood of hospitalization, declining from about 3.4% for children under age 5 years to 1.9% for 15-24 year-olds, but then rising to more than 25% for those ages 75 years and older. The likelihood of hospitalization was also significantly affected by the victim's sex, as well as by the types of products involved, fire involvement, and the size and type of hospital at which the injury was treated. This study shows that the probability of hospitalization is strongly correlated with the characteristics of those who are injured, as well as other factors.

  5. Innovative Home Visit Models Associated With Reductions In Costs, Hospitalizations, And Emergency Department Use.

    PubMed

    Ruiz, Sarah; Snyder, Lynne Page; Rotondo, Christina; Cross-Barnet, Caitlin; Colligan, Erin Murphy; Giuriceo, Katherine

    2017-03-01

    While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits. Two models achieved significant reductions in Medicare expenditures, and three models reduced utilization in the form of emergency department visits, hospitalizations, or both for beneficiaries relative to comparators. These findings present a strong case for the potential value of home visits by practice-extender teams to reduce Medicare expenditures and service use in a particularly vulnerable and costly segment of the Medicare population.

  6. [Current status and needs of the department of neurology as a specialized department of a general hospital].

    PubMed

    Yamane, K

    2000-12-01

    In this report, I have summarized the current situation surrounding diagnosis, treatment and related needs in the department of neurology in relation to postgraduate neurology training considered from the standpoint of a specialized department within a general hospital. This summary is based on the responses to a questionnaire that was sent to the persons in charge of education and training at 180 institutions affiliated with the Japanese Society of Neurology and 478 education and training institutions among Japanese city hospitals, excluding university hospitals and special research institutions. Replies were received from 305 hospitals, amounting to a response rate of 63.8%. The number of doctors working in the department of neurology was found to be low at 2 in 84 hospitals and 3 in 65 hospitals. The majority of neurologists at general hospitals are fully engaged in examining outpatients as well as inpatients, and they do not have adequate time for research, education and training and participation in the activities of academic associations. Of the 10 items cited in the questionnaire relating to the types of postgraduate neurology training desired by neurologists employed in general hospitals, the most common selections in order of decreasing frequency were improvement in the capacity to manage common disorders (such as headache, dizziness, numbness, etc.) diagnosed in the outpatient clinic, improvement in the capacity to diagnose the acute phase of cerebral apoplexy, further education about EEG (electroencephalogram) and EMG (electromyogram), and medical ethical issues such as informed consent. The views about postgraduate neurological education and training described in detail in writing by the respondents were as follows. 1) Neurologists required by a city general hospital Numerous respondents commented that the capacity to diagnose medical neurological diseases associated with internal (systemic) medical disorders is needed since there are remarkably few

  7. Disparities in asthma hospitalizations among children seen in the emergency department.

    PubMed

    Kruse, Lakota K; Deshpande, Sandy; Vezina, Melissa

    2007-12-01

    We examined the race/ethnicity variation in the risk of hospitalization among children seen in the emergency department (ED) for asthma. ED and hospitalization records for children 1 to 19 years of age in New Jersey for 2004 and 2005 were linked. The dataset identified 47,548 ED and hospitalizations among 37,216 children. ED and hospitalization rates indicated persistent disparities in pediatric asthma. ED admission rates were similar across race/ethnic groups, suggesting similar management of pediatric asthma patients once they are seen in the ED. Integrating existing ED and hospitalization records will enhance asthma surveillance and the targeting of interventions to reduce race/ethnicity disparities.

  8. Books for the Hospital Emergency Service

    PubMed Central

    Roy, Donald E.; Morgan, Virginia W.

    1966-01-01

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

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

    PubMed

    Muller, M

    2000-06-01

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

  10. Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt.

    PubMed

    Hoytema van Konijnenburg, Eva M M; Diderich, Hester M; Teeuw, Arianne H; Klein Velderman, Mariska; Oudesluys-Murphy, Anne Marie; van der Lee, Johanna H

    2016-03-01

    To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol ('Amsterdam protocol') was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment.

  11. Rising pressure: hospital emergency departments as barometers of the health care system.

    PubMed

    O'Malley, Ann S; Gerland, Anneliese M; Pham, Hoangmai H; Berenson, Robert A

    2005-11-01

    Pressures--ranging from persuading specialists to provide on-call coverage to dealing with growing numbers of patients with serious mental illness--are building in already-crowded hospital emergency departments (EDs) across the country, according to findings from the Center for Studying Health System Change's (HSC) 2005 site visits to 12 nationally representative communities. As the number of ED visits rises significantly faster than population growth, many hospitals are expanding emergency department capacity. At the same time, hospitals face an ongoing nursing shortage, contributing to tight inpatient capacity that in turn hinders admitting ED patients. In their role as hospitals' "front door" for attracting insured inpatient admissions, emergency departments also increasingly are expected to help hospitals compete for insured patients while still meeting obligations to provide emergency care to all-comers under federal law. Failure to address these growing pressures may compromise access to emergency care for patients and spur already rapidly rising health care costs.

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

    PubMed

    Gluck, Jeannine Cyr

    2004-01-01

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

  13. Does type of hospital ownership influence physicians' daily work schedules? An observational real-time study in German hospital departments

    PubMed Central

    Mache, Stefanie; Scutaru, Cristian; Vitzthum, Karin; Quarcoo, David; Schöffel, Norman; Welte, Tobias; Klapp, Burghard F; Groneberg, David A

    2009-01-01

    Background During the last two decades the German hospital sector has been engaged in a constant process of transformation. One obvious sign of this is the growing amount of hospital privatization. To date, most research studies have focused on the effects of privatization regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Yet little attention has been devoted to the effects of privatization on physicians' working routines. The aim of this observational real-time study is to deliver exact data about physicians' work at hospitals of different ownership. By analysing working hours, further impacts of hospital privatization can be assessed and areas of improvement identified. Methods Observations were made by shadowing 100 physicians working in private, for-profit or non-profit as well as public hospital departments individually during whole weekday shifts in urban German settings. A total of 300 days of observations were conducted. All working activities were recorded, accurate to the second, by using a mobile personal computer. Results Results have shown significant differences in physicians' working activities, depending on hospital ownership, concerning working hours and time spent on direct and indirect patient care. Conclusion This is the first real-time analysis on differences in work activities depending on hospital ownership. The study provides an objective insight into physicians' daily work routines at hospitals of different ownership, with additional information on effects of hospital privatization. PMID:19473487

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

    PubMed

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

    2006-01-01

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

  15. Embedded ubiquitous services on hospital information systems.

    PubMed

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

    2012-11-01

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

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

    PubMed

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

    1997-02-01

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

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

    PubMed

    Sheehan-Smith, Lisa

    2006-04-01

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

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

    PubMed Central

    Babakus, E; Mangold, W G

    1992-01-01

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

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

    PubMed

    Babakus, E; Mangold, W G

    1992-02-01

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

  20. 77 FR 12273 - Public Availability of Department of Energy FY 2011 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ....gov/management/downloads/service-contract-inventory . FOR FURTHER INFORMATION CONTACT: Questions... Availability of Department of Energy FY 2011 Service Contract Inventory AGENCY: Department of Energy. ACTION: Notice of Public Availability of FY 2011 Service Contract Inventories. SUMMARY: In accordance...

  1. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  2. Validation of an Algorithm for Categorizing the Severity of Hospital Emergency Department Visits

    PubMed Central

    Ballard, Dustin W.; Price, Mary; Fung, Vicki; Brand, Richard; Reed, Mary E.; Fireman, Bruce; Newhouse, Joseph P.; Selby, Joseph V.; Hsu, John

    2013-01-01

    Background Differentiating between appropriate and inappropriate resource use represents a critical challenge in health services research. The New York University Emergency Department (NYU ED) visit severity algorithm attempts to classify visits to the ED based on diagnosis, but it has not been formally validated. Objective To assess the validity of the NYU algorithm. Research Design: A longitudinal study in a single integrated delivery system (IDS) from January 1999 to December 2001. Subjects 2,257,445 commercial and 261,091 Medicare members of an IDS. Measures ED visits were classified as emergent, non-emergent, or intermediate severity, using the NYU ED algorithm. We examined the relationship between visit-severity and the probability of future hospitalizations and death using a logistic model with a general estimating equation (GEE) approach. Results Among commercially insured subjects, ED visits categorized as emergent were significantly more likely to result in a hospitalization within one-day (OR=3.37, 95% CI: 3.31–3.44) or death within 30-days (OR=2.81, 95% CI: 2.62–3.00) than visits categorized as non-emergent. We found similar results in Medicare patients and in sensitivity analyses using different probability thresholds. ED overuse for non-emergent conditions was not related to socio-economic status or insurance type. Conclusions The evidence presented supports the validity of the NYU ED visit severity algorithm for differentiating ED visits based on need for hospitalization and/or mortality risk; therefore, it can contribute to evidence-based policies aimed at reducing the use of the ED for non-emergencies. PMID:19952803

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

    PubMed

    Jajko, P

    1992-01-01

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

  4. Patients of internists in hospital outpatient departments and in private practice.

    PubMed Central

    Rudd, P.; Carrier, A. C.

    1978-01-01

    To test the contention that patients in outpatient departments and private practices differ, variables were assessed that might affect both the process and the outcome of medical care. Two groups of 60 patients consulting nine Montreal internists who worked in both private practice and in an outpatient department of a university teaching hospital were surveyed. The internists served as their own controls. The two groups of patients were compared for 57 demographic, socioeconomic, access, utilization, attitudinal and current medical status variables. Financial factors were minimized by the existence of universal health insurance. The outpatient group was found to be older, less fluent in English, less likely to be employed, less educated, less wealthy, more dependent on public transportation, more disabled, more likely to use ambulatory services, more anxious about health, and more sceptical about physicians, yet more dependent on them than the private practice group. The outpatient group tended to have more active, significant medical conditions and to receive more prescriptions for medication than the private practice group, in contrast to the national patterns in the practice of internal medicine in the United States. Medical educators, researchers, administrators and providers of health care who have assumed that these two groups of patients are comparable must re-evaluate their practices. PMID:737639

  5. [Services portfolio of a department of endocrinology and clinical nutrition].

    PubMed

    Vicente Delgado, Almudena; Gómez Enterría, Pilar; Tinahones Madueño, Francisco

    2011-03-01

    Endocrinology and Clinical Nutrition are branches of Medicine that deal with the study of physiology of body glands and hormones and their disorders, intermediate metabolism of nutrients, enteral and parenteral nutrition, promotion of health by prevention of diet-related diseases, and appropriate use of the diagnostic, therapeutic, and preventive tools related to these disciplines. Development of Endocrinology and Clinical Nutrition support services requires accurate definition and management of a number of complex resources, both human and material, as well as adequate planning of the care provided. It is therefore essential to know the services portfolio of an ideal Department of Endocrinology and Clinical Nutrition because this is a useful, valid and necessary tool to optimize the available resources, to increase efficiency, and to improve the quality of care.

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

    PubMed Central

    2012-01-01

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

  7. U.S. Department of Energy Office of Inspector General report on audit of Department of Energy support service contracting

    SciTech Connect

    1995-06-30

    The purpose of this audit was to review the Department`s acquisition and use of support service contractors and subcontractors. The audit objectives were to determine if the Department (1) paid fees to both support service contractors and subcontractors for services exclusively performed by subcontractors, (2) used support service contractors to perform inherent government functions, and (3) rolled over unearned award fees to subsequent evaluation periods and had adequate management controls to ensure that contractor performance would be evaluated. The Department did not always obtain support services in the most economical and effective manner. The Department negotiated and paid four of six support service contractors an estimated $5.1 million in fees for services exclusively provided by subcontractors because the Department did not have a policy which addressed the inclusion, at the pre-award phase, of subcontract labor in the support service contractors` fee determinations. Furthermore, while the authors found no instances where support service contractors performed inherent government functions, they did note that the Department maintained minimal administration over major portions of contracted-for services on three of six support service contracts. This occurred because contractors subcontracted extensively for support services. Consequently, the Department may have decreased their ability to control cost growth on these three contracts. As discussed in Part 4, the Department`s process was sufficient in five of six cases to evaluate support service contractor performance. However, one of six cost-plus-award-fee contractors received award fees that exceeded its performance ratings by $89,000 because one Departmental office elected to rollover unearned portions of fees from prior evaluation periods and make them available in the next evaluation period.

  8. THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN

    PubMed Central

    Pouragha, Behrouz; Zarei, Ehsan

    2016-01-01

    Aim: The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. Methods: this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson’s correlation, and multivariate regression methods with the SPSS.18 software. Results: According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. Conclusion: The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction. PMID:27047262

  9. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  10. Implementing "lean" principles to improve the efficiency of the endoscopy department of a community hospital: a case study.

    PubMed

    Laing, Karen; Baumgartner, Katherine

    2005-01-01

    Many endoscopy units are looking for ways to improve their efficiency without increasing the number of staff, purchasing additional equipment, or making the patients feel as if they have been rushed through the care process. To accomplish this, a few hospitals have looked to other industries for help. Recently, "lean" methods and tools from the manufacturing industry, have been applied successfully in health care systems, and have proven to be an effective way to eliminate waste and redundancy in workplace processes. The "lean" method and tools in service organizations focuses on providing the most efficient and effective flow of service and products. This article will describe the journey of one endoscopy department within a community hospital to illustrate application of "lean" methods and tools and results.

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

    PubMed Central

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain

    2015-01-01

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

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

    PubMed

    Pai, Yogesh P; Chary, Satyanarayana T

    2016-04-18

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

  13. [ The hospitalization of Jews in mental hospitals under Vichy in the department of the Seine].

    PubMed

    Caire, Michel

    2008-01-01

    The author presents the state of his research about a question not very studied till now in a French départment whose specificities have to be considered. The studying of some fifty medical records and some unpublished documents allows to point out how people persecuted by racial laws have been set in psychiatric hospitals and protected. As for their goods it seems that the system intending to protect psychiatric in-patients during their stay at the hospital has been turned away and used to despoil the patents "claimed or alleged Jews".

  14. Emergency department visits and resulting hospitalizations by elderly nursing home residents, 2001-2008.

    PubMed

    Hsiao, Chun-Ju; Hing, Esther

    2014-03-01

    This study examines emergency department (ED) visits by nursing home (NH) residents aged 65 and over, and factors associated with hospital admission from the ED visit using data from the 2001-2008 National Hospital Ambulatory Medical Care Survey. Cross-sectional analyses were conducted on patient characteristics, diagnosis, procedures received, and triage status. On average, elderly NH residents visited EDs at a rate of 123 visits per 100 institutionalized persons. Nearly 15% of all ED visits had ambulatory care sensitive condition diagnoses. Nearly half of these visits resulted in hospital admission; chronic obstructive pulmonary disease, congestive heart failure, kidney/urinary tract infection, and dehydration were associated with higher odds of admission. Previous studies suggested that adequate medical staffing and appropriate care in the NH could reduce ED visits and hospital admissions. Recent initiatives seek to reduce ED visits and hospitalizations by providing financial incentives to spur better coordination between NH and hospital.

  15. [A university department as a psychiatric service centre for children and adolescents].

    PubMed

    Remschmidt, Helmut; Walter, Reinhard; Theisen, Frank; Ulbrich, Rainer; Martin, Matthias

    2006-11-01

    The article reports on a system of care for psychiatrically ill children and adolescents that has been designed, established and expanded since 1980 by a university department in a rural region. The department is responsible for the mental health care of three counties with altogether 807 000 inhabitants. The development of this system of care was due in great part to the model program of the German Federal Government for the reform of mental health care that comprised 14 model regions, out of which the region of Marburg and its surrounding counties was the only one with a focus on the situation of psychiatrically ill children and adolescents. With the aid of this model program, a comprehensive evaluation of existing psychiatric services was carried out and at the same time, new services for this clientele were established such as a mobile child and adolescent psychiatric service and a day hospital. A particular focus was laid on the development of a complete network of psychiatric services with manifold, and over the years well proven, cooperation measures. Finally, the quality of mental health care was significantly increased by a continuous evaluation of services and the implementation of two institutes for psychotherapeutic training. Several research initiatives in the field of social psychiatry have contributed to this amelioration and at the same time, to a successful integration of mental health care and research.

  16. Benefits of Early Roflumilast Treatment After Hospital or Emergency Department Discharge for a COPD Exacerbation

    PubMed Central

    Lee, Qing; Mocarski, Michelle; Sun, Shawn X.

    2016-01-01

    treatment had moderate (P = .013) or severe (P = .002) exacerbations. Early roflumilast treatment also was associated with reduced annualized COPD-related (P = .012) and all-cause (P = .009) rehospitalizations, outpatient visits per patient (P <.001 for COPD-related and all-cause), and procedures or therapies (COPD-related, P = .016; all-cause, P = .009). The early treatment group had fewer COPD-related emergency department visits per patient than the delayed roflumilast treatment group (P = .035), and the total mean annualized COPD-related and all-cause costs were reduced by $7273 (P = .014) and $14,111 (P = .002), respectively. Multivariate analyses showed that early treatment was associated with lower COPD-related and all-cause annualized health services costs per patient annually (P <.001 for both). Conclusion In this real-world study, the patients with COPD who initiated roflumilast treatment ≤30 days after a hospital or emergency department discharge for a COPD-related exacerbation experienced fewer subsequent exacerbations and rehospitalizations, reduced healthcare utilizations, and lower healthcare costs than the patients who delayed their roflumilast treatment. PMID:27606039

  17. 77 FR 5614 - Department of State FY11 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ... Department of State FY11 Service Contract Inventory AGENCY: Department of State. ACTION: Notice of the release of the Department of State FY11 Service Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory for FY11 and its analysis of the FY10 inventory. They...

  18. 76 FR 9399 - Department of State FY10 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... Department of State FY10 Service Contract Inventory AGENCY: Department of State. ACTION: Notice of the release of the Department of State FY10 Service Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory for FY10. Section 743 of Division C of the FY...

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

    PubMed Central

    Green, L V; Nguyen, V

    2001-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

    Domingo, Rene T

    2015-01-01

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

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

    PubMed

    Sakamoto, N

    1998-03-01

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

  3. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  4. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  5. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  6. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  7. Building areas of hospitals in Japan and distribution of areas by department--1980's.

    PubMed

    Itoh, M; Nakayama, S; Liu, Y Y; Kawaguchi, Y

    1993-07-01

    (1) Areas of entire hospitals which have been continuously increasing in the past 30 years are finally showing signs for slowing down. The areas of the hospitals completed in the 1980's were generally 50 to 80 m2 per bed. (2) The distribution of the nursing department to the entire hospitals in area ratio ranges from 30 to slightly more than 40%, or higher than 35% in most cases. The actual areas of the nursing department has surpassed 20 m2 per bed in a considerably large number of hospitals. (3) The area ratio of the outpatient department tends to concentrate to about 12%. Of this percentage, in almost all hospitals, the proportion of the emergency division was less than 2%. (4) As in the 1970's, the diagnostic and treatment facilities were within the range of 18 to 22% in the majority of the hospitals. The distribution shifted to ratios higher than the previous survey. The distributions for the various sections are as follows: 1) Specimen test rooms 3 to 5% 2) Physiological examination rooms slightly below 1% to slightly above 2% 3) X-ray diagnosis rooms about 4% 4) Radiation therapy rooms about 1% 5) Nuclear medicine rooms about 1% 6) Operating department 3 to 5%, 2 to 3 m2/bed 7) Delivery suite less than 1% 8) Rehabilitation department 1 to 4% 9) Hemodialysis suite about 1% (5) The area ratios of the supply department dispersed substantially between 12 and 25%. About 70% of the hospitals remained in the range of 15 to 20%. The ratios of the various sections in the department are as follows: 1) Pharmacy: slightly less than 2% to slightly less than 3% 2) Central sterile and supply department: about 2% 3) Blood bank: installed in hospitals with more than 500 beds 4) Kitchen: slightly more than 2% to slightly more than 3%, 1.5 to 2.5 m2/bed 5) Laundry: less than 1% 6) Central storage and material hundling unit: about 1% 7) Mechanical plant: 5 to 13% (6) The administration department allocates 7 to 14% of its area to the management division and 2 to 6% to the

  8. Evaluation of preventable trauma death in emergency department of Imam Reza hospital

    PubMed Central

    Gholipour, Changiz; Rad, Bahram Samadi; Vahdati, Samad Shams; Ghaffarzad, Amir; Masoud, Armita

    2016-01-01

    BACKGROUND: Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents (MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This study aimed to investigate the causes and prevention of death in trauma patients. METHODS: This retrospective, descriptive-analytic study assessed 100 trauma patients referred to our emergency department (ED) from January 2013 to Januanry 2015. The included patients were those with trauma died after arrival at our ED. Age, sex, cause of trauma, clinical causes of death, causes of death defined by autopsy, way of transfer to the ED, time of ambulance arrival at the scene of trauma, and time elapsed to enter the ED from the scene of trauma were studied. RESULTS: In the 100 patients, 21 (21%) patients were female and 79 (79%) male. Forty-three patients were older than 60 years. Trauma was largely due to pedestrian accidents in 31% of the patients, and 33% had a hypo-volemic shock. About 80% of deaths were due to intra-cranial hemorrhage (ICH) or intra-ventricular hemorrhage (IVH), and spinal injuries were not preventable. Autopsy revealed that 28% of the patients suffered from internal injuries. Autopsy revealed that 19% of the deaths were not preventable and 81% were considered preventable. In our patients, 76 were transferred to the hospital by emergency medicine services (EMS). Analysis of time for ambulance arrival to the scene and frequency of death revealed that 52.2% of the deaths occurred between 11 and 15 minutes. Analysis of time for admission to the ED from the scene of trauma showed that 74.6% deaths occurred between 6 and 10 minutes. CONCLUSIONS: The rate of hospital preventable deaths is about 80%, a high mortality rate, which denotes a lack of proper diagnosis and treatment. The time for arrival of EMS at the scene of trauma is longer than that in other countries. PMID:27313809

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

    PubMed

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

    2017-02-01

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

  10. A survey of pandemic influenza preparedness and response capabilities in Chicago area hospital security departments.

    PubMed

    Kimmerly, David P

    2009-01-01

    This article is a summary based on a December 2007 paper prepared by the author in partial fulfillment of the requirements for a master's degree in business and organizational security management at Webster University. The project described was intended to assess Chicago-area healthcare organization security departments' preparedness and response capabilities for a potential influenza pandemic. While the author says healthcare organizations are learning from the pandemics of the past, little research has been conducted on the requirements necessary within hospital security departments. The article explores staffing, planning, preparation and response capabilities within a healthcare security context to determine existing resources available to the healthcare security community. Eleven completed surveys were received from hospital security managers throughout the geographical Chicago area. They reveal that hospital security managers are conscious of the risks of a pandemic influenza outbreak. Yet, it was found that several gaps existed within hospital security department staffing and response capabilities, as hospital security departments may not have the available resources necessary to adequately maintain their operations during a pandemic incident.

  11. 7 CFR 1951.136 - Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 14 2012-01-01 2012-01-01 false Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service (Community Facility Program only) and the Rural Business-Cooperative Service. 1951.136 Section 1951.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE,...

  12. 7 CFR 1951.136 - Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 14 2013-01-01 2013-01-01 false Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service (Community Facility Program only) and the Rural Business-Cooperative Service. 1951.136 Section 1951.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE,...

  13. 7 CFR 1951.136 - Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service (Community Facility Program only) and the Rural Business-Cooperative Service. 1951.136 Section 1951.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE,...

  14. 7 CFR 1951.136 - Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 14 2014-01-01 2014-01-01 false Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service (Community Facility Program only) and the Rural Business-Cooperative Service. 1951.136 Section 1951.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE,...

  15. 7 CFR 1951.136 - Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 14 2011-01-01 2011-01-01 false Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service (Community Facility Program only) and the Rural Business-Cooperative Service. 1951.136 Section 1951.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE,...

  16. Military hospitalizations among deployed US service members following anthrax vaccination, 1998-2001.

    PubMed

    Wells, Timothy Steven; Sato, Paul A; Smith, Tyler Clain; Wang, Linda Zhenling; Reed, Robert John; Ryan, Margaret Angela Kappel

    2006-01-01

    Safety concerns have confronted the Department of Defense Anthrax Vaccine Immunization Program since inception in 1998. To determine if anthrax vaccination was associated with an increased risk of hospitalization, a historical cohort study utilizing pre- and post-anthrax-vaccination hospitalizations was undertaken and analyzed with Cox proportional hazards models. The study population consisted of 170,723 active duty US service members who were anthrax-vaccinated and deployed during the time period January 1, 1998 to December 31, 2001. Study outcomes included hospitalizations due to any-cause, 14 broad International Classification of Diseases diagnostic categories, autoimmune organ specific and organ non-specific hospitalizations, and asthma. After adjustment, anthrax vaccination was associated with significantly fewer hospitalizations for any-cause, diseases of the blood and blood forming organs, and diseases of the respiratory system. Comparing anthrax post-vaccination hospitalization experience with the pre-vaccination period resulted in no significant increased hazard for any of the hospitalization outcomes studied. Although there was no apparent increase in risk of morbidity in this study population, the relationship between anthrax vaccine and deployment on health outcomes among US service members needs further study.

  17. Emergency Department Visits and Hospitalizations in Children With Chronic Pancreatitis in the United States.

    PubMed

    Pant, Chaitanya; Sferra, Thomas J

    2015-11-01

    We analyzed 2 national databases to assess the use of health care resources by children with chronic pancreatitis (CP). In 2012, the hospital discharge rate for pediatric CP was 2.73/100,000 children. Patients with CP were sicker with a greater burden of illness than age- and sex-matched counterparts. Acute pancreatitis occurred frequently in hospitalized children with CP. Abdominal pain and nausea, and vomiting were the most common gastrointestinal symptoms associated with emergency department visits in children with CP. A significant proportion of these visits resulted in a hospitalization. These findings add to our understanding of the epidemiology of CP in the United States.

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

    PubMed

    Kalina, Michael

    2016-01-01

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

  19. Quality of the clinical laboratory department in a specialized hospital in Alexandria, Egypt.

    PubMed

    Elhoseeny, T A; Mohammad, E K

    2013-01-01

    Assessment and improvement of turnaround times (TAT) as well as customer satisfaction is essential for laboratory quality management. This study in a specialized hospital in Alexandria, Egypt measured the current TAT for outpatient department bilirubin samples and evaluated the satisfaction of physicians with aspects of clinical laboratory services. While the mean TAT for 110 bilirubin tests [58.1 (SD 31.8) min] was within the College of American Pathologists' benchmark, the 90th percentile was long (96.7 min); 62.7% of tests were reported within 60 min. The mean overall satisfaction score of physicians (range 1-5) was 3.46 (SD 0.49). The highest satisfaction rating was for staff courtesy while the lowest ratings were for laboratory management responsiveness, outpatient stat TAT and critical value notification. Quality or reliability of results was judged by physicians as the most important factor (32.3%), followed by routine test TAT (18.5%). Further analysis of the different steps of the TAT would be helpful and follow-up through examining outliers is recommended

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

    ERIC Educational Resources Information Center

    Calhoun, Olivia H.

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

  1. Initiation of a medical toxicology consult service at a tertiary care children’s hospital

    PubMed Central

    WANG, GEORGE SAM; MONTE, ANDREW; HATTEN, BENJAMIN; BRENT, JEFFREY; BUCHANAN, JENNIE; HEARD, KENNON J.

    2015-01-01

    Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children < 6 years, poisoning continues to be a common pediatric diagnosis and bedside toxicology consultation is not common at children’s hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children’s hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8–16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship. PMID:25686099

  2. A multi agent system model for evaluating quality service of Clinical Engineering Department.

    PubMed

    Gaetano, Laura; Balestra, Gabriella

    2011-01-01

    Biomedical technology is strategically important to the operational effectiveness of healthcare facilities. As a consequence, clinical engineers have become an essential figure in hospital environment: their role in maintenance, support, evaluation, integration, assessment of new, advanced and complex technologies in point of view of patient safety and cost reduction is become inalienable. For this reason, nations have begun to establish Clinical Engineering Department, but, unfortunately, in a very diversified and fragmented way. So, a tool able to evaluate and improve the quality of current services is needed. Hence, this work builds a model that acts as a reference tool in order to assess the quality of an existing Clinical Engineering Department, underlining its defaulting aspects and suggesting improvements.

  3. The Association of Longitudinal and Interpersonal Continuity of Care with Emergency Department Use, Hospitalization, and Mortality among Medicare Beneficiaries

    PubMed Central

    Bentler, Suzanne E.; Morgan, Robert O.; Virnig, Beth A.; Wolinsky, Fredric D.

    2014-01-01

    Background Continuity of medical care is widely believed to lead to better health outcomes and service utilization patterns for patients. Most continuity studies, however, have only used administrative claims to assess longitudinal continuity with a provider. As a result, little is known about how interpersonal continuity (the patient's experience at the visit) relates to improved health outcomes and service use. Methods We linked claims-based longitudinal continuity and survey-based self-reported interpersonal continuity indicators for 1,219 Medicare beneficiaries who completed the National Health and Health Services Use Questionnaire. With these linked data, we prospectively evaluated the effect of both types of continuity of care indicators on emergency department use, hospitalization, and mortality over a five-year period. Results Patient-reported continuity was associated with reduced emergency department use, preventable hospitalization, and mortality. Most of the claims-based measures, including those most frequently used to assess continuity, were not associated with reduced utilization or mortality. Conclusion Our results indicate that the patient- and claims-based indicators of continuity have very different effects on these important health outcomes, suggesting that reform efforts must include the patient-provider experience when evaluating health care quality. PMID:25531108

  4. Using Simulation to Examine the Effect of Physician Heterogeneity on the Operational Efficiency of an Overcrowded Hospital Emergency Department

    NASA Astrophysics Data System (ADS)

    Kuo, Y.-H.; Leung, J. M. Y.; Graham, C. A.

    2015-05-01

    In this paper, we present a case study of modelling and analyzing the patient flow of a hospital emergency department in Hong Kong. The emergency department is facing the challenge of overcrowding and the patients there usually experience a long waiting time. Our project team was requested by a senior consultant of the emergency department to analyze the patient flow and provide a decision support tool to help improve their operations. We adopt a simulation approach to mimic their daily operations. With the simulation model, we conduct a computational study to examine the effect of physician heterogeneity on the emergency department performance. We found that physician heterogeneity has a great impact on the operational efficiency and thus should be considered when developing simulation models. Our computational results show that, with the same average of service rates among the physicians, variation in the rates can improve overcrowding situation. This suggests that emergency departments may consider having some efficient physicians to speed up the overall service rate in return for more time for patients who need extra medical care.

  5. 38 CFR 17.242 - Coordination of programs with Department of Health and Human Services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... with Department of Health and Human Services. 17.242 Section 17.242 Pensions, Bonuses, and Veterans... § 17.242 Coordination of programs with Department of Health and Human Services. Programs for sharing... jurisdiction of the Department of Health and Human Services. Grants for Exchange of Information...

  6. 38 CFR 17.242 - Coordination of programs with Department of Health and Human Services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... with Department of Health and Human Services. 17.242 Section 17.242 Pensions, Bonuses, and Veterans... § 17.242 Coordination of programs with Department of Health and Human Services. Programs for sharing... jurisdiction of the Department of Health and Human Services. Grants for Exchange of Information...

  7. 38 CFR 17.242 - Coordination of programs with Department of Health and Human Services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... with Department of Health and Human Services. 17.242 Section 17.242 Pensions, Bonuses, and Veterans... § 17.242 Coordination of programs with Department of Health and Human Services. Programs for sharing... jurisdiction of the Department of Health and Human Services. Grants for Exchange of Information...

  8. 38 CFR 17.242 - Coordination of programs with Department of Health and Human Services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... with Department of Health and Human Services. 17.242 Section 17.242 Pensions, Bonuses, and Veterans... § 17.242 Coordination of programs with Department of Health and Human Services. Programs for sharing... jurisdiction of the Department of Health and Human Services. Grants for Exchange of Information...

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Noble, Vanessa; Parle, Julie

    2014-04-01

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

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

    PubMed

    Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee

    2011-12-01

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

  12. Patient Safety in Obstetrics and Gynecology Departments of two Teaching Hospitals in Delhi

    PubMed Central

    Gupta, Bindiya; Guleria, Kiran; Arora, Renu

    2016-01-01

    Background: A healthy safety culture is integral to positive health care. A sound safety climate is required in Obstetrics and Gynecology to prevent adverse outcomes. Objective: The objective of this study was to assess and compare patient safety culture in two departments of Obstetrics and Gynecology. Materials and Methods: Using a closed-ended standard version of Hospital Survey on Patient Safety Culture (HSOPS), respondents were asked to answer 42 survey items, grouped into 10 dimensions and two outcome variables in two tertiary care teaching hospitals in Delhi. Qualitative data were compared using Fisher's exact test and chi-square test wherever applicable. Mean values were calculated and compared using unpaired t-test. Results: The overall survey response rate was 55%. A positive response rate of 57% was seen in the overall perception of patient safety that ranged from very good to acceptable. Sixty-four percent showed positive teamwork across hospital departments and units, while 36% gave an affirmative opinion with respect to interdepartmental handoffs. However, few adverse events (0-10) were reported in the last 12 months and only 38% of mistakes by doctors were reported. Half of the respondents agreed that their mistakes were held against them. There was no statistical difference in the safety culture between the two hospitals. Conclusions: Although the perception of patient safety and standards of patient safety were high in both the hospitals' departments, there is plenty of scope for improvement with respect to event reporting, positive feedback, and nonpunitive error. PMID:27385879

  13. Acute pain management services: a comparison between Air Force and U.S. hospitals.

    PubMed

    Rayos, C L; McDonough, J P

    1999-12-01

    The purpose of this descriptive study was to assess the prevalence of acute pain management services (APMS) in Air Force medical facilities. There are no published reports on the current status of Air Force pain programs. This study used a telephone survey to all facilities worldwide that house an anesthesia department. Anesthesia providers in charge of pain services or department chiefs were interviewed from December 1996 to May 1997. Respondents were asked questions related to the initiation of a formal APMS, components, and familiarity with the Agency for Health Care Policy and Research guidelines on pain management. Data analysis described current practices and used chi 2 analysis to compare results with a national study of U.S. hospitals. Air Force anesthesia departments (45%) had established as many acute pain services as U.S. hospitals (42%). Formal pain programs are becoming more prevalent in Air Force hospitals. These findings suggest an increased awareness of the need for pain management and future establishment of pain programs.

  14. Design of computerized maintenance management system for the chilean naval hospital biomedical engineering department.

    PubMed

    Acevedo, Francisco; Fuentes, Jose; Enderle, John

    2005-01-01

    The purpose of this project was to design and implement a computerized maintenance management system (CMMS) to be used at the Chilean Naval Hospital Biomedical Engineering Department. It is designed to meet the specific needs of this military facility and follows the generic clinical engineering maintenance management system suggested by Association for the Advancement of Medical Instrumentation (AAMI).

  15. 76 FR 5559 - Public Availability of Department of Commerce FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-01

    ...; ] DEPARTMENT OF COMMERCE Public Availability of Department of Commerce FY 2010 Service Contract Inventory AGENCY: Department of Commerce. ACTION: Notice of Public Availability of FY 2010 Service Contract... 2010 (Pub. L. 111-117), Department of Commerce is publishing this notice to advise the public of...

  16. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  17. Acinetobacter sp. isolates from emergency departments in two hospitals of South Korea.

    PubMed

    Choi, Ji-Young; Ko, Eun Ah; Kwon, Ki Tae; Lee, Shinwon; Kang, Choel In; Chung, Doo-Ryeon; Peck, Kyong Ran; Song, Jae-Hoon; Ko, Kwan Soo

    2014-10-01

    A total of 114 Acinetobacter sp. isolates were collected from patients in the emergency departments (EDs) of two Korean hospitals. Most isolates belonged to the Acinetobacter baumannii complex (105 isolates, 92.1 %). Imipenem resistance was found in 39 isolates (34.2 %) of the Acinetobacter sp. isolates, and 6 colistin-resistant isolates were also identified. Species distribution and antimicrobial-resistance rates were different between the two hospitals. In addition, two main clones were identified in the imipenem-resistant A. baumannii isolates from hospital B, but very diverse and novel genotypes were found in those from hospital A. Many Acinetobacter sp. isolates, including the imipenem-resistant A. baumannii, are considered to be associated with the community. The evidence of high antimicrobial resistance and different features in these Acinetobacter sp. isolates between the two EDs suggests the need for continuous testing to monitor changes in epidemiology.

  18. Hospital Based Emergency Department Visits Attributed to Child Physical Abuse in United States: Predictors of In-Hospital Mortality

    PubMed Central

    Allareddy, Veerajalandhar; Asad, Rahimullah; Lee, Min Kyeong; Nalliah, Romesh P.; Rampa, Sankeerth; Speicher, David G.; Rotta, Alexandre T.; Allareddy, Veerasathpurush

    2014-01-01

    Objectives To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. Materials and Methods We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS), the largest all payer hospital based ED database, for the years 2008–2010. All ED visits and subsequent hospitalizations with a diagnosis of “Child physical abuse” (Battered baby or child syndrome) due to various injuries were identified using ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes. In addition, we also examined the prevalence of sexual abuse in this cohort. A multivariable logistic regression model was used to examine the association between mortality and types of injuries after adjusting for a multitude of patient and hospital level factors. Results Of the 16897 ED visits that were attributed to child physical abuse, 5182 (30.7%) required hospitalization. Hospitalized children were younger than those released treated and released from the ED (1.9 years vs. 6.4 years). Male or female partner of the child’s parent/guardian accounted for >45% of perpetrators. Common injuries in hospitalized children include- any fractures (63.5%), intracranial injuries (32.3%) and crushing/internal injuries (9.1%). Death occurred in 246 patients (13 in ED and 233 following hospitalization). Amongst the 16897 ED visits, 1.3% also had sexual abuse. Multivariable analyses revealed each 1 year increase in age was associated with a lower odds of mortality (OR = 0.88, 95% CI = 0.81–0.96, p<0.0001). Females (OR = 2.39, 1.07–5.34, p = 0.03), those with intracranial injuries (OR = 65.24, 27.57–154.41, p<0.0001), or crushing/internal injury (OR = 4.98, 2.24–11.07, p<0

  19. Patient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding

    PubMed Central

    Fan, Guanrong; Zou, Dongdong; Wang, Tong

    2017-01-01

    Background Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care. Objective To assess outpatient experience with different aspects of physician services at China’s public hospitals and its association with overcrowding of the hospital outpatient departments. Research design Retrospective analysis of a large survey of outpatient experience in Shanghai, China. We tested the hypotheses that patient experience was poorer with physician-patient communication, education, and shared decision-making and where and when there was greater overcrowding of the hospital outpatient departments. Ordered logistic models were estimated separately for general and specialty hospitals. Subjects 7,147 outpatients at 40 public hospitals in Shanghai, China, in 2014. Measures Patient experience with physician services were self-reported based on 12 questions as part of a validated instrument. Indicators of overcrowding included time of visit (morning vs. afternoon, Monday vs. rest of the week) and hospital outpatient volume in the first half of 2014. Results Overall, patients reported very favorable experience with physician services. Two out of the 12 questions pertaining to both communication and shared decision-making consistently received lower ratings. Hospitals whose outpatient volumes were in the top two quartiles received lower patient ratings, but the relationship achieved statistical significance among specialty hospitals only. Conclusions Inadequate physician-patient communication and shared decision-making and hospital overcrowding compromise outpatient experience with physician services at Chinese public hospitals. Effective diversion of patients with chronic and less complex conditions to community health centers will be critical to alleviate the extreme workloads at hospitals with high patient volumes and, in turn, improve patient experience. PMID:28207783

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

    PubMed

    Melton, Gary B

    2014-11-01

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

  1. Going beyond information management: using the Comprehensive Accreditation Manual for Hospitals to promote knowledge-based information services.

    PubMed

    Schardt, C M

    1998-10-01

    In 1987, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) initiated the Agenda for Change, a major revision in the evaluation process for hospitals. An essential component of that change was to shift the emphasis away from standards for individual departments to standards for hospital-wide functions. In recent years, hospital librarians have focused their energy and attention on complying with the standards for the "Management of Information" chapter, specifically the IM.9 section on knowledge-based information. However, the JCAHO has listed the health sciences librarian and library services as having responsibilities in six other chapters within the Comprehensive Accreditation Manual for Hospitals. These chapters can have a major impact on the services of the hospital library for two reasons: (1) they are being read by hospital leaders and other professionals in the organization, and (2) they articulate specific ways to apply knowledge-based information services to the major functions within the hospital. These chapters are "Education"; "Improving Organizational Performance"; "Leadership"; "Management of Human Resources"; "Management of the Environment of Care"; and "Surveillance, Prevention, and Control of Infection." The standards that these chapters promote present specific opportunities for hospital librarians to apply knowledge-based information resources and service to hospital-wide functions. This article reviews these chapters and discusses the standards that relate to knowledge-based information.

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

    PubMed

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

    2011-12-01

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

  3. State Regulation Of Freestanding Emergency Departments Varies Widely, Affecting Location, Growth, And Services Provided.

    PubMed

    Gutierrez, Catherine; Lindor, Rachel A; Baker, Olesya; Cutler, David; Schuur, Jeremiah D

    2016-10-01

    Freestanding emergency departments (EDs), which offer emergency medical care at sites separate from hospitals, are a rapidly growing alternative to traditional hospital-based EDs. We evaluated state regulations of freestanding EDs and describe their effect on the EDs' location, staffing, and services. As of December 2015, thirty-two states collectively had 400 freestanding EDs. Twenty-one states had regulations that allowed freestanding EDs, and twenty-nine states did not have regulations that applied specifically to such EDs (one state had hospital regulations that precluded them). State policies regarding freestanding EDs varied widely, with no standard requirements for location, staffing patterns, or clinical capabilities. States requiring freestanding EDs to have a certificate of need had fewer of such EDs per capita than states without such a requirement. For patients to better understand the capabilities and costs of freestanding EDs and to be able to choose the most appropriate site of emergency care, consistent state regulation of freestanding EDs is needed.

  4. Benchmarking as a tool for the improvement of health services' supply departments.

    PubMed

    Dacosta-Claro, Ivan; Lapierre, Sophie D

    2003-11-01

    This paper presents a benchmarking study carried out on the supply departments of Quebec's health services. The paper begins with the definition of a methodology to collect the information needed, both environmental (to enable institutions to be sorted into homogenous groups) and performance related. The analysis of indicators and the data envelopment analysis (DEA) models allowed classification of each hospital's performance and explained the operational approaches used, either at a general level or for each subprocess of the supply chain. It was observed that important economies of scale may be achieved with better co-ordination and with the regrouping of the supplying activities, both for purchasing management and central store management. The study showed that the best performance of central store services comes with flexible administrative structures, by receiving packages as small as possible and by using employees from the lowest range of the hierarchy. Purchasing services should employ highly qualified and well-paid staff. Although such services are relatively small with respect to their purchase volume, they show a higher activity rate. As a result of the discovered performing strategies, the possible economies range from 20% to 30% of the actual supply-chain management cost.

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

    PubMed

    Smith, S M; Clark, M

    1990-09-01

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

  6. 77 FR 5012 - Environmental Protection Agency, Department of Health and Human Services and Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... office of Animal and Plant Health Inspection Service/Biotechnology Regulatory Services (APHIS/BRS) and... private entities pursuant to its biotechnology regulations under 7 CFR part 340 only as described...

  7. Department of Agriculture, Animal and Plant Health Inspection Service

    MedlinePlus

    ... Blog Home Our Focus Animal Health Animal Welfare Biotechnology Business Services Civil Rights Emergency Response Imports & Exports ... Landing Page Popular Topics Animal Health Animal Welfare Biotechnology Emergency Response Imports & Exports International Services Plant Health ...

  8. "Hotel-style services" evolve in hospital setting.

    PubMed

    Schirg, G

    1995-10-01

    Glenn Schirg has been the director of nutrition services at Vanderbilt University Medical Center in Nashville, Tennessee for the past 11 years. Besides taking full responsibility for his department, he now acts as a team leader responsible for facilitating one of the medical center's 10 major initiatives.

  9. 42 CFR 412.20 - Hospital services subject to the prospective payment systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  10. Evaluation of Purchased Day Care: Texas Department of Human Services Day Care Service Control Pilot Study, 1985 through 1989.

    ERIC Educational Resources Information Center

    Monroe, Marian

    This pilot study of facilities from which the Texas Department of Human Services (TDHS) purchased day care services gathered and analyzed data for use in developing day care service control standards by means of which the quality of purchased day care services could be systematically assessed. Random samples were selected from contract centers,…

  11. 39 CFR 760.1 - Treasury Department regulations; applicability to Postal Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Treasury Department regulations; applicability to... OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS APPLICABILITY OF TREASURY DEPARTMENT REGULATIONS § 760.1 Treasury Department regulations; applicability to Postal Service. The provisions of Treasury...

  12. 76 FR 79221 - Penske Logistics, LLC, Customer Service Department General Motors and Tier Finished Goods...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... Employment and Training Administration Penske Logistics, LLC, Customer Service Department General Motors and... workers of Penske Logistics, LLC, Customer Service Department, a subsidiary of General Electric/Penske... correct name of the worker group department of the subject firm should read Penske Logistics,...

  13. 31 CFR 223.22 - Fees for services of the Treasury Department.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... running to the United States) of surety companies doing business with the United States (see § 223.12(a... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS WITH THE UNITED STATES § 223.22 Fees for services of the Treasury Department. (a) Fees shall...

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  15. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  16. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  17. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  18. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  19. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  20. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  2. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  3. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  4. Regionalization of Health Care Services within the Department of Defense

    DTIC Science & Technology

    1981-02-01

    systems that were linked by formal and informal sharing, coordination, and cooperation. Shared services , cross utilization of personnel, and other limited...wasappearing in the private sector. This effort was in the form of multihospital systems and shared services organizations. These arrangements were...these are considered to be of greatest Importance when looking at the 8 reasons for success of multihospital systems and shared services arrangements

  5. First Chinese public hospital wins Joint Commission International accreditation: the Health Information Department played a key role in the process.

    PubMed

    Shaffer, Audrey; Jun, Cheng Li

    2008-07-01

    Sir Run Run Shaw Hospital in Hangzhou, China spent five years preparing for a Joint Commission International accreditation survey. In March 2007 it became the first public hospital on the Chinese mainland to attain international accreditation. The Health Information Department, managed according to Western standards, played an integral role in preparing the hospital for the survey.

  6. Factors Affecting Quality of Emergency Service in Iran’s Military Hospitals: A Qualitative Study

    PubMed Central

    Zaboli, Rouhollah; Shokri, Mohamad; Javadi, Maryam Seyed; Teymourzadeh, Ehsan; Ameryoun, Ahmad

    2016-01-01

    Introduction Quality is a key factor for the success of any organization. Moreover, accessing quality in the emergency department is highly significant due to the sensitive and complex role of this department in hospitals as well as the healthcare and medical treatment system. This study aimed to identify, from the perspective of medical experts and nurses serving in the military health and medical treatment system, the factors that affect the quality of emergency service provided in selected military hospitals in Iran. Methods This qualitative research was performed in Valiaser Hospital of Tehran (Iran) in 2015, using the framework analysis method. The purposive sampling technique was used for data collection. A total of 14 participants included two emergency medicine specialists, four general physicians, two senior nurses (holding M.Sc. degrees), and six nurses (holding B.Sc. degree). Data were collected through semistructured interviews. Sampling continued until data saturation occurred. The Atlas/Ti software was employed for data analysis. Results Four basic themes emerged as the effective factors on the quality of emergency services, namely, structural themes, process/performance themes, outcome themes, and environmental/contextual themes. Moreover, through a framework analysis, 47 subthemes were specified and summarized as indicators of the different aspects of the main themes. Conclusion The factors affecting the quality of emergency services in Iran’s selected military hospitals are especially complicated due to the diversity of the missions involved; thus, different factors can influence this quality. Therefore, an effort should be made to tackle the existing obstacles, facilitate the identification of these effective factors, and promotion of the quality of healthcare services. PMID:27790355

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

    PubMed Central

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

    1998-01-01

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

  8. Military Base Closures and Affected Defense Department Civil Service Employees

    DTIC Science & Technology

    2006-03-07

    5 Voluntary Early Retirement Authority (VERA) . . . . . . . . . . . . . . . . . . . . . . 5 Voluntary Separation Incentive Payments (VSIPs...be eligible for transition assistance. Voluntary Early Retirement Authority (VERA) Employees who are at least 50 years of age with at least 20 years...of creditable service (or 25 years of service at any age) may be eligible for early retirement . These requirements apply to individuals covered by

  9. 75 FR 47631 - Swets Information Services, Operations Department, Information Technology Group, Marketing Group...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... Technology Group, Marketing Group, Finance Group, Runnemede, NJ; Amended Certification Regarding Eligibility... investigation combined the Operations Department, Information Technology (IT) Group, Marketing Group and the... Information Services, Operations Department, Information Technology Group, Marketing Group, and......

  10. Nations first federal combined solar power purchase launched by EPA, Forest Service, Energy Department and GSA

    EPA Pesticide Factsheets

    SAN FRANCISCO - The U.S. Environmental Protection Agency, U.S. Forest Service, Department of Energy and General Services Administration announced the first ever federal partnership to purchase solar power. This action follows President Obama's order

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

    PubMed

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

    1991-01-01

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

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

    PubMed

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

    2008-12-01

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

  13. Hospital Factors Impact Variation in Emergency Department Length of Stay more than Physician Factors

    PubMed Central

    Krall, Scott P.; Cornelius, Angela P.; Addison, J. Bruce

    2014-01-01

    Introduction To analyze the correlation between the many different emergency department (ED) treatment metric intervals and determine if the metrics directly impacted by the physician correlate to the “door to room” interval in an ED (interval determined by ED bed availability). Our null hypothesis was that the cause of the variation in delay to receiving a room was multifactorial and does not correlate to any one metric interval. Methods We collected daily interval averages from the ED information system, Meditech©. Patient flow metrics were collected on a 24-hour basis. We analyzed the relationship between the time intervals that make up an ED visit and the “arrival to room” interval using simple correlation (Pearson Correlation coefficients). Summary statistics of industry standard metrics were also done by dividing the intervals into 2 groups, based on the average ED length of stay (LOS) from the National Hospital Ambulatory Medical Care Survey: 2008 Emergency Department Summary. Results Simple correlation analysis showed that the doctor-to-discharge time interval had no correlation to the interval of “door to room (waiting room time)”, correlation coefficient (CC) (CC=0.000, p=0.96). “Room to doctor” had a low correlation to “door to room” CC=0.143, while “decision to admitted patients departing the ED time” had a moderate correlation of 0.29 (p <0.001). “New arrivals” (daily patient census) had a strong correlation to longer “door to room” times, 0.657, p<0.001. The “door to discharge” times had a very strong correlation CC=0.804 (p<0.001), to the extended “door to room” time. Conclusion Physician-dependent intervals had minimal correlation to the variation in arrival to room time. The “door to room” interval was a significant component to the variation in “door to discharge” i.e. LOS. The hospital-influenced “admit decision to hospital bed” i.e. hospital inpatient capacity, interval had a correlation to

  14. Predictive factors for hospitalization of nonurgent patients in the emergency department

    PubMed Central

    Ng, Chip-Jin; Liao, Pei-Ju; Chang, Yu-Che; Kuan, Jen-Tze; Chen, Jih-Chang; Hsu, Kuang-Hung

    2016-01-01

    Abstract Nonurgent emergency department (ED) patients are a controversial issue in the era of ED overcrowding. However, a substantial number of post-ED hospitalizations were found, which prompted for investigation and strategy management. The objective of this study is to identify risk factors for predicting the subsequent hospitalization of nonurgent emergency patients. This was a retrospective study of a database of adult nontrauma ED visits in a medical center for a period of 12 months from January 2013 to December 2013. Patient triages as either Taiwan Triage and Acuity Scale (TTAS) level 4 or 5 were considered “nonurgent.” Basic demographic data, primary and secondary diagnoses, clinical parameters including blood pressure, heart rate, body temperature, and chief complaint category in TTAS were analyzed to determine if correlation exists between potential predictors and hospitalization in nonurgent patients. A total of 16,499 nonurgent patients were included for study. The overall hospitalization rate was 12.47 % (2058/16,499). In the multiple logistic regression model, patients with characteristics of males (odds ratio, OR = 1.37), age more than 65 years old (OR = 1.56), arrival by ambulance (OR = 2.40), heart rate more than 100/min (OR = 1.47), fever (OR = 2.73), and presented with skin swelling/redness (OR = 4.64) were predictors for hospitalization. The area under receiver-operator calibration curve (AUROC) for the prediction model was 0.70. Nonurgent patients might still be admitted for further care especially in male, the elderly, with more secondary diagnoses, abnormal vital signs, and presented with dermatologic complaints. Using the TTAS acuity level to identify patients for diversion away from the ED is unsafe and will lead to inappropriate refusal of care for many patients requiring hospital treatment. PMID:27368040

  15. Functional status of bio-medical engg. departments in tertiary care hospitals--a comparative study.

    PubMed

    Kumar, G V; Satyanarayana, P

    1993-01-01

    The Bio-medical Engineering departments of two major hospitals having high-tech equipment needed for routine day to day patient care were compared with respect to their staffing pattern, proficiency, frequency of failure of major and minor equipment and predictable/non-predictable 'Down time' of the selected equipment using non-parametric statistical test. The study shows that Bio-medical Engineering Department (BME) of our Institute though not full fledged as compared to Hospital 'B' however showed better results in bringing down the down time both in major, minor equipment. The major cause of failure of equipment in both the hospitals was found to be rough handling, the need for imparting training to physicians, nurses, paramedical personnel dealing with bio-medical equipment and its role in preventive maintenance is discussed. Based on the study recommendations were made for preventive maintenance, purchase policy and linked to the policy of administration. Recommendations were made to bring down the Down time to acceptable limit though not for complete elimination.

  16. Housing code violation density associated with emergency department and hospital use by children with asthma.

    PubMed

    Beck, Andrew F; Huang, Bin; Chundur, Raj; Kahn, Robert S

    2014-11-01

    Local agencies that enforce housing policies can partner with the health care system to target pediatric asthma care. These agencies retain data that can be used to pinpoint potential clusters of high asthma morbidity. We sought to assess whether the density of housing code violations in census tracts-the in-tract asthma-relevant violations (such as the presence of mold or cockroaches) divided by the number of housing units-was associated with population-level asthma morbidity and could be used to predict a hospitalized patient's risk of subsequent morbidity. We found that increased density in housing code violations was associated with population-level morbidity independent of poverty, and that the density explained 22 percent of the variation in rates of asthma-related emergency department visits and hospitalizations. Children who had been hospitalized for asthma had 1.84 greater odds of a revisit to the emergency department or a rehospitalization within twelve months if they lived in the highest quartile of housing code violation tracts, compared to those living in the lowest quartile. Integrating housing and health data could highlight at-risk areas and patients for targeted interventions.

  17. Housing Code Violation Density Associated With Emergency Department And Hospital Use By Children With Asthma

    PubMed Central

    Beck, Andrew F.; Huang, Bin; Chundur, Raj; Kahn, Robert S.

    2015-01-01

    Local agencies that enforce housing policies can partner with the health care system to target pediatric asthma care. These agencies retain data that can be used to pinpoint potential clusters of high asthma morbidity. We sought to assess whether the density of housing code violations in census tracts—the in-tract asthma-relevant violations (such as the presence of mold or cockroaches) divided by the number of housing units—was associated with population-level asthma morbidity and could be used to predict a hospitalized patient’s risk of subsequent morbidity. We found that increased density in housing code violations was associated with population-level morbidity independent of poverty, and that the density explained 22 percent of the variation in rates of asthma-related emergency department visits and hospitalizations. Children who had been hospitalized for asthma had 1.84 greater odds of a revisit to the emergency department or a rehospitalization within twelve months if they lived in the highest quartile of housing code violation tracts, compared to those living in the lowest quartile. Integrating housing and health data could highlight at-risk areas and patients for targeted interventions. PMID:25367995

  18. Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study

    PubMed Central

    Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

    2016-01-01

    Background: Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. Objectives: The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. Materials and Methods: This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. Results: “Management and empowerment of human resources’’ (weight = 0.465) and “requirements and facilities” (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. Conclusion: The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative

  19. Temporal dynamics of emergency department and hospital admissions of pediatric asthmatics

    NASA Technical Reports Server (NTRS)

    Kimes, Daniel; Levine, Elissa; Timmins, Sidey; Weiss, Sheila R.; Bollinger, Mary E.; Blaisdell, Carol

    2004-01-01

    Asthma is a chronic disease that can result in exacerbations leading to urgent care in emergency departments (EDs) and hospitals. We examined seasonal and temporal trends in pediatric asthma ED (1997-1999) and hospital (1986-1999) admission data so as to identify periods of increased risk of urgent care by age group, gender, and race. All pediatric ED and hospital admission data for Maryland residents occurring within the state of Maryland were evaluated. Distinct peaks in pediatric ED and hospital asthma admissions occurred each year during the winter-spring and autumn seasons. Although the number and timing of these peaks were consistent across age and racial groups, the magnitude of the peaks differed by age and race. The same number, timing, and relative magnitude of the major peaks in asthma admissions occurred statewide, implying that the variables affecting these seasonal patterns of acute asthma exacerbations occur statewide. Similar gross seasonal trends are observed worldwide. Although several environmental, infectious, and psychosocial factors have been linked with increases in asthma exacerbations among children, thus far they have not explained these seasonal patterns of admissions. The striking temporal patterns of pediatric asthma admissions within Maryland, as described here, provide valuable information in the search for causes.

  20. Decreasing avoidable hospital admissions with the implementation of an emergency department case management program.

    PubMed

    Sharieff, Ghazala Q; Cantonis, Matt; Tressler, Michelle; Whitehead, Mary; Russe, Jamie; Lovell, Eric

    2014-01-01

    With the passage of the Affordable Care Act, increased emphasis has been placed on optimizing quality and reducing expenditures. The use of an emergency department case manager (EDCM) is reemerging as an important initiative in the quest to provide high-quality care and decrease unnecessary hospital admissions. A pilot study of the use of EDCMs was conducted in one of the authors' EDs during a 6-month trial period. By using evidence-based criteria, the EDCM helped in real time to verify admission criteria, assisted with inpatient versus outpatient designation, found community alternatives to hospital admission, and initiated discharge planning for patients who required admission and were at high risk for readmission. EDCMs also worked with pharmacists to assist with medication management for patients who required assistance with obtaining prescriptions. Because of the pilot study's success, the authors' health care system will be implementing EDCMs throughout the organization.

  1. Delivery and collection of radioactive packages to and from UK hospital nuclear medicine departments.

    PubMed

    Lawson, Richard S; Davies, Glyn; Hesslewood, Stuart R; Hinton, Paul J; Maxwell, Alan

    2004-12-01

    Under radiation protection legislation in the UK, employers have a duty to maintain appropriate records to account for radioactive materials in their possession and to ensure security of these materials. This applies to radioactive packages, containing items such as technetium generators, which are regularly delivered to hospital nuclear medicine departments. It also applies to the collection of packages, such as those containing used generators for return to the supplier. This article has been written by the professional bodies representing nuclear medicine in the UK in order to provide guidance to hospitals on appropriate procedures that will comply with the legislation. General principles, which should be met by any acceptable protocol, are stated, and practical guidance on how these may be implemented is given. Some example scenarios are outlined.

  2. The use of urological hospital services by nonagenarians

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2008-08-01

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

  4. Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

    SciTech Connect

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-03-15

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of Euro 1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

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

    PubMed

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

    1997-04-01

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

  6. [Alcohol-related injuries--an emergency department study in the Lausanne University Hospital].

    PubMed

    Gmel, Gerhard; Kuendig, Hervé; Gaume, Jacques; Daeppen, Jean-Bernard

    2007-09-05

    Alcohol-related injuries are responsible for a large share of the global mortality and morbidity burden. Scant information existed, however, for Switzerland. Based on 3653 injured patients and 3519 patients attending the emergency department of the Lausanne University Hospital for other reasons, alcohol attributable fractions with regard to the alcohol consumption in the 6 hours before the injury were estimated. Among men 17% of all injures were alcohol attributable, and 12% among women. Relative risks increased in dose-response relationship with alcohol intake. Leisure time related injuries were most likely to be alcohol attributable. Most of the alcohol-related injuries occurred at already small ethanol quantities ingested.

  7. An exploratory analysis of suspected drug-facilitated sexual assault seen in a hospital emergency department.

    PubMed

    McGregor, Margaret J; Lipowska, Magdalena; Shah, Seema; Du Mont, Janice; De Siato, Christine

    2003-01-01

    This retrospective review of sexual assault cases seen in an emergency department from 1993 to 1999 examined rates and characteristics of suspected drug-facilitated sexual assault (DFSA). Overall, 12% of cases were identified as suspected DFSAs. The rate of suspected DFSA in 1999 was more than double that in the preceding six years. As well, compared to other sexual assaults, suspected DFSA cases had a longer time delay in presenting to the hospital, were less likely to involve the police, and had a lower occurrence of both genital and extra-genital injury. The clinical implications of these findings, particularly in terms of toxicology evidence collection, are discussed.

  8. 78 FR 70584 - ATOS IT Solutions & Services, Inc., Billing and Collections Department, Including Workers Whose...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... Doc No: 2013-28332] DEPARTMENT OF LABOR Employment and Training Administration [TA-W-82,999] ATOS IT... Insurance (UI) Wages are Reported Through Siemens IT Solutions and Services, Mason, Ohio; Amended... workers of ATOS IT Solutions & Services, Inc., Billing and Collections Department, Mason, Ohio....

  9. 76 FR 5364 - Public Availability of Department of Energy FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... the inventory at the following link: http://www.management.energy.gov/policy_guidance/competitive... Availability of Department of Energy FY 2010 Service Contract Inventory AGENCY: Department of Energy. ACTION: Notice of public availability of FY 2010 Service Contract Inventories. SUMMARY: In accordance...

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

    PubMed Central

    Horwitz, Jill R; Nichols, Austin

    2011-01-01

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

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

    PubMed

    Parkum, K H

    1985-09-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  15. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  16. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  17. Characteristics of patients who return to the emergency department within 72 hours in one community hospital.

    PubMed

    White, Debra; Kaplan, Louise; Eddy, Linda

    2011-01-01

    This study identifies characteristics of patients who return to the emergency department (ED) within 72 hr after an initial visit. An exploratory quantitative descriptive study was conducted to identify characteristics of patients with unscheduled 72 hr ED returns. The sample consisted of all patients with 72 hr ED return visits for the month of January 2009 at the study facility. Data were collected from electronic patient records utilizing the National Hospital Ambulatory Medical Care Survey instrument modified to eliminate patient identifiers. There were 169 individuals who had at least one 72 hr return visit to the ED for a total of 393 initial and return ED visits. The most common diagnoses were for gastrointestinal complaints. Over a third of the patients who returned had chronic health conditions. There were more emergency department return visits in individuals who lacked access to primary care.

  18. Defense Department Advisory Committee on Women in the Services (DACOWITS)

    DTIC Science & Technology

    2004-12-09

    who were aware of sexual assault occurring in the military, probably due to the smaller amount of time these personnel have spent on Active or...differences in rates found across the Service branches. Rates of sexual assault against female Active duty personnel varied by pay grade, with junior... Active duty.63 DoD Central Registry uses common report forms (DD 2486) to report incidents of sexual assault. However, reporting practices lack

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

    ERIC Educational Resources Information Center

    Colenda, Christopher C.; And Others

    1988-01-01

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

  20. An Ambient Intelligence Framework for End-User Service Provisioning in a Hospital Pharmacy: a Case Study.

    PubMed

    Martín, Diego; Alcarria, Ramón; Sánchez-Picot, Álvaro; Robles, Tomás

    2015-10-01

    End-user development is a new trend to provide tailored services to dynamic environments such as hospitals. These services not only facilitate daily work for pharmacy personnel but also improve self-care in elder people that are still related to hospital, such as discharged patients. This paper presents an ambient intelligence (AmI) environment for End-user service provisioning in the pharmacy department of Gregorio Marañón Hospital in Madrid, composed of a drug traceability infrastructure (DP-TraIN) and a ubiquitous application for enabling the pharmacy staff to create and execute their own services for facilitating drug management and dispensing. The authors carried out a case study with various experiments where different roles from the pharmacy department of Gregorio Marañón Hospital were involved in activities such as drug identification, dispensing and medication administering. The authors analyzed the effort required to create services by pharmacy staff, the discharged patients' perception of the AmI environment and the quantifiable benefits in reducing patient waiting time for drug dispensing.

  1. 38 CFR 1.514 - Disclosure to private physicians and hospitals other than Department of Veterans Affairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., or treatment as is requested, including the loan of original X-ray films, whether Department of Veterans Affairs clinical X-rays or service department entrance and separation X-rays, provided there...

  2. 38 CFR 1.514 - Disclosure to private physicians and hospitals other than Department of Veterans Affairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., or treatment as is requested, including the loan of original X-ray films, whether Department of Veterans Affairs clinical X-rays or service department entrance and separation X-rays, provided there...

  3. 38 CFR 1.514 - Disclosure to private physicians and hospitals other than Department of Veterans Affairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., or treatment as is requested, including the loan of original X-ray films, whether Department of Veterans Affairs clinical X-rays or service department entrance and separation X-rays, provided there...

  4. 38 CFR 1.514 - Disclosure to private physicians and hospitals other than Department of Veterans Affairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., or treatment as is requested, including the loan of original X-ray films, whether Department of Veterans Affairs clinical X-rays or service department entrance and separation X-rays, provided there...

  5. 38 CFR 1.514 - Disclosure to private physicians and hospitals other than Department of Veterans Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., or treatment as is requested, including the loan of original X-ray films, whether Department of Veterans Affairs clinical X-rays or service department entrance and separation X-rays, provided there...

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

    NASA Technical Reports Server (NTRS)

    Potter, J. G.

    1979-01-01

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

  7. A retrospective review of maternal and child health services at the Albert Schweitzer Hospital in rural Haiti.

    PubMed

    Wallace, C E; Marshall, F N; Robinson, C

    1982-01-01

    For the past 25 years the Albert Schweitzer Hospital in Deschapelles, Haiti has been providing a wide range of maternal and child health services to the people of its rural district. Numerous special services for mothers and children have been added over the years, but these began to realize considerably greater potential with the creation of the hospital's Community Health Department in 1967. This department has carried out numerous preventive health programs and services designed to accommodate these groups' special health needs. Attention is directed to neonatal tetanus control; surveillance, treatment, and prevention of malnutrition; and other maternal and child health services (school programs, immunization activities, prenatal and postnatal care, family planning, the midwives' program, the "cord-cut" unit, the low birth weight project, and dispensaries and health agents). In 1967 the hospital began to develop programs especially designed to control neonatal tetanus. Communities were immunized systematically. By establishing outdoor immunization clinics at the hospital and at major marketplaces in the district and by working with traditional midwives, these programs were responsible for a sharp decline in the incidence of neonatal tetanus. Malnutrition has remained the most frequently occurring health problem among children in the hospital district. Several services and programs have been established throughout the years to meet the identified needs. These include the following which are described: the nutrition clinic; courtyard education; "weigh-ins;" nutrition recovery centers; the 3-day center at Deschapelles; nutrition intervention and case follow-up program; and malnutrition treatment. The hospital's family planning program has gradually increased its use of community education to reach the population and to try to gain acceptance of the need to space and limit births. This community education has been disseminated by dispensaries, mobile health team

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

    PubMed

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

    2010-09-01

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

  9. 77 FR 12798 - Public Availability of Department of Commerce FY2011 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Office of the Secretary Public Availability of Department of Commerce FY2011 Service Contract Inventory AGENCY: Office of the Secretary, Department of Commerce. ACTION: Notice of Public Availability of FY...

  10. 78 FR 17349 - Public Availability of Department of Commerce FY2012 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Office of the Secretary Public Availability of Department of Commerce FY2012 Service Contract Inventory AGENCY: Office of the Secretary, Department of Commerce. ACTION: Notice of public availability of FY...

  11. 76 FR 5778 - Public Availability of the Department of Agriculture FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Public Availability of the Department of Agriculture FY 2010 Service Contract Inventory AGENCY: Office of... 2010 (Pub. L. 111-117), Department of Agriculture is publishing this notice to advise the public of...

  12. The effects of noise on the cognitive performance of physicians in a hospital emergency department

    NASA Astrophysics Data System (ADS)

    Dodds, Peter

    In this research, the acoustic environment of a contemporary urban hospital emergency department has been characterized. Perceptive and cognitive tests relating to the acoustic environment were conducted on both medical professionals and lay people and a methodology for developing augmentable acoustic simulations from field recordings was developed. While research of healthcare environments remains a popular area of investigation for the acoustics community, a lack of communication between medical and acoustics researchers as well as a lack of sophistication in the methods implemented to evaluate hospital environments and their occupants has led to stagnation. This research attempted to replicate traditional methods for the evaluation of hospital acoustic environments including impulse response based room acoustics measurements as well as psychoacoustic evaluations. This thesis also demonstrates some of the issues associated with conducting such research and provides an outline and implementation for alternative advanced methods of re- search. Advancements include the use of the n-Back test to evaluate the effects of the acoustic environment on cognitive function as well as the outline of a new methodology for implementing realistic immersive simulations for cognitive and perceptual testing using field recordings and signal processing techniques. Additionally, this research utilizes feedback from working emergency medicine physicians to determine the subjective degree of distraction subjects felt in response to a simulated acoustic environment. Results of the room acoustics measurements and all experiments will be presented and analyzed and possible directions for future research will be presented.

  13. Proposed ICD-10-CM Surveillance Case Definitions for Injury Hospitalizations and Emergency Department Visits.

    PubMed

    Hedegaard, Holly B; Johnson, Renee L; Ballesteros, Michael F

    2017-01-01

    This report describes a collaboration between the National Center for Health Statistics and the National Center for Injury Prevention and Control to develop proposed surveillance case definitions for injury hospitalizations and emergency department (ED) visits for use with administrative data sets coded using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). The proposed ICD-10-CM surveillance case definitions were developed by applying General Equivalence Mappings to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) definitions. As with the ICD-9-CM definitions, there are slight differences between the proposed ICD-10-CM surveillance case definition for injury hospitalizations and the one for ED visits. The inclusion criteria for an injury hospitalization requires a case to have a principal diagnosis of one of the included nature-of-injury (injury diagnosis) codes. The inclusion criteria for an injury ED visit requires the case to have either a principal diagnosis of one of the included nature-of-injury codes or the presence of selected external-cause codes. The ICD-10-CM nature-of-injury and external-cause codes included in the proposed definitions are presented and caveats for use of the proposed definitions are described.

  14. Glass injuries seen in the emergency department of a South African district hospital

    PubMed Central

    Nzaumvila, Doudou; Kramer, Efraim B.

    2015-01-01

    Background The emergency department of Embhuleni Hospital frequently manages patients with glass-related injuries. This study assessed these injuries and the glass that caused them in more detail. Aim The objectives of our study included determining the type of glass causing these injuries and describing the circumstances associated with different types of glass injuries. Setting The emergency department of Embhuleni Hospital in Elukwatini, Mpumalanga province, South Africa. Methods This was a cross-sectional study with a sample size of 104 patients. Descriptive statistics were used to assess the characteristics of the glass injuries. Results Five different types of glass were reported to have caused the injuries, namely car glass (7.69%), glass ampoules (3.85%), glass bottles (82.69%), glass windows (3.85%) and street glass shards (1.92%). Glass bottle injuries were mainly caused by assaults (90.47%) and most victims were mostly young males (80.23%). The assaults occurred at alcohol-licensed premises in 65.11% of cases. These injuries occurred mostly over weekends (83.72%), between 18:00 and 04:00. The face (34.23%) and the scalp (26.84%) were the sites that were injured most often. Conclusion Assault is the most common cause of glass injuries, usually involving young men at alcohol-licensed premises. Glass injuries generally resulted in minor lacerations, with few complications (2.68%). PMID:28235334

  15. 39 CFR 602.2 - Office of Licensing, Philatelic and Retail Services Department.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... THE U.S. POSTAL SERVICE: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS INTELLECTUAL PROPERTY RIGHTS... Department, formulates the program for the management of the Postal Service's rights in intellectual property... intellectual properties in which the Postal Service should secure its rights. It receives and...

  16. 75 FR 67696 - Meeting of the Defense Department Advisory Committee on Women in the Services (DACOWITS)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... --Service briefs on DACOWITS 2009 Report --Briefings from DoD Task Force on Sexual Assault in the Military... of the Secretary Meeting of the Defense Department Advisory Committee on Women in the Services... Committee on Women in the Services (DACOWITS). The purpose of the meeting is for the Committee to...

  17. 31 CFR 223.22 - Fees for services of the Treasury Department.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... running to the United States) of surety companies doing business with the United States (see § 223.12(a... fee will be collected from every company requesting a particular category of service, e.g... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES...

  18. [A guide to successful public relations for hospitals and emergency medical services].

    PubMed

    Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V

    2014-04-01

    Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you

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

    PubMed Central

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

    1974-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  1. Etiology of Illness in Patients with Severe Sepsis Admitted to the Hospital from the Emergency Department

    PubMed Central

    Heffner, Alan C.; Horton, James M.; Marchick, Michael R.; Jones, Alan E.

    2010-01-01

    Background Patients identified with sepsis in the emergency department often are treated on the basis of the presumption of infection; however, various noninfectious conditions that require specific treatments have clinical presentations very similar to that of sepsis. Our aim was to describe the etiology of illness in patients identified and treated for severe sepsis in the emergency department. Methods We conducted a prospective observational study of patients treated with goal-directed resuscitation for severe sepsis in the emergency department. Inclusion criteria were suspected infection, 2 or more criteria for systemic inflammation, and evidence of hypoperfusion. Exclusion criteria were age of <18 years and the need for immediate surgery. Clinical data on eligible patients were prospectively collected for 2 years. Blinded observers used a priori definitions to determine the final cause of hospitalization. Results In total, 211 patients were enrolled; 95 (45%) had positive culture results, and 116 (55%) had negative culture results. The overall mortality rate was 19%. Patients with positive culture results were more likely to have indwelling vascular lines (P = .03) be residents of nursing homes (P = .04), and have a shorter time to administration of antibiotics in the emergency department (83 vs 97 min; P = .03). Of patients with negative culture results, 44% had clinical infections, 8% had atypical infections, 32% had noninfectious mimics, and 16% had an illness of indeterminate etiology. Conclusion In this study, we found that >50% of patients identified and treated for severe sepsis in the emergency department had negative culture results. Of patients identified with a sepsis syndrome at presentation, 18% had a noninfectious diagnosis that mimicked sepsis, and the clinical characteristics of these patients were similar to those of patients with culture-positive sepsis. PMID:20144044

  2. 42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  3. Assessing causes of death in the Cardiology Department of Yalgado Ouédraogo University Hospital

    PubMed Central

    Yameogo, Aristide Relwende; Mandi, Germain; Millogo, Georges; Samadoulougou, Andre; Zabsonre, Patrice

    2014-01-01

    Introduction Analysis of the underlying causes of death can develop action plans for prevention of death that could be avoided. The aim of our study was to analyse the causes of cardiovascular deaths in the cardiology department of Yalgado Ouedraogo University Hospital. Methods The study was a descriptive retrospective study over a 24 month period among patients who died in the department. Results Prevalence of death in the cardiology department was of 13.2%. Sex ratio was of 1.2 and 72.7% of patients were residing in Ouagadougou. Mean age of patients was 56.1 years and 59.4% of patients were under 65 years old. Hypertension was the major cardiovascular risk factor (46.1%) and 27.4% of patients had a medical history of dilated cardiomyopathy. Cardiogenic shock was the immediate cause of death in 55.5% of cases and the initial cause of death was hypertension and its complications in 46.1% of cases. Death was not notified in 18% of cases and no death had been medically certified. Conclusion Death statistics are the most reliable data for public health interventions. However, it is necessary to establish an effective method of data gathering according to the WHO standards in order to facilitate international comparison. PMID:25767673

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

    PubMed Central

    Blustein, J; Weitzman, B C

    1995-01-01

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

  5. Predictive score for mortality in patients with COPD exacerbations attending hospital emergency departments

    PubMed Central

    2014-01-01

    Background Limited information is available about predictors of short-term outcomes in patients with exacerbation of chronic obstructive pulmonary disease (eCOPD) attending an emergency department (ED). Such information could help stratify these patients and guide medical decision-making. The aim of this study was to develop a clinical prediction rule for short-term mortality during hospital admission or within a week after the index ED visit. Methods This was a prospective cohort study of patients with eCOPD attending the EDs of 16 participating hospitals. Recruitment started in June 2008 and ended in September 2010. Information on possible predictor variables was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up. Main short-term outcomes were death during hospital admission or within 1 week of discharge to home from the ED, as well as at death within 1 month of the index ED visit. Multivariate logistic regression models were developed in a derivation sample and validated in a validation sample. The score was compared with other published prediction rules for patients with stable COPD. Results In total, 2,487 patients were included in the study. Predictors of death during hospital admission, or within 1 week of discharge to home from the ED were patient age, baseline dyspnea, previous need for long-term home oxygen therapy or non-invasive mechanical ventilation, altered mental status, and use of inspiratory accessory muscles or paradoxical breathing upon ED arrival (area under the curve (AUC) = 0.85). Addition of arterial blood gas parameters (oxygen and carbon dioxide partial pressures (PO2 and PCO2)) and pH) did not improve the model. The same variables were predictors of death at 1 month (AUC = 0.85). Compared with other commonly used tools for predicting the severity of COPD in stable patients, our rule was significantly better

  6. 78 FR 38343 - Notice of a Department of Health and Human Services Public Meeting and Request for Comments on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... HUMAN SERVICES Notice of a Department of Health and Human Services Public Meeting and Request for... Interventions AGENCY: Office of the Secretary, Department of Health and Human Services. ACTION: Notice of meeting and request for comments. SUMMARY: The Department of Health and Human Services (HHS) is...

  7. Temporal and spatial organization of doctors' computer usage in a UK hospital department.

    PubMed

    Martins, H M G; Nightingale, P; Jones, M R

    2005-06-01

    This paper describes the use of an application accessible via distributed desktop computing and wireless mobile devices in a specialist department of a UK acute hospital. Data (application logs, in-depth interviews, and ethnographic observation) were simultaneously collected to study doctors' work via this application, when and where they accessed different areas of it, and from what computing devices. These show that the application is widely used, but in significantly different ways over time and space. For example, physicians and surgeons differ in how they use the application and in their choice of mobile or desktop computing. Consultants and junior doctors in the same teams also seem to access different sources of patient information, at different times, and from different locations. Mobile technology was used almost exclusively during the morning by groups of clinicians, predominantly for ward rounds.

  8. 76 FR 15349 - Fiscal Year 2011 Cost of Hospital and Medical Care Treatment Furnished by the Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-21

    ... BUDGET Fiscal Year 2011 Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Medical Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable Third... furnished by military treatment facilities through the Department of Defense (DoD). The rates have...

  9. Medication-related emergency department visits and hospitalizations among older adults

    PubMed Central

    Bayoumi, Imaan; Dolovich, Lisa; Hutchison, Brian; Holbrook, Anne

    2014-01-01

    Abstract Objective To identify medications that have a high risk of adverse drug effects (ADEs) among seniors, using data from publicly available administrative databases. Design Cross-sectional study using the Discharge Abstracts Database (DAD) (which contains data on acute care institutions in all provinces and territories except Quebec), the National Ambulatory Care Reporting System (NACRS) (which contains data on emergency department [ED] visits in Ontario), and the IMS Brogan database Canadian CompuScript. Setting Canada. Participants Adults 65 years of age and older with diagnostic codes for drugs, medicaments, and biologic substances causing adverse effects in therapeutic use. Main outcome measures Adverse drug events from 2006 to 2008 associated with hospitalizations and ED visits among adults 65 years of age and older were identified by the DAD and the NACRS. The medications most frequently prescribed by primary care providers in 2008 were identified using data from Canadian CompuScript. Results From 2006 to 2008, the DAD identified 92 141 ADEs among older adults, and the NACRS identified 23 845 ADEs among older adults in Ontario EDs, which represented 2.9% of inpatients and 0.8% of ED patients (21.5% of whom were admitted to hospital). Drugs implicated in the DAD ADEs included anticoagulants (15.4%), antineoplastic agents (10.6%), opioids (9.2%), and nonsteroidal anti-inflammatory drugs (6.5%); drugs included in the ADEs of ED visits were anti-infective agents (15.9%), anticoagulants (14.2%), antineoplastic agents (9.6%), and opioids (7.3%). Conclusion Among older adults, the drug classes most often associated with causing harm in the hospital setting and occurring out of proportion to the frequency prescribed were anticoagulants, opioids, antibiotics, and cardiovascular drugs. Thus, these drug classes should be the focus of quality improvement efforts in primary care. PMID:24733341

  10. Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

    PubMed Central

    Hokkam, Emad; Gonna, Abdelaziz; Zakaria, Ossama; El-shemally, Amany

    2015-01-01

    BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital (JGH) in the southwest corner of Saudi Arabia. METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies. RESULTS: The mean age of the patients was 25.3±16.8 years. Most (45.1%) of the patients were at age of 18–30 years. Males (64.3%) were affected by trauma more common than females. More than half (60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury (60%), followed by blunt trauma (30.9%) and then penetrating trauma (9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority (48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%. CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority. PMID:25802567

  11. Psychiatric Disorders in Children and Adolescents Attending Pediatric Out Patient Departments of Tertiary Hospitals

    PubMed Central

    Jesmin, Akhter; Rahman, Khan Muhammad Zillur; Muntasir, Maruf Mohammad

    2016-01-01

    Objectives Psychiatric disorders are increasingly recognized among children and adolescents in Bangladesh. Psychiatric disorders are more common in children with chronic and acute pediatric disorders. Our study was designed to determine the psychiatric disorders among children and adolescents attending pediatric outpatient departments of tertiary care hospitals. Methods This cross-sectional study was carried out from July 2012 to February 2013 in pediatric outpatient departments of three prime tertiary level hospitals of Dhaka, Bangladesh. A purposive sampling technique was used. A total of 240 male and female children aged 5 to 16 years old were included in the study. We used a semi-structured questionnaire to obtain sociodemographic and other relevant clinical information about the children and their families from their parents or caregivers and a validated parent version of the Bangla Development and Well-Being Assessment (DAWBA) for measuring psychopathology. Results The mean age of the children was 9.0± 2.6 years. The majority (71%) of children were in the 5–10 year age group. The male/female ratio was 1.2:1. Among the respondents, 18% were found to have a psychiatric disorder. Behavioral disorders, emotional disorders, and developmental disorders were found in 9.0%, 15.0% and 0.4% respectively. Hyperkinetic disorder was the single most frequent (5.0%) psychiatric disorder. Conclusions A significant number of children were found to have psychiatric disorders. Our study indicates the importance of identification and subsequent management of psychiatric conditions among the pediatric population. PMID:27403237

  12. [Histrionic personality disorder in a psychiatry department at a general hospital].

    PubMed

    Abril, A; Valle, J; Moreno, D; de Miguel, D; Molina, D

    1991-01-01

    The personality disturbances imply problem within the psychiatric assistance, both for its difficult delimitation and classification and for the limited results and bad use obtained from therapeutic resources. We studied 402 patients psychiatric service of a general hospital over a period approximately 2 years, 70 (17.5%) were diagnosed DSM-III with Personality disturbances: 44 females (62.9%) and 26 males (37.1%), of an age group between 18 and 67 years old. The most frequent diagnosis was of histrionic of the personality followed by unspecific and border-line. Within the histrionic disturbance of the personality there was a clear predominance of women, whereas in the others types, no significant differences were observed.

  13. [Estimating the grade of patient satisfaction at the bone marrow transplantation department in Florence hospitals].

    PubMed

    Marsullo, M; Tozzi, S; Biagini, S; Rinaldi, L

    2000-01-01

    The satisfaction of the patients admitted to the bone marrow transplant unit of Careggi Hospital was evaluated by the nursing team. The aim of the evaluation was to measure the level of satisfaction for the nursing care and services and the areas of improvement. The questionnaire, with 23 questions referring to 5 areas (hotel care, Nurses' reliability, Ability to reassure, to answer to patients' needs and Empathy) derived from the conceptual model of Servqual. Ninety patients were given (or mailed) the questionnaire during a follow-up visit. Patients were asked to answer the questions evaluating each aspect on a scale from 1 (falls short of expectation) to 10 (exceeds all expectations). The answers show a very high satisfaction (> 8) for all the areas except for the food that reported a medium score of 5.2. Further analysis will allow a better understanding of the causes of dissatisfaction.

  14. Development and evaluation of an inpatient [correction of impatient] holistic nursing care services department.

    PubMed

    Newshan, Gayle

    2004-08-01

    This paper describes the development and evaluation of a holistic nursing department at a 261-bed conventional, community hospital. Through the holistic nursing department, a nurse visits hospitalized inpatients. The visit might include complementary and alternative modalities (CAM) therapies, such as relaxation techniques, therapeutic touch, aromatherapy, and therapeutic suggestion. Evaluation of visits occurred through a retrospective chart review and patient satisfaction surveys. Main outcome measures were patient satisfaction, physiological changes, and pre- and post-distress scores. Discomfort and distress was decreased and patient satisfaction high when CAM therapies were used in conjunction with traditional inpatient medical and nursing care.

  15. Evaluation of disinfecting procedures for aseptic transfer in hospital pharmacy departments.

    PubMed

    Mehmi, Manita; Marshall, Lindsay J; Lambert, Peter A; Smith, Julian C

    2009-01-01

    Current practice in National Health Service (NHS) hospitals employs 70% Industrial Methylated Spirit spray for surface disinfection of components required in Grade A pharmaceutical environments. This study seeks to investigate other agents and procedures that may provide more effective sanitisation. Several methods are available to test the efficacy of disinfectants against vegetative organisms. However, no methods currently available test the efficacy of disinfectants against spores on the hard surfaces encountered in the pharmacy aseptic processing environment. Therefore, a method has been developed to test the efficacy of disinfectants against spores, modified from British Standard 13697 and Association of Analytical Chemists standards. The testing procedure was used to evaluate alternative biocides and disinfection methods for transferring components into hospital pharmacy cleanrooms, and to determine which combinations of biocide and application method have the greatest efficacy against spores of Bacillus subtilis subspecies subtilis 168, Bacillus subtilis American Type Culture Collection (ATCC) 6633, and Bacillus pumilis ATCC 27142. Stainless steel carrier test plates were used to represent the hard surfaces in hospital pharmacy cleanrooms. Plates were inoculated with 10(7)-10(8) colony-forming units per milliliter (CFU/mL) and treated with the various biocide formulations, using different disinfection methods. Sporicidal activity was calculated as log reduction in CFU. Of the biocides tested, 6% hydrogen peroxide and a quaternary ammonium compound/chlorine dioxide combination were most effective compared to a Quat/biguanide, amphoteric surfactant, 70% v/v ethanol in deionised water and isopropyl alcohol in water for injection. Of the different application methods tested, spraying followed by wiping was the most effective, followed closely by wiping alone. Spraying alone was least effective.

  16. Impact of early in-hospital medication review by clinical pharmacists on health services utilization

    PubMed Central

    Partovi, Nilu; Ghement, Isabella; Wickham, Maeve E.; McGrail, Kimberlyn; Reddekopp, Lisa N.; Sobolev, Boris

    2017-01-01

    Background Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients. Methods We used a quasi-randomized design to evaluate a quality improvement project in three hospitals in British Columbia, Canada. We incorporated a clinical decision rule into emergency department triage pathways, allowing nurses to identify patients at high-risk for adverse drug events. After randomly selecting the first eligible patient for participation, clinical pharmacists systematically allocated subsequent high-risk patients to medication review or usual care. Medication review included obtaining a best possible medication history and reviewing the patient’s medications for appropriateness and adverse drug events. The primary outcome was the number of days spent in-hospital over 30 days, and was ascertained using administrative data. We used median and inverse propensity score weighted logistic regression modeling to determine the effect of pharmacist-led medication review on downstream health services use. Results Of 10,807 high-risk patients, 6,416 received early pharmacist-led medication review and 4,391 usual care. Their baseline characteristics were balanced. The median number of hospital days was reduced by 0.48 days (95% confidence intervals [CI] = 0.00 to 0.96; p = 0.058) in the medication review group compared to usual care, representing an 8% reduction in the median length of stay. Among patients under 80 years of age, the median number of hospital days was reduced by 0.60 days (95% CI = 0.06 to 1.17; p = 0.03), representing 11% reduction in the median

  17. [Quality management according to the new SN EN ISO-Norm 9001:2000--experiences from initial certification of a hospital department].

    PubMed

    Steffen, Th; Hochberger, G; Eisner, L

    2002-04-24

    Those who want to implement a quality-management system at a hospital these days cannot fall back on a broad-based system proven over the years. Though quality management as defined by ISO norm 9001 has been established as the central standard in many industrial areas, applicability of this ISO norm in the hospital sector has stirred up much controversy during recent years. Introduction of the new ISO norm 9001:2000 has changed the situation. The 2000 version of the new standard seeks to meet the demand for service operations--especially by establishing a clear procedural orientation. This report describes the new standard and its introduction in the Department of Surgery at the Cantonal Hospital in Olten, Canton Solothurn, Switzerland. It indicates the steps taken, for instance in the spheres of top management, quality management, procedural guidance, as well as customer and staff counselling. It also discusses the project's cost/benefit ratio for the organization.

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

    PubMed

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

    2009-01-01

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

  19. After Medicaid Expansion In Kentucky, Use Of Hospital Emergency Departments For Dental Conditions Increased.

    PubMed

    Chalmers, Natalia; Grover, Jane; Compton, Rob

    2016-12-01

    Access to oral health care is a critical need for the adult Medicaid population. Following the 2014 expansion of Medicaid eligibility in Kentucky, millions of adults became eligible to receive dental benefits. We examined the impact of the expansion on adult Medicaid enrollees' use of hospital emergency departments (EDs) for conditions related to dental or oral health in the period 2010-14. Based on our analysis of data for Kentucky from the State Emergency Department Databases, we found that the rate of discharges for these conditions from the ED increased significantly, from 1,833 per 100,000 population in 2013 to 5,635 in 2014. Adults covered by Medicaid who used the ED for treatment of oral health conditions in 2014 had high levels of chronic comorbidities and were more likely to be male and nonwhite than those in earlier years. To avoid costly and inappropriate use of the ED, states considering adding an adult Medicaid dental benefit should consider also making changes to assist beneficiaries in obtaining access to the dental health care delivery system.

  20. [The obstetrics and gynaecology departments in the French public hospitals: an updated overview].

    PubMed

    Nohuz, E; Schumacher, J-C; Alaboud, M; Dalkiliç, S; Lenglet, Y; Varga, J; Ab Der Halden, M; Chaumette, D; Desroches, A; Collet, J; Brunel, A; Dauptain, G; Dognin, C; Zerr, V

    2012-11-01

    Restructuring the surgery and gynecology-obstetrics departments taking place now raise many interrogations. It appears as a mandatory necessity to some people and as a tribute to financial strategies to others to the detriment of quality and accessibility of care. Its effect is to clarify a good amount of socioeconomical and medical indicators. The plans of perinatality for the obstetrical aspect and the thresholds of activity for the surgical aspect constitute the major lines of these restructurings. A survey soliciting all the French public hospitals was used to assess the state of obstetrics and gynecology departments in the light of these recent restructurings. Medical demography, preserving and improving the quality and continuity of care, efficiency of the technical supports are discriminating criteria of the involved challenges. Such restructurings have an impact on the doctor's lives, which looks globally positive and a good omen to complete this remodeling process. The activity was safeguarded by a redistribution and a refocusing of institutions. One should not minimize the social impact of these changes, with a potential deterioration of working conditions (internal professional reclassifications, mobility obligation towards other sites). It thus appears that the deep changes which affect the small size institutions will be able to achieve well only if they are clearly done (information) and truly integrated in their medical project.

  1. 77 FR 24990 - Public Availability of the Department of Labor FY 2011 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-26

    ... contract inventory should be directed to Gladys M. Bailey in the DOL/ Office of Acquisition Management... Availability of the Department of Labor FY 2011 Service Contract Inventory AGENCY: Office of Assistant Secretary for Administration and Management, Department of Labor. ACTION: Notice of Public Availability...

  2. Decision-tree model for predicting outcomes after out-of-hospital cardiac arrest in the emergency department

    PubMed Central

    2013-01-01

    Introduction Estimation of outcomes in patients after out-of-hospital cardiac arrest (OHCA) soon after arrival at the hospital may help clinicians guide in-hospital strategies, particularly in the emergency department. This study aimed to develop a simple and generally applicable bedside model for predicting outcomes after cardiac arrest. Methods We analyzed data for 390,226 adult patients who had undergone OHCA, from a prospectively recorded nationwide Utstein-style Japanese database for 2005 through 2009. The primary end point was survival with favorable neurologic outcome (cerebral performance category (CPC) scale, categories 1 to 2 [CPC 1 to 2]) at 1 month. The secondary end point was survival at 1 month. We developed a decision-tree prediction model by using data from a 4-year period (2005 through 2008, n = 307,896), with validation by using external data from 2009 (n = 82,330). Results Recursive partitioning analysis of the development cohort for 10 predictors indicated that the best single predictor for survival and CPC 1 to 2 was shockable initial rhythm. The next predictors for patients with shockable initial rhythm were age (<70 years) followed by witnessed arrest and age (>70 years) followed by arrest witnessed by emergency medical services (EMS) personnel. For patients with unshockable initial rhythm, the next best predictor was witnessed arrest. A simple decision-tree prediction mode permitted stratification into four prediction groups: good, moderately good, poor, and absolutely poor. This model identified patient groups with a range from 1.2% to 30.2% for survival and from 0.3% to 23.2% for CPC 1 to 2 probabilities. Similar results were observed when this model was applied to the validation cohort. Conclusions On the basis of a decision-tree prediction model using four prehospital variables (shockable initial rhythm, age, witnessed arrest, and witnessed by EMS personnel), OHCA patients can be readily stratified into the four groups (good, moderately

  3. [Enrichment of the functions of the psychiatric department in a general hospital and collaboration within the area].

    PubMed

    Koishikawa, Hiraki; Ookami, Toshihiko

    2014-01-01

    Psychiatric disease has been included in the five main diseases, and a medical care plan is required. In it, there are many problems, for example, physical complications and which general hospital should chiefly deal with it. Here, we present a way to cope with these problems on the basis of achievements in the psychiatric department of Kameda General Hospital. Specifically, we would like to assert that creating a consultation-liaison team and enriching the section of clinical psychiatry are very important and effective. The activities of the consultation-liaison team, created to address various issues after establishing a psychiatric ward, have led to the possibility of a psychiatric department in a general hospital. Experience to date indicates that, in the context of a general hospital with a psychiatric inpatient unit, the existence of a multidisciplinary liaison team working across departmental boundaries is crucial to determining and managing the treatment of patients with psychiatric emergencies, as well as patients with psychiatric issues and physical complications. Additionally, in order to increase the effectiveness of the hospital liaison team, it is critical to realize seamless, prompt collaboration with facilities outside the hospital. In this respect, the role of a patient care coordinator is expected to become increasingly important. Additionally, enriching and guarding activities of clinical psychologists have contributed to the growth of psychiatric departments in general hospitals and proved to be effective in combination with activities of the consultation-liaison team.

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

    PubMed

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

    2010-01-01

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

  5. Working Paper on Staffing, Services and Organization of Reference Departments in Large Academic Libraries.

    ERIC Educational Resources Information Center

    Watson, Paula D.; Landis, Martha

    Data from 43 responses to a questionnaire distributed to the academic members of the RASD Discussion Group in Reference Services in Large Research Libraries are summarized in tables. The purpose of the survey was to reflect patterns of staff size, services, and organization in reference departments in large academic libraries. The tables present…

  6. 77 FR 27263 - Computer Matching Between the Selective Service System and the Department of Education

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ... From the Federal Register Online via the Government Publishing Office SELECTIVE SERVICE SYSTEM Computer Matching Between the Selective Service System and the Department of Education AGENCY: Selective... the Computer Matching and Privacy Protection Act of 1988 (Pub. L. 100-503), and the Office...

  7. 44 CFR 351.23 - The Department of Health and Human Services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Human Services. 351.23 Section 351.23 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Interagency Assignments § 351.23 The Department of Health and Human Services. (a) Develop and specify protective actions and associated guidance to State and local governments for human food and animal feed...

  8. 44 CFR 351.23 - The Department of Health and Human Services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... emergencies, of human food and animal feed in the emergency planning zones around fixed nuclear facilities. (m... Human Services. 351.23 Section 351.23 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Interagency Assignments § 351.23 The Department of Health and Human Services. (a) Develop and...

  9. The Suffolk County Department of Social Services Performance Study. An Executive Summary.

    ERIC Educational Resources Information Center

    Spottheim, David; Wilson, George R.

    The logic and methodology applied in a management science approach to performance and staff utilization in the Client Benefits (CBA) and Community Service (CSA) divisions of the Suffolk County (New York) Department of Social Services (SCDSS) are described. Using a blend of classical organization theory and management science techniques, the CBA…

  10. 44 CFR 351.23 - The Department of Health and Human Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Human Services. 351.23 Section 351.23 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Interagency Assignments § 351.23 The Department of Health and Human Services. (a) Develop and specify protective actions and associated guidance to State and local governments for human food and animal feed...

  11. 44 CFR 351.23 - The Department of Health and Human Services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Human Services. 351.23 Section 351.23 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... Interagency Assignments § 351.23 The Department of Health and Human Services. (a) Develop and specify protective actions and associated guidance to State and local governments for human food and animal feed...

  12. 75 FR 11869 - Meeting of the Defense Department Advisory Committee on Women in the Services (DACOWITS)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... members of the public. Dated: March 8, 2010. Mitchell S. Bryman, Alternate OSD Federal Register Liaison... of the Secretary Meeting of the Defense Department Advisory Committee on Women in the Services... Advisory Committee on Women in the Services (DACOWITS). The purpose of the meeting is for the Committee...

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed Central

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

    1987-01-01

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

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

    PubMed

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

    2014-10-01

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

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

    ERIC Educational Resources Information Center

    Peay, Moiselle

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

  17. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  18. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  19. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  20. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  1. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  2. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  3. 42 CFR 410.110 - Requirements for coverage of partial hospitalization services by CMHCs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  4. 42 CFR 136.30 - Payment to Medicare-participating hospitals for authorized Contract Health Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    PubMed

    Howard, J

    1999-01-01

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

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

    PubMed

    Horwitz, Jill R; Nichols, Austin

    2009-09-01

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

  7. 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.

  8. Prevalence of Unrecognised Depression Among Outpatient Department Attendees of A Rural Hospital in Delhi, India

    PubMed Central

    Kohli, Charu; Kishore, Jugal; Agarwal, Paras; Singh, Satya Vir

    2013-01-01

    Background: Depression is one of the most common mental disorders affecting 121 million people in the world and it frequently goes unrecognised among patients. This study was carried out to find out the prevalence of unrecognised depression among out patient attendees of a rural hospital in Delhi, India and its socio demographic correlates. Material and Methods: This is a rural hospital based cross sectional study among 395 patients attending different non-psychiatric outpatient departments. Data was collected by using predesigned & pretested questionnaire and prevalence of depression was determined by PRIME MD (PHQ-9) and analysed by using SPSS version 16. Data was analysed using chi-square test with “p” value < 0.05 considered as significant. Independent association of socio demographic variables were determined by multi–variate logistic regression analysis using WHO EPI INFO software. Results: The study included 67% females and 33% males with mean age 31.73 + 12 years. Most were Hindu (80%), married (75%), illiterate (47%) and were unemployed (65%). Out of 395 patients, 119 (30.1%) were diagnosed to be having depression. Out of 119 patients who were found depressed, 25 (21%) were already diagnosed case of depression and 94 (79%) were detected by using PRIME-MD, giving prevalence of unrecognised depression 23.8%. Among socio demographic factors, gender, religion, education status and being widow/separated were found to be statistically significantly associated with hidden depression among the patients. Conclusion: Unrecognized depression is a common in non-psychiatric OPDs. There is a need to screen patients presenting in such OPDs for depression. PMID:24179898

  9. Clinical impact of diagnostic imaging discrepancy by radiology trainees in an urban teaching hospital emergency department

    PubMed Central

    2013-01-01

    Background To characterize clinically significant diagnostic imaging (DI) discrepancies by radiology trainees and the impact on emergency department (ED) patients. Methods Consecutive case series methodology over a 6-month period in an urban, tertiary care teaching hospital. Emergency physicians (EPs) were recruited to flag discrepant DI interpretations by radiology trainees that the EP deemed clinically significant. Cases were characterized using chart review and EP interview. Results Twenty-eight discrepant reports were identified (representing 0.1% of 18,185 images interpreted). The mean time between provisional discrepant diagnosis (PDDx) and revised diagnosis (RDx) by attending radiology staff was 8.6 h (median 4.8 h, range 1.1-48.4), and 67.9% (n = 19) of the patients had left the ED by time of notification. The most frequently reported PDDx was CT abd/pelvis (32.1%, n = 9) and CT head (28.6%, n = 8). The impact of RDx was deemed major in 57.1% (n = 16) for reasons including altered admitting status (32.1%, n = 9), immediate subspecialty referral (n = 16, 57.1%), impact on management (25%, n = 7), and surgical management (21.4%, n = 6). EPs reported likely perceived impact of PDDx as resulting in increased pain (17. 9%, n = 5), morbidity (10.7%, n = 3), and prolonged hospitalization (25%, n = 7), but not altered long-term outcome or mortality. Conclusions Relatively few clinically important discrepant reads were reported. Revised diagnosis (RDx) was associated with major clinical impact in 57.1% of reports, but few patients experienced increased morbidity, and none increased mortality. The importance of expedient communication of discrepant reports by staff radiologists is stressed, as is EP verification of patient contact information prior to discharge. PMID:23866048

  10. DynCorp Tricities Services, Inc. Hanford fire department FY 1998 annual work plan

    SciTech Connect

    Good, D.E.

    1997-08-19

    The mission of the Hanford Fire Department (HFD) is to support the safe and timely cleanup of the Hanford site by providing fire suppression, fire prevention, emergency rescue, emergency medical service, and hazardous materials response; and to be capable of dealing with and terminating emergency situations which could threaten the operations, employees, or interest of the U.S. Department of Energy operated Hanford site. This includes response to surrounding fire departments/districts under mutual aid and state mobilization agreements and fire fighting, hazardous materials, and ambulance support to Washington Public Power Supply System (Supply System) and various commercial entities operating on site through Requests for Service from DOE-RL. This fire department also provides site fire marshal overview authority, fire system testing and maintenance, respiratory protection services, building tours and inspections, ignitable and reactive waste site inspections, prefire planning, and employee fire prevention education. This plan provides a program overview, program baselines, and schedule baseline.

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

    PubMed

    Lee-Ross, D

    1999-01-01

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

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

    PubMed

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

    2014-12-30

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

  13. Dispensing medications at the hospital upon discharge from an emergency department.

    PubMed

    Yamamoto, Loren G; Manzi, Shannon; Shaw, Kathy N; Ackerman, Alice D; Chun, Thomas H; Conners, Gregory P; Dudley, Nanette C; Fein, Joel A; Fuchs, Susan M; Moore, Brian R; Selbst, Steven M; Wright, Joseph L

    2012-02-01

    Although most health care services can and should be provided by their medical home, children will be referred or require visits to the emergency department (ED) for emergent clinical conditions or injuries. Continuation of medical care after discharge from an ED is dependent on parents or caregivers' understanding of and compliance with follow-up instructions and on adherence to medication recommendations. ED visits often occur at times when the majority of pharmacies are not open and caregivers are concerned with getting their ill or injured child directly home. Approximately one-third of patients fail to obtain priority medications from a pharmacy after discharge from an ED. The option of judiciously dispensing ED discharge medications from the ED's outpatient pharmacy within the facility is a major convenience that overcomes this obstacle, improving the likelihood of medication adherence. Emergency care encounters should be routinely followed up with primary care provider medical homes to ensure complete and comprehensive care.

  14. [Children's department and child care institutions of the Central military, hospital of People's commissariat during the Great Patriotic War].

    PubMed

    Simonenko, V B; Krainyukov, P E; Abashin, V G

    2016-01-01

    The article presents historical data about paediatric health care delivery and escort of children of the Command of the Red Army during their evacuation from Moscow in 1941. Data on foundation of kindergartens of People's commissariat in 1942-1943, their support and foundation of children's department in the hospital is given. Special subdivision governed by the head of child care institutions of the hospital was formed for managing child care institutions.

  15. Services Supply Chain in the Department of Defense: Drivers of Success in Services Acquisition

    DTIC Science & Technology

    2014-04-30

    Success in Services Acquisition Rene Rendon, Naval Postgraduate School Uday Apte, Naval Postgraduate School Michael Dixon, Naval Postgraduate School...Drivers of Success in Services Acquisition 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...13. SUPPLEMENTARY NOTES 14. ABSTRACT Over the last few decades, services acquisition has continued to increase in scope and dollars obligated

  16. "Managing the unmanageable" the U.S. Department of Health and Human Services, 1989-1993.

    PubMed Central

    Sullivan, Louis W.

    2002-01-01

    The author served as the 17th U.S. Secretary of Health and Human Services, from March 1, 1989 until January 20, 1993. The department had 250 programs and 38 percent of the expenditures of the federal government ($600.0 billion), the fourth largest budget in the world. The history of the department included the fact that the tenure of previous Secretaries had ranged from only eight months up to 37 months, and had averaged 27.5 months, resulting in the view that the department was unmanageable. The author's tenure as Secretary was 47 months, and, in the author's view, the department was indeed manageable. The United States Department of Health, Education and Welfare (DHEW) was created as a cabinet agency in 1953, during the administration of President Dwight D. Eisenhower. The Department was formed by bringing together the Social Security Administration (founded in 1935), the United States Commissioner of Education, and the United States Public Health Service (founded in 1798) to serve the United States Merchant Marines). This new cabinet department contained the nation's major domestic programs concerned with income security, public health and education. Oveta Culp Hobby of Texas was the first Secretary of the Department. By 1989, the department's programs had increased to more than 250, including Medicare, Medicaid, Headstart, Welfare, and others. During the administration of President Jimmy Carter, the Education programs were separated into a new cabinet agency, the U.S. Department of Education, and the name of the U.S. Department of Health, Education and Welfare became the U.S. Department of Health and Human Services (DHHS). Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:12053720

  17. 77 FR 68821 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark-St. Francis...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark...: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Ozark-St. Francis...

  18. 78 FR 59953 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Coconino National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service... Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest...

  19. 75 FR 45656 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Siuslaw National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service.... Department of Agriculture, Forest Service, Siuslaw National Forest, Waldport, OR. The human remains...

  20. 75 FR 52014 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Cherokee National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service... control of the U.S. Department of Agriculture, Forest Service, Cherokee National Forest, Cleveland,...

  1. 78 FR 2436 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark-St. Francis...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark.... ACTION: Notice; correction. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service,...

  2. 77 FR 68819 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark-St. Francis...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark...: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Ozark-St. Francis...

  3. 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.

  4. Bed Capacity Planning Using Stochastic Simulation Approach in Cardiac-surgery Department of Teaching Hospitals, Tehran, Iran

    PubMed Central

    TORABIPOUR, Amin; ZERAATI, Hojjat; ARAB, Mohammad; RASHIDIAN, Arash; AKBARI SARI, Ali; SARZAIEM, Mahmuod Reza

    2016-01-01

    Background: To determine the hospital required beds using stochastic simulation approach in cardiac surgery departments. Methods: This study was performed from Mar 2011 to Jul 2012 in three phases: First, collection data from 649 patients in cardiac surgery departments of two large teaching hospitals (in Tehran, Iran). Second, statistical analysis and formulate a multivariate linier regression model to determine factors that affect patient's length of stay. Third, develop a stochastic simulation system (from admission to discharge) based on key parameters to estimate required bed capacity. Results: Current cardiac surgery department with 33 beds can only admit patients in 90.7% of days. (4535 d) and will be required to over the 33 beds only in 9.3% of days (efficient cut off point). According to simulation method, studied cardiac surgery department will requires 41–52 beds for admission of all patients in the 12 next years. Finally, one-day reduction of length of stay lead to decrease need for two hospital beds annually. Conclusion: Variation of length of stay and its affecting factors can affect required beds. Statistic and stochastic simulation model are applied and useful methods to estimate and manage hospital beds based on key hospital parameters. PMID:27957466

  5. Antibiotic consumption at 46 VINCat hospitals from 2007 to 2009, stratified by hospital size and clinical services.

    PubMed

    Grau, Santiago; Fondevilla, Esther; Mojal, Sergi; Palomar, Mercedes; Vallès, Jordi; Gudiol, Francesc

    2012-06-01

    The aim of the study was to assess the evolution of antibiotic consumption in acute care hospitals in Catalonia (population 7.5 million), according to hospital size and department, during the period 2007-2009. The methodology used for monitoring antibiotic consumption was the ATC/DDD system, and the unit of measurement was DDD/100 occupied bed-days (DDD/100 OBD). Hospitals were stratified according to size: I) large university hospitals (with more than 500 beds); II) medium-sized hospitals (between 200 and 500 beds); and III) small hospitals (fewer than 200 beds). The consumption was also analyzed and stratified according to department: medical, surgical and intensive care unit (ICU). Specific training in data management on antibiotic consumption was given to all participant hospitals before the implementation of the program. The mean antibiotic (J01) consumption, calculated in DDD/100 OBD, increased although without statistical significance (p=0.640): 74.68 (2007), 75.13 (2008) and 78.04 (2009). The values of the medians expressed in DDD/100 OBD in group I were 83.27 (in 2007), 82.16 (2008) and 86.93 (2009), in group II 72.60 (2007), 70.78 (2008) and 75.17 (2009) and in group III 65.66 (2007), 69.32 (2008) and 72.39 (2009). Antibiotic consumption was higher in large hospitals than in medium-sized or small hospitals. Catalan hospitals recorded an increase of 4.49% from 2007 to 2009, especially due to the rising use of carbapenems, cephalosporins, monobactams and the other antibiotic groups.

  6. ‘Why must I wait?’ The performance of legitimacy in a hospital emergency department

    PubMed Central

    Hillman, Alexandra

    2015-01-01

    This article examines the processes of negotiation that occur between patients and medical staff over accessing emergency medical resources. The field extracts are drawn from an ethnographic study of a UK emergency department (ED) in a large, inner city teaching hospital. The article focuses on the triage system for patient prioritisation as the first point of access to the ED. The processes of categorising patients for priority of treatment and care provide staff with the opportunities to maintain control over what defines the ED as a service, as types of work and as particular kinds of patients. Patients and relatives are implicated in this categorical work in the course of interactions with staff as they provide reasons and justifications for their attendance. Their success in legitimising their claim to treatment depends upon self-presentation and identity work that (re)produces individual responsibility as a dominant moral order. The extent to which people attending the ED can successfully perform as legitimate is shown to contribute to their placement into positive or negative staff-constituted patient categories, thus shaping their access to the resources of emergency medicine and their experience of care. PMID:24053721

  7. 32 CFR 700.835 - Work, facilities, supplies, or services for other Government departments, State or local...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... other Government departments, State or local governments, foreign governments, private parties and... Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED....835 Work, facilities, supplies, or services for other Government departments, State or...

  8. 32 CFR 700.835 - Work, facilities, supplies, or services for other Government departments, State or local...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... other Government departments, State or local governments, foreign governments, private parties and... Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED....835 Work, facilities, supplies, or services for other Government departments, State or...

  9. 32 CFR 700.835 - Work, facilities, supplies, or services for other Government departments, State or local...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... other Government departments, State or local governments, foreign governments, private parties and... Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED....835 Work, facilities, supplies, or services for other Government departments, State or...

  10. 42 CFR 59.7 - What criteria will the Department of Health and Human Services use to decide which family...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Human Services use to decide which family planning services projects to fund and in what amount? 59.7... FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.7 What criteria will the Department of Health and Human Services use to decide which family planning services projects to fund and...

  11. 42 CFR 59.7 - What criteria will the Department of Health and Human Services use to decide which family...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Human Services use to decide which family planning services projects to fund and in what amount? 59.7... FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.7 What criteria will the Department of Health and Human Services use to decide which family planning services projects to fund and...

  12. Anaphylaxis in an emergency department: a 2-year study in a tertiary-care hospital.

    PubMed

    Piromrat, Kanika; Chinratanapisit, Sasawan; Trathong, Sommai

    2008-01-01

    The aim of this study was to estimate the incidence of anaphylaxis in the emergency department of a tertiary-care hospital, describe the clinical features and the management of the patients and determine those with mild manifestations. A retrospective study was conducted from 2005 to 2006 using anaphylaxis-related ICD-10 terms. Two different sets of criteria for the diagnosis of anaphylaxis were applied, first the criteria previously accepted by emergency practice, followed by the recent criteria set forth at the 2005 international meeting. Sixty-four patients fulfilled the previous criteria with an average incidence of 52.5 per 100,000 patients per year with a shift towards females in 2006. The most common presentations were cutaneous, followed by respiratory symptoms. Food allergy was the most common cause, especially prawn. After applying the recent criteria, 13 patients (20.4%) were excluded, which reduced the incidence to 42.2 per 100,000 patients per year. Long term follow up is suggested for the possible or mild cases that were re-categorized.

  13. Paediatric trauma in the USA: patterns of emergency department visits and associated hospital resource use.

    PubMed

    Odetola, Folafoluwa O; Gebremariam, Achamyeleh

    2015-01-01

    Trauma is the leading cause of mortality and morbidity among children in the USA. To examine the variation in the epidemiology and patterns of visits to emergency departments (EDs), and test the hypothesis that children evaluated at trauma centre EDs will have higher injury severity and a higher likelihood of hospitalisation versus those evaluated at non-trauma centre EDs, we analysed a national database of all injured children aged 0-20 years evaluated at US EDs in 2009. Childhood injuries are a frequent cause of visits to US EDs, with a national point prevalence of 620 cases per 10,000 children aged 0-20 years. Epidemiology of childhood injuries in the USA is significant for male gender preponderance, significant seasonal and geographical variation, and disproportionately more frequent injury to the extremities than other sites of the body. National hospital resource use was significant, with greater burden borne by trauma centres which disproportionately provided care to the most severely injured children.

  14. Chest pain prevalence, causes, and disposition in the emergency department of a regional hospital in Pretoria

    PubMed Central

    2016-01-01

    Background Chest pain is a common clinical syndrome. However, there is a paucity of African studies describing the causes, prevalence, aetiology, and disposition of patients with chest pain presenting in the emergency department (ED). Aim The aim of this retrospective descriptive study was to determine the prevalence, causes, demographics, and disposition of all adult patients with the main complaint of chest pain presenting at the ED of a regional hospital in South Africa. Methods Records of all patients 18 years and older presenting with the complaint of chest pain from 1 December 2011 through 10 April 2012 were assessed. A data collection sheet capturing patient demographics and disposition from the ED was used. The diagnosis was subdivided into groups: cardiovascular, respiratory, gastrointestinal, musculoskeletal, psychiatric/psychogenic, other, and unknown. Results Of the 312 patients presenting with chest pain, 210 patient files were retrieved. The prevalence of non-traumatic chest pain was 1.66%. Respiratory disease was the most common cause (36.19%), with pneumonia the most common diagnosis (24.40%). Logistic regression showed diagnoses of acute cardiovascular disease or respiratory disease, older age, and transport by ambulance as being associated with admission. Conclusion The main cause of acute chest pain was found to be respiratory disease, followed by musculoskeletal disorders. In the African context, the aetiology of acute chest pain differs from that in first world countries. Health workers should therefore pay special attention to respiratory conditions during diagnosis and management in African patients with acute chest pain. PMID:27380782

  15. Determinants in the number of staff in hospitals' maintenance departments: a multivariate regression analysis approach.

    PubMed

    Miguel Cruz, Antonio; Guarín, Mayra R

    2017-02-01

    To date, there are no broadly accepted or accurate models to determine appropriate staffing [levels] for clinical engineering departments (CEDs). The purpose of this study is to determine what the determinants of the staffing levels are (total number of full time equivalents (FTEs)) in CEDs in healthcare organisations. In doing so, we used a cross-sectional exploratory approach by using a multivariate regression model over a secondary source of data information from the AAMI Benchmarking Solutions-Healthcare Technology Management database. Two hundred and one healthcare organisations were included in our study. Our study revealed that on average, there are almost 14 biomedical technicians (BMETs) per clinical engineer and one FTE per 1083.72 devices (SD 545.69). The results of this study also revealed that the total number of devices and the total technology management hours devoted to these devices positively affects the number of FTEs in a CED, whereas the hospital complexity, measured by healthcare organisation patient discharges matters inversely. The most important factor that matters in the number of FTEs in CEDs was the total technology management hours devoted to devices. A value of explained variance (i.e. R(2)) of 85% was obtained, indicating the strong power of the prediction accuracy of our multivariate regression model.

  16. Hospital care and medical services for Camp Lejeune veterans. Final rule.

    PubMed

    2014-09-24

    This document amends Department of Veterans Affairs (VA) regulations in order to implement a statutory mandate that VA provide health care to certain veterans who served at Camp Lejeune, North Carolina, for at least 30 days during the period beginning on January 1, 1957, and ending on December 31, 1987. The law requires VA to furnish hospital care and medical services for these veterans for certain illnesses and conditions that may be attributed to exposure to toxins in the water system at Camp Lejeune. This rule does not implement the statutory provision requiring VA to provide health care to these veterans' family members; regulations applicable to such family members will be promulgated through a separate notice.

  17. 77 FR 52055 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... National Park Service Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service, Coconino National Forest, Flagstaff, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Coconino National Forest,...

  18. 77 FR 51562 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-24

    ... National Park Service Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service, Coconino National Forest, Flagstaff, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Coconino National Forest,...

  19. 78 FR 21404 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand Canyon National Park, Grand Canyon, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Grand Canyon National...

  20. 78 FR 21400 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand Canyon National Park, Grand Canyon, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Grand Canyon National...

  1. 78 FR 65362 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Capitol...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Capitol Reef National Park, Torrey, UT AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Capitol Reef National Park...

  2. 78 FR 21407 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand Canyon National Park, Grand Canyon, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Grand Canyon National...

  3. 78 FR 21405 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand Canyon National Park, Grand Canyon, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Grand Canyon National...

  4. 75 FR 30428 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-01

    ... National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand Canyon National Park, Grand Canyon, AZ AGENCY: National Park Service, Interior. ACTION... the U.S. Department of the Interior, National Park Service, Grand Canyon National Park, Grand...

  5. 78 FR 72703 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-03

    ... National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Canyonlands National Park, Moab, UT AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Canyonlands National Park,...

  6. Managing the Services Supply Chain in the Department of Defense: An Empirical Study of Current Management Practices

    DTIC Science & Technology

    2008-04-23

    of services and the increasing importance of services acquisition offer a unique and significant opportunity for conducting research in the management of the service supply chain in the Department of Defense.

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

    PubMed Central

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

    1981-01-01

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

  8. Evaluation of performance of the Medical Research Department in ‘Research naive’ non-academic hospital: An audit

    PubMed Central

    Kuyare, Mukta Sunil; Sarve, Parag Vijayrao; Dalal, Komal S.; Tripathi, Raakhi K.

    2016-01-01

    Introduction: Conducting medical research is not limited to academia and pharmaceutical industry but even multispeciality hospitals need to venture in this area along with patient care. To develop research culture among well-established non-acedemic hospital is always difficult and challenging task. This article attempts to evaluate the performance of the department in ‘Research naïve’ hospital in the last two years and review the strengths and challenges it faced at each step. Methods: This was a retrospective document analysis study evaluating the steps towards setting and sustaining of Medical Research Department of Bhaktivedanta Hospital during the period of January 2013 to June 2015 (30 Months). The authors developed a checklist (along with performance indicators) to assess the Preparatory phase and Activity phase of the research department which were evaluated by Institute Quality Management Team. Each step of both phases was also reviewed in terms of strengths and challenges as perceived by the authors. Results: During 2 year journey of research naïve Hospital, Institute had witnessed Hospital initiated (n=24, 59%) and sponsored projects (n=17, 41%) in all specialties. HRC reviewed (n=2.13) projects per meeting for administrative consideration while IEC reviewed (n=2.15) projects for scientific and ethical review. Challenges during preparatory phases were circumvent by immense cooperation of hospital management for initial investment, sensitization through research workshops for consultants, established procedures and trained support manpower and constant encouragement by research coordinator. Conclusion: Considering evaluation of 41 studies in very first 2 years in ‘Research naive non academic institute demonstrated successful implementation of trio model of Hospital Research Committee for administrative review, IEC for scientific-ethical review, centralized MRD for coordinating all research projects under one roof which may act as role model for

  9. Screening for Older Emergency Department Inpatients at Risk of Prolonged Hospital Stay: The Brief Geriatric Assessment Tool

    PubMed Central

    Launay, Cyrille P.; de Decker, Laure; Kabeshova, Anastasiia; Annweiler, Cédric; Beauchet, Olivier

    2014-01-01

    Background The aims of this study were 1) to confirm that combinations of brief geriatric assessment (BGA) items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED); and 2) to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS. Methods Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female) recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day), use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year). The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry. Results Area under receiver operating characteristic (ROC) curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010). Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (P<0.003). Prognostic value for prolonged LHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4) and a low likelihood ratio of positive test under 5.6. Conclusion Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients. PMID:25333271

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

    PubMed

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

    2014-09-01

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

  11. The tele-interpreter service at the Bangkok Hospital Medical Center, Thailand.

    PubMed

    Jaroensawat, Boonthida; Wankijcharoen, Somsak

    2013-01-01

    Thailand has become one of the most famous medical hub countries, which is reflected in the increasing number of international patients visiting the Bangkok Hospital Medical Center (BMC). In response, the Interpreter Department at BMC has been established to provide translation for non-English speaking patients. Overtime the Interpreter Department frequently reaches maximum capacity when providing prompt services on demand, resulting in long waiting times and delayed medical treatment. BMC has foreseen the necessity to implement a tele-interpreter system via videoconferencing technology to provide effective translations in the medical environment where delay is usually not tolerated. Tele-interpretation allows doctors to simply select a language icon on their Wi-Fi IP telephone to instantly connect to an interpreter. After implementation in 2oo9, the overall customer satisfaction index for the Interpreter Department increased from 64.5% in Quarter 1 to 85.5% in Quarter 3 of 2011. The tele-interpretation system is currently the closest approximation to the face-to-face interpretation method.

  12. Consultations by Asylum Seekers: Recent Trends in the Emergency Department of a Swiss University Hospital

    PubMed Central

    Srivastava, David; Exadaktylos, Aristomenis K.

    2016-01-01

    Background Large-scale war-related migration to Switzerland and other European countries is currently challenging European health systems. Little is known about recent patterns and trends in Emergency Department (ED) consultations by Asylum Seekers (AS). Methods A retrospective single-centre analysis was performed of the data from all adult patients with the official status of “Asylum Seeker” or “Refugee” who consulted the ED of Bern University Hospital, Switzerland, between June 2012 and June 2015. Patient characteristics and clinical information, such as triage category, type of referral and discharge, violence-related injury and diagnostic group on discharge, were extracted from the computerised database or determined from the medical reports. Changes in categorical variables between the three studied years were described. Results A total of 1,653 eligible adult patients were identified in the 3-year period. Between the first (06/12–06/13) and third periods (06/14–06/15), the number of presentations per year increased by about 45%. The AS came from 62 different nations, the most common countries being Eritrea (13%), Somalia (13%) and Syria (11%). The mean age was 33.3 years (SD 12.3) and two thirds (65.7%) were male. The proportion of women increased over time. Moreover the relative proportions shifted from patients between 20 and 50 years to patients of under 20 or over 60 years. Nearly two thirds of the patients were walk-in emergencies and this proportion increased over time. The mean triage score was 2.9 (SD 0.7), with more than 90% presenting as “urgent consultation”. About half of the patients were treated for trauma (17.2%), infections (16.8%) or psychiatric problems (14.2%). Trauma was seen in a higher proportion of male than female patients. About 25% of the patients were admitted for in-hospital treatment. Conclusions The recent rise in AS in the population has lead to an increase in AS presenting to EDs. This changes the composition of

  13. Who leaves the emergency department without being seen? A public hospital experience in Georgetown, Guyana

    PubMed Central

    2013-01-01

    Background Left without being seen (LWBS) proportions are commonly used as quality control indicators, but little data is available on LWBS proportions in the developing world. This study sought to determine the proportion and characteristics of patients who LWBS from the emergency department (ED) of the main public hospital in Georgetown, Guyana. Methods This is a retrospective cross-sectional analysis of an ED quality assurance database. Registration personnel collected demographic information on patients presenting to the ED over a 2-week period in July 2010. Both univariate and multivariate analysis were conducted to determine patient characteristics associated with LWBS. Results The LWBS proportion was 5.7%. In univariate analysis, patients 18 or older (OR 1.48, 95%CI 1.03-2.12), presenting during the 4PM-12AM shift (OR 2.15, 95%CI 1.53-3.01), with non-urgent triage classification (OR 1.88, 95%CI 1.76-4.66), with non-traumatic chief complaints (OR 1.70, 95%CI 1.14-2.55), or who were not transferred (OR 2.13, 95%CI 1.00-4.55) had significantly higher odds of LWBS. On multivariate analysis, only patients 18 or older (OR 1.54, 95%CI 1.02-2.33), presenting during the 4PM-12AM shift (OR 2.29, 95%CI 1.54-3.40), and with non-traumatic chief complaints (OR 2.39, 95%CI 1.43-4.02) were found to be significantly associated with LWBS. Sex, residence in the capital city, time to triage, transfer status, use of EMS, and triage classification were not statistically associated with LWBS. Conclusions LWBS proportions are used as quality control indicators and this study determined the LWBS proportion at a public hospital in a developing country and some of the patient characteristics associated with LWBS. This can be helpful to develop strategies to decrease LWBS proportions and to assess progress over time. PMID:23786454

  14. Profile of trauma patients in the emergency department of a tertiary care hospital in South India

    PubMed Central

    Abhilash, Kundavaram Paul Prabhakar; Chakraborthy, Nilanchal; Pandian, Gautham Raja; Dhanawade, Vineet Subodh; Bhanu, Thomas Kurien; Priya, Krishna

    2016-01-01

    Background: Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital. Materials and Methods: This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted. Results: The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents. The gender distribution was 73.6% males and 26.4% females. The mean age was 40.2 ± 16.7 years. The median duration from time of incident to time of arrival to the ED was 3 h (interquartile range [IQR]: 1.5–6.5) for priority one patients, 3 h (IQR: 1.5–7.7) for priority two patients, and 1.5 h (IQR: 1–7) for priority three patients. The average number of trauma incidents increased by 28% during the weekends. Road traffic accident (RTA) (65%) was the most common mode of injury, followed by fall on level ground (13.5%), fall from height (6.3%), work place injuries (6.3%), and others. Traumatic brain injury was seen in 17% of patients while 13.3% had polytrauma with two-wheeler accidents contributing to the majority. The ED team alone managed 23.4% of patients while the remaining 76.6% required evaluation and treatment by the trauma, surgical teams. The in-hospital mortality rate was 2.3%. Multivariate analysis showed low Glasgow coma score (odds ratio [OR]: 0.65, 95% confidence interval [CI]: 0.55–0.76, P < 0.001) and high respiratory rate (OR: 1.15, 95% CI: 1.07–1.24, P < 0.001) to be independent predictors of mortality among polytrauma victims. Conclusions: RTA and falls are the predominant causes of trauma. A simple physiological variable-based scoring system such as the revised trauma score may be used to prioritize patients with polytrauma. PMID:28217583

  15. Comparison of emergency department and hospital admissions data for air pollution time-series studies

    PubMed Central

    2012-01-01

    Background Emergency department (ED) visit and hospital admissions (HA) data have been an indispensible resource for assessing acute morbidity impacts of air pollution. ED visits and HAs are types of health care visits with similarities, but also potentially important differences. Little previous information is available regarding the impact of health care visit type on observed acute air pollution-health associations from studies conducted for the same location, time period, outcome definitions and model specifications. Methods As part of a broader study of air pollution and health in St. Louis, individual-level ED and HA data were obtained for a 6.5 year period for acute care hospitals in the eight Missouri counties of the St. Louis metropolitan area. Patient demographic characteristics and diagnostic code distributions were compared for four visit types including ED visits, HAs, HAs that came through the ED, and non-elective HAs. Time-series analyses of the relationship between daily ambient ozone and PM2.5 and selected cardiorespiratory outcomes were conducted for each visit type. Results Our results indicate that, compared with ED patients, HA patients tended to be older, had evidence of greater severity for some outcomes, and had a different mix of specific outcomes. Consideration of ‘HA through ED’ appeared to more effectively select acute visits than consideration of ‘non-elective HA’. While outcomes with the strongest observed temporal associations with air pollutants tended to show strong associations for all visit types, we found some differences in observed associations for ED visits and HAs. For example, risk ratios for the respiratory disease-ozone association were 1.020 for ED visits and 1.004 for ‘HA through ED’; risk ratios for the asthma/wheeze-ozone association were 1.069 for ED visits and 1.106 for ‘HA through ED’. Several factors (e.g. age) were identified that may be responsible, in part, for the differences in observed

  16. Services Supply Chain in the Department of Defense: Drivers of Acquisition Management Practices in the Army

    DTIC Science & Technology

    2012-02-13

    Services Supply Chain in the Department of Defense: Drivers of Acquisition Management Practices in the Army 13 February 2012 by Dr. Aruna ...mlpqdo^ar^qb=p`elli= About the Authors Dr. Aruna Apte is an Assistant Professor in the Operations and Logistics Management Department, Graduate School... Aruna Apte Graduate School of Business and Public Policy Naval Postgraduate School Monterey, CA 93943-5000 Tel: 831-656-7583 Fax: (831) 656-3407 E

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  18. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  19. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  20. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

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

    PubMed

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

    2015-04-01

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

  2. 38 CFR 3.1605 - Death while traveling under prior authorization or while hospitalized by the Department of...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....1605 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Burial... funeral, burial, plot, or interment expenses of a person who dies while in a hospital, domiciliary, or... Affairs. (See § 3.1600(c)). In addition, the cost of transporting the body to the place of burial may...

  3. 38 CFR 3.1605 - Death while traveling under prior authorization or while hospitalized by the Department of...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....1605 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Burial... funeral, burial, plot, or interment expenses of a person who dies while in a hospital, domiciliary, or... Affairs. (See § 3.1600(c)). In addition, the cost of transporting the body to the place of burial may...

  4. 38 CFR 3.1605 - Death while traveling under prior authorization or while hospitalized by the Department of...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....1605 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Burial... funeral, burial, plot, or interment expenses of a person who dies while in a hospital, domiciliary, or... Affairs. (See § 3.1600(c)). In addition, the cost of transporting the body to the place of burial may...

  5. Age Differences in Emergency Department Visits and Inpatient Hospitalizations in Preadolescent and Adolescent Youth with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Schlenz, Alyssa M.; Carpenter, Laura A.; Bradley, Catherine; Charles, Jane; Boan, Andrea

    2015-01-01

    This paper evaluated age differences in emergency department care and inpatient hospitalizations in 252 preadolescent and adolescent youth with autism spectrum disorders (ASDs; ages 9-18). Records from youth with ASDs were linked to acute care utilization records and were compared to a demographically similar comparison group of youth without ASDs…

  6. Use of Hospital-based Services among Young Adults with Behavioral Health Diagnoses Before and After Health Insurance Expansions

    PubMed Central

    Golberstein, Ezra; Zaha, Rebecca; Greenfield, Shelly F.; Beardslee, William R.; Busch, Susan H.

    2014-01-01

    Importance Young adults have high levels of behavioral health needs but often lack health insurance. Recent health reforms have increased coverage, but it is unclear how use of hospital-based care changed after expanding insurance. Objective To evaluate the association between health insurance coverage expansions and use of hospital-based care among young adults with behavioral health diagnoses. Design Quasi-experimental analyses of hospital inpatient and emergency department use from 2003–2009 based on hospital discharge data, comparing differential changes in service use among young adults with behavioral health diagnoses in Massachusetts versus other states before and after Massachusetts’ 2006 health reform. Setting Hospital inpatient departments in the U.S. and emergency departments in Massachusetts and Maryland. Participants Population-based sample of inpatient admissions (n=12,821,746 across 7 years) nationwide and emergency department visits (n=6,756,303 across 7 years) from Maryland and Massachusetts for 12 to 25 year olds. Main Outcomes and Measures Inpatient admission rates per 1000 population for primary diagnosis of any behavioral health disorder, by diagnosis; emergency department visit rates per 1000 population by behavioral health diagnosis; and insurance coverage for discharges. Results After 2006, uninsurance among 19 to 25 year olds in Massachusetts fell from 26% to 10% (16 percentage points; 95% CI, 13–20). Young adults experienced relative declines in inpatient admission rates of 2.0 per 1000 for primary diagnoses of any behavioral health disorder (95% CI, 0.88–3.1), 0.38 for depression (95% CI, 0.18–0.58), and 1.3 for substance use disorder (95% CI, 0.68–1.8). The rise in emergency department visits with any behavioral health diagnosis after 2006 was lower among young adults in Massachusetts compared to Maryland (16.5 per 1000; 95% CI, 11.4–21.6). Among young adults in Massachusetts, the percent of behavioral health discharges

  7. Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department

    PubMed Central

    Kittipittayakorn, Cholada

    2016-01-01

    Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries' healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES) and agent-based simulation (ABS) to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department. PMID:27195606

  8. Benefit or burden? A sociotechnical analysis of diagnostic computer kiosks in four California hospital emergency departments.

    PubMed

    Ackerman, Sara L; Tebb, Kathleen; Stein, John C; Frazee, Bradley W; Hendey, Gregory W; Schmidt, Laura A; Gonzales, Ralph

    2012-12-01

    High expectations for new technologies coexist with wide variability in the actual adoption and impact of information technology (IT) projects in clinical settings, and the frequent failure to incorporate otherwise "successful" projects into routine practice. This paper draws on actor-network theory to present an in-depth, sociotechnical analysis of one such project--a computer kiosk designed to diagnose and expedite treatment of urinary tract infections (UTI) in adult women. Research at a hospital urgent care clinic demonstrated the kiosk program's effectiveness at diagnosing UTI and reducing patient wait times, and the kiosk was subsequently adopted by the clinic for routine patient care. However, a study promoting the adoption of the device at emergency departments (ED) was characterized by persistent staff resistance and lower-than-expected patient eligibility for kiosk-assisted care. The device was ultimately abandoned at all but one of the new sites. Observations and interviews with ED staff and the design/research team were conducted at four California EDs between April and July 2011 and point to conflicting understandings of evidence for the device's usefulness and reasons for its (non)adoption. The kiosk program's designers had attempted to "rationalize" medical work by embedding a formal representation of triage practices in the kiosk's software. However, the kiosk's "network" failed to stabilize as it encountered different patient populations, institutional politics, and the complex, pragmatic aspects of ED work at each site. The results of this evaluation challenge the persistent myth that a priori qualities and meanings inhere in technology regardless of context. The design and deployment of new IT projects in complex medical settings would benefit from empirically informed understandings of, and responses to, the contingent properties of human-technology relations.

  9. Attendance at a hospital emergency department by drivers involved in automobile accidents in Italy

    PubMed Central

    Pileggi, C; Nicotera, G; Angelillo, I

    2005-01-01

    Objective: This study investigated the profile of drivers involved in automobile accidents attending a hospital emergency department (ED) in Catanzaro (Italy). Methods: Car drivers involved in automobile accidents who were registered for emergency care between May 2003 and February 2004 were included in the study. Demographics and details of the accident were collected immediately after admittance, before examination by the medical staff. For each patient, the medical staff completed a form including diagnostic investigations and medical/surgical examination in the ED. Results: Of a total of 424 drivers included in the study 27.4% had conditions that were definitely non-urgent problems. Multiple logistic regression analysis indicated that the use of the ED as a source of non-urgent care was significantly higher among patients who were driving at a lower speed when the accident occurred, among those who presented to the ED before the implementation of the new Italian traffic code, and among those who underwent fewer diagnostic investigations and medical/surgical examinations in the ED. Most of the automobile related lesions occurred in the neck (43.9%) followed by multiple body regions (12.5%) and the upper extremities (10.4%). According to the nature of the injury a third were contusions (34%), followed by pain without physical signs and symptoms (28.8%), and dislocation, sprains, and strains (22.9%). Conclusions: Development of health promotion and education campaigns is required to prevent the use of the ED as a source of non-urgent care by those involved in automobile accidents. PMID:15788821

  10. Frequency of medication errors in an emergency department of a large teaching hospital in southern Iran

    PubMed Central

    Vazin, Afsaneh; Zamani, Zahra; Hatam, Nahid

    2014-01-01

    This study was conducted with the purpose of determining the frequency of medication errors (MEs) occurring in tertiary care emergency department (ED) of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5%) MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2%) and antimicrobial (23.6%) medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6%) and wrong time error (4.4%) were the most frequent administration errors. The less-experienced nurses (P=0.04), higher patient-to-nurse ratio (P=0.017), and the morning shifts (P=0.035) were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction of MEs in EDs. PMID:25525391

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

    PubMed

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

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

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

    PubMed Central

    Moscovice, I S

    1989-01-01

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

  13. Challenges and Perspectives for Tertiary Level Hospitals in Bolivia: The case of Santa Cruz de La Sierra Department.

    PubMed

    Medici, André

    2015-01-01

    Current legislation transferred public tertiary hospitals in Bolivia from the Municipalities to the Regional Level. However, the Regional Governments are experiencing technical and financial constraints to reform infrastructure, modernize equipment and introduce reforms to allow better governance, management and sustainability of these hospitals. This articles summarizes the recent experience of the Government of Santa Cruz de la Sierra in Bolivia where five tertiary hospitals and blood bank (most of them in precarious working conditions) has been transferred in 2012 from the Municipal Government of Santa Cruz (the capital) to the Regional Government of Santa Cruz. To face the challenges, the Regional Government of Santa Cruz implement several improvements, such as contract new clinical and administrative personal, increases hospital budgetary autonomy, outsource hospitals' auxiliary services, take measures to eliminate waiting lists and make several new investments to modernize and equip the hospitals. The World Bank was contracted to evaluated the future financial sustainability of these investments and to advice the Government to propose changes to increase the hospitals' management performance. The article describes the remaining challenges in these hospitals and the proposals from the World Bank Study. In the area of quality of care, the main challenge is to improve client satisfaction and continuous outcomes monitoring and evaluation according quality standards. In the area of financing, the challenge is how to assure the sustainability of these hospitals with the current level of health financing and the insufficient financial transfers from the National Government. In the area of Governance, reforms to streamline and simplify internal processes need to be introduced in order to establish mechanisms to increase transparency and accountability, allowing the hospital to have a good administration and adequate participation of the main actors in the guidance of

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

    PubMed

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

    2011-01-01

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

  15. 78 FR 15052 - Naugatuck Valley Surgical Center, Department of Saint Mary's Hospital, Waterbury, Connecticut...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... transcription services. Pursuant to 29 CFR 90.18(c), reconsideration may be granted under the following... in the supply of medical transcription services (or like or directly competitive services) to a foreign country, no acquisition from a foreign country the supply of medical transcription services...

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  18. 42 CFR 424.122 - Conditions for payment for emergency inpatient hospital services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  19. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  20. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  2. Exploring Intercollegiate Athletic Department-Community Partnerships through the Lens of Community Service Organizations

    ERIC Educational Resources Information Center

    Svensson, Per G.; Huml, Matthew R.; Hancock, Meg G.

    2014-01-01

    Institutions of higher education are increasingly engaging in partnerships with local communities. Within a sport context, the creation of the NCAA CHAMPS/Life Skills Program has emphasized partnerships between athletic departments and local community service organizations (CSOs). Prior studies, however, have used student-athletes rather than the…

  3. Evaluation Report: Projects in Personnel Services from the Department of Education, San Juan, Puerto Rico.

    ERIC Educational Resources Information Center

    1974

    This mammoth document consists of a random series of project reports and proposals from the Puerto Rican Department of Education. Each report is a distinct entity, and lists the school districts involved in the project under discussion. The papers all focus on those aspects of strategies and services which will help students to remain in school,…

  4. Investigation of Shifts in Autism Reporting in the California Department of Developmental Services

    ERIC Educational Resources Information Center

    Grether, Judith K.; Rosen, Nila J.; Smith, Karen S.; Croen, Lisa A.

    2009-01-01

    We investigated if shifts in the coding of qualifying conditions in the California Department of Developmental Services (DDS) have contributed to the increase in California children with autism observed in recent years. Qualifying condition codes for mental retardation (MR) and autism in DDS electronic files were compared to hard-copy records for…

  5. Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments.

    PubMed

    Wijesekera, Olindi; Reed, Amanda; Chastain, Parker S; Biggs, Shauna; Clark, Elizabeth G; Kole, Tamorish; Chakrapani, Anoop T; Ashish, Nandy; Rajhans, Prasad; Breaud, Alan H; Jacquet, Gabrielle A

    2016-12-01

    Introduction Without a universal Emergency Medical Services (EMS) system in India, data on the epidemiology of patients who utilize EMS are limited. This retrospective chart review aimed to quantify and describe the burden of disease and patient demographics of patients who arrived by EMS to four Indian emergency departments (EDs) in order to inform a national EMS curriculum.

  6. Using Excel's Solver Function to Facilitate Reciprocal Service Department Cost Allocations

    ERIC Educational Resources Information Center

    Leese, Wallace R.

    2013-01-01

    The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated and theoretically incorrect direct or step-down methods. This article illustrates how Excel's Solver…

  7. Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army

    DTIC Science & Technology

    2009-09-21

    Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army 21 September...Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army 5a. CONTRACT NUMBER 5b...Service Supply Chain , Services Acquisition, Service Lifecycle, Contract Management, Project Management, Program Management = = ^Åèìáëáíáçå=oÉëÉ~êÅÜ

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

    PubMed

    Whynes, D K; Reed, G

    1995-11-01

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

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

    ERIC Educational Resources Information Center

    White, Kathleen M.; And Others

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

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

    PubMed

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

    1994-09-01

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

  11. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  12. 78 FR 55671 - Hospital Care and Medical Services for Camp Lejeune Veterans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

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

  13. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  14. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    ERIC Educational Resources Information Center

    Casas, Paula; Isarowong, Nucha

    2015-01-01

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

  16. 75 FR 44808 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-29

    ... National Park Service Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest... repatriate cultural items in the control of the U.S. Department of Agriculture, Forest Service, Coconino... Canyon with the Hopi Tribe of Arizona. Officials of the U.S. Department of Agriculture, Forest...

  17. 49 CFR 40.403 - Must a service agent notify its clients when the Department issues a PIE?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Department issues a PIE? 40.403 Section 40.403 Transportation Office of the Secretary of Transportation... Must a service agent notify its clients when the Department issues a PIE? (a) As a service agent, if the Department issues a PIE concerning you, you must notify each of your DOT-regulated...

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

    PubMed

    Sahin, Alper A

    2014-01-01

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

  19. 78 FR 48163 - Notice of a Department of Health and Human Services Public Meeting and Request for Comments on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... and Human Services (HHS) published in the Federal Register an announcement of a public meeting to be... Doc No: 2013-19056] DEPARTMENT OF HEALTH AND HUMAN SERVICES Notice of a Department of Health and Human Services Public Meeting and Request for Comments on Matters Related to the Protection of Human Subjects...

  20. 78 FR 11677 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Apache-Sitgreaves...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service... Agriculture (USDA), Forest Service, Apache-Sitgreaves National Forests and the Field Museum of Natural...

  1. 7 CFR Exhibit A to Subpart F of... - National Park Service, U.S. Department of the Interior Regional Offices

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false National Park Service, U.S. Department of the.... A Exhibit A to Subpart F of Part 1901—National Park Service, U.S. Department of the Interior... Archeological and Historic Preservation, National Park Service. The three Regional Offices are: San...

  2. 7 CFR Exhibit A to Subpart F of... - National Park Service, U.S. Department of the Interior Regional Offices

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false National Park Service, U.S. Department of the.... A Exhibit A to Subpart F of Part 1901—National Park Service, U.S. Department of the Interior... Archeological and Historic Preservation, National Park Service. The three Regional Offices are: San...

  3. 7 CFR Exhibit A to Subpart F of... - National Park Service, U.S. Department of the Interior Regional Offices

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false National Park Service, U.S. Department of the.... A Exhibit A to Subpart F of Part 1901—National Park Service, U.S. Department of the Interior... Archeological and Historic Preservation, National Park Service. The three Regional Offices are: San...

  4. 7 CFR Exhibit A to Subpart F of... - National Park Service, U.S. Department of the Interior Regional Offices

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true National Park Service, U.S. Department of the Interior... to Subpart F of Part 1901—National Park Service, U.S. Department of the Interior Regional Offices... Historic Preservation, National Park Service. The three Regional Offices are: San Francisco Office:...

  5. 7 CFR Exhibit A to Subpart F of... - National Park Service, U.S. Department of the Interior Regional Offices

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false National Park Service, U.S. Department of the.... A Exhibit A to Subpart F of Part 1901—National Park Service, U.S. Department of the Interior... Archeological and Historic Preservation, National Park Service. The three Regional Offices are: San...

  6. 22 CFR 40.82 - Alien who departed the United States to avoid service in the armed forces.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... service in the armed forces. 40.82 Section 40.82 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS... Ineligible for Citizenship. § 40.82 Alien who departed the United States to avoid service in the armed forces... avoid or evade training or service in the United States Armed Forces. (b) Applicability to...

  7. 22 CFR 40.82 - Alien who departed the United States to avoid service in the armed forces.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... service in the armed forces. 40.82 Section 40.82 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS... Ineligible for Citizenship. § 40.82 Alien who departed the United States to avoid service in the armed forces... avoid or evade training or service in the United States Armed Forces. (b) Applicability to...

  8. 38 CFR 17.95 - Outpatient medical services for Department of Veterans Affairs employees and others in emergencies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Outpatient medical services for Department of Veterans Affairs employees and others in emergencies. Outpatient medical services for which charges shall be made as required by § 17.101 may be authorized for... services for Department of Veterans Affairs employees and others in emergencies. 17.95 Section...

  9. 38 CFR 17.95 - Outpatient medical services for Department of Veterans Affairs employees and others in emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Outpatient medical services for Department of Veterans Affairs employees and others in emergencies. Outpatient medical services for which charges shall be made as required by § 17.101 may be authorized for... services for Department of Veterans Affairs employees and others in emergencies. 17.95 Section...

  10. 38 CFR 17.95 - Outpatient medical services for Department of Veterans Affairs employees and others in emergencies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Outpatient medical services for Department of Veterans Affairs employees and others in emergencies. Outpatient medical services for which charges shall be made as required by § 17.101 may be authorized for... services for Department of Veterans Affairs employees and others in emergencies. 17.95 Section...

  11. 38 CFR 17.95 - Outpatient medical services for Department of Veterans Affairs employees and others in emergencies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Outpatient medical services for Department of Veterans Affairs employees and others in emergencies. Outpatient medical services for which charges shall be made as required by § 17.101 may be authorized for... services for Department of Veterans Affairs employees and others in emergencies. 17.95 Section...

  12. 38 CFR 17.95 - Outpatient medical services for Department of Veterans Affairs employees and others in emergencies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Outpatient medical services for Department of Veterans Affairs employees and others in emergencies. Outpatient medical services for which charges shall be made as required by § 17.101 may be authorized for... services for Department of Veterans Affairs employees and others in emergencies. 17.95 Section...

  13. Geographic information system analysis on the distribution of patients visiting the periodontology department at a dental college hospital

    PubMed Central

    2016-01-01

    Purpose The aim of this study is to analyze and visualize the distribution of patients visiting the periodontology department at a dental college hospital, using a geographic information system (GIS) to utilize these data in patient care and treatment planning, which may help to assess the risk and prevent periodontal diseases. Methods Basic patient information data were obtained from Dankook University Dental Hospital, including the unit number, gender, date of birth, and address, down to the dong (neighborhood) administrative district unit, of 306,656 patients who visited the hospital between 2007 and 2014. The data of only 26,457 patients who visited the periodontology department were included in this analysis. The patient distribution was visualized using GIS. Statistical analyses including multiple regression, logistic regression, and geographically weighted regression were performed using SAS 9.3 and ArcGIS 10.1. Five factors, namely proximity, accessibility, age, gender, and socioeconomic status, were investigated as the explanatory variables of the patient distribution. Results The visualized patient data showed a nationwide scale of the patient distribution. The mean distance from each patient’s regional center to the hospital was 30.94±29.62 km and was inversely proportional to the number of patients from the respective regions. The distance from a regional center to the adjacent toll gate had various effects depending on the local distance from the hospital. The average age of the patients was 52.41±12.97 years. Further, a majority of regions showed a male dominance. Personal income had inconsistent results between analyses. Conclusions The distribution of patients is significantly affected by the proximity, accessibility, age, gender and socioeconomic status of patients, and the patients visiting the periodontology department travelled farther distances than those visiting the other departments. The underlying reason for this needs to be analyzed

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

    PubMed

    Teaff, J D; Van Hyning, T E

    1988-01-01

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

  15. Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

    PubMed

    Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

    2016-06-01

    This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases.

  16. Negative correlation between mycological surfaces pollution in hospital emergency departments and blood monocytes phagocytosis of healthcare workers

    PubMed Central

    Lewicki, Sławomir; Bielawska-Drózd, Agata; Winnicka, Izabela; Leszczyński, Paweł; Cieślik, Piotr; Korniłłowicz-Kowalska, Teresa; Bohacz, Justyna; Jaroszuk-Ściseł, Jolanta; Kocik, Janusz

    2015-01-01

    The aim of the present study was to find a possible relationship between the presence of yeast and filamentous fungi in hospital emergency departments and the activity levels of blood granulocytes and monocytes in emergency personnel. The study of mycological pollution was conducted in winter; the samples were collected from 10 Warsaw hospitals emergency departments (HE D) and in 10 control locations (office spaces) and included air samples and swabbing of floor and walls. The blood for immunological investigation was taken in spring, from 40 men, 26 to 53 years old, healthcare workers of these departments, who have been working for at least 5 years in their current positions, and from 36 corresponding controls, working in control offices. Evaluation of blood leukocyte subpopulations was done by hematological analyzer and cytometry analysis and monocyte and granulocyte phagocytosis by Phagotest. There were no significant differences in the level of mycological contamination between the test and control places. The qualitative analysis of the surfaces and air samples revealed a prevalence of strains belonging to Aspergillus spp. and Penicillium spp. genus. Statistical analysis revealed the existence of negative correlation between the number of phagocytizing blood monocytes and fungi spores content on floor and wall surfaces in hospital emergency departments (r = –0.3282, p < 0.05 and positive correlation between the number of phagocytizing monocytes in the blood of office workers and fungi pollution of control offices (r = 0.4421, p < 0.01). PMID:26648782

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-09

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

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    PubMed

    Postal, S N

    1990-06-01

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

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

    PubMed

    Sanford, Kathleen D

    2011-12-01

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

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

    PubMed

    Desombre, T; Eccles, G

    1998-01-01

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

  2. Oncogenetics service and the Brazilian public health system: the experience of a reference Cancer Hospital.

    PubMed

    Palmero, Edenir I; Galvão, Henrique C R; Fernandes, Gabriela C; Paula, André E de; Oliveira, Junea C; Souza, Cristiano P; Andrade, Carlos E; Romagnolo, Luis G C; Volc, Sahlua; C Neto, Maximiliano; Sabato, Cristina; Grasel, Rebeca; Mauad, Edmundo; Reis, Rui M; Michelli, Rodrigo A D

    2016-05-13

    The identification of families at-risk for hereditary cancer is extremely important due to the prevention potential in those families. However, the number of Brazilian genetic services providing oncogenetic care is extremely low for the continental dimension of the country and its population. Therefore, at-risk patients do not receive appropriate assistance. This report describes the creation, structure and management of a cancer genetics service in a reference center for cancer prevention and treatment, the Barretos Cancer Hospital (BCH). The Oncogenetics Department (OD) of BCH offers, free of charge, to all patients/relatives with clinical criteria, the possibility to perform i) genetic counseling, ii) preventive examinations and iii) genetic testing with the best quality standards. The OD has a multidisciplinary team and is integrated with all specialties. The genetic counseling process consists (mostly) of two visits. In 2014, 614 individuals (371 families) were seen by the OD. To date, over 800 families were referred by the OD for genetic testing. The support provided by the Oncogenetics team is crucial to identify at-risk individuals and to develop preventive and personalized behaviors for each situation, not only to the upper-middle class population, but also to the people whose only possibility is the public health system.

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed Central

    Park, Arum; Chang, Hyejung

    2017-01-01

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

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

    PubMed

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

    2013-01-01

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

  6. [An evaluation of the 4 years of the Oral Rehydration Service of the Hospital Infantil de Monterrey].

    PubMed

    Muraira-Gutiérrez, A; Méndez-Jara, A; Ruiz-Villalpando, G

    1992-06-01

    At four years of being founded the Service of Oral Hydration from Hospital Infantil de Monterrey, we carried out this investigation to know its productivity, to determine costs of internments, death rates due to diarrhea and dehydration in the hospital and at a State level. The statistics from the hospital were revised in the previous and subsequent years to the institution of the Service in September of 1986, so as the statistics of death due to diarrhea from the State Health Department. The cases attended were 12,139, from which 9,024 belonged to plan A, 2,983 to plan B and 72 to plan C. Three hundred (300) doctors were trained and nine (9) research studies were accomplished. A decrease was achieved from the hospital rate admission by diarrhea and dehydration, throw the oral dehydration therapy in a 66%, the mortality rate was reduced 72% and an expenditure of $619,243,480.00 pesos in drugs and auxiliary examinations of diagnostic was avoided. At a State level the general death rate due to diarrhea got a cutdown of 13.1 to 5.8, and in infants under a year old decreased from 275 to 122.3. The oral hydration therapy applied in the State seems to be the main reason in that results.

  7. Report on the Time and Frequency Activities of the Time Service Department of the U.S. Naval Observatory

    DTIC Science & Technology

    2001-11-01

    33’’ Annual Precise Time and Time Interval (PTTI) Meeting Administrators Secretary Engineers and Technicians REPORT ON THE TIME AND FREQUENCY OF...THE U.S. NAVAL OBSERVATORY ACTIVITIES OF THE TIME SERVICE DEPARTMENT 2 1 4 Demetrios Matsakis and the staff of the Time Service Department U.S...requirements of many real- time users, the best known among them being GPS. 1 THE BASICS The most important part of the USNO Time Service Department is its

  8. A study of occupational health and safety measures in the Laundry Department of a private tertiary care teaching hospital, Bengaluru

    PubMed Central

    Kumar, M. Shashi; Goud, B. Ramakrishna; Joseph, Bobby

    2014-01-01

    Introduction: The Laundry Department plays an important role in preventing the spread of infection and continuously supplying clean linen to various departments in any hospital. Objectives of the Study: To identify existing practices and occupational safety and health (OSH) measures in the Laundry Department and to assess the use of personal protective equipments (PPEs) among health care workers. Materials and Methods: A cross-sectional study was carried out in a private tertiary care teaching hospital. An observation checklist was developed, which was partially based on occupational hazard checklist of OSHA for Laundry Department. This was field tested and validated for applicability for this study. Results: The potential biological hazards are infections through exposure to aerosols, spills and splashes during various activities, fungal infection due to wet clothes and environment and infections through fomites. The potential physical hazards are injuries due to slips and falls, exposure to heat, humidity, dust, noise, and vibration. The potential chemical hazards are contact dermatitis and allergic asthma due to exposure to detergents, phenyl solution, bleaching powder, and soap oil solution. The potential ergonomic hazards are musculoskeletal diseases and repetitive stress injuries at the shoulder, elbow, and small joints of the hands. PPEs were not used consistently in most areas of the department. PMID:25006311

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

    ERIC Educational Resources Information Center

    Bucks County Technical School, Fairless Hills, PA.

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

  10. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  11. 42 CFR 419.21 - Hospital services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  12. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  13. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  14. 42 CFR 419.21 - Hospital services subject to the outpatient prospective payment system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  16. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  17. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  18. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  19. 42 CFR 410.28 - Hospital or CAH diagnostic services furnished to outpatients: Conditions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    PubMed

    1997-06-01

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

  2. 77 FR 69504 - Calendar Year 2012 Cost of Outpatient Medical and Dental Services Furnished by Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... the cost of outpatient medical and dental services furnished by military treatment facilities through... BUDGET Calendar Year 2012 Cost of Outpatient Medical and Dental Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable...

  3. 77 FR 11571 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... Service, Gila National Forest, Silver City, NM; Arizona State Museum, University of Arizona, Tucson, AZ... control of the U.S. Department of Agriculture, Forest Service, Gila National Forest, Silver City, NM,...

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

    PubMed

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

    2004-12-01

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

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

    PubMed Central

    Noble, Vanessa; Parle, Julie

    2014-01-01

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

  6. The health of irregular and illegal immigrants: analysis of day-hospital admissions in a department of migration medicine.

    PubMed

    Affronti, Mario; Affronti, Andrea; Pagano, Salvatore; Soresi, Maurizio; Giannitrapani, Lydia; Valenti, Miriam; La Spada, Emanuele; Montalto, Giuseppe

    2013-10-01

    It is difficult to trace full details of the path which irregular or illegal immigrants follow when seeking assistance in the network of the various hospital departments and health structures. The aim of this work was to analyze the health needs of immigrant people by reviewing the types of treatment given to them in the day-hospital of our Department of Migration Medicine. Our study analyzed day-hospital admissions between 2003 and 2009. The patient charts used for managing day-hospital activity were adopted in 2002 in conformity with the "OSI project". From these it is possible to draw up a scale picture of the distribution of each pathology in the immigrant population. The sample population consisted of 1,758 subjects, representing 7.4% of potential users. More than half came from Africa, followed by Asia, and then Europe. Gastroenterological diseases ranked first, with dyspeptic syndromes most frequently diagnosed. Infections and parasitic diseases ranked second, and the most frequent diagnoses were sexually transmitted diseases. Third were diseases of the genitourinary system. Metabolic disorders ranked fourth, among them, more than half of the cases were of diabetes mellitus, in patients from south-east Asia. Diseases of the circulatory system were sixth, with hypertension the most frequent pathology. Our data confirm a marked persistence of the phenomenon known as the "healthy immigrant effect" in these types of patients, as well as the prominent role played by "social determinants" in conditioning the health of immigrants, particularly in the case of some infectious diseases.

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

    PubMed

    Forbes, Ian; Hindle, Don; Degeling, Pieter; Zhang, Kai; Xu, Lingzhong; Meng, Qingyue; Wang, Jian

    2002-01-01

    The Chinese government began a major reform of the hospital sector in the early 1980s. The main aim was to increase productivity by phasing out prospective global budgets from the government, and encouraging between-hospital competition for the business of user-pay and insured patients. This goal was to be achieved without unreasonable prejudice to the financial sustainability of hospitals or to the fairness of access and service provision. We explored the effects of these changes by analysing data for four levels of hospital in two of the most populous provinces between 1985 and 1999. We used data envelope analysis, and found that the majority of hospitals experienced a decline in productivity. Social efficiency (measured by the level of provision of unnecessary services) also declined, especially in the largest hospitals that could easily increase the use of expensive technologies. Most hospitals increased their economic sustainability, measured as the ratio between revenue and expenditures. However, the lowest-level hospitals experienced stable or reduced sustainability due to their inability to compete with marketing by higher-level hospitals. We conclude that, although there were many benefits, the overall impact of the introduction of market forces may have been negative. An important factor was that not all aspects (such as supplier-induced demand) were adequately controlled by government agencies. We suggest ways of alleviating the most problematic elements of current arrangements.

  8. US Department of Agriculture forest service eastern region strategic telecommunication plan: 1994-2003

    SciTech Connect

    Rust, W.R.; Haakinson, E.J.

    1994-05-01

    This report documents the development of a telecommunication strategy for 1994-2003 for the Eastern Region of the U.S. Department of Agriculture Forest Service. The Institute for Telecommunicaiton Sciences (ITS) identified telecommunication needs, assessed the existing telecommunication systems of the 15 National Forests in the Region, assessed internal and external factors that impact telecommunication planning, and assessed telecommunication technologies. Based on the foregoing, ITS developed a telecommunication strategy intended to ensure that Eastern Region telecommunication systems and services support the mission of the organization in a reliable and cost-effective manner.

  9. [Definition of "Safety and Hygiene Packages" as a management model for the Hospital Hygiene Service (HHS)].

    PubMed

    Raponi, Matteo; Damiani, Gianfranco; Vincenti, Sara; Wachocka, Malgorzata; Boninti, Federica; Bruno, Stefania; Quaranta, Gianluigi; Moscato, Umberto; Boccia, Stefania; Ficarra, Maria Giovanna; Specchia, Maria Lucia; Posteraro, Brunella; Berloco, Filippo; Celani, Fabrizio; Ricciardi, Walter; Laurenti, Patrizia

    2014-01-01

    The purpose of this research is to identify and formalize the Hospital Hygiene Service activities and products, evaluating them in a cost accounting management view. The ultimate aim, is to evaluate the financial adverse events prevention impact, in an Hospital Hygiene Service management. A three step methodology based on affinity grouping activities, was employed. This methodology led us to identify 4 action areas, with 23 related productive processes, and 86 available safety packages. Owing to this new methodology, we was able to implement a systematic evaluation of the furnished services.

  10. Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

    PubMed Central

    2014-01-01

    Background A minority of patients with incurable and advanced disease receive specialised palliative care. Specialised palliative care services that complement the care of difficult and complex cases ought to be integrated with services that deliver general care for most patients. A typical setting in which this integrative concept takes place is the hospital setting, where patients suffering from incurable and advanced disease are treated in many different departments. The aim of the study is to investigate the profile and spectrum of a palliative care consultation service (PCCS) at a German university hospital with special reference to pain therapy. Methods We retrospectively analysed the PCCS documentation of three years. Results Most patients were referred from non-surgical departments, 72% were inpatients, and 28% were outpatients. 98% of the patients suffered from cancer. Counselling in pain therapy was one of the key aspects of the consultation: For 76% of all consulted patients, modifications of the analgesic regimen were recommended, which involved opioids in 96%. Recommendations on breakthrough-pain medication were made for 70% of the patients; this was an opioid in most cases (68%). The most commonly used opioid was morphine. For 17% of the patients, additional diagnostic procedures were recommended. Besides pain management palliative care consultation implied a wide range of recommendations and services: In addition to organising home care infrastructure, palliative care services supported patients and their families in understanding the life-limiting diseases. They also coordinated physical therapy and social and legal advice. Conclusion This survey clearly shows that for a consultation service to support patients with incurable or advanced disease, a multi-disciplinary approach is necessary to meet the complex requirements of a needs-adapted palliative care in inpatient or outpatient settings. Timely integration of palliative expertise may support

  11. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...)(ii) of the Act. (c) Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Act... the ESRD composite rate and drugs and supplies furnished during dialysis but not included in the composite rate. (2) Renal dialysis services provided on or after January 1, 2011, for patients with...

  12. Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

    PubMed Central

    Kim, Jinkyung; Han, Woosok

    2012-01-01

    Objectives To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents’ and organizational characteristics. Results The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. Conclusion The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria. PMID:24159497

  13. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

    PubMed Central

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids. Results Throughout the services, hospital duvets, cotton blankets and plastic “bubble-wrap” were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols. Conclusion The most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic “bubble wrap”, and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units. PMID:23938145

  14. Identifying geographical regions serviced by hospitals to assess laboratory-based outcomes

    PubMed Central

    Gandhi, Sonja; Shariff, Salimah Z; Beyea, Michael M; Weir, Matthew A; Hands, Theresa; Kearns, Glen; Garg, Amit X

    2013-01-01

    Objective To define geographical regions (forward sortation areas; FSAs) in Southwestern Ontario, Canada from which patients would reliably present to a hospital with linked laboratory data if they developed adverse events related to medications dispensed in outpatient pharmacies. Design Descriptive research. Setting Forty-five hospitals in Southwestern Ontario, Canada, from 2003 to 2009. Participants Patients aged 66 years and older who received an outpatient prescription for any drug and presented to the emergency department in the subsequent 120 days. Main outcome measure The proportion of patients in a given FSA presenting to an emergency department at a hospital with linked laboratory data versus a hospital without linked laboratory data. To be included in the catchment area at least 90% of emergency department visits in an FSA must have occurred at laboratory-linked hospitals in a given year. Results Over the study period, there were 649 713 emergency department visits by patients with recent prescription claims from pharmacies in 1 of 118 FSAs. In total, 141 302 of these patients presented to an emergency department at a laboratory-linked hospital. For the year 2003, 12 FSAs met our criteria to be in the catchment area and this number grew to 25 FSAs by the year 2009. Conclusions The relevant geographical regions for hospitals with linked laboratory data have been successfully identified. Studies can now be conducted using these well-defined areas to obtain reliable information on the incidence and absolute risk of presenting to hospital with laboratory abnormalities in older adults dispensed commonly prescribed medications in outpatient pharmacies. PMID:23293246

  15. Evaluation of the Career Development and Compensation Program in the Department of Paediatrics at The Hospital for Sick Children.

    PubMed

    Daneman, Denis; Kennedy, Julia; Coyte, Peter C

    2010-01-01

    The Career Development and Compensation Program (CDCP) was created by the Department of Paediatrics at The Hospital for Sick Children, in Toronto, Ontario, to provide clearly defined job expectations, enhance career development and assess performance through two distinct processes: the annual review and the triennial review. Staff are expected to advance the goals of the department and the hospital through activities in clinical care, education and mentorship, and research and are rewarded for excellence through compensation and career advancement. We evaluated the CDCP and conducted interviews with 27 members of the department; these formed the primary basis for our summative evaluation. The study objectives were to evaluate (1) mechanisms to recognize contributions, (2) processes used to ensure staff accountability and (3) opportunities to increase efficiencies. Interviews with members of the department resulted in a broad and comprehensive understanding of the CDCP. It is regarded as a rigorous, transparent and fair program. Concerns about the CDCP stem from the potential negative outcomes of assigning value to particular activities, the inequitable level of support provided to staff across the department and the costs of the review processes. Several recommendations were identified that serve to increase equality and strengthen supports for members of the department, to improve the ability of the CDCP to evaluate the softer aspects of clinical care and scholarship and to adopt a more holistic and integrated approach in the evaluation of staff. These re-formed arrangements build upon past modifications to the CDCP and represent natural progressions in the development of a program that has wide support from members of the department.

  16. Communication services for a distributed hospital information system.

    PubMed

    Graeber, S

    1996-09-01

    Planning principles and development are described of a communication server which controls and performs all information exchange between distributed and heterogeneous applications in a hospital information system. The analysis is based on business process modeling. At present, the core of the server uses a commercial product (Cloverleaf). This allows to connect both old systems with no or few interface features and new systems with modern interface facilities (such as HL7). Prerequisites, functions, and configuration of the server software are described in detail. Experiences, advantages, and disadvantages are discussed.

  17. The use of bed distribution and service population indexes for hospital bed allocation.

    PubMed Central

    Bay, K S; Nestman, L J

    1984-01-01

    To provide an empirical base for bed reallocation within a hospital planning jurisdiction in Canada, this article proposes a population-based method to measure the distribution of acute care beds for each district and the service load for each hospital. The measure for the bed distribution (BDI) is the number of beds per 1,000 age-sex-adjusted number of residents in a district, while the service load of a hospital is measured by the number of persons being served per bed (SPI). The number of beds allocated to each district, or the number of persons served by each hospital, was estimated by applying the hospital service population model, which employs both relevance- and commitment-index methods. The method thus proposed was applied to Alberta data. It appears that both BDI and SPI measures are stable across the variation of methods or data sources, yet sensitive enough to detect changes over the years. Using these indexes, potentially over- or underbedded districts and over- or underloaded hospitals can be identified for further investigation so that possible reallocation of acute care beds among the hospitals may take place. PMID:6547418

  18. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    PubMed Central

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2017-01-01

    Background: This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Methods: Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results: In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion: By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. PMID:28005539

  19. Outcomes and Costs of Poisoned Patients Admitted to an Adult Emergency Department of a Spanish Tertiary Hospital: Evaluation through a Toxicovigilance Program

    PubMed Central

    Quintana, Manuel; Martínez, Ana; Carcas, Antonio J.

    2016-01-01

    Abstract Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them. Objective Through a validated toxicovigilance program (SAT-HULP) we examined the characteristics of acute poisoning cases (APC) attended in the Emergency Department (ED) of La Paz Hospital (Madrid, Spain) and assessed their economic impact on the health system. Material and Methods The active poisoning surveillance system performs a daily search for cases in the hospital´s computerized case records. Found cases are entered into a database for recording of type of poisoning episode, reasons for exposure, causative agent, signs and symptoms and treatment. We carried out a cross-sectional epidemiological study with analytical projection, based on an impact study on cost per survivor. The data for the costs attributable to cases of APC observed at HULP (outpatients and inpatients) was obtained from the based on the information provided by the diagnosis-related groups (DRG) through the corresponding hospital discharge reports (available through SAT-HULP). Results During the first 30 month of SAT-HULP operation we found a total of 3,195 APC, a cumulative incidence rate of 1.75% of patients attended in the ED. The mean (SD) patient age was 40.9 (17.8) years and 51.2% were men. Drug abuse accounted for 47.5% of the cases. Suicide attempt was the second most frequent category (38.1%) and other causes accounted for 14.5% of APC. The total cost of hospital care for our hospital rose to €1,825,263.24 (approximately €730,105.30/year) resulting in a permanent occupation of 4 beds/year. Conclusions SAT-HULP constitutes a validated toxicovigilance tool, which continuously integrates available data in real-time and helps health services manage APC data flexibly, including the consumption of resources from the health system. PMID:27100460

  20. Is it relevant to screen young women hospitalized in psychiatric department for neuropsychiatric systemic lupus erythematosus (NPSLE)?

    PubMed Central

    Audemard-Verger, Alexandra; Comby, Elizabeth; Nathou, Clément; Sultan, Audrey; Frémont, Mathieu; Baldolli, Aurélie; Trumier, Louis Simon; Marzloff, Vincent; Le Mauff, Brigitte; Manuzak, Jennifer; Dollfus, Sonia; Bienvenu, Boris

    2016-01-01

    Abstract On the basis that diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) is sometimes difficult and systemic lupus erythematosus (SLE) can present with isolated psychiatric symptoms, we initiated a survey in a psychiatric department to screen for NPSLE in young female inpatients. We prospectively studied consecutive young female patients referred to the department of psychiatry. Antinuclear antibodies (ANA), anti-deoxyribonucleic acid (DNA), and antiextractable soluble nuclear antigens (ENA) in the serum of patients were screened. In case of positive anti-DNA or anti-ENA, the patient was referred to the department of internal medicine. One hundred patients were enrolled, mean age 33.1 ± 8.4 years. Most patients presented underlying psychiatric disorders: depression (46%), schizophrenia (13%), anxiety disorder (6%), and personality disorder (10%). A quarter of the cohort did not display underlying psychiatric disorders before hospitalization. Positive ANA ≥1:160 were found in 32 of the 100 patients tested (32%). No patients presented anti-DNA antibodies. One patient had positive anti-sjogrën's syndrome related antigen A (SSA), but did not present any features of SLE or Sjögren syndrome. Thus, systematic screening of SLE is not relevant in young women hospitalized in psychiatric department. However, clinicians should keep in mind that SLE can present with pure psychiatric symptoms. PMID:27893665