Sample records for hospitals special

  1. Case-mix specialization in the market for hospital services.

    PubMed Central

    Farley, D E; Hogan, C

    1990-01-01

    Historically, cost-based reimbursement encouraged hospitals to compete on the basis of quality, leading to duplication of services and other inefficient behavior. More recently, prospective payment, selective contracting, and other innovations in reimbursement have strengthened incentives for more efficient hospital operations. In principle, hospitals may be able to reduce their costs by limiting the array of services they provide, but there has been little empirical evidence that U.S. hospitals are moving toward greater specialization or that specialization leads to cost savings. This article explores recent changes in case-mix specialization and the relationship of these changes to hospital costs. It first describes an index of specialization derived from Information Theory and shows that this index provides intuitively reasonable results in characterizing patterns of specialization across hospitals. The analysis then demonstrates that specialization, as measured by this index, in fact increased from 1980 through 1985; that specialization can indeed lower hospital costs; and that increases in specialization have been largest in those hospitals with the greatest incentives to reduce costs. PMID:2123838

  2. Hospital costs and specialization: benefits of limiting the number of product lines.

    PubMed

    Eastaugh, Steven R

    2009-01-01

    Trends in hospital specialization are studied using multiple regression analysis for the period 1999-2008. The observed 31.3 percent rise in specialization was associated with a 9.5 percent decline in unit cost per admission. The number of specialized hospitals has grown by 149 percent in the past decade. Other hospitals are getting more specialized by reducing their product lines. Specialization has been highest in competitive West Coast markets and lowest in the rate-regulated states (New York and Massachusetts). Hospitals have less incentive to contain costs by decreasing the array of services offered in stringent rate-setting states. The term "underspecialization" is advanced to capture the inability of some hospitals to selectively prune out product lines in order to specialize. Such hospitals spread resources so thin that many good departments suffer. Unit cost per case (DRG-adjusted) is higher in the less specialized hospitals.

  3. Hospital differences in special care nursery use for newborns of gestational diabetic mothers.

    PubMed

    Danilack, Valery A; Muri, Janet H; Savitz, David A; Caldwell, Donna L; Wood, Carolyn L

    2016-09-01

    Relatively healthy newborns of mothers with gestational diabetes mellitus (GDM) sometimes receive unwarranted surveillance. We studied the relationship between hospital characteristics and special care nursery use and total length of stay among GDM deliveries. We identified GDM deliveries at 44 USA member hospitals of the National Perinatal Information Center from 2007 to 2011. To study low risk, relatively healthy newborns with presumed discretion in special care nursery use, we analyzed 43 444 singleton newborns with only minor or moderate complications and WHO were not preterm or low birthweight. Among eligible newborns, 6% received special care, but this ranged from 1% to 16% across 44 hospitals studied. Unadjusted associations suggested special care nursery use was highest in academic teaching hospitals, the Midwest, hospitals with ≥40% Medicaid births, and hospitals with a high supply of special care nursery beds. However, after controlling for clustering within hospitals, there were no significant associations between hospital characteristics and special care nursery use or length of stay. Hospital-level variation in special care nursery use and length of stay of relatively healthy newborns of mothers with GDM is unexplained by hospital characteristics and suggests other operational or management factors impacting utilization of newborn care resources.

  4. The Impact of Hospital’s Cardiac Specialization on Outcomes after Coronary Artery Bypass Graft Surgery: Analysis of Medicare Claims Data

    PubMed Central

    Girotra, Saket; Lu, Xin; Popescu, Ioana; Vaughan-Sarrazin, Mary; Horwitz, Phillip A.; Cram, Peter

    2011-01-01

    Background Hospital volume has been widely embraced as a proxy measure for hospital quality; little attention has been focused on an alternative quality measure-hospital specialization. Even though specialization occurs on a continuum, previous studies have only focused on a small number of highly specialized hospitals (single-specialty hospitals). Studies on the broad relationship between hospital specialization and outcomes after coronary artery bypass grafting (CABG) are limited. Methods and Results We conducted a retrospective cohort study of 705,084 Medicare patients (1130 hospitals) who underwent CABG during 2001-2005. We stratified hospitals into quintiles based on their degree of cardiac specialization (proportion of a hospital’s Medicare discharges classified as Major Diagnostic Category 5 – cardiovascular diseases). We compared patient and hospital characteristics and outcomes across quintiles of cardiac specialization. Patient characteristics were generally similar across quintiles, but mean annual CABG volume increased progressively from quintile 1 (least-specialized) to quintile 5 (most-specialized). Unadjusted 30-day mortality was similar at hospitals in quintiles 1-4 (4.8%), except quintile 5 where mortality was lower (4.3%). A strong inverse association was seen between hospital cardiac specialization and 30-day mortality after adjustment for patient characteristics (P trend=0.001). However, this was no longer significant after additional adjustment for CABG volume (P trend=0.65). Results were similar for other mortality outcomes and length of stay. Conclusions After accounting for patient characteristics and CABG volume, greater cardiac specialization was not associated with clinically significant improvement in patient outcomes. This study calls into question the benefit of cardiac specialization for the vast majority of CABG-performing U.S. hospitals. PMID:20923993

  5. The relationship between hospital specialization and hospital efficiency: do different measures of specialization lead to different results?

    PubMed

    Lindlbauer, Ivonne; Schreyögg, Jonas

    2014-12-01

    This study investigated the relationship between hospital specialization and technical efficiency using different measures of specialization, including two novel approaches based on patient volumes rather than patient proportions. It was motivated by the observation that most studies to date have quantified hospital specialization using information about hospital patients grouped into different categories based on their diagnosis, and in doing so have used proportions-thus indirectly assuming that these categories are dependent on one other. In order to account for the diversification of organizations and the idea that hospitals can be specialized in terms of professional expertise or technical equipment within a given diagnosis category, we developed our two specialization measures based on patient volume in each category. Using a one-step stochastic frontier approach on randomly selected data from the annual reports of 1,239 acute care German hospitals for the years 2000 through 2010, we estimated the relationship of inefficiency to exogenous variables, such as specialization. The results show that specialization as quantified by our novel measures has effects on efficiency that are the opposite of those obtained using earlier measures of specialization. These results underscore the importance of always providing an exact definition of specialization when studying its effects. Additionally, a Monte Carlo simulation based on three scenarios is provided to facilitate the choice of a specialization measure for further analysis.

  6. [Communication of psychiatric hospitals' specialization].

    PubMed

    Thielscher, Christian; Kox, Andreas; Schütte, Michael

    2010-09-01

    To analyze whether specialization of psychiatric hospitals results in quality improvement, and whether it can and should be measured and communicated to patients and ambulatory care physicians. Depth interviews with key deciders in the German psychiatric care system. There are several specializations within the system of psychiatric hospital care which can be communicated to patients and physicians; this would facilitate choice of hospital. There is no national database available yet. Data collection and communication as provided by an independent organization would improve knowledge about hospital specialization.

  7. 42 CFR 412.101 - Special treatment: Inpatient hospital payment adjustment for low-volume hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System for... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Inpatient hospital payment...

  8. A comparison of the surgical mortality due to colorectal perforation at different hospitals with data from 10,090 cases in the Japanese National Clinical Database.

    PubMed

    Ohki, Takeshi; Yamamoto, Masakazu; Miyata, Hiroaki; Sato, Yasuto; Saida, Yoshihisa; Morimoto, Tsuyoshi; Konno, Hiroyuki; Seto, Yasuyuki; Hirata, Koichi

    2017-01-01

    Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database.Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted. The primary outcome measures included the 30-day postsurgery mortality and surgical mortality of colorectal perforation. We analyzed differences in the observed-to-expected mortality (O/E) ratio between the two groups of hospitals, that is, specialized and non-specialized, using the logistic regression analysis forward selection method.There were 10,090 cases of disease-induced colorectal perforation during the study period. The annual average postoperative fatality rate was 11.36%. There were 3884 patients in the specialized hospital group and 6206 in the non-specialized hospital group. The O/E ratio (0.9106) was significantly lower in the specialized hospital group than in the non-specialized hospital group (1.0704). The experience level of hospitals in treating cases of colorectal perforation negatively correlated with the O/E ratio.We conducted the first study investigating differences among hospitals with respect to their fatality rate of colorectal perforation on the basis of data from a nationwide database. Our data suggest that patients with colorectal perforation should choose to be treated at a specialized hospital or a hospital that treats five or more cases of colorectal perforation per year. The results of this study indicate that specialized hospitals may provide higher quality medical care, which in turn proves that government policy on healthcare is effective at improving the medical system in Japan.

  9. 42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Hospitals that incur indirect costs for graduate medical education programs. 412.105 Section 412.105 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective...

  10. 42 CFR 412.102 - Special treatment: Hospitals located in areas that are reclassified from urban to rural as a...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Hospitals located in areas that...

  11. Two-tier charging in Maputo Central Hospital: costs, revenues and effects on equity of access to hospital services.

    PubMed

    McPake, Barbara; Hongoro, Charles; Russo, Giuliano

    2011-06-02

    Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total), where capital and drug costs were surprisingly low (2 and 4% respectively). We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a) the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b) because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic operations, rather than the other way around. We conclude that the observed lack of transparency may create scope for an inequitable cross subsidy of private customers by public resources.

  12. 42 CFR 412.531 - Special payment provisions when an interruption of a stay occurs in a long-term care hospital.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... a stay occurs in a long-term care hospital. 412.531 Section 412.531 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.531 Special payment provisions when an interruption of a stay occurs in a long-term care hospital. (a...

  13. Chapter 21: special hospitals in neurology and neurosurgery.

    PubMed

    Sammet, Kai

    2010-01-01

    Central to medicine is often where care and treatment are provided. Whereas today hospitals are the main locations to deliver medical help, in history we find different places for care and treatment. This chapter deals with these different places beginning in antiquity and sketching, e.g., the Greek asclepieion or the Roman valetudinarium. The roots of the modern hospital lie in the Middle Ages. Byzantine, Islamic as well as Christian hospitals are described. Around 1800 the rise of the general hospital began. Three ways into modernity are sketched: the British, the German and the French development of hospitals during the 18th and 19th century. Subsequently the emergence of special hospitals in Great Britain and in Germany is depicted. Whereas in Great Britain neurology had its roots as a specialty at the Queen Square Hospital, development in Germany differed. Here we can find different special neurological departments in general hospitals. The description of the emergence of neurotraumatological and neurosurgical special hospitals follows. Particularly World War I had a deep impact on the development of those facilities. Finally the history of neurotraumatology and neurology in Great Britain and Germany after World War II is sketched.

  14. Distribution of specialized care centers in the United States.

    PubMed

    Wang, Henry E; Yealy, Donald M

    2012-11-01

    As a recommended strategy for optimally managing critical illness, regionalization of care involves matching the needs of the target population with available hospital resources. The national supply and characteristics of hospitals providing specialized critical care services is currently unknown. We seek to characterize the current distribution of specialized care centers in the United States. Using public data linked with the American Hospital Association directory and US Census, we identified US general acute hospitals providing specialized care for ST-segment elevation myocardial infarction (STEMI) (≥40 annual primary percutaneous coronary interventions reported in Medicare Hospital Compare), stroke (The Joint Commission certified stroke centers), trauma (American College of Surgeons or state-designated, adult or pediatric, level I or II), and pediatric critical care (presence of a pediatric ICU) services. We determined the characteristics and state-level distribution and density of specialized care centers (centers per state and centers per state population). Among 4,931 acute care hospitals in the United States, 1,325 (26.9%) provided one of the 4 defined specialized care services, including 574 STEMI, 763 stroke, 508 trauma, and 457 pediatric critical care centers. Approximately half of the 1,325 hospitals provided 2 or more specialized services, and one fifth provided 3 or 4 specialized services. There was variation in the number of each type of specialized care center in each state: STEMI median 7 interquartile range (IQR 2 to 14), stroke 8 (IQR 3 to 17), trauma 6 (IQR 3 to 11), pediatric specialized care 6 (IQR 3 to 11). Similarly, there was variation in the number of each type of specialized care center per population: STEMI median 1 center per 585,135 persons (IQR 418,729 to 696,143), stroke 1 center per 412,188 persons (IQR 321,604 to 572,387), trauma 1 center per 610,589 persons (IQR 406,192 to 917,588), and pediatric critical care 1 center per 665,282 persons (IQR 441,525 to 942,254). The national distribution patterns differed for each type of specialized care center. The distribution of specialized care centers varies across the United States. These observations highlight unanswered questions about the regional organization of specialized care in the United States. Copyright © 2012. Published by Mosby, Inc.

  15. An Analysis of Organizational Performance Based on Hospital Specialization Level and Strategy Type

    PubMed Central

    Kim, Han-Sung; Kim, Young-Hoon; Woo, Jung-Sik; Hyun, Sook-Jung

    2015-01-01

    Introduction Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized. Methodology This study uses the information theory index (ITI) and the Herfindahl-Hirschman index (HHI) to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care. Study Results The results show that a focused strategy (high HHI) improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI) improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds). In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care. PMID:26218570

  16. An Analysis of Organizational Performance Based on Hospital Specialization Level and Strategy Type.

    PubMed

    Kim, Han-Sung; Kim, Young-Hoon; Woo, Jung-Sik; Hyun, Sook-Jung

    2015-01-01

    Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized. This study uses the information theory index (ITI) and the Herfindahl-Hirschman index (HHI) to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care. The results show that a focused strategy (high HHI) improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI) improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds). In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care.

  17. Individual and hospital-specific factors influencing medical graduates' time to medical specialization.

    PubMed

    Johannessen, Karl-Arne; Hagen, Terje P

    2013-11-01

    Previous studies of gender differences in relation to medical specialization have focused more on social variables than hospital-specific factors. In a multivariate analysis with extended Cox regression, we used register data for socio-demographic variables (gender, family and having a child born during the study period) together with hospital-specific variables (the amount of supervision available, efficiency pressure and the type of teaching hospital) to study the concurrent effect of these variables on specialty qualification among all 2474 Norwegian residents who began specialization in 1999-2001. We followed the residents until 2010. A lower proportion of women qualified for a specialty in the study period (67.9% compared with 78.7% of men, p < 0.001), and they took on average six months longer than men did to complete the specialization qualification (p < 0.01). Fewer women than men entered specialties providing emergency services and those with longer working hours, and women worked shorter hours than men in all specialties. Hospital factors were significant predictors for the timely attainment of specialization: working at university hospitals (regional) or central hospitals was associated with a reduction in the time taken to complete the specialization, whereas an increased patient load and less supervision had the opposite effect. Multivariate analysis showed that the smaller proportion of women who qualified for a specialty was explained principally by childbirth and by the number of children aged under 18 years. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. [Hospital financing in 2015. Relevant changes for rheumatology].

    PubMed

    Fiori, W; Lakomek, H-J; Buscham, K; Lehmann, H; Fuchs, A-K; Bessler, F; Roeder, N

    2015-06-01

    The announced major reforms will most probably not have an impact on hospital financing before 2016. Nevertheless, the numerous minor changes in the legislative framework and the new version of the German diagnosis-related groups (G-DRG) system can be important for hospitals specialized in rheumatology. The following article presents the relevant changes and discusses the consequences for hospitals specialized in rheumatology.

  19. A systematic review of the impact of volume of surgery and specialization on patient outcome.

    PubMed

    Chowdhury, M M; Dagash, H; Pierro, A

    2007-02-01

    Volume of surgery and specialization may affect patient outcome. Articles examining the effects of one or more of three variables (hospital volume of surgery, surgeon volume and specialization) on outcome (measured by length of hospital stay, mortality and complication rate) were analysed. Reviews, opinion articles and observational studies were excluded. The methodological quality of each study was assessed, a correlation between the variables analysed and the outcome accepted if it was significant. The search identified 55,391 articles published between 1957 and 2002; 1075 were relevant to the study, of which 163 (9,904,850 patients) fulfilled the entry criteria. These 163 examined 42 different surgical procedures, spanning 13 surgical specialities. None were randomized and 40 investigated more than one variable. Hospital volume was reported in 127 studies; high-volume hospitals had significantly better outcomes in 74.2 per cent of studies, but this effect was limited in prospective studies (40 per cent). Surgeon volume was reported in 58 studies; high-volume surgeons had significantly better outcomes in 74 per cent of studies. Specialization was reported in 22 studies; specialist surgeons had significantly better outcomes than general surgeons in 91 per cent of studies. The benefit of high surgeon volume and specialization varied in magnitude between specialities. High surgeon volume and specialization are associated with improved patient outcome, while high hospital volume is of limited benefit. Copyright (c) 2007 British Journal of Surgery Society Ltd.

  20. Differentiation and specialization in the California hospital industry 1983 to 1988.

    PubMed

    Zwanziger, J; Melnick, G A; Simonson, L

    1996-04-01

    This article examines changes in the service mix of California hospitals as part of their response to shifts in the system of reimbursement between 1983 and 1988. The Hospital Discharge Data Set and the Annual Hospital Disclosure Report produced by California Office of Statewide Health Planning and Development were used in this study. Characteristics of inpatient hospital services in California before and after the introduction of new reimbursement mechanisms (including the Medicare Prospective Payment System [PPS] and the growth of selective contracting plans) were compared. The factors that influence two measures of hospital service mix, one focusing on specialization and the other on differentiation, were studied. The factors included hospital characteristics and changes in hospital reimbursement. Variables describing a hospital's service mix and the level in its market were constructed from data in the annual discharge abstracts. Data pertaining to average hospital costs and reimbursements under the Medicare PPS were drawn from a file containing a 20% sample of hospital stay records for the year of PPS. Other hospital data, such as ownership and bed size, were taken from the California Annual Disclosure Report data set. The results indicate that completion among hospitals tended to increase differentiation whereas higher financial PPS pressure is associated with increased specialization. Hospitals tend to adopt some high visibility services offered by their competitors while filling market niches selectively overall. It also appears that the cost savings expected for specialization may prevail only for narrowly defined services. Study of subsequent data sets should show whether the cost containment strategies used by the hospitals to achieve these results have been maintained over a period of sustained financial pressure.

  1. [Why hospitalize stroke patients in a specialized unit?].

    PubMed

    Jaillard, A; Hommel, M

    1999-01-30

    A PUBLIC HEALTH CHALLENGE: Cerebral vascular events are the third most frequent cause of death in the adult population and the number one cause of disabilities, a public health challenge both in terms of health care service and health care expenditures. Structured health care facilities, particularly specialized hospital units, can lower mortality, limit residual disability and reduce the need for long-term institutionalization. Specialized research and teaching units are paradigmatic of the impact of health care organization. The limited number of such specialized units in France raises important ethical considerations about effective access to health care. Functioning units could be a useful criteria for auditing quality of hospital facilities.

  2. 42 CFR 406.24 - Special enrollment period related to coverage under group health plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE ELIGIBILITY AND ENTITLEMENT Premium Hospital Insurance § 406.24 Special enrollment period related to coverage under group health plans... 42 Public Health 2 2010-10-01 2010-10-01 false Special enrollment period related to coverage under...

  3. 42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

  4. 42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

  5. 42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

  6. 42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

  7. 42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

  8. Emergency pediatric surgery: Comparing the economic burden in specialized versus nonspecialized children's centers.

    PubMed

    Kvasnovsky, Charlotte L; Lumpkins, Kimberly; Diaz, Jose J; Chun, Jeannie Y

    2018-05-01

    The American College of Surgeons has developed a verification program for children's surgery centers. Highly specialized hospitals may be verified as Level I, while those with fewer dedicated resources as Level II or Level III, respectively. We hypothesized that more specialized children's centers would utilize more resources. We performed a retrospective study of the Maryland Health Services Cost Review Commission (HSCRC) database from 2009 to 2013. We assessed total charge, length of stay (LOS), and charge per day for all inpatients with an emergency pediatric surgery diagnosis, controlling for severity of illness (SOI). Using published resources, we assigned theoretical level designations to each hospital. Two hospitals would qualify as Level 1 hospitals, with 4593 total emergency pediatric surgery admissions (38.5%) over the five-year study period. Charges were significantly higher for children treated at Level I hospitals (all P<0.0001). Across all SOI, children at Level I hospitals had significantly longer LOS (all P<0.0001). Hospitals defined as Level II and Level III provided the majority of care and were able to do so with shorter hospitalizations and lower charges, regardless of SOI. As care shifts towards specialized centers, this charge differential may have significant impact on future health care costs. Level III Cost Effectiveness Study. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Striving towards efficiency in the Greek hospitals by reviewing case mix classifications.

    PubMed

    Polyzos, Nicholas M

    2002-09-01

    In order to verify the efficiency level of Greek public hospitals, this paper evaluates the most recent indicators. Relevant data were collected from the two following databases: (a) hospitals' utilisation data generally and per clinical speciality [Ministry of Health, Athens, (Data based) 1995]; (b) Patients' and hospitals' characteristics per diagnosis [National Statistical Office, Athens, (Data based) 1993]. As explanatory variables, the study examines supply and demand factors following case mix classifications. Firstly, average length of stay (ALOS) and secondly, cost per case were regressed as dependent variables. The study highlights the extent of variability across hospitals for different groups of patients with the same condition. The results specify the most important factors that affect ALOS and cost pertaining to efficiency. Per speciality analysis shows occupancy, size-type of the hospital, beds and doctors per speciality, access and use of outpatient services, and surgical operations, etc. as the most significant factors. Per disease-diagnosis analysis shows age of over 65 years, gender, residence, marital status, surgical operation and insurance as the most important factors. General cost analysis in all National Health Systems (NHS) hospitals shows that economies of scale appear in: (a) district and/or specialised hospitals of 250-400 beds; (b) regional and/or teaching hospitals of over but near to 400 beds. Consequently, the author determines the 'Greek' Diagnostic Related Groups (DRGs), based on the cost per clinical speciality in the nine basic specialities and on the cost per diagnosis of the top 15 diagnoses. Further to the scientific results, such studies will enhance much necessary discussions on the organisation of service delivery and financing, by following case mix classification. Copyright 2002 Elsevier Science Ireland Ltd.

  10. Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework.

    PubMed

    Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William; Misago, Chizuru

    2013-11-11

    Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu's organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women's choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals.

  11. Commercial enteral formulas and nutrition support teams improve the outcome of home enteral tube feeding.

    PubMed

    Klek, Stanislaw; Szybinski, Piotr; Sierzega, Marek; Szczepanek, Kinga; Sumlet, Magdalena; Kupiec, Monika; Koczur-Szozda, Elzbieta; Steinhoff-Nowak, Malgorzata; Figula, Krzysztof; Kowalczyk, Tomasz; Kulig, Jan

    2011-05-01

    The benefits of home enteral tube feeding (HETF) provided by nutrition support teams (NSTs) have been questioned recently, given the growing costs to the healthcare system. This study examined the effect of a specialized home enteral nutrition program on clinical outcome variables in HETF patients. The observational study included 203 patients (103 women, 100 men; mean age 52.5 years) receiving HETF with homemade diets for at least 12 months before starting a specialized home nutrition program for another 12 months consisting of provision of commercial enteral formulas and the guidance of an NST. Both study periods were compared regarding the number of hospital admissions, length of hospital and intensive care unit (ICU) stay, and costs of hospitalization. A specialized HETF program significantly reduced the number of hospital admissions and the duration of hospital and ICU stays. The need for hospitalization and ICU admission was significantly reduced, with odds ratios of 0.083 (95% confidence interval, 0.051-0.133, P < .001) and 0.259 (95% confidence interval, 0.124-0.539, P < .001), respectively. Specialized HETF was associated with a significant decrease in the prevalence of pneumonia (24.1% vs 14.2%), respiratory failure (7.3% vs 1.9%), urinary tract infection (11.3% vs 4.9%), and anemia (3.9% vs 0%) requiring hospitalization. The average yearly cost of hospital treatment decreased from $764.65 per patient to $142.66 per year per patient. The specialized HETF care program reduces morbidity and costs related to long-term enteral feeding at home.

  12. Neglected roots of regionalism? The Commissioners for the special areas and grants to hospital services in the 1930s.

    PubMed

    Mohan, J

    1997-08-01

    The inter-war years in the UK were notable for debates about the extent to which an extension of state intervention in hospital provision was desirable and necessary, and about the limits to and future of the voluntary hospital system which relied largely on various forms of private charity. These themes were intertwined in the UK's 'Special Areas', locations recognized as having suffered adversely from the inter-war depression, with consequent effects on their ability to finance desirable investments in social infrastructures. Grant aid was offered to hospitals in these locations under the terms of the Special Areas legislation of 1934, but there were extensive debates about the principle and practice of such subsidies to hospital development. This paper reviews these debates and considers whether the measures taken by the Commissioners can be seen as neglected antecedents of the regionalism detected in British hospital policy by several commentators.

  13. Hospitality: A Teacher's Guide to an Employment Orientation Course for Special Needs Students.

    ERIC Educational Resources Information Center

    Grubb, Francine

    This teachers' guide on hospitality is one of a series of six designed for the employment orientation program for special needs students at the Gloucester County Vocational-Technical School in Sewell, New Jersey. The series includes laundry, hospitality, sewing, basic business, foods, and beauty culture. The foreword indicates that objectives are…

  14. Children's Specialized Hospital and GetWellNetwork Collaborate to Improve Patient Education and Outcomes Using an Innovative Approach.

    PubMed

    Kompany, Laura; Luis, Kiersten; Manganaro, Julie; Motacki, Kathleen; Mustacchio, Elaine; Provenzano, Donna

    2016-01-01

    Patient education in a pediatric setting is unique. There are different patient ages, degrees of learning, and diagnoses to take into account when educating children and their families. A new and innovative trend in practice called Interactive Patient Care (IPC) integrates technology into care processes to advance pediatric nursing education and patient and family satisfaction. Children's Specialized Hospital is the first pediatric rehabilitation hospital to develop and implement this type of program using an IPC platform from the GetWellNetwork. With the implementation of the GetWellNetwork, Children's Specialized Hospital has achieved positive results in patient satisfaction, health care utilization, quality, and safety measures.

  15. Effects of physician-owned specialized facilities in health care: a systematic review.

    PubMed

    Trybou, Jeroen; De Regge, Melissa; Gemmel, Paul; Duyck, Philippe; Annemans, Lieven

    2014-12-01

    Multiple studies have investigated physician-owned specialized facilities (specialized hospitals and ambulatory surgery centres). However, the evidence is fragmented and the literature lacks cohesion. To provide a comprehensive overview of the effects of physician-owned specialized facilities by synthesizing the findings of published empirical studies. Two reviewers independently researched relevant studies using a standardized search strategy. The Institute of Medicine's quality framework (safe, effective, equitable, efficient, patient-centred, and accessible care) was applied in order to evaluate the performance of such facilities. In addition, the impact on the performance of full-service general hospitals was assessed. Forty-six studies were included in the systematic review. Overall, the quality of the included studies was satisfactory. Our results show that little evidence exists to confirm the advantages attributed to physician-owned specialized facilities, and their impact on full-service general hospitals remains limited. Although data is available on a wide variety of effects, the evidence base is surprisingly thin. There is no compelling evidence available demonstrating the added value of physician-owned specialized facilities in terms of quality or cost of the delivered care. More research is necessary on the relative merits of physician-owned specialized facilities. In addition, their corresponding impact on full-service general hospitals remains unclear. The development of physician-owned specialized facilities should thus be monitored carefully. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework

    PubMed Central

    2013-01-01

    Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu’s organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women’s choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals. PMID:24215446

  17. Medi-Cal Hospital Contracting—Did It Achieve Its Legislative Objectives?

    PubMed Central

    Brown, E. Richard; Price, Walter T.; Cousineau, Michael R.

    1985-01-01

    The 1982 Medi-Cal reforms and reductions established selective contracting with hospitals for inpatient care of Medi-Cal beneficiaries. The legislation established a special negotiator and criteria to be used in selecting contract hospitals. We report the findings of a study that analyzed the characteristics of contract and noncontract hospitals in Los Angeles County to assess how well these criteria were reflected in the outcome of the contracting process. We examine issues of beneficiary access to general inpatient care and to specialized services, the efficiency of contract hospitals compared with noncontract ones and quality-related issues. PMID:3898595

  18. [Plan for stroke healthcare delivery].

    PubMed

    Alvarez Sabín, J; Alonso de Leciñana, M; Gállego, J; Gil-Peralta, A; Casado, I; Castillo, J; Díez Tejedor, E; Gil, A; Jiménez, C; Lago, A; Martínez-Vila, E; Ortega, A; Rebollo, M; Rubio, F

    2006-12-01

    All stroke patients should receive the same degree of specialized healthcare attention according to the stage of their disease, independently of where they live, their age, gender or ethnicity. To create an organized healthcare system able to offer the needed care for each patient, optimizing the use of the existing resource. A committee of 14 neurologists specialized in neurovascular diseases representing different regions of Spain evaluated the available scientific evidence according to the published literature. During the acute phase, all stroke patients must be evaluated in hospitals that offer access to specialized physicians (neurologists) and the indicated diagnostic and therapeutic procedures. Hospitals that deliver care to acute stroke patients must be prepared to attend these patients and need to arrange a predefined transferring circuit coordinated with the extrahospitalary emergency service. Since resources are limited, they should be structured into different care levels according to the target population. Thus, three types of hospitals will be defined for stroke care: reference stroke hospital, hospital with stroke unit, hospital with stroke team.

  19. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs.

    PubMed

    Gordon, John B; Colby, Holly H; Bartelt, Tera; Jablonski, Debra; Krauthoefer, Mary L; Havens, Peter

    2007-10-01

    To evaluate the impact of a tertiary care center special needs program that partners with families and primary care physicians to ensure seamless inpatient and outpatient care and assist in providing medical homes. Up to 3 years of preenrollment and postenrollment data were compared for patients in the special needs program from July 1, 2002, through June 30, 2005. A tertiary care center pediatric hospital and medical school serving urban and rural patients. A total of 227 of 230 medically complex and fragile children and youth with special needs who had a wide range of chronic disorders and were enrolled in the special needs program. Care coordination provided by a special needs program pediatric nurse case manager with or without a special needs program physician. Preenrollment and postenrollment tertiary care center resource utilization, charges, and payments. A statistically significant decrease was found in the number of hospitalizations, number of hospital days, and tertiary care center charges and payments, and an increase was found in the use of outpatient services. Aggregate data revealed a decrease in hospital days from 7926 to 3831, an increase in clinic visits from 3150 to 5420, and a decrease in tertiary care center payments of $10.7 million. The special needs program budget for fiscal year 2005 had a deficit of $400,000. This tertiary care-primary care partnership model improved health care and reduced costs with relatively modest institutional support.

  20. Impact of specialized inpatient IBD care on outcomes of IBD hospitalizations: A cohort study

    PubMed Central

    Law, Cindy CY; Sasidharan, Saranya; Rodrigues, Rodrigo; Nguyen, Deanna D; Sauk, Jenny; Garber, John; Giallourakis, Cosmas; Xavier, Ramnik; Khalili, Hamed; Yajnik, Vijay; Ananthakrishnan, Ashwin N

    2016-01-01

    Background The management of inflammatory bowel diseases (IBD; Crohn’s disease (CD), ulcerative colitis (UC)) is increasingly complex. Specialized care has been associated with improved ambulatory IBD outcomes. Aims To examine if the implementation of specialized inpatient IBD care modified short and long-term clinical outcomes in IBD-related hospitalizations. Methods This retrospective cohort study included IBD patients hospitalized between July 2013 and April 2015 at a single tertiary referral center where a specialized inpatient IBD care model was implemented in July 2014. In-hospital medical and surgical outcomes as well as post-discharge outcomes at 30 and 90 days were analyzed along with measures of quality of in-hospital care. Effect of specialist IBD care was examined on multivariate analysis. Results A total of 408 IBD-related admissions were included. With implementation of specialized IBD inpatient care, we observed increased frequency of use of high-dose biologic therapy for induction (26% vs. 9%, odds ratio (OR) 5.50, 95% CI 1.30 – 23.17) and higher proportion of patients in remission at 90 days after discharge (multivariate OR 1.60, 95% CI 0.99 – 2.69). While there was no difference in surgery by 90 days, among those who underwent surgery, early surgery defined as in-hospital or within 30 days of discharge, was more common in the study period (71%) compared to the control period (46%, multivariate OR 2.73, 95% CI 1.22 – 6.12). There was no difference in length of stay between the two years. Conclusions Implementation of specialized inpatient IBD care beneficially impacted remission and facilitated early surgical treatment. PMID:27482978

  1. Impact of specialization in gynecology and obstetrics departments on pregnant women's choice of maternity institutions.

    PubMed

    Adachi, Yoshimi; Iso, Hiroyasu; Shen, Junyi; Ban, Kanami; Fukui, On; Hashimoto, Hiroyuki; Nakashima, Takako; Morishige, Kenichiro; Saijo, Tatuyoshi

    2013-12-23

    In April 2008, specialization in gynecology and obstetrics departments was introduced in the Sennan area of Osaka prefecture in Japan that aimed at solving the problems of regional provisions of obstetrics services (e.g., shortage of obstetricians, overworking of obstetricians, and provision of specialist maternity services for high-risk pregnancies). Under this specialization, the gynecology and obstetrics departments in two city hospitals were combined and reconstructed into two centers, i.e., the gynecological care center in Kaizuka City Hospital and the prenatal care center in Izumisano City Hospital. This paper investigates to what extent and how this specialization affected pregnant women's choices of the prenatal care center and other maternity institutions. We used birth certificate data of 15,927 newborns from the Sennan area between April 1, 2007 and March 30, 2010, for Before and After Analysis to examine changes in pregnant women's choices of maternity institutions before and after the specialization was instituted. Our results indicated that this specialization scheme was, to some extent, successful on the basis of providing maternity services for high-risk pregnancies at the prenatal care center (i.e., Izumisano City Hospital) and having created a positive effect by pregnant women to other facilities in the nearby area.

  2. Impact of specialization in gynecology and obstetrics departments on pregnant women’s choice of maternity institutions

    PubMed Central

    2013-01-01

    In April 2008, specialization in gynecology and obstetrics departments was introduced in the Sennan area of Osaka prefecture in Japan that aimed at solving the problems of regional provisions of obstetrics services (e.g., shortage of obstetricians, overworking of obstetricians, and provision of specialist maternity services for high-risk pregnancies). Under this specialization, the gynecology and obstetrics departments in two city hospitals were combined and reconstructed into two centers, i.e., the gynecological care center in Kaizuka City Hospital and the prenatal care center in Izumisano City Hospital. This paper investigates to what extent and how this specialization affected pregnant women’s choices of the prenatal care center and other maternity institutions. We used birth certificate data of 15,927 newborns from the Sennan area between April 1, 2007 and March 30, 2010, for Before and After Analysis to examine changes in pregnant women’s choices of maternity institutions before and after the specialization was instituted. Our results indicated that this specialization scheme was, to some extent, successful on the basis of providing maternity services for high-risk pregnancies at the prenatal care center (i.e., Izumisano City Hospital) and having created a positive effect by pregnant women to other facilities in the nearby area. PMID:24364885

  3. Nursing models in a special hospital: cybernetics, hyperreality and beyond.

    PubMed

    Mason, T; Chandley, M

    1992-11-01

    Two emerging themes that resulted from research carried out in a special hospital on the use of nursing models are identified. The first theme to emerge was the tendency of the subjects to perceive the models as concrete entities thus undergoing a process of reification. The second theme identified was the adherence to the models outside the contextual nature of the setting which limited their effectiveness. A theoretical framework in which to locate the results of the study is explored using cybernetic learning theory and the notion of hyperreality, using the works of Jean Baudrillard. A method for innovation and changing practice in the special hospital setting is suggested.

  4. 42 CFR 412.108 - Special treatment: Medicare-dependent, small rural hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System for Inpatient Operating Costs... including days and discharges from units excluded from the prospective payment system under §§ 412.25...

  5. 32 CFR 199.4 - Basic program benefits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... its derivatives, including equipment and supplies, and its administration. (x) Radiation therapy... accommodations are occupied; or (4) When a patient is admitted to an acute care hospital (general or special... available; or, in the case of an acute care hospital (general or special) which does not have semiprivate...

  6. 32 CFR 199.4 - Basic program benefits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... its derivatives, including equipment and supplies, and its administration. (x) Radiation therapy... accommodations are occupied; or (4) When a patient is admitted to an acute care hospital (general or special... available; or, in the case of an acute care hospital (general or special) which does not have semiprivate...

  7. 32 CFR 199.4 - Basic program benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... its derivatives, including equipment and supplies, and its administration. (x) Radiation therapy... accommodations are occupied; or (4) When a patient is admitted to an acute care hospital (general or special... available; or, in the case of an acute care hospital (general or special) which does not have semiprivate...

  8. 32 CFR 199.4 - Basic program benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... its derivatives, including equipment and supplies, and its administration. (x) Radiation therapy... accommodations are occupied; or (4) When a patient is admitted to an acute care hospital (general or special... available; or, in the case of an acute care hospital (general or special) which does not have semiprivate...

  9. 32 CFR 199.4 - Basic program benefits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... its derivatives, including equipment and supplies, and its administration. (x) Radiation therapy... accommodations are occupied; or (4) When a patient is admitted to an acute care hospital (general or special... available; or, in the case of an acute care hospital (general or special) which does not have semiprivate...

  10. Performance evaluation of hospitals that provide care in the public health system, Brazil.

    PubMed

    Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

    2015-01-01

    OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

  11. Performance evaluation of hospitals that provide care in the public health system, Brazil

    PubMed Central

    Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

    2015-01-01

    OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimento s de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals. PMID:26247385

  12. Early Childhood Special Educators and the Hospital Ethics Committee.

    ERIC Educational Resources Information Center

    Lowenthal, Barbara

    1989-01-01

    The paper discusses issues of concern to early childhood special educators serving on hospital ethics committees to assist families with seriously ill and handicapped infants in neonatal intensive care units. Issues include infant euthanasia and the right to life, child abuse legislation, and possible effects on families. (Author/JDD)

  13. [Organization and contents of the specialized surgical care in multiprofile military hospitals of the 1st level during counter-terrorist operations on the northern Caucasus (report V)].

    PubMed

    Gumanenko, E K; Samokhvalov, I M; Trusov, A A; Badalov, V I

    2006-03-01

    The principle difference of the work of multiprofile military hospitals (MMH) of the Ist level during the armed conflicts on the Northern Caucasus, particularly during the second, was rendering specialized surgical care to the primary contingent of the wounded, evacuated during the nearest hours after a wound. The incoming flow to MMH of the 1st level - in connection with the primary entering of the wounded practically from a battle field - was characterized by severity (one third of the wounded had severe and extremely severe wounds) and the significant number of the wounded with multiple and combined injuries (up to 60% of the wounded). Effective treatment of the above-mentioned wounded can only be carried by specially trained surgeons in appropriately-equipped multiprofile medical hospitals. The rendered volume of specialized surgical care in MMH of the 1st level included the following operations: neurosurgical (2,4%), thoracoabdominal (19,8%), traumatologic (17,0%), angiosurgical (8,2%), special (otorhinolaryngologic, maxillofacial, ophthalmologic, urologic) - 17,7%, general surgery (35,4%). During the armed conflict of 1999-2002 due to the introduction of the early specialized surgical care concept three MMH of the 1st level in the advanced way executed 86,4 % of all complex operations in medical units and hospitals of the combat zone.

  14. Medication prescribing errors in the medical intensive care unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

    PubMed

    Sada, Oumer; Melkie, Addisu; Shibeshi, Workineh

    2015-09-16

    Medication errors (MEs) are important problems in all hospitalized populations, especially in intensive care unit (ICU). Little is known about the prevalence of medication prescribing errors in the ICU of hospitals in Ethiopia. The aim of this study was to assess medication prescribing errors in the ICU of Tikur Anbessa Specialized Hospital using retrospective cross-sectional analysis of patient cards and medication charts. About 220 patient charts were reviewed with a total of 1311 patient-days, and 882 prescription episodes. 359 MEs were detected; with prevalence of 40 per 100 orders. Common prescribing errors were omission errors 154 (42.89%), 101 (28.13%) wrong combination, 48 (13.37%) wrong abbreviation, 30 (8.36%) wrong dose, wrong frequency 18 (5.01%) and wrong indications 8 (2.23%). The present study shows that medication errors are common in medical ICU of Tikur Anbessa Specialized Hospital. These results suggest future targets of prevention strategies to reduce the rate of medication error.

  15. Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics.

    PubMed

    Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro

    2011-12-01

    The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

  16. The Special Educator and the Hospital Ethics Committee.

    ERIC Educational Resources Information Center

    Lowenthal, Barbara; And Others

    With the advent of Public Law 99-457, special educators may be expected to observe and/or serve on Hospital Ethics Committees (HECs) in order to better assist families who have seriously ill and handicapped infants and children. Issues considered by such committees include alternative viewpoints on infant euthanasia and their right to life, the…

  17. DefenseLink Special: U.S. Military Relief Aid After the 2005 Pakistan

    Science.gov Websites

    Websites Contact Us Banner Art - Military Support of Pakistan Earthquake Special U.S. Donates Mobile Hospital WASHINGTON, Feb. 16, 2006 - The United States today transferred the 212th Mobile Army Surgical * USS Pearl Harbor to Assist Victims * Globemaster Airlifts Mobile Hospital * Hercules Airmen Deliver

  18. Hospital dental practice in special patients

    PubMed Central

    Silvestre-Rangil, Javier; Espín-Gálvez, Fernando

    2014-01-01

    Dental patients with special needs are people with different systemic diseases, multiple disorders or severe physical and/or mental disabilities. A Medline search was made, yielding a total of 29 articles that served as the basis for this study, which offers a brief description of the dental intervention protocols in medically compromised patients. Dental treatment in patients with special needs, whether presenting medical problems or disabilities, is sometimes complex. For this reason the hospital should be regarded as the ideal setting for the care of these individuals. Before starting any dental intervention, a correct patient evaluation is needed, based on a correct anamnesis, medical records and interconsultation reports, and with due assessment of the medical risks involved. The hospital setting offers the advantage of access to electronic medical records and to data referred to any complementary tests that may have been made, and we moreover have the possibility of performing treatments under general anesthesia. In this context, ambulatory major surgery is the best approach when considering general anesthesia in patients of this kind. Key words:Hospital dentistry, special patients, medically compromised patients. PMID:24121921

  19. The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital

    PubMed Central

    2011-01-01

    Background Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care. The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada. Methods A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected. Results Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training environment of the hospital leading to the presence of too many health care professionals, and consequently, a lack of privacy and continuity of care. Conclusion The argument of medical intervention and technology at birth being an opposing factor to the humanization of birth was not seen to be an issue in the studied highly specialized university affiliated hospital. PMID:22114870

  20. [Administrative efficiency in the Mexican Fund for the Prevention of Catastrophic Expenditures in Health].

    PubMed

    Orozco-Núñez, Emanuel; Alcalde-Rabanal, Jaqueline; Navarro, Juan; Lozano, Rafael

    2016-01-01

    To show that the administrative regime of specialized hospitals has some influence on the administrative processes to operate the Mexican Fund for Catastrophic Expenditures in Health (FPGC, in Spanish), for providing health care to breast cancer, cervical cancer and child leukemia. The variable for estimating administrative efficiency was the time estimated from case notification to reimbursement. For its estimation, semistructured interviews were applied to key actors involved in management of cancer care financed by FPGC. Additionally, a group of experts was organized to make recommendations for improving processes. Specialized hospitals with a decentralized scheme showed less time to solve the administrative process in comparison with the model on the hospitals dependent on State Health Services, where timing and intermediation levels were higher. Decentralized hospitals administrative scheme for specialized care is more efficient, because they tend to be more autonomous.

  1. Programme for specialization in family medicine

    PubMed Central

    Polliack, M. R.; Medalie, Jack H.

    1969-01-01

    A programme for specialized training in family medicine at Tel Aviv University Medical School provides four years of postgraduate study, two of which are in recognized hospital departments and two in clinics recognized for training in family medicine. At the end of this four-year period the graduate must submit a thesis of original work or an approved research project on an aspect of family medicine. Continuing contact of the trainee with both the family medicine clinic and the hospital departments is maintained throughout the period. While in hospital the trainee spends half a day a week in the family clinic with his personal tutor, and when in the clinic he spends half a day a week in the hospital. This programme has been provisionally accepted as meeting the formal requirements of the Israel Medical Association for specialization in family medicine, and the first physician has started training. PMID:5354841

  2. 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.

  3. Nationwide survey of care facilities for adults with congenital heart disease in Japan.

    PubMed

    Toyoda, Tomohiko; Tateno, Shigeru; Kawasoe, Yasutaka; Shirai, Takeaki; Shiina, Yumi; Matsuo, Kozo; Niwa, Koichiro

    2009-06-01

    The number of adults with congenital heart disease (CHD) is increasing rapidly, but care programs have not been fully established in Japan. Questionnaires regarding current status and resources of outpatient and in-hospital services, and management of pregnancy in patients with adult CHD (ACHD) were sent to 1,033 training hospitals for board-certified cardiologists. Useful replies were obtained from 458 hospitals (44%). In 417 hospitals (91%), at least 1 patient was followed in the outpatient clinic; however, only 14 hospitals (3%) had specialized outpatient clinics; 354 hospitals (77%) had in-hospital patients, but only 6 hospitals (2%) admitted >50 patients per year. Surgery for ACHD was performed in 232 hospitals (51%), but in 135 of these (58%), the number of operations was <5 per year. Pregnant women with CHD were managed in 157 hospitals (34%), although only 3 hospitals (2%) managed >10 cases per year. In most hospitals in Japan, a limited number of ACHD patients have been followed up and specialized multi-disciplinary facilities for ACHD need to be established.

  4. Investigation of health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences: health-promoting hospitals.

    PubMed

    Hamidi, Yadollah; Hazavehei, Seyed Mohammad Mahdi; Karimi-Shahanjarini, Akram; SeifRabiei, Mohamad Ali; Farhadian, Maryam; Alimohamadi, Shohreh; Kharghani Moghadam, Seyedeh Melika

    2017-12-01

    The prophecy of health promoting hospitals (HPH) is bringing about a change and transition from treatment-oriented to health-oriented attitudes. In Iran, hospitals usually play the traditional roles. The present study was aimed at the evaluation of the health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences (HUMS). This applied study was conducted in two Hamadan specialized hospitals in the Hamadan city. The health promotion status was evaluated using a self-assessment checklist designed by the World Health Organization's HPH. The evaluation was done in five standards including management policy, patient assessment, patient information and intervention, promotion of a healthy workplace and continuity and cooperation. The results showed that both the hospitals studied had a poor status in terms of promoting a healthy workplace (average = 31.24%) and management policy standards (average = 35.29%) in comparison with the other relevant standards: patient assessment (53.12%), patient information and intervention (62.5%), continuity and cooperation (65.78%)). The results of the standards and sub-standards status displayed better performance in the cardiovascular hospital (53.67%) compared to the women and parturition hospital (42.64%). The findings indicated that HPH standards are very low in the studied hospitals. The reason behind this wide gap might be due to the fact that hospitals in Iran are more treatment-oriented and patient-oriented and they do not play an active part in health promoting. It was found that management policy and promoting healthy workplace standards had the worst status and must be improved.

  5. The dimensioning and development of hospital electric installations to guarantee the continuity of use of the therapeutic and diagnostic system.

    PubMed

    Stroili, M; Pavan, E C; Gorela, M; Kenda, F

    2015-08-01

    The Technical Services and the Medical Administration of the Hospitals of Trieste have been working for years to ensure the optimal functioning of the Medicine, Surgery, Diagnostics and Research services offered to the Patients and to the University in an 800-bed hospital complex, transforming and innovating the buildings and support installations. We have dedicated special attention to the technologies necessary to guarantee the continuity of the power supply to the electromedical devices, increasingly numerous in highly specialized hospitals. We report our electricity consumption and the power of the generator sets and the UPS and our opinion that their power must be related to the overall consumption of the Hospital, with a reserve margin.

  6. 42 CFR 412.534 - Special payment provisions for long-term care hospitals within hospitals and satellites of long...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... meets the criteria of § 412.22(h) from another hospital that is not the co-located hospital are made... hospital satellite facility from the co-located hospital are made under either of the following: (1) For... percent were admitted to the hospital or its satellite facility from the co-located hospital, payments are...

  7. Special report. Twin Cities hospital breaks down ambulatory care, overcomes fears of outpatient care.

    PubMed

    1995-01-06

    With payers pushing for shorter hospital stays and outpatient services generating growing shares of hospitals' revenues, experts everywhere are projecting the end of the traditional inpatient-oriented hospital. Those predictions have triggered a scramble by many hospital managers to adapt their organizations and empty beds to the expected predominance of same-day services. One Minnesota facility that surveyed the outpatient trend, however, found that its strategic options weren't limited to becoming a jumbo-sized outpatient clinic, explain David Allen, a partner with The Chancellor Group, Bloomington, Minn., and Daniel Weber, vice president of Fairview Southdale Hospital, Edina, Minn., in this special report. By understanding the multidimensional nature of ambulatory services and focusing its efforts on becoming a regional hub of healthcare services, Fairview Southdale has carved its own niche in a changing provider market.

  8. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective payment...

  9. 42 CFR 412.374 - Payments to hospitals located in Puerto Rico.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payments to hospitals located in Puerto Rico. 412... Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.374 Payments to hospitals located in Puerto Rico. (a) FY 1998 through FY 2004. Payments for capital-related...

  10. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective payment...

  11. 42 CFR 412.374 - Payments to hospitals located in Puerto Rico.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payments to hospitals located in Puerto Rico. 412... Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.374 Payments to hospitals located in Puerto Rico. (a) FY 1998 through FY 2004. Payments for capital-related...

  12. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective payment...

  13. 42 CFR 412.374 - Payments to hospitals located in Puerto Rico.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payments to hospitals located in Puerto Rico. 412... Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.374 Payments to hospitals located in Puerto Rico. (a) FY 1998 through FY 2004. Payments for capital-related...

  14. 42 CFR 412.374 - Payments to hospitals located in Puerto Rico.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payments to hospitals located in Puerto Rico. 412... Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.374 Payments to hospitals located in Puerto Rico. (a) FY 1998 through FY 2004. Payments for capital-related...

  15. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective payment...

  16. 42 CFR 412.374 - Payments to hospitals located in Puerto Rico.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payments to hospitals located in Puerto Rico. 412... Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.374 Payments to hospitals located in Puerto Rico. (a) FY 1998 through FY 2004. Payments for capital-related...

  17. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective payment...

  18. [Work organization of the Civic Hospital in Split during the Second World War (1941-1945)].

    PubMed

    Brisky, Livia

    2011-01-01

    In the first half of the 20th century, Civic Hospital in Split intensified its formation towards health institution in the modern sense. The need for competent physicians and specialized experts, heads of the individual hospital departments, also became in Split Hospital the part of the global process of disintegration of medicine into the direction of medical specializations. The aim of this study was to investigate the function of the Civic Hospital in Split during the Second World War on the basis of the archival sources preserved in the State Archives in Split. The work organization, the names of the physicians and detailed arrangements of hospital beds were presented, as well as the increase of its capacity during analyzed period.Great attention was also dedicated to the foundation of new hospital departments. This study revealed the development of the Civic Hospital in Split between 1941 and 1945 which could offer complete medical care to the sick and wounded persons.

  19. 42 CFR 412.96 - Special treatment: Referral centers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System for Inpatient Operating Costs § 412.96 Special treatment... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Referral centers. 412.96 Section...

  20. Astronomy Outreach for Special Needs Children

    NASA Astrophysics Data System (ADS)

    Lubowich, D.

    2008-06-01

    While there are many outreach programs for the public and for children, there are few programs for special needs children. I describe a NASA-STScI-IDEAS funded outreach program I created for children using a telescope (including remote and robotic observations), hands-on astronomy demonstrations (often with edible ingredients). The target audience is seriously ill children with special medical needs and their families who are staying at the Long Island Ronald McDonald House in conjunction the children's surgery and medical treatments at local hospitals. These educational activities help children and their families learn about astronomy while providing a diversion to take their minds off their illness during a stressful time. A related program for hospitalized children has been started at the Hagedorn Pediatric Inpatient Center at Winthrop University Hospital.

  1. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    ERIC Educational Resources Information Center

    Anderson, David W.

    2011-01-01

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

  2. Use of telemedicine to improve burn care in Ukraine.

    PubMed

    Fuzaylov, Gennadiy; Knittel, Justin; Driscoll, Daniel N

    2013-01-01

    Global burn injuries have been described as the "forgotten public health crises" by the World Health Organization. Nearly 11 million people a year suffer burns severe enough to require medical attention; more people are burned each year than are infected with human immunodeficiency virus/acquired immunodeficiency syndrome and tuberculosis combined. Telemedicine has the potential to link experts in specialized fields, such as burn care, to regions of the world that have limited or no access to such specialized care. A multilevel telemedicine program was developed between Massachusetts General Hospital/Shriners Hospital in Boston, Massachusetts, and City Hospital #8 in Lviv, Ukraine. The program should lead to a sustainable improvement in the care of burn victims in Ukraine. The authors helped establish a Learning Center at City Hospital #8 in Lviv, Ukraine, through which they were able to consult from Shriners Hospital in Boston, on a total of 14 acute burn patients in Ukraine. This article discusses two case reports with the use of telemedicine and how it has allowed the authors to provide not only acute care consultation on an international scale, but also to arrange for direct expert examination and international transport to their specialized burn center in the United States. The authors have established a program through doctors from Massachusetts General Hospital/Shriner's Hospital in Boston, which works with a hospital in Ukraine and has provided acute consultation, as well as patient transportation to the United States for treatment and direct assessment.

  3. Understanding differences between high- and low-price hospitals: implications for efforts to rein in costs.

    PubMed

    White, Chapin; Reschovsky, James D; Bond, Amelia M

    2014-02-01

    Private insurers pay widely varying prices for inpatient care across hospitals. Previous research indicates that certain hospitals use market clout to obtain higher payment rates, but there have been few in-depth examinations of the relationship between hospital characteristics and pricing power. This study used private insurance claims data to identify hospitals receiving inpatient prices significantly higher or lower than the median in their market. High-price hospitals, compared to other hospitals, tend to be larger; be major teaching hospitals; belong to systems with large market shares; and provide specialized services, such as heart transplants and Level I trauma care. High-price hospitals also receive significant revenues from nonpatient sources, such as state Medicaid disproportionate-share hospital funds, and they enjoy healthy total financial margins. Quality indicators for high-price hospitals were mixed: High-price hospitals fared much better than low-price hospitals did in U.S. News & World Report rankings, which are largely based on reputation, while generally scoring worse on objective measures of quality, such as postsurgical mortality rates. Thus, insurers may face resistance if they attempt to steer patients away from high-price hospitals because these facilities have good reputations and offer specialized services that may be unique in their markets.

  4. Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals

    ERIC Educational Resources Information Center

    Casey, Michelle M.; Moscovice, Ira S.; Davidson, Gestur

    2006-01-01

    Context: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. Purpose: This study assessed the capacity of small rural hospitals to implement medication safety…

  5. Hospital ownership and drug utilization under a global budget: a quantile regression analysis.

    PubMed

    Zhang, Jing Hua; Chou, Shin-Yi; Deily, Mary E; Lien, Hsien-Ming

    2014-03-01

    A global budgeting system helps control the growth of healthcare spending by setting expenditure ceilings. However, the hospital global budget implemented in Taiwan in 2002 included a special provision: drug expenditures are reimbursed at face value, while other expenditures are subject to discounting. That gives hospitals, particularly those that are for-profit, an incentive to increase drug expenditures in treating patients. We calculated monthly drug expenditures by hospital departments from January 1997 to June 2006, using a sample of 348 193 patient claims to Taiwan National Health Insurance. To allow for variation among responses by departments with differing reliance on drugs and among hospitals of different ownerships, we used quantile regression to identify the effect of the hospital global budget on drug expenditures. Although drug expenditure increased in all hospital departments after the enactment of the hospital global budget, departments in for-profit hospitals that rely more heavily on drug treatments increased drug spending more, relative to public hospitals. Our findings suggest that a global budgeting system with special reimbursement provisions for certain treatment categories may alter treatment decisions and may undermine cost-containment goals, particularly among for-profit hospitals.

  6. In-hospital organization of primary care of patients presenting a life-threatening emergency: A French national survey in 32 university hospitals.

    PubMed

    Quintard, Hervé; Severac, Mathilde; Martin, Claude; Ichai, Carole

    2015-08-01

    The development of specialized units dedicated to life-threatening management has demonstrated to improve the prognosis of patients requiring such treatments. However, apart those focused on trauma and stroke, networks are still lacking in France. Despite, the implementation of standardisation of practices and guidelines, particularly in prehospital care, in-hospital clinical practices at admission remain heterogenous. This survey aimed to assess the structural and human organization of teaching hospitals in France concerning the primary in-hospital care for critically ill patients. A questionnaire of 45 items was sent by e-mail to 32 teaching hospitals between January and March 2013. It included information related to the description of the emergency department, of ICUs, and both structural and human organizations for primary in-hospital care of life-threatening patients. Seventy-five percent of teaching hospitals answered to the survey. Seven hundred to 1400 patients were admitted to emergency units per week and among them 10 to 20 were admitted for critically ill conditions. These latter were addressed in a specialized room of the emergency unit (Service d'admission des urgences vitales [SAUV]) in 40% of hospitals and in specialized room in ICU in 18% of cases. Intensivists were involved in 50% of hospitals, emergency physicians in 26% and it was mixed in 24% of hospitals. This survey is the first to assess the in-hospital organization of primary care for instable and life-threatening patients in France. Our results confirmed the extreme heterogeneity of structural and human organizations for primary in-hospital care of patients presenting at least one organ failure. Thus, a consensus is probably needed to homogenize and improve our practices. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  7. 34 CFR 300.39 - Special education.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hospitals and institutions, and in other settings; and (ii) Instruction in physical education. (2) Special... their parents as a part of the regular education program. (2) Physical education means— (i) The... (ii) Includes special physical education, adapted physical education, movement education, and motor...

  8. 42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... equivalent based on the proportion of time worked in any areas of the hospital listed in paragraph (f)(1)(ii... proportion of time assigned to an area of the hospital listed in paragraph (f)(1)(ii) of this section... by the appropriate accrediting body or temporarily trained residents at another hospital(s) until the...

  9. 42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... equivalent based on the proportion of time worked in any areas of the hospital listed in paragraph (f)(1)(ii... proportion of time assigned to an area of the hospital listed in paragraph (f)(1)(ii) of this section... by the appropriate accrediting body or temporarily trained residents at another hospital(s) until the...

  10. 42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... equivalent based on the proportion of time worked in any areas of the hospital listed in paragraph (f)(1)(ii... proportion of time assigned to an area of the hospital listed in paragraph (f)(1)(ii) of this section... by the appropriate accrediting body or temporarily trained residents at another hospital(s) until the...

  11. Going to the Hospital

    MedlinePlus

    ... to your room. Most hospitals have TVs or video games, and many have computers (with games!) that can be brought to your bed. Also, many hospitals for kids have special visitors stop by, like clowns ... (Video Landing Page) Having Your Tonsils Taken Out What ...

  12. Hospital pharmacy workforce in Brazil.

    PubMed

    Santos, Thiago R; Penm, Jonathan; Baldoni, André O; Ayres, Lorena Rocha; Moles, Rebekah; Sanches, Cristina

    2018-01-04

    This study aims to describe the distribution of the hospital pharmacy workforce in Brazil. Data were acquired, during 2016, through the Brazilian National Database of Healthcare Facilities (CNES). The following variables were extracted: hospital name, registry number, telephone, e-mail, state, type of institution, subtype, management nature, ownership, presence of research/teaching activities, complexity level, number of hospital beds, presence of pharmacists, number of pharmacists, pharmacist specialization. All statistical analyses were performed by IBM SPSS v.19. The number of hospitals with a complete registry in the national database was 4790. The majority were general hospitals (77.9%), managed by municipalities (66.1%), under public administration (44.0%), had no research/teaching activities (90.5%), classified as medium complexity (71.6%), and had no pharmacist in their team (50.6%). Furthermore, almost 60.0% of hospitals did not comply with the minimum recommendations of having a pharmacist per 50 hospital beds. The Southeast region had the highest prevalence of pharmacists, with 64.4% of hospitals having a pharmaceutical professional. This may have occurred as this region had the highest population to hospital ratio. Non-profit hospitals were more likely to have pharmacists compared to those under public administration and private hospitals. This study mapped the hospital pharmacy workforce in Brazil, showing a higher prevalence of hospital pharmacists in the Southeast region, and in non-profit specialized hospitals.

  13. The Hospital for Special Surgery 1972–1989; Philip D. Wilson, Jr., Eighth Surgeon-in-Chief

    PubMed Central

    2010-01-01

    After nearly a decade as the seventh Surgeon-in-Chief (1963–1972) of The Hospital for Special Surgery (HSS), Robert Lee Patterson, Jr., MD (1907–1994) retired, having repaired adverse relations between HSS and the New York Hospital-Cornell Medical Center. Patterson, who had first joined the staff of The Hospital for the Ruptured and Crippled in 1936 as a Visiting Surgeon, was able to accomplish this very challenging task mainly through his close relationship with Preston Wade, MD (1901–1982), a general surgeon who had served with Patterson as Co-Chief of the combined New York Hospital-HSS Fracture service. The Board of Trustees of the New York Society for the Relief of the Ruptured and Crippled appointed Philip D. Wilson, Jr. MD, as the eighth Surgeon-in-Chief of The Hospital for Special Surgery. He assumed that office on July 1, 1972. Wilson, who had joined the staff as an Orthopaedic Surgeon to the Out-Patient Department in 1951, had trained as an orthopaedic resident at HSS from 1948 to 1950 and in 1951, finished his residency at the University of California Hospital Medical Center, San Francisco. During his 17 years as Surgeon-in-Chief, he led the hospital into the advanced field of implant research and development and building a world-class center for patient care. Additionally, many other orthopaedic services such as Sports Medicine, Scoliosis and Metabolic Bone Diseases became the leaders in their fields. Supporting Departments of Rheumatology, Anesthesia and others were likewise recognized foremost in the country. PMID:21886524

  14. The role of hospitals in bridging the care continuum: a systematic review of coordination of care and follow-up for adults with chronic conditions.

    PubMed

    De Regge, Melissa; De Pourcq, Kaat; Meijboom, Bert; Trybou, Jeroen; Mortier, Eric; Eeckloo, Kristof

    2017-08-09

    Multiple studies have investigated the outcome of integrated care programs for chronically ill patients. However, few studies have addressed the specific role hospitals can play in the downstream collaboration for chronic disease management. Our objective here is to provide a comprehensive overview of the role of the hospitals by synthesizing the advantages and disadvantages of hospital interference in the chronic discourse for chronically ill patients found in published empirical studies. Systematic literature review. Two reviewers independently investigated relevant studies using a standardized search strategy. Thirty-two articles were included in the systematic review. Overall, the quality of the included studies is high. Four important themes were identified: the impact of transitional care interventions initiated from the hospital's side, the role of specialized care settings, the comparison of inpatient and outpatient care, and the effect of chronic care coordination on the experience of patients. Our results show that hospitals can play an important role in transitional care interventions and the coordination of chronic care with better outcomes for the patients by taking a leading role in integrated care programs. Above that, the patient experiences are positively influenced by the coordinating role of a specialist. Specialized care settings, as components of the hospital, facilitate the coordination of the care processes. In the future, specialized care centers and primary care could play a more extensive role in care for chronic patients by collaborating.

  15. Astronomy Outreach Activities for Special Needs Children and Their Families

    NASA Astrophysics Data System (ADS)

    Lubowich, Donald A.

    2008-05-01

    While there are outreach programs for the public and for children, there are few programs for special needs children. Here I describe two NASA-IDEAS/STSc funded outreach programs I created for special needs children using telescope observations (including remote and robotic observations) and hands-on astronomy activities. The target audience is seriously ill children and their families who are staying at the Ronald McDonald House of Long Island in conjunction the children's surgery and medical treatments or children hospitalized at the Hagedorn Pediatric Inpatient Center at Winthrop University Hospital. These educational activities help children and their families learn about astronomy while providing a diversion to take their minds off their illness during a stressful time. I have also conducted a similar program in camps for special needs children. These programs should be expanded so that special needs children and their families part of the IYA 2009 activities.

  16. Astronomy Outreach Activities for Special Needs Children and Their Families

    NASA Astrophysics Data System (ADS)

    Lubowich, D.

    2008-11-01

    While there are outreach programs for the public and for children, there are few programs for special needs children. Here I describe two NASA-IDEAS/STScI funded outreach programs I created for special needs children using telescope observations (including remote observations) and hands-on astronomy activities. The target audience is seriously ill children and their families who are staying at the Ronald McDonald House of Long Island in conjunction the children's medical treatments or children hospitalized at the Children's Medical Center at Winthrop University Hospital. These educational activities help children and their families learn about astronomy while providing a diversion to take their minds off their illness during a stressful time. I have also conducted a similar program in camps for special needs children. These programs should be expanded so that special needs children and their families are part of the IYA2009 activities.

  17. 42 CFR 489.26 - Special requirements concerning veterans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Special requirements concerning veterans. 489.26... Provider Agreements § 489.26 Special requirements concerning veterans. For inpatient services, a hospital... concerning admissions practices and payment methodology and amounts. This section applies to services...

  18. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... December 29, 2007, was co-located with an entity that is a provider-based, off-campus location of a... hospital or the satellite facility from any individual hospital not co-located with the long-term care... from any individual hospital not co-located with the long-term care hospital or with the satellite of a...

  19. A cost-benefit analysis on the specialization in departments of obstetrics and gynecology in Japan.

    PubMed

    Shen, Junyi; Fukui, On; Hashimoto, Hiroyuki; Nakashima, Takako; Kimura, Tadashi; Morishige, Kenichiro; Saijo, Tatsuyoshi

    2012-03-27

    In April 2008, the specialization in departments of obstetrics and gynecology was conducted in Sennan area of Osaka prefecture in Japan, which aims at solving the problems of regional provision of obstetrical service. Under this specialization, the departments of obstetrics and gynecology in two city hospitals were combined as one medical center, whilst one hospital is in charge of the department of gynecology and the other one operates the department of obstetrics. In this paper, we implement a cost-benefit analysis to evaluate the validity of this specialization. The benefit-cost ratio is estimated at 1.367 under a basic scenario, indicating that the specialization can generate a net benefit. In addition, with a consideration of different kinds of uncertainty in the future, a number of sensitivity analyses are conducted. The results of these sensitivity analyses suggest that the specialization is valid in the sense that all the estimated benefit-cost ratios are above 1.0 in any case.

  20. 32 CFR 199.2 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... may have periodic acute episodes and may require intermittent inpatient hospital care. However, a... patients. Hospital, acute care (general and special). An institution that meets the criteria as set forth...

  1. 32 CFR 199.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... may have periodic acute episodes and may require intermittent inpatient hospital care. However, a... patients. Hospital, acute care (general and special). An institution that meets the criteria as set forth...

  2. 32 CFR 199.2 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... may have periodic acute episodes and may require intermittent inpatient hospital care. However, a... patients. Hospital, acute care (general and special). An institution that meets the criteria as set forth...

  3. 32 CFR 199.2 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... periodic acute episodes and may require intermittent inpatient hospital care. However, a chronic medical... patients. Hospital, acute care (general and special). An institution that meets the criteria as set forth...

  4. 32 CFR 199.2 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... may have periodic acute episodes and may require intermittent inpatient hospital care. However, a... patients. Hospital, acute care (general and special). An institution that meets the criteria as set forth...

  5. Hospital Dermatology, Introduction.

    PubMed

    Fox, Lindy P

    2017-03-01

    Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.

  6. [Problems in career planning for novice medical technologists in Japanese national hospitals].

    PubMed

    Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki

    2012-12-01

    Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs.

  7. The Effects of Single-Family Rooms on Parenting Behavior and Maternal Psychological Factors.

    PubMed

    Jones, Rachelle; Jones, Liz; Feary, Anne-Marie

    2016-01-01

    To examine the relationships among special care nursery design, parental presence, breastfeeding, psychological distress, hospital-related stress, and maternal parenting self-efficacy at the infant's discharge from hospital and at 4 months postdischarge. We used a causal comparative design to compare two special care nursery designs: open ward nursery (OW) and single-family room (SFR) nursery. Special care nurseries of two tertiary hospitals on the Gold Coast, Australia, with the newly built second hospital replacing the first. Fifty-six mothers of infants cared for in the special care nurseries (OW, n = 31; SFR, n = 25). Participating mothers completed parental presence records during their infants' stays in hospital and completed two surveys, one at discharge and the other at 4 months postdischarge, to measure their psychological distress, hospital-related stress, parenting self-efficacy, and infant feeding method. Mothers with newborns in SFR nurseries spent markedly more time with their newborns, without any more visits or fewer visits, than mothers of newborns in OW nurseries during the first 2 weeks of their newborns' lives. For mothers with low levels of presence, parental role alteration stress was significantly greater for mothers in OW compared with SFR nurseries. Compared with mothers of infants in OW nurseries, mothers of newborns in SFR nurseries were significantly more likely to exclusively breastfeed their newborns at discharge from the hospital and at 4 months postdischarge. Compared with mothers with infants in OW nurseries, mothers with infants in SFR nurseries were more likely to be present and to initiate and maintain breastfeeding. Likewise, the SFR nursery was protective against stress related to changes in the parenting role for mothers who had low levels of presence. Copyright © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  8. [The role of the N. N. Burdenko Main Military Clinical Hospital in the development of specialized medical care in the Armed Forces of the Russian Federation].

    PubMed

    1997-11-01

    The article give the characteristic of the specialized medical care as the highest form of the medical care, enabling to use more effectively the most advanced achievements of all fields of the clinical medicine and appropriate categories of the experts with the purposes of the successful treatment of the injured and patients. A role of V. A. Oppel', N. N. Burdenko, E. I. Smirnov in origin and development of the specialized medical help in military-field conditions is marked. On example of Burdenko Main Military Clinical Hospital achievement and problems of the specialized medical help at the present stage are shown, prospects and ways of its further development and perfection are planned.

  9. The epidemiology of spinal cord injuries in Papua New Guinea.

    PubMed

    Gee, R W; Sinha, S N

    1982-06-01

    Thirty six patients with traumatic spinal cord injury were studied in Papua New Guinean hospitals. Road trauma and falls from trees each accounted for 1/3 of injuries. The mean age of patients, 80% of whom were male, was 26 years. Complications included pressure sores (69%), urinary tract infection (61%) and contractures (22%). Two thirds of patients failed to make any significant recovery and remained permanently in hospital. At present there are no special facilities for treating paraplegic patients in this country but as the number of cases is increasing it is recommended that major hospitals provide special units and a standard management protocol for these patients.

  10. Medical necessity for the hospitalization of the abused and neglected child. American Academy of Pediatrics. Committee on Hospital Care and Committee on Child Abuse and Neglect.

    PubMed

    1998-04-01

    The child suspected of being abused or neglected demands prompt evaluation in a protective environment where knowledgeable consultants are readily available. In communities without specialized centers for the care of abused children, the hospital inpatient unit becomes an appropriate setting for their initial management. Medical, psychosocial, and legal concerns may be assessed expeditiously while the child is housed in a safe haven awaiting final disposition by child protective services. The American Academy of Pediatrics recommends that hospitalization of abused and neglected children, when medically indicated or for their protection/diagnosis when there are no specialized facilities in the community for their care, should be viewed as medically necessary by both health professionals and third-party payors.

  11. Changing the nursing culture in a special hospital.

    PubMed

    Dale, C; Rae, M; Tarbuck, P

    In August 1992 a damning report was published on the mental health services provided at Ashworth Special Hospital in Merseyside. It described a brutalising and damaging regime in which nurses were singled out for the strongest criticism. In November 1994 the Health Advisory Service (HAS), which has a watchdog role, spent three weeks at Ashworth reviewing developments in the wake of the inquiry report. The HAS report, published last March, praised the hospital for undergoing tremendous change and recovery. Areas of exemplary practice were evident and major dehumanising practices had been eliminated. This paper attempts to analyse some of the difficulties confronting nurses at the hospital during the years of change between the public inquiry and the HAS visit, and identifies recent major achievements and areas for further work.

  12. 22 CFR 145.14 - Special award conditions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Special award conditions. 145.14 Section 145.14 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Pre-Award Requirements § 145.14 Special award...

  13. 38 CFR 17.240 - Sharing specialized medical resources.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., public or private hospitals or other medical installations having hospital facilities or organ banks, blood banks, or similar institutions, or medical schools or clinics in a medical community with...

  14. Assessment of hospital performance with a case-mix standardized mortality model using an existing administrative database in Japan.

    PubMed

    Miyata, Hiroaki; Hashimoto, Hideki; Horiguchi, Hiromasa; Fushimi, Kiyohide; Matsuda, Shinya

    2010-05-19

    Few studies have examined whether risk adjustment is evenly applicable to hospitals with various characteristics and case-mix. In this study, we applied a generic prediction model to nationwide discharge data from hospitals with various characteristics. We used standardized data of 1,878,767 discharged patients provided by 469 hospitals from July 1 to October 31, 2006. We generated and validated a case-mix in-hospital mortality prediction model using 50/50 split sample validation. We classified hospitals into two groups based on c-index value (hospitals with c-index > or = 0.8; hospitals with c-index < 0.8) and examined differences in their characteristics. The model demonstrated excellent discrimination as indicated by the high average c-index and small standard deviation (c-index = 0.88 +/- 0.04). Expected mortality rate of each hospital was highly correlated with observed mortality rate (r = 0.693, p < 0.001). Among the studied hospitals, 446 (95%) had a c-index of >/=0.8 and were classified as the higher c-index group. A significantly higher proportion of hospitals in the lower c-index group were specialized hospitals and hospitals with convalescent wards. The model fits well to a group of hospitals with a wide variety of acute care events, though model fit is less satisfactory for specialized hospitals and those with convalescent wards. Further sophistication of the generic prediction model would be recommended to obtain optimal indices to region specific conditions.

  15. What Is an Ophthalmologist?

    MedlinePlus

    ... medical tests and minor office surgery. Ophthalmic Registered Nurse These clinicians have undergone special nursing training and ... with hospital or office surgery. Some ophthalmic registered nurses also serve as clinic or hospital administrators. Ophthalmic ...

  16. Transitioning Children from Psychiatric Hospitals to Schools: The Role of the Special Educator

    ERIC Educational Resources Information Center

    Simon, Joan B.; Savina, Elena A.

    2010-01-01

    Over a quarter of a million U.S. students each year reside for a period of time in a psychiatric inpatient hospital setting to receive mental health treatment. Following inpatient treatment, most children are transitioned from the hospital into a regular school setting. Little is known about how these transitions are managed by hospital or school…

  17. Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

    PubMed

    Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

    2016-01-01

    To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

  18. Need for Formal Specialization in Pharmacy in Canada: A Survey of Hospital Pharmacists

    PubMed Central

    Penm, Jonathan; MacKinnon, Neil J; Jorgenson, Derek; Ying, Jun; Smith, Jennifer

    2016-01-01

    Background The Blueprint for Pharmacy was a collaborative initiative involving all of the major pharmacy associations in Canada. It aimed to coordinate, facilitate, and be a catalyst for changes required to align pharmacy practice with the health care needs of Canadians. In partial fulfilment of this mandate, a needs assessment for specialist certification for pharmacists was conducted. Objective To conduct a secondary analysis of data from the needs assessment to determine the perceptions of hospital pharmacists regarding a formal certification process for pharmacist specialties in Canada. Methods A survey was developed in consultation with the Blueprint for Pharmacy Specialization Project Advisory Group and other key stakeholders. It was distributed electronically, in English and French, to Canadian pharmacists identified through national and provincial pharmacy organizations (survey period January 15 to February 12, 2015). Data for hospital pharmacists were extracted for this secondary analysis. Multivariable logistic regression analyses were conducted to characterize those respondents who supported the certification process and those intending to become certified if a Canadian process were introduced. Results A total of 640 responses were received from hospital pharmacists. Nearly 85% of the respondents (543/640 [84.8%]) supported a formal certification process for pharmacist specialization, and more than 70% (249/349 [71.3%]) indicated their intention to obtain specialty certification if a Canadian process were introduced. Respondents believed that the main barriers to developing such a system were lack of reimbursement models, the time required, and lack of public awareness of pharmacist specialties. They felt that the most important factors for an optimal certification process were a consistent definition of pharmacist specialty practice and consistent recognition of pharmacist specialty practice across Canada. Multiple regression analysis showed that female respondents were more likely to support a formal certification process (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.2–5.7). Also, those who already specialized in pharmacotherapy were more likely to support mandatory certification (OR 2.6, 95% CI 1.1–6.1). Conclusions Hospital pharmacists who responded to this survey overwhelmingly supported certification for pharmacist specialization in Canada. Questions remain about the feasibility of establishing a pharmacist specialization system in Canada. PMID:27826153

  19. In-School Suspension Practices and the Prison Hospital Experience

    ERIC Educational Resources Information Center

    Wiles, David K.; Rockoff, Edward

    1977-01-01

    Explores the legal implications of in-school suspension practices through consideration of individual versus institutional rights within a special punitive-rehabilitative setting. Argues that the prison hospital model is applicable to in-school suspension programs and discusses a number of legal questions raised by the prison hospital model.…

  20. Contract law for the hospital and health administrator.

    PubMed

    Bates, P W

    1986-01-01

    The author discusses the concept of a legal 'contract' and gives many examples of its application in hospitals and health settings. He describes the main features of a contract and gives special attention to personnel and clinical ramifications and to the role of agents in making contracts on behalf of hospitals.

  1. 76 FR 19365 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ... Fiscal Year 2011 Final Wage Indices Implementing the Medicare and Medicaid Extenders Act AGENCY: Centers... fiscal year (FY) 2011 wage indices and hospital reclassifications and other related tables which reflect... reclassifications and special exception wage indices through September 30, 2011. DATES: Applicability Date: The...

  2. [Community coordination of dental care needs in a home medical care support ward and at home].

    PubMed

    Sumi, Yasunori; Ozawa, Nobuyoshi; Miura, Hiroko; Miura, Hisayuki; Toba, Kenji

    2011-01-01

    The purpose of this study was to ascertain the current statuses and problems of dental home care patients by surveying the oral care status and needs of patients in the home medical care support ward at the National Center for Geriatrics and Gerontology. Patients that required continuous oral management even after discharge from the hospital were referred to local dental clinics to receive home dental care. We investigated the suitability and problems associated with such care, and identified the dental care needs of home patients and the status of local care coordination, including those in hospitals. The subjects were 82 patients. We ascertained their general condition and oral status, and also investigated the problems associated with patients judged to need specialized oral care by a dentist during oral treatment. Patients who required continuous specialized oral care after discharge from hospital were referred to dental clinics that could provide regular care, and the problems at the time of referral were identified. Dry mouth was reported by many patients. A large number of patients also needed specialized dental treatment such as the removal of dental calculus or tooth extraction. Problems were seen in oral function, with 38 of the patients (46%) unable to gargle and 23 (28%) unable to hold their mouths open. About half of the patients also had dementia, and communication with these patients was difficult. Of the 43 patients who were judged to need continuing oral care after discharge from hospital, their referral to a dental clinic for regular care was successful for 22 (51%) patients and unsuccessful for 21 (49%) patients. The reasons for unsuccessful referrals included the fact that the family, patient, nurse, or caregiver did not understand the need for specialized oral care. The present results suggest the need for specialized oral treatment in home medical care. These findings also suggest that coordinating seamless dental care among primary physicians, intermediates, and transferring care after hospital discharge to regular dentists is difficult.

  3. Design, Planning and Management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón.

    PubMed

    Fuente-Martín, C de la; Fuente Martín, B de la; Grifol-Clar, E

    2017-12-01

    The design and management of a Hospital Custody Unit at Hospital Universitario Fundación Alcorcón, to focus the aim of this study on specialized medical care for extra-penitentiary patients who have suffered from a disease. We are building a new space to facilitate their daily lives at hospital and we want to offer a double function to the patients that consists of a custody space and a health rehabilitation space. We carried out a scientific literature search on the international and national databases, about Hospital Custody Units or Restricted Access Units. The language of the reviews that we checked was English and Spanish. We wrote the Action Guide of the Hospital Custody Unit for the design, planning and management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón. (We included complementary bibliographic material and the Quick Guide in the Unit). The Hospital Custody Unit will be compatible with medical activity, occupational safety and the custody of patients that are in prison. We thus require consensus with police departments about custody protocols along with assistance from the clinicians' teams at penitentiary centers and referral hospitals. Furthermore, it is important to step up special care for mental health and to promote telemedicine and new technologies to streamline medical care along with coordination with healthcare professionals.

  4. Hospital for Special Surgery: origin and early history first site 1863-1870.

    PubMed

    Levine, David B

    2005-09-01

    Hospital for Special Surgery (HSS) originated as the Hospital for the Ruptured and Crippled (R&C) 142 years ago in New York City. As the first and only orthopaedic hospital of its kind in this country, it was located in the residence of its founder James Knight on Second Avenue, south of Sixth Street, and started with 28 inpatient beds for children but no operating facilities. The history of this institution has been documented in two books and occasionally published and unpublished papers. Many of these accounts have been limited by time, focus on a particular subject, or overall reviews. The emergence of such a specialized facility in the middle of the 19th century during a time of medicine in its infancy, our country at war and the city of New York racked in poverty, disease, civil riots, and political corruption is a story not necessarily appreciated in our day. The vision of one little-known physician and the cooperation and support of a small group of prominent New Yorkers and philanthropists were responsible for the origin of this hospital and particularly for its survival in such troubled times when most small hospitals of this period lasted only for a few years. Fortunately, almost all of the original Annual Reports of the Board of Managers, photographs, manuscripts, personal records, and newspaper clippings have been saved. They are now being collected, preserved, catalogued, and displayed in the newly formed HSS Archives from which this material has been taken.

  5. [Gynecologic oncology at the Royal Hospital for Women, Sidney. Report on a 10 month overseas stay].

    PubMed

    Gitsch, G

    1995-01-01

    Gynecologic oncology is centralized in Australia. In centers like the Royal Hospital for Women in Sydney, more than 300 patients/year with gynecologic malignancies are operated on. The establishment of gynecologic oncology as a special field is illustrated. In addition, the 3-year training program of gynecologic oncologists is reviewed. The international trend towards specialization is emphasized, and the advantages of centralization and additional training are pointed out. An adaptation of the Australian model for Austrian circumstances is proposed.

  6. Marketing implications of the shift in power of the hospital.

    PubMed

    Rayburn, J M; Rayburn, L G

    1995-01-01

    With the introduction of the Prospective Payment System, hospital accountants' role changed from reimbursement maximizers to an important role in decision making. Faced with increased competition, hospitals are installing financial controls. Hospital marketers are also engaging in external promotional and health awareness campaigns and expanding their services to stabilize income and reduce the effects of a changing environment. Thus, hospitals operate in a more competitive environment with increasing uncertainty. When faced with uncertainty, organizations often believe that they must convince society that their existence is legitimate. Increasing specialization and organizational complexity in health care professions have made the expert important. Experts, such as the role assumed by hospital accountants and physicians, maintain power because the organization depends on them for their special skills and information. Marketing should also develop an internal marketing program to reach these power influencers. Scarce resource coupled with uncertainty move hospital accountants as experts into the power equation in the changing control of the U.S. healthcare system. Previously, the physician was the major source of hospital power. Since accountants often serve as monitors of scarce resources, information about the resource allocation directly affects the distribution of power. Marketers should acknowledge that this places hospital accountants in a critical role of assisting their institutions in adapting to a new environment.

  7. 42 CFR 482.68 - Special requirements for transplant centers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Special requirements for transplant centers. 482.68... Specialty Hospitals § 482.68 Special requirements for transplant centers. A transplant center located within... specified in §§ 482.72 through 482.104 in order to be granted approval from CMS to provide transplant...

  8. 42 CFR 482.68 - Special requirements for transplant centers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Special requirements for transplant centers. 482.68... Specialty Hospitals § 482.68 Special requirements for transplant centers. A transplant center located within... specified in §§ 482.72 through 482.104 in order to be granted approval from CMS to provide transplant...

  9. 42 CFR 482.68 - Special requirements for transplant centers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Special requirements for transplant centers. 482.68... Specialty Hospitals § 482.68 Special requirements for transplant centers. A transplant center located within... specified in §§ 482.72 through 482.104 in order to be granted approval from CMS to provide transplant...

  10. 42 CFR 482.68 - Special requirements for transplant centers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Special requirements for transplant centers. 482.68... Specialty Hospitals § 482.68 Special requirements for transplant centers. A transplant center located within... specified in §§ 482.72 through 482.104 in order to be granted approval from CMS to provide transplant...

  11. 42 CFR 482.68 - Special requirements for transplant centers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Special requirements for transplant centers. 482.68... Specialty Hospitals § 482.68 Special requirements for transplant centers. A transplant center located within... specified in §§ 482.72 through 482.104 in order to be granted approval from CMS to provide transplant...

  12. 42 CFR 406.25 - Special enrollment period for volunteers outside the United States.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Special enrollment period for volunteers outside... Premium Hospital Insurance § 406.25 Special enrollment period for volunteers outside the United States. (a... meets the following requirements: (1) The individual is serving as a volunteer outside of the United...

  13. 42 CFR 406.25 - Special enrollment period for volunteers outside the United States.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Special enrollment period for volunteers outside... Premium Hospital Insurance § 406.25 Special enrollment period for volunteers outside the United States. (a... meets the following requirements: (1) The individual is serving as a volunteer outside of the United...

  14. 42 CFR 406.25 - Special enrollment period for volunteers outside the United States.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Special enrollment period for volunteers outside... Premium Hospital Insurance § 406.25 Special enrollment period for volunteers outside the United States. (a... meets the following requirements: (1) The individual is serving as a volunteer outside of the United...

  15. 42 CFR 406.25 - Special enrollment period for volunteers outside the United States.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Special enrollment period for volunteers outside... Premium Hospital Insurance § 406.25 Special enrollment period for volunteers outside the United States. (a... meets the following requirements: (1) The individual is serving as a volunteer outside of the United...

  16. 42 CFR 406.25 - Special enrollment period for volunteers outside the United States.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special enrollment period for volunteers outside... Premium Hospital Insurance § 406.25 Special enrollment period for volunteers outside the United States. (a... meets the following requirements: (1) The individual is serving as a volunteer outside of the United...

  17. Predictors of Specialized Inpatient Admissions for Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Modi, Miti; McMorris, Carly; Palucka, Anna; Raina, Poonam; Lunsky, Yona

    2015-01-01

    Individuals with intellectual disability (ID) have complex mental health needs and may seek specialized ID psychiatric services. This study reports on predictors of specialized inpatient admissions for 234 individuals with ID who received outpatient services at a psychiatric hospital. Overall, from 2007-2012, 55 of the 234 outpatients were triaged…

  18. Specialized new graduate RN pediatric orientation: a strategy for nursing retention and its financial impact.

    PubMed

    Friedman, M Isabel; Delaney, Margaret M; Schmidt, Kathleen; Quinn, Carolyn; Macyk, Irene

    2013-01-01

    New graduate RN retention in the first year of employment is a challenge for hospitals, ranging from a low of 25% to a high of 64%. In 2005, hospitals in New York state spent 11.7% of their nursing budgets on temporary nursing staffing. The objectives of this study were to determine the retention and costs associated with the employment of new graduate RNs before and after the initiation of specialized year-long pediatric critical care, emergency department, and hematology/oncology orientation programs. The major study findings were improved retention of 84% to 94%, significant retention between the two groups at 9 months, and an annual financial savings related to decreased nursing turnover in the specialized orientation group. Specialized orientation programs that support new graduate RNs have documented increased RN retention and decreased RN turnover. In concert with the increased retention and decreased turnover, health care finances were positively impacted by specialized orientation programs.

  19. Save the patient a trip. Outcome difference between conservatively treated patients with traumatic brain injury in a nonspecialized intensive care unit vs a specialized neurosurgical intensive care unit in the Sultanate of Oman.

    PubMed

    Al-Kashmiri, Ammar M; Al-Shaqsi, Sultan Z; Al-Kharusi, Adil S; Al-Tamimi, Laila A

    2015-06-01

    Traumatic brain injury (TBI) continues to be the main cause of death among trauma patients. Accurate diagnosis and timely surgical interventions are critical steps in reducing the mortality from this disease. For patients who have no surgically reversible head injury pathology, the decision to transfer to a dedicated neurosurgical unit is usually controversial. To compare the outcome of patients with severe TBI treated conservatively in a specialized neurosurgical intensive care unit (ICU) and those treated conservatively at a general ICU in the Sultanate of Oman. Retrospective cohort study. This is a retrospective study of patients with severe TBI admitted to Khoula Hospital ICU (specialized neurosurgical ICU) and Nizwa Hospital ICU (general ICU) in Oman in 2013. Surgically treated patients were excluded. Data extracted included demographics, injury details, interventions, and outcomes. The outcome variables included mortality, length of stay, length of ICU days, and ventilated days. There were 100 patients with severe TBI treated conservatively at Khoula Hospital compared with 74 patients at Nizwa Hospital. Basic demographics were similar between the 2 groups. No significant difference was found in mortality, length of stay, ICU days, and ventilation days. There is no difference in outcome between patients with TBI treated conservatively in a specialized neurosurgical ICU and those treated in a general nonspecialized ICU in Oman in 2013. Therefore, unless neurosurgical intervention is warranted or expected, patients with TBI may be managed in a general ICU, saving the risk and expense of a transfer to a specialized neurosurgical ICU. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. 42 CFR 412.84 - Payment for extraordinarily high-cost cases (cost outliers).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for... circumstances: (i) New hospitals that have not yet submitted their first Medicare cost report. (For this purpose, a new hospital is defined as an entity that has not accepted assignment of an existing hospital's...

  1. 42 CFR 412.109 - Special treatment: Essential access community hospitals (EACHs).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... standardized payment amount by CMS or the Medicare Geographic Classification Review Board; or (4) Is not... health network. (2) Request and documentation. In order for a hospital to qualify for an increase in its... resulting from the hospital's participation in a rural health network and show that the increased costs...

  2. 42 CFR 412.109 - Special treatment: Essential access community hospitals (EACHs).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... standardized payment amount by CMS or the Medicare Geographic Classification Review Board; or (4) Is not... health network. (2) Request and documentation. In order for a hospital to qualify for an increase in its... resulting from the hospital's participation in a rural health network and show that the increased costs...

  3. 42 CFR 412.109 - Special treatment: Essential access community hospitals (EACHs).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... standardized payment amount by CMS or the Medicare Geographic Classification Review Board; or (4) Is not... health network. (2) Request and documentation. In order for a hospital to qualify for an increase in its... resulting from the hospital's participation in a rural health network and show that the increased costs...

  4. 42 CFR 412.109 - Special treatment: Essential access community hospitals (EACHs).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... standardized payment amount by CMS or the Medicare Geographic Classification Review Board; or (4) Is not... health network. (2) Request and documentation. In order for a hospital to qualify for an increase in its... resulting from the hospital's participation in a rural health network and show that the increased costs...

  5. 42 CFR 412.109 - Special treatment: Essential access community hospitals (EACHs).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... standardized payment amount by CMS or the Medicare Geographic Classification Review Board; or (4) Is not... health network. (2) Request and documentation. In order for a hospital to qualify for an increase in its... resulting from the hospital's participation in a rural health network and show that the increased costs...

  6. 29 CFR 778.601 - Special overtime provisions available for hospital and residential care establishments under...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... residential care establishments under section 7(j). 778.601 Section 778.601 Labor Regulations Relating to... provisions available for hospital and residential care establishments under section 7(j). (a) The statutory provision. Section 7(j) of the Act provides, for hospital and residential care establishment employment...

  7. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... provisions. The following classifications of hospitals are paid under special provisions and therefore are... criteria for one or more of the excluded classifications described in § 412.23. For purposes of this... following criteria in order to be excluded from the prospective payment systems specified in § 412.1(a)(1...

  8. Towards Age-Friendly Hospitals in Developing Countries: A Case Study in Iran

    PubMed Central

    Ahmadi, Ahmad; Seyedin, Hesam; Fadaye-Vatan, Reza

    2015-01-01

    Background: Developing countries such as Iran are experiencing a growth in the elderly population. This is a challenge for healthcare providers and their families. This study investigated the extent in which hospitals at Tehran meet the criteria of age-friendly hospitals. Methods: In this descriptive study, using convenience sampling, 26 hospitals were selected in Tehran, the capital city of Iran. The instrument was a checklist included 50 items in the three dimensions of information and training of service providers, management systems in health care centers, physical environment and accessibility of hospitals. Results: Most hospitals were in a good condition regarding physical environment and access to public transportation, but in a poor condition for special healthcare programs for the elderly, teaching principles of geriatrics and gerontology, interaction of medical staff, physicians and nurses with senior patients and systems of priority for them. Conclusion: Due to the growing elderly population, it is necessary for health policymakers, especially in developing countries, to consider seriously the issue of elderly healthcare and their need for special outpatient and inpatient services. PMID:26000245

  9. [Re-organization of internal medicine wing in hospitals: a last-ditch effort or the beginning of reform?].

    PubMed

    Sharabi, Yehonatan

    2014-01-01

    Over the last decade numerous publications have dealt with ongoing changes in the traditional practice of internal medicine. In general, in-hospital medicine has evolved into ambulatory or specialized care. In this volume of Harefuah, Yinon et al. discuss trends at Shaare-Zedek Medical Center, focusing on the challenge of attracting residents to general internal medicine. Their model addresses local problems, but they have laid the groundwork for a more radical change. They present an evolutionary process that would transform hospital practice to become both more patient-centered and integrative, with an interdisciplinary team that translates the strengths of in-hospital (in- and out-patient care) vs. ambulatory or over-specialized care. Such reform should also include changes in clinical medical education, coupled with research and academic activities that can only take place in hospitals. The health care system is waiting for the next academic medical center that will take the lead in accepting this challenge and spearhead much needed reform.

  10. An outbreak of Serratia marcescens infection in a special-care baby unit of a community hospital in United Arab Emirates: the importance of the air conditioner duct as a nosocomial reservoir.

    PubMed

    Uduman, S A; Farrukh, A S; Nath, K N R; Zuhair, M Y H; Ifrah, A; Khawla, A D; Sunita, P

    2002-11-01

    We report an outbreak of Serratia marcescens infection in a special-care baby unit (SCBU) of a university-affiliated community hospital in the United Arab Emirates. The outbreak involved 36 infants and lasted for 20 weeks. Seven of the colonized infants developed invasive illnesses in the form of bacteraemia (four cases), bacteraemic meningitis (two) and clinical sepsis (one). Three other term infants had purulent conjunctivitis. There were five deaths with an overall mortality of 14%. S. marcescens was cultured from airflow samples from the air conditioning (AC) which was the reservoir of infection in this outbreak. Elimination of the nosocomial source and outbreak containment were eventually achieved by specialized robotic cleaning of the entire AC duct system of the SCBU. Strict adherence to the infection control policies was reinforced to prevent transmission of cross-infection. Copyright 2002 The Hospital Infection Society

  11. Specialization in general practice *

    PubMed Central

    Hart, Julian Tudor

    1980-01-01

    Ideas about general practitioner specialism may have been hampered in the past because of the three models of general practitioner specialism — in the hospital service, the fee-earning specialoid or the general practitioner obstetrician — none of which is satisfactory. However, general practitioner specialism can be justified in guaranteeing standards by concentrating groups of patients, accepting responsibility, and planning care. Medico-political changes may be needed to achieve improvement in clinical standards. PMID:7411511

  12. Special Issue of Teaching Ideas.

    ERIC Educational Resources Information Center

    Health Education (Washington D.C.), 1986

    1986-01-01

    This special issue contains teaching strategies and suggestions for health-related activities at all educational levels. A few of the topics addressed by the 21 articles are heart disease, testicular cancer, hospital stress, family life, and sexual responsibility. (MT)

  13. Education level and inequalities in stroke reperfusion therapy: observations in the Swedish stroke register.

    PubMed

    Stecksén, Anna; Glader, Eva-Lotta; Asplund, Kjell; Norrving, Bo; Eriksson, Marie

    2014-09-01

    Previous studies have revealed inequalities in stroke treatment based on demographics, hospital type, and region. We used the Swedish Stroke Register (Riksstroke) to test whether patient education level is associated with reperfusion (either or both of thrombolysis and thrombectomy) treatment. We included 85 885 patients with ischemic stroke aged 18 to 80 years registered in Riksstroke between 2003 and 2009. Education level was retrieved from Statistics Sweden, and thrombolysis, thrombectomy, patient, and hospital data were obtained from Riksstroke. We used multivariable logistic regression to analyze the association between reperfusion therapy and patient education. A total of 3649 (4.2%) of the patients received reperfusion therapy. University-educated patients were more likely to be treated (5.5%) than patients with secondary (4.6%) or primary education (3.6%; P<0.001). The inequality associated with education was still present after adjustment for patient characteristics; university education odds ratio, 1.14; 95% confidence interval, 1.03 to 1.26 and secondary education odds ratio, 1.08; 95% confidence interval, 1.00 to 1.17 compared with primary education. Higher hospital specialization level was also associated with higher reperfusion levels (P<0.001). In stratified multivariable analyses by hospital type, significant treatment differences by education level existed only among large nonuniversity hospitals (university education odds ratio, 1.20; 95% confidence interval, 1.04-1.40; secondary education odds ratio, 1.14; 95% confidence interval, 1.01-1.29). We demonstrated a social stratification in reperfusion, partly explained by patient characteristics and the local hospital specialization level. Further studies should address treatment delays, stroke knowledge, and means to improve reperfusion implementation in less specialized hospitals. © 2014 American Heart Association, Inc.

  14. Nurses' caring and empathy in Jordanian psychiatric hospitals: A national survey.

    PubMed

    Alhadidi, Majdi M B; Abdalrahim, Maysoon S; Al-Hussami, Mahmoud

    2016-08-01

    Nurses working in psychiatric hospitals need to acquire the skills of therapeutic communication and empathy, and have higher levels of caring. The present study aims to investigate the level of caring and empathy among nurses working in psychiatric hospitals. A cross-sectional survey was utilized to collect data from 205 nurses recruited from three psychiatric hospitals in Jordan. The Background Information Questionnaire, Modified Caring Dimensions Inventory, and Toronto Empathy Questionnaire were administered to the recruited participants. The findings revealed that the sampled nurses had a high level of caring and empathy. Significant correlations were found between caring and having a specialized training in mental health nursing, and having organizational and managerial support. However, no significant correlations were found between empathy and participants' characteristics. Specialized training in mental health nursing, having organizational and managerial support, and empathy were found predictors for caring. © 2016 Australian College of Mental Health Nurses Inc.

  15. [Decentralization of psychiatric health service].

    PubMed

    Dabrowski, S

    1996-01-01

    The article discusses two stages of de-centralization of psychiatric hospitals: the first consists in further division into sub-districts, the second one includes successive establishment of psychiatric wards in general hospitals. With the growth of their number these wards are to take over more and more general psychiatric tasks from the specialized psychiatric hospitals. These wards will not substitute psychiatric hospitals completely. The hospitals, though decreasing in size and number, will be a necessary element of the de-centralized and versatile psychiatric care for a long time to come.

  16. 42 CFR 412.106 - Special treatment: Hospitals that serve a disproportionate share of low-income patients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... disproportionate share of low-income patients. 412.106 Section 412.106 Public Health CENTERS FOR MEDICARE...-income patients. (a) General considerations. (1) The factors considered in determining whether a hospital qualifies for a payment adjustment include the number of beds, the number of patient days, and the hospital...

  17. 42 CFR 412.532 - Special payment provisions for patients who are transferred to onsite providers and readmitted to...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... percent) of the total number of its Medicare inpatients discharged from that acute care hospital, all such... transferred to onsite providers and readmitted to a long-term care hospital. 412.532 Section 412.532 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care...

  18. [Analysis of mortality and convergence tendencies in inpatient care of stroke and myocardial infarction].

    PubMed

    Rath, T; Büscher, G; Schwartze, D; Drabik, A; Bokern, E; Lüngen, M

    2010-09-01

    An increase in the convergence of medical services toward specialized hospitals with high case numbers as well as the effects on quality of care are often assumed to be the result of diagnosis-related groups (DRGs; case-based lump-sum reimbursement). Estimates of the extent to which these effects occur in emergency diagnoses are not available. Claims data relating to approximately 23.6 million insured within the period 2004-2007 (inclusive) were analyzed. All cases with the main diagnosis of stroke (ICD-10: I63 and I64) and myocardial infarction (ICD-10: I21) were included in the study. Increasing case numbers could be observed for all entities within the period studied (myocardial infarction: +12.71%; stroke: +1.73%). The absolute increase in case numbers seems to affect those hospitals with case numbers >100 per year, whereas case numbers of hospital groups including hospitals with low case numbers per year remain unchanged or grow slower. No absolute trend in mortality could be seen. However, a disproportionate rate of mortality in hospitals with low case numbers per year for both diagnoses was observed. The convergence of emergency treatment in a few specialized centers has not yet been accelerated by the implementation of DRGs. Essentially, relative changes can be seen due to case number increases in large centers rather than because of service cutbacks and shifts from smaller hospitals. The reason for this could be the need to maintain emergency care in rural regions, while specialized centers are increasingly built in urban areas.

  19. Microbiological Assessment of Indoor Air of Teaching Hospital Wards: A case of Jimma University Specialized Hospital.

    PubMed

    Fekadu, Samuel; Getachewu, Bahilu

    2015-04-01

    Hospital environment represents a congenial situation where microorganisms and susceptible patients are indoors together. Thus, the objective of this study is to provide fundamental data related to the microbial quality of indoor air of Jimma University Specialized Hospital wards, to estimate the health hazard and to create standards for indoor air quality control. The microbial quality of indoor air of seven wards of Jimma University Specialized Hospital was determined. Passive air sampling technique, using open Petri-dishes containing different culture media, was employed to collect sample twice daily. The concentrations of bacteria and fungi aerosols in the indoor environment of the wards ranged between 2123 - 9733 CFU/m(3). The statistical analysis showed that the concentrations of bacteria that were measured in all studied wards were significantly different from each other (p-value=0.017), whereas the concentrations of fungi that were measured in all sampled wards were not significantly different from each other (p-value=0.850). Moreover, the concentrations of bacteria that were measured at different sampling time (morning and afternoon) were significantly different (p-value =0.001). All wards that were included in the study were heavily contaminated with bacteria and fungi. Thus, immediate interventions are needed to control those environmental factors which favor the growth and multiplication of microbes, and it is vital to control visitors and students in and out the wards. Moreover, it is advisable that strict measures be put in place to check the increasing microbial load in the hospital environment.

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

    PubMed

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

    2006-01-01

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

  1. 20 CFR 435.14 - Special award conditions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Special award conditions. 435.14 Section 435.14 Employees' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS, AND...

  2. [Experience in training in emergencies, Division of Special Projects in Health, Instituto Mexicano del Seguro Social].

    PubMed

    Cruz-Vega, Felipe; Loría-Castellanos, Jorge; Hernández-Olivas, Irma Patricia; Franco-Bey, Rubén; Ochoa-Avila, César; Sánchez-Badillo, Victoria

    2016-01-01

    There has been interest in the Division of Special Projects in Health to offer the Instituto Mexicano del Seguro Social personnel resources for training and quality thereby respond to potential contingencies. Presented here is their experience in this field. To describe and analyse the productivity in different training programs in emergencies and disasters developed by the Division of Special Projects in Health, Mexican Social Security Institute (IMSS). Observational study in which different training activities conducted by the Division of Special Projects in Health between 1989 and 2014 are described. Descriptive statistics were used. In these 25 years have trained 20,674 participants; 19.451 IMSS and 1,223 other health institutions. The most productive courses were life support (BLS/ACLS) (47.17%), distance courses "Hospital medical evacuation plans and units" (14.17%), the workshop-run "Evacuation of hospital units with an emphasis on critical areas" (5.93%) and course "Programme Evaluators of Hospital Insurance" (8.43%). Although the Special Projects Division Health has primarily operational functions, it nevertheless has neglected its responsibility to maintain constantly trained and updated institute staff that every day is in a position to face any type of emergency and disaster. This increases the chance that the answer to any contingency is more organised and of higher quality, always to the benefit of the population. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  3. Preventing the cure from being worse than the disease: special issues in hospital outsourcing.

    PubMed

    Beardwood, John; Alleyne, Andrew

    2004-01-01

    Like private sector organizations, hospitals are increasingly outsourcing services from food/cafeteria and security and facilities maintenance to the consulting and training of personnel and information technology (IT) functions. Also like private sector organizations, while hospitals seek the cure that will improve services at less cost, without careful management, the cure can be worse than the disease.

  4. Job satisfaction of nurses in Jimma University Specialized Teaching Hospital, Ethiopia.

    PubMed

    Negussie, Nebiat

    2016-03-01

    In Ethiopia nurses have played a very important role in providing timely and quality health service in healthcare organizations. However, there is a limited literature in the area of nurses' job satisfaction in Ethiopian public hospitals. The objective of this research is to measure job satisfaction of nurses in Jimma University Specialized Teaching Hospital and to determine the influencing factors. A cross-sectional survey was conducted from January 2012 to June 2012 in Jimma University Specialized Teaching Hospital. All full-time nurses with nonsupervisory management position and more than 1 year of work experience were invited to participate in the study. Minnesota Satisfaction Questionnaire was used to collect the data. A total of 175 copies of the questionnaires were returned out of 186 copies distributed to the respondents. The results indicated that nurses were not satisfied by their job (mean=2.21, SD=0.52). Remuneration (r=0.71, P<0.01) and job advancement (r=0.69, P<0.01) were statically significant and strongly correlated with nurses' job satisfaction. Job security was associated with highest satisfaction (r=0.41, P<0.05) CONCLUSION AND RECOMMENDATIONS: Remuneration and job advancement were the most important factors for nurses' job satisfaction. Hospital administrators as well as health policy makers need to address the two major identified sources of nurses' job dissatisfaction in the study (i.e. remuneration and narrow opportunity of job advancement) and take appropriate measures to overcome their consequences.

  5. Night emergency cover for ENT in England: a national survey.

    PubMed

    Biswas, D; Rafferty, A; Jassar, P

    2009-08-01

    To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the 'Modernising Medical Careers' initiative, in England. We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England. One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents' hospitals (51 per cent), these courses were of varying duration. Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.

  6. Controlling Legal Risk for Effective Hospital Management

    PubMed Central

    Park, Hyun Jun; Cho, Duk Young; Park, Yong Sug; Kim, Sun Wook; Park, Jae-Hong

    2016-01-01

    Purpose To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. Materials and Methods This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Results Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). Conclusions Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital. PMID:27169130

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

    PubMed

    Trontzos, Christos

    2004-01-01

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

  8. [Surgical treatment of colonic and rectal tumors].

    PubMed

    Verushkin, I I; Ratmanov, A M; Kotomin, S V; Sharnov, V A; Verushkina, N I

    1996-01-01

    The study included three groups of patients with rectal and colonic tumors operated on under emergency and routine conditions. The percentage of emergency operations proved rather high, surgery being performed under both hospital and field conditions. Causes for calls have been evaluated and extent of surgery versus operating conditions and immediate results in each group assessed. Operating under hospital conditions is recommended for carrying out procedures like that of Hartman involving obligatory removal of tumor and verification of diagnosis. Reconstructive surgery should be performed in specialized wards of a regional clinic. Higher expertise of rural surgeons as well as increased competence of general practitioners in oncopathology, timely inclusion of oncologists into on-call teams of doctors and hospitalization of patients into specialized wards contribute to higher effectiveness of treatment of bowel pathologies.

  9. [The specialty clinical centers within the structure of the regional multi-specialty hospital].

    PubMed

    Fadeev, M G

    2008-01-01

    The analysis of the functioning of the regional referral clinical center of hand surgery, the eye injury center, the pediatric burns center and the neurosurgical center situated on the basis of large multi-field hospitals of the City of Ekaterinburg is presented. Such common conditions of their activity as experienced manpower availability and medical Academy chairs maintenance are revealed. The special referral clinical centers organized prior to the perstroyka and reformation, continue to function successfully providing high-tech medical care to the patients of the megapolis and to the inhabitants of the Sverdlovskaya Oblast. The effectiveness and perspectiveness of further functioning of the special referral clinical centers embedded into the structure of the municipal multi-field hospitals in the conditions of health reforms is demonstrated.

  10. The SOLO Librarian's Sourcebook.

    ERIC Educational Resources Information Center

    Siess, Judith A.

    This book provides an introduction to single staff information services, or SOLO librarianship. SOLO librarians are usually found in corporate libraries, private companies, small public libraries, museums, schools, churches or synagogues, prisons, law firms, hospitals or special libraries with specialized or limited materials and services with…

  11. Case studies of orthopedic surgery in California: the virtues of care coordination versus specialization.

    PubMed

    Robinson, James C

    2013-05-01

    Two overarching frameworks compete to address the organizational ills of the health care system. One framework diagnoses lack of coordination and prescribes integration and global payment. The other diagnoses loss of focus and prescribes specialization and episode payment. This article, based on research and interviews, assesses how the two frameworks manifest themselves at two high-volume orthopedic hospitals in Irvine, California. The Kaiser Permanente Irvine Medical Center is part of a large and diversified health system. The Hoag Orthopedic Institute is a single-specialty facility jointly owned by the physicians and the hospital. Market outcomes, such as the merger of the Hoag specialty hospital into a larger diversified health system, suggest that Kaiser's focus on coordination of patient care from preadmission to postdischarge is a key factor in its success. But Hoag's specialization also leads to improved efficiencies. The integrated approach appears to be prevailing. At the same time, large diversified organizations might obtain further efficiencies by pursuing service-line strategies as described in this article--for instance, by providing incentives for efficiency and quality for each specialty and type of care.

  12. Hospital consultants breaking bad news with simulated patients: an analysis of communication using the Roter Interaction Analysis System.

    PubMed

    Vail, Laura; Sandhu, Harbinder; Fisher, Joanne; Cooke, Heather; Dale, Jeremy; Barnett, Mandy

    2011-05-01

    To explore how experienced clinicians from wide ranging specialities deliver bad news, and to investigate the relationship between physician characteristics and patient centredness. Consultations involving 46 hospital consultants from 22 different specialties were coded using the Roter Interaction Analysis System. Consultants mainly focussed upon providing biomedical information and did not discuss lifestyle and psychosocial issues frequently. Doctor gender, age, place of qualification, and speciality were not significantly related to patient centredness. Hospital consultants from wide ranging specialities tend to adopt a disease-centred approach when delivering bad news. Consultant characteristics had little impact upon patient centredness. Further large-scale studies are needed to examine the effect of doctor characteristics on behaviour during breaking bad news consultations. It is possible to observe breaking bad news encounters by video-recording interactions between clinicians and simulated patients. Future training programmes should focus on increasing patient-centred behaviours which include actively involving patients in the consultation, initiating psychosocial discussion, and providing patients with opportunities to ask questions. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. [Current status of "hospital-clinic" and "hospital-pharmacy" cooperation for inhalation therapy -based on hospital surveys throughout Japan].

    PubMed

    Yoshimura, Chie; Momose, Yasuyuki; Horie, Takeo; Komase, Yuko; Niimi, Akio; Dobashi, Kunio; Fujimoto, Keisaku; Tohda, Yuuji; Ohta, Ken; Adachi, Mitsuru

    2014-02-01

    The "zero death from asthma strategy" in the medical treatment for bronchial asthma has been promoted by the Ministry of Health, Labour, and Welfare from 2006, and it indicates that medical and non-medical specialists, as well as pharmacists, should cooperate, and strives to build cooperation which is suited the actual conditions of an area. It is also important for COPD. Although hospitals in some areas cooperate with clinics and pharmacies, the overall concept of cooperation appears to be absent in most Japanese hospitals. A questionnaire was administered in early March, 2012 to 477 allergology institutions, and was authorized by an educational establishment. Among 246 replies from the institutions, cooperation between hospitals and clinics was carried out by 98 institutions (39.8%) specializing in bronchial asthma, and in 64 institutions (37.2%) specializing in COPD. However, cooperation tools were used in only 37 of these institutions (15.0%). The ability to fill prescriptions outside the hospital was available in 209 institutions (85.0%). One-hundred and seventeen institutions (47.6%) replied that they have no tools for hospital-pharmacy cooperation. Direct indications were written in prescriptions by 82 institutions (33.3). In order to build inter-regional association and to equalize medical treatment, we suggest that developing tools and organization for cooperation between health professionals who treat patients with bronchial asthma and COPD is necessary.

  14. 42 CFR 412.107 - Special treatment: Hospitals that receive an additional update for FYs 1998 and 1999.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the following provisions: (i) The indirect medical education adjustment made under § 412.105. (ii) The... section if it meets all of the following criteria: (1) Definition. The hospital is not a Medicare...

  15. 42 CFR 412.107 - Special treatment: Hospitals that receive an additional update for FYs 1998 and 1999.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the following provisions: (i) The indirect medical education adjustment made under § 412.105. (ii) The... section if it meets all of the following criteria: (1) Definition. The hospital is not a Medicare...

  16. [Improvement of the recruitment of surgery interns derived from the Epreuves Nationales Classantes (National-Ranking Exam): practical solution applied to urology].

    PubMed

    Beley, Sébastien; Dubosq, Francis; Simon, Pascal; Larré, Stéphane; Battisti, Simon; Ballereau, Charles; Boublil, Véronique; Richard, François; Rouprêt, Morgan

    2005-12-01

    To analyse the value of an urology initiation session proposed to young interns to improve recruitment of the discipline since the introduction of the new National-Ranking Exam (NRE). In October 2004, the 77 interns appointed to surgery in Paris on the basis of the ENC participated in a one-day urology initiation session organized by the AFUF, at the AP-HP School of Surgery. All interns were given a questionnaire at the beginning of the session to record the following data: age, gender, teaching hospital, a student attachment in urology and desired specialization as a function of the surgical training programmes proposed by the ENC. Items concerning the desired specialization were resubmitted to the interns at the end of the session. Population. 77 interns, 48 females (62.3%) and 29 males (37.7%) with a mean age of 25.2 +/- 5 years (range: 23-31). 55 interns had trained at a Parisian teaching hospital (67%) and 22 (28.6%) had trained at a provincial teaching hospital. 16 interns (20.8%) had completed at least one urology attachment during their medical training. Desired specialization. Orthopaedics was the discipline most frequently cited (n = 20; 26%). Urology was chosen by 8 interns (10.40%), who had all completed an urology attachment during their medical training. At the end of the urology initiation session, another 8 interns expressed the desire to specialize in urology. Of the 16 potential urology interns, 9 (56.2%) confirmed that their decision was final. Urology occupies a special place and remains a popular surgical speciality among students. Organization of practical sessions constitutes a solution to inform, create an emulation and motivate surgery interns to choose urology.

  17. Teaching Specialized Vocabulary by Integrating a Corpus-Based Approach: Implications for ESP Course Design at the University Level

    ERIC Educational Resources Information Center

    Hou, Hsiao-I

    2014-01-01

    The purpose of this study is to demonstrate how to integrate two in-house specialized corpora into a university-level English for Specific Purposes (ESP) course for nonnative speakers of English. The ESP course was an introductory level of wine tasting for Applied English Department students at a university specializing in hospitality in Taiwan.…

  18. A substantial number of scientific publications originate from non-university hospitals.

    PubMed

    Fedder, Jens; Nielsen, Gunnar Lauge; Petersen, Lars J; Rasmussen, Claus; Lauszus, Finn F; Frost, Lars; Hornung, Nete; Lederballe, Ole; Andersen, Jens Peter

    2011-11-01

    As we found no recent published reports on the amount and kind of research published from Danish hospitals without university affiliation, we have found it relevant to conduct a bibliometric survey disclosing these research activities. We retrieved all scientific papers published in the period 2000-2009 emanating from all seven Danish non-university hospitals in two regions, comprising 1.8 million inhabitants, and which were registered in a minimum of one of the three databases: PubMed MEDLINE, Thomson Reuters Web of Science and Elsevier's Scopus. In 878 of 1,252 papers, the first and/or last author was affiliated to a non-university hospital. Original papers made up 69% of these publications versus 86% of publications with university affiliation on first or last place. Case reports and reviews most frequently had authors from regional hospitals as first and/or last authors. The total number of publications from regional hospitals increased by 48% over the 10-year period. Publications were cited more often if the first or last author was from a university hospital and even more so if they were affiliated to foreign institutions. Cardiology, gynaecology and obstetrics, and environmental medicine were the three specialities with the largest number of regional hospital publications. A substantial number of scientific publications originate from non-university hospitals. Almost two thirds of the publications were original research published in international journals. Variations between specialities may reflect local conditions. not relevant. not relevant.

  19. Financial impact of disease-related malnutrition at the San Pedro de Alcántara hospital. Estimated cost savings associated to a specialized nutritional survey.

    PubMed

    Morán López, Jesús Manuel; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Beneítez Moralejo, Belén; Piedra León, María; de Luis, Daniel A; Amado Señaris, José Antonio

    2017-10-01

    DRM is a highly prevalent condition in Spanish hospitals and is associated to increased healthcare costs. Costs associated to DRM were calculated using the methods of the PREDyCES study. The potential savings derived from specialized nutritional treatment were calculated by extrapolating the results of the SNAQ strategy. Median cost per procedure in patients with DRM was €9,679.85, with a final cost of €28,700,775.2. The cost of each patient with DRM was 2.63 times higher than the cost of patients with no DRM. The potential cost saving associated to specialized nutritional treatment was estimated at €1,682,317.28 (5.86% of total cost associated to DRM). Patients with DRM showed a higher consumption of financial resources as compared to well-nourished patients. Specialized nutritional treatment is a potential cost-saving procedure. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Modeling organizational determinants of hospital mortality.

    PubMed Central

    al-Haider, A S; Wan, T T

    1991-01-01

    This study examines hospital characteristics that affect the differential in hospital mortality. Death rates for 1984 Medicare inpatients in acute care hospitals, released by the Health Care Financing Administration in 1986, were analyzed. A confirmatory statistical approach to organizational determinants of hospital mortality was formulated and validated through an empirical examination of 239 hospitals. The findings suggest that the effect of hospital size and specialization on mortality was a spurious one when the effects of other variables were simultaneously controlled. A positive association existed between service intensity and hospital mortality: the more hospital services consumed, the higher the mortality rate. Community attributes accounted for more variance in hospital mortality rates than did organizational attributes. The organizational and community factors studied explained 27 percent of the total variance in hospital mortality. PMID:1869442

  1. Dying in Palliative Care Units and in Hospital: A Comparison of the Quality of Life of Terminal Cancer Patients.

    ERIC Educational Resources Information Center

    Viney, Linda L.; And Others

    1994-01-01

    Compared quality of life of terminal cancer patients (n=182) in two palliative care units with that of those in general hospital. Patients in specialized palliative care units were found to differ from those dying in hospital, showing less indirectly expressed anger but more positive feelings. They also reported more anxiety about death but less…

  2. Hospital-Based Comprehensive Care Programs for Children With Special Health Care Needs

    PubMed Central

    Cohen, Eyal; Jovcevska, Vesna; Kuo, Dennis Z.; Mahant, Sanjay

    2014-01-01

    Objective To examine the effectiveness of hospital-based comprehensive care programs in improving the quality of care for children with special health care needs. Data Sources A systematic review was conducted using Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Sociological Abstracts SocioFile, and Web of Science. Study Selection Evaluations of comprehensive care programs for categorical (those with single disease) and noncategorical groups of children with special health care needs were included. Selected articles were reviewed independently by 2 raters. Data Extraction Models of care focused on comprehensive care based at least partially in a hospital setting. The main outcome measures were the proportions of studies demonstrating improvement in the Institute of Medicine’s quality-of-care domains (effectiveness of care, efficiency of care, patient or family centeredness, patient safety, timeliness of care, and equity of care). Data Synthesis Thirty-three unique programs were included, 13 (39%) of which were randomized controlled trials. Improved outcomes most commonly reported were efficiency of care (64% [49 of 76 outcomes]), effectiveness of care (60% [57 of 95 outcomes]), and patient or family centeredness (53% [10 of 19 outcomes). Outcomes less commonly evaluated were patient safety (9% [3 of 33 programs]), timeliness of care (6% [2 of 33 programs]), and equity of care (0%). Randomized controlled trials occurred more frequently in studies evaluating categorical vs noncategorical disease populations (11 of 17 [65%] vs 2 of 16 [17%], P = .008). Conclusions Although positive, the evidence supporting comprehensive hospital-based programs for children with special health care needs is restricted primarily to nonexperimental studies of children with categorical diseases and is limited by inadequate outcome measures. Additional high-quality evidence with appropriate comparative groups and broad outcomes is necessary to justify continued development and growth of programs for broad groups of children with special health care needs. PMID:21646589

  3. Outsourcing information technology. An executive's guide to creating and managing IT contracts.

    PubMed

    Hoppszallern, Suzanna

    2003-01-01

    Many hospitals outsource one or more key areas of their IT operations, but not all are happy with the outcomes. In this special foldout, H&HN looks at what sectors hospitals should consider outsourcing and what questions to ask potential partners.

  4. Estimating Treatment and Treatment Times for Special and Nonspecial Patients in Hospital Ambulatory Dental Clinics.

    ERIC Educational Resources Information Center

    Rosenberg, Dara J.; And Others

    1986-01-01

    A study compared the treatments and the amount of time needed for treatment of the dental needs of developmentally disabled, severely compromised, and moderately compromised patients with those of nondisabled patients in a hospital ambulatory dental clinic. (MSE)

  5. Cholera in pregnancy: outcomes from a specialized cholera treatment unit for pregnant women in Léogâne, Haiti.

    PubMed

    Ciglenecki, Iza; Bichet, Mathieu; Tena, Javier; Mondesir, Erneau; Bastard, Mathieu; Tran, Nguyen-Toan; Antierens, Annick; Staderini, Nelly

    2013-01-01

    The association between cholera in pregnancy and negative fetal outcome has been described since the 19(th) century. However, there is limited published literature on the subject. We describe pregnancy outcomes from a specialized multidisciplinary hospital unit at the onset of a large cholera outbreak in Haiti in 2010 and 2011. Pregnant women with cholera were hospitalized in a specialized unit within the MSF hospital compound in Léogâne and treated using standard cholera treatment guidelines but with earlier, more intense fluid replacement. All women had intravenous access established at admission regardless of their hydration status, and all received antibiotic treatment. Data were collected on patient demographics, pregnancy and cholera status, and pregnancy outcome. In this analysis we calculated risk ratios for fetal death and performed logistic regression analysis to control for confounding factors. 263 pregnant women with cholera were hospitalized between December 2010 and July 2011. None died during hospitalization, 226 (86%) were discharged with a preserved pregnancy and 16 (6%) had live fullterm singleton births, of whom 2 died within the first 5 days postpartum. The remaining 21 pregnancies (8%) resulted in intrauterine fetal death. The risk of fetal death was associated with factors reflecting severity of the cholera episode: after adjusting for confounding factors, the strongest risk factor for fetal death was severe maternal dehydration (adjusted risk ratio for severe vs. mild dehydration was 9.4, 95% CI 2.5-35.3, p = 0.005), followed by severe vomiting (adjusted risk ratio 5.1, 95% 1.1-23.8, p = 0.041). This is the largest cohort of pregnant women with cholera described to date. The main risk factor identified for fetal death was severity of dehydration. Our experience suggests that establishing specialized multidisciplinary units which facilitate close follow-up of both pregnancy and dehydration status due to cholera could be beneficial for patients, especially in large epidemics.

  6. [Children's Psychiatric Hospital Dr. Juan N. Navarro: 50 years of attention to the mental health of children and adolescents in Mexico].

    PubMed

    Márquez-Caraveo, Maria Elena; Arroyo-García, Eduardo; Granados-Rojas, Armida; Ángeles-Llerenas, Angélica

    2017-01-01

    The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016) at the Children's Psychiatric Hospital "Dr. Juan N. Navarro" (HPI), as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital has progressed towards diagnostic and therapeutic care of outpatients through the creation of specialized clinics (emotions, behavior, development, adolescence, among others) and the development of more actualized and integral therapeutic programs (behavioral psychotherapy, cognitive behavioral, psychodynamic; individual, group, family, etc.). In the field of education, the hospital has been the most important institution in the training of child psychiatrists in Mexico and its recognition as a research interdisciplinary center has grown.

  7. Care coordination for children with special health care needs: a cohort study.

    PubMed

    Zanello, Elisa; Calugi, Simona; Sanders, Lee M; Lenzi, Jacopo; Faldella, Giacomo; Rucci, Paola; Fantini, Maria Pia

    2017-02-03

    Care coordination is widely recognized as a key element of care for patients with chronic and complex medical conditions and their families. In care for children with special health care needs the Family Pediatrician (FP) plays a central role as care coordinator. This study aims to evaluate the FPs' activities of care coordination for children with special health care needs in the pediatric primary care setting, using an on-line measurement tool. Within the prospective cohort study SpeNK (Special Needs Kids), newborns and children with special health care needs were recruited at discharge from three hospital facilities in Bologna province, from October 1st 2012 to September 30th 2014. Their FPs were invited to complete a questionnaire (SpeNK-FP) at each encounter for the patient during a 9-month period after hospital discharge. SpeNK-FP was developed by adapting the Care Coordination Measurement Tool (CCMT©) developed by Antonelli et al., to the Italian organizational context. The outcome of interest, derived from the questionnaire, is inappropriate use of services. Forty FPs completed assessments for 49 children at each of 382 clinical encounters. The majority of children (71.4%) had special health care needs, without complicating social issues. FPs reported "no need for care coordination" in 50.8% of the encounters and 41.1% of records about patient needs requiring care coordination. The most common activity implemented to meet children's needs was telephone contact with a medical provider. According to FPs, 80% of encounters prevented inappropriate services use. In multivariate regression, pediatric-specialist contact (telephone or in person) was associated with reduced odds of physician report of preventable hospitalization (OR = 0.06, 95% CI 0.01-0.42, p = 0.005). The study shows the potential for FPs in Italy to serve as care coordinators and facilitate the implementation of integrated care pathways for children with special health care needs.

  8. 42 CFR 412.96 - Special treatment: Referral centers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Facilities Under the Prospective Payment System for Inpatient Operating Costs § 412.96 Special treatment... meets the applicable criteria of paragraph (b) or (c) of this section. (b) Criteria for cost reporting... cost reporting period unless the hospital submits written documentation with its application that its...

  9. 42 CFR 412.96 - Special treatment: Referral centers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Facilities Under the Prospective Payment System for Inpatient Operating Costs § 412.96 Special treatment... meets the applicable criteria of paragraph (b) or (c) of this section. (b) Criteria for cost reporting... cost reporting period unless the hospital submits written documentation with its application that its...

  10. 42 CFR 412.96 - Special treatment: Referral centers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Facilities Under the Prospective Payment System for Inpatient Operating Costs § 412.96 Special treatment... meets the applicable criteria of paragraph (b) or (c) of this section. (b) Criteria for cost reporting... cost reporting period unless the hospital submits written documentation with its application that its...

  11. 42 CFR 412.96 - Special treatment: Referral centers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Facilities Under the Prospective Payment System for Inpatient Operating Costs § 412.96 Special treatment... meets the applicable criteria of paragraph (b) or (c) of this section. (b) Criteria for cost reporting... cost reporting period unless the hospital submits written documentation with its application that its...

  12. 38 CFR 3.804 - Special allowance under 38 U.S.C. 1312.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Special Benefits § 3... Veterans Affairs hospitalization, treatment, examination, or training; (2) Where the veteran's death was due to service rendered with the Commonwealth Army of the Philippines while such forces were in the...

  13. 34 CFR 74.14 - Special award conditions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Special award conditions. 74.14 Section 74.14 Education Office of the Secretary, Department of Education ADMINISTRATION OF GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Pre-Award Requirements § 74.14...

  14. Transition from neonatal intensive care unit to special care nurseries: experiences of parents and nurses.

    PubMed

    Helder, Onno K; Verweij, Jos C M; van Staa, AnneLoes

    2012-05-01

    To explore parents' and nurses' experiences with the transition of infants from the neonatal intensive care unit to a special care nursery. Qualitative explorative study in two phases. Level IIID neonatal intensive care unit in a university hospital and special care nurseries (level II) in five community hospitals in the Netherlands. Twenty-one pairs of parents and 18 critical care nurses. Semistructured interviews were used. Thematic analysis and comparison of themes across participants were performed. Trust was a central theme for parents. Three subthemes, related to the chronological stages of transition, were identified: gaining trust; betrayal of trust; and rebuilding confidence. Trust was associated with five other themes: professional attitude; information management; coordination of transfer; different environments; and parent participation. Although nurses at an early stage repeatedly mentioned a possible transition to community hospitals, the actual announcement took many parents by surprise. Parents felt excluded during the actual transfer and most questioned its necessity. In the special care nursery, parents found it difficult to adjust to new routines and to gain trust in new caregivers, but eventually their worries dissolved. In contrast to neonatal intensive care unit nurses, special care nursery nurses quite understood the impact of transition on parents. Both parents and nurses considered present transitional arrangements to be inadequate. Nurses should provide more effective discharge planning and transitional care. A positive labeling of the transition as a first step to home discharge for the newborn seems appropriate. Parents need to be better-informed and should be involved in the planning process.

  15. School-Age Test Proficiency and Special Education after Congenital Heart Disease Surgery in Infancy

    PubMed Central

    Mulkey, Sarah B.; Bai, Shasha; Luo, Chunqiao; Cleavenger, Jordyn E.; Gibson, Neal; Holland, Greg; Mosley, Bridget S.; Kaiser, Jeffrey R.; Bhutta, Adnan T.

    2016-01-01

    Objective To evaluate test proficiency and the receipt of special education services in school-age children who had surgery for congenital heart disease (CHD) <1 year of age. Study design Data from Arkansas-born children who had CHD surgery at Arkansas Children's Hospital at <1 year of age from 1996–2004 were linked to state birth certificates and the Arkansas Department of Education longitudinal database containing achievement test scores in literacy and mathematics for grades 3-4 and special education codes. The primary negative outcome was not achieving grade-level proficiency on achievement tests. Logistic regression accounting for repeated measures associated achieving proficiency with demographics, maternal education, and clinical factors. Results 362 of 458 (79%) children who received surgery for CHD matched to the ADE database; 285 had grade 3 and/or 4 achievement tests scores. Fewer students with CHD achieved proficiency in literacy and mathematics (P < .05) compared with grade-matched state students. Higher 5-minute Apgar score, shorter hospitalization, and higher maternal education predicted proficiency in literacy (P < .05). White race, no cardiopulmonary bypass, and shorter hospitalization predicted proficiency in mathematics (P < .05). Sex, gestational age, age at surgery, CHD diagnosis, and type and number of surgeries did not predict test proficiency. Compared with all public school students, more children with CHD received special education services (26.9% vs 11.6%, P < .001). Conclusion Children with CHD had poorer academic achievement and were more likely to receive special education services than all state students. Results from this study support the need for neurodevelopmental evaluations as standard in children with CHD. PMID:27453376

  16. Integrated Specialized Early-Course Psychosis Treatment Services - University Psychiatric Hospital Vrapce Model.

    PubMed

    Ostojić, DraŽenka; Čulo, Ilaria; Silić, Ante; Kos, Suzana; Savić, Aleksandar

    2018-06-01

    First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models.

  17. 20 CFR 609.2 - Definitions of terms.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... National Oceanic and Atmospheric Administration; (3) By Foreign Service personnel for whom special... attached to a hospital, clinic, or medical or dental laboratory operated by an agency as defined in section... a hospital, clinic, or medical or dental laboratory operated by such an agency, who is designated by...

  18. 20 CFR 609.2 - Definitions of terms.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... National Oceanic and Atmospheric Administration; (3) By Foreign Service personnel for whom special... attached to a hospital, clinic, or medical or dental laboratory operated by an agency as defined in section... a hospital, clinic, or medical or dental laboratory operated by such an agency, who is designated by...

  19. 20 CFR 609.2 - Definitions of terms.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... National Oceanic and Atmospheric Administration; (3) By Foreign Service personnel for whom special... attached to a hospital, clinic, or medical or dental laboratory operated by an agency as defined in section... a hospital, clinic, or medical or dental laboratory operated by such an agency, who is designated by...

  20. 20 CFR 609.2 - Definitions of terms.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... National Oceanic and Atmospheric Administration; (3) By Foreign Service personnel for whom special... attached to a hospital, clinic, or medical or dental laboratory operated by an agency as defined in section... a hospital, clinic, or medical or dental laboratory operated by such an agency, who is designated by...

  1. 42 CFR 412.529 - Special payment provision for short-stay outliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... system DRG weighting factors. (B) Is adjusted for different area wage levels based on the geographic...-related share, using the applicable hospital inpatient prospective payment system wage index value for... share of low-income patients. (iii) Hospital inpatient prospective payment system capital Federal rate...

  2. Aligning physician and hospital incentives: the approach at hospital for special surgery.

    PubMed

    Ranawat, Anil S; Koenig, Jonathan H; Thomas, Adrian J; Krna, Catherine D; Shapiro, Louis A

    2009-10-01

    Healthcare administrators and physicians alike are navigating an increasingly complex and highly regulated healthcare environment. Unlike in the past, institutions now require strong collaboration among physician and administrative leaders. As providers and managers are trained and work differently, new methods are needed to provide the infrastructure and resources necessary to create, nurture, and sustain alignment between them. We describe four initiatives by administrators and physicians at Hospital for Special Surgery to work together in mutually beneficial relationships that help us achieve the highest level of patient care, satisfaction and safety. These initiatives include improving management efficiency through an orthopaedic service line structure, helping individual physicians grow their practices through the demand-office-operating room initiative of the Physicians Service Department, controlling costs through the supply effectiveness policy, and promoting teamwork in innovation through the technology transfer program.

  3. [Correct and timely referral of patients to centers of reference].

    PubMed

    Costa, Joana; Valença-Filipe, Rita; Rodrigues, Jorge

    2013-01-01

    The correct and timely referral of patients, from peripheral hospitals, without specialized surgical care, namely in hand surgery, like Plastic Surgery or Orthopedics is of crucial importance. The authors report the case of a patient that presents in the Plastic Surgery Department with a chronic infection of the hypothenar eminence of the right hand. The clinical history suggests the persistence of a foreign body, despite two previous surgical procedures for removal, performed in the residence hospital. Surgical exploration was performed and the foreign body was removed without complications. The intent of this presentation is to alert for the importance of the timely referral of patients that can benefit of specialized care, namely of plastic surgery, when this is no possible in the residence hospital, in view of better health care and better patient treatment.

  4. Distinctiveness of management in a university psychiatric hospital as a public health institution.

    PubMed

    Koncina, Miroslav

    2008-06-01

    The distinctiveness of management of a university psychiatric hospital which has the status of a public health institution is manifested in the following ways: * Distinctive features and characteristics of managing service provider organizations compared to those whose operational results involve tangible products; * Distinctive features of management which originate from its role as a regional hospital and a tertiary research and educational institution in the field of psychiatry, with special importance for the Republic of Slovenia as a whole; * Distinctive features of management that are defined by the social and legal framework of operation of public health institutions and their special social mission. This paper therefore discusses the specific theoretical and practical findings regarding management of service provider organizations from the viewpoint of their social mission and significance, as well as their legal organization, internal structure and values.

  5. [The perspective of a medical technologist].

    PubMed

    Ohsawa, S

    1998-10-01

    Medical technologists must send reliable laboratory data to clinicians before consulting about the data. It is indispensable for medical technologists to acquire and maintain special technological knowledge. What technologists can do to support clinical work is derived basically from the information involved in analyzing samples. Such information could be sent along with the data to the clinical doctor and thus support clinical work. In large hospitals, such as university hospitals, in addition to the usual support for clinicians, we should attempt to develop new methods for analyzing pathological conditions in various diseases. Moreover, we could even support clinical research with our special technological knowledge and skilled application. However, in small hospitals, medical technologists may have to do work that doctors in the laboratory usually do. Curricula and textbooks must be prepared to educate technologists to assume those roles when necessary.

  6. Perceived Effects of Paid Family Leave among Parents of Children with Special Health Care Needs: California's Experience. Research Highlights

    ERIC Educational Resources Information Center

    Vaiana, Mary E.

    2010-01-01

    About 15 percent of children in the United States are chronically ill. These children with special health care needs (CSHCN) account for half of all child hospital days nationwide, require many more medical visits than other children, and miss many more days of school. Their parents face special challenges as they struggle to balance work and the…

  7. Business Performance of Health Spa Tourism Providers in Relation to the Structure of Employees in the Republic of Croatia.

    PubMed

    Vrkljan, Sanela; Grazio, Simeon

    2017-12-01

    Health spa tourism services are provided in special hospitals for medical rehabilitation and health resorts, and include controlled use of natural healing factors and physical therapy under medical supervision in order to improve and preserve health. Health tourism is a service industry and therefore labor-intensive industry in which human resources are one of the key factors of business success. The aim of this study was to analyze business performance of special hospitals for medical rehabilitation and health resorts in Croatia in relation to the structure of employees, specifically the number of physicians and total medical personnel, as well as the share of physicians and medical personnel in the total number of employees. The assumption was that those who employ more physicians and medical employees are more successful. The empirical research was conducted and the assumption was tested firstly by correlation analysis and afterwards by regression analysis. The total number of employees in the researched health resorts and special hospitals amounted to 2,863, of which the share of physicians specialists accounted for almost 7%, while the share of total medical staff was almost 53%. From the results of our research, it can be concluded that special hospitals for medical rehabilitation and health resorts, which employ more physicians and medical personnel, are achieving better financial business performance. Based on the results obtained, it is possible to provide guidance for further growth and development in the direction of basing the primary offer on medical-health offer, rather than on wellness offer, which is a strong trend in the world. These findings are important for planning the health and tourism policies in Croatia and similar countries.

  8. BUSINESS PERFORMANCE OF HEALTH TOURISM SERVICE PROVIDERS IN THE REPUBLIC OF CROATIA.

    PubMed

    Vrkljan, Sanela; Hendija, Zvjezdana

    2016-03-01

    Health tourism can be generally divided into medical, health spa and wellness tourism. Health spa tourism services are provided in special hospitals for medical rehabilitation and health resorts, and include under medical supervision controlled use of natural healing factors and physical therapy in order to improve and preserve health. There are 13 special hospitals for medical rehabilitation and health resorts in Croatia. Most of them are financed through the state budget and lesser by sale on the market. More than half of their accommodation capacity is offered for sale on the market while the rest is under contract with the Croatian Health Insurance Fund. Domestic overnights are several times higher than foreign overnights. The aim of this study was to analyze business performance of special hospitals for medical rehabilitation and health resorts in Croatia in relation to the sources of financing and the structure of service users. The assumption was that those who are more market-oriented achieve better business performance. In proving these assumptions, an empirical research was conducted and the assumptions were tested. A positive correlation was proven in tested indicators of business performance of the analyzed service providers of health-spa tourism with a higher amount of overnight stays realized through sales on the market in relation to total overnight stays, with a greater share of foreign overnights in total of overnights and with a higher share of realized revenue on the market out of total revenue. The results of the research show that special hospitals for medical rehabilitation and health resorts that are more market-oriented are more successful in their business performance. These findings are important for planning the health and tourism policies in countries like Croatia.

  9. Infant Transport Monitoring

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The photo sequence illustrates the movement of an ill infant to a special care hospital by means of a new Pediatric Monitoring and Transport System, in which NASA technology and technical assistance are being applied to an urgent medical problem. Development of the system is a collaborative effort involving several organizations, principally, NASA Ames Research Center and Children's Hospital Medical Center, Oakland, California. Key to the system's efficacy is a custom-designed ambulance-to-hospital and hospital-to-hospital communications network, including two-way voice capability and space-derived biotelemetry; it allows a specialist at the destination hospital to monitor continuously the vital signs of the patient during transit.

  10. Reductions in Medication-Related Hospitalizations in Older Adults with Medication Management by Hospital and Community Pharmacists: A Quasi-Experimental Study.

    PubMed

    Pellegrin, Karen L; Krenk, Les; Oakes, Sheena Jolson; Ciarleglio, Anita; Lynn, Joanne; McInnis, Terry; Bairos, Alistair W; Gomez, Lara; McCrary, Mercedes Benitez; Hanlon, Alexandra L; Miyamura, Jill

    2017-01-01

    To evaluate the association between a system of medication management services provided by specially trained hospital and community pharmacists (Pharm2Pharm) and rates and costs of medication-related hospitalization in older adults. Quasi-experimental interrupted time series design comparing intervention and nonintervention hospitals using a mixed-effects analysis that modeled the intervention as a time-dependent variable. Sequential implementation of Pharm2Pharm at six general nonfederal acute care hospitals in Hawaii with more than 50 beds in 2013 and 2014. All five other such hospitals served as a contemporaneous comparison group. Adult inpatients who met criteria for being at risk for medication problems (N = 2,083), 62% of whom were aged 65 or older. A state-wide system of medication management services provided by specially trained hospital and community pharmacists serving high-risk individuals from hospitalization through transition to home and for up to 1 year after discharge. Medication-related hospitalization rate per 1,000 admissions of individuals aged 65 and older, adjusted for case mix; estimate of costs of hospitalizations and actual costs of pharmacist services. The predicted, case mix-adjusted medication-related hospitalization rate of individuals aged 65 and older was 36.5% lower in the Pharm2Pharm hospitals after implementation than in the nonintervention hospitals (P = .01). The estimated annualized cost of avoided admissions was $6.6 million. The annual cost of the pharmacist services for all Pharm2Pharm participants was $1.8 million. The Pharm2Pharm model was associated with an estimated 36% reduction in the medication-related hospitalization rate for older adults and a 2.6:1 return on investment, highlighting the value of pharmacists as drug therapy experts in geriatric care. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

  11. Multi-Criteria Knapsack Problem for Disease Selection in an Observation Ward

    NASA Astrophysics Data System (ADS)

    Lurkittikul, N.; Kittithreerapronchai, O.

    2014-06-01

    The aging population and the introduction of Thailand universal healthcare have increased inpatients and outpatients to public hospitals, particularly to a hospital that provides special and comprehensive health services. Many inpatient wards have experienced large influx of inpatients as the hospitals have to admit all patients regardless their conditions. These overcrowding wards cause stress to medical staffs, block access between medical departments, hospital-acquired infections, and ineffective uses of resources. One way to manage such inundated inpatient is to select some patients whose conditions require less clinical attention or whose lengths of stay are predictable and short and, then, place them at an observation ward. This intermediate ward increases turnover of beds and reduces unnecessary paperwork as patients are considered to be outpatients. In this article, we studied inpatient data of a tertiary care hospital in which an observation ward was considered to alleviate the overcrowding problem at Internal Medicine Department. The analysis of data showed that the hospital can balance inpatient flow by managing a group of patients who is admitted because of treatments ordered by its special clinics. Having explored several alternatives, we suggested patient selection criteria and proposed a layout at an observation ward. The hospital should increase medical beds in a new building ward because the current observation ward can handle 27.3% of total short stay patients, while the observation ward is projected to handle 80% of total short stay patients.

  12. A Study to Ascertain the Feasibility of Joint Efforts to Establish a Comprehensive Health Care Delivery System Utilizing Hill-Burton Constructed Hospital,

    DTIC Science & Technology

    1978-12-15

    Utilization Review Procedures ................ 22 Reduced Philanthropy ......................... 22 Lack of Incentives ........................... 23 Reductions...challenges are made on hospitals in the form of status of technology, elite physician compliments, and increased specialization of labor which ccnstantly...construction are now marginally subsidized by philanthropy . Third party reimbursement is now the dominant source of hospital revenue with cost based formula

  13. Variability in adherence to clinical practice guidelines and recommendations in COPD outpatients: a multi-level, cross-sectional analysis of the EPOCONSUL study.

    PubMed

    Calle Rubio, Myriam; López-Campos, José Luis; Soler-Cataluña, Juan J; Alcázar Navarrete, Bernardino; Soriano, Joan B; Rodríguez González-Moro, José Miguel; Fuentes Ferrer, Manuel E; Rodríguez Hermosa, Juan Luis

    2017-12-02

    Clinical audits have reported considerable variability in COPD medical care and frequent inconsistencies with recommendations. The objectives of this study were to identify factors associated with a better adherence to clinical practice guidelines and to explore determinants of this variability at the the hospital level. EPOCONSUL is a Spanish nationwide clinical audit that evaluates the outpatient management of COPD. Multilevel logistic regression with two levels was performed to assess the relationships between individual and disease-related factors, as well as hospital characteristics. A total of 4508 clinical records of COPD patients from 59 Spanish hospitals were evaluated. High variability was observed among hospitals in terms of medical care. Some of the patient's characteristics (airflow obstruction, degree of dyspnea, exacerbation risk, presence of comorbidities), the hospital factors (size and respiratory nurses available) and treatment at a specialized COPD outpatient clinic were identified as factors associated with a better adherence to recommendations, although this only explains a small proportion of the total variance. To be treated at a specialized COPD outpatient clinic and some intrinsic patient characteristics were factors associated with a better adherence to guideline recommendations, although these variables were only explaining part of the high variability observed among hospitals in terms of COPD medical care.

  14. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

    PubMed

    Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

    2015-06-01

    The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

  15. An Inclusion Initiative in Singapore for Preschool Children with Special Needs

    ERIC Educational Resources Information Center

    Yeo, Lay See; Neihart, Maureen; Tang, Hui Nee; Chong, Wan Har; Huan, Vivien S.

    2011-01-01

    This paper describes a preschool inclusion initiative in Singapore, which currently has no mandate for integrating children with special needs in mainstream schools. This very small-scale qualitative study involving children with mild learning disabilities discusses a therapy outreach programme by a local children's hospital. It explores the…

  16. Special report. Hospitals that are becoming 'hotel friendly' to guests ... and the role played by security officers.

    PubMed

    1996-01-01

    Faced with increasing competition, hospitals in New York City are developing programs to become more user friendly and, like hotels, to treat patients more as "guests" than as "customers." These programs, which have particular applications for security personnel, are also seeking to improve communications and relationships among the hospital's medical staff and other employees. In this report, we'll describe some of these efforts in which hospitals are turning to hoteliers, consultants, and others for advice in the area of customer service, and the role seen for hospital security.

  17. Trends in epidemiology and hospitalization utilization for myelomeningocele repair from 2000 to 2009.

    PubMed

    Harris, Dominic A; Cherian, Jacob; LoPresti, Melissa; Jea, Andrew; Lam, Sandi

    2016-07-01

    Although the incidence of myelomeningocele (MMC) has declined over the past decades with folic acid supplementation and prenatal screening, neural tube defects remain the most common birth defect in the USA. A majority of affected neonates require surgical repair. To characterize US trends in the epidemiology and hospital utilization of MMC repair over the past decade, we analyzed a nationally representative database. We queried the Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for all discharges with procedure code for MMC repair for the years 2000, 2003, 2006, and 2009. The cohorts from these time points were compared for their demographic and in-hospital variables. Results are reported as estimated frequencies and means with 95 % confidence intervals (CI). Sex, race, insurance status, family income level, and mortality of affected infants have not changed significantly over the decade. A majority of neonatal MMC repairs occur in larger hospital bed size and more specialized children's hospital centers. Of patients, 52.3 to 60 % receive VPS placement during the same admission as the primary MMC repair. Total hospital costs for the MMC hospitalizations have remained relatively stable from 42,843 dollars in 2003 to 46,749 dollars in 2009 (adjusted to 2009 dollars). Demographics of children having MMC repair have not changed significantly over the past decade, while these surgeries have become more concentrated in pediatric-specialized centers. There appears to be a plateau in public health and access advances with relatively stable cost of MMC hospital care.

  18. 42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...

  19. 42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...

  20. 42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...

  1. 42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...

  2. EDUCATION OF HOMEBOUND OR HOSPITALIZED CHILDREN. TC SERIES IN SPECIAL EDUCATION.

    ERIC Educational Resources Information Center

    CONNOR, FRANCES P.

    THIS MONOGRAPH PRESENTS A VIEW OF EDUCATION FOR HOMEBOUND AND HOSPITALIZED CHILDREN AND SHOWS ITS SIMILARITIES AND DIFFERENCES IN RESPECT TO GENERAL EDUCATION. CHAPTER TWO FOCUSES ON THE TEACHER AS A PERSON, DISCUSSING PHILOSOPHICAL, PSYCHOLOGICAL, AND SOCIOLOGICAL FACTORS. PROFESSIONAL PREPARATION AND GENERAL EDUCATION PREPARATION ARE ALSO…

  3. A Response to the Invited Commentaries on Wallace and Beange (2008)

    ERIC Educational Resources Information Center

    Wallace, Robyn A.; Beange, Helen

    2008-01-01

    This article presents the authors' response to the invited commentaries on their paper (Wallace and Beange, 2008). On the point of "specialism", the authors emphasise a fundamental premise of their argument: the proposed "specialist" hospital-based service is inherently enmeshed within generic services at the hospital level,…

  4. Alcohol-attributable morbidity and resulting health care costs in Canada in 2002: recommendations for policy and prevention.

    PubMed

    Taylor, Benjamin; Rehm, Jürgen; Patra, Jayadeep; Popova, Svetlana; Baliunas, Dolly

    2007-01-01

    Alcohol is one of the most important risk factors for burden of disease, particularly in high-income countries such as Canada. The purpose of this article was to estimate the number of hospitalizations, hospital days, and the resulting costs attributable to alcohol for Canada in 2002. Exposure distribution was taken from the Canadian Addiction Survey and corrected for per capita consumption from production and sales. For chronic disease, risk relations were taken from the published literature and combined with exposure to calculate age- and gender-specific alcohol-attributable fractions. For injury, alcohol-attributable fractions were taken directly from available statistics. Data on the most responsible diagnosis, length of stay for hospitalizations, and costs were obtained from the national Canadian databases. For Canada in 2002, there were 195,970 alcohol-related diagnoses among acute care hospitalizations, 2,058 alcohol-attributable psychiatric hospitalizations, and 183,589 alcohol-attributable admissions to specialized treatment centers. These accounted for 1,246,945 hospital days in acute care facilities, 54,114 hospital days in psychiatric hospitals, and 3,018,688 hospital days in specialized treatment centers (inpatient and outpatient). The main causes of alcohol-attributable morbidity were neuropsychiatric conditions, cardiovascular disease, and unintentional injuries. In total, Can. $2.29 billion were spent on alcohol-related health care. Alcohol poses a heavy burden of disease as well as a financial strain on Canadian society. However, there are evidence-based effective and cost-effective policy and legislative interventions as well as measures to better enforce these laws.

  5. [The role of patient flow and surge capacity for in-hospital response in mass casualty events].

    PubMed

    Sefrin, Peter; Kuhnigk, Herbert

    2008-03-01

    Mass casualty events make demands on emergency services and disaster control. However, optimized in- hospital response defines the quality of definitive care. Therefore, German federal law governs the role of hospitals in mass casualty incidents. In hospital casualty surge is depending on resources that have to be expanded with a practicable alarm plan. Thus, in-hospital mass casualty management planning is recommended to be organized by specialized persons. To minimise inhospital patient overflow casualty surge principles have to be implemented in both, pre-hospital and in-hospital disaster planning. World soccer championship 2006 facilitated the initiation of surge and damage control principles in in-hospital disaster planning strategies for German hospitals. The presented concept of strict control of in-hospital patient flow using surge principles minimises the risk of in-hospital breakdown and increases definitive hospital treatment capacity in mass casualty incidents.

  6. Consensus Report of the XI Congress of the Spanish Society of Odontology for the Handicapped and Special Patients

    PubMed Central

    Cabrerizo-Merino, Carmen; Cutando-Soriano, Antonio; Giménez-Prats, María J.; Silvestre-Donat, Farncisco J.; Tomás-Carmona, Inmaculada

    2014-01-01

    This article summarizes the findings of consensus of the XI congress of the SEOEME. All of these conclusions are referring to the review articles responsible to the general rapporteurs in order to bringing up to date knowledge with regard to the use of implants in patients medically compromised and with special needs and, in the dental management of autism and cerebral palsy, in the dental treatment of patients with genetic and adquired haematological disorders, the dental implications of cardiovascular disease and hospital dentistry. Key words:Autism, cardiovascular diseases, cerebral palsy, dental implants, disabled patients, haematological disorders, hospital dentistry. PMID:24608224

  7. [Effects of social origins and professional socialization on the vocational preferences of medical interns in Mexico].

    PubMed

    Frenk, J

    1985-01-01

    Using data from a survey of 923 medical interns in Mexico, this article analyzes preferences for type of medical activity (general or specialized practice), type of site (ambulatory or hospital), and type of medical care institution (public assistance, social security, or private). Four independent variables are examined: social origin, medical school, place of internship, and assimilation to the internship hospital. The great majority of the interns expressed a preference for specialty practice, hospitals, and social security institutions. The role of social origin was to selectively direct students into different medical schools. From then on, the structural attributes of the school itself and of the place of internship, as well as the socialization experiences that took place there, emerged as the most important determinants of career preferences. Such a process, however, tended to produce a "social specialization" of interns in terms of the role they expect to play in the medical field. It is argued that this kind of specialization has negative implications for the professional status of physicians, although it also poses a challenge to the development of innovative theories about the process of professionalization in medicine.

  8. [The impact of technology in Pathological Anatomy and the contribution of this speciality to technological development].

    PubMed

    Puras-Gil, A M; López-Cousillas, A

    1999-01-01

    It is obvious that technology has contributed throughout history to the development of the different sciences. In this article, we define the concept of Pathology as a medical speciality, and we explain its influence in a hospital, considering very different fields such as education, research, quality control, hospital information, and patient care. This speciality has undergone a considerable evolution, to which technological innovation has undoubtedly contributed. As a basic discipline, it is of great importance in pre and post-graduate training, in the medical education at the hospital or outside it, and in the fields previously mentioned. Its relation with other disciplines such us Chemistry, (fixation and dyeing), Physics (mechanical devices), Mathematics (algorithms, morphometry, statistics...) and Telecommunications (telepathology, image analysis...) is examined and their contribution to Pathology is evaluated. We are also aware of contributions made by Pathology to technological innovation in the evaluation of different diagnostic methods or in the recent therapeutic technologies based on Radiotherapy, Hyperthermia, laser, prothesis, etc.; where histological examination provides accurate information about the therapeutic capacity or side-effects, or the rejection reactions caused, aiding the research to obtain adequate results.

  9. A preliminary analysis of the US dental health care system's capacity to treat children with special health care needs.

    PubMed

    Kerins, Carolyn; Casamassimo, Paul S; Ciesla, David; Lee, Yosuk; Seale, N Sue

    2011-01-01

    The purpose of this study was to use existing data to determine capacity of the US dental care system to treat children with special health care needs (CSHCN). A deductive analysis using recent existing data was used to determine the: possible available appointments for CSHCN in hospitals and educational programs/institutions; and the ratio of CSHCN to potential available and able providers in the United States sorted by 6 American Academy of Pediatric Dentistry (AAPD) districts. Using existing data sets, this analysis found 57 dental schools, 61 advanced education in general dentistry programs, 174 general practice residencies, and 87 children's hospital dental clinics in the United States. Nationally, the number of CSHCN was determined to be 10,221,436. The distribution, on average, of CSHCN per care source/provider ranged from 1,327 to 2,357 in the 6 AAPD districts. Children's hospital dental clinics had fewer than 1 clinic appointment or 1 operating room appointment available per CSHCN. The mean number of CSHCN patients per provider, if distributed equally, was 1,792. The current US dental care system has extremely limited capacity to care for children with special health care needs.

  10. Accuracy of Pediatric Trauma Field Triage: A Systematic Review.

    PubMed

    van der Sluijs, Rogier; van Rein, Eveline A J; Wijnand, Joep G J; Leenen, Luke P H; van Heijl, Mark

    2018-05-16

    Field triage of pediatric patients with trauma is critical for transporting the right patient to the right hospital. Mortality and lifelong disabilities are potentially attributable to erroneously transporting a patient in need of specialized care to a lower-level trauma center. To quantify the accuracy of field triage and associated diagnostic protocols used to identify children in need of specialized trauma care. MEDLINE, Embase, PsycINFO, and Cochrane Register of Controlled Trials were searched from database inception to November 6, 2017, for studies describing the accuracy of diagnostic tests to identify children in need of specialized trauma care in a prehospital setting. Identified articles with a study population including patients not transported by emergency medical services were excluded. Quality assessment was performed using a modified version of the Quality Assessment of Diagnostic Accuracy Studies-2. After deduplication, 1430 relevant articles were assessed, a full-text review of 38 articles was conducted, and 5 of those articles were included. All studies were observational, published between 1996 and 2017, and conducted in the United States, and data collection was prospective in 1 study. Three different protocols were studied that analyzed a combined total of 1222 children in need of specialized trauma care. One protocol was specifically developed for a pediatric out-of-hospital cohort. The percentage of pediatric patients requiring specialized trauma care in each study varied between 2.6% (110 of 4197) and 54.7% (58 of 106). The sensitivity of the prehospital triage tools ranged from 49.1% to 87.3%, and the specificity ranged from 41.7% to 84.8%. No prehospital triage protocol alone complied with the international standard of 95% or greater sensitivity. Undertriage and overtriage rates, representative of the quality of the full diagnostic strategy to transport a patient to the right hospital, were not reported for inclusive trauma systems or emergency medical services regions. It is crucial to transport the right patient to the right hospital. Yet the quality of the full diagnostic strategy to determine the optimal receiving hospital is unknown. None of the investigated field triage protocols complied with current sensitivity targets. Improved efforts are needed to develop accurate child-specific tools to prevent undertriage and its potential life-threatening consequences.

  11. The hospital financing system of the Federal Republic of Germany.

    PubMed

    Leidl, R

    1983-10-01

    This paper deals with the present hospital financing system of the Federal Republic of Germany. The structure of the financing system is treated as well as the actual financing process, and, as far as possible, both are also quantitatively described. The first section contains a description of the structure, and is concerned with the major institutions participating in the hospital financing system:--the hospitals are described according to ownership, number of beds, specialization, personnel, regional distribution and utilization;--the health insurance system is illustrated by the two major institutions, i.e. statutory and private health insurance agencies, and its effect on hospital financing is explained;--the regulation of the hospital financing system by the federal political system is discussed;--finally, the major economic functions of the institutions involved are summarized; the interrelations of hospital care and the ambulatory sector are also mentioned. The second section contains a detailed description of the actual financing process, which can be classified according to the sections of financing:--the basic system of the German hospital financing law is introduced;--in the section on investment costs, public grants and their allocation, which are closely related to hospital planning, are discussed;--in the section on operating costs, full cost reimbursement as the basic principle, the structure of costs, the elements and the mechanism of operating cost financing, the actual prices, the financing of private patients' care and special services are described;--a short view of accounting balances, i.e. the differences between costs and financing of hospital services which result in profits or deficits, is given. A few considerations on the evaluation of the financing system conclude the paper.

  12. Emergency Communications Console

    NASA Technical Reports Server (NTRS)

    1978-01-01

    NASA has applied its communications equipment expertise to development of a communications console that provides, in a compact package only slightly larger than an electric typewriter, all the emergency medical services communications functions needed for a regional hospital. A prototype unit, built by Johnson Space Center, has been installed in the Odessa (Texas) Medical Center Hospital. The hospital is the medical control center for the 17-county Permian Basin Emergency Medical System in west Texas. The console project originated in response to a request to NASA from the Texas governor's office, which sought a better way of providing emergency medical care in rural areas. Because ambulance travel time is frequently long in remote areas of west Texas, it is important that treatment begin at the scene of the emergency rather than at the hospital emergency room. A radio and telephone system linking ambulance emergency technicians and hospital staff makes this possible. But earlier equipment was complex, requiring specialized operators. A highly reliable system was needed to minimize breakdowns and provide controls of utmost simplicity, so that the system could be operated by physicians and nurses rather than by communications specialists. The resulting console has both radio and telephone sections. With the radio equipment, hospital personnel can communicate with ambulance drivers and paramedics, receive incoming electrocardiagrams, consult with other hospitals, page hospital staff and set up a radio-to-telephone "patch." The telephone portion of the system includes a hotline from the Permian Basin Emergency Medical Service's resource control center, an automatic dialer for contacting special care facilities in the Permian Basin network, a hospital intercom terminal and a means of relaying cardioscope displays and other data between hospitals. The integrated system also provides links with local disaster and civil defense organizations and with emergency "Dial 911" control points.

  13. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    PubMed

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  14. Hospital acquired Janthinobacterium lividum septicemia in Srinagarind Hospital.

    PubMed

    Patijanasoontorn, B; Boonma, P; Wilailackana, C; Sitthikesorn, J; Lumbiganon, P; Chetchotisakd, P; Noppawinyoowong, C; Simajareuk, K

    1992-03-01

    Nine patients admitted to the intensive care unit, Srinagarind Hospital, who had septicaemia by J. lividum were reported. Seven patients died, one directly of septicaemia, despite intensive antimicrobial therapy. Investigation revealed that the sources of infection were: special mouth wash solution, distilled water and normal saline used in the ward. After changing to uncontaminated solution and more meticulous care of medical equipment, there was no evidence of the micro-organism after one year follow-up.

  15. Funding the essentials: the Australian Health Care Agreements, 2003-2008.

    PubMed

    Deeble, John

    2002-01-01

    This editorial reviews a number of papers in a special issue of the Australian Health Review covering the Australian Health Care Agreements to be concluded by June 2003. These include a report on consultations by the Australian Healthcare Association with industry representatives from July-October 2002. For hospitals, the agreements will set the main financial parameters for the next five years. Apart from the quantum of Commonwealth grants, the issues seen as most important involved linkages with primary care providers and aged care facilities, the dominance of inpatient work in current arrangements, workforce planning and public/private sector relationships. The possibility of recent private health insurance changes reducing the sums available for public hospitals was noted. Some estimates are presented of the possible effects of private insurance reform, together with some data from a special AHA survey of public hospital activity this year.

  16. Patient passports aim to speed appropriate care for medically complex children presenting to ED.

    PubMed

    2015-05-01

    Mattel Children's Hospital at Ronald Reagan UCLA Medical Center in Los Angeles, CA, has developed a "patient passport" to improve the timely and appropriate care of medically complex children who present to the ED. The one-page form, which parents can keep in their wallets, highlights any special indications or sensitivities that the child has as well as contact information for the patient's primary care provider. The form also includes special instructions for the triage nurse. Creation of the tool was prompted by the parents who complained that their medically complex children were receiving different care in the ED than on the pediatric floor of the hospital. The tool was developed by a group comprised of parents, pediatric providers, and ED representatives. Physicians must create and sign the passports, either in the hospital or in their outpatient clinics, although parents may request a passport for their children.

  17. Vector potential of hospital houseflies with special reference to Klebsiella species.

    PubMed Central

    Fotedar, R.; Banerjee, U.; Samantray, J. C.; Shriniwas

    1992-01-01

    The vector potential of houseflies (Musca domestica) for Klebsiella spp. was investigated. Klebsiella spp. (mostly Klebsiella pneumoniae) were isolated from 36.7% of hospital flies and 28.1% of infected wounds of patients. Antibiograms of Klebsiella spp. showed that 82.0% of isolates from hospital flies and 96.3% from infected wounds were resistant to four or more commonly used antimicrobials. In contrast, from the control group, only 8.7% klebsiella isolates showed similar antimicrobial resistance pattern (P less than 0.001). Similar strains of Klebsiella spp. were encountered among patients and hospital houseflies. The results indicate that flies in the hospital environs are potential vectors of hospital resistant strains of Klebsiella spp. PMID:1499668

  18. Accountability and Accreditation for Special Libraries: It Can Be Done!

    ERIC Educational Resources Information Center

    Glockner, Brigitte

    2004-01-01

    Health librarians are very familiar with the accreditation process in hospitals. In 2000 the first ALIA National Policy Congress recommended that accreditation of special libraries should be implemented. The proposed guidelines have been roughly based on the EQuIP Program of the Australian Council on Healthcare Standards. This program is…

  19. Specialized Inpatient Psychiatry for Serious Behavioral Disturbance in Autism and Intellectual Disability

    ERIC Educational Resources Information Center

    Siegel, Matthew; Milligan, Briana; Chemelski, Bruce; Payne, David; Ellsworth, Beth; Harmon, Jamie; Teer, Olivia; Smith, Kahsi A.

    2014-01-01

    Psychiatric hospitalization of children with autism spectrum disorder and/or intellectual disability is common, however, the effectiveness of this intervention is largely unknown. Thirty-eight clinically-referred children 8-19 years old admitted to a specialized inpatient psychiatry unit were assessed by a consistent caregiver on the Aberrant…

  20. HOSA Competitive Event Guidelines. Health Occupations Students of America. Students with Special Needs.

    ERIC Educational Resources Information Center

    Candelori, Elaine M.; And Others

    Designed for use by instructors and advisors of handicapped students, this guide presents guidelines for judging the performance of special needs students in Health Occupations Students of America (HOSA) competetive events in eight allied health occupations education areas. These areas are dietetics, first aid, hospitality, housekeeping, job…

  1. There's No Place Like Home: Training, Practices, and Perceptions of Homebound Services

    ERIC Educational Resources Information Center

    Petit, Constance C.; Patterson, Philip P.

    2014-01-01

    Homebound services involve the delivery of special education in settings other than school sites. Such settings typically include students' homes or hospitals. Most often associated with early childhood special education and with students who are medically or physically fragile, homebound services can also be for those in need of interim…

  2. [Hand surgery in the German DRG System 2007].

    PubMed

    Franz, D; Windolf, J; Kaufmann, M; Siebert, C H; Roeder, N

    2007-05-01

    Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. The DRG structure concerning hand surgery increased in version 2007 of the G-DRG system. The main parameter of DRG splitting is the complexity of the operation. Furthermore additional criteria such as more than one significant OR procedure, the patients' age, or special diagnoses influence case allocation. A special OPS code for complex cases treated with hand surgery was implemented. The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.

  3. Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals.

    PubMed

    Steger, Florian

    2006-09-01

    During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945.

  4. School-Age Test Proficiency and Special Education After Congenital Heart Disease Surgery in Infancy.

    PubMed

    Mulkey, Sarah B; Bai, Shasha; Luo, Chunqiao; Cleavenger, Jordyn E; Gibson, Neal; Holland, Greg; Mosley, Bridget S; Kaiser, Jeffrey R; Bhutta, Adnan T

    2016-11-01

    To evaluate test proficiency and the receipt of special education services in school-age children who had undergone surgery for congenital heart disease (CHD) at age <1 year. Data from Arkansas-born children who underwent surgery for CHD at Arkansas Children's Hospital at age <1 year between 1996 and 2004 were linked to state birth certificates and the Arkansas Department of Education longitudinal database containing achievement test scores in literacy and mathematics for grades 3-4 and special education codes. The primary negative outcome was not achieving grade-level proficiency on achievement tests. Logistic regression accounting for repeated measures was used to evaluate for associations between achieving proficiency and demographic data, maternal education, and clinical factors. A total of 362 of 458 (79%) children who underwent surgery for CHD were matched to the Arkansas Department of Education database, 285 of whom had grade 3 and/or 4 achievement tests scores. Fewer students with CHD achieved proficiency in literacy and mathematics (P < .05) compared with grade-matched state students. Higher 5-minute Apgar score, shorter duration of hospitalization, and higher maternal education predicted proficiency in literacy (P < .05). White race, no cardiopulmonary bypass, and shorter hospitalization predicted proficiency in mathematics (P < .05). Sex, gestational age, age at surgery, CHD diagnosis, and type and number of surgeries did not predict test proficiency. Compared with all public school students, more children with CHD received special education services (26.9% vs 11.6%; P < .001). Children with CHD had poorer academic achievement and were more likely to receive special education services than all state students. Results from this study support the need for neurodevelopmental evaluations as standard practice in children with CHD. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Public perception of Plastic Surgery.

    PubMed

    de Blacam, Catherine; Kilmartin, Darren; Mc Dermott, Clodagh; Kelly, Jack

    2015-02-01

    Public perception of Plastic Surgery is strongly influenced by the media and may not reflect the broad scope of work within the speciality. The aim of this study was to provide an assessment of the general public's perception of plastic surgical practice and to report the perceived importance of Plastic Surgery relative to other specialities working within a large tertiary referral centre. 899 members of the public who attended our Emergency Department completed a questionnaire where they matched eight surgical specialities with 30 operative procedures and ranked the importance of 30 different hospital specialities using a Likert scale. The majority of respondents correctly identified plastic surgeons as performing each of the cosmetic procedures listed (abdominoplasty 63.7%; breast augmentation 59.1%; facelift 61.35%; liposuction 59.7%). Plastic Surgery was identified as the primary speciality involved in breast reconstruction (49.3%) and burns surgery (43.0%). There was poor understanding of the role of plastic surgeons in hand surgery, with only 4.7% of respondents attributing tendon repair to plastic surgeons. Plastic Surgery ranked lowest of 30 specialities in terms of importance in providing care for patients within the hospital. Plastic Surgery is often misunderstood within the wider community and misconceptions reflect the influence of the media in highlighting certain aspects of the speciality. It behoves our professional organisations to highlight the importance of Plastic and Reconstructive Surgery within major tertiary referral centres. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. The Volume and Mix of Inpatient Services Provided by Academic Medical Centers.

    ERIC Educational Resources Information Center

    Moy, Ernest; And Others

    1996-01-01

    A study examined trends in the volume and type of inpatient clinical diagnoses, common medical services, and specialized services in academic medical centers (AMCs)--integrated and independent, other teaching hospitals, and nonteaching hospitals. Results indicate that despite rapid change in the health care environment, little change has occurred…

  7. PROGRAMMED INSTRUCTION AND THE HOSPITAL, A REPORT ON THE USE OF PROGRAMMED INSTRUCTION IN HEALTH CARE INSTITUTIONS.

    ERIC Educational Resources Information Center

    Hospital Research and Educational Trust, Chicago, IL.

    THE FIRST SECTION OF THIS REPORT ON PROGRAMED INSTRUCTION IN THE HEALTH CARE FIELD EXAMINES THE HOSPITAL MILIEU AND SUCH PROBLEMS AS PERSONNEL SHORTAGES, INCREASING SPECIALIZATION, AND STRICT TECHNICAL AND EDUCATIONAL REQUIREMENTS. THE SECOND SECTION REVIEWS SOME RECENT ADVANCES IN BEHAVIORAL TECHNOLOGY, FUNDAMENTAL PRINCIPLES OF TEACHING…

  8. 42 CFR 412.104 - Special treatment: Hospitals with high percentage of ESRD discharges.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for classification. CMS provides an additional payment to a hospital for inpatient services provided... established that ESRD beneficiary discharges, excluding discharges classified into MS-DRG 652 (Renal Failure), MS-DRG 682 (Renal Failure with MCC), MS-DRG 683 (Renal Failure with CC), MS-DRG 684 (Renal Failure...

  9. 76 FR 13413 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP); Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... Hospitalized Persons Study, FOA IP11-011; Spectrum of Respiratory Pathogens in Acute Respiratory Tract... Tropical and Developing Countries, FOA IP11-013; and Influenza and Other Respiratory Diseases in Southern...-Associated Community-Acquired Pneumonia in Hospitalized Persons Study, FOA IP11-011; Spectrum of Respiratory...

  10. Capital: who's got it? How to get it!

    PubMed

    Blecher, M B

    1997-06-20

    Cruel. Fickle. Demanding. While hospitals and HMOs face tougher scrutiny by credit-rating agencies, Wall Street has slowed the flow of capital to practice management and assisted-living start-ups. Meanwhile, some investor-owned hospitals now emphasize debt over equity. In this special report, we examine the capital markets sector by sector.

  11. 38 CFR 21.266 - Payment of subsistence allowance under special conditions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and... rehabilitation program under Chapter 31 while hospitalized in a VA medical center or in any other hospital at VA... provided under § 21.264 that may be paid to a veteran pursuing a rehabilitation program for any month for...

  12. The Haiti earthquake: the provision of wound care for mass casualties utilizing negative-pressure wound therapy.

    PubMed

    Gabriel, Allen; Gialich, Shelby; Kirk, Julie; Edwards, Sheriden; Beck, Brooke; Sorocéanu, Alexandra; Nelson, Scott; Gabriel, Cassie; Gupta, Subhas

    2011-10-01

    Many months after the devastating earthquake in January 2010, wounds remain a major disease burden in Haiti. Since January 2010, through the efforts of corporations, nonprofit charitable organizations, and medical professionals, advanced wound care techniques, including negative-pressure wound therapy (NPWT), have been introduced into the wound care regimens of various hospitals in Haiti. In June 2010, the authors completed their second volunteer trip at a Haitian hospital specializing in orthopedic wounds. The medical team was composed of a plastic surgeon, orthopedic surgeon, anesthesiologist, medical assistant, scrub technician, and registered nurse (specializing in plastic surgery and orthopedics). The authors' team supplied NPWT devices, reticulated open-cell foam dressings, and canisters donated by Kinetic Concepts, Inc, San Antonio, Texas, for use at the hospital. This report describes the medical challenges in postearthquake Haiti (including limb salvage and infection), benefits of adjunctive use of NPWT/reticulated open-cell foam, and current wound care status in a Haitian orthopedic hospital. The future role of NPWT in Haiti and during mass catastrophe in a least-developed country is also discussed.

  13. [Increased revenues from secondary diagnoses : A comparison from dermatology, ophthalmology, and infectious diseases].

    PubMed

    Blaschke, V; Brauns, B; Khaladj, N; Schmidt, C; Emmert, S

    2018-02-27

    Hospital revenues generated by diagnosis-related groups (DRGs) are in part dependent on the coding of secondary diagnoses. Therefore, more and more hospitals trust specialized coders with this task, thereby relieving doctors from time-consuming administrative burdens and establishing a highly professionalized coding environment. However, it is vastly unknown if the revenues generated by the coders do indeed exceed their incurred costs. Coding data from the departments of dermatology, ophthalmology, and infectious diseases from Rostock University Hospital from 2007-2016 were analyzed for the effects of secondary diagnoses on the resulting DRG, i. e., hospital charges. Ophthalmological case were highly resistant to the addition of secondary diagnoses. In contrast, adding secondary diagnoses to cases from infectious diseases resulted in 15% higher revenues. Although dermatological and infectious cases share the same sensitivity to secondary diagnoses, higher revenues could only rarely be realized in dermatology, probably owing to a younger, less multimorbid patient population. Except for ophthalmology, trusting specialized coders with clinical coding generates additional revenues through the coding of secondary diagnoses which exceed the costs for employing these coders.

  14. [Treatment of emergencies in the hospital--problems and management].

    PubMed

    Sablotzki, A; Schubert, S; Kuhn, C; Radke, J; Czeslick, E

    2003-01-01

    Due to the growing number of high-risk patients, the increasing proportion of geriatric patients and the expansion of surgical and invasive-diagnostic procedures, medical stuff in hospitals are confronted with a rising number of emergency situations. Nearly 50% are of cardio-circulatory origin and occur during surgical interventions or immediately afterwards. Another cause of life-threatening complications are side-effects of orally or intravenously administered agents, especially after treatment with antibiotics, anaesthetics, analgetics and sedatives. Due to a lack of emergency training and management in most hospitals, the survival rate after cardiopulmonary resuscitation in general wards lies between just two and 35%. Thus it seems necessary to perform special training in CPR procedures and emergency management at regular intervals for the entire medical stuff. In addition, a special infrastructure for giving sufficient treatment in emergencies has to be established (emergency team, emergency telephone number, intra-hospital emergency car). The second part of this review presents current diagnostic and therapeutic strategies for the most common emergency situations, e.g. anaphylaxis, myocardial infarction, pulmonary embolism, gastrointestinal bleeding, and heparin-induced thrombocytopenia (HIT).

  15. Admission to dedicated pediatric cardiac intensive care units is associated with decreased resource use in neonatal cardiac surgery.

    PubMed

    Johnson, Joyce T; Wilkes, Jacob F; Menon, Shaji C; Tani, Lloyd Y; Weng, Hsin-Yi; Marino, Bradley S; Pinto, Nelangi M

    2018-06-01

    Neonates undergoing congenital heart surgery require highly specialized, resource-intensive care. Location of care and degree of specialization can vary between and within institutions. Using a multi-institutional cohort, we sought to determine whether location of admission is associated with an increase in health care costs, resource use and mortality. We retrospectively analyzed admission for neonates (<30 days) undergoing congenital heart surgery between 2004 and 2013 by using the Pediatric Health Information Systems database (44 children's hospitals). Multivariate generalized estimating equations adjusted for center- and patient-specific risk factors and stratified by age at admission were performed to examine the association of admission intensive care unit (ICU) with total hospital costs, mortality, and length of stay. Of 19,984 neonates (60% male) identified, 39% were initially admitted to a cardiac ICU (CICU), 48% to a neonatal ICU (NICU), and 13% to a pediatric ICU. In adjusted models, admission to a CICU versus NICU was associated with a $20,440 reduction in total hospital cost for infants aged 2 to 7 days at admission (P = .007) and a $23,700 reduction in total cost for infants aged 8 to 14 days at admission (P = .01). Initial admission to a CICU or pediatric ICU versus NICU at <15 days of age was associated with shorter hospital and ICU length of stay and fewer days of mechanical ventilation. There was no difference in adjusted mortality by admission location. Admission to an ICU specializing in cardiac care is associated with significantly decreased hospital costs and more efficient resource use for neonates requiring cardiac surgery. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  16. Characteristics of HIV patients who missed their scheduled appointments

    PubMed Central

    Nagata, Delsa; Gutierrez, Eliana Battaggia

    2016-01-01

    ABSTRACT OBJECTIVE To analyze whether sociodemographic characteristics, consultations and care in special services are associated with scheduled infectious diseases appointments missed by people living with HIV. METHODS This cross-sectional and analytical study included 3,075 people living with HIV who had at least one scheduled appointment with an infectologist at a specialized health unit in 2007. A secondary data base from the Hospital Management & Information System was used. The outcome variable was missing a scheduled medical appointment. The independent variables were sex, age, appointments in specialized and available disciplines, hospitalizations at the Central Institute of the Clinical Hospital at the Faculdade de Medicina of the Universidade de São Paulo, antiretroviral treatment and change of infectologist. Crude and multiple association analysis were performed among the variables, with a statistical significance of p ≤ 0.05. RESULTS More than a third (38.9%) of the patients missed at least one of their scheduled infectious diseases appointments; 70.0% of the patients were male. The rate of missed appointments was 13.9%, albeit with no observed association between sex and absences. Age was inversely associated to missed appointment. Not undertaking anti-retroviral treatment, having unscheduled infectious diseases consultations or social services care and being hospitalized at the Central Institute were directly associated to missed appointments. CONCLUSIONS The Hospital Management & Information System proved to be a useful tool for developing indicators related to the quality of health care of people living with HIV. Other informational systems, which are often developed for administrative purposes, can also be useful for local and regional management and for evaluating the quality of care provided for patients living with HIV. PMID:26786472

  17. Physician staffing pattern in intensive care units: Have we cracked the code?

    PubMed Central

    Juneja, Deven; Nasa, Prashant; Singh, Omender

    2012-01-01

    Intensive care is slowly being recognized as a separate medical specialization. Physicians, called intensivists, are being specially trained to manage intensive care units (ICUs) and provide focused, high quality care to critically ill patients. However, these ICUs were traditionally managed by primary physicians who used to admit patients in ICUs under their own care. The presence of specially trained intensivists in these ICUs has started a “turf” war. In spite of the availability of overwhelming evidence that intensivists-based ICUs can provide better patient care leading to improved outcome, there is hesitancy among hospital administrators and other policy makers towards adopting such a model. Major critical care societies and workgroups have recommended intensivists-based ICU models to care for critically ill patients, but even in developed countries, on-site intensivist coverage is lacking in a great majority of hospitals. Lack of funds and unavailability of skilled intensivists are commonly cited as the main reasons for not implementing intensivist-led ICU care in most of the ICUs. To provide optimal, comprehensive and skilled care to this severely ill patient population, it is imperative that a multi-disciplinary team approach must be adopted with intensivists as in-charge. Even though ICU organization and staffing may be determined by hospital policies and other local factors, all efforts must be made to attain the goal of having round-the-clock onsite intensivist coverage to ensure continuity of specialized care for all critically ill patients. PMID:24701396

  18. [Assessment of medical waste management in a Palestinian hospital].

    PubMed

    Al-Khatib, I A; Khatib, R A

    2006-01-01

    We studied medical waste management in a Palestinian hospital in the West Bank and the role of municipality in this management. In general, "good management practices" were inadequate; there was insufficient separation between hazardous and non-hazardous wastes, an absence of necessary rules and regulations for the collection of wastes from the hospital wards and the on-site transport to a temporary storage location inside and outside the hospital and inadequate waste treatment and disposal of hospital wastes along with municipal garbage. Moreover, training of personnel was lacking and protective equipment and measures for staff were not available. No special landfills for hazardous wastes were found within the municipality.

  19. Study on the impact of caregivers in an Italian high specialization hospital: presence, costs and nurse's perception.

    PubMed

    Quattrin, Rosanna; Artico, Carlo; Farneti, Federico; Panariti, Mateo; Palese, Alvisa; Brusaferro, Silvio

    2009-06-01

    The study analysed two key questions: (i) the prevalence of informal caregiving in medical and surgical wards of a high specialization hospital; (ii) the reasonable cost for the structure that would have to pay to replace informal caregiving? The study was conducted in June 2006 as a prevalence survey, using a questionnaire administered to informal caregivers and nurses working in medical and surgical wards of a high specialization hospital by ad hoc trained personnel. Questionnaire consisted in three sections: the first focused on patient's characteristics, the second on caregivers and the third on nurses' perception on caregiving phenomenon. One hundred and twenty-four eligible caregivers were identified. During the study patients admitted to hospital medical and surgery wards were 520. Among these 16.5% (86/520) was assisted by one or more caregivers. Caregivers' response rate was 69.4% (86/124), corresponding to 66 patients. This study yielded an average of 455.9 minutes per day (SD = 370.2; range = 120-1440) or 52.9 hours per week. Caregiver's presence was recognized in 88.9% (56/63) of patients. Despite the societal perspective, the costs and effects of informal caregiving to the informal caregiver are often ignored in economic evaluation. The costs of informal care are an important extent related to time inputs by relatives and friends of the care recipients. Our approach has been to monetize the informal activity care contribution of family members and/or caregivers.

  20. Changes in the organ procurement system in South Korea: effects on brain-dead donor numbers.

    PubMed

    Lee, S D; Kim, J H

    2009-11-01

    In Korea, the Organ Transplantation Act came into effect in 2000, establishing the Korean Network for Organ Sharing (KONOS) with centralized authority for organ procurement as well as for approval of donors and recipients to ensure fair organ allocation. However, the number of brain-dead donors decreased sharply, and the organ allocation system proved inefficient. The government revised the Organ Transplantation Act in August 2002, introducing an incentive system. If a transplantation hospital formed a Committee for Brain Death Evaluation and a Hospital Organ Procurement Organization, it could receive a kidney from a brain dead-donor as an incentive to foster organ procurement regardless of the KONOS wait list. The government also launched a pilot brain-dead donor registry program to strengthen Hospital Organ Procurement Organization activity. If local hospitals collaborated with specialized hospitals in organ procurement, local hospitals obtained financial incentives. But because the organ shortage problem has not been resolved, the government has proposed four initiatives: first, broadening the incentive system, which makes it possible to give each specialized hospital a choice of one of eight organs from each donor as an incentive; second, development of an Independent Organ Procurement Organization; third introduction of an opt-out system; and last, improvement of the Committee for Brain Death Evaluation system. It is uncertain which initiatives will be adopted, but changes in organ procurement systems are nonetheless considered a key to solve the organ shortage problem in Korea.

  1. Docs are buying in. Faltering hospitals are finding new life with physician-owners, but they may face challenges getting their facilities up to speed.

    PubMed

    Romano, Michael

    2005-01-10

    More physicians are stepping forward to buy their own hospitals, often aging or faltering facilities that need some special attention. Kamlesh Gosai, left, led a group that helped keep open Brownsville (Pa.) General Hospital, saving 250 jobs. Often such doc investors are confident they'll suceed in managing their fellow physicians. But others warn they'll face some tough decisions.

  2. Progress with the implementation of kangaroo mother care in four regions in Ghana.

    PubMed

    Bergh, A-M; Manu, R; Davy, K; Van Rooyen, E; Quansah Asare, G; Awoonor-Williams, Jk; Dedzo, M; Twumasi, A; Nang-Beifubah, A

    2013-06-01

    To measure progress with the implementation of kangaroo mother care (KMC) for low birth-weight (LBW) infants at a health systems level. Action research design, with district and regional hospitals as the unit of analysis. Four regions in Ghana, identified by the Ghana Health Service and UNICEF. Health workers and officials, health care facilities and districts in the four regions. A one-year implementation programme with three phases: (1) introduction to KMC, skills development in KMC practice and the management of implementation; (2) advanced skills development for regional steering committee members; and (3) an assessment of progress at the end of the intervention. Description of practices, services and facilities for KMC and the identification of strengths and challenges. Twenty-six of 38 hospitals (68%) demonstrated sufficient progress with KMC implementation. Half of the hospitals had designated a special ward for KMC. 66% of hospitals used a special record for infants receiving KMC. Two of the main challenges were lack of support for mothers who had to remain with their LBW infants in hospital and no follow-up review services for LBW infants in 39% of hospitals. It was possible to roll out KMC in Ghana, but further support for the regions is needed to maintain the momentum. Lessons learned from this project could inform further scale-up of KMC and other projects in Ghana.

  3. Factors Associated With Late Specialized Rehabilitation among Veterans with Lower Extremity Amputation Who Underwent Immediate Postoperative Rehabilitation

    PubMed Central

    Kurichi, Jibby E.; Xie, Dawei; Kwong, Pui L.; Bates, Barbara E.; Vogel, W. Bruce; Stineman, Margaret G.

    2011-01-01

    Objective To determine what patient- and facility-level characteristics drive late specialized rehabilitation among veterans who already received immediate postoperative services. Design Data were obtained from 8 administrative databases for 2,453 patients who underwent lower extremity amputation in Veterans Affairs Medical Centers in 2002-2004. A Cox proportional hazards model was used to determine the hazards ratios and 95% confidence intervals of the factors associated with days to readmission for late services after discharge from the surgical hospitalization. Results There were 2,304 patients who received only immediate postoperative services, while 152 also received late specialized rehabilitation. After adjustment, veterans who were less disabled physically, residing in the South Central compared to the Southeast region, and had their surgeries in CARF accredited facilities were all more likely to receive late services. The hazards ratios for type of immediate postoperative rehabilitation were not constant over time. At hospital discharge, there was no difference in receipt, however, after 3 months, those who received early specialized rehabilitation were significantly less likely to receive late services. Conclusion The factors associated with late specialized rehabilitation were due mainly to facility-level characteristics and care process variables. Knowledge of these factors may help with decision-making policies regarding CARF accredited units. PMID:21389847

  4. Community-based care for the specialized management of heart failure: an evidence-based analysis.

    PubMed

    2009-01-01

    In August 2008, the Medical Advisory Secretariat (MAS) presented a vignette to the Ontario Health Technology Advisory Committee (OHTAC) on a proposed targeted health care delivery model for chronic care. The proposed model was defined as multidisciplinary, ambulatory, community-based care that bridged the gap between primary and tertiary care, and was intended for individuals with a chronic disease who were at risk of a hospital admission or emergency department visit. The goals of this care model were thought to include: the prevention of emergency department visits, a reduction in hospital admissions and re-admissions, facilitation of earlier hospital discharge, a reduction or delay in long-term care admissions, and an improvement in mortality and other disease-specific patient outcomes.OHTAC approved the development of an evidence-based assessment to determine the effectiveness of specialized community based care for the management of heart failure, Type 2 diabetes and chronic wounds.PLEASE VISIT THE MEDICAL ADVISORY SECRETARIAT WEB SITE AT: www.health.gov.on.ca/ohtas to review the following reports associated with the Specialized Multidisciplinary Community-Based care series.Specialized multidisciplinary community-based care series: a summary of evidence-based analysesCommunity-based care for the specialized management of heart failure: an evidence-based analysisCommunity-based care for chronic wound management: an evidence-based analysisPlease note that the evidence-based analysis of specialized community-based care for the management of diabetes titled: "Community-based care for the management of type 2 diabetes: an evidence-based analysis" has been published as part of the Diabetes Strategy Evidence Platform at this URL: http://www.health.gov.on.ca/english/providers/program/mas/tech/ohtas/tech_diabetes_20091020.htmlPLEASE VISIT THE TORONTO HEALTH ECONOMICS AND TECHNOLOGY ASSESSMENT COLLABORATIVE WEB SITE AT: http://theta.utoronto.ca/papers/MAS_CHF_Clinics_Report.pdf to review the following economic project associated with this series:Community-based Care for the specialized management of heart failure: a cost-effectiveness and budget impact analysis. The objective of this evidence-based analysis was to determine the effectiveness of specialized multidisciplinary care in the management of heart failure (HF). TARGET POPULATION AND CONDITION HF is a progressive, chronic condition in which the heart becomes unable to sufficiently pump blood throughout the body. There are several risk factors for developing the condition including hypertension, diabetes, obesity, previous myocardial infarction, and valvular heart disease.(1) Based on data from a 2005 study of the Canadian Community Health Survey (CCHS), the prevalence of congestive heart failure in Canada is approximately 1% of the population over the age of 12.(2) This figure rises sharply after the age of 45, with prevalence reports ranging from 2.2% to 12%.(3) Extrapolating this to the Ontario population, an estimated 98,000 residents in Ontario are believed to have HF. Disease management programs are multidisciplinary approaches to care for chronic disease that coordinate comprehensive care strategies along the disease continuum and across healthcare delivery systems.(4) Evidence for the effectiveness of disease management programs for HF has been provided by seven systematic reviews completed between 2004 and 2007 (Table 1) with consistency of effect demonstrated across four main outcomes measures: all cause mortality and hospitalization, and heart-failure specific mortality and hospitalization. (4-10) However, while disease management programs are multidisciplinary by definition, the published evidence lacks consistency and clarity as to the exact nature of each program and usual care comparators are generally ill defined. Consequently, the effectiveness of multidisciplinary care for the management of persons with HF is still uncertain. Therefore, MAS has completed a systematic review of specialized, multidisciplinary, community-based care disease management programs compared to a well-defined usual care group for persons with HF. What is the effectiveness of specialized, multidisciplinary, community-based care (SMCCC) compared with usual care for persons with HF? LITERATURE SEARCH STRATEGY: A comprehensive literature search was completed of electronic databases including MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, Cochrane Library and Cumulative Index to Nursing & Allied Health Literature. Bibliographic references of selected studies were also searched. After a review of the title and abstracts, relevant studies were obtained and the full reports evaluated. All studies meeting explicit inclusion and exclusion criteria were retained. Where appropriate, a meta-analysis was undertaken to determine the pooled estimate of effect of specialized multidisciplinary community-based care for explicit outcomes. The quality of the body of evidence, defined as one or more relevant studies was determined using GRADE Working Group criteria. (11) INCLUSION CRITERIA: Randomized controlled trialSystematic review with meta analysisPopulation includes persons with New York Heart Association (NYHA) classification 1-IV HFThe intervention includes a team consisting of a nurse and physician one of which is a specialist in HF management.The control group receives care by a single practitioner (e.g. primary care physician (PCP) or cardiologist)The intervention begins after discharge from the hospitalThe study reports 1-year outcomes The intervention is delivered predominately through home-visitsStudies with mixed populations where discrete data for HF is not reported All cause mortalityAll cause hospitalizationHF specific mortalityHF specific hospitalizationAll cause duration of hospital stayHF specific duration of hospital stayEmergency room visitsQuality of Life One large and seven small randomized controlled trials were obtained from the literature search. A meta-analysis was completed for four of the seven outcomes including: All cause mortalityHF-specific mortalityAll cause hospitalizationHF-specific hospitalization.Where the pooled analysis was associated with significant heterogeneity, subgroup analyses were completed using two primary categories: direct and indirect model of care; andtype of control group (PCP or cardiologist).The direct model of care was a clinic-based multidisciplinary HF program and the indirect model of care was a physician supervised, nurse-led telephonic HF program. All studies, except one, were completed in jurisdictions outside North America. (12-19) Similarly, all but one study had a sample size of less than 250. The mean age in the studies ranged from 65 to 77 years. Six of the studies(12;14-18) included populations with a NYHA classification of II-III. In two studies, the control treatment was a cardiologist (12;15) and two studies reported the inclusion of a dietitian, physiotherapist and psychologist as members of the multidisciplinary team (12;19). ALL CAUSE MORTALITY: Eight studies reported all cause mortality (number of persons) at 1 year follow-up. (12-19) When the results of all eight studies were pooled, there was a statistically significant RRR of 29% with moderate heterogeneity (I(2) of 38%). The results of the subgroup analyses indicated a significant RRR of 40% in all cause mortality when SMCCC is delivered through a direct team model (clinic) and a 35% RRR when SMCCC was compared with a primary care practitioner. HF-SPECIFIC MORTALITY: Three studies reported HF-specific mortality (number of persons) at 1 year follow-up. (15;18;19) When the results of these were pooled, there was an insignificant RRR of 42% with high statistical heterogeneity (I(2) of 60%). The GRADE quality of evidence is moderate for the pooled analysis of all studies. ALL CAUSE HOSPITALIZATION: Seven studies reported all cause hospitalization at 1-year follow-up (13-15;17-19). When pooled, their results showed a statistically insignificant 12% increase in hospitalizations in the SMCCC group with high statistical heterogeneity (I(2) of 81%). A significant RRR of 12% in all cause hospitalization in favour of the SMCCC care group was achieved when SMCCC was delivered using an indirect model (telephonic) with an associated (I(2) of 0%). The Grade quality of evidence was found to be low for the pooled analysis of all studies and moderate for the subgroup analysis of the indirect team care model. HF-SPECIFIC HOSPITALIZATION: Six studies reported HF-specific hospitalization at 1-year follow-up. (13-15;17;19) When pooled, the results of these studies showed an insignificant RRR of 14% with high statistical heterogeneity (I(2) of 60%); however, the quality of evidence for the pooled analysis of was low. DURATION OF HOSPITAL STAY: Seven studies reported duration of hospital stay, four in terms of mean duration of stay in days (14;16;17;19) and three in terms of total hospital bed days (12;13;18). Most studies reported all cause duration of hospital stay while two also reported HF-specific duration of hospital stay. These data were not amenable to meta-analyses as standard deviations were not provided in the reports. However, in general (and in all but one study) it appears that persons receiving SMCCC had shorter hospital stays, whether measured as mean days in hospital or total hospital bed days. EMERGENCY ROOM VISITS: Only one study reported emergency room visits. (14) This was presented as a composite of readmissions and ER visits, where the authors reported that 77% (59/76) of the SMCCC group and 84% (63/75) of the usual care group were either readmitted or had an ER visit within the 1 year of follow-up (P=0.029). (ABSTRACT TRUNCATED)

  5. Foods: A Teacher's Guide to an Employment Orientation Course for Special Needs Students.

    ERIC Educational Resources Information Center

    Grubb, Francine

    This teacher's guide on foods is one of a series of six designed for the employment orientation program for special needs students at the Gloucester County Vocational-Technical School in Sewell, New Jersey. The series includes laundry, hospitality, sewing, basic business, foods, and beauty culture. Each guide contains lesson plans consisting of…

  6. Special Deveice as Aids in the Management of Child Self-Mutilation in the Lesch-Nyhan Syndrome

    ERIC Educational Resources Information Center

    Letts, R. M.; Hobson, Douglas A.

    1975-01-01

    A multidisciplinary team at a hospital special devices clinic designed multiple use wheelchair and car seats with unique tabletop or arm enclosures for two educable mentally retarded brothers (11 and 14-years-old) afflicted with Lesch-Nyhan syndrome, a purine metabolic disorder characterized by an insatiable urge for self-mutilation. (LH)

  7. Sewing: A Teacher's Guide to an Employment Orientation Course for Special Needs Students.

    ERIC Educational Resources Information Center

    Grubb, Francine

    This teacher's guide on sewing is one of a series of six designed for the employment orientation program for special needs students at the Gloucester County Vocational-Technical School in Sewell, New Jersey. The series includes laundry, hospitality, sewing, basic business, foods, and beauty culture. Each guide contains daily lesson plans…

  8. Laundry: A Teacher's Guide to an Employment Orientation Course for Special Needs Students.

    ERIC Educational Resources Information Center

    Grubb, Francine

    This teacher's guide on laundry is one of a series of six designed for the employment orientation program for special needs students at the Gloucester County Vocational-Technical School in Sewell, New Jersey. The series includes laundry, hospitality, sewing, basic business, foods, and beauty culture. Each guide contains lesson plans consisting of…

  9. Beauty Culture: A Teacher's Guide to an Employment Orientation Course for Special Needs Students.

    ERIC Educational Resources Information Center

    Grubb, Francine

    This teacher's guide on beauty culture is one of a series of six designed for the employment orientation program for special needs students at the Gloucester County Vocational-Technical School in Sewell, New Jersey. The series includes laundry, hospitality, sewing, basic business, food, and beauty culture. Each guide contains lesson plans…

  10. A widening gap? Static and dynamic performance differences between specialist and general hospitals.

    PubMed

    Vera, Antonio; Petratos, Pythagoras; Salge, Torsten Oliver

    2018-03-01

    This paper develops and tests a dynamic model of hospital focus. It does so by tracing the performance trajectories of specialist and general hospitals to identify whether a performance gap exists and whether it widens or shrinks over time. Our longitudinal analyses of all hospital organizations within the English National Health Service (NHS) reveal not only a notable performance gap between specialist and general hospitals in particular with regards to patient satisfaction that widens over time, but also the emergence of a gap especially with regards to hospital staff job satisfaction. These findings reflect the considerable potential of specialization as a means to enhance hospital effectiveness. However, they also alert health policy makers to the threat of a widening performance gap between specialist and general hospitals with potential negative repercussions at the patient and health system level.

  11. [Improving the provision of major obstetric interventions by task delegation in Africa: An example from the Bogodogo health district hospital in Ouagadougou, Burkina Faso].

    PubMed

    Ouédraogo, C M; Ouattara, A; Ouédraogo, A; Bikienga, M; Lankoandé, J

    2015-01-01

    To describe the role of task delegation in the practice of major obstetric procedures in the Bogodogo health district hospital. This descriptive and analytic prospective study took place in the hospital's department of obstetrics and gynecology from February through October 2013. It included all women undergoing a major obstetric surgical intervention, performed by either by a gynecologist-obstetrician or by a nurse specializing in surgery. Data were collected from individual records and analyzed by SPSS and Epidata software. There were 601 major obstetric interventions during the study period. The women's mean age was 26.7 years. Cesarean deliveries accounted for 90% of these procedures, followed by laparotomy (7.7%). The Misgav-Ladach technique was used for cesareans by 86.5% of the obstetricians and 95.3% of the nurses specialized in surgery. The primary complications were anemia and postpartum hemorrhage. Maternal mortality did not differ significantly between the groups of operators, nor did maternal, fetal, and neonatal outcomes. Task delegation in obstetric surgery at the Bogodogo district hospital is effective. Its extension to the national level would make it possible to overcome the lack of highly qualified human resources to enable adequate availability of major obstetric interventions in rural hospitals.

  12. Availability of hospital dental care services under sedation or general anesthesia for individuals with special needs in the Unified Health System for the State of Minas Gerais (SUS-MG), Brazil.

    PubMed

    Santos, Jacqueline Silva; Valle, Déborah Andrade; Palmier, Andréa Clemente; do Amaral, João Henrique Lara; de Abreu, Mauro Henrique Nogueira Guimarães

    2015-02-01

    This study identified the demographic characteristics of individuals and dental treatment care under sedation/general anesthesia in a hospital environment in the Unified Health System in the State of Minas Gerais (SUS-MG). All Hospitalization Authorizations (AIHs) for Dental Treatment for Patients with Special Needs procedures were evaluated between July 2011 and June 2012. Demographic and health care variables for treatment were also assessed. Hospitalization rates per 10,000 inhabitants, and health care coverage provided in the state of Minas Gerais and in each of the Broader Health Regions were calculated. Descriptive analysis of data was carried out by calculating the central trend and variability frequency and measurements. All 1,063 AIHs paid during the study period were evaluated, which is equivalent to a rate of 0.54 hospitalizations per 10,000 individuals. The majority of the patients were adult, male, diagnosed with mental or behavioral disorders and resident in 27.7% of the municipalities in Minas Gerais. The procedures were performed in 39 municipalities and the care coverage was equal to 1.58%. The study reveals a classic demographic and clinical profile of patient attendance. Difficulties in establishing a network of dental care were identified.

  13. COP - Pet Owners - What is Comparative Oncology | Center for Cancer Research

    Cancer.gov

    What is Comparative Oncology? Cancer, in the pet population, is a spontaneous disease. Pet owners, motivated by the desire to prolong their animals' quality of life, frequently seek out the specialized care and treatment of veterinary oncologists at private referral veterinary hospitals and veterinary teaching hospitals across the country. Therapeutic modalities for veterinary

  14. Relationship marketing in health care.

    PubMed

    Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W

    1994-01-01

    Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.

  15. The Attitude Scale towards Distance Nursing Education (AstDNE)

    ERIC Educational Resources Information Center

    Boz Yuksekdag, Belgian; Unsal Barlas, Gul

    2015-01-01

    In this study, a measurement is seen as an instrument to measure the attitudes of the nurses towards the distance nursing education was developed. The study population consist of nurses who working in two hospitals of the ministry of health and two special hospitals in Istanbul. The sample of the study consisted of 194 nurses who agreed to…

  16. Home/Hospital Instruction: Instructional Approach to Working with Students with Major Depressive Disorder

    ERIC Educational Resources Information Center

    Newman, Cara

    2012-01-01

    School districts throughout the United States provide in-home schooling for students whose health problems, both physical and mental, prevent them from attending regular classes. This service is an outgrowth of the federal legislation which addressed the provision of education to all children with special needs. Home/Hospital teachers who serve…

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., based on the most recent census. (3) The hospital does not have in effect a 24-hour nursing waiver... within the two years previous to application. (b) Skilled nursing facility services. The facility is substantially in compliance with the following skilled nursing facility requirements contained in subpart B of...

  18. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., based on the most recent census. (3) The hospital does not have in effect a 24-hour nursing waiver... within the two years previous to application. (b) Skilled nursing facility services. The facility is substantially in compliance with the following skilled nursing facility requirements contained in subpart B of...

  19. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., based on the most recent census. (3) The hospital does not have in effect a 24-hour nursing waiver... within the two years previous to application. (b) Skilled nursing facility services. The facility is substantially in compliance with the following skilled nursing facility requirements contained in subpart B of...

  20. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., based on the most recent census. (3) The hospital does not have in effect a 24-hour nursing waiver... within the two years previous to application. (b) Skilled nursing facility services. The facility is substantially in compliance with the following skilled nursing facility requirements contained in subpart B of...

  1. Approaching Hospital-Bound/Home-Bound Special Education as an Opportunity for Innovation in Teaching

    ERIC Educational Resources Information Center

    Trentin, Guglielmo

    2014-01-01

    Paradoxically some "extreme" didactic needs, such as those of students who are unable to attend normal education regularly (e.g., hospitalized and/or homebound students), have shown themselves to be ideal for the development of a teaching style aimed at stimulating the active role of the student, at fostering a learning process based…

  2. Adventure Counseling as an Adjunct to Group Counseling in Hospital and Clinical Settings

    ERIC Educational Resources Information Center

    Gillen, Mark C.; Balkin, Richard S.

    2006-01-01

    Adventure counseling has been thought of as a highly specialized application of group counseling skills in a wilderness environment. In fact, adventure counseling is based on a developmental theory of group, can be useful for a variety of clients, and can be thoughtfully integrated into clinical and hospital settings. This article describes the…

  3. Hospital Schools in the United States. Bulletin, 1938, No. 17

    ERIC Educational Resources Information Center

    Matheison, Clele Lee

    1939-01-01

    Among the exceptional children for whom special educational facilities are essential are those who must spend weeks or months or years in a hospital or a sanatorium. Many of these children, while undergoing physical treatment, can very profitably engage in school work. Comparatively little has been written about this phase of educational activity,…

  4. Efficiency determinants and capacity issues in Brazilian for-profit hospitals.

    PubMed

    Araújo, Cláudia; Barros, Carlos P; Wanke, Peter

    2014-06-01

    This paper reports on the use of different approaches for assessing efficiency of a sample of major Brazilian for-profit hospitals. Starting out with the bootstrapping technique, several DEA estimates were generated, allowing the use of confidence intervals and bias correction in central estimates to test for significant differences in efficiency levels and input-decreasing/output-increasing potentials. The findings indicate that efficiency is mixed in Brazilian for-profit hospitals. Opportunities for accommodating future demand appear to be scarce and strongly dependent on particular conditions related to the accreditation and specialization of a given hospital.

  5. 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.

  6. 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

  7. Discussion on a Public Hospital's Practice in Culture Shaping and Innovative Development.

    PubMed

    Zhang, Peiying

    2015-05-01

    Culture shaping is an important part of a hospital's quality management to enhance its medical service, improve doctor-patient relations, and cement its brand image (Jianping and Hong in Chinese Hospital Management 29(1):36-37, 2009). First built in 1953, Xuzhou Central Hospital is a tertiary general hospital in the Huaihai Economic Zone and has won a series of honorary titles for its reforms, innovations, and the level of medical services provided. In recent years, the hospital has increased its efforts in culture shaping through the construction of special departments, medical services, hospital culture, and professional ethics. This has resulted in substantial progress in the hospital's medical capabilities and service quality, and laid a solid foundation to achieve its ambitious goal of becoming a nationally prestigious hospital, among the best in Jiangsu and a regional healthcare center in the Huaihai Economic Zone.

  8. Group cohesion and social support of the nurses in a special unit and a general unit in Korea.

    PubMed

    Ko, Yu Kyung

    2011-07-01

    To identify the degree of group cohesion and social support of nurses in special and general units in hospitals in Korea, and to compare group cohesion and social support between the two groups. The level of commitment nurses have to their organizations has been shown to correlate with work group cohesion and social support. The participants were 1751 nurses who were working in Korean hospitals. Data were collected using a structured questionnaire and were analysed using SAS. The statistical methods included: descriptive statistics, t-test, anova and Pearson's correlation coefficients. Group cohesion of nurses on special wards was significantly higher than for nurses on general wards. No significant difference was found between types of units in terms of social support. The degree of group cohesion was significantly different in terms of the respondents' clinical experience, position, religion, job satisfaction, number of supportive superiors and number of supportive peers. A statistically significant correlation was found between group cohesion scores and degree of social support. Hospital management can accomplish their goals more effectively through knowledge of the level of group cohesion, superior support and peer support for nursing staff in accordance with unit specialty. © 2011 The Author. Journal compilation © 2011 Blackwell Publishing Ltd.

  9. Trauma systems and the costs of trauma care.

    PubMed Central

    Goldfarb, M G; Bazzoli, G J; Coffey, R M

    1996-01-01

    OBJECTIVE. This study examines the cost of providing trauma services in trauma centers organized by publicly administered trauma systems, compared to hospitals not part of a formal trauma system. DATA SOURCES AND STUDY SETTING. Secondary administrative discharge abstracts for a national sample of severely injured trauma patients in 44 trauma centers and 60 matched control hospitals for the year 1987 were used. STUDY DESIGN. Retrospective univariate and multivariate analyses were conducted to examine the impact of formal trauma systems and trauma center designation on the costs of treating trauma patients. Key dependent variables included length of stay, charge per day per patient, and charge per hospital stay. Key impact variables were type of trauma system and level of trauma designation. Control variables included patient, hospital, and community characteristics. DATA COLLECTION/EXTRACTION METHODS. Data were selected for hospitals based on (1) a large national hospital discharge database, the Hospital Cost and Utilization Project, 1980-1987 (HCUP-2) and (2) a special survey of trauma systems and trauma designation undertaken by the Hospital Research and Educational Trust of the American Hospital Association. PRINCIPAL FINDINGS. The results show that publicly designated Level I trauma centers, which are the focal point of most trauma systems, have the highest charge per case, the highest average charge per day, and similar or longer average lengths of stay than other hospitals. These findings persist after controlling for patient injury and health status, and for demographic characteristics and hospital and community characteristics. CONCLUSIONS. Prior research shows that severely injured trauma patients have greater chances of survival when treated in specialized trauma centers. However, findings here should be of concern to the many states developing trauma systems since the high costs of Level I centers support limiting the number of centers designated at this level and/or reconsidering the requirements placed on these centers. PMID:8617611

  10. Hospital Nuclear Pharmacy Survey: Preliminary Aspects In Brazil

    PubMed Central

    Brasil, Marcelo Pau; de Barros, Marcio Paes; Antunes, Leila Jorge; Santos-Oliveira, Ralph

    2012-01-01

    Radiopharmaceuticals are special drugs that in the composition preserve one or more radionuclides which can be used as diagnostic or therapeutic tools in Nuclear Medicine Units. This study evaluated hospitals and clinics which have nuclear medicines services at the city of Rio de Janeiro from August to November 2010. The data were obtained through a longitudinal research. The results showed that most of the hospitals (>80%) did not have pharmacist and all them (100%) considered that a pharmacist in the nuclear pharmacy is not required. PMID:23493051

  11. [Efforts of gender equality at Kinki University School of Medicine].

    PubMed

    Miyamoto, Katsuichi

    2013-01-01

    In recent years, medical doctors are in short supply in many university hospitals. Retirement of female doctor after delivery is one of the reasons. Although they want to return to work after giving birth, they quit unavoidable because the working conditions do not match. Then, Kinki university hospital established the "provisions for special work arrangements". This work arrangement is the wage less, but the working hours is less than the regular. This work arrangement increased returner to the university hospital after delivery.

  12. [The work of R.T.H. Laennec at the Necker Hospital, then Charity Hospital from 1821 to 1826].

    PubMed

    Dubois, Charles

    2006-01-01

    His bad health obliged RTH Laennec to interrupt his hospital activities from 1819 to 1821. He goes back to his head functions in Necker's then Charity's Hospitals from 1821 to 1826. His others activities, especially teaching, affect his busy time table. His unit's recruitment is less specialized in thoracic pathologies than it was from 1816 to 1819. It is true that his "Collège of France Lessons" as his lectures, in the faculty of medicine concern all the clinical aspects. So the links between hospital activities and the second edition of his Treaty are not so strong as they were with the first one.

  13. The impact of hospital market structure on patient volume, average length of stay, and the cost of care.

    PubMed

    Robinson, J C; Luft, H S

    1985-12-01

    A variety of recent proposals rely heavily on market forces as a means of controlling hospital cost inflation. Sceptics argue, however, that increased competition might lead to cost-increasing acquisitions of specialized clinical services and other forms of non-price competition as means of attracting physicians and patients. Using data from hospitals in 1972 we analyzed the impact of market structure on average hospital costs, measured in terms of both cost per patient and cost per patient day. Under the retrospective reimbursement system in place at the time, hospitals in more competitive environments exhibited significantly higher costs of production than did those in less competitive environments.

  14. Syncope

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  15. Prevalence of fall injuries and risk factors for fall among hospitalized children in a specialized childrens hospital in Saudi Arabia.

    PubMed

    AlSowailmi, Banan Abdullah; AlAkeely, Maha Heshaam; AlJutaily, Hayat Ibrahim; Alhasoon, Mohammad Abdulaziz; Omair, Amir; AlKhalaf, Hamad Abdullah

    2018-01-01

    Fall injuries among children during hospital stay is a major patient safety issue. Inpatient pediatric falls can lead to numerous negative consequences. In contrast to adults, there is a paucity of information on the prevalence and risk factors associated with children's falls during hospitalization. Identify the prevalence of fall injuries among hospital.ized children and describe the demographic and environmental factors that could predict a higher risk of severe outcomes of fall. Descriptive, cross-sectional prevalence study. Specialized children's hospital. Data was obtained through the electronic Safety Reporting System (SRS). All reported fall events during hospitalization in children less than or equal 14 years of age for the period from 1 April 2015 to 30 April 2016 were included. Fall events that occurred in the day care unit and the outpatient clinic were excluded. Prevalence and possible risk factors for fall events. 48. The prevalence of falls among the 4860 admitted children was 9.9 (95% CI=7.5, 13.1) per 1000 patients (48/4860). A majority of the falls were among boys (n=26, 54%), in the age group from 1-5 years old (n=22, 46%), in children at high risk of falling (n=35, 73%), with normal mobility status (n=21, 44%), and with no history of previ.ous falls (n=33, 69%). Severe injuries accounted for 25% of falls (n=12). However, falls among the moderate risk category (n=9, 69%) were more often severe than falls among the high risk category of children (n=12, 34%) (P=.03). Risk factor identification is required to prevent falls and their severe outcomes. Underreporting and single-centered study. None.

  16. Functional Independence, Diagnostic Groups, Hospital Stay, and Modality of Payment in Three Croatian Seaside Inpatient Rehabilitation Centers

    PubMed Central

    Mrčela, Nada Tomasović; Massari, Dražen; Vlak, Tonko

    2010-01-01

    Aim To determine patients’ functional independence, diagnostic groups, duration of hospital stay, and modality of payment of rehabilitation in major special hospitals for rheumatology and medical rehabilitation on the Croatian seaside. Methods In a cross-sectional study conducted from October 2006 until January 2009, we surveyed 400 patients treated at 3 special hospitals for medical rehabilitation. Their functional independence was assessed by modified Barthel index and they self-evaluated their health using the first item from the 36-Item Short-Form Health Survey questionnaire. Results On admission, almost half of the patients (46%) were fully functionally independent, 33% were slightly dependent, while 21% were moderately or severely dependent. At the end of the hospitalization, significant predictors for the increase in Barthel index were longer hospital stay (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06-1.22), diagnosis of post-procedural musculoskeletal disorders (OR, 4.84; 95% CI, 1.90-10.57), diagnosis of conditions following acute ischemic heart disease (OR, 9.71; 95% CI, 3.40-27.75), and lower Barthel index at admission (OR, 0.96; 95% CI, 0.94-0.97). Of the 97 patients with dorsopathy, 73 (75%) were fully functionally independent and 57 (59%) paid for the treatment either themselves or contributed substantially to the total cost. Conclusion Assessment of patients’ functional status is important for the organization of inpatient rehabilitation. Patients with dorsopathy could be targeted as a population for medical tourism in rehabilitation medicine in order to maximize the use of rehabilitation hospitals. PMID:21162166

  17. The Recent Emergence of Clostridium difficile Infection in Romanian Hospitals is Associated with a High Prevalence of Polymerase Chain Reaction Ribotype 027.

    PubMed

    Popescu, Gabriel Adrian; Serban, Roxana; Pistol, Adriana; Niculcea, Andreea; Preda, Andreea; Lemeni, Daniela; Macovei, Ioana Sabina; Tălăpan, Daniela; Rafila, Alexandru; Florea, Dragoş

    2018-03-15

    To investigate the epidemiology of Clostridium difficile infection in Romanian hospitals. A survey was conducted at nine hospitals throughout Romania between November 2013 and February 2014. The survey identified 393 patients with Clostridium difficile infection. The median age was 67 years (range: 2-94 years); 56% of patients were aged >65 years. The mean prevalence of Clostridium difficile infection was 5.2 cases per 10.000 patient-days. The highest prevalences were 24.9 and 20 per 10.000 patient-days in hospitals specializing in gastroenterology and infectious diseases, respectively. Clostridium difficile infections were health care-associated in 70.5% patients and community-acquired in 10.2%. The origin was not determined in 19.3%. Clostridium difficile infection was severe in 12.3% of patients, and the in-hospital all-cause mortality was 8.8%. Polymerase chain reaction ribotype 027 had the highest prevalence in all participating hospitals and represented 82.6% of the total ribotyped isolates. The minimum inhibitory concentration of moxifloxacin was >4 μg/mL for 59 of 80 tested isolates (73.8%). Of 59 isolates, 54 were highly resistant to moxifloxacin (minimum inhibitory concentration ≥32 μg/mL), and the majority were polymerase chain reaction ribotype 027 (p<0.0001). The ribotype 027 was the predominant cause of Clostridium difficile infections in Romania. In some specialized hospitals, the prevalence of Clostridium difficile infection was higher than the European mean prevalence, and this demonstrates the need for strict adherence to infection control programs.

  18. Pain treatment facilities: do we need quantity or quality?

    PubMed

    de Meij, Nelleke; Köke, Albère; van der Weijden, Trudy; van Kleef, Maarten; Patijn, Jacob

    2014-10-01

    Chronic pain patients referred to a pain treatment facility have no guarantee that they will receive a proper diagnostic procedure or treatment. To obtain information about organizational aspects of pain treatment facilities and the content of their daily pain practice, we performed a questionnaire survey. The aim of the study was to evaluate the amount of pain treatment facilities, the content of organized specialized pain care and adherence to the criteria of the internationally accepted guidelines for pain treatment services. The University Pain Centre Maastricht in the Department of Anaesthesiology and Pain Management at Maastricht University Medical Centre developed a questionnaire survey based on the Recommendations for Pain Treatment Services of the International Association for the Study of Pain (IASP). The questionnaire was sent to the medical boards of all hospitals in the Netherlands (n=94). The response rate was 86% (n=81). Of all hospitals, 88.9% (n=72) reported the provision of organized specialized pain care, which was provided by a pain management team in 86.1% (n=62) and by an individual specialist in 13.9% (n=10). Insight was obtained from pain treatment facilities in five different domains: the organizational structure of pain management, composition of the pain team, pain team practice, patient characteristics, and research and education facilities. Although 88.9% of all hospitals stated that organized specialized pain care was provided, only a few hospitals could adhere to the criteria for pain treatment services of the IASP. The outcome of the questionnaire survey may help to define quality improvement standards for pain treatment facilities. © 2014 John Wiley & Sons, Ltd.

  19. Intervention for Food Selectivity in a Specialized School Setting: Teacher Implemented Prompting, Reinforcement, and Demand Fading for an Adolescent Student with Autism

    ERIC Educational Resources Information Center

    Knox, Maria; Rue, Hanna C.; Wildenger, Leah; Lamb, Kara; Luiselli, James K.

    2012-01-01

    Food selectivity is a common problem among children and youth who have intellectual and developmental disabilities or autism spectrum disorders. Whereas most intervention research has been conducted under simulated conditions in clinic and hospital settings, this study evaluated teacher implemented procedures at a specialized school. The…

  20. Establishing special needs car seat loan program.

    PubMed

    Bull, M J; Stroup, K B; Stout, J; Doll, J P; Jones, J; Feller, N

    1990-04-01

    Car seat loan and rental programs have provided many families with low-cost access to child restraints. When an infant or child is unable to be accommodated in a standard car seat or seat belt owing to physical or medical problems, parents of these children have few, if any available resources. The establishment and operation of a loan program at the Indiana University School of Medicine for children who are medically fragile is reviewed in this article. This program was developed by the Automotive Safety for Children Program at the James Whitcomb Riley Hospital for Children, Indiana University Medical Center, to meet the special transportation needs of children with respiratory, orthopaedic, and other medical and physical difficulties. A summary table is included to highlight restraints that have performed satisfactorily during dynamic crash tests and are used to meet patient transportation needs at Riley Hospital. Guidelines for establishing and maintaining a child restraint loan program for children with special needs are outlined to encourage replication of this effort.

  1. Radiation Protection in Pediatric Radiology: Results of a Survey Among Dutch Hospitals.

    PubMed

    Bijwaard, Harmen; Valk, Doreth; de Waard-Schalkx, Ischa

    2016-10-01

    A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children's hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children's hospitals but also between the respective general and children's hospitals. It is recommended that hospitals consult each other to come up with more uniform best practices. Few hospitals were able to supply doses that can be compared to the national Diagnostic Reference Levels (DRLs). The ones that could be compared exceeded the DRLs in one in five cases, which is more than was expected beforehand.

  2. 42 CFR 482.58 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... census. (3) The hospital does not have in effect a 24-hour nursing waiver granted under § 488.54(c) of... previous to application. (b) Skilled nursing facility services. The facility is substantially in compliance with the following skilled nursing facility requirements contained in subpart B of part 483 of this...

  3. Attachment, Parenting, and Separation-Individuation in Adolescence: A Comparison of Hospitalized Adolescents, Institutionalized Delinquents, and Controls

    ERIC Educational Resources Information Center

    Delhaye, Marie; Kempenaers, Chantal; Burton, Julie; Linkowski, Paul; Stroobants, Rob; Goossens, Luc

    2012-01-01

    The authors compared parent-related perceptions by hospitalized adolescents (i.e., who were admitted to a specialized psychiatric unit; n = 50) and delinquent adolescents (i.e., who were placed at a juvenile treatment institution; n = 51) with adolescents from the general population (n = 51). All adolescents completed a broad set of measures of…

  4. [Survey about responsiveness of third-level hospitals to a medical disaster: after the pandemic influenza in Mexico].

    PubMed

    Serna-Ojeda, Juan Carlos; Castañón-González, Jorge Alberto; Macías, Alejandro E; Mansilla-Olivares, Armando; Domínguez-Cherit, Guillermo; Polanco-González, Carlos

    2012-01-01

    The recent pandemic influenza AH1N1 virus made it clear that planning for medical disaster response is critical. To know the responsiveness of a sample of highly specialized hospitals in Mexico to a medical disaster, with the previous pandemic influenza AH1N1 as reference. A survey was conducted among the Medical Directors of a sample of highly specialized hospitals, covering: previous experience with the pandemic influenza, space considerations, material resources, staff, logistics, and current general perspectives. Descriptive statistics were used for analysis. A 95% response was obtained from the institutions (19 hospitals). Of these, 47.4% considered that the medical institution was not ready to respond to pandemic influenza. The median surge capacity for the Intensive Care Unit beds was 30% (range 0 to 32 beds). The least reserve in medication was found in the antivirals (26.3%). Only 47.4% considered having enough intensive care nurses and 57.9% enough respiratory technicians; 42.1% would not have an easy access to resources in an emergency. Prevention is key in responsiveness to medical disasters, and therefore the basic steps for planning strategies must be considered.

  5. [Organization of clinical emergency units. Mission and environmental factors determine the organizational concept].

    PubMed

    Genewein, U; Jakob, M; Bingisser, R; Burla, S; Heberer, M

    2009-02-01

    Mission and organization of emergency units were analysed to understand the underlying principles and concepts. The recent literature (2000-2007) on organizational structures and functional concepts of clinical emergency units was reviewed. An organizational portfolio based on the criteria specialization (presence of medical specialists on the emergency unit) and integration (integration of the emergency unit into the hospital structure) was established. The resulting organizational archetypes were comparatively assessed based on established efficiency criteria (efficiency of resource utilization, process efficiency, market efficiency). Clinical emergency units differ with regard to autonomy (within the hospital structure), range of services and service depth (horizontal and vertical integration). The "specialization"-"integration"-portfolio enabled the definition of typical organizational patterns (so-called archetypes): profit centres primarily driven by economic objectives, service centres operating on the basis of agreements with the hospital board, functional clinical units integrated into medical specialty units (e.g., surgery, gynaecology) and modular organizations characterized by small emergency teams that would call specialists immediately after triage and initial diagnostic. There is no "one fits all" concept for the organization of clinical emergency units. Instead, a number of well characterized organizational concepts are available enabling a rational choice based on a hospital's mission and demand.

  6. [Estimation of species diversity of coagulase-negative staphylococci isolated in hospitals of Russian Federation in 2009-2010].

    PubMed

    Voronina, O L; Kunda, M S; Dmitrienko, O A; Liubasovskaia, L A; Kovalishena, O V; Popov, D A; Lunin, V G

    2011-01-01

    Comparative analysis of species diversity of sample of coagulase-negative staphylococci (CNS) isolated in hospitals of different specializations. For identification of 102 CNS strains, biochemical systems manufactured by NPO "Diagnostic Systems", VITEK 2 Compact, and BBL Crystal as well as sequencing of fragments of tuf and gap genes were used. Greater differentiating capability of genotyping compared with phenotyping methods for species identification of staphylococci was demonstrated. Six CNS species were identified in the sample: S. epidermidis, S. haemolyticus, S. hominis, S. warneri, S. capitis, and S. pasteuri. The largest species diversity was noted for strains from maternity hospitals in Nizhny Novgorod and Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology. Strains isolated from blood of patients in Bakulev Center for Cardiovascular Surgery were represented mostly by S. epidermidis and S. haemolyticus. Differences in species diversity of CNS--causative agents of neonatal conjunctivitis and omphalitis--were observed. Two species of CNS: S. epidermidis and S. haemolyticus pose special threat as nosocomial pathogens both in hospitals for adults and obstetrical facilities. Additionally, in neonatal units it is necessary to control such species as S. warneri, S. capitis, S. pasteuri.

  7. Managing prices for hospital pharmaceuticals: a successful strategy for New Zealand?

    PubMed

    Tordoff, June M; Norris, Pauline T; Reith, David M

    2005-01-01

    In 2002, as part of a National Hospital Pharmaceutical Strategy, the New Zealand (NZ) government agency PHARMAC commenced a 3-year period of negotiating prices for 90% of hospital pharmaceuticals on behalf of all NZ public hospitals. The present study was undertaken to determine the effects of this first year of "pooled procurement." Using price changes and volume data for each of their top 150 pharmaceutical items, chief pharmacists at 11 public hospitals calculated projected cost savings for the financial year July 2003 to June 2004. Researchers calculated total projected savings for all 11 hospitals, and for three types of hospitals. Estimates of projected savings were made for all 29 major public hospitals by using savings per bed and savings per bed-day. A sensitivity analysis was undertaken. Items showing savings were categorized by using the Anatomical Therapeutic Chemical classification system. For the 11 hospitals, the top 150 items comprised 612 different items. Projected savings for 2003 to 2004 were NZ dollar 2,652,814, NZ dollar 658,984, and NZ dollar 127,952 for tertiary, secondary, and rural/special hospitals, respectively. Percentage savings as a median (range) of the total top 150 expenditure were: tertiary 5.28% (3.09-16.05%), secondary 7.41% (4.67-12.85%), and rural/special 9.55% (6.27-10.09%). For all 29 hospitals, estimated projected savings were NZ dollar 5,234,919 (NZ dollar 3,304,606-NZ dollar 8,044,482) by savings per bed, and NZ dollar 5,255,781 (NZ dollar 2,936,850-NZ dollar 8,693,239) by savings per bed-day. The main contributors to savings were: agents for infections, the nervous system, musculoskeletal system, and blood/blood-forming organs. The first year of pooled procurement under the National Hospital Pharmaceutical Strategy (2002-2003) has resulted in moderate savings. For all 29 major public hospitals, savings of around NZ dollar 5.2 million (dollar 2.9 million-dollar 8.7 million) or 3.7% were projected for 2003 to 2004. Longer-term effects, however, on patient outcomes and availability of pharmaceuticals, as well as on pharmaceutical expenditure, have yet to be evaluated.

  8. The geographical accessibility of hospitals to the aged: a geographic information systems analysis within Illinois.

    PubMed Central

    Love, D; Lindquist, P

    1995-01-01

    OBJECTIVE. This article uses geographic information systems and their related tools to empirically measure and display the geographic accessibility of the aged population to hospital facilities within Illinois. DATA SOURCES AND STUDY SETTING. Geographic accessibility of Illinois' aged population is measured from each of the state's 10,796 census block groups to the state's 214 hospital facilities. Block group demographic compositions and centroids are obtained from 1990 census files. Hospital coordinates are obtained by the authors. STUDY DESIGN. Of five alternative measures of accessibility considered, empirical estimates are obtained for two: choice set and minimum distance. Access to both general hospitals and the subset having specialized geriatric facilities is measured with special attention to differences in accessibility between the aged within metropolitan statistical areas (MSAs) and those outside MSAs. Cumulative accessibility distributions and their summary statistics provide a basis of comparison among subgroups. DATA COLLECTION AND EXTRACTION. Geographic information systems (GIS) and their related tools are used as a means of efficiently capturing, organizing, storing, and retrieving the required data. Hospitals and census block groups are geocoded to specific locations in the database, and aspatial attributes are assigned to the hospitals and block groups. The GIS database is queried to produce shaded isarithm and point distribution maps that show the location of hospitals relative to surrounding aged populations. CONCLUSION. The vast majority of Illinois' aged population is within close proximity to hospital facilities. Eighty percent (1,147,504 persons) of the aged in Illinois are within 4.8 miles (7.7 km) of a hospital and 11.6 miles (18.7 km) of two hospitals. However, geographic accessibility differences between the aged living in MSAs and those living outside MSAs to hospitals offering geriatric services are substantial; but there is no evidence that the aged's geographical accessibility to hospitals is less favorable than that of the general population. Detailed accessibility measures permitted by geographic information system technology call into question the continued use of crude empirical accessibility measures. Images Figure 2 PMID:7860317

  9. The direct hospitalization cost of care for acute burns in Lagos, Nigeria: a one-year prospective study

    PubMed Central

    Ahachi, C.N.; Fadeyibi, I.O.; Abikoye, F.O.; Chira, M.K.; Ugburo, A.O.; Ademiluyi, S.A.

    2011-01-01

    Summary Objective. We conducted a prospective study to identify the direct hospitalization cost of managing major acute burns in Lagos, Nigeria, and to determine the factors that influence the cost. Method. All consecutive and consenting patients seen and managed for major burns at the National Orthopaedic Hospital, Igbobi, Lagos, between 1 June 2007 and 31 May 2008 were recruited for the study. A special form designed for the study was used to collect the necessary data. Results. Fifty-two patients were seen during the study period (27 males and 25 females). The ages ranged from 2 months to 69 yr with a mean of 25.4 ± 17.1 yr. The length of hospital stay ranged from 0.3-12 months (mean, 3.2 ± 3.1 months). The average daily cost of treating a patient was ₦ (naira) 8,855 (₦1000 = €4.44) and the average overall cost was ₦209,303.70, with the costs of wound dressings, hospital admission, and surgery constituting respectively 29.5%, 25.7%, and 19.1% of the total amount spent. Conclusion. The length of hospital stay was prolonged in many patients and management methods should be reviewed to reduce this. The cost of managing burns is prohibitive for an average Nigerian. Efforts should be intensified to prevent burn injury and a Special Health Insurance policy should be established to finance burns management. PMID:22262967

  10. Varicose Veins

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  11. Prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, south west Ethiopia.

    PubMed

    Toru, Milkiyas; Beyene, Getnet; Kassa, Tesfaye; Gizachew, Zeleke; Howe, Rawleigh; Yeshitila, Biruk

    2018-05-08

    This study was done to determine the prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, Southwest Ethiopia. The overall prevalence of Enterococci species was 5.5% (22/403). Five (22.7%) of Enterococci species were vancomycin resistant. Haemolysin, gelatinase and biofilm production was seen among 45.5, 68.2 and 77.3% of isolates respectively. The overall rate of antibiotic resistance was 95.5% (21/22). High resistance was observed against norfloxacin (87.5%), and tetracycline (77.3%). Whereas, low resistance (36.5%) was observed against ciprofloxacin and eighteen (80.8%) of the isolates were multi-drug resistant.

  12. Special report. The Oklahoma City bombing: mass casualties and the local hospital response.

    PubMed

    1995-09-01

    A morning blast at the Alfred P. Murrah Federal Building, Oklahoma City, OK, on April 19, 1995, killed 168 persons and injured more than 500 in the worst terrorist attack in U.S. history. Hospital workers, physicians, and volunteers at nine hospitals there mobilized, put their disaster emergency plans into operation, and treated 466 persons in emergency rooms--many of them later being admitted as patients. To complicate matters, two of the hospitals received bomb threats called in after the disaster. This report will look at the security plans put into force by each of the nine hospitals; the handling of the great influx of persons, including victims, relatives, friends, concerned persons, volunteers, and the news media; and the lessons hospital officials learned from their experiences.

  13. The financial performance of rural hospitals and implications for elimination of the Critical Access Hospital program.

    PubMed

    Holmes, George M; Pink, George H; Friedman, Sarah A

    2013-01-01

    To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.

  14. Radial Artery Catheterization

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  15. Thrombophilia and Hypercoagulability

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  16. Heart-Healthy Exercise

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  17. Heparin-Induced Thrombocytopenia

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  18. Learning the available and supplied religious facilities for inpatient services: an example of Taiwan's hospital environment.

    PubMed

    Yin, Chang-Yi; Tzeng, Huey-Ming

    2007-01-01

    Holistic nursing care is typically defined to include the assessment and support of a patient's religious background to respect his/her beliefs and promote coping with illness, rehabilitation, and/or dying. An assessment of Taiwanese hospitals reveals variation in the policies and environment supporting religious practices. The survey of nursing executives revealed that only 40% of hospitals had any facilities for religious service or prayer and only 4% employed a chaplain or recruited volunteers to provide religious support. Approximately 20% of hospitals did provide a room for special ceremonies, often used for rituals after patient death.

  19. Strategic opportunities in the oversight of the U.S. hospital accreditation system.

    PubMed

    Moffett, Maurice L; Morgan, Robert O; Ashton, Carol M

    2005-12-01

    Hospital accreditation and state certification are the means that the Centers for Medicare & Medicaid Services (CMS) employs to meet quality of care requirements for medical care reimbursement. Hospitals can choose to use either a national accrediting agency or a state certification inspection in order to receive Medicare payments. Approximately, 80% of hospitals choose the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The purpose of this paper is to analyze and discuss improvements on the structure of the accreditation process in a Principal-Agent-Supervisor framework with a special emphasis on the oversight by the principal (CMS) of the supervisor (JCAHO).

  20. [Hospital financing in 2016. Relevant changes for rheumatology].

    PubMed

    Fiori, W; Bunzemeier, H; Lakomek, H-J; Buscham, K; Lehmann, H; Fuchs, A-K; Bessler, F; Roeder, N

    2016-03-01

    Hospital financing 2016 will be influenced by the prospects of the approaching considerable changes. It is assumed that the following years will lead to a considerable reallocation of financial resources between hospitals. While not directly targeted by new regulations, reallocations always also affect specialties like rheumatology. Compared to the alterations in the legislative framework the financial effects of the yearly adaptation of the German diagnosis-related groups system are subordinate. Only by comprehensive consideration of current and expected changes a forward-looking and sustainable strategy can be developed. The following article presents the relevant changes and discusses the consequences for hospitals specialized in rheumatology.

  1. Special issue dedicated to the 70th birthday of Glenn F. Webb. Preface.

    PubMed

    Hinow, Peter; Magal, Pierre; Ruan, Shigui

    2015-08-01

    This special issue is dedicated to the 70th birthday of Glenn F. Webb. The topics of the 12 articles appearing in this special issue include evolutionary dynamics of population growth, spatio-temporal dynamics in reaction-diffusion biological models, transmission dynamics of infectious diseases, modeling of antibiotic-resistant bacteria in hospitals, analysis of Prion models, age-structured models in ecology and epidemiology, modeling of immune response to infections, modeling of cancer growth, etc. These topics partially represent the broad areas of Glenn's research interest.

  2. Medical Devices; General Hospital and Personal Use Devices; Classification of the Ultraviolet Radiation Chamber Disinfection Device. Final order.

    PubMed

    2015-11-20

    The Food and Drug Administration (FDA or the Agency) is classifying the ultraviolet (UV) radiation chamber disinfection device into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the UV radiation chamber disinfection device classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

  3. Sensitization to epoxy resin systems in special flooring workers.

    PubMed

    Condé-Salazar, L; Gonzalez de Domingo, M A; Guimaraens, D

    1994-09-01

    The use of new products in building and public works is increasing, among them being special floor coverings containing epoxy resins and derivatives. These are used principally in heavily frequented areas, such as shopping precincts, hospitals, civic centres, etc., due to their high resistance to wear and tear, environmental factors, etc. In the last 2 years, we have studied 15 cases of men sensitized to epoxy resin, or derivatives, who worked with special floorings. Speed of sensitization, severity of lesions, and localization to the hands, face and legs were characteristic.

  4. Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study

    PubMed Central

    Kuluski, Kerry; Bechsgaard, Gitte; Ridgway, Jennifer; Katz, Joel

    2016-01-01

    Introduction. The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital. Design. Single-cohort repeated measures design. Methods. Participants (N = 10) admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min Hatha Yoga class (modified for wheelchair users/seated position) once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing), psychological variables (depression, anxiety, and experiences with injustice), mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention. Results. Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1) anxiety subscale of the Hospital Anxiety and Depression Scale, F(2,18) = 4.74, p < .05, and η p 2 = .35, (2) Self-Compassion Scale-Short Form, F(2,18) = 3.71, p < .05, and η p 2 = .29, and (3) Magnification subscale of the Pain Catastrophizing Scale, F(2,18) = 3. 66, p < .05, and η p 2 = .29. Discussion. The results suggest that an 8-week Hatha Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital. PMID:28115969

  5. The treatment of hospital wastewater: an appraisal.

    PubMed

    Pauwels, B; Verstraete, W

    2006-12-01

    Hospitals discharge considerable amounts of chemicals and microbial agents in their wastewaters. Problem chemicals present in hospital wastewater belong to different groups, such as antibiotics, X-ray contrast agents, disinfectants and pharmaceuticals. Many of these chemical compounds resist normal wastewater treatment. They end up in surface waters where they can influence the aquatic ecosystem and interfere with the food chain. Humans are particularly exposed by the drinking water, produced from surface water. Microbial agents of special concern are multiresistant microbial strains. The latter are suspected to contribute to the spread of antibiotic resistance. In this paper, we will discuss the different approaches towards hospital wastewater treatment. The principle of uncoupling hospitals from public sewers warrants indepth evaluation by technologists and ecotoxicologists as well as public health specialists.

  6. 75 FR 31118 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-02

    ...This notice contains the final wage indices, hospital reclassifications, payment rates, impacts, and other related tables effective for the fiscal year (FY) 2010 hospital inpatient prospective payment systems (IPPS) and rate year 2010 long-term care hospital (LTCH) prospective payment system (PPS). The rates, tables, and impacts included in this notice reflect changes required by or resulting from the implementation of several provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. These provisions require the extension of the expiration date for certain geographic reclassifications and special exception wage indices through September 30, 2010; and certain market basket updates for the IPPS and LTCH PPS.

  7. Financing care for the uninsured: the dilemma vexes New Jersey hospitals and payers.

    PubMed

    Wells, E V

    1996-05-01

    New Jersey's diverse constituencies and special interest groups don't usually agree on a public policy issue. However, almost everyone in the public policy arena agrees that hospitals should treat people who show up in emergency departments with problems requiring medical attention. For over a decade, Garden State policymakers, payers, and providers have faced the dilemma of excess demand on hospitals that treat the uninsured. This demand has risen due to increasing health care costs, development of costly technology, state deregulation of hospital payments, and employers' reluctance to insure workers and their families coupled with a mobile workforce holding part-time and seasonal jobs. The fiscal solvency of inner-city hospitals is threatened yet the problem continues to elude resolution.

  8. The hospital information system as a source for the planning and feed-back of specialized health care.

    PubMed

    Liebelt, P; Sleyster, E; Leeferink-Smit, J

    1995-01-01

    1. INTRODUCTION. In university hospitals, choices are made to which extend specialized health care will be supported. It is characteristic, for this type of care, that it takes place in a process of the continual advance of medical technology and the growing awareness by consumers and payors. Specialized healthcare contributes to the hospital qualifiers having a political and strategic impact. The hospital board needs information for planning and budgeting these new tasks. Much of the information will be based on data stored in the Hospital Information System (HIS). Due to load limitations, instant retrieval is not preferred. A separate executive information system, uploaded with HIS data, features statistics, on a corporate level, with the power to drill-down to detailed levels. However, the ability to supply information on new types of healthcare is limited since most of these topics require a flexible system for new dedicated cross-sections, like medical treatment from several specialisms and functional levels. 2. DATA RETRIEVAL AND DISTRIBUTION. During the information analysis, details were gathered on the necessary working procedures and the administrative organization, including the data registration in the HIS. In the next phase, all relevant data was organized in a relational datamodel. For each topic of care, dedicated views were developed at both low and high aggregation levels. It revealed that a matching change of the administrative organization was required, with an emphasis on financial registration aspects. For the selection of relevant data, a bottom-up approach was applied, which was based on the registrations starting from the patient administrative subsystem, through several transactional systems, ending at the general ledger in the HIS. Data on all levels was gathered, resulting in medical details presented in quantities, up to financial figures expressed in amounts of money. This procedure distinguishes from the predefined top-down techniques generally used for management and executive information systems. Data was regularly collected from the HIS, then converted and reorganized into relational datasets using XBase protocols. After having performed central quality controls and privacy protection measures, the datasets were distributed electronically to local PCs. Standard low-cost software packages enable analyses by user-friendly selection and presentation facilities. 3. EVALUATION. The method developed for data retrieval is flexible and easy to implement. If all basic data is registered in the HIS, the procedure can be applied for all strategic hospital functions that require planning and controlling during a certain time. Critical success factors and pitfalls will be presented in the poster. Using one consistent dataset, the information required about production and budget is presented at several functional levels and is quantified in units familiar to that level. The motivation for fast and accurate registration in the HIS was improved from the moment the medical and administrative staff recognized their own data in the feed-back on specialized health care.

  9. [Problems in the admission to in-hospital oral surgical care from the patient's viewpoint--results of patient interviews in the hospital for dental and maxillo-facial surgery of the Karl Marx University, Leipzig].

    PubMed

    Erpenbeck, F; Birnbaum, K; Langanke, B; Niemand, B; Thomzyk, I

    1979-06-01

    The author deals with the results from the interviewing of oral surgery patients on their problems concerning the sending and the admission to the hospital, with special attention to the problems of waiting for admission, the familiarization with the clinical environment and the improvement suggestions of the patients. The conclusions concern tasks arising from the medical and dental care for inpatients as well as for outpatients.

  10. Unpaid hospital bills: evidence from Florida.

    PubMed

    Campbell, E S

    1992-01-01

    Most of what we know about the population generating uncompensated care is inferred from data on the uninsured population. The use of insurance status as an indicator for potential charity patients is justifiable considering the lack of alternative information. This study directly examines uncompensated hospital care using a unique data set generated from a special survey conducted in Florida. A selection model estimated using these data explains who is likely to default on their bill and what amount will be left unpaid. The results provide a clearer picture of the uncompensated hospital care problem.

  11. Use of a control chart to monitor diarrhoea admissions: a quality improvement exercise in West Kalimantan Provincial Hospital, Pontianak, Indonesia.

    PubMed

    Purba, M

    1999-09-01

    Data on the number of admissions for diarrhoea each week to the West Kalimantan Provincial Hospital, Pontianak, Indonesia over a 5 year period, 1992-1996, were collected. After cleaning and exclusion of extreme values, transformation was then performed to ensure that the data were free of special cause variation and normally distributed. A control chart was then constructed to provide an 'early warning' system for hospital authorities in order to facilitate the management of the epidemic and to improve patient care.

  12. Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia

    PubMed Central

    2014-01-01

    Background Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patients. Patients may perceive the day of surgery as the biggest and the most threatening day in their lives. There is paucity of information on predictors of anxiety in the current study area. The main objective of this study is to assess predictors of preoperative anxiety among patients scheduled for surgery in Jimma University Specialized Teaching Hospital. Methods A facility based cross-sectional study was conducted using quantitative data collection technique in Jimma University Specialized Teaching Hospital from February 13 to April 13, 2012 on 239 patients scheduled for surgery. The data were collected by five trained diploma nurses using structured interviewer administered questionnaires that were prepared based on state trait anxiety inventory measurement scale. The quantitative data were entered into SPSS for windows version 16. 0 and descriptive, simple and multiple linear regression analyses were performed. Results A total of 239 patients were enrolled in the study with a response rate of 93.0%. Their mean age was 42.7 ± 1.8 years (range 16 to 85 years). Nearly over half 53.6% were females, while 48.1% illiterate, 72.4% Oromo and 56.5% were Muslim followers. Significant preoperative anxiety was seen in 70.3% patients. The most common factors that lead to anxiety were fear of death 38.1% and fear of unknown origin 24.3% and the most common strategy mentioned by patient in reducing anxiety were talking to other patient 79.8% and religious belief. Conclusions In the present study, two third 70.3% of preoperative patients had anxiety. Factors which were positively correlated with anxiety were trait anxiety, single and divorced, time of operation and income. Factors which were shown to reduce anxiety were preoperative anxiety related information provision and afternoon operation. Health professionals working in the hospital should provide anxiety related information for patients. PMID:25189274

  13. Ten-Year Profile of Infectious and Parasitic Disease Hospitalizations

    DTIC Science & Technology

    1989-03-09

    mononucleosis, rubella, chickenpox , measles, intestinal infections due to other organisms, A.. .... Codos 2 - .Avati and/0- iDlst Special AVL other...five-year period: chickenpox , enteritis due to a specific organism, early and symptomatic syphilis, other diseases of conjunctiva due to viruses and...ciated with childhood, including measles, mumps, and chickenpox . Women had significantly higher age-adjusted rates of total first hospitalizations for

  14. The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

    ERIC Educational Resources Information Center

    Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

    2009-01-01

    Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

  15. [110 years--University Obstetrics and Gynecology Hospital "Maichin dom"].

    PubMed

    Zlatkov, V

    2014-01-01

    The first specialized Obstetrics and Gynecology Hospital in Bulgaria was founded based on the idea of Queen Maria Luisa (1883). Construction began in 1896 and the official opening of the hospital took place on November 19, 1903. What is unique about the University Obstetrics and Gynecology Hospital "Maichin dom" is above all the fact that the Bulgarian school of obstetrics and gynecology was founded within its institution. Currently, the hospital has nearly 400 beds and 600 employees who work at nine clinics and six laboratories, covering the entire spectrum of obstetric and gynecological activities. Its leading specialists still continue to embody the highest level of professionalism and dedication. The future development of the hospital is chiefly associated with the renovation of facilities, resources and equipment and with the enhancement of the professional competence of the staff and of the quality of hospital products to improve the health and satisfaction of the patients.

  16. Functional consistency across two behavioural modalities: fire-setting and self-harm in female special hospital patients.

    PubMed

    Miller, Sarah; Fritzon, Katarina

    2007-01-01

    Fire-setting and self-harm behaviours among women in high security special hospitals may be understood using Shye's Action System Theory (AST) in which four functional modes are recognized: 'adaptive', 'expressive', 'integrative', and 'conservative'. To test for relationships between different forms of fire-setting and self-harm behaviours and AST modes among women in special hospital, and for consistency within modes across the two behaviours. Clinical case files evidencing both fire-setting and self-harm behaviours (n = 50) were analysed for content, focusing on incident characteristics. A total of 29 fire-setting and 22 self-harm variables were analysed using Smallest Space Analysis (SSA). Chi-square and Spearman's rho (rho) analyses were used to determine functional consistency across behavioural modes. Most women showed one predominant AST mode in fire-setting (n = 39) and self-harm (n = 35). Significant positive correlations were found between integrative and adaptive modes of functioning. The lack of correlation between conservative and expressive modes reflects the differing behaviours used in each activity. Despite this, significant cross-tabulations revealed that each woman had parallel fire-setting and self-harm styles. Findings suggest that, for some women, setting fires and self harm fulfil a similar underlying function. Support is given to AST as a way of furthering understanding of damaging behaviours, whether self- or other-inflicted. Copyright 2007 John Wiley & Sons, Ltd.

  17. [Profesionalismo en médicos de un hospital de segundo nivel].

    PubMed

    Prieto-Miranda, Sergio Emilio; Jiménez-Bernardino, Carlos Alberto; Monjaraz-Guzmán, Elizabeth Guadalupe; Esparza-Pérez, Ramiro Israel

    2017-01-01

    It takes many years to acquire abilities and technical skills necessary to do a good work as a doctor and even more years, for being "good professionals". Much of this training is based on old teaching schemes, but medicine has changed. So far no studies in our medium addressing the problem are known. The aim of this paper was to determine the level of professionalism in physicians that work in a second-level hospital. Descriptive cross-sectional study. We apply a survey to physicians, residents and medical interns in a second-level hospital. We developed and implemented a questionnaire on professionalism, which contained 18 items, 3 demographic questions and 15 questions with a Likert scale, which identified four dimensions: specialized knowledge, autonomy in decision-making, self-regulation and social commitment. Descriptive and inferential statistics were used, considering significant a p-value <0.05. We surveyed 228 physicians, 57.5% demonstrated competence in professionalism. 93.3% of the participants were competent in specialized knowledge and 60.5% in social commitment. The physicians and residents got the higher scores, and these differences were significant between autonomy in decision-making and specialized knowledge (p < 0.001). The medical interns obtained lower scores in all dimensions compared with residents and physicians. More than a half of physicians surveyed had a competent level of professionalism but only in some dimensions. We observed higher scores with a higher academic grade.

  18. Usage of emergency medical services by children with special health care needs.

    PubMed

    Suruda, A; Vernon, D D; Diller, E; Dean, J M

    2000-01-01

    To describe the usage of emergency medical services (EMS) by children with special health care needs (CSHCN). All EMS runs and related hospital records for children aged 0-17 years in Utah in 1991-92 were linked. The CSHCN status was determined from ICD-9 diagnoses using three available definitions. The amounts of EMS usage were compared between CSHCN and other children. A pediatric intensive care practitioner determined CSHCN status by chart review for 915 children transported by EMS to a pediatric tertiary care hospital, and his classification was compared with the CSHCN status assigned by the three ICD-9-based definitions. The three definitions assigned CSHCN status for 2% to 24% of children using EMS. When compared with other children, CSHCN were more likely to be admitted to the hospital, more likely to use EMS for transfer between health care facilities, and more likely to receive prehospital procedures such as intravenous therapy. In the group of children whose charts were reviewed individually, one ICD-9-based definition most closely agreed to determination of CSHCN status by a pediatric intensive care practitioner. Children with special health care needs who use EMS are more likely to receive advanced life support service, to receive prehospital procedures, and to be transferred from one health care facility to another. There is need for a specific and measurable definition of CSHCN that can be applied to existing health data.

  19. Update on prehospital emergency care of severe trauma patients.

    PubMed

    Tazarourte, K; Cesaréo, E; Sapir, D; Atchabahian, A; Tourtier, J-P; Briole, N; Vigué, B

    2013-01-01

    The prognosis of severe trauma patients is determined by the ability of a healthcare system to provide high intensity therapeutic treatment on the field and to transport patients as quickly as possible to the structure best suited to their condition. Direct admission to a specialized center ("trauma center") reduces the mortality of the most severe trauma at 30 days and one year. Triage in a non-specialized hospital is a major risk of loss of chance and should be avoided whenever possible. Medical dispatching plays a major role in determining patient care. The establishment of a hospital care network is an important issue that is not formalized enough in France. The initial triage of severe trauma patients must be improved to avoid taking patients to hospitals that are not equipped to take care of them. For this purpose, the MGAP score can predict severity and help decide where to transport the patient. However, it does not help predict the need for urgent resuscitation procedures. Hemodynamic management is central to the care of hemorrhagic shock and severe head trauma. Transport helicopter with a physician on board has an important role to allow direct admission to a specialized center in geographical areas that are difficult to access. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  20. Catheter Ablation of Ventricular Tachycardia

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  1. Radiation from Cardiac Imaging Tests

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  2. Stroke Prevention in Atrial Fibrillation

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  3. Characterising the ambient sound environment for infants in intensive care wards.

    PubMed

    Shoemark, Helen; Harcourt, Edward; Arnup, Sarah J; Hunt, Rod W

    2016-04-01

    The purpose of this study is to characterise ambient sound levels of paediatric and neonatal intensive care units in an old and new hospital according to current standards. The sound environment was surveyed for 24-h data collection periods (n = 80) in the Neonatal and Paediatric Intensive Care Units (NICUs and PICUs) and Special Care Nursery of the old and new Royal Children's Hospital Melbourne. The ambient sound environment was characterised as the proportion of time the ongoing ambient sound met standard benchmarks, the mean 5-s sound levels and the number and duration of noise events. In the old hospital, none of the data collection periods in the NICU and PICU met the standard benchmark for ongoing ambient sound, while only 5 of the 22 data collection periods in the new hospital met the recommended level. There was no change in proportion of time at recommended Leq between the old and the new Special Care Nursery. There was strong evidence for a difference in the mean number of events >65 dBA (Lmax ) in the old and new hospital (rate ratio = 0.82, 95% confidence interval: 0.73 to 0.92, P = 0.001). The NICU and PICU were above 50 dBA in 75% of all data collection periods, with ventilatory equipment associated with higher ongoing ambient sound levels. The ongoing ambient sound suggests that the background sound environment of the new hospital is not different to the old hospital. However, there may be a reduction in the number of noise events. © 2016 The Authors Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. The hospital of tomorrow in 10 points.

    PubMed

    Vincent, Jean-Louis; Creteur, Jacques

    2017-04-11

    Technology has advanced rapidly in recent years and is continuing to do so, with associated changes in multiple areas, including hospital structure and function. Here we describe in 10 points our vision of some of the ways in which we see our hospitals, particularly those in developed countries, evolving in the future, including increased specialization, greater use of telemedicine and robots, the changing place of the intensive care unit, improved pre-hospital and post-hospital management, and improved end-of-life care. New technology is going to increasingly impact how we practice medicine. We must learn how best to adapt to and encompass these changes if we are to achieve maximum benefit from them for ourselves and our patients. Importantly, while the future hospital will be more advanced technologically, it will also be more advanced on a personal, humane patient care level.

  5. Boric acid poisoning

    MedlinePlus

    ... effectively treat (adsorb) boric acid. For skin exposure, treatment may include: Surgical removal of burned skin (debridement) Transfer to a hospital that specializes in burn care Washing of the skin (irrigation), possibly every ...

  6. Potassium hydroxide poisoning

    MedlinePlus

    ... effectively treat (adsorb) sodium hydroxide. For skin exposure, treatment may include: Surgical removal of burned skin (debridement) Transfer to a hospital that specializes in burn care Washing of the skin (irrigation), possibly every ...

  7. What to Expect during Cardiac Catheterization

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  8. Legal risks and responsibilities of physicians in the AIDS epidemic.

    PubMed

    Annas, George J

    1988-01-01

    Existing law in the United States applicable to physicians' obligations to treat AIDS and HIV-infected patients is summarized and ways are identified to strengthen current law so that these obligations are more sharply defined. Courts have affirmed an obligation to treat both in limited emergency situations and within the consensual physician patient relationship. Also, physicians may assume contractual obligations to entire groups of patients under employment contracts with hospitals and prepaid health plans and by agreements for Medicare and Medicaid reimbursement. Annas describes antidiscimination statutes as limited in scope and suggests ways to strengthen them. He maintains that physicians have special legal obligations because society has granted them special privileges, and he supports delineation and enforcement of ethical obligations by organized medicine, state licensing boards, hospitals, and medical schools.

  9. Relapse and hospitalization in patients with schizophrenia and bipolar disorder at the St Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a comparative quantitative cross-sectional study.

    PubMed

    Ayano, Getnet; Duko, Bereket

    2017-01-01

    Relapse and hospital admission are common among, and carry a heavy burden in, patients with schizophrenia and bipolar disorder. The aim of this study was to assess the risk of relapse and hospitalizations in patients with schizophrenia and bipolar disorder at the St Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. A hospital-based comparative cross-sectional study was conducted in June 2016. Systematic random sampling technique was used to recruit 521 (260 schizophrenia cases and 261 bipolar disorder cases) study participants. Face-to-face interviews were conducted by trained psychiatry professionals. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and Structured Clinical Interview of DSM-IV (SCID) were used. The risk of relapse and hospitalizations was slightly higher in patients with bipolar disorder than in patients with schizophrenia. A majority of schizophrenic (213 [81.92%]) and bipolar (215 [82.37%]) patients had a history of hospital admission, and 228 (87.69%) schizophrenic and 230 (88.12%) bipolar patients had a history of relapse. Patients who had a history of hospitalizations also had co-occurring substance use disorders compared to those who had no history of hospitalizations for schizophrenia (81.5% vs 37.9%) and bipolar disorder (82.56% vs 38.2%), respectively. Similarly, those patients who had a history of relapse had high comorbid substance use disorders than those who had no history of relapse for both schizophrenia (87.88% vs 47.37%) and bipolar disorder (88.37% vs 47.19%), respectively. It is vital that, in the local context, mental health professionals strengthen their therapeutic relationships with patients and their caregivers. This might enable patients and their caregivers to express their needs and concerns to them, as well as help to plan proper interventions for patients. Attention needs to be given to screening for comorbid substance use disorders in patients with schizophrenia and bipolar disorder, especially in those who have had a history of relapse and hospitalizations.

  10. Differences in resource utilization between patients with diabetes receiving glycemia-targeted specialized nutrition vs standard nutrition formulas in U.S. hospitals.

    PubMed

    Hamdy, Osama; Ernst, Frank R; Baumer, Dorothy; Mustad, Vikkie; Partridge, Jamie; Hegazi, Refaat

    2014-11-01

    The purpose of the study was to compare patient outcomes and costs for patients with diabetes mellitus (DM) receiving glycemia-targeted specialized nutrition (GTSN) with similar patients receiving standard nutrition (STDN) formulas during acute care hospitalizations. The study was designed as a retrospective analysis over a 10-year period (2000-2009) of clinical and cost data from 125,000 hospital inpatient episodes in the Premier Research Database. Patients received either GTSN or STDN, by tube or orally, as a component of comprehensive care for hyperglycemia in patients with DM. To adjust for potential cohort imbalances, GTSN patients were matched with STDN patients on the basis of propensity scores, adjusting for many characteristics, including age, sex, race, All Patient Refined Diagnosis-Related Group (APR-DRG) illness severity, APR-DRG mortality risk, and comorbidities. Tube-fed patients with DM who were provided GTSN had a 0.88-day (95% confidence interval [CI], 0.73-1.02) shorter length of hospital stay (LOS) on average compared with those patients provided STDN. Orally fed patients with DM who were provided GTSN had a 0.17-day (95% CI, 0.14-0.21) shorter LOS than did those patients provided STDN. The shorter LOS associated with GTSN contributed to a cost savings of $2586 for tube-fed patients and $1356 for orally fed patients. The use of GTSN feeding formulas for patients with DM in acute care hospital settings was associated with reduced LOS and inpatient hospital episode cost in comparison to STDN. © 2014 Abbott Nutrition.

  11. A financial planning model for estimating hospital debt capacity.

    PubMed Central

    Hopkins, D S; Heath, D; Levin, P J

    1982-01-01

    A computer-based financial planning model was formulated to measure the impact of a major capital improvement project on the fiscal health of Stanford University Hospital. The model had to be responsive to many variables and easy to use, so as to allow for the testing of numerous alternatives. Special efforts were made to identify the key variables that needed to be presented in the model and to include all known links between capital investment, debt, and hospital operating expenses. Growth in the number of patient days of care was singled out as a major source of uncertainty that would have profound effects on the hospital's finances. Therefore this variable was subjected to special scrutiny in terms of efforts to gauge expected demographic trends and market forces. In addition, alternative base runs of the model were made under three distinct patient-demand assumptions. Use of the model enabled planners at the Stanford University Hospital (a) to determine that a proposed modernization plan was financially feasible under a reasonable (that is, not unduly optimistic) set of assumptions and (b) to examine the major sources of risk. Other than patient demand, these sources were found to be gross revenues per patient, operating costs, and future limitations on government reimbursement programs. When the likely financial consequences of these risks were estimated, both separately and in combination, it was determined that even if two or more assumptions took a somewhat more negative turn than was expected, the hospital would be able to offset adverse consequences by a relatively minor reduction in operating costs. PMID:7111658

  12. [Cost and Revenue Relationship in Orthopaedic and Trauma Surgery Patients in Relation to Body Mass Index].

    PubMed

    Schmelz, Helmut A; Geraedts, Max

    2018-06-14

    Growing numbers of patients in orthopaedic and trauma surgery are obese. The risks involved are e.g. surgical complications, higher costs for longer hospital stays or special operating tables. It is a moot point whether revenues in the German DRG system cover the individual costs in relation to patients' body mass index (BMI) and in which area of hospital care potentially higher costs occur. Data related to BMI, individual costs and revenues were extracted from the hospital information system for 13,833 patients of a large hospital who were operated in 2007 to 2010 on their upper or lower extremities. We analysed differences in cost revenue relations dependent on patients' BMI and surgical site, and differences in the distribution of hospital cost areas in relation to patients' BMI by t and U tests. Individual costs of morbidly obese (BMI ≥ 40) and underweight patients (BMI < 18.5) significantly (p < 0.05) exceeded individual DRG revenues. Significantly higher cost revenue relations were detected for all operations on the lower and upper extremities except for ankle joint surgeries in which arthroscopical procedures predominate. Most of the incremental costs resulted from higher spending for nursing care, medication and special appliances. Costs for doctors and medical ancillary staff did not increase in relation to patients' BMI. To avoid BMI related patient discrimination, supplementary fees to cover extra costs for morbidly obese or underweight patients with upper or lower extremities operations should raise DRG revenues. Moreover, hospitals should be organisationally prepared for these patients. Georg Thieme Verlag KG Stuttgart · New York.

  13. One Family's Journey: Medical Home and the Network of Supports It Offers Children and Youth with Special Healthcare Needs--Medical Homes in Hospital Systems. Part Six

    ERIC Educational Resources Information Center

    Macdonald, Sarah; Hoffman, Alisa; Hagenbach, Tracy; Rusert, Julia

    2008-01-01

    In this 12 installment Medical Home series, "Exceptional Parent" presents a case study about the American Academy of Pediatrics' Medical Home Initiative. A "Medical Home" is not a building but an approach to providing healthcare services to children with special healthcare needs. This sixth part of the Medical Home series describes the experiences…

  14. JMAT 2.0 Operating Room Requirements Estimation Study

    DTIC Science & Technology

    2011-05-25

    Health Research Center 140 Sylvester Rd. San Diego, CA 92106-3521 Report No. 11-10J, supported by the Office of the Assistant...expected-value methodology for estimating OR requirements in a theater hospital; (b) algorithms for estimating a special case OR table requirement...assuming the probabilities of entering the OR are either 1 or 0; and (c) an Excel worksheet that calculates the special case OR table estimates

  15. Hospital morbidity in the Fiji islands with special reference to the saccharine disease.

    PubMed

    Sorokin, M

    1975-08-23

    The concept of the excessive consumption of carbohydrates as a cause of many diseases of civilisation has previously been proposed under the name of the 'saccharine disease'. A review of the hospital morbidity figures for these diseases in a divisional hospital in the Fiji Islands is presented. The hospital serves a population comprised of Indians and Fijians, suggesting comparison with the province of Natal, South Africa. Indians have a higher incidence of diabetes melitus, myocardial infarction, duodenal ulcer, acute appendicitis, gallstones, renal stones and eclampsia. Their diets differ mainly in the higher consumption of refined fibre-depleted carbohydrates, and it is suggested that the association is compatible with the concept of the "saccharine disease".

  16. 32 CFR 220.10 - Special rules for Medicare supplemental plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... Medicare-certified hospital. (c) Charges for Healthcare services other than inpatient deductible amount. (1...

  17. 32 CFR 220.10 - Special rules for Medicare supplemental plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... Medicare-certified hospital. (c) Charges for Healthcare services other than inpatient deductible amount. (1...

  18. 32 CFR 220.10 - Special rules for Medicare supplemental plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... Medicare-certified hospital. (c) Charges for Healthcare services other than inpatient deductible amount. (1...

  19. 32 CFR 220.10 - Special rules for Medicare supplemental plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... Medicare-certified hospital. (c) Charges for Healthcare services other than inpatient deductible amount. (1...

  20. 32 CFR 220.10 - Special rules for Medicare supplemental plans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE... Medicare-certified hospital. (c) Charges for Healthcare services other than inpatient deductible amount. (1...

  1. Renovation and Expansion of the Caspary Research Building. Final Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Grassia, V. L.

    2004-02-07

    Critical to the Hospital's rebuilding efforts have been its public partners at the federal, state, and local government levels who have made a major financial commitment to renovating the Hospital's research infrastructure. To date, the Hospital for Special Surgery (HSS) has been awarded a total of nearly $8.5 million to create and equip new, state-of-the-art laboratories for scientific investigations. The modernization of the Hospital's research facilities was jump-started in 1998 with a $950,000 seed grant from the National Institutes of Health (NIH) to renovate laboratories for immunology research in the Caspary Research Building. Coupled with a matching $5.5 million commitmentmore » from HSS, this infusion of NIH funding laid the groundwork for an overhaul of all of the Hospital's research space.« less

  2. End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

    PubMed Central

    Klein, M S; Ross, F

    1997-01-01

    Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations. PMID:9285126

  3. Making the invisible, visible.

    PubMed

    Warner, H K

    2000-01-01

    Special needs children experience all the difficulties experienced by any child admitted to hospital although these are hugely magnified. Parents continue to carry the burden of care, even after hospital admission, when their child has complex needs. Nurses need to remember that these children have all the needs of any child in addition to needs specific to their disability. Nurses should focus what the child can do, rather than what they cannot do.

  4. COP - Pet Owners - What is Comparative Oncology | Center for Cancer Research

    Cancer.gov

    What is Comparative Oncology? Cancer, in the pet population, is a spontaneous disease. Pet owners, motivated by the desire to prolong their animals' quality of life, frequently seek out the specialized care and treatment of veterinary oncologists at private referral veterinary hospitals and veterinary teaching hospitals across the country. Therapeutic modalities for veterinary cancer patients are similar to those for humans, including surgery, chemotherapy, radiation therapy, and biotherapy.

  5. Predicting Resource Needs for Multiple and Mass Casualty Events in Combat: Lessons Learned From Combat Support Hospital Experience in Operation Iraqi Freedom

    DTIC Science & Technology

    2009-04-01

    from rocket attack near a forward operating base (Photo courtesy of Tommy A. Brown). Predicting Resource Needs for Mass Casualty in Combat Volume 66...combat support hospital. J Trauma 2008; 64(2 suppl):S79–S85. 19. Wedmore I, McManus JG, Pusateri AE, et al. A special report on the chitosan -based

  6. [Communication center in public health].

    PubMed

    George, W; Grimminger, F; Krause, B

    2002-06-01

    The Communications Center's portfolio covers areas such as marketing, contacts, distribution of information, sales activities and collection of bills by telephone (encashment). A special emphasis is Customer Care Management (Customer Relationship Management) to the patient and his caregivers (relatives), the customers, especially the physicians who send their patients to the hospital and the hospital doctor. By providing communication centers, the hospital would be able to improve the communication with the G.P.s, and identify the wishes and requirements more accurately and easily from the beginning. Dealing effectively with information and communication is already also of special importance for hospital doctors today. One can assume that the demands on doctors in this respect will become even more complex in the future. Doctors who are involved in scientific research are of course fully aware of the growing importance of the Internet with its new information and communication channels. Therefore analysing the current situation, the demands on a future information management system can be formulated: A system that will help doctors to avoid dealing with little goal-oriented information and thus setting up effective communication channels; an information system which is multi-media oriented towards the interests and needs of the patients and patient's relatives and which is further developed continually and directly by those involved.

  7. Telehealth among US hospitals: several factors, including state reimbursement and licensure policies, influence adoption.

    PubMed

    Adler-Milstein, Julia; Kvedar, Joseph; Bates, David W

    2014-02-01

    Telehealth is widely believed to hold great potential to improve access to, and increase the value of, health care. Gaining a better understanding of why some hospitals adopt telehealth technologies while others do not is critically important. We examined factors associated with telehealth adoption among US hospitals. Data from the Information Technology Supplement to the American Hospital Association's 2012 annual survey of acute care hospitals show that 42 percent of US hospitals have telehealth capabilities. Hospitals more likely to have telehealth capabilities are teaching hospitals, those equipped with additional advanced medical technology, those that are members of a larger system, and those that are nonprofit institutions. Rates of hospital telehealth adoption by state vary substantially and are associated with differences in state policy. Policies that promote private payer reimbursement for telehealth are associated with greater likelihood of telehealth adoption, while policies that require out-of-state providers to have a special license to provide telehealth services reduce the likelihood of adoption. Our findings suggest steps that policy makers can take to achieve greater adoption of telehealth by hospitals.

  8. Exploring interhospital transfers and partnerships in the hospital sector in New South Wales, Australia.

    PubMed

    Assareh, Hassan; Achat, Helen M; Levesque, Jean-Frederic; Leeder, Stephen R

    2017-12-01

    Objective The aim of the present study was to explore characteristics of interhospital transfers (IHT) and sharing of care among hospitals in New South Wales (NSW), Australia. Methods Data were extracted from patient-level linked hospital administrative datasets for separations from all NSW acute care hospitals from 1 July 2013 to 30 June 2015. Patient discharge and arrival information was used to identify IHTs. Characteristics of patients and related hospitals were then analysed. Results Transfer-in patients accounted for 3.9% of all NSW admitted patients and, overall, 7.3% of NSW admissions were associated with transfers (IHT rate). Patients with injuries and circulatory system diseases had the highest IHT rate, accounting for one-third of all IHTs. Patients were more often transferred to larger than smaller hospitals (61% vs 29%). Compared with private hospitals, public hospitals had a higher IHT rate (8.4% vs 5.1%) and a greater proportion of transfer-out IHTs (52% vs 28%). Larger public hospitals had lower IHT rates (3-8%) compared with smaller public hospitals (13-26%). Larger public hospitals received and retransferred higher proportions of IHT patients (52-58% and 11% respectively) than their smaller counterparts (26-30% and 2-3% respectively). Less than one-quarter of IHTs were between the public and private sectors or between government health regions. The number of interacting hospitals and their interactions varied across hospital peer groups. Conclusion NSW IHTs were often to hospitals with greater speciality services. The patterns of interhospital interactions could be affected by organisational and regional preferences. What is known about the topic? IHTs aim to provide efficient and effective care. Nonetheless, information on transfers and the sharing of care among hospitals in an Australian setting is lacking. Studies of transfers and hospital partnership patterns will inform efforts to improve patient-centred transfers and hospital accountability in terms of end outcomes for patients. What does this paper add? Transfer-in patients accounted for 3.9% of all NSW admissions; they were often (61%) transferred to hospitals with greater speciality services. The number of IHTs and sharing of care among hospitals varied across hospital peer groups, and could have been affected by organisational and regional preferences. What are the implications for practitioners? The findings of the present study suggest that different patterns of IHTs may not only have resulted from clinical priorities, but that organisational and regional preferences are also likely to be influential factors. Patient-centred IHTs and the development of guidelines need to be pursued to enhance the care and functionality of healthcare. Patient sharing should be acknowledged in hospital and regional performance profiling.

  9. Infant test/procedure preparation

    MedlinePlus

    ... care. Crying is a normal response to the strange environment, unfamiliar people, restraints, and separation from you. ... opening the mouth. Many children's hospitals have child life specialists who are specially trained to educate patients ...

  10. Self-Care Guide for the Heart Failure Patient

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  11. Coronary Artery Revascularization in Patients with Diabetes Mellitus

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  12. Screening for Critical Congenital Heart Disease in Newborns

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  13. 38 CFR 43.4 - Applicability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... State and local hospitals. (2) The block grants authorized by the Omnibus Budget Reconciliation Act of...) Entitlement grants under the following programs of The Child Nutrition Act of 1966: (i) Special Milk (section...

  14. Drain cleaner poisoning

    MedlinePlus

    ... may include: Surgical removal of burned skin (debridement) Transfer to a hospital that specializes in burn care ... Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  15. Health Facilities

    MedlinePlus

    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, ... psychiatric care centers. When you choose a health facility, you might want to consider How close it ...

  16. Descriptive study of the Specialized Care of the Spanish Health System.

    PubMed

    Nombela-Monterroso, Karen; González-Chordá, Víctor M; Roman, Pablo

    2018-02-05

    The objective of this study is to analyze the trend of the Key Indicators of the National Health System of Spain and its autonomous communities, related to Specialized Care, from the publication of the Law of Cohesion and Quality. This is an ecological study of temporary series of Spain and its autonomous communities from 2003 to 2014. We have analyzed 10 indicators related to Specialized Care (percentage of expenditure, professionals, waiting lists, surgical activity, average duration, infections, and mortality) using the Prais-Winsten regression method. We have obtained data from the health information system of the Spanish Ministry of Health, Social Services, and Equality. Specialized care expenditure (APC = 0.059, 95%CI 0.041-0.074), number of medical professionals (APC = 0.0006, 95%CI 0.0003-0.0009) and nursing professionals (APC = 0.001, 95%CI 0.0005-0.0016), hospital infections (APC = 0.0003, 95%CI 0.0002-0.0004), and in-hospital mortality (APC = 0.0008, 95%CI 0.0006-0.001) had an increasing trend in Spain. Average duration presented a decreasing trend (APC = -0.0017, 95%CI -0.002- -0.0014). The trend of waiting lists (specialized appointment and non-urgent surgical interventions) was static. The trend of these indicators varied in the Autonomous Communities. We have observed a non-compliance with the principles of equity and quality of the services offered. Increased aging, technological development, and inadequate strategies taken to reduce health costs may be the main causes.

  17. Benefits of early specialized nutritional support in malnourished patients.

    PubMed

    Morán López, Jesús Manuel; Beneítez Moralejo, Belén; Piedra León, María; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio

    2017-04-07

    Disease related malnutrition (DRM) is highly prevalent in Spain, affecting 23% of in-hospital patients, and is associated with clinical complications. Specialized nutritional support (SNS) can reduce these complications. Prospective study carried out in standard clinical practice conditions to test if SNS during the first 5 days of hospitalization, or subsequently, was associated to a lower length of stay or reduced complications in patients with a NRS-2002 score≥3 points. In the group of patients who initiated early SNS, the length of stay was 8.83 days shorter than in the group with a later introduction (95% CI 3.55-14.10); nevertheless, the higher prevalence of male and oncological patients in this group could have impacted the results. A tendency towards a statistically significant lower mortality rate and a reduced amount of total complications was described. The early introduction of SNS (within the first 5 days of hospitalization) in patients with DRM was associated with a 32.4% reduction in the length of stay. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  18. Development of pediatric emergency medicine at Addis Ababa University/Tikuranbessa Specialized Hospital, Ethiopia.

    PubMed

    Tefera, Muluwork; Bacha, Tigist; Butteris, Sabrina; Teshome, Getachew; Ross, Joshua; Hagen, Scott; Svenson, Jim; Busse, Heidi; Tefera, Girma

    2014-07-01

    In the world emergencies occur everywhere, and each day they consume ressources regardless of whether there are systems capable of achieving good outcomes. Low-income countries suffer the most highest rates of every category of injury--from traffic and the highest rates of acute complications of communicable diseases including tuberculosis, malaria and HIV. To describe the development of pediatrics emergency medicine at Tikur Anbesa Specialized Hospital A twinning partnership model was used in developing a pediatric emergency medicine training program helps in development of pediatrics emergency system. Strengthening the capacity of Addis Ababa University (AAU), Tikur Anbessa Hospital (TASH) to provide pediatric emergency medical services through improved organization of the pediatrics emergency department and strengthening of continuing education opportunities for faculty and staff capacity building by this improving quality of care in pediatrics patients in the country. The Addis Ababa University, University of Wiscosin and People to People partners intend to continue working together to strengthening and developing effetive systems to deliver quality pediatrics emergency medicine care troughout all regions of Ethiopia.

  19. A Hybrid Approach Using Case-Based Reasoning and Rule-Based Reasoning to Support Cancer Diagnosis: A Pilot Study.

    PubMed

    Saraiva, Renata M; Bezerra, João; Perkusich, Mirko; Almeida, Hyggo; Siebra, Clauirton

    2015-01-01

    Recently there has been an increasing interest in applying information technology to support the diagnosis of diseases such as cancer. In this paper, we present a hybrid approach using case-based reasoning (CBR) and rule-based reasoning (RBR) to support cancer diagnosis. We used symptoms, signs, and personal information from patients as inputs to our model. To form specialized diagnoses, we used rules to define the input factors' importance according to the patient's characteristics. The model's output presents the probability of the patient having a type of cancer. To carry out this research, we had the approval of the ethics committee at Napoleão Laureano Hospital, in João Pessoa, Brazil. To define our model's cases, we collected real patient data at Napoleão Laureano Hospital. To define our model's rules and weights, we researched specialized literature and interviewed health professional. To validate our model, we used K-fold cross validation with the data collected at Napoleão Laureano Hospital. The results showed that our approach is an effective CBR system to diagnose cancer.

  20. Prescription for concern.

    PubMed

    Haugh, Richard; Thrall, Terese Hudson; Scalise, Dagmara

    2002-02-01

    As U.S. medical care relies more heavily on prescription drugs, hospitals are caught in an increasingly painful situation. Shortages of critical pharmaceuticals often leave hospitals empty-handed and, according to clinicians, endanger patient safety. Soaring drug costs account for a huge proportion of burgeoning health care spending, and strategies to control costs, including pharmacy benefit managers and drug discount cards for seniors, so far have had limited or negligible success. Direct-to-consumer advertising has increased demand for expensive--and according to some experts, unnecessary or inappropriate--prescription drugs. In this special report H&HN examines the pressures that these factors put on hospitals.

  1. NASA Sponsors Cancer Research at Children's Hospital

    NASA Technical Reports Server (NTRS)

    1998-01-01

    NASA Administrator Dan Goldin (left), during a visit at Children's Hospital of Wisconsin in Milwaukee, Wisconsin, discussed how NASA's special lighting technology may soon treat cancer. Goldin talked with Dr.Harry Whelan (right) and Dr. Kerneth Reichert (center left), both pediatric neurologists with the Hospital and professors at the Medical College of Wisconsin in Milwaukee. Accompanied by Astronaut Mary Ellen Weber, Goldin was shown this innovative treatment, called Photodynamic Therapy, a method used to destroy the tumor without damaging the delicate brain tissue around it. The treatment uses tiny pinhead-size Light Emitting Diodes (LEDs) developed for Space Product Development plant growth experiments.

  2. The role of the trauma nurse leader in a pediatric trauma center.

    PubMed

    Wurster, Lee Ann; Coffey, Carla; Haley, Kathy; Covert, Julia

    2009-01-01

    The trauma nurse leader role was developed by a group of trauma surgeons, hospital administrators, and emergency department and trauma leaders at Nationwide Children's Hospital who recognized the need for the development of a core group of nurses who provided expert trauma care. The intent was to provide an experienced group of nurses who could identify and resolve issues in the trauma room. Through increased education, exposure, mentoring, and professional development, the trauma nurse leader role has become an essential part of the specialized pediatric trauma care provided at Nationwide Children's Hospital.

  3. Preferred Provider Organization (PPO) Plans

    MedlinePlus

    ... Find & compare doctors, hospitals, & other providers Preferred Provider Organization (PPO) Plans How PPO Plans Work A Medicare ... extra for these benefits. Related Resources Health Maintenance Organization (HMO) Private Fee-for-Service (PFFS) Special Needs ...

  4. Health Maintenance Organization (HMO) Plan

    MedlinePlus

    ... Find & compare doctors, hospitals, & other providers Health Maintenance Organization (HMO) Plan In most HMO Plans, you generally ... certain service when needed. Related Resources Preferred Provider Organization (PPO) Private Fee-for-Service (PFFS) Special Needs ...

  5. 15 CFR 24.4 - Applicability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... local hospitals. (2) The block grants authorized by the Omnibus Budget Reconciliation Act of 1981... under the following programs of The Child Nutrition Act of 1966: (i) Special Milk (section 3 of the Act...

  6. 13 CFR 143.4 - Applicability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... local hospitals. (2) The block grants authorized by the Omnibus Budget Reconciliation Act of 1981... under the following programs of The Child Nutrition Act of 1966: (i) Special Milk (section 3 of the Act...

  7. Journal of Special Operations Medicine. Training Supplement to Fall 2008. Tactics, Techniques, and Procedures

    DTIC Science & Technology

    2008-01-01

    Special Operations Medicine Staphylococcus, E. coli, and alimentary tract anaerobes (AI). Initial antibacterial activity should not be directed at multidrug... active service. 6. Hospital ships (T-AH) may provide support to major amphibious operations or be designated as a theater-level 3 support capability...USSOCOM is actively engaged in the JLLP, where the goal is to improve interoperability between all LL centers in the community of practice to enhance

  8. Special effects.

    PubMed

    Davis, Carol

    The nursing team on the day case ward at Alder Hey Hospital has introduced changes to the environment to help children with special needs, who often attend the ward repeatedly. Small changes, such as keeping colours on the ward neutral, can help children relax. Nurses contact parents a week before admission to find out about their child's likes and dislikes. Parents are encouraged to bring a child's favourite items with them. Operating sessions are scheduled to meet these children's needs.

  9. Social work role in developing and managing employee assistance programs in health care settings.

    PubMed

    Foster, Z; Hirsch, S; Zaske, K

    1991-01-01

    The hospital setting presents special needs for an Employee Assistance Program and special complications for sponsorship, development, and maintenance. What has been learned, how certain problems can be solved or avoided, how responsibility and accountability can be negotiated are presented by a team that has successfully established such a program at a large metropolitan medical center. In addition to successes, some unsolved problems are identified for further study.

  10. 42 CFR 412.92 - Special treatment: Sole community hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the circumstances under which the classification was approved. (c) Terminology. As used in this....106 and for indirect medical education costs as determined under § 412.105). (i) In determining the...

  11. What You Need to Know If You Have Coronary Artery Disease

    MedlinePlus

    ... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

  12. Children with Special Health Care Needs

    MedlinePlus

    ... to the Hospital Heroes On Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns ... to all caregivers of children, such as babysitters, teachers, and school nurses. Resources Emergency Care For You ...

  13. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... medicine or osteopathy, psychiatric services for the diagnosis and treatment of mentally ill persons; (b... determine the degree and intensity of treatment furnished to Medicare beneficiaries, as specified in § 482...

  14. 42 CFR 412.92 - Special treatment: Sole community hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the circumstances under which the classification was approved. (c) Terminology. As used in this....106 and for indirect medical education costs as determined under § 412.105). (i) In determining the...

  15. Does specialization improve outcome in abdominal aortic aneurysm surgery?

    PubMed

    Rosenthal, Rachel; von Känel, Oliver; Eugster, Thomas; Stierli, Peter; Gürke, Lorenz

    2005-01-01

    Specialization and high volume are reported to be related to a better outcome after abdominal aortic aneurysm repair. The aim of this study was to compare, in patients undergoing abdominal aortic aneurysm repair, the outcomes of those whose surgery was done by general surgeons with the outcomes of those whose surgery was done by specialist vascular surgeons. All patients undergoing abdominal aortic aneurysm repair at the Basel University Hospital (referral center) from January 1990 to December 2000 were included. Patients with endovascular treatment were excluded. Operations in group A (n = 189), between January 1990 and May 1995, were done by general surgeons. Operations in group B (n = 291), between June 1995 and December 2000, were done by vascular surgeons. In-hospital mortality and local and systemic complications were assessed. In-hospital mortality rates were significantly lower for group B (with specialist surgeons) than for group A, both overall (group B, 11.7%; group A, 21.7%; p = .003) and for emergency interventions (group B, 28.1%; group A, 41.9%; p = .042). The reduction in mortality for elective surgery in group B was not statistically significant (group B, 1.1%; group A, 4.9%; p = .054). There were significantly fewer pulmonary complications in group B compared with group A (p = .000). We conclude that in patients undergoing abdominal aortic aneurysm repair, those whose surgery is done by a specialized team have a significantly better outcome than those whose surgery is done by general surgeons.

  16. Residents' willingness-to-pay for attributes of rural health care facilities.

    PubMed

    Allen, James E; Davis, Alison F; Hu, Wuyang; Owusu-Amankwah, Emmanuel

    2015-01-01

    As today's rural hospitals have struggled with financial sustainability for the past 2 decades, it is critical to understand their value relative to alternatives, such as rural health clinics and private practices. To estimate the willingness-to-pay for specific attributes of rural health care facilities in rural Kentucky to determine which services and operational characteristics are most valued by rural residents. We fitted choice experiment data from 769 respondents in 10 rural Kentucky counties to a conditional logit model and used the results to estimate willingness-to-pay for attributes in several categories, including hours open, types of insurance accepted, and availability of health care professionals and specialized care. Acceptance of Medicaid/Medicare with use of a sliding fee scale versus acceptance of only private insurance was the most valued attribute. Presence of full diagnostic services, an emergency room, and 24-hour/7-day-per-week access were also highly valued. Conversely, the presence of specialized care, such as physical therapy, cancer care, or dialysis, was not valued. In total, respondents were willing to pay $225 more annually to support a hospital relative to a rural health clinic. Rural Kentuckians value the services, convenience, and security that rural hospitals offer, though they are not willing to pay more for specialized care that may be available in larger medical treatment centers. The results also inform which attributes might be added to existing rural health facilities to make them more valuable to local residents. © 2014 National Rural Health Association.

  17. Setting up psychiatric services: cross-cultural issues in planning and delivery.

    PubMed

    Bhugra, D

    1997-01-01

    There is convincing evidence that in the UK, various ethnic minorities are over-represented in psychiatric hospitals, prisons and special hospitals. Various explanations have been put forward for this picture. The expanding emphasis on community care means that models for looking after ethnic communities should be innovative and work from a bottom-up approach. Psychiatric emphasis on clinical diagnoses means that services are developed according to the diagnoses rather than needs.

  18. Laser Journal (Selected Articles),

    DTIC Science & Technology

    1982-09-10

    temperature CO2 branch selection laser with a lifetime already exceeding 6500 hours which may be even longer. HIGH POWER LONG LIFE HeCd LASER Qu Shipu...method of plating single crystal gold film in a vacuum with the foreign material extension method. First mica is used as the substrate. Then a special...Hospital) Chen Zhasping Zhou Yiping et al (Eye, Ear, Nose, Throat Hospital, Examination Department, Shanghai Medical School Number 1.) Qu Zhipu et al

  19. A Visitor Control Policy for Martin Army Hospital,

    DTIC Science & Technology

    1978-04-05

    gathered at York Hospital resulted in the limitation of two visitors per patient at one time. This was not an arbitrary decision by management but...management is required to receive input from the consumer on many management decisions . Even discounting the above, the patient was felt to be a logical...proximity of the parking areas to the primary entrances, no additional staff entrances ,4 are needed, therefore no special locking devices for any auxillary

  20. [Brief history of the First Hospital of Harbin City (1913-2013)].

    PubMed

    Ji, Y; Li, Z P

    2017-03-28

    In 1913, after the Russian Prostitutes Sanatorium of Harbin Eastern Railway was received by the board of directors, they established the "Harbin City Board Hospital" and funded its expansion. In March 1926, the provisional Committee of the Harbin autonomous renamed the "City Board of First Hospital" to "The Public Hospital" . In November 1926, "The Public Hospital" was renamed as "Harbin Special Municipal Hospital" by the Harbin City Council and further funds were invested in its construction. In 1931, the Japanese invaded Northeast China, and controlled the "City Hospital" . In 1946, when Harbin was liberated, after the Communist's take-over of the Hospital, it developed sustainedly since then. From 1946-1949, The First Hospital of Harbin City dispatched manpower, material resources, and financial resources to support the people's Liberation Army, establishedthe medical service team, received and treated the wounded. From the 1930s, the Hospital was involved in the treatment of cholera, plague, scarlet fever, typhus and other infectious diseases, and participated in the medical rescue in Wenchuan of Sichuan and Xinjiang Aletai area. From 1928, the Hospital took over from Binjiang Hospital as the Teaching Hospital of Harbin Medical School, and later became the Harbin Medical University Teaching Hospital. It made contribution to the training of medical students.

  1. A tale of two cultures: examining patient-centered care in a forensic mental health hospital

    PubMed Central

    Livingston, James D.; Nijdam-Jones, Alicia; Brink, Johann

    2012-01-01

    Several questions remain unanswered regarding the extent to which the principles and practices of patient-centered care are achievable in the context of a forensic mental health hospital. This study examined patient-centered care from the perspectives of patients and providers in a forensic mental health hospital. Patient-centered care was assessed using several measures of complementary constructs. Interviews were conducted with 30 patients and surveys were completed by 28 service providers in a forensic mental health hospital. Patients and providers shared similar views of the therapeutic milieu and recovery orientation of services; however, providers were more likely to perceive the hospital as being potentially unsafe. Overall, the findings indicated that characteristics of patient-centered care may be found within a forensic mental health hospital. The principles of patient-centered care can be integrated into service delivery in forensic mental health hospitals, though special attention to providers’ perceptions of safety is needed. PMID:22815648

  2. Impact of Hospital Information Systems on Emergency Patient Processing

    PubMed Central

    Rusnak, James E.

    1981-01-01

    The Emergency Department offers the Hospital Information System's designer some unique problems to solve in the operational areas of patient registration, order entry, charge recording, and treatment processing. In a number of instances, Hospital Information Systems implementers have encountered serious difficulties in trying to design system components to support the requirements of the Emergency Services Department's operations. Washington Hospital has developed a very effective system for Emergency Services. The system's features are designed to meet the special requirements of the department and to maximize the use of the data captured by the Hospital Information System. The system supports accurate and timely charging for services. The treatment of the patient has been dramatically improved through the use of a computerized order processing and control. The installed systems resulted in a higher quality of care and cost effective operations.

  3. [Neuropathological research on organs of patients of the "Heil- und pflegeanstalt" (state hospital) Günzburg].

    PubMed

    Steger, F; Strube, W; Becker, T

    2011-03-31

    The two Kaiser Wilhelm-Institutes (KWI) in Berlin (1914, new building 1931) and in Munich (1917, new building 1926-28), specialized on pathologic anatomical as well as psychiatric genetic research, were set up before times of National Socialism. Data evaluation is based on patient documents and annual reports of the archive of today's district hospital Günzburg and on patient documents (copies) of the historical archive of today's Max-Planck Institute of Psychiatry. The KWI in Munich was indirectly provided with brain material by Bavarian "Heil- und Pflegeanstalten" (state hospitals) including the state hospital Günzburg. During National Socialism patients' organs were sent from the "Heil- und Pflegeanstalt" (state hospital) Günzburg to the KWI in Munich for the purpose of conducting research. Commemorating patients' fates and clarifying what happened defines a place of remembrance.

  4. [Central interdisciplinary emergency department. Organization of emergency medicine from the perspective of hospital management].

    PubMed

    Mayer, U; Debatin, J F

    2011-04-01

    The treatment of emergencies in a hospital should be organized in a central interdisciplinary emergency department (ER). It is the main entrance for all patients with acute illness or injuries. There are multiple advantages of such a central unit. Quality of treatment and economic efficiency is improved. The interdisciplinary diagnostics and treatment at one place prevents time-consuming and unnecessary transport. The fact that more complex diseases and injuries need specialized doctors in specific disciplines should be considered in personnel planning of the ER. To reinsure that the entire medical staff of the hospital is familiar with the daily routine and clinical pathways of the ER, doctors from other departments of the hospital should always be part of the ER team.

  5. Good practices in health care "management experimentation models": insights from an international public-private partnership on transplantation and advanced specialized therapies.

    PubMed

    Longo, Maria Cristina

    2015-01-01

    The research analyzes good practices in health care "management experimentation models," which fall within the broader range of the integrative public-private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the "management experimentation models" are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations. In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC - Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies. The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable. The recognition of ISMETT's good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

  6. Aquapheresis Versus Intravenous Diuretics and Hospitalizations for Heart Failure.

    PubMed

    Costanzo, Maria Rosa; Negoianu, Daniel; Jaski, Brian E; Bart, Bradley A; Heywood, James T; Anand, Inder S; Smelser, James M; Kaneshige, Alan M; Chomsky, Don B; Adler, Eric D; Haas, Garrie J; Watts, James A; Nabut, Jose L; Schollmeyer, Michael P; Fonarow, Gregg C

    2016-02-01

    The AVOID-HF (Aquapheresis versus Intravenous Diuretics and Hospitalization for Heart Failure) trial tested the hypothesis that patients hospitalized for HF treated with adjustable ultrafiltration (AUF) would have a longer time to first HF event within 90 days after hospital discharge than those receiving adjustable intravenous loop diuretics (ALD). Congestion in hospitalized heart failure (HF) patients portends unfavorable outcomes. The AVOID-HF trial, designed as a multicenter, 1-to-1 randomized study of 810 hospitalized HF patients, was terminated unilaterally and prematurely by the sponsor (Baxter Healthcare, Deerfield, Illinois) after enrollment of 224 patients (27.5%). Aquadex FlexFlow System (Baxter Healthcare) was used for AUF. A Clinical Events Committee, blinded to the randomized treatment, adjudicated whether 90-day events were due to HF. A total of 110 patients were randomized to AUF and 114 to ALD. Baseline characteristics were similar. Estimated days to first HF event for the AUF and ALD group were, respectively, 62 and 34 (p = 0.106). At 30 days, compared with the ALD group, the AUF group had fewer HF and cardiovascular events. Renal function changes were similar. More AUF patients experienced an adverse effect of special interest (p = 0.018) and a serious study product-related adverse event (p = 0.026). The 90-day mortality was similar. Compared with the ALD group, the AUF group trended toward a longer time to first HF event within 90 days and fewer HF and cardiovascular events. More patients in the AUF group experienced special interest or serious product-related adverse event. Due to the trial's untimely termination, additional AUF investigation is warranted. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis.

    PubMed

    Kalhor, Rohollah; Amini, Saeed; Sokhanvar, Mobin; Lotfi, Farhad; Sharifi, Marziye; Kakemam, Edris

    2016-03-01

    Restrictions on resource accessibility and its optimal application is the main challenge in organizations nowadays. The aim of this research was to study the technical efficiency and its related factors in Tehran general hospitals. This descriptive analytical study was conducted retrospectively in 2014. Fifty-four hospitals with private, university, and social security ownerships from the total 110 general hospitals were randomly selected for inclusion into this study on the basis of the share of ownership. Data were collected using a checklist with three sections, including background variables, inputs, and outputs. Seventeen (31.48%) hospitals had an efficiency score of 1 (highest efficiency score). The highest average efficiency score was in social security hospitals (84.32). Private and university hospitals ranked next with an average of 84.29 and 79.64, respectively. Analytical results showed that there was a significant relationship between hospital ownership, hospital type in terms of duty and specialization, educational field of the chief executive officer, and technical efficiency. There was no significant relationship between education level of hospital manager and technical efficiency. Most of the studied hospitals were operating at low efficiency. Therefore, policymakers should plan to improve the hospital operations and promote hospitals to an optimal level of efficiency.

  8. 42 CFR 412.92 - Special treatment: Sole community hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... was approved. (c) Terminology. As used in this section— (1) The term miles means the shortest distance... low-income patients as determined under § 412.106 and for indirect medical education costs as...

  9. 42 CFR 412.92 - Special treatment: Sole community hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... was approved. (c) Terminology. As used in this section— (1) The term miles means the shortest distance... low-income patients as determined under § 412.106 and for indirect medical education costs as...

  10. 42 CFR 412.92 - Special treatment: Sole community hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... was approved. (c) Terminology. As used in this section— (1) The term miles means the shortest distance... low-income patients as determined under § 412.106 and for indirect medical education costs as...

  11. 42 CFR 424.124 - Conditions for payment for physician services and ambulance services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Special... connection with covered inpatient hospital services; and (2) They meet the conditions set forth in paragraphs...

  12. 42 CFR 424.124 - Conditions for payment for physician services and ambulance services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Special... connection with covered inpatient hospital services; and (2) They meet the conditions set forth in paragraphs...

  13. American hospitals react to terrorist attacks with determination.

    PubMed

    Rees, T

    2001-01-01

    In this timely special section, editor Tom Rees recounts some of the swift, supportive actions health care providers took in response to the Sept. 11 terrorist attacks on the World Trade Center and the Pentagon.

  14. 29 CFR 779.381 - Establishments within special exceptions or exemptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... exceptions provided in the 1961 amendments for hotels, motels, restaurants, hospitals, institutions for the..., motels, and restaurants continue to be eligible for exemption under section 13(a)(2), but must meet all...

  15. Rich anniversary book honors 'The city that doctors built'.

    PubMed

    Botvin, Judith D

    2005-01-01

    Medical City, Dallas, celebrated its 30th anniversary with a special edition of its internal publication. Called "The City That Doctors Built," the substantial book honors the physicians that people this unique specialty hospital.

  16. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...— (i) A substantiated diagnosis; (ii) Short-term and long-range goals; (iii) The specific treatment...) Describe attitudes and behavior; (6) Estimate intellectual functioning, memory functioning, and orientation...

  17. Injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia: a prospective hospital based study.

    PubMed

    Seid, Mohammed; Azazh, Aklilu; Enquselassie, Fikre; Yisma, Engida

    2015-05-20

    Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world's roads, and the risk of dying as a result of a road traffic injury is highest in Africa. A prospective hospital based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 20.0. Hierarchical multiple regression analysis was used to identify predictors of fatalities among the road traffic crash victims. A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims' ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4%. Hierarchical multiple regression analysis showed that age of the victims (ß = 0.16, p < 0.05), systolic blood pressure on admission (ß = -0.35, p < 0.001) and Glasgow coma scale (ß = -0.44, p < 0.001) were statistically significant predictors of fatalities among the victims. This study showed diverse injury characteristics and high morbidity and mortality among the victims attending Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. The findings reflect that road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

  18. [Further challenges in collaboration and cross-specialization work in psychiatric services].

    PubMed

    Sakano, Yuji; Nakamura, Touru; Nakajima, Kimihiro

    2011-01-01

    Using a case illustrating cognitive behavioral treatment for a patient with obsessive-compulsive disorder, clinical tips and challenges are described in the context of collaboration between multiple health professionals from different backgrounds in a psychiatric hospital. Furthermore, after reviewing the current status of education and training issues related to collaboration, and introducing the fundamental concept of cross-specialization work, existing tasks and future challenges involved in the education and training of multiple health professions are discussed.

  19. THE Rh FACTOR IN RURAL PRACTICE—Responsibility of the General Practitioner

    PubMed Central

    Dennis, James L.

    1951-01-01

    As the incidence of erythroblastosis fetalis is as high in rural as in urban areas, it behooves physicians in rural areas to anticipate the disease, to make special antepartum studies to determine the Rh status of obstetrical patients, and to be prepared to treat the affected baby if the aid of a specialist and special facilities are not obtainable. Exchange transfusions have been carried out, by means described, in a small rural hospital. PMID:14886745

  20. Overview of rehabilitative efforts in understanding and managing sexually coercive behaviors.

    PubMed

    Schwartz, Barbara K

    2003-06-01

    In reviewing approaches to rehabilitative efforts in understanding and managing sexually coercive behaviors within the past two decades, one is struck by the development of two totally divergent paths. In 1971, there were a few civil commitment programs operated by mental health departments-most notably were the Sexual Psychopath Program at Western State Hospital in Fort Steilacoom, Washington, and the Massachusetts Treatment Center for Sexually Dangerous Persons. There were a few programs in prisons started by therapists who were interested in this population but given little recognition and even fewer resources. Additionally there were a handful of community-based programs including the J.J. Peters Institute in Philadelphia and PASO (Positive Approaches to Sex Offenders) in Albuquerque, New Mexico. Today there are thousands of specialized sexual offender treatment programs treating sexual abusers of every age, gender, ethnicity, and with a wide range of comorbid conditions. They are treated in the community, prisons, mental hospitals, residential facilities, and private practices. There is an international organization, a specialized research journal, and a specialized branch of the Department of Justice, the Center for Sex Offender Management. This chapter will provide an overview of the developments in the field, primarily covering the last 25 years. It will look at the evolution of theoretical approaches, the development of specialized approaches for subpopulations, significant landmarks, and possible future trends.

  1. Prescribing pattern of psychotropic medications in child psychiatric practice in a mental referral hospital in Botswana

    PubMed Central

    Olashore, Anthony; Ayugi, James; Opondo, Philip

    2017-01-01

    Introduction There is a growing preference for psycho-pharmacological therapy over non-pharmacological care. The prescription pattern and the choice of psychotropic medications vary in different settings. Whilst newer agents and rational prescribing are favored in the more specialized settings, the pattern remains unclear in less specialized units, largely due to lack of data. The aims were to conduct a treatment audit in the only mental referral hospital in Botswana, which is a non-specialized child and adolescent care setting and see how it conforms to best practice. Methods A retrospective audit which involved the extraction of socio-demographic and clinical information from the records of patients who were ≤ 17 years and seen from January 1, 2012-July 31, 2016. Results A total of 238 files were used for this report. Mean age (SD) was 12.41 (4.1) years. Of the 120 (50.4%) patients who had pharmacological intervention, only 85(70.8%) had monotherapy. The most commonly prescribed psychotropic agents were antipsychotics (40%). Off-label use of antipsychotics and polypharmacy were 31.2% and 29.2% respectively. Conclusion The level of conformity to standard practice in terms of psychotropic prescribing in our setting is consistent with the reports from developed countries where more specialized care ostensibly exists. Further studies will be necessary to determine the scope of psychotropic use. PMID:28491214

  2. Do hospital chief executive officers extract rents from Certificate of Need laws?

    PubMed

    Eichmann, Traci L; Santerre, Rexford E

    2011-01-01

    Prior research suggests that Certificate of Need (CON) laws reduce competition in the hospital services industry. As a result, this study empirically investigates if not-for-profit hospital chief executive officers (CEOs) are able to extract rents from CON laws in the form of higher compensation. A sample of 256 not-for-profit hospital CEOs in states with and without CON laws and data for 2007 are used in the empirical analysis. The study considers the endogenous nature of a CON law and allows such a law to indirectly affect CEO compensation through its impact on the number of hospitals and beds. The multiple regression results indicate that special and public interests both motivate the decision of a state to maintain a CON law. CON laws are shown to reduce the number of beds at the typical hospital by 12 percent, on average, and the number of hospitals per 100,000 persons by 48 percent. These reductions ultimately lead urban hospital CEOs in states with CON laws to extract economic rents of $91,000 annually.

  3. [On the issue of organization of consultative medical care on hospital stage].

    PubMed

    2011-01-01

    The study picked out several groups of in-demand specialties of consulting physicians. It is proposed to elaborate specific model of hospital consultative medical care providing the possibility of counseling by the most in-demand specialists already on the level of admission department. The key target is to avoid the involvement of less in-demand specialists at the expense of organization the specialized consultative crew on the basis on emergency medical care.

  4. An effective intervention to improve the cleanliness of medical lead clothes in an orthopedic specialized hospital.

    PubMed

    Chen, Lu; Xu, YingJun; Zhang, Fengxia; Yang, Qingfeng; Yuan, Juxiang

    2016-11-01

    Dirty medical lead clothes, contaminated with blood or other infected material, may carry ongoing bioburden, which increase the risk of hospital-acquired infection. In this study, we investigated medical lead clothes contamination levels and assessed the effectiveness of the intervention that was constructed to improve the cleanliness of lead clothes. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Descriptive study of the Specialized Care of the Spanish Health System

    PubMed Central

    Nombela-Monterroso, Karen; González-Chordá, Víctor M; Roman, Pablo

    2018-01-01

    ABSTRACT OBJECTIVE The objective of this study is to analyze the trend of the Key Indicators of the National Health System of Spain and its autonomous communities, related to Specialized Care, from the publication of the Law of Cohesion and Quality. METHODS This is an ecological study of temporary series of Spain and its autonomous communities from 2003 to 2014. We have analyzed 10 indicators related to Specialized Care (percentage of expenditure, professionals, waiting lists, surgical activity, average duration, infections, and mortality) using the Prais-Winsten regression method. We have obtained data from the health information system of the Spanish Ministry of Health, Social Services, and Equality. RESULTS Specialized care expenditure (APC = 0.059, 95%CI 0.041–0.074), number of medical professionals (APC = 0.0006, 95%CI 0.0003–0.0009) and nursing professionals (APC = 0.001, 95%CI 0.0005–0.0016), hospital infections (APC = 0.0003, 95%CI 0.0002–0.0004), and in-hospital mortality (APC = 0.0008, 95%CI 0.0006–0.001) had an increasing trend in Spain. Average duration presented a decreasing trend (APC = -0.0017, 95%CI -0.002– -0.0014). The trend of waiting lists (specialized appointment and non-urgent surgical interventions) was static. The trend of these indicators varied in the Autonomous Communities. CONCLUSIONS We have observed a non-compliance with the principles of equity and quality of the services offered. Increased aging, technological development, and inadequate strategies taken to reduce health costs may be the main causes. PMID:29412372

  6. Special report. TB and health care workers: the challenge for hospitals and their safety directors.

    PubMed

    1994-06-01

    New federal regulations seeking to prevent tubercular infection of health care workers have created conflicts between unions and hospital administrators over the best and cheapest methods of reducing the threat. Though there has been dispute over the particulars, there has been little argument that some steps must be taken, particularly in urban areas, to control the spread of a disease that has rebounded in new and deadly forms in recent years. Most agree that one of the most effective ways to avoid infection is to train employees to identify new hospital arrivals who are likely to have active cases of TB.

  7. Marketing the mental health care hospital: identification of communication factors.

    PubMed

    Patzer, G L; Rawwas, M Y

    1994-01-01

    The current study provides guidance to hospital administrators in their effort to develop more effective marketing communication strategies. Two types of communication factors are revealed: primary and secondary. Marketers of psychiatric hospitals may use the primary factors as basic issues for their communication campaign, while secondary factors may be used for segmentation or positioning purposes. The primary factors are open wards, special treatment for adolescents, temporary absence, while patient, in-patient care, and visitation management. The secondary factors are temporary absence while a patient, voluntary consent to admit oneself, visitation management, health insurance, open staff, accreditation, physical plant, and credentials of psychiatrists.

  8. Modeling interdependencies between business and communication processes in hospitals.

    PubMed

    Brigl, Birgit; Wendt, Thomas; Winter, Alfred

    2003-01-01

    The optimization and redesign of business processes in hospitals is an important challenge for the hospital information management who has to design and implement a suitable HIS architecture. Nevertheless, there are no tools available specializing in modeling information-driven business processes and the consequences on the communication between information processing, tools. Therefore, we will present an approach which facilitates the representation and analysis of business processes and resulting communication processes between application components and their interdependencies. This approach aims not only to visualize those processes, but to also to evaluate if there are weaknesses concerning the information processing infrastructure which hinder the smooth implementation of the business processes.

  9. Causes, magnitude and management of burns in under-fives in district hospitals in Dar es Salaam, Tanzania.

    PubMed

    Justin-Temu, M; Rimoy, G; Premji, Z; Matemu, G

    2008-04-01

    To determine the causes, magnitude and management of burns in children under five years of age who were admitted in the district hospitals of Dar es Salaam City, Tanzania. In this study, a total of 204 under fives were enrolled. Questionnaires were used to elicit if the parent/caretaker had the knowledge of the cause of the burns, what was done immediately after burn injury, first aid given immediately after burn, source of the knowledge of first aid and when the child was taken to the hospital. Also the questionnaire was cited with data on the management of burns in the hospitals through observation and checking the treatment files. Forty nine percent were males while 50.5% were females. Most of the children (54.9%) were aged between 1-2 years. 78.4% had scalds while 21.6% had flame burns. No children were found to have burns caused by chemicals or electricity. Most of the burns (97.5%) occurred accidentally, although some (2.5%) were intentional. 68.6% of these burn injuries occurred in the kitchen. Immediately after burn 87.3% of the children had first aid applied on their wounds while 12.7% didn't apply anything. Of the agents used, honey was the most used (32.8%) followed by cold water (16.7%). The source of knowledge on these agents was from relatives and friends (72.5%), schools (7%), media (6%) and medical personnel (14%). The study further revealed that analgesics, intravenous fluids, antiseptics and antibiotics were the drugs used for treatment of burns in the hospital and that there was no specialized unit for burns in the hospitals. Causes of childhood burns are largely preventable requiring active social/medical education and public enlighten campaigns on the various methods of prevention. The government to see to it that hospitals have specialized units for managing burn cases and also the socio-economic status of its people be improved.

  10. The use of medical care and the prevalence of serious illness in an adult Prader-Willi syndrome cohort.

    PubMed

    Sinnema, Margje; Maaskant, Marian A; van Schrojenstein Lantman-de Valk, Henny M J; Boer, Harm; Curfs, Leopold M G; Schrander-Stumpel, Constance T R M

    2013-08-01

    Adults with Prader-Willi syndrome (PWS) have an increased occurrence of several medical conditions. We report on the consequences of high morbidity rates such as prevalence rate of hospital admissions, medication use and surgery in a Dutch cohort of adults with PWS. Special attention is paid to causes and symptoms of serious illness. Participants were contacted via the Dutch Prader-Willi Parent Association and through physicians specializing in persons with ID. The persons with PWS and their main caregivers were visited at home. Information was collected through semi-structured interviews on 102 adults with PWS. The need for medical care in the neonatal period is associated with hypotonia and feeding problems. Hospital admissions for respiratory tract infections are frequent. During childhood most hospital admissions were due to PWS syndrome specific surgery. During adolescence hospital admissions occurred for scoliosis surgery and endocrine evaluations. At adult age, hospitalization was associated with inguinal hernia surgery, diabetes mellitus, psychosis, erysipelas, water and drug intoxications. In the older group, respiratory infections were again the main reason for hospital admissions. Frequently used medications at adult age included psychotropics, laxatives, anti-diabetics and dermatologic preparations. Abnormal drinking patterns, problems with anesthesia, decreased ability to vomit, abnormal pain awareness and unpredictable fever responses were frequent and often lead to delayed diagnoses of serious conditions. People with PWS are frequent users of medical-care. Reasons for hospitalization and medication use are age specific. Knowledge on the different presentation of symptoms in people with PWS is needed. In case of unexplained illness, disturbances of consciousness and behavioral changes in people with PWS, an infection should be ruled out in the first place. Information from this study may help in preventing conditions and recognizing conditions in an early stage. Adequate preventive management and treatment of PWS related morbidity, could reduce medical care use in the long term and could improve quality adjusted life years. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Pediatric issues in disaster management, Part 1: the emergency medical system and surge capacity.

    PubMed

    Mace, Sharon E; Sharieff, Ghazala; Bern, Andrew; Benjamin, Lee; Burbulys, Dave; Johnson, Ramon; Schreiber, Merritt

    2010-01-01

    Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. The authors discuss key components of disaster planning and management for pediatric patients, including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs (SHCNs), mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three-part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate setup and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: children with SHCNs and mental health issues.

  12. Making strides in women’s mental health care delivery in rural Ethiopia: demographics of a female outpatient psychiatric cohort at Jimma University Specialized Hospital (2006–2008)

    PubMed Central

    Chemali, Zeina N; Borba, Christina PC; Henderson, Tanya E; Tesfaye, Markos

    2013-01-01

    This paper presents the delivery of mental health care to a sample of women living in Jimma, rural Ethiopia, and their access to mental health services. A total of 226 psychiatric charts were reviewed for women seen at Jimma University Specialized Hospital. The mental health charts included documentation ranging from one paragraph to a full note. No psychiatric chart recorded medication status, detailed substance abuse history, or a history of violence. Rendering appropriate mental health care for women requires concerted efforts by multiple stake holders. Using our results, we advance concrete and practical suggestions for improving women’s mental health in rural Ethiopia. We point out that the health care system needs to be responsive, allowing for change starting with gender rights, so that rural women have access to basic mental health services. PMID:23901297

  13. [Rehabilitation of patients with acquired brain injury].

    PubMed

    Rasmussen, Anne Almskou; Jørgensen, Henrik Stig; Nielsen, Jørgen Feldbæk

    2014-05-12

    In Denmark the development of rehabilitation of patients with acquired brain injury (ABI) has differed from most parts of Europe. Denmark has no medical rehabilitation specialty. In 2000 two specialized hospital units were established to serve the population of 5.7 million inhabitants. They cover the needs of patients with the most severe ABIs. Only recently rehabilitation of patients with ABI has been anchored in the medical specialty of neurology. Since then the development has taken an up-going curve. This process has been supported by The Danish Health and Medicines Authority publishing several papers that highlights evidence-based organization and interventions. Current development aim to define: 1) skills of the medical doctor engaged in the rehabilitation of patients with ABI, 2) stratification to different levels of specialization at hospital and in the community, and 3) national guidelines that specify skills and collaboration between groups of professionals working with ABI rehabilitation.

  14. A review of transfusion practice before, during, and after hematopoietic progenitor cell transplantation

    PubMed Central

    Johnson, Viviana V.; Sandler, S. Gerald; Sayegh, Antoine; Klumpp, Thomas R.

    2008-01-01

    The increased use of hematopoietic progenitor cell (HPC) transplantation has implications and consequences for transfusion services: not only in hospitals where HPC transplantations are performed, but also in hospitals that do not perform HPC transplantations but manage patients before or after transplantation. Candidates for HPC transplantation have specific and specialized transfusion requirements before, during, and after transplantation that are necessary to avert the adverse consequences of alloimmunization to human leukocyte antigens, immunohematologic consequences of ABO-mismatched transplantations, or immunosuppression. Decisions concerning blood transfusions during any of these times may compromise the outcome of an otherwise successful transplantation. Years after an HPC transplantation, and even during clinical remission, recipients may continue to be immunosuppressed and may have critically important, special transfusion requirements. Without a thorough understanding of these special requirements, provision of compatible blood components may be delayed and often urgent transfusion needs prohibit appropriate consultation with the patient's transplantation specialist. To optimize the relevance of issues and communication between clinical hematologists, transplantation physicians, and transfusion medicine physicians, the data and opinions presented in this review are organized by sequence of patient presentation, namely, before, during, and after transplantation. PMID:18583566

  15. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

    PubMed

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

  16. Hospital financial performance under the prospective payment system by type of admission: psychiatric versus medical/surgical.

    PubMed Central

    Freiman, M P

    1990-01-01

    We performed detailed simulations of DRG-based payments to general hospitals for treatment of nonexempt psychiatric and medical/surgical patients under Medicare's prospective payment system (PPS). We then compared these results to calculated costs for the same patients. Hospitals without specialized psychiatric units tend to fare better financially on their psychiatric than on their medical/surgical caseloads, although the levels of gain for these two types of patients are correlated. Hospitals with nonexempt psychiatric units generally have similar rates of gain on psychiatric and medical/surgical patients. Comparing psychiatric treatment in "scatter-bed" sites with that provided in nonexempt units, the higher rate of gain under PPS for treatment in scatter beds results largely from shorter lengths of stay. We discuss hospital behavior and the relationships between treatment of psychiatric illness under DRG-based payment and its treatment in exempt psychiatric units, which are excluded from DRG-based payment. PMID:2123839

  17. [Criteria for evaluating the effective work of a tuberculosis hospital, accounting, and software].

    PubMed

    Lekhliaĭder, M V; Okhtiarkina, V V

    2007-01-01

    The hospital stage is by right basic in the treatment of patients with tuberculosis. Hospitalization meets two challenges: 1) controlled treatment of a patient and 2) his isolation from healthy individuals. However, the analysis of the efficiency of hospital work only by resource characteristics does not reflect the actual volume and rate of delivered antituberculous care. A check of the work of tuberculosis hospitals in the Chelyabinsk Region has shown a number of unsolved questions requiring a detailed analysis and managerial decision making. At present, there is a need for an exact calculation of the number of specialized tuberculosis beds, their conversion, as well as, to make the most use of all available therapeutic and diagnostic capacities of tuberculosis-controlling service of the subject of the Russian Federation, for the development of a regional route for a tuberculosis patient on the basis of the adopted health care standards.

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

    PubMed

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

    2009-01-01

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

  19. Medical psychology services in dutch general hospitals: state of the art developments and recommendations for the future.

    PubMed

    Soons, Paul; Denollet, Johan

    2009-06-01

    In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in general, teaching and academic hospitals. Nowadays, they are an integrated non-medical specialism working in the medical setting of hospitals in the Netherlands, and are a full-member of the medical board. This paper discusses several topics: the position of the general hospital in the health care system in the Netherlands, the emergence of medical psychology in Dutch hospitals, the role of the professional association of medical psychologists, and the characteristics of patients seen by clinical psychologists. Following the discussion about the situation of medical psychology in other countries, recommendations are formulated for the further development of medical psychology in the Netherlands as well as in other countries.

  20. Mobile ECMO - A divine technology or bridge to nowhere?

    PubMed

    Merkle, Julia; Djorjevic, Ilija; Sabashnikov, Anton; Kuhn, Elmar W; Deppe, Antje-Christin; Eghbalzadeh, Kaveh; Fattulayev, Javid; Hohmann, Christopher; Zeriouh, Mohamed; Kuhn-Régnier, Ferdinand; Choi, Yeong-Hoon; Mader, Navid; Wahlers, Thorsten

    2017-10-01

    Extracorporeal life support emerged as a salvage option in patients with therapy-refractory severe hemodynamic or respiratory failure. However, this promising therapy option has been limited by the use of experienced teams in highly specialized tertiary-care centers. Thus, in order to provide this standard of care in local hospitals and due to increasing evidence on improved outcomes using ECMO devices and setting for patients with heart and lung failure, an increasing number of experienced ECMO centers have launched mobile ECMO retrieval services in recent years. Areas covered: This review provides a summary on the current scientific status concerning use, indications and complications of mobile ECMO devices and services. A scientific literature research was conducted in MEDLINE, Embase, Cochrane and Web of Science databases using keywords denoted. Expert commentary: Mobile ECMO devices and setting offer severely ill patients refractory to maximal conventional treatment an option of hemodynamic and/or respiratory stabilization and subsequent transportation to specialized care centers for further treatment. Compared to in-hospital ECMO support, out-of-hospital mobile ECMO implantation, transport and retrieval of patients require additional organizational, logistical and clinical efforts. This review provides a summary on the current scientific status concerning use, indications and complications of mobile ECMO services.

  1. [Philanthropy, privatization, and reform: psychiatric assistance scenarios in the state of Paraná].

    PubMed

    Wadi, Yonissa Marmitt; Olinto, Beatriz Anselmo; Casagrande, Attiliana De Bona

    2015-12-01

    The article discusses different psychiatric assistance arrangements in Paraná from the earliest years through today, taking into account the state's unique features and relations with national policies. This assistance was first provided in 1903, when the Hospício Nossa Senhora da Luz philanthropic asylum was founded. It was only in 1954 that Hospital Colônia Adauto Botelho, the state's first public hospital, began operations. In the 1960s, the Paraná government signed agreements with private hospitals for more beds in the interior, accelerating the provision of psychiatric assistance and fostering a privatization approach. This strategy led to the current situation in Paraná, where specialized hospitals are the rule, despite the existence of other facilities foreseen under the psychiatric reform legislation.

  2. Author! author!: creating a digital archive of publications in a hospital library setting.

    PubMed

    Rourke, Diane; Samsundar, Devica Ramjit; Shalini, Channapatna

    2005-01-01

    Baptist Hospital of Miami has been honoring its staff authors annually during National Library Week since 1979, at the time the library was relocated. Upon "doing the math" and realizing that twenty-five years had passed, a special event was planned to celebrate the occasion in 2004. A merger of four hospitals in 1995 to form Baptist Health South Florida, and an addition of a fifth hospital in 2003 added into the complexity of these publications. Organizing the event led to the conclusion that there had to be a "better way" to manage the publication archive. This paper will include a look back at the event's past, present efforts to develop an archival database, and future plans to make articles available electronically to users, copyright permitting.

  3. Primary health-care costs associated with special health care needs up to age 7 years: Australian population-based study.

    PubMed

    Quach, Jon; Oberklaid, Frank; Gold, Lisa; Lucas, Nina; Mensah, Fiona K; Wake, Melissa

    2014-10-01

    We studied infants and children with and without special health care needs (SHCN) during the first 8 years of life to compare the (i) types and costs to the government's Medicare system of non-hospital health-care services and prescription medication in each year and (ii) cumulative costs according to persistence of SHCN. Data from the first two biennial waves of the nationally representative Longitudinal Study of Australian Children, comprising two independent cohorts recruited in 2004, at ages 0-1 (n = 5107) and 4-5 (n = 4983) years. Exposure condition: parent-reported Children with Special Health Care Needs Screener at both waves, spanning ages 0-7 years. Federal Government Medicare expenditure, via data linkage to the Medicare database, on non-hospital health-care attendances and prescriptions from birth to 8 years. At both waves and in both cohorts, >92% of children had complete SHCN and Medicare data. The proportion of children with SHCN increased from 6.1% at age 0-1 years to 15.0% at age 6-7 years. Their additional Medicare costs ranged from $491 per child at 6-7 years to $1202 at 0-1 year. This equates to an additional $161.8 million annual cost or 0.8% of federal funding for non-hospital-based health care. In both cohorts, costs were highest for children with persistent SHCNs. SHCNs incur substantial non-hospital costs to Medicare, and no doubt other sources of care, from early childhood. This suggests that economic evaluations of early prevention and intervention services for SHCNs should consider impacts on not only the child and family but also the health-care system. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital

    PubMed Central

    2013-01-01

    Introduction Hospital acquired infections are recognized as critical public health problems. Infections are frequently caused by organisms residing in healthcare environment, including contaminated medical equipment like Stethoscopes. Objective To determine bacterial contamination, bacterial profile and anti-microbial susceptibility pattern of the isolates from stethoscopes at Jimma University Specialized Hospital. Methodology Cross-sectional study conducted from May to September 2011 at Jimma University Specialized Hospital. One hundred seventy-six stethoscopes owned by Health Care Workers (HCWs) and Medical students were randomly selected and studied. Self-administered structured questionnaire was used to collect socio-demographic data. Specimen was collected using moisten sterile cotton swab and 1 ml normal saline was used to transport the specimen, all laboratory investigations were done following standard microbiological techniques, at Microbiology Laboratory, Jimma University. SPSS windows version 16 used for data analysis and P <0.05 was considered statistically significant. Result: A total, of 151 (85.8%) stethoscopes were contaminated. A total of 256 bacterial strains and a mean of 1.44×104 CFUs/diaphragm of stethoscopes was isolated. Of the 256 isolates, 133 (52%) were potential pathogens like S. aureus, Klebsiella spp., Citrobacter spp., Salmonella spp., Proteus spp., Enterobacter spp., P. aeruginosa and E. coli. All strains were resistant to multiple classes of antibiotics (two to eight classes of antibiotics). Disinfection practice was poor. Disinfection practice was found to be associated with bacterial contamination of stethoscopes (P < 0.05). High contamination rate 100 (90.9%) was observed among stethoscopes that had never been disinfected; while the least contamination 29 (72.2%) was found on those disinfected a week or less before the survey. Conclusion Bacterial contamination of the stethoscope was significant. The isolates were potential pathogens and resistant to multiple classes of antibiotics. Stethoscope is potential vehicle in the transmission of infections between patients and Healthcare Workers. Stethoscope diaphragm should be disinfected before and after each patient contact. PMID:24330702

  5. Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital.

    PubMed

    Shiferaw, Teklu; Beyene, Getenet; Kassa, Tesfaye; Sewunet, Tsegaye

    2013-12-13

    Hospital acquired infections are recognized as critical public health problems. Infections are frequently caused by organisms residing in healthcare environment, including contaminated medical equipment like Stethoscopes. To determine bacterial contamination, bacterial profile and anti-microbial susceptibility pattern of the isolates from stethoscopes at Jimma University Specialized Hospital. Cross-sectional study conducted from May to September 2011 at Jimma University Specialized Hospital. One hundred seventy-six stethoscopes owned by Health Care Workers (HCWs) and Medical students were randomly selected and studied. Self-administered structured questionnaire was used to collect socio-demographic data. Specimen was collected using moisten sterile cotton swab and 1 ml normal saline was used to transport the specimen, all laboratory investigations were done following standard microbiological techniques, at Microbiology Laboratory, Jimma University. SPSS windows version 16 used for data analysis and P <0.05 was considered statistically significant. A total, of 151 (85.8%) stethoscopes were contaminated. A total of 256 bacterial strains and a mean of 1.44×104 CFUs/diaphragm of stethoscopes was isolated. Of the 256 isolates, 133 (52%) were potential pathogens like S. aureus, Klebsiella spp., Citrobacter spp., Salmonella spp., Proteus spp., Enterobacter spp., P. aeruginosa and E. coli. All strains were resistant to multiple classes of antibiotics (two to eight classes of antibiotics). Disinfection practice was poor. Disinfection practice was found to be associated with bacterial contamination of stethoscopes (P < 0.05). High contamination rate 100 (90.9%) was observed among stethoscopes that had never been disinfected; while the least contamination 29 (72.2%) was found on those disinfected a week or less before the survey. Bacterial contamination of the stethoscope was significant. The isolates were potential pathogens and resistant to multiple classes of antibiotics. Stethoscope is potential vehicle in the transmission of infections between patients and Healthcare Workers. Stethoscope diaphragm should be disinfected before and after each patient contact.

  6. Reasons and outcomes of admissions to the medical wards of jimma university specialized hospital, southwest ethiopia.

    PubMed

    Ali, Elias; Woldie, Mirkuzie

    2010-07-01

    Non-communicable diseases are the main reasons for admission to the medical wards in high-income countries. While in low and middle income countries communicable diseases are the main reasons for admission to the medical wards. However, in some low and middle income countries the reasons for admission are changing from communicable diseases to non-communicable diseases. But, data on reasons for admission to the medical wards of low income countries is scarce. Therefore, this study takes one year data from a low income country referral hospital aiming at describing the recent reasons and outcomes of medical admissions to see whether there is a change in reasons for admission and the outcome. A retrospective study examined patient case notes and ward registration books of medical admissions at Jimma University Specialized Hospital from January 1, 2008 to December 31, 2008. Socio-demographic variables, reasons and outcomes of admission were some of the variables recorded during the data collection. The International Statistical Classification of Disease was used for sorting and categorizing the diagnosis. The data was then analyzed using SPSS windows version 13.0. A total of 610 patient case notes were reviewed. The mean age of the patients was 36 years (SD ± 15.75). The highest number of admissions 218 (35.7%) was among the age groups 21 to 30 years. Communicable diseases; namely severe community acquired pneumonia 139(22.8%), all infectious and parasitic diseases category 100 (16.4%), and pyogenic as well as chronic meningitis 80(13.1%) were the most common reasons for admission. The death rate among patients admitted to the medical wards was 12.6%. Communicable diseases were still the common reasons for medical admissions at Jimma University Specialized Hospital. The outcome of medical admissions has not changed over sixteen years.

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

    PubMed

    Illés, S Tamás

    2016-07-01

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

  8. Evaluating Nurses Acceptance of Hospital Information Systems: A Case Study of a Tertiary Care Hospital.

    PubMed

    Khalifa, Mohamed

    2016-01-01

    This study aims at evaluating hospital information systems (HIS) acceptance factors among nurses, in order to provide suggestions for successful HIS implementation. The study used mainly quantitative survey methods to collect data directly from nurses through a questionnaire. The availability of computers in the hospital was one of the most influential factors, with a special emphasis on the unavailability of laptop computers and computers on wheels to facilitate immediate data entry and retrieval when nurses are at the point of care. Nurses believed that HIS might frequently slow down the process of care delivery and increase the time spent by patients inside the hospital especially during slow performance and responsiveness phases. Recommendations were classified into three main areas; improving system performance and availability of computers in the hospital, increasing organizational support in the form of providing training and protected time for nurses' to learn and enhancing users' feedback by listening to their complaints and considering their suggestions.

  9. EARNINGS MANAGEMENT IN U.S. HOSPITALS.

    PubMed

    Dong, Gang Nathan

    2016-01-01

    This paper examines the hospital management practices of manipulating financial earnings within the bounds of generally accepted accounting principles (GAAP). We conduct regression analyses that relate earnings management to hospital characteristics to assess the economic determinants of hospital earnings management behavior. From the CMS Cost Reports we collected hospital financial data of all U.S. hospitals that request reimbursement from the federal government for treating Medicare patients, and regress discretionary accruals on hospital size, profitability, asset liquidity, operating efficiency, labor cost, and ownership. Hospitals with higher profit margin, current ratio, working capital, days of patient receivables outstanding and total wage are associated with more earnings management, whereas those with larger size and higher debt level, asset turnover, days cash on hand, fixed asset age are associated with lower level of earnings manipulation. Additionally, managers of non-profit hospitals are more likely to undertake some form of window-dressing by manipulating accounting accruals without changing business models or pricing strategies than their public hospital counterparts. We provide direct evidence of the use of discretionary accruals to manage financial earnings among U.S. hospitals and the finding has profound policy implications in terms of assessing the pervasiveness of accounting manipulation and the overall integrity of financial reporting in this very special public and quasi-public service sector.

  10. Severe sepsis and septic shock in pre-hospital emergency medicine: survey results of medical directors of emergency medical services concerning antibiotics, blood cultures and algorithms.

    PubMed

    Casu, Sebastian; Häske, David

    2016-06-01

    Delayed antibiotic treatment for patients in severe sepsis and septic shock decreases the probability of survival. In this survey, medical directors of different emergency medical services (EMS) in Germany were asked if they are prepared for pre-hospital sepsis therapy with antibiotics or special algorithms to evaluate the individual preparations of the different rescue areas for the treatment of patients with this infectious disease. The objective of the survey was to obtain a general picture of the current status of the EMS with respect to rapid antibiotic treatment for sepsis. A total of 166 medical directors were invited to complete a short survey on behalf of the different rescue service districts in Germany via an electronic cover letter. Of the rescue districts, 25.6 % (n = 20) stated that they keep antibiotics on EMS vehicles. In addition, 2.6 % carry blood cultures on the vehicles. The most common antibiotic is ceftriaxone (third generation cephalosporin). In total, 8 (10.3 %) rescue districts use an algorithm for patients with sepsis, severe sepsis or septic shock. Although the German EMS is an emergency physician-based rescue system, special opportunities in the form of antibiotics on emergency physician vehicles are missing. Simultaneously, only 10.3 % of the rescue districts use a special algorithm for sepsis therapy. Sepsis, severe sepsis and septic shock do not appear to be prioritized as highly as these deadly diseases should be in the pre-hospital setting.

  11. Advantages of multifamily therapy for families of psychiatric inpatients.

    PubMed

    Tangari, A; Class, L

    1977-01-01

    This paper considers the effectiveness of multifamily therapy as a treatment for families of emotionally ill patients who are hospitalized. Multifamily therapy groups on two sections of the C. F. Menninger Memorial Hospital are described, with special reference to variations in the criteria for inclusion of members. Initial findings of a limited study of one of the groups suggest a high degree of agreement among parent-members as to the ameliorative effect of this type of therapy, notably its capacity to assuage feelings of isolation.

  12. The Microsurgery Fellowship at Chang Gung Memorial Hospital: Blossom of Caterpillars

    PubMed Central

    2015-01-01

    Summary: Against a background of globalization and medical migration, issues have been raised regarding training outside the clinician’s own context. Fellowship was not commonly used as a career step, or a means of migration, but as a process of professional and personal development. Taking Chang Gung Memorial Hospital Microsurgery Fellowship as the case study, I would like to highlight an example of a long-running successful training program in a special field such as plastic surgery. PMID:25973354

  13. [Innovation drive is the original motive force of discipline construction: the developing road of Department of Burns and Plastic Surgery in the 309th Hospital of PLA].

    PubMed

    Jia, C Y

    2018-03-20

    Discipline construction is a systematic project, covering clinic, teaching, scientific research, management, and humanity. Based on the perspective of innovation drive, from the aspects of discipline structure setting, specialized laboratory construction, sub-specialty formation, clinical characteristic and advantage formation, and management concept update, this article summarizes the growth process of Department of Burns and Plastic Surgery in the 309th Hospital of PLA.

  14. Management of patients with risk factors

    PubMed Central

    Waldfahrer, Frank

    2013-01-01

    This review addresses concomitant diseases and risk factors in patients treated for diseases of the ears, nose and throat in outpatient and hospital services. Besides heart disease, lung disease, liver disease and kidney disease, this article also covers disorders of coagulation (including therapy with new oral anticoagulants) and electrolyte imbalance. Special attention is paid to the prophylaxis, diagnosis and treatment of perioperative delirium. It is also intended to help optimise the preparation for surgical procedures and pharmacotherapy during the hospital stay. PMID:24403970

  15. Welcome to Naval Hospital Jacksonville

    Science.gov Websites

    Active Duty Special Work Operational Support Welcome Packets 75th Anniversary 2 NHJax mobile app listed RelayHealth.com Click here to join our facebook page Tweets by @NHJAX Download our mobile app today! Our News URL

  16. 41 CFR 102-73.225 - What types of special purpose space may the Department of Veterans Affairs lease?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...: (a) Guidance and training centers located at schools and colleges. (b) Space used for veterans hospitals, including outpatient and medical-related clinics, such as drug, mental health, and alcohol...

  17. DRINKING WATER MICROBIOLOGY - NEW DIRECTIONS TOWARD WATER QUALITY ENHANCEMENT

    EPA Science Inventory

    Many concerns result from information on new waterborne agents, treatment problems of raw water qualities, biofilm development in some distribution systems, and special quality needs unique to hospitals and industries. Protozoan cyst penetration after some disinfection practices ...

  18. 76 FR 27327 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... Hospitalized Persons Study; FOA IP11-011, Spectrum of Respiratory Pathogens in Acute Respiratory Tract... Developing Countries; FOA IP11-013, Influenza and Other Respiratory Diseases in Southern Hemisphere; and FOA...

  19. Cost effects of hospital mergers in Portugal.

    PubMed

    Azevedo, Helda; Mateus, Céu

    2014-12-01

    The Portuguese hospital sector has been restructured by wide-ranging hospital mergers, following a conviction among policy makers that bigger hospitals lead to lower average costs. Since the effects of mergers have not been systematically evaluated, the purpose of this article is to contribute to this area of knowledge by assessing potential economies of scale to explore and compare these results with realized cost savings after mergers. Considering the period 2003-2009, we estimate the translog cost function to examine economies of scale in the years preceding restructuring. Additionally, we use the difference-in-differences approach to evaluate hospital centres (HC) that occurred between 2004 and 2007, comparing the years after and before mergers. Our findings suggest that economies of scale are present in the pre-merger configuration with an optimum hospital size of around 230 beds. However, the mergers between two or more hospitals led to statistically significant post-merger cost increases, of about 8 %. This result indicates that some HC become too large to explore economies of scale and suggests the difficulty of achieving efficiencies through combining operations and service specialization.

  20. Report of the Special Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care.

    PubMed

    Anderson, R J; Milburn, L T

    1990-04-01

    Texas not-for-profit hospitals recently received intense scrutiny regarding their involvement in charity-related contributions when Texas Attorney General Jim Mattox formed the Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care. This article details the task force's recommendations concerning charity care obligations of Texas not-for-profit hospitals. Setting the stage for these recommendations was a broad definition of charitable services that included costs for delivering services to indigents and for providing community services to fulfill the hospital's charitable, religious, educational, research, or eleemosynary purposes. The task force unanimously agreed that a mandated level of charity care was incongruent with the hospitals' individual missions and specific community needs, but they supported the formation of standard accounting procedures for charitable services and the voluntary submission of their mission statements to the attorney general of Texas. While the hospitals' role in providing charitable services is very important, the task force emphasized that the overall need for adequate financing and reimbursement of health care is a societal problem that needs specific state and federal actions.

  1. [Nutritional status and risk in hospitalized children].

    PubMed

    Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P

    2001-11-01

    A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was < -2 SD, > +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

  2. Emergency response planning in hospitals, United States: 2003-2004.

    PubMed

    Niska, Richard W; Burt, Catharine W

    2007-08-20

    This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

  3. Acute Brain Failure: Pathophysiology, Diagnosis, Management, and Sequelae of Delirium.

    PubMed

    Maldonado, José R

    2017-07-01

    Delirium is the most common psychiatric syndrome found in the general hospital setting, with an incidence as high as 87% in the acute care setting. Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances. The development of delirium is associated with increased morbidity, mortality, cost of care, hospital-acquired complications, placement in specialized intermediate and long-term care facilities, slower rate of recovery, poor functional and cognitive recovery, decreased quality of life, and prolonged hospital stays. This article discusses the epidemiology, known etiological factors, presentation and characteristics, prevention, management, and impact of delirium. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Should there be pediatric neurohospitalists?

    PubMed

    Nash, Kendall B; Josephson, S Andrew; Sun, Karen; Ferriero, Donna M

    2013-03-05

    Hospitalist medicine has gown rapidly over the past decade in response to increasing complexity of hospitalized patients, financial pressures, and a national call for improved quality and safety outcomes. An adult neurohospitalist model of care has recently emerged to address these factors and the need for inpatient neurologists who offer expertise and immediate availability for emergent neurologic conditions such as acute stroke and status epilepticus. Similarly, hospitalized children with acute neurologic disorders require a uniquely high level of care, which increasingly cannot be delivered by pediatric neurologists with busy outpatient practices or by pediatric hospitalists without specialized training. This perspective explores the concept of a pediatric neurohospitalist model of care, including the potential impact on quality of care, hospitalization costs, and education.

  5. Caring for homeless persons with serious mental illness in general hospitals.

    PubMed

    Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

    2013-01-01

    The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  6. Hospital social workers in Saudi Arabia: characteristics and functions.

    PubMed

    Albrithen, Abdulaziz; Yalli, Nadir

    2015-01-01

    Social work practitioners are important members of the health care team and the hospital sector has been a traditional employer of social workers. Social work practitioners have become increasingly involved in hospital work as a result of the growing recognition of the important link between the biophysical aspects of health and the surrounding psychosocial circumstances, which require multidisciplinary interventions and demand the involvement of specialized social work personnel to deal with such issues. The article has been carried out in order to contribute to the literature by exploring to see if the characteristics and functions of contemporary professional social workers (who practice in the health sector in western Saudi Arabia) are achieving best practice.

  7. The application of volume-outcome contouring in data warehousing.

    PubMed

    Studnicki, James; Berndt, Donald J; Luther, Stephen L; Fisher, John W

    2004-01-01

    Despite a compelling body of published research on the nature of provider volume and clinical outcomes, healthcare executives and policymakers have not managed to develop and implement systems that are useful in directing patients to higher volume providers via selective referral or avoidance. A specialized data warehouse application, utilizing hospital discharge data linked to physician biographical information, allows detailed analysis of physician and hospital volume and the resulting pattern (contour) of related outcomes such as mortality, complications, and medical errors. The approach utilizes a historical repository of hospital discharge data in which the outcomes of interest, important patient characteristics and risk factors used in severity-adjusting of the outcomes are derived from the coding structure of the data.

  8. Rescheduling the special interest group.

    PubMed

    Peace, Helen

    1993-06-09

    The committee members of the RCN Social Interest Group for Nurses Working Within Day Hospitals/Day Care for Older People would like to apologise to the large number of people who were interested in attending our conference, which unfortunately had to be postponed.

  9. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... made on every patient at the time of admission, and must include the diagnoses of intercurrent diseases... record of mental status; (4) Note the onset of illness and the circumstances leading to admission; (5...

  10. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... made on every patient at the time of admission, and must include the diagnoses of intercurrent diseases... record of mental status; (4) Note the onset of illness and the circumstances leading to admission; (5...

  11. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... made on every patient at the time of admission, and must include the diagnoses of intercurrent diseases... record of mental status; (4) Note the onset of illness and the circumstances leading to admission; (5...

  12. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... made on every patient at the time of admission, and must include the diagnoses of intercurrent diseases... record of mental status; (4) Note the onset of illness and the circumstances leading to admission; (5...

  13. Networking the rural community.

    PubMed

    Tiongson, K H; Arneson, S I

    1993-04-01

    A branch network of affiliate hospitals has been providing home care services to rural North Dakota residents successfully for a decade. Here's how this effective system meets the special challenges that a rural environment poses for hiring, training, scheduling, and supporting home care aides.

  14. Bibliography. Citations Obtained through the National Library of Medicine's MEDLARS Program.

    ERIC Educational Resources Information Center

    Journal of Medical Education, 1980

    1980-01-01

    Approximately 250 citations on medical education are presented. Topics include professional continuing education, student evaluation, graduate medical education, medical schools, specialization, teaching hospitals, teaching methods and materials, educational history, medical students, faculty, computers, curriculum, accreditation, and medical…

  15. Graduate Medical Education: A Continuing History

    ERIC Educational Resources Information Center

    Stevens, Rosemary A.

    1978-01-01

    Five interweaving themes are discussed: the meaning of graduate education; who should control specialization; the role of residents in filling hospital needs; whether graduate medical education is a university responsibility; and how far the distribution of residencies should match perceived manpower needs. (LBH)

  16. Environmental Design for Young Children.

    ERIC Educational Resources Information Center

    Frank, Mary, Ed.

    1977-01-01

    The special issue of the journal, Children in Contemporary Society, contains 17 brief articles on environmental design for young handicapped and normal children. Articles have the following titles: "Introduction", "Environmental Design and Architecture", "Why Is Environmental Design Important to Young Children", "Children's Hospital National…

  17. Are all children with visual impairment known to the eye clinic?

    PubMed

    Pilling, Rachel F; Outhwaite, Louise

    2017-04-01

    There is a growing body of evidence that children with special needs are more likely to have visual problems, be that visual impairment, visual processing problems or refractive error. While there is widespread provision of vision screening in mainstream schools, patchy provision exists in special schools. The aim of the study was to determine the unmet need and undiagnosed visual problems of children attending primary special schools in Bradford, England. Children attending special schools who were not currently under the care of the hospital eye service were identified. Assessments of visual function and refractive error were undertaken on site at the schools by an experienced orthoptist and/or paediatric ophthalmologist. A total of 157 children were identified as eligible for the study, with a mean age of 7.8 years (range 4-12 years). Of these, 33% of children were found to have visual impairment, as defined by WHO and six children were eligible for severe sight impairment certification. The study demonstrates significant unmet need or undiagnosed visual impairment in a high-risk population. It also highlights the poor uptake of hospital eye care for children identified with significant visual needs and suggests the importance of providing in-school assessment and support, including refractive correction, to fully realise the benefits of a visual assessment programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Evacuation of institutionalized and specialized populations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vogt, B.M.

    The purpose of this research was to assess the needs of organizations caring for institutional and specialized populations when faced with a threat or hazard requiring an evacuation. Individuals within specialized populations are unlike other victims of disaster because of their inherent dependency on organizational care givers and require different management strategies on the part of organizations and agencies in an evacuation. The research sought to identify those aspects of coping strategies that have been used successfully to manage an emergency evacuation. To identify special populations that have evacuated from institutions and similar facilities over a four-year period, a computerizedmore » search was conducted of media accounts describing such events. The search yielded a total of 1024 accounts from which four major subgroups were identified: nursing homes and related care facilities, hospitals, educational institutions, and correctional facilities. A miscellaneous group including housing for the elderly, apartments and other building complexes, workplaces and factories, public facilities, and places occupied by transient populations, such as transportation units and recreational facilities, could be used for future study. Among the factors found to affect evacuations were the extent of organizational resources (such as the number of staff or other individuals available at the time of the event), the type and number of clientele, and such community characteristics as population density. The study focuses on selected organizational characteristics of health care facilities (nursing homes and related care facilities and hospitals) which have recently experienced either a partial or complete evacuation of their facilities. 165 refs., 13 tabs.« less

  19. Improving practice at the point of care through the optimization of the breastfeeding resource nurse model.

    PubMed

    Spatz, Diane L; Froh, Elizabeth B; Flynn-Roth, Regina; Barton, Sharon

    2015-01-01

    To describe and understand the Breastfeeding Resource Nurse (BRN) role and program. The primary study was a multimethod prospective study in which quantitative surveys and qualitative interviews of nurses who received education through the BRN program were used. Results presented herein are from the quantitative arm of the primary study. A large free-standing urban children's hospital with a birthing unit for specialized deliveries and a primary and specialty care network. A total of 425 of 600 nurses who took the BRN course responded to the survey. These nurses worked in all settings throughout the enterprise. The research team created a Survey Monkey interview that was e-mailed to all current nurses with valid hospital e-mail addresses who had taken the BRN course. Monthly e-mail reminders were sent and nurse managers were asked to encourage their staff to fill out the survey. Nurses who received specialized education through BRN course integrated the provision of evidence-based breastfeeding support and care into their daily routines. Furthermore, nurses became breastfeeding advocates and supported family, friends, and members of their communities in their breastfeeding experiences. The type of education needed for nurses who work at children's hospitals and in neonatal intensive care units is different than traditional breastfeeding education for birth hospitals. Implementation of the BRN course resulted in positive outcomes for staff; the course is transferrable to other facilities worldwide. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  20. White paper of Italian Gastroenterology: delivery of services for digestive diseases in Italy: weaknesses and strengths.

    PubMed

    Buscarini, Elisabetta; Conte, Dario; Cannizzaro, Renato; Bazzoli, Franco; De Boni, Michele; Delle Fave, Gianfranco; Farinati, Fabio; Ravelli, Paolo; Testoni, Pier Alberto; Lisiero, Manola; Spolaore, Paolo

    2014-07-01

    In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16-25% versus 29-87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies' official report, which constitutes the "White paper of Italian Gastroenterology". Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. [Porto and the construction of the modern city: the case of Hospital Geral de Santo António in the eighteenth and nineteenth centuries].

    PubMed

    da Silva, Helena

    2014-01-01

    During a period of demographic and urban growth of the city of Porto, the need arose for a new hospital. The Santa Casa da Misericórdia of Porto, in charge of erecting the new health facility, appointed the British architect John Carr to design the project. By means of the analysis of a set of archival sources and sundry literature on the topic, we examine the criteria chosen for the design and construction of Hospital Geral de Santo António and if it fulfilled expectations, becoming a special space in the city. This article opens up a perspective on the study of the development of the city and the creation of this health facility, contributing to the historical trajectory of hospital architecture.

  2. Enterprise resource planning for hospitals.

    PubMed

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

    2004-06-30

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

  3. Early neonatal special care units and their scientific achievements.

    PubMed

    Obladen, Michael

    2012-01-01

    Treatment of sick neonates originated in maternity and foundling hospitals in the 19th century. Nosocomial infections and difficult logistics of wet-nursing prevented admission of neonates in most children's hospitals well into the 20th century. In this article, 31 hospitals are described, all located in large cities, in which preterm and sick neonates were treated before the Great Depression. Even though mostly initiated by private charity, these institutions performed research right from the start. Topics included warming and feeding preterm infants, collecting and distributing human milk, developing and storing breast milk substitutes, prevention of rickets and nosocomial infections, maternal and public education regarding infection control, pathoanatomic characterisation of diseases and malformations and epidemiologic studies of infant mortality. These pioneering hospitals, their founding dates, researchers and classic publications are presented in a table. Copyright © 2012 S. Karger AG, Basel.

  4. An investigation of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility-to-hospital readmissions: a systematic review.

    PubMed

    Mileski, Michael; Topinka, Joseph Baar; Lee, Kimberly; Brooks, Matthew; McNeil, Christopher; Jackson, Jenna

    2017-01-01

    The main objective was to investigate the applicability and effectiveness of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility (SNF)-to-hospital readmissions. The rate of rehospitalizations from SNF within 30 days of original discharge has increased within the last decade. The research team participants conducted a literature review via Cumulative Index of Nursing and Allied Health Literature and PubMed to collect data about quality improvement implemented in SNFs. The most common facilitator was the incorporation of specialized staff. The most cited barriers were quality improvement tracking and implementation. These strategy examples can be useful to acute care hospitals attempting to lower bounce back from subacute care providers and long-term care facilities seeking quality improvement initiatives to reduce hospital readmissions.

  5. [Ambulance in emergency medicine].

    PubMed

    Aksoy, Fikret; Ergun, Alper

    2002-07-01

    The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services

  6. [The organizational characteristics of the medical support for the troops in the first operations at the start of a war (based on the experience of exercises)].

    PubMed

    Iziumtsev, I S

    1995-03-01

    The article summarized the experience of an explorative tactical-special exercise on medical support of Mobile Forces in first military operations of the initial period of war which has studied the following questions: the organic structure and organization of work of the medical service of a motorized infantry brigade in defense; joint direction of organic hospital facilities and field traumatological hospital. The author also studies the deployment peculiarities of a military multipurpose hospital on the basis of a garrison hospital. The experience of these exercises has proved the necessity to update the organic structure and principles of the employment of medical assets in accordance with the requirements of new military doctrine, as well as realize the technical re-equipment of medical service.

  7. Satisfaction with emergent transfer for percutaneous coronary interventions on patients with ST-segment-elevation myocardial infarction and their families.

    PubMed

    Henry, Jason T; Christiansen, Ellen; Garberich, Ross F; Handran, Chauncy B; Larson, David M; Unger, Barbara T; Henry, Timothy D

    2014-03-01

    Transfer for primary percutaneous coronary intervention (PCI) is superior to fibrinolysis if performed in a timely manner but frequently requires dislocation of patients and their families from their local community. Although patient satisfaction is increasingly viewed as an important quality indicator, there are no data on how emergent transfer for PCI affects patients with ST-segment-elevation myocardial infarction and their families. The Minneapolis Heart Institute's Level 1 Regional ST-Segment-Elevation Myocardial Infarction program is designed to facilitate emergent transfer for PCI in patients with ST-segment-elevation myocardial infarction from 31 rural and community hospitals. To determine the effect of emergent transfer, questionnaires were given to 152 patients and their families who survived to hospital discharge with a 65.8% response rate (mean age, 63.9 years; 29% women). Ninety-five percent of patients felt the reasons and process of transfer were well explained, and 97% felt transfer for care was necessary. Despite this, 15% of patients would have preferred to stay in their local hospital. The majority of the families felt the transfer process (88%) and family member's condition (94%) were well explained. Although 99% felt it was necessary for their family member to be transferred for specialized care, 11% of families still would have preferred that their family members remain at the local community hospital. Our results suggest that ST-segment-elevation myocardial infarction patients and families can be informed, even in time-critical situations, about the transfer process for PCI and understand the need for specialized care. Still, a significant minority would prefer to stay at their local hospital, despite acknowledging transfer for PCI provided optimal care.

  8. Economic impact of interventional study on rational use of antiseptics and disinfectants in Super Speciality Hospital of Nagpur.

    PubMed

    Agarwal, Vandana; Gharpure, Kunda; Thawani, Vijay; Makhija, Sushil; Thakur, Anita; Powar, Rajaram

    2008-03-01

    To measure the impact of interventions on rational use of antiseptics and disinfectants (A and D) for cost containment in Super Speciality Hospital (SSH) of Government Medical College, Nagpur (GMCN), India. This study was conducted from October 2003 to March 2007 in SSH of GMCN. In the pre-interventional phase (Phase-I), purchase, stocking and distribution of A and D was studied to find problem areas. Based on this formative data an intervention was planned (Phase-II) during which rationing of the A and D was done. Rational quantities needed for different A and D procedures were calculated based on recommendations of National Aids Control Organization (NACO) with modifications to suit our hospital setup. Detailed information, education, communication and training about rational use of A and D were provided to the hospital staff. In the post-interventional phase (Phase-III), the use of A and D was rationalized at the distribution level and the efficacy of in-use A and D was tested at user sites. Data about medicine expenditure, patient record and A and D usage in various departments was obtained from hospital records. Savings on A and D as against total annual medicine expenditure was calculated taking the cost of A and D in the post-intervention period. The expenditure on A and D as a result of intervention decreased by 20.7%. Out of the total medicine expenditure, the expenditure on A and D which accounted for 6.2% before intervention, decreased to 1.95% after the intervention. The information, education and communication (IEC) interventions attempted by us resulted in significant decrease in the use and expenditure of A and D.

  9. Common data elements for secondary use of electronic health record data for clinical trial execution and serious adverse event reporting.

    PubMed

    Bruland, Philipp; McGilchrist, Mark; Zapletal, Eric; Acosta, Dionisio; Proeve, Johann; Askin, Scott; Ganslandt, Thomas; Doods, Justin; Dugas, Martin

    2016-11-22

    Data capture is one of the most expensive phases during the conduct of a clinical trial and the increasing use of electronic health records (EHR) offers significant savings to clinical research. To facilitate these secondary uses of routinely collected patient data, it is beneficial to know what data elements are captured in clinical trials. Therefore our aim here is to determine the most commonly used data elements in clinical trials and their availability in hospital EHR systems. Case report forms for 23 clinical trials in differing disease areas were analyzed. Through an iterative and consensus-based process of medical informatics professionals from academia and trial experts from the European pharmaceutical industry, data elements were compiled for all disease areas and with special focus on the reporting of adverse events. Afterwards, data elements were identified and statistics acquired from hospital sites providing data to the EHR4CR project. The analysis identified 133 unique data elements. Fifty elements were congruent with a published data inventory for patient recruitment and 83 new elements were identified for clinical trial execution, including adverse event reporting. Demographic and laboratory elements lead the list of available elements in hospitals EHR systems. For the reporting of serious adverse events only very few elements could be identified in the patient records. Common data elements in clinical trials have been identified and their availability in hospital systems elucidated. Several elements, often those related to reimbursement, are frequently available whereas more specialized elements are ranked at the bottom of the data inventory list. Hospitals that want to obtain the benefits of reusing data for research from their EHR are now able to prioritize their efforts based on this common data element list.

  10. Economic impact of interventional study on rational use of antiseptics and disinfectants in Super Speciality Hospital of Nagpur

    PubMed Central

    Agarwal, Vandana; Gharpure, Kunda; Thawani, Vijay; Makhija, Sushil; Thakur, Anita; Powar, Rajaram

    2008-01-01

    Objective: To measure the impact of interventions on rational use of antiseptics and disinfectants (A and D) for cost containment in Super Speciality Hospital (SSH) of Government Medical College, Nagpur (GMCN), India. Materials and Methods: This study was conducted from October 2003 to March 2007 in SSH of GMCN. In the pre-interventional phase (Phase-I), purchase, stocking and distribution of A and D was studied to find problem areas. Based on this formative data an intervention was planned (Phase-II) during which rationing of the A and D was done. Rational quantities needed for different A and D procedures were calculated based on recommendations of National Aids Control Organization (NACO) with modifications to suit our hospital setup. Detailed information, education, communication and training about rational use of A and D were provided to the hospital staff. In the post-interventional phase (Phase-III), the use of A and D was rationalized at the distribution level and the efficacy of in-use A and D was tested at user sites. Data about medicine expenditure, patient record and A and D usage in various departments was obtained from hospital records. Savings on A and D as against total annual medicine expenditure was calculated taking the cost of A and D in the post-intervention period. Results: The expenditure on A and D as a result of intervention decreased by 20.7%. Out of the total medicine expenditure, the expenditure on A and D which accounted for 6.2% before intervention, decreased to 1.95% after the intervention. Conclusion: The information, education and communication (IEC) interventions attempted by us resulted in significant decrease in the use and expenditure of A and D. PMID:21279171

  11. Specialty hospital market proliferation: Strategic implications for general hospitals.

    PubMed

    Al-Amin, Mona; Zinn, Jacqueline; Rosko, Michael D; Aaronson, William

    2010-01-01

    Since the early 1990s, specialty hospitals have been continuously increasing in number. A moratorium was passed in 2003 that prohibited physicians' referrals of Medicare patients to newly established specialty hospitals if the physician has ownership stakes in the hospital. Although this moratorium expired in effect in 2007, many are still demanding that the government pass new policies to discourage the proliferation of specialty hospitals. This study aimed at examining the regulatory and environmental forces that influence specialty hospitals founding rate. Specifically, we use the resource partitioning theory to investigate the relationship between general hospitals closure rates and the market entry of specialty hospitals. This study will help managers of general hospitals in their strategic thinking and planning. We rely on secondary data resources, which include the American Hospital Association, Area Resource file, census, and Center for Medicare and Medicaid Services data, to perform a longitudinal analysis of the founding rate of specialty hospital in the 48 states. Specifically, we use the negative binomial generalized estimating equation approach available through Stata 9.0 to study the effect of general hospitals closure rate and environmental variables on the proliferation of specialty hospitals. Specialty hospitals founding rate seems to be significantly related to general hospitals closure rates. Moreover, results indicate that economic, supply, regulatory, and financial conditions determine the founding rate of specialty hospitals in different states. The results from this study indicate that the closure of general hospitals creates market conditions that encourage the market entry of specialized health care delivery forms such as specialty hospitals. Managers of surviving general hospitals have to view the closure of other general hospitals not just as an opportunity to increase market share but also as a threat of competition from new forms of health care organizations.

  12. Information technology governance domains in hospitals: a case study in Iran.

    PubMed

    Shahi, Mehraban; Sadoughi, Farahnaz; Ahmadi, Maryam

    2014-11-30

    IT governance is a set of organizational structures ensuring decision-making rights and responsibilities with regard to the organization's IT assets. This qualitative study was carried out to identify the IT governance domains in teaching hospitals affiliated to Iran University of Medical Sciences. There were 10 heads of IT departments and 10 hospital directors. Semi structured interviews used for data collection. To analyze the data content analysis was applied. All the interviewees (100%) believed that decisions upon hospital software needs could be made in a decentralized fashion by the IT department of the university. Most of the interviewees (90%) believed that there were policies for logistics and maintenance of networks, purchase and maintenance, standards and general policies in the direction of the policies of the ministry of health and medical education. About 80% of the interviewees believed that the current emphasis of the hospital's IT unit and the hospital management for outsourcing of services were in the format of specialized contracts and under supervision of the university Statistic and IT department. A hospital strategic committee is an official organizational group consisting of hospital executives, heads of IT and multiple functional areas and business units in a hospital. In this committee, "the head of hospital" acts as the director of IT activities and ensures that IT strategies are alignment with the hospital business strategies.

  13. 42 CFR 412.98 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false [Reserved] 412.98 Section 412.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the...

  14. Research and the Polytechnic

    ERIC Educational Resources Information Center

    Jones, Glen A.; Gopaul, Bryan

    2006-01-01

    In 1994, the Government of Norway initiated a major restructuring of the non-university sector. Almost one hundred vocationally-oriented institutions were amalgamated to create twenty-six comprehensive, autonomous colleges. Nursing education was completely reorganized. Once offered in specialized schools closely linked to hospitals, nursing became…

  15. Handle with Caring: Meeting Elderly Clients' Special Learning Needs.

    ERIC Educational Resources Information Center

    Fielo, Sandra B.; Rizzolo, Mary Anne

    1988-01-01

    The authors describe a course for senior nursing students in providing patient education to older adults who are no longer in the hospital. Topics covered in the class include body changes as a result of aging, pharmacokinetics, and patient adherence. (CH)

  16. 42 CFR 412.103 - Special treatment: Hospitals located in urban areas and that apply for reclassification as rural.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Commuting Area codes, as determined by the Office of Rural Health Policy (ORHP) of the Health Resources and... approved reclassification under this section remains in effect without need for reapproval unless there is...

  17. 5 CFR 7401.102 - Prior approval for outside employment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... participation in the activities of a nonprofit charitable, religious, professional, social, fraternal... specialized instruction and study in an institution of higher education, hospital, or similar facility... alternate DAEO may issue instructions or manual issuances governing the submission of requests for approval...

  18. 5 CFR 7401.102 - Prior approval for outside employment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... participation in the activities of a nonprofit charitable, religious, professional, social, fraternal... specialized instruction and study in an institution of higher education, hospital, or similar facility... alternate DAEO may issue instructions or manual issuances governing the submission of requests for approval...

  19. 5 CFR 7401.102 - Prior approval for outside employment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... participation in the activities of a nonprofit charitable, religious, professional, social, fraternal... specialized instruction and study in an institution of higher education, hospital, or similar facility... alternate DAEO may issue instructions or manual issuances governing the submission of requests for approval...

  20. 5 CFR 7401.102 - Prior approval for outside employment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... participation in the activities of a nonprofit charitable, religious, professional, social, fraternal... specialized instruction and study in an institution of higher education, hospital, or similar facility... alternate DAEO may issue instructions or manual issuances governing the submission of requests for approval...

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