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Sample records for ancillary services hospital

  1. Ancillary Services from Wind Farms

    Meeting the EU objectives of sustainable energy supply in the near future involves a dramatic increase of the electricity demand covered by variable renewable sources, among which wind power holds an important role. This important role comes together with ever increasing requirements of wind powe...... plants ability of delivering ancillary services to the power system. The presentation attempts at giving an overview of the present (and future) research on the ability of large (offshore) wind farms to provide power system services....

  2. Ancillary service provision from distributed generation

    This report summarises the findings of a study undertaken to investigate the potential for establishing ancillary service markets at the distribution level in the UK. Existing arrangements for ancillary service markets globally, the design of these markets, regulatory and legislative changes that may be required, different forms of distributed generation (DG), and prospects of increasing the connection to the distributed network are examined along with commercial frameworks and technical procedures, infrastructure requirements, and the effects on different market participants. The scope for new ancillary services at the distribution level, ancillary services from DG, the prospects for DG, commercial and technical aspects, and impact assessments are reviewed

  3. Ancillary service provision from distributed generation

    NONE

    2004-07-01

    This report summarises the findings of a study undertaken to investigate the potential for establishing ancillary service markets at the distribution level in the UK. Existing arrangements for ancillary service markets globally, the design of these markets, regulatory and legislative changes that may be required, different forms of distributed generation (DG), and prospects of increasing the connection to the distributed network are examined along with commercial frameworks and technical procedures, infrastructure requirements, and the effects on different market participants. The scope for new ancillary services at the distribution level, ancillary services from DG, the prospects for DG, commercial and technical aspects, and impact assessments are reviewed.

  4. The relationship of hospital ownership and service composition to hospital charges

    Eskoz, Robin; Peddecord, K. Michael

    1985-01-01

    The relationship of hospital ownership and service composition to hospital charges was examined for 456 general acute hospitals in California. Ancillary services had higher profit margins, both gross and net profits, than daily hospital services. Ancillary services accounted for 55.3 percent of total patient revenue. Charges per day were 23 percent higher for ancillary services than for daily hospital services. Net profits for daily and ancillary services were lowest at county hospitals. Prop...

  5. Ancillary services available to the orthopedic surgeon.

    Bert, Jack M

    2008-01-01

    The delivery of high quality medical services is approaching a crisis situation in the United States. As physician reimbursements decline and overhead increases, orthopedic surgeons must seek additional sources of revenue to remain financially viable and control the quality of medical care that they deliver. The orthopedic surgeon group is well positioned to control its own service lines and deliver excellent patient care as a result. This article reviews the possibilities of multiple types of ancillary service lines available for the orthopedic group practice. PMID:18061762

  6. Reliability Assessment of Coalitions for the Provision of Ancillary Services

    Blank, Marita

    2015-01-01

    The introduction of distributed renewable power units (RPU) changes the operation of electrical power systems. RPU take over tasks of conventional power plants such as energy supply and the provision of ancillary services. The ancillary service provision must be reliable in order to guarantee secure system operations. In this thesis, the RelACs-method is introduced to assess coalitions, i.e. aggregations of RPU, with respect of how reliably they are able to provide ancillary services, particu...

  7. Illustration of Modern Wind Turbine Ancillary Services

    Margaris, Ioannis D.; Hansen, Anca Daniela; Sørensen, Poul Ejnar; Hatziargyriou, Nikolaos D.

    2010-01-01

    Increasing levels of wind power penetration in modern power systems has set intensively high standards with respect to wind turbine technology during the last years. Security issues have become rather critical and operation of wind farms as conventional power plants is becoming a necessity as wind...... turbines replace conventional units on the production side. This article includes a review of the basic control issues regarding the capability of the Doubly Fed Induction Generator (DFIG) wind turbine configuration to fulfill the basic technical requirements set by the system operators and contribute to...... power system security. An overview of ancillary services provided by wind turbine technology nowadays is provided, i.e., fault ride-through capability, reactive power supply and frequency-active power control....

  8. Options for pricing ancillary services in a deregulated power system

    Yamin, Hatim Yahya

    2001-07-01

    GENCOs in restructured systems are compensated for selling energy in the market. In a restructured market, a mechanism is required to entice participants in the market to provide ancillary services and to ensure adequate compensation that would guarantee its economic viability. The ISO controls the dispatch of generation, manages the reliability of the transmission grid, provides open access to the transmission, buys and provides ancillary services as required, coordinates day-ahead, hour-ahead schedules and performs real time balancing of load and generation, settles real time imbalances and ancillary services sales and purchases. The ISO, also, administers congestion management protocols for the transmission grid. Since the ISO does not own any generating units it must ensure that there is enough reserves for maintaining reliability according to FERC regulations, and sufficient unloaded generating capacity for balancing services in a real-time market. The ISO could meet these requirements by creating a competitive market for ancillary services, which are metered and remain unbundled to provide an accurate compensation for each supplier and cost to each consumer, In this study, we give an overview for restructuring and ancillary services in a restructured power marketplace. Also, we discuss the effect of GENCOs' actions in the competitive energy and ancillary service markets. In addition, we propose an auction market design for hedging ancillary service costs in California market. Furthermore, we show how to include the n-1 and voltage contingencies in security constrained unit commitment. Finally, we present two approaches for GENCOs' unit commitment in a restructured power market; one is based on game theory and the other is based on market price forecasting. In each of the two GENCOs' unit commitment approaches, we discuss the GENCOs' optimal bidding strategies in energy and ancillary service markets to maximize the GENCOs' profit.

  9. Load Participation in Ancillary Services System from An Operator Perspective

    Kujawski, Don [PJM, Audubon, PA (United States); Petri, Mark C. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2011-10-25

    Ancillary services as defined by FERC (Order 888) distinguished by response time, duration, frequency. Met when DR has capability to balance supply and demand; and LMP payment to DR is cost effective.

  10. Frequency control ancillary services in large interconnected systems

    Diouf, Edmond

    2013-01-01

    This research focuses on frequency control ancillary services in large interconnected systems. It analyses and assesses possible alternatives for optimal and innovative solutions of major frequency control issues in large interconnected systems within liberalised electricity markets. Possible improvements in the performance of frequency control are identified. A framework of frequency control ancillary services in large interconnected systems by including loads and wind generation is also pro...

  11. Survey of U.S. Ancillary Services Markets

    Zhou, Zhi [Argonne National Lab. (ANL), Argonne, IL (United States); Levin, Todd [Argonne National Lab. (ANL), Argonne, IL (United States); Conzelmann, Guenter [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-01-01

    In addition to providing energy to end-consumers, power system operators are also responsible for ensuring system reliability. To this end, power markets maintain an array of ancillary services to ensure it is always possible to balance the supply and demand for energy in real-time. A subset of these ancillary services are commonly procured through market-based mechanisms: namely, Regulation, Spinning, and Non-spinning Reserves.

  12. Using OWL-S to annotate services with ancillary behaviour

    Belecheanu, R A; Jacyno, M; Payne, T.

    2004-01-01

    This paper introduces the concept of services with ancillary behaviour and illustrates the use of OWL-S to semantically describe them. The OWL-S syntax used reflects the dynamic and core-function independent nature of ancillary behaviour. The approach is illustrated on the case of a ubiquitous computing system designed to offer care in the home of a cardiac patient. Here one of the challenges is to ensure service availability, team awareness and transaction atomicity. The concept of commitmen...

  13. Integration of Flexible Consumers in the Ancillary Service Markets

    Biegel, Benjamin; Westenholz, Mikkel; Hansen, Lars Henrik;

    2014-01-01

    Flexible consumption devices are often able to quickly adjust the power consumption making these devices very well suited as providers of fast ancillary services such as primary and secondary reserves. As these reserves are among the most well-paid ancillary services, it is an interesting idea...... to let an aggregator control a portfolio of flexible consumption devices and sell the accumulated flexibility in the primary and secondary reserve markets. However, two issues make it difficult for a portfolio of consumption devices to provide ancillary services: First, flexible consumption devices only...... have a limited energy capacity and are therefore not able to provide actual energy deliveries. Second, it is often difficult to make an accurate consumption baseline estimate for a portfolio of flexible consumption devices. These two issues do not fit the current regulations for providing ancillary...

  14. The evolving design of RTO ancillary service markets

    Although the markets for ancillary services at the North American Independent System Operators are often structured in quite different ways there is an emerging set of core design elements that represent a rough consensus as to what the optimal design configuration for ancillary services should be, albeit with some regional variation. This paper looks back at how the design of ancillary services markets has recently evolved to put this development in context. Thereafter it examines the methods by which ancillary services are procured by highlighting the procurement practices at a number of different Independent System Operators, principally those in California, New York, New England, Texas and the PJM Interconnection, in an attempt to tease out the remaining reasons why the ancillary service markets are still so different. This is important as there are many innovations that are not rooted in regional differences but reflect genuine technical advances and economic efficiency gains and can be replicated across other ISOs to produce more efficient designs, greater reliability and lower costs. (author)

  15. Loads Providing Ancillary Services: Review of International Experience

    Heffner, Grayson; Goldman, Charles; Kintner-Meyer, Michael

    2007-05-01

    In this study, we examine the arrangements for and experiences of end-use loads providing ancillary services (AS) in five electricity markets: Australia, the United Kingdom (UK), the Nordic market, and the ERCOT and PJM markets in the United States. Our objective in undertaking this review of international experience was to identify specific approaches or market designs that have enabled customer loads to effectively deliver various ancillary services (AS) products. We hope that this report will contribute to the ongoing discussion in the U.S. and elsewhere regarding what institutional and technical developments are needed to ensure that customer loads can meaningfully participate in all wholesale electricity markets.

  16. Optimal generator bidding strategies for power and ancillary services

    Morinec, Allen G.

    As the electric power industry transitions to a deregulated market, power transactions are made upon price rather than cost. Generator companies are interested in maximizing their profits rather than overall system efficiency. A method to equitably compensate generation providers for real power, and ancillary services such as reactive power and spinning reserve, will ensure a competitive market with an adequate number of suppliers. Optimizing the generation product mix during bidding is necessary to maximize a generator company's profits. The objective of this research work is to determine and formulate appropriate optimal bidding strategies for a generation company in both the energy and ancillary services markets. These strategies should incorporate the capability curves of their generators as constraints to define the optimal product mix and price offered in the day-ahead and real time spot markets. In order to achieve such a goal, a two-player model was composed to simulate market auctions for power generation. A dynamic game methodology was developed to identify Nash Equilibria and Mixed-Strategy Nash Equilibria solutions as optimal generation bidding strategies for two-player non-cooperative variable-sum matrix games with incomplete information. These games integrated the generation product mix of real power, reactive power, and spinning reserve with the generators's capability curves as constraints. The research includes simulations of market auctions, where strategies were tested for generators with different unit constraints, costs, types of competitors, strategies, and demand levels. Studies on the capability of large hydrogen cooled synchronous generators were utilized to derive useful equations that define the exact shape of the capability curve from the intersections of the arcs defined by the centers and radial vectors of the rotor, stator, and steady-state stability limits. The available reactive reserve and spinning reserve were calculated given a

  17. Demand Response Resources for Energy and Ancillary Services (Presentation)

    Hummon, M.

    2014-04-01

    Demand response (DR) resources present a potentially important source of grid flexibility particularly on future systems with high penetrations of variable wind an solar power generation. However, DR in grid models is limited by data availability and modeling complexity. This presentation focuses on the co-optimization of DR resources to provide energy and ancillary services in a production cost model of the Colorado test system. We assume each DR resource can provide energy services by either shedding load or shifting its use between different times, as well as operating

  18. Ancillary services and optimal household energy management with photovoltaic production

    This article presents a project designed to increase the monetary value of photovoltaic (PV) solar production for residential applications. To contribute to developing new functionalities for this type of PV system and an efficient control system for optimising its operation, this article explains how the proposed system could contract to provide ancillary services, particularly the supply of active power services. This provision of service by a PV-based system for domestic applications, not currently available, has prompted a market design proposal related to the distribution system. The mathematical model for calculating the system's optimal operation (sources, load and exchanges of power with the grid) results in a linear mix integer optimisation problem in which the objective is to maximise the profits achieved by taking part in the electricity market. Our approach is illustrated in a case study. PV producers could gain by taking part in the markets for balancing power or ancillary services despite the negative impact on profit of several types of uncertainty, notably the intermittent nature of the PV source. (author)

  19. Ancillary services and optimal household energy management with photovoltaic production

    This article presents a project designed to increase the monetary value of photovoltaic (PV) solar production for residential applications. To contribute to developing new functionalities for this type of PV system and an efficient control system for optimising its operation, this article explains how the proposed system could contract to provide ancillary services, particularly the supply of active power services. This provision of service by a PV-based system for domestic applications, not currently available, has prompted a market design proposal related to the distribution system. The mathematical model for calculating the system's optimal operation (sources, load and exchanges of power with the grid) results in a linear mix integer optimisation problem in which the objective is to maximise the profits achieved by taking part in the electricity market. Our approach is illustrated in a case study. PV producers could gain by taking part in the markets for balancing power or ancillary services despite the negative impact on profit of several types of uncertainty, notably the intermittent nature of the PV source.

  20. Commercial Building Loads Providing Ancillary Services in PJM

    MacDonald, Jason; Kiliccote, Sila; Boch, Jim; Chen, Jonathan; Nawy, Robert

    2014-06-27

    The adoption of low carbon energy technologies such as variable renewable energy and electric vehicles, coupled with the efficacy of energy efficiency to reduce traditional base load has increased the uncertainty inherent in the net load shape. Handling this variability with slower, traditional resources leads to inefficient system dispatch, and in some cases may compromise reliability. Grid operators are looking to future energy technologies, such as automated demand response (DR), to provide capacity-based reliability services as the need for these services increase. While DR resources are expected to have the flexibility characteristics operators are looking for, demonstrations are necessary to build confidence in their capabilities. Additionally, building owners are uncertain of the monetary value and operational burden of providing these services. To address this, the present study demonstrates the ability of demand response resources providing two ancillary services in the PJM territory, synchronous reserve and regulation, using an OpenADR 2.0b signaling architecture. The loads under control include HVAC and lighting at a big box retail store and variable frequency fan loads. The study examines performance characteristics of the resource: the speed of response, communications latencies in the architecture, and accuracy of response. It also examines the frequency and duration of events and the value in the marketplace which can be used to examine if the opportunity is sufficient to entice building owners to participate.

  1. Effective Ancillary Services Market Designs on High Wind Power Penetration Systems: Preprint

    Ela, E.; Kirby, B.; Navid, N.; Smith, J. C.

    2011-12-01

    This paper focuses on how the ancillary service market designs are implemented and how they may require changes on systems with greater penetrations of variable renewable energy suppliers, in particular wind power. Ancillary services markets have been developed in many of the restructured power system regions throughout the world. Ancillary services include the services that support the provision of energy to support power system reliability. The ancillary services markets are tied tightly to the design of the energy market and to the physics of the system and therefore careful consideration of power system economics and engineering must be considered in their design. This paper focuses on how the ancillary service market designs are implemented and how they may require changes on systems with greater penetrations of variable renewable energy suppliers, in particular wind power.

  2. Transactive Control and Coordination of Distributed Assets for Ancillary Services

    Subbarao, Krishnappa; Fuller, Jason C.; Kalsi, Karanjit; Somani, Abhishek; Pratt, Robert G.; Widergren, Steven E.; Chassin, David P.

    2013-09-18

    The need to diversify energy supplies, the need to mitigate energy-related environmental impact, and the entry of electric vehicles in large numbers present challenges and opportunities to power system professionals. Wind and solar power provide many benefits, and to reap the benefits the resulting increased variability—forecasted as well as unforecasted—should be addressed. Demand resources are receiving increasing attention as one means of providing the grid balancing services. Control and coordination of a large number (~millions) of distributed smart grid assets requires innovative approaches. One such is transactive control and coordination (TC2)—a distributed, agent-based incentive and control system. The TC2 paradigm is to create a market system with the following characteristics: • Participation should be entirely voluntary. • The participant decides at what price s/he is willing to participate. • The bids and responses are automated. Such an approach has been developed and demonstrated by Pacific Northwest National Laboratory for energy markets. It is the purpose of this project to develop a similar approach for ancillary services. In this report, the following ancillary services are considered: • spinning reserve • ramping • regulation. These services are to be provided by the following devices: • refrigerators • water heaters • clothes dryers • variable speed drives. The important results are summarized below: The regulation signal can be divided into an energy-neutral high frequency component and a low frequency component. The high frequency component is particularly well suited for demand resources. The low frequency component, which carries energy non-neutrality, can be handled by a combination of generators and demand resources. An explicit method for such a separation is obtained from an exponentially weighted moving average filter. Causal filters (i.e., filters that process only present and past values of a signal

  3. 78 FR 46177 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    2013-07-30

    ... Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric Storage...-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric Storage... services. \\6\\ Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for...

  4. Technical and economic aspects of ancillary services markets in the electric power industry: an international comparison

    We present a comparative analysis of technical and economic aspects of ancillary services on the markets of England and Wales, Nordic Countries, California, Argentina, Australia and Spain, comparing the services of voltage control, frequency regulation and system restoration. All the analyzed markets rely on the existence of an administrator of ancillary services, function that leads to the figure of the system operator. Among the services analyzed, the mandatory nature of voltage control and primary frequency regulation stands out, being both the ancillary services with the higher market price and the shortest period of time requirements. In general, the recognized costs of the services correspond to investments operation, maintenance, and opportunity costs. In the provision of these ancillary services, there are no clear preferences for a particular resource allocation mechanism, where mandatory provision, auctions, competitive offers and different time length bilateral contracts are combined

  5. 77 FR 40413 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    2012-07-09

    ... 101 Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric... 101 Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric... jurisdiction. \\2\\ Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for...

  6. Capabilities and costs for ancillary services provision by wind power plants. Deliverable D 3.1

    Faiella, Mariano; Hennig, Tobias; Cutululis, Nicolaos Antonio; Van Hulle, Frans

    This report is the deliverable of the third work package of the REserviceS project and describes the technical options and related costs for the provision of ancillary services specifically from wind energy technologies. It is focused on the set of ancillary services defined in the previous work...... package 2, shown in table 1 below. The information from this deliverable will be used as input to the case studies in subsequent work packages, which are expected to provide additional insights to the actual provision of ancillary services in transmission and distribution networks....

  7. The Nordic approach to market-based provision of ancillary services

    This paper presents an overview of the markets for ancillary services, which are regulated and traded differently within and across borders in the Nordic countries. We describe the services provided and their characteristics in terms of definition, participation, contracting approach and duration, selection of offers, and dispatch criteria. Further, we assess the costs, specify the payments, and discuss cost allocation, and we conclude with a policy discussion of ancillary services in the Nordic countries

  8. The Nordic approach to market-based provision of ancillary services

    This paper presents an overview of the markets for ancillary services, which are regulated and traded differently within and across borders in the Nordic countries. We describe the services provided and their characteristics in terms of definition, participation, contracting approach and duration, selection of offers, and dispatch criteria. Further, we assess the costs, specify the payments, and discuss cost allocation, and we conclude with a policy discussion of ancillary services in the Nordic countries. (author)

  9. Ancillary services: technical specifications, system needs and costs. Deliverable D 2.2

    Holttinen, Hannele; Cutululis, Nicolaos Antonio; Gubina, Andrej;

    2012-01-01

    In this report, different ancillary services are described and a table listing main services is presented. While Chapter 2 is describing the services from (renewable) generators point of view, Chapter 3 is considering future system needs for services with increased wind and solar penetration. The...

  10. Ancillary Services for the European Grid with High Shares of Wind and Solar Power

    Van Hulle, Frans; Holttinen, Hannele; Kiviluoma, Juha;

    2012-01-01

    With significantly increasing share of variable renewable power generation like wind and solar PV, the need in the power system for ancillary services supporting the network frequency, voltage, etc. changes. Turning this issue around, market opportunities will emerge for wind and solar PV...... technology to deliver such grid services. In the European power system, adequate market mechanisms need to be developed to ensure that there will be an efficient trading of these services. For that purpose a range of (economic) characteristics of wind (and solar) power as providers of grid services need......) conceptually analyzing system needs for ancillary services and at assessing the technical aspects of and cost of delivering these services by solar PV and wind power, in scenarios of high renewable penetration. (2) Investigation of the need for ancillary services in typical transmission and distribution...

  11. Security-constrained ancillary services allocation and pricing in integrated markets

    Ancillary services are used to control system frequency and to ensure the secure and reliable transmission of electricity from suppliers to consumers. A new dispatch formulation for determining optimal network security constraints for generator active-power schedules and the allocation of ancillary services was presented in this study. The conventional optimal power flow (OPF) formulation was based on an integrated market model with energy and ancillary services procured simultaneously using a co-optimization process. The Newton method for optimizing the Lagrange function formed from individual cost functions and constraints was used. The contingency formulation considered power demand variations at load nodes. Additional control variables were added in order to meet new load demands in the dispatch formulation. A Lagrange function was used to develop an extended set of security constraints as well as individual prices for ancillary service providers. Costs related to maintenance, lower efficiency and lower active-power generation were the variable costs of frequency control. Services compensating the transmission system losses between consumers and suppliers were described as grid loss compensation services. Case studies of representative power systems were used to verify the new dispatch calculation method. The study showed that minimizing the procurement costs of ancillary services can lead to insecure system operations. 13 refs., 3 tabs., 3 figs.

  12. Simulating the Operation of Markets for Bulk-Power Ancillary Services

    Eric Hirst; Brendan Kirby

    1998-01-01

    The U.S. Federal Energy Regulatory Commission (FERC) requires electric utilities to offer six ancillary services. Most of the tariffs filed with FERC price these services on the basis of traditional cost-of-service (embedded) costs, Because most of these services are provided by generating units, however, it should be possible to create competitive markets for them. This paper describes, the structure of, and results from, a spreadsheet model that simulates markets for seven services: losses,...

  13. Service Robots for Hospitals

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable......, adaptable and scalable. Robots have to be semi-autonomous, and should reliably navigate in large and dynamic environments in the hospital. The complexity of the problem has to be manageable, and the solutions have to be flexible, so that the system can be applicable in real world settings. This thesis...

  14. Ancillary services in the health care industry: is Six Sigma reasonable?

    Johnstone, Peter A S; Hendrickson, Julie A W; Dernbach, Allison J; Secord, Ann R; Parker, John C; Favata, Michael A; Puckett, Michael L

    2003-01-01

    Within the naval medical center construct, the disparate disciplines encompassed within ancillary services lend themselves to formal quality analysis and process improvement. This analysis uses the Six Sigma approach. Error rates were investigated and calculated for various processes within ancillary services at Naval Medical Center, San Diego. These were translated into the common metric of defects per million opportunities (DPMO). DPMO rates vary between 21.5 and 420,000. These correspond to Sigma values from 1.7 to approaching 6. Rates vary with biological complexity of the system and the degree of automation available. Some ancillary services translate well into a Six Sigma schema. Systems with high potential patient risk if performed poorly and those amenable to second checking and computer oversight may be candidates for such optimization. This should be undertaken in a local environment conducive to individual error reporting, and in a corporate environment with the will and funding to support the transition. PMID:12593375

  15. Hospitality Services. Curriculum Guide.

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

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

  16. Loads Providing Ancillary Services: Review of InternationalExperience-- Technical Appendix: Market Descriptions

    Grayson Heffner, Charles Goldman, Kintner-Meyer, M; Kirby, Brendan

    2007-05-01

    In this study, we examine the arrangements for andexperiences of end-use loads providing ancillary services (AS) in fiveelectricity markets: Australia, the United Kingdom (UK), the Nordicmarket, and the ERCOT and PJM markets in the United States. Our objectivein undertaking this review of international experience was to identifyspecific approaches or market designs that have enabled customer loads toeffectively deliver various ancillary services (AS) products. We hopethat this report will contribute to the ongoing discussion in the U.S.and elsewhere regarding what institutional and technical developments areneeded to ensure that customer loads can meaningfully participate in allwholesale electricity markets.

  17. Mixed integer non-linear programming and Artificial Neural Network based approach to ancillary services dispatch in competitive electricity markets

    Highlights: • Ancillary services market management. • Ancillary services requirements forecast based on Artificial Neural Network. • Ancillary services clearing mechanisms without complex bids and with complex bids. - Abstract: Ancillary services represent a good business opportunity that must be considered by market players. This paper presents a new methodology for ancillary services market dispatch. The method considers the bids submitted to the market and includes a market clearing mechanism based on deterministic optimization. An Artificial Neural Network is used for day-ahead prediction of Regulation Down, regulation-up, Spin Reserve and Non-Spin Reserve requirements. Two test cases based on California Independent System Operator data concerning dispatch of Regulation Down, Regulation Up, Spin Reserve and Non-Spin Reserve services are included in this paper to illustrate the application of the proposed method: (1) dispatch considering simple bids; (2) dispatch considering complex bids

  18. Risk Management: Supporting the District's Ancillary Services Staff

    Waldmann, Steve; Strasburger, Tom

    2013-01-01

    The everyday operations of a school district depend on a network of people, including students, teachers, staff, and administrators. However, the ancillary services staff are really responsible for making the school day run smoothly. They are often the first employees that students see in the morning, either on the school bus or in the cafeteria,…

  19. Optimal Sizing and Allocation of Residential Photovoltaic Panels in a Distribution Network for Ancillary Services Application

    Kordheili, Reza Ahmadi; Pourmousavi, Ali; Pillai, Jayakrishnan Radhakrishna; M. Hasanien, Hany; Bak-Jensen, Birgitte; Nehrir, M. Hashem

    Tremendous penetration of renewable energy in electric networks, despite its valuable opportunities, such as balancing reserve and ancillary service, has raised concerns for network operators. Such concern stems from grid operating conditions. Such huge penetration can lead to violation in the gr...

  20. The business of medicine: how to overcome financial obstacles and secure financing for your private practice and ancillary services business.

    Nayor, David

    2012-01-01

    Doctors across the country who operate private medical practices are facing increasing financial obstacles, namely shrinking income as a result of rising costs and lower reimbursements. In addition, as hospitals have become overburdened many physicians have opened up private surgical centers; magnetic resonance imaging and computed tomography and positron emission tomography scanning facilities; pathology labs; colonoscopy/endoscopy suites; lithotripsy centers; and other medical businesses typically performed within the hospital. Moreover, many doctors seek loans to purchase existing practices or for their capital contribution in medical partnerships. The past decade has thus seen a significant increase in the number of doctors taking out small business loans. Indeed, banks view the healthcare industry as a large growth market. This article includes practical information, advice, and resources to help doctors to secure bank financing for their practices, ancillary services business, real estate, and equipment on the best possible market terms. PMID:22920034

  1. Ancillary services for the European grid with high shares of wind and solar power

    Hulle, Frans van [EWEA, Brussels (Belgium); Holttinen, Hannele; Kiviluoma, Juha [VTT (Finland); Cutululis, Nicolaos [DTU (Denmark)

    2012-07-01

    With significantly increasing share of variable renewable power generation like wind and solar PV, the need in the power system for ancillary services supporting the network frequency, voltage, etc. changes. Turning this issue around, market opportunities will emerge for wind and solar PV technology to deliver such grid services. In the European power system, adequate market mechanisms need to be developed to ensure that there will be an efficient trading of these services. For that purpose a range of (economic) characteristics of wind (and solar) power as providers of grid services need to be better understood. This relates both to the technical capabilities of the plants for delivering specific services and to the quantification of the needs. The paper presents the approach of the European lEE project REserviceS, aiming at establishing reference guidance for the ongoing developments in Europe of network codes and electricity market design. Economic insights gained from REserviceS will be shaped into recommendations to be used when establishing electricity market mechanisms and Network Codes at EU level. The project approach presented in the paper consists of two main parts namely (1) conceptually analyzing system needs for ancillary services and at assessing the technical aspects of and cost of delivering these services by solar PV and wind power, in scenarios of high renewable penetration. (2) Investigation of the need for ancillary services in typical transmission and distribution networks, and the cost and options to deliver these services at high penetration. The paper will give an overview of case studies envisaged, together with the intended methods used for the analysis. The paper also gives some initial project results. It presents the outcome of the assessment of ancillary services that are especially relevant for wind and solar power. These are mainly related to frequency, voltage control and restoration of the system. In addition, based on existing

  2. VOLTTRON-Based System for Providing Ancillary Services with Residential Building Loads

    Jin, Xin

    2016-07-01

    Ancillary services entail controlled modulation of building equipment to maintain a stable balance of generation and load in the power system. Ancillary services include frequency regulation and contingency reserves, whose acting time ranges from several seconds to several minutes. Many pilot studies have been implemented to use industrial loads to provide ancillary services, and some have explored services from commercial building loads or electric vehicle charging loads. Residential loads, such as space conditioning and water heating, represent a largely untapped resource for providing ancillary services. The residential building sector accounts for a significant fraction of the total electricity use in the United States. Many loads in residential buildings are flexible and could potentially be curtailed or shifted at the request of the grid. However, there are many barriers that prevent residential loads being widely used for ancillary services. One of the major technical barriers is the lack of communication capabilities between end-use devices and the grid. End-use devices need to be able to receive the automatic generation control (AGC) signal from the grid operator and supply certain types of telemetry to verify response. With the advance of consumer electronics, communication-enabled, or 'connected,' residential equipment has emerged to overcome the communication barrier. However, these end-use devices have introduced a new interoperability challenge due to the existence of numerous standards and communication protocols among different end devices. In this paper, we present a VOLTTRON-based system that overcomes these technical challenges and provides ancillary services with residential loads. VOLTTRON is an open-source control and sensing platform for building energy management, facilitating interoperability solutions for end devices. We have developed drivers to communicate and control different types of end devices through standard

  3. Alternative Approaches for Incentivizing the Frequency Responsive Reserve Ancillary Service

    Ela, E.; Milligan, M.; Kirby, B.; Tuohy, A.; Brooks, D.

    2012-03-01

    Frequency responsive reserve is the autonomous response of generators and demand response to deviations of system frequency, usually as a result of the instantaneous outage of a large supplier. Frequency responsive reserve arrests the frequency decline resulting in the stabilization of system frequency, and avoids the triggering of under-frequency load-shedding or the reaching of unstable frequencies that could ultimately lead to system blackouts. It is a crucial service required to maintain a reliable and secure power system. Regions with restructured electricity markets have historically had a lack of incentives for frequency responsive reserve because generators inherently provided the response and on large interconnected systems, more than sufficient response has been available. This may not be the case in future systems due to new technologies and declining response. This paper discusses the issues that can occur without proper incentives and even disincentives, and proposes alternatives to introduce incentives for resources to provide frequency responsive reserve to ensure an efficient and reliable power system.

  4. Market and policy barriers for demand response providing ancillary services in U.S. markets

    Cappers, Peter [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); MacDonald, Jason [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)

    2013-03-01

    This study provides an examination of various market and policy barriers to demand response providing ancillary services in both ISO/RTO and non-ISO/RTO regions, especially at the program provider level. It is useful to classify barriers in order to create a holistic understanding and identify parties that could be responsible for their removal. This study develops a typology of barriers focusing on smaller customers that must rely on a program provider (i.e., electric investor owned utility or IOU, ARC) to create an aggregated DR resource in order to bring ancillary services to the balancing authority. The barriers were identified through examinations of regulatory structures, market environments, and product offerings; and discussions with industry stakeholders and regulators. In order to help illustrate the differences in barriers among various wholesale market designs and their constituent retail environments, four regions were chosen to use as case studies: Colorado, Texas, Wisconsin, and New Jersey.

  5. Simulated annealing to handle energy and ancillary services joint management considering electric vehicles

    Sousa, Tiago M; Soares, Tiago; Morais, Hugo;

    2016-01-01

    The massive use of distributed generation and electric vehicles will lead to a more complex management of the power system, requiring new approaches to be used in the optimal resource scheduling field. Electric vehicles with vehicle-to-grid capability can be useful for the aggregator players in the...... mitigation of renewable sources intermittency and in the ancillary services procurement. In this paper, an energy and ancillary services joint management model is proposed. A simulated annealing approach is used to solve the joint management for the following day, considering the minimization of the...... aggregator total operation costs. The case study considers a distribution network with 33-bus, 66 distributed generation and 2000 electric vehicles. The proposed simulated annealing is matched with a deterministic approach allowing an effective and efficient comparison. The simulated annealing presents a...

  6. Techno-economic analysis of energy storage systems for grid ancillary services

    Peracaula Ruiz, Àlex

    2014-01-01

    In a future with a higher renewable penetration, energy storage technologies will play an important role. They may, for example, use curtailed energy for arbitrage or supply ancillary services, help in relieving the grid congestion, and promote distributed generation. A techno-economic understanding and comparison between several electrical energy storage options is pursued as the main objective. Technologies with particular interest are: pumped hydropower storage, compressed air energy stora...

  7. Usage of direct search methods in predictive control of ancillary services

    Most European transmission systems are interconnected to ensure the reliability and accessibility of electric power supply. Transmission system operators (TSOs) are responsible for ensuring that contracted cross-border supplies are available and that deficits are accommodated. TSOs typically buy ancillary services in advance for use in periods of deficit. This paper described a predictive control approach for ancillary services in interconnected electricity systems. The model was designed to predict the difference between contracted and actual cross-border transmission of electric power. The power sources were considered as individual power plants. The receding horizon principle was applied in order to compute the time sequences of individual sources for longer prediction periods using only the initial part of the sequences. Coverage included positive tertiary regulation; negative tertiary regulation; quickstart; dispatch reserve; and energy bought from other countries. Inputs were converted into binary values for the optimization algorithm. The technical properties of individual sources were used as fundamental constraints. The optimization algorithm was able to determine optimal sequences of ancillary services within a prediction horizon of 6 hours. 6 refs., 1 tab., 6 figs.

  8. Identifying children in need of ancillary and enabling services: a population approach.

    Benedict, Ruth E; Farel, Anita M

    2003-12-01

    Children with chronic or disabling conditions use health, education and social services at a higher rate than their healthy peers. Estimates of the number of children in need of these specialized services are widely varied and often depend on categorical definitions that do not account for either the diversity or commonality of their experiences. Developing methods for identifying the population in need of services, particularly children likely to use long-term ancillary (audiology, occupational, physical or speech therapy, or social work) and/or enabling services (special equipment, personal care assistance, respite care, transportation, or environmental modifications), is essential for effective policy and program implementation. This study examines several recent attempts to operationalize definitions of children with chronic conditions using a noncategorical classification approach. Particular emphasis is placed on the subgroup of children identified as having functional limitations. Proposed operational definitions of children with functional limitations are compared using data from the 1994-1995 Disability Supplement to the US National Health Interview Survey. Estimates of the number of children reported to be using ancillary and enabling services are generated and compared across operational definitions of functional limitation as well as by the number, severity, and type (i.e. mobility, self-care, communication/sensory, social cognition/learning ability) of limitation. Depending on the operational definition selected, 9-14% of US community-dwelling children are estimated to have functional limitations. Among children with limitations, 26-30% regularly use ancillary services and 11-14% use enabling services. The strengths, limitations, and potential applications for each operational definition are discussed. PMID:14512235

  9. Analysis of the Impact of Wind Power Participating in Both Energy and Ancillary Services Markets – The Danish Case

    Soares, Tiago; Morais, Hugo; Pinson, Pierre

    2014-01-01

    The impact of a high penetration of wind power generation in power systems motivates need for an assessment of its inte raction with electricity markets. With the continuous evolution of wind turbines technology, wind farms have today the ability to provide certain ancillary services with...... appropriate levels of security and reliability . The participation of wind f arms i n ancillary service market s ought to rely on market designs and offering strategies that satisfy power system needs, as well as their operating characteristics . Here we evaluate the system impact of different offering...... strategies that wind farms employ on ene rgy and ancillary service market. A lready proposed Proportional Wind Reserve Strategy (PWRS) and a Continuo us Wind Reserve Strategy (CWRS) are used to determine the amount of available power for ancillary services. A case study based on real and recent dat a for...

  10. 76 FR 36400 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    2011-06-22

    ... providing ancillary services; and accounting and financial reporting matters as they relate to recovery of costs for electric storage technologies, noting that the Commission's accounting and financial reporting... Requirements for Energy Storage Resources 23. The Commission's accounting \\40\\ and financial...

  11. Hospitality Services. Student Activity Book.

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

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

  12. Resource and revenue potential of California residential load participation in ancillary services

    Increasing penetrations of intermittent renewable energy resources will require additional power system services. California recently adopted an energy storage mandate to support its renewable portfolio standard, which requires 33% of delivered energy from renewables by 2020. The objective of this paper is to estimate the amount of energy storage that could be provided by residential thermostatically controlled loads, such as refrigerators and air conditioners, and the amount of revenue that could be earned by loads participating in ancillary services markets. We model load aggregations as virtual energy storage, and use simple dynamical system models and publicly available data to generate our resource and revenue estimates. We find that the resource potential is large: 10–40 GW/8–12 GWh, which is significantly more than that required by the mandate. We also find that regulation and spinning/non-spinning reserve revenues vary significantly depending upon type of load and, for heat pumps and air conditioners, climate zone. For example, mean regulation revenues for refrigerators are $11/year, for electric water heaters are $24/year, for air conditioners are $0-32/year, and for heat pumps are $22–56/year. Both consumer choices, such as appliance settings, and policy, such as the design of ancillary service compensation and appliance standards, could increase revenue potentials. - Highlights: • California's energy storage mandate requires 1.325 GW of energy storage by 2020. • Residential loads such as refrigerators have thermal energy storage. • California's residential loads could provide 10-40 GW/8-12 GWh of storage. • Loads participating in ancillary services markets could earn up to $56/load/year. • Consumer choices and policy mechanisms could increase revenue potentials

  13. Technical Feasibility of Ancillary Services provided by ReGen Plants

    Altin, Müfit; Han, Xue; Hansen, Anca Daniela; Løvenstein Olsen, Rasmus; Nicolaos Antonio CUTULULIS; Iov, Florin

    2015-01-01

    This report is the first deliverable in WP1 in the project “Ancillary services from renewable power plants” (RePlan). RePlan is funded as PSO project 2015 no. 12347 by the Danish PSO-programme ForskEL, which is administered by Energinet.DK. RePlan is carried out in collaboration between DTU Wind Energy, DTU Elektro, Aalborg University Energy Technology, Aalborg University Wireless Communication Networks and Vestas Wind System A/S. DTU Wind Energy is manager of the project.

  14. An integrated pan-European ancillary services market for frequency control

    Real-time balancing of mismatches between consumption and production is one of the key elements for the secure operation of power systems. This takes place within the framework of ancillary services managed by respective national transmission system operating companies. The objective of this paper is to investigate the option of one integrated pan-European ancillary services market. Our contribution is twofold: quantifying the potential benefit of such an option and outlining a possible approach to such an option highlighting its positive properties as well as risks and challenges. In several recently published considerations of pan-European electricity supply models this topic has not been adequately addressed, but we believe it is one of the crucial subjects in shaping the future electricity supply in Europe. -- Author-Highlights: •We investigated the option of a one-area market for frequency control in Continental Europe. •For the current situation a centralised approach may lead to a significant reduction of control reserves. •In the long run it is a possibility to avoid a tremendous increase of needed control reserves. •The implementation of an integrated market is not to be underestimated

  15. Open Automated Demand Response Communications in Demand Response for Wholesale Ancillary Services

    Kiliccote, Sila; Piette, Mary Ann; Ghatikar, Girish; Koch, Ed; Hennage, Dan; Hernandez, John; Chiu, Albert; Sezgen, Osman; Goodin, John

    2009-11-06

    The Pacific Gas and Electric Company (PG&E) is conducting a pilot program to investigate the technical feasibility of bidding certain demand response (DR) resources into the California Independent System Operator's (CAISO) day-ahead market for ancillary services nonspinning reserve. Three facilities, a retail store, a local government office building, and a bakery, are recruited into the pilot program. For each facility, hourly demand, and load curtailment potential are forecasted two days ahead and submitted to the CAISO the day before the operation as an available resource. These DR resources are optimized against all other generation resources in the CAISO ancillary service. Each facility is equipped with four-second real time telemetry equipment to ensure resource accountability and visibility to CAISO operators. When CAISO requests DR resources, PG&E's OpenADR (Open Automated DR) communications infrastructure is utilized to deliver DR signals to the facilities energy management and control systems (EMCS). The pre-programmed DR strategies are triggered without a human in the loop. This paper describes the automated system architecture and the flow of information to trigger and monitor the performance of the DR events. We outline the DR strategies at each of the participating facilities. At one site a real time electric measurement feedback loop is implemented to assure the delivery of CAISO dispatched demand reductions. Finally, we present results from each of the facilities and discuss findings.

  16. An assessment of market and policy barriers for demand response providing ancillary services in U.S. electricity markets

    An impact of increased variable renewable generation is the need for balancing authorities to procure more ancillary services. While demand response resources are technically capable of providing these services, current experience across the U.S. illustrates they are relatively minor players in most regions. Accessing demand response resources for ancillary services may require a number of changes to policies and common practices at multiple levels. Regional reliability councils must first define ancillary services such that demand response resources may provide them. Once the opportunity exists, balancing authorities define and promulgate rules that set the infrastructure investments and performance attributes of a resource wishing to provide such services. These rules also dictate expected revenue streams which reveal the cost effectiveness of these resources. The regulatory compact between utility and state regulators, along with other statutes and decisions by state policymakers, may impact the interest of demand response program providers to pursue these resources as ancillary service providers. This paper identifies within these broad categories specific market and policy barriers to demand response providing ancillary services in different wholesale and retail environments, with emphasis on smaller customers who must be aggregated through a program provider to meet minimum size requirements for wholesale transactions. - Highlights: • We identify barriers keeping demand response from providing ancillary services. • Institutional, financial and program provider business model barriers exist. • Product definitions and rules do not always accommodate demand response well. • Expected revenues are uncertain and may not exceed required investments costs. • Regulatory compact and state statutes limit opportunities for program providers

  17. Development of modified rational buyer auction for procurement of ancillary services utilizing participation matrix

    The rational buyer auction is based on a simultaneous auction that is the redesigned auction mechanism for ancillary services by the California independent system operator (CAISO). The incentive for the rational buyer auction is CAISO's intent to adopt a common sense rule of substituting higher-quality lower-cost services for lower-quality higher-cost services, when it results in reduced total procurement cost. For the purposes of designing a desirable auction where the minimum cost for the objective function as well as prevention of price reversal are achieved, either the payment cost in marginal pricing auction must be lowered or price reversal in rational buyer auction must be avoided. The objectives of this study are (a) to develop a newly proposed 'modified rational buyer' auction that does not allow price reversal and (b) to propose and validate a solution procedure that is based on participation matrix and discrete programming. The validation of the proposed solution procedure is accomplished through examination of two case studies available in the literature. Based on the first case study data, it is shown that the newly developed modified rational buyer auction avoids price reversal occurrence, while the total payment of ISO is increased by 5.8%, as compared with rational buyer auction. Also in comparison with marginal pricing auction, the ISO payment is lowered by 38.8%, when the newly developed modified rational buyer auction is utilized. For future work, it is recommended that the application of the modified rational buyer auction to joint dispatch of energy and ancillary services is investigated. (author)

  18. Hospital-based neuropsychological services.

    Sciara, A D

    1986-01-01

    Hospital-based neuropsychological services may provide the hospital with a new means of interfacing with the general medical community, especially neurologists and neurosurgeons. This could produce increased census through the evaluation and treatment of patients who may not have been referred to the psychiatric hospital previously. Additionally, it is a service that can be marketed to the legal community. The establishment of neuropsychological services is a relatively inexpensive project that requires little in the way of physical plant and personnel needs other than a qualified technician and neuropsychologist. PMID:10279536

  19. Electric industry restructuring, ancillary services, and the potential impact on wind

    Kirby, B.; Hirst, E. [Oak Ridge National Lab., TN (United States); Parsons, B.; Porter, K. [National Renewable Energy Lab., Golden, CO (United States)] [and others

    1997-12-31

    The new competitive electric power environment raises increased challenges for wind power. The DOE and EPRI wind programs have dealt extensively with the traditional vertically integrated utility planning and operating environment in which the host utility owns the generation (or purchases the power) and provides dispatch and transmission services. Under this traditional environment, 1794 MW of wind power, principally in California, have been successfully integrated into the U.S. electric power system. Another 4200 MW are installed elsewhere in the world. As issues have arisen, such as intermittency and voltage regulation, they have been successfully addressed with accepted power system procedures and practices. For an intermittent, non-dispatchable resource such as wind, new regulatory rules affecting power transmission services, raise questions about which ancillary services wind plants will be able to sell, which they will be required to purchase, and what the economic impacts will be on individual wind projects. This paper begins to look at issues of concern to wind in a restructured electric industry. The paper first briefly looks at the range of unbundled services and comments on their unique significance to wind. To illustrate the concerns that arise with restructuring, the paper then takes a more detailed look at a single service: regulation. Finally, the paper takes a brief look at technologies and strategies that could improve the competitive position of wind.

  20. Ancillary services and the integration of substantial quantities of wind power

    Østergaard, Poul Alberg

    2006-01-01

    Denmark has the World’s highest penetration of grid connected wind power in electricity generation with a share of 15.0% of total domestic demand in 2002 [Danish Energy Authority. Rapport fra arbejdsgruppen om kraftvarme- og VE-elektricitet. Bilagsrapport. Copenhagen: Danish Energy Authority; 2001......]. This is unevenly distributed in the two separate electricity systems comprising Denmark, giving a 2003 share as high as 21% in Western Denmark [Eltra. http://www.Eltra.dk. Skærbæk: Eltra; 2004] compared with a more modest 8% in the more densely populated Eastern Denmark [Elkraft System. Miljøberetning 2004...... as the potential impact of heat pumps used for district heating and installed for integration purposes. The analyses are made with particular focus on grid stability and delivery of ancillary services (required to control voltage and frequency) and demonstrate that it is possible to accommodate 50% or more wind...

  1. Cost-Causation-Based Tariffs for Wind Ancillary Service Impacts: Preprint

    Kirby, B.; Milligan, M.; Wan, Y.

    2006-06-01

    Conference paper discussing the integration cost of wind. Although specific tariffs for wind generation for ancillary services are uncommon, we anticipate that balancing authorities (control areas) and other entities will move toward such tariffs. Tariffs for regulation and imbalance services should be cost-based, recognize the relevant time scales that correspond with utility operational cycles, and properly allocate those costs to those entities that cause the balancing authority to incur the costs. In this paper, we present methods for separating wind's impact into regulation and load following (imbalance) time scales. We show that approximating these impacts with simpler methods can significantly distort cost causation and even cause confusion between the relevant time scales. We present results from NREL's wind data collection program to illustrate the dangers of linearly scaling wind resource data from small wind plants to approximate the wind resource data from large wind plants. Finally, we provide a framework for developing regulation and imbalance tariffs, we outline methods to begin examining contingency reserve requirements for wind plants, we provide guidance on the important characteristics to consider, and we provide hypothetical cases that the tariff can be tested against to determine whether the results are desired.

  2. Integrated Power Management of Conventional Units and Industrial Loads in China’s Ancillary Services Scheduling

    Mingtao Yao

    2015-05-01

    Full Text Available With the development of the smart grid in China, new opportunities for responsive industrial loads to participate in the provision of ancillary services (AS will become accessible. This paper summarizes AS in China and analyzes the necessary characteristics and advantages of industrial users to provide AS according to their response mechanism. Cement manufacturing and aluminum smelter processes are selected as two representatives of responsive industrial loads. An agent-based model that includes generation, industrial user, and grid agents is proposed. Using two case studies, we analyze the integrated power management of conventional units and industrial loads in day-ahead and real-time AS scheduling based on real device parameters, price mechanisms and production data. The simulation results indicate that the participation of responsive industrial loads in the provision of AS, in China, can improve the coal consumption rate and the system-wide load factor as well as reduce the total system cost for the provision of AS significantly.

  3. Impact of Production from Photovoltaic Power Plants on Increase of Ancillary Services in the Czech Republic

    Martin Smocek

    2016-01-01

    Full Text Available Renewable energy resources represent a noticeable part of the overall energetic concept development. New integration of renewable energy resources into power grids has a significant impact on the reliability and quality of power supply. The major problem of the photovoltaic and wind power plants is their dependency on weather conditions, since it has a direct effect on their immediate output produced that shows stochastic behaviour. These stochastic outputs result in very adverse impacts on the power grid. Further development of these resources could lead to exceeding of the control and absorption abilities of the power grid. The power grid must be set in balance with respect to the production and consumption of electric power at any time. The operation of photovoltaic power plants impair keeping this balance. That has an adverse impact on the very operation and maintenance of network parameters within the extent required. This survey deals with analysis focused on operation of the photovoltaic power plants with respect to the increase of reserve power in ancillary services in the Czech Republic.

  4. Analysis of the Effects of a Flexible Ramping Ancillary Service Product on Power System Operations: Preprint

    Krad, Ibrahim; Ibanez, Eduardo; Ela, Erik

    2015-10-19

    The recent increased interest in utilizing variable generation (VG) resources such as wind and solar in power systems has motivated investigations into new operating procedures. Although these resources provide desirable value to a system (e.g., no fuel costs or emissions), interconnecting them provides unique challenges. Their variable, non-controllable nature in particular requires significant attention, because it directly results in increased power system variability and uncertainty. One way to handle this is via new operating reserve schemes. Operating reserves provide upward and downward generation and ramping capacity to counteract uncertainty and variability prior to their realization. For instance, uncertainty and variability in real-time dispatch can be accounted for in the hour-ahead unit commitment. New operating reserve methodologies that specifically account for the increased variability and uncertainty caused by VG are currently being investigated and developed by academia and industry. This paper examines one method inspired by the new operating reserve product being proposed by the California Independent System Operator. The method is based on examining the potential ramping requirements at any given time and enforcing those requirements via a reserve demand curve in the market-clearing optimization as an additional ancillary service product.

  5. Pump Storage Hydropower for delivering Balancing Power and Ancillary Services - A Case Study of Illvatn Pump Storage Power Plant

    Norang, Ingunn

    2015-01-01

    The power markets in Europe are changing rapidly. The drastic shift towards renewable energy and interconnection between power markets has brought with it challenges related to power balance and grid stability. Consumption and generation of electric power needs to be at balance at all times and a secure and reliable power system requires sensitivity to multiple time scales. Increased demand for balancing energy and ancillary services has the potential of making pump storage projects in Norway...

  6. Vip service in hospitality industry

    Sirkiä, Noora

    2013-01-01

    This bachelor’s thesis investigates the processes involved with VIP treatment in hospitality industry and more specifically in the hotel environment. It aims to explain the significance of the VIPs in the hotel business and the tools the hotel can utilize to accommodate the needs and requests of the VIP guests’. This study was commissioned by a full service hotel Baltimore Marriott Waterfront in the United States. This thesis gives information about the types of VIP guests in hotel industr...

  7. Impact of Market Behavior, Fleet Composition, and Ancillary Services on Revenue Sufficiency

    Frew, Bethany [National Renewable Energy Lab. (NREL), Golden, CO (United States); Gallo, Giulia [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brinkman, Gregory [National Renewable Energy Lab. (NREL), Golden, CO (United States); Milligan, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Clark, Kara [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bloom, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-06-01

    Revenue insufficiency, or the missing money problem, occurs when the revenues that generators earn from the market are not sufficient to cover both fixed and variable costs to remain in the market and/or justify investments in new capacity, which may be needed for reliability. The near-zero marginal cost of variable renewable generators further exacerbates these revenue challenges. Estimating the extent of the missing money problem in current electricity markets is an important, nontrivial task that requires representing both how the power system operates and how market participants behave. This paper explores the missing money problem using a production cost model that represented a simplified version of the Electric Reliability Council of Texas (ERCOT) energy-only market for the years 2012-2014. We evaluate how various market structures -- including market behavior, ancillary services, and changing fleet compositions -- affect net revenues in this ERCOT-like system. In most production cost modeling exercises, resources are assumed to offer their marginal capabilities at marginal costs. Although this assumption is reasonable for feasibility studies and long-term planning, it does not adequately consider the market behaviors that impact revenue sufficiency. In this work, we simulate a limited set of market participant strategic bidding behaviors by means of different sets of markups; these markups are applied to the true production costs of all gas generators, which are the most prominent generators in ERCOT. Results show that markups can help generators increase their net revenues overall, although net revenues may increase or decrease depending on the technology and the year under study. Results also confirm that conventional, variable-cost-based production cost simulations do not capture prices accurately, and this particular feature calls for proxies for strategic behaviors (e.g., markups) and more accurate representations of how electricity markets work. The

  8. Secure provision of reactive power ancillary services in competitive electricity markets

    El-Samahy, Ismael

    decoupled and assumed to be fixed during the reactive power dispatch procedures; however, the effect of reactive power on real power is considered in the model by calculating the required reduction in real power output of a generator due to an increase in its reactive power supply. In this case, real power generation is allowed to be rescheduled, within given limits, from the already dispatched levels obtained from the energy market clearing process. The proposed dispatch model achieves the main objective of an ISO in a competitive electricity market, which is to provide the required reactive power support from generators at least cost while ensuring a secure operation of the power system. The proposed reactive power procurement and dispatch models capture both the technical and economic aspects of power system operation in competitive electricity markets; however, from an optimization point of view, these models represent non-convex mixed integer non-linear programming (MINLP) problems due to the presence of binary variables associated with the different regions of reactive power operation in a synchronous generator. Such MINLP optimization problems are difficult to solve, especially for an actual power system. A novel Generator Reactive Power Classification (GRPC) algorithm is proposed in this thesis to address this issue, with the advantage of iteratively solving the optimization models as a series of non-linear programming (NLP) sub-problems. The proposed reactive power procurement and dispatch models are implemented and tested on the CIGRE 32-bus system, with several case studies that represent different practical operating scenarios. The developed models are also compared with other approaches for reactive power provision, and the results demonstrate the robustness and effectiveness of the proposed model. The results clearly reveal the main features of the proposed models for optimal provision of reactive power ancillary service, in order to suit the requirements of

  9. From a bundled energy-capacity pricing model to an energy-capacity-ancillary services pricing model

    In this paper, we extend the Chilean power generation pricing mechanism, with capacity and energy payments, to one where ancillary services (AS), as frequency regulation and voltage control, are explicitly recognized. Adequacy and security attributes of the electric system and the public good characteristics of AS are set within the payment structure to distribute the financing of AS among those who benefit from their provision. The contribution to finance the provision of AS is determined assessing the value assigned to the system security by each agent, following what's an efficient pricing mechanism in the presence of public goods

  10. Active Power Control of Wind Turbines for Ancillary Services: A Comparison of Pitch and Torque Control Methodologies

    Aho, Jacob; Fleming, Paul; Pao, Lucy Y.

    2016-08-01

    As wind energy generation becomes more prevalent in some regions, there is increased demand for wind power plants to provide ancillary services, which are essential for grid reliability. This paper compares two different wind turbine control methodologies to provide active power control (APC) ancillary services, which include derating or curtailing power generation, providing automatic generation control (AGC), and providing primary frequency control (PFC). The torque APC controller provides all power control through the power electronics whereas the pitch APC controller uses the blade pitch actuators as the primary means of power control. These controllers are simulated under various wind conditions with different derating set points and AGC participation levels. The metrics used to compare their performance are the damage equivalent loads (DELs) induced on the structural components and AGC performance metrics, which are used to determine the payments for AGC services by system operators in the United States. The simulation results show that derating the turbine reduces structural loads for both control methods, with the APC pitch control providing larger reductions in DELs, lower AGC performance scores, and higher root-mean-square pitch rates. Providing AGC increases the structural loads when compared to only derating the turbine, but even the AGC DELs are generally lower than those of the baseline control system. The torque APC control methodology also allows for more sustained PFC responses under certain derating conditions.

  11. Strategic management of Public Hospitals' medical services.

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

    2016-01-01

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

  12. A framework for cost-based pricing of transmission and ancillary services in competitive electric power markets

    In this paper the authors propose a framework for accurate cost determination and pricing of transmission and ancillary services in competitive electric power markets. The proposed framework is based on their anticipation of the evolving environment and industry structure. They envision the future as a competitive energy market with a centralized control entity that coordinates system activities, prices transmission and ancillary services and controls various system resources. This control entity has control over a certain (pre-defined) geographical area. It is proposed that the system operation and control be kept as they are currently done in control centers, no major change in these functions is required for the proposed pricing strategy. The pricing strategy is divided into two main classes based on time scale separation and firmness, short and long term, firm and interruptible contracts. The approach is based on superposition of different transaction on the network, and a three-part tariff design. The charges are directly related to the impact of each transaction on the system

  13. Three utilization patterns of the renovated Moste hydro power plant on an electricity market of power and ancillary services

    In addition to electricity, most hydro power plants can offer also the ancillary services: secondary and tertiary control reserve. On emerging electricity markets the need for these additional services is becoming more and more important, recognised and also paid. However, for each plant, there is some interdependence among those options. The same plant cannot provide maximal peaking electricity, maximal secondary control reserve as well as maximal tertiary control reserve at the same time. The generation capabilities of the plant must thus be partitioned properly among those options so as to achieve some overall goal (e.g. the maximum of revenue, etc.). This article briefly presents those options for the renovated Moste cascade on the upper Sava river near Bled in Slovenia. A small but effective mixed integer linear programme has been used. (author)

  14. Estimating hospital service areas using mortality statistics.

    Carpenter, E S; Plessas, D. J.

    1985-01-01

    This article reports research testing an alternative methodology for patient origin studies that uses hospital deaths as a proxy measure for all discharges from a selected group of urban tertiary hospitals. Results indicated that mortality data from vital statistics records provide a reasonable approximation of patient travel patterns to acute care hospitals. Hospital service area indexes constructed from mortality statistics accurately predicted, on an aggregate regional basis, the results o...

  15. Service quality for facilities management in hospitals

    Sui Pheng, Low

    2016-01-01

    This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...

  16. Map of risks for the implementation of radio-frequency identification: application of ancillaries in the University Hospital Jean Verdier.

    Bertrand, E; Schlatter, J

    2010-01-01

    Ancillaries are surgical instruments, such as orthopedical instruments set for reconstruction of knee (a mounting arm...) used to implant or extract prosthesis. Their management involves the departments of sterilization and surgery as well as the suppliers. Such a long circuit exposes the instruments to potential risk hazards like a lack of traceability as the suspicion of Creutzfeldt-Jakob. In order to reduce the risk of errors we will propose the implementation of radio-frequency identification (RFID) to trace the ancillaries during each step of the supply chain. The objective of our study is to analyze and to map the risks associated with RFID implementation. A preliminary analysis of risks (APR) is conducted to map out the hazards for the implementation of RFID. The APR identifies 162 scenarios with a maximum risk connected to environment and technology. To reduce the risks identified, 22 courses of action are proposed, such as audits, training, and internal controls. For each action, a procedure has been designed and evaluated. This preliminary analysis of risks allows targeting the potential dangers for the RFID implementation applied to ancillaries and reduces them significantly. PMID:20187581

  17. Proposal for the award of an industrial services contract for operation of the hostels, apartments and ancillary premises

    2000-01-01

    This document concerns the award of an Industrial Services contract for operation of the hostels, apartments and ancillary premises run by the CERN Housing Service. Following a market survey carried out among 32 firms in ten Member States, a call for tenders (IT-2404/AS/Rev.) was sent on 5 April 2000 to one firm and three consortia in four Member States. By the closing date, CERN had received tenders from the firm and the three consortia. The Finance Committee is invited to agree to the negotiation of a contract with the consortium VIENNA INTERNATIONAL HOTEL MANAGEMENT (AT) - SEREG (CH), the lowest bidder, for an initial period of five years, to enter into force on 1 January 2001, for a total amount of 6 871 850 Swiss francs, not subject to revision until 31 December 2001. The contract will include an option for two one-year extensions beyond the initial five-year period. The consortium has indicated the following distribution by country of the contract value covered by this adjudication proposal: CH-60%, AT-...

  18. Industrial Use of Distributed Generation in Real-Time Energy and Ancillary Service Markets

    Hudson, C.R.

    2001-10-24

    Industrial consumers of energy now have the opportunity to participate directly in electricity generation. This report seeks to give the reader (1) insights into the various types of generation services that distributed generation (DG) units could provide, (2) a mechanism to evaluate the economics of using DG, (3) an overview of the status of DG deployment in selected states, and (4) a summary of the communication technologies involved with DG and what testing activities are needed to encourage industrial application of DG. Section 1 provides details on electricity markets and the types of services that can be offered. Subsequent sections in the report address the technical requirements for participating in such markets, the economic decision process that an industrial energy user should go through in evaluating distributed generation, the status of current deployment efforts, and the requirements for test-bed or field demonstration projects.

  19. eServices for Hospital Equipment

    De Jonge, M.; Van der Linden, W.P.M.; Willems, H.X.

    2007-01-01

    In this paper we explore the idea that by combining different sources of information in a hospital environment, valuable e-services canbe developed that may help in reducing cost and improving quality of service. Companies, like Philips Medical Systems, may have a compe-titive advantage, because the

  20. Online AMR Domestic Load Profile Characteristic Change Monitor to Support Ancillary Demand Services

    Stephen, Bruce; Isleifsson, Fridrik Rafn; Galloway, Stuart;

    2014-01-01

    remote rural communities, are currently modeled with homogenous and coarse load profiles developed from aggregated data. An objective of AMR deployment is to clarify the nature and variability of the residential LV customer. In this paper, an algorithm for tracking the consistency of the behavior of...... small loads is presented. This would allow them to be assessed for their availability to provide demand services to the grid. In the method presented, significant changes in behavior are detected using Bayesian changepoint analysis which tracks a multivariate Gaussian representation of a residential...

  1. Hospital services and casemix in Western Australia.

    Hendrie, Delia; Boldy, Duncan

    2002-01-01

    The Health Department of WA currently operates as a single integrated funder and purchaser of health services for the State. Health Service Agreements defining the level of health provision are negotiated with the various health services in WA. During the latter part of the 1990s, the funding of public hospitals for acute inpatient care moved away from a historical basis to output-based funding using a casemix approach based on Diagnosis Related Groups (DRGs). Other hospital services are still mainly purchased using historical funding levels, negotiated block funding or bedday payments, with output-based funding mechanisms under investigation. WA has developed its own approach to classifying admitted patients that recognises differences in complexity of care among episodes grouped to the same DRG. WA also has a unique cost estimation model for calculating DRG cost weights, which is based on a linear estimate of the relationship between nights of stay in hospital and the cost of hospital care for each DRG. Another emerging trend in the provision of public hospital services in WA has been the greater involvement of the private sector through the contracting of private providers to operate public hospitals. While no close examination has been undertaken of the outcomes of these changes in terms of their effect on efficiency or other relevant indicators of hospital performance, current purchasing arrangements are being reviewed following recommendations made in a report by the Health Administrative Review Committee. No decision has yet been made as to future changes to the funding policy of WA public hospitals. PMID:11974956

  2. Ancillary revenue pricing

    Wittmer, Andreas; Oberlin, Nicole

    2014-01-01

    The airline industry has evolved from a system of long-established state owned carriers operating in a regular market to a dynamic, deregulated industry. This development - especially the emerging competition of Low Cost Carriers - had a major influence on the price setting behavior of airlines. Profitability of airlines is limited and pricing systems are reconsidered. In order to stay competitive traditional full service carriers consider the implementation of ancillary revenue systems (simi...

  3. 42 CFR 447.280 - Hospital providers of NF services (swing-bed hospitals).

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Hospital providers of NF services (swing-bed hospitals). 447.280 Section 447.280 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Inpatient Hospital and Long-Term Care Facility Services Swing-Bed Hospitals § 447.280 Hospital providers...

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

    2010-10-01

    ... mental diseases. 440.140 Section 440.140 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... services for individuals age 65 or older in institutions for mental diseases. (a) Inpatient hospital services. “Inpatient hospital services for individuals age 65 or older in institutions for mental...

  5. 77 FR 69848 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    2012-11-21

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

  6. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    2010-11-09

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

  7. 42 CFR 409.26 - Transfer agreement hospital services.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Transfer agreement hospital services. 409.26... SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.26 Transfer agreement hospital services. (a) Services furnished by an intern or a resident-in-training. Medicare pays for...

  8. Uninterrupted service on the hospital menu.

    Vines, Lee

    2014-09-01

    Lee Vines, sales and marketing director at PKL Group, a leading supplier of temporary and permanent catering infrastructure, considers the challenges facing hospital caterers and estates managers in ensuring that catering equipment is kept up-to-date and fit-for-purpose. He also discusses the options available to make sure kitchen services are able to run without interruption during planned or unplanned periods of kitchen 'downtime'. PMID:25282991

  9. Smart microgrid hierarchical frequency control ancillary service provision based on virtual inertia concept: An integrated demand response and droop controlled distributed generation framework

    Highlights: • Detailed formulation of the microgrid static and dynamic securities based on droop control and virtual inertia concepts. • Constructing a novel objective function using frequency excursion and rate of change of frequency profiles. • Ensuring the microgrid security subject to the microgrid economic and environmental policies. • Coordinated management of demand response and droop controlled distributed generation resources. • Precise scheduling of day-ahead hierarchical frequency control ancillary services using a scenario based stochastic programming. - Abstract: Low inertia stack, high penetration levels of renewable energy source and great ratio of power deviations in a small power delivery system put microgrid frequency at risk of instability. On the basis of the close coupling between the microgrid frequency and system security requirements, procurement of adequate ancillary services from cost-effective and environmental friendly resources is a great challenge requests an efficient energy management system. Motivated by this need, this paper presents a novel energy management system that is aimed to coordinately manage the demand response and distributed generation resources. The proposed approach is carried out by constructing a hierarchical frequency control structure in which the frequency dependent control functions of the microgrid components are modeled comprehensively. On the basis of the derived modeling, both the static and dynamic frequency securities of an islanded microgrid are provided in primary and secondary control levels. Besides, to cope with the low inertia stack of islanded microgrids, novel virtual inertia concept is devised based on the precise modeling of droop controlled distributed generation resources. The proposed approach is applied to typical test microgrid. Energy and hierarchical reserve resource are scheduled precisely using a scenario-based stochastic programming methodology. Moreover, analyzing the

  10. Peer-to-Peer Consultations: Ancillary Services Peer Exchange with India: Experience from South Africa, Europe & the United States (Fact Sheet)

    2014-05-01

    In support of national and subnational decision makers, the 21st Century Power Partnership regularly works with country partners to organize peer-to-peer consultations on critical issues. In March 2014, 21CPP collaborated with the Regulatory Assistance Project - India to host two peer-to-peer exchanges among experts from India, South Africa, Europe, and the United States to discuss the provision of ancillary services, particularly in the context of added variability and uncertainty from renewable energy. This factsheet provides a high level summary of the peer-to-peer consultation.

  11. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    2010-10-01

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

  12. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    2013-10-30

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

  13. [Quality of services in a small hospital].

    Clément, Y

    1993-04-01

    The nursing services department of a 64 bed hospital in Caraquet, New Brunswick, (serving a widespread population of 25,000 people) decided to check the quality of care offered to their patients. A search was conducted among numerous quality of care management models to find the one that best suited their needs. They chose a structured quality appraisal and management program currently being used by the Royal Victoria Hospital in Montreal. The author outlines the way quality assurance directors in this Montreal hospital empower their health care providers. The author describes the concept of quality and summarizes the oriental and occidental ideologies that influence it. The nursing staff's perception of the essential elements of quality assurance are explained and the stages are identified. The author maintains that decentralization and delegation empowers individuals and instills confidence while maintaining the essential personal touch. She believes that the organization of the future is one that will promote teamwork. She also believes that motivation, participative management and workplace satisfaction promote quality care--"care that doesn't cost a dime." This program has numerous advantages. It allows employees to fully participate in the process. It also averts potential problems, and provides employees with the ability to discover and problem solve when necessary. It also allows for the strengths and weaknesses of each service to be outlined and identified deficiencies corrected. PMID:8472244

  14. Prehospital digital photography and automated image transmission in an emergency medical service – an ancillary retrospective analysis of a prospective controlled trial

    Bergrath Sebastian

    2013-01-01

    Full Text Available Abstract Background Still picture transmission was performed using a telemedicine system in an Emergency Medical Service (EMS during a prospective, controlled trial. In this ancillary, retrospective study the quality and content of the transmitted pictures and the possible influences of this application on prehospital time requirements were investigated. Methods A digital camera was used with a telemedicine system enabling encrypted audio and data transmission between an ambulance and a remotely located physician. By default, images were compressed (jpeg, 640 x 480 pixels. On occasion, this compression was deactivated (3648 x 2736 pixels. Two independent investigators assessed all transmitted pictures according to predefined criteria. In cases of different ratings, a third investigator had final decision competence. Patient characteristics and time intervals were extracted from the EMS protocol sheets and dispatch centre reports. Results Overall 314 pictures (mean 2.77 ± 2.42 pictures/mission were transmitted during 113 missions (group 1. Pictures were not taken for 151 missions (group 2. Regarding picture quality, the content of 240 (76.4% pictures was clearly identifiable; 45 (14.3% pictures were considered “limited quality” and 29 (9.2% pictures were deemed “not useful” due to not/hardly identifiable content. For pictures with file compression (n = 84 missions and without (n = 17 missions, the content was clearly identifiable in 74% and 97% of the pictures, respectively (p = 0.003. Medical reports (n = 98, 32.8%, medication lists (n = 49, 16.4% and 12-lead ECGs (n = 28, 9.4% were most frequently photographed. The patient characteristics of group 1 vs. 2 were as follows: median age – 72.5 vs. 56.5 years, p = 0.001; frequency of acute coronary syndrome – 24/113 vs. 15/151, p = 0.014. The NACA scores and gender distribution were comparable. Median on-scene times were longer with picture

  15. Hospitality and service: leading real change.

    Kerfoot, Karlene M

    2009-01-01

    A patient's decision to recommend a health care organization and the patient's loyalty scores are largely determined by the interaction patients and their families have with the nurses. Hospitality is how the delivery of that product makes the person feel and is a dialogue that requires the server to be "on the guest's side" throughout the experience. The challenge for health care is to help our patients and their families transcend the usual routine care of our health care world and to experience an emotional connection that provides that sense of affiliation and emotional kinship with the organization and the staff. Moving from the service mindset in health care to the hospitality mindset that engages people positively and emotionally is what healing is all about. PMID:19927973

  16. Compliance with technical codes becomes obligatory for receipt of feed-in tariff and ancillary services bonus for wind power plants in Germany

    Boemer, Jens. C. [Ecofys Germany GmbH, Berlin (Germany). Power Systems and Markets Group; Delft Univ. of Technology (Netherlands). Electrical Power Systems Group; Burges, Karsten [Ecofys Germany GmbH, Berlin (Germany). Power Systems and Markets Group; Kumm, Thomas [VDE, Network Technology and Operation Forum (FNN), Berlin (Germany); Poeller, Markus [DIgSILENT GmbH, Gomaringen (Germany)

    2009-07-01

    The German government aims at a share of electricity generation based on renewable sources (RES-E) of more than 30% by 2020. A major part of this share will be reached by the use of wind power plants (WPP). Therefore, when amending the Renewable Energy Sources Act (EEG) in June 2008, the German government acknowledged the importance of enhanced technical requirements for WPP and announced the development of a respective technical ordinance. For all WPP that go into operation after June 2010, full grid code-compliance becomes a precondition for privileged network access, receipt of feed-in tariff, and extra payments (''ancillary services bonus''). The basis for the technical requirements in the EEG has been laid down by Medium-Voltage (MV)-Directive 2008 and the TransmissionCode 2007. However, the work of the authors - consulting the German government during the development of the technical ordinance - showed that the TransmissionCode 2007 needed careful review and some clarifying specifications were proposed. Eventually, the so called ''Ancillary Services Ordinance'' for wind power plants went into power in July 2009. The interrelation between all three grid codes as well as their specifications and implications for renewable energy sources generators, with special regard to wind power plants, are presented in this paper. (orig.)

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

    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

  18. Computerized system for hospital engineering service management

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

  19. Unit cost of medical services at different hospitals in India.

    Susmita Chatterjee

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

  20. Coldwater River NWR Ancillary Bird Observations 2006

    US Fish and Wildlife Service, Department of the Interior — Ancillary bird observations on Coldwater River NWR in 2006 were recorded by local birders. No sampling design was used to generate the observations

  1. Coldwater River NWR Ancillary Bird Observations 2009

    US Fish and Wildlife Service, Department of the Interior — Ancillary bird observations on Coldwater River NWR in 2009 were recorded by local birders. No sampling design was used to generate the observations

  2. A study of the consumer decision process for hospitality services

    Teare, Richard Edward

    1989-01-01

    The purpose of the study was to investigate the consumer decision process for hospitality services, with particular reference to the interactions occuring between the consumer and the producer during service delivery. As the hospitality industry is very diverse, the hotel short break product was selected as the locus for the study. At the outset, a hypothetical model of the consumer decision process was constructed, drawing on the characteristics of hospitality services and the differing ...

  3. Pre-hospital critical care by anaesthesiologist-staffed pre-hospital services in Scandinavia

    Krüger, A J; Lossius, H M; Mikkelsen, S;

    2013-01-01

    All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...

  4. The right to arrange ancillary services in line with municipal awards of concession; Das Recht auf Vereinbarung von Nebenleistungen im Rahmen gemeindlicher Konzessionsvergaben

    Templin, Wolf [Boos Hummel und Wegerich Rechtsanwaelte, Berlin (Germany)

    2012-12-15

    Due to the plurality of concession contracts currently levelling off in the fields of electricity and natural gas as well as due to the increasing competition for the power distribution systems, the municipal granting of concession contracts as well as the relevant standards come in the focus of the legal disputes. Recently, the increasing competition and the claims of sustainable impacts of the municipalities on the local energy policy also in line with the awarding of concessions have led to the use of concession contracts for the control of local government concerns and climate political concerns of the municipalities. Under this aspect, the author of the contribution under consideration report on the right to arrange ancillary services in line with municipal awards of concession.

  5. Measuring the Quality of Hospital Services Hospital Specific Factors and Individual Evaluations

    2009-01-01

    Is an increase in the quality of health services, as perceived by the hospital, appreciated by the consumers? If so, patients should respond positively to an increase in the quality of hospital services. Using two indicators to capture the quality of hospital services I investigate the relationship between these indicators and inpatients experiences. The health sector has increased substantially in most OECD countries over the last few decades. In Norway, total health care expenditures a...

  6. 47 CFR 25.149 - Application requirements for ancillary terrestrial components in the mobile-satellite service...

    2010-10-01

    ... terrestrial components in the mobile-satellite service networks operating in the 1.5./1.6 GHz, 1.6/2.4 GHz and... service networks operating in the 1.5./1.6 GHz, 1.6/2.4 GHz and 2 GHz mobile-satellite service. (a... shall not exceed the geographical coverage area of the mobile satellite service network of the...

  7. A home from hospital service for older people.

    Donnelly, Michael; Dempster, Martin

    1999-01-01

    Current policy and practice emphasises much more than ever before a need for purchasers and providers to reduce appropriately the length of hospital stay. Consequently, a number of early discharge "schemes" have been developed. This paper presents the findings from an evaluation of a "home from hospital" (HFH) scheme. The HFH service provides a maximum of six weeks' intensive domiciliary care for older people on their discharge from hospital. The aim of the service is to facilitate early disc...

  8. Do Agglomeration Economies Exist in the Hospital Services Industry

    Laurie J. Bates; Rexford E. Santerre

    2005-01-01

    Given the importance of knowledge flows and the continued emphasis on face-to-face encounters especially for medical care, close proximity of hospitals may be essential for the efficient delivery of medical care. That is, hospital productivity might be greater where hospitals cluster and allow knowledge to more easily and quickly disperse among personnel in the various organizations. To add to the understanding about agglomeration economies in the hospital services sector, this study analyzes...

  9. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for inpatient services of hospitals other than psychiatric hospitals. 424.13 Section 424.13 Public Health CENTERS FOR MEDICARE & MEDICAID... PAYMENT Certification and Plan Requirements § 424.13 Requirements for inpatient services of...

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

    Babakus, E; Mangold, W G

    1992-01-01

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

  11. Obesity, hospital services use and costs

    Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid;

    2007-01-01

    To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and...

  12. Service Robots for Hospitals: A Case Study of Transportation Tasks in a Hospital

    Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen; Klæstrup Kristensen, Jens; Christensen, Kim Hardam; Aanæs, Henrik

    2009-01-01

    In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order to...... verify the need for automation and identify possible areas of improvement. The analysis shows that most of the existing transportation is carried out manually, and hospitals can greatly benefit from automated transportation. Based on the results of the analysis, three alternatives are derived for...... implementing mobile service robots for transportation tasks in hospitals....

  13. Veterinary Teaching Hospital to launch small animal outpatient imaging service

    Jackson, Christy

    2009-01-01

    Beginning in June 2009, the Virginia-Maryland Regional College of Veterinary Medicine at Virginia Tech's Veterinary Teaching Hospital will introduce a new outpatient advanced imaging service for surrounding small animal veterinarian practices.

  14. Health science library and information services in the hospital.

    Wakeley, P J; Marshall, S B; Foster, E C

    1985-01-01

    In an increasingly information-based society, hospitals need a variety of information for multiple purposes--direct patient care, staff development and training, continuing education, patient and community education, and administrative decision support. Health science library and information services play a key role in providing broad-based information support within the hospital. This guide identifies resources that will help administrators plan information services that are appropriate to their needs. PMID:10271908

  15. Promoting hospital-based smoking cessation services at major Swiss hospitals: a before and after study

    Bolliger, Chris T; van Biljon, X.; Humair, Jean-Paul Luc André; El Fehri, V.; Cornuz, J.

    2008-01-01

    QUESTIONS UNDER STUDY: Whether a 1-year nationwide, government supported programme is effective in significantly increasing the number of smoking cessation clinics at major Swiss hospitals as well as providing basic training for the staff running them. METHODS: We conducted a baseline evaluation of hospital services for smoking cessation, hypertension, and obesity by web search and telephone contact followed by personal visits between October 2005 and January 2006 of 44 major public hospitals...

  16. Birthing Centers and Hospital Maternity Services

    ... and baby. If you give birth in a teaching hospital, medical students or residents might be present during the birth. ... Privacy Policy & Terms of Use Visit the Nemours Web ... For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- ...

  17. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    2010-10-01

    ... profession under State law, if the physician performs the services in the clinic or the services are... residence” does not include a hospital or a skilled nursing facility. (c) Other ambulatory...

  18. SERVICE MARKETING MIX OF INDIAN HOSPITALS: A CRITICAL REVIEW

    Dharmesh, MOTWANI

    2014-07-01

    Full Text Available Sreenivas, Srinivasarao and Srinivasa (2013 said that “The health care market has become consumer centered and expecting high quality care at a reasonable price. The mushroomed development of corporate hospitals in India, competition is also bringing massive changes in industry structure. In this context, hospital services’ marketing is slowly and surely coming of age and is being woven into the fabric of hospitals planning and public relations programmes.” The essence of any marketing activity is marketing mix, and the central theme of the present paper revolves around the contemporary service marketing mix offered by Indian hospitals. In this paper author has critically reviewed 51 papers to describe elements of hospital service marketing mix; product, price, place, promotion, people, process and physical evidence.

  19. Project reconversion Service Hospital Radiation Oncology Clinics-Medical School

    Introduction: The Health Sector operates within the framework of Social Policy and it is therefore one of the ways of distribution of public benefit, like Housing, Education and Social Security. While public spending on health has grown in recent years, its distribution has been uneven and the sector faces funding and management problems. The Service Hospital Radiation Oncology has reduced its health care liavility , lack technological development and unsufficient human resources and training. Aim: developing an inclusive reform bill Service Hospital Radiation Oncology .Material and Methods: This project tends to form a network institutional, introducing concepts of evidence-based medicine, risk models, cost analysis, coding systems, system implementation of quality management (ISO-9000 Standards). Proposes redefining radiotherapy centers and their potential participation in training resource development goals humanos.Promueve scientific research of national interest. Separate strictly administrative function, management and teaching. The project takes into account the characteristics of demand, the need to order it and organize around her, institutional network system and within the Hospital das Clinicas own related services related to Service Hospital Radiation Oncology , Encourages freedom of choice, and confers greater equity in care. The project would managed by the Hospital Clínicas. Conclusions: We believe this proposal identifies problems and opportunities, Service Hospital Radiation Oncology proposes the development of institutional network under one management model

  20. OBESITY, HOSPITAL SERVICES USE AND COSTS

    Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid;

    2007-01-01

    ) and information from The National Patient Registry and The Danish Case-Mix System (DRG). PARTICIPANTS: The study population consisted of two sub-samples from the Inter99 study at Research Centre for Prevention and Health in 1999-2001. One sub-sample used WC as an indicator for obesity (n = 5......OBJECTIVE: To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC......,151), whereas the other used BMI as an indicator for obesity (n = 4,048). Using WC, obesity was defined as WC > 102 cm for men and > 88 cm for women. Normal weight was defined as circumference < 94 cm for men and < 80 cm for women. Using BMI, obesity was defined as BMI > 30 kg/m2, whereas individuals with BMI...

  1. 42 CFR 456.101 - UR plan required for inpatient hospital services.

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient hospital services... hospital services. (a) A State plan must provide that each hospital furnishing inpatient services under the... that the hospital furnishes him. (b) Each written hospital UR plan must meet the requirements...

  2. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services subject to the... FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System § 419.21 Hospital outpatient...

  3. MEMBANGUN SERVICE QUALITY UNTUK MENCAPAI KEPUASAN KONSUMEN DI INDUSTRI HOSPITALITY

    Sienny Thio

    2001-01-01

    Full Text Available Service quality is necessary especially in the hospitality industry, remembering that consumers have expectations that must be fulfilled and satisfied. Consumers often expect to get maximal service from the service providers and wish to be treated professionally and as a unique individual. This paper seeks to give a further idea about service quality which can be developed and done by service providers with the hope of fulfilling consumer expectations and finally to satisfy all consumers, both internal and external to the company. Abstract in Bahasa Indonesia : Service Quality sangat dibutuhkan terutama di industri hospitality mengingat konsumen yang mempunyai ekspektasi yang selalu ingin dipenuhi dan dipuaskan. Konsumen selalu mengharapkan untuk mendapatkan service yang maksimal dari para penyedia jasa dalam hal ingin diperlakukan secara professional, dan diperlakukan sebagai individu yang unik. Tulisan ini dimaksudkan untuk memberikan gambaran yang lebih jauh mengenai service quality yang dapat dibangun dan dilakukan oleh para penyedia jasa yang diharapkan dapat memenuhi ekspektasi dari konsumen yang pada akhirnya dapat memuaskan eksternal konsumen maupun internal konsumen. Kata kunci: hospitality, service quality, ekspektasi, kepuasan, penyedia jasa.

  4. Ancillary investigations in uveitis

    Vishali Gupta; Amod Gupta

    2013-01-01

    Ancillary investigations are the backbone of uveitis work-up both for anterior and posterior segment diseases. They help in making the diagnosis, ruling out certain differential diagnosis and monitoring inflammation during the follow-up. This review aims to be an overview describing the role of commonly used investigations for uveitis.

  5. 42 CFR 424.122 - Conditions for payment for emergency inpatient hospital services.

    2010-10-01

    ... hospital services. 424.122 Section 424.122 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... hospital services. Medicare Part A pays for emergency inpatient hospital services furnished by a foreign hospital if the following conditions are met: (a) At the time of the emergency that required the...

  6. Evaluation of a radioisotope service in a general hospital

    The value of radioisotopes in medicine has become increasingly apparent over the last few years. Nuclear medicine however recent, has nevertheless reached adult hood and doctors appreciate its substantial contribution in the field of diagnosis especially. So far nuclear medicine has been confined to University Hospital Centres, mainly for legal reasons. However the considerable help offered by this discipline is now taken for granted in the medical world and the wholly experimental stage is long past. While this aspect of nuclar medicine still exists, and is still dealt with by the services of University Hospital Centres, radioisotopes are now used to a large extend and on a day-to-day basis in pathology. Owing to pressure of work it is difficult for UH Centres to meet all request for examinations, so would the presence of nuclear medicine Service be justified in general Hospitals. The existence of one such service at the Bayonne HC might help to answer this question. For this reason the activity of the Bayonne HC Nuclear Medicine Service during its first year of practice is examined here. For a better understanding of the position this report first presents the Bayonne Hospital and the place occupied by a nuclear Medicine service in such an establishment. The activity of this service during its first year is then studied and the situation weighed up generally

  7. Analysing Shared Service Contracts: The Case of Food Services for Winnipeg Hospitals

    Cyrenne, Philippe

    1999-01-01

    In November 1994, Winnipeg’s nine urban hospitals announced that they agreed to pursue opportunities to share four common support services - food services, material management, biomedical waste disposal and laundry to determine the potential for improving efficiency, reducing duplication and increasing buying power. A new non-profit organization called the Urban Shared Services Corporation (USSC)was created to manage the shared functions. Given that a majority of hospitals have chos...

  8. Providing Support Services in Selected Decentral¬ized Hospital

    R Hafezi

    2009-03-01

    Full Text Available "nBackground: Upon the implementation of the plans of the selected hospitals in Paragraph (C Article [88] of the Law of the Fourth Development Plan, the amount of assessment relative to the execution of each of the Paragraphs related to the direc­tives or guidelines of the mode of managing these hospitals is compulsory. The present article has made efforts to assess the imple­mentation basis of Paragraph [9] of the above-mentioned directives and a survey of conditions as to the performance of the support services in these hospitals."nMethods: This study rested on the performance of 14 supporting activities of 18 selected decentralized hospitals that took place in 2007. Data were collected from questionnaire that had 6 parts about support services and how they were done in each hospital. Then the data were analyzed with Excel software."nResults: In hospitals 35. 60 % of the activities are performed by the contractor. The materials utilized in activities are 10. 34 per­cent, equipping is 26. 48% and equipment repair is 31. 47% of the cases are secured by the contractor. Results pertaining to the survey of manpower engaged in activities show that 62. 71% of the manpower engaged has an intermediate level of educa­tion and the relative average of manpower active in such work as of functional beds can be stated as 0.64, likewise, the average satisfaction rate of the services rendered was 71%."nConclusion: A strategy leading to a decrease of incumbency and an elevation in the support service quality can bring about an increment in the quality of support services being presently rendered in hospitals which could prove effective.

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

    Domingo, Rene T

    2015-01-01

    Operating simultaneously like a repair shop, prison, and hotel, hospitals are prone to seven common pitfalls in customer service. Patient care is often fragmented, inscrutable, inflexible, insensitive, reactive, myopic, and unsafe. Hospitals are vying to be more high-tech, rather than high-touch even though staff engagement with patients rather than facilities and equipment strongly influence patient satisfaction. Unless processes, policies, and people are made customer-centered, the high quality of the hospital's human and hardware resources will not translate into high patient satisfaction and patient loyalty. PMID:26058286

  10. Experience of the Spiritist Hospital Chaplaincy Service: A Retrospective Study.

    Anefalos, Alexandre; E Silva, Wilkens Aurélio Buarque; Pinto, Renan Mercuri; Ferrari, Renée Danckwardt; de Fátima Boni, Aparecida; Dos Santos, Hélio Goulart; Duarte, Cleide Borges

    2016-06-01

    The Hospital Chaplaincy service is made of religious volunteer work done by representatives of various religions properly trained to offer spiritual support to hospitalized patients, as well as their families, contributing as a source of protection, comfort and restoring faith in the face of illness. The objective of this study is to present a retrospective analysis of records made by chaplains, guided by the Spiritist Medical Association of Piracicaba, through 7419 calls to 2191 patients admitted at Unimed Hospital of Piracicaba in 2014. The results contributed to the production of scientific documentation about this new holistic model that still lies in acceptance phase in the country. PMID:26272098

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

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

    2014-01-01

    Background: The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient’s trust is the service quality. Objectives: This study aimed to examine the effect of quality of services provided in private hospitals on the patient’s trust. Patients and Methods: In this descriptive cross-sectional study, 96...

  12. Service-Oriented Organizational Citizenship Behavior, Perceived Service Quality and Customer Satisfaction in Hospitality Industry

    Po-Hsuan Wu; Jui-Fan Liao

    2016-01-01

    This study aims to identify the factors that contribute to service-oriented organizational citizenship behavior, perceived service quality and customer satisfaction in hospitality industry. The author proposes a model to examine the relationships among service-oriented organizational citizenship behavior, perceived service quality and customer satisfaction. From the results, the major findings of this study are as the following; Firstly, service-oriented organizational citizenship behavior an...

  13. Predictors of Language Service Availability in U.S. Hospitals

    Melody K. Schiaffino

    2014-10-01

    Full Text Available Background Hispanics comprise 17% of the total U.S. population, surpassing African-Americans as the largest minority group. Linguistically, almost 60 million people speak a language other than English. This language diversity can create barriers and additional burden and risk when seeking health services. Patients with Limited English Proficiency (LEP for example, have been shown to experience a disproportionate risk of poor health outcomes, making the provision of Language Services (LS in healthcare facilities critical. Research on the determinants of LS adoption has focused more on overall cultural competence and internal managerial decision-making than on measuring LS adoption as a process outcome influenced by contextual or external factors. The current investigation examines the relationship between state policy, service area factors, and hospital characteristics on hospital LS adoption. Methods We employ a cross-sectional analysis of survey data from a national sample of hospitals in the American Hospital Association (AHA database for 2011 (N= 4876 to analyze hospital characteristics and outcomes, augmented with additional population data from the American Community Survey (ACS to estimate language diversity in the hospital service area. Additional data from the National Health Law Program (NHeLP facilitated the state level Medicaid reimbursement factor. Results Only 64%of hospitals offered LS. Hospitals that adopted LS were more likely to be not-for-profit, in areas with higher than average language diversity, larger, and urban. Hospitals in above average language diverse counties had more than 2-fold greater odds of adopting LS than less language diverse areas [Adjusted Odds Ratio (AOR: 2.26, P< 0.01]. Further, hospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, P< 0.001. Conclusion Our findings support the importance of structural and contextual factors as they relate to

  14. 42 CFR 410.66 - Emergency outpatient services furnished by a nonparticipating hospital and services furnished in...

    2010-10-01

    ... nonparticipating hospital and services furnished in a foreign country. 410.66 Section 410.66 Public Health CENTERS... services furnished by a nonparticipating hospital and services furnished in a foreign country. Conditions for payment of emergency inpatient services furnished by a nonparticipating U.S. hospital and...

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

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  16. Hospital and community health service costs: England and Scotland compared

    Glen, A C; Hulbert, J K

    1987-01-01

    In publications which have compared the health expenditure in the component parts of the United Kingdom by applying the Resource Allocation Working Party (RAWP) formula to the health budget of England, Scotland, Wales, and Northern Ireland it has been previously concluded that Scotland's hospital and community health services expenditure is more than 19% above what would be a fair distribution. It has also been implied that Scotland's allocation should be cut substantially to improve services...

  17. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital... inpatient mental hospital services. (a) The State plan must provide that each mental hospital furnishing...'s need for the services that the mental hospital furnishes him. (b) Each written mental hospital...

  18. 38 CFR 4.29 - Ratings for service-connected disabilities requiring hospital treatment or observation.

    2010-07-01

    ... § 4.29 Ratings for service-connected disabilities requiring hospital treatment or observation. A total... when it is established that a service-connected disability has required hospital treatment in a... hospital admission was for disability not connected with service, if during such hospitalization,...

  19. Optimal Policies for Simultaneous Energy Consumption and Ancillary Service Provision for Flexible Loads under Stochastic Prices and No Capacity Reservation Constraint

    Kefayati, Mahdi; Baldick, Ross

    2014-01-01

    Flexible loads, i.e. the loads whose power trajectory is not bound to a specific one, constitute a sizable portion of current and future electric demand. This flexibility can be used to improve the performance of the grid, should the right incentives be in place. In this paper, we consider the optimal decision making problem faced by a flexible load, demanding a certain amount of energy over its availability period, subject to rate constraints. The load is also capable of providing Ancillary ...

  20. Multi-agent Response Simulation of Industrial Loads for Ancillary Services%工业负荷提供辅助服务的多智能体响应模拟

    姚明涛; 胡兆光; 张宁; 段炜; 张健

    2014-01-01

    ABSTRACT:The characteristics of demand side resources, such as fast response and low cost, are very helpful to improve wind power penetration when they are utilized to provide ancillary services for the power system. Typically, industrial demand response resources have the advantages of large capacity, load stability and are easy to manage when they are compared with commerce and inhabitant users. As a result, industrial demand response resources are very suitable to deal with large-scale wind power integration. In order to have an in-depth study on the response mechanism of industrial loads to provide ancillary services, this paper chosen electrolytic aluminum and irrigation pumping station as two typical industrial power users and analyzed the ancillary services type which could be provided. Then, a multi-agent response modeling containing these two kinds of industrial loads and the grid was built based on multi-agent technology. The goal, structure and behavior strategies of each agent were explained in the paper. In the process of simulation, the grid companies could adjust the ancillary services price according to the response of industrial power consumers. The results show that the pricing strategy of ancillary services in this model can fully exploit the response potential of all types of industrial power users to provide ancillary services while satisfying their interests.%挖掘响应迅速且成本较低的需求侧资源为电力系统提供辅助服务,对促进风电消纳具有积极意义。工业需求响应资源与商业、居民等用户相比具有容量大、负荷稳定、易于管理等优势,在应对大规模风电接入等方面具有更明显的优势。为深入研究工业用户提供辅助服务的响应机理,在分析电解铝、灌溉泵站2类典型工业负荷提供辅助服务类型的基础上,基于多智能体技术,构建了包含电网及以上2类工业负荷的多智能体系统,阐述各类智能体的目标

  1. 42 CFR 410.28 - Hospital or CAH diagnostic services furnished to outpatients: Conditions.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Hospital or CAH diagnostic services furnished to... Medical and Other Health Services § 410.28 Hospital or CAH diagnostic services furnished to outpatients: Conditions. (a) Medicare Part B pays for hospital or CAH diagnostic services furnished to...

  2. 42 CFR 412.20 - Hospital services subject to the prospective payment systems.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Hospital services subject to the prospective... OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and Excluded From the Prospective Payment Systems for...

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

    Melton, Gary B

    2014-11-01

    Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents. PMID:25486150

  4. Provision of general paediatric surgical services in a regional hospital.

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  5. Utilisation by homeless people of acute hospital services in London.

    Black, M E; Scheuer, M A; Victor, C.; Benzeval, M; Gill, M; Judge, K.

    1991-01-01

    OBJECTIVES--To estimate the numbers and distribution of homeless people in London; to quantify the utilisation of acute inpatient services by homeless people in two health authorities; and to predict the total numbers of admissions in homeless people in district health authorities across London. DESIGN--Data were collected from various sources on the distribution of homeless people across London boroughs. All unplanned acute inpatient admissions during November 1990 to relevant hospitals were...

  6. Professional Nursing Duties in the Central Services: Hospital Pharmacy Nurses

    Inmaculada Gómez-Villegas; Belén Ruíz-Pérez; Dolores López-del-Pino; Francisco García-España

    2015-01-01

    Introduction. The new demands of a fast changing world necessitate expanding the traditional concepts of nursing, extending the classical aspects to cover new areas. Purpose. Based on their professional duties, the nursing team in the pharmacy of a second-level hospital aimed to establish a theoretical and situational framework for nurses working in the central services. Material and Methods. Application of the nursing process to nursing work in an area with no direct contact with patients. R...

  7. Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

    O'Donoghue, Brian

    2013-05-01

    OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.

  8. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in... economical hospital care or medical services because of geographic inaccessibility or are not capable...

  9. The marketing concept of customer value of hospitality service

    O.V. Gerasimenko

    2015-12-01

    customer’s satisfaction to create an intangible asset of the company is a segment of loyal and regular customers. Secondly, the process of developing marketing actions aimed at creating high customer value hospitality services As the conclusion, understanding the genesis of scientific theories customer value product/service allows to conclude that marketing concept to create customer value is a reason to determine structural elements of hotel services. This phase of the research was based on the fact that a functional feature of the hotel is its service differentiation on the main (accommodation and meals and additional services (range which depends on the category and type of business. Secondly, the formation of hotel services should be interpreted in the format of the production chain. Implementation of the marketing concept of customer value of hotel services in hotel marketing activities aims to maximize the realization of customer’s satisfaction in order to create an intangible asset of the company – a segment of loyal and regular customers.

  10. Payment for nondistributive hospital pharmacy services--a regional survey.

    Strandberg, L R; Stennett, D J; Simonson, W

    1978-07-01

    Questionnaires were mailed to all (464) nongovernment, not-for-profit and investor owned for-profit hospital pharmacies in Washingon, Oregon and California. Responses were received from 350 institutions, a return rate of 75.4 percent. Pharmacists were asked to report data relating to the incidence of, the range of fees charged, and the extent of reimbursement received from third party carriers for the provision of nondistributive pharmacy services. The data received indicate that pharmacy consultation to physicians was provided by 77.9 percent of the respondents, drug therapy monitoring by 48.1 percent, generalized patient discharge consultation by 40.8 percent, CPR team participation by 27.2 percent, indepth patient discharge consultation by 17.5 percent and admitting medication history by 8.8 percent. Additionally, 12 institutions charged for providing 16 nondistributive pharmacy services. Directors of pharmacy from six hospitals indicated that they billed third party carriers for nondistributive pharmacy services as part of their total pharmacy charge via their usual billing procedure. All third party carriers billed in this manner paid for the nondistributive pharmacy service. PMID:10308024

  11. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. PMID:26444698

  12. 42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.

    2010-10-01

    ... hospitals. 482.2 Section 482.2 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS General Provisions § 482.2 Provision of emergency services by nonparticipating hospitals. (a) The...

  13. 78 FR 55671 - Hospital Care and Medical Services for Camp Lejeune Veterans

    2013-09-11

    ... hospital care and medical services. As discussed in a separate notice (78 FR 39832, July 2, 2013), we are... their service at Camp Lejeune. Section 102 of Public Law 112-154 requires VA to provide hospital care... AFFAIRS 38 CFR Part 17 RIN 2900-AO78 Hospital Care and Medical Services for Camp Lejeune Veterans...

  14. 42 CFR 412.509 - Furnishing of inpatient hospital services directly or under arrangement.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Furnishing of inpatient hospital services directly..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.509 Furnishing of inpatient...

  15. 42 CFR 412.50 - Furnishing of inpatient hospital services directly or under arrangements.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Furnishing of inpatient hospital services directly..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL... Inpatient Capital-Related Costs § 412.50 Furnishing of inpatient hospital services directly or...

  16. Hospital Staff and Patient Recognition Toward Opening of Medical Services Market, and Factors in Selecting a Foreign Hospital

    Ryu, Hyang Jin; Park, Eun Cheol; Sohn, Tae Yong; Yu, Seung Hum

    2007-01-01

    Purpose The objectives of this study are to compare the hospital employees' and patients' recognition and attitudes toward the opening of the medical services market, to analyze the differences between hospital employees and patients on the factors in selecting a foreign hospital. Materials and Methods This study collected and analyzed data using systematic questionnaires that were self-administered by employees and outpatients to compare their recognition of the opening of the medical servic...

  17. [Authorization, institutional services, hospital-based practices and cooperation in the hospital--from the point of view of the hospital owners].

    Kersting, Thomas

    2003-11-01

    Structural changes in the financing of hospital-based health care in Germany make a revision of the currently existing strict separation between ambulatory and stationary patient care inevitable. The present monopolist situation of office-based physicians (organised in private practices without any legal or financial relation to a hospital) will be amended by the participation of hospitals and hospital-employed doctors in ambulatory services of a different kind. These may include the institutional authorization of hospitals to participate in ambulatory services, especially in the case of emergencies and first aid, and co-operations between doctors in private practices and hospitals. Such co-operations are now legally enabled to provide "integrated services", but still lacking acceptance by the parties involved in the health care services. Ambulatory medical care is an already huge and now rapidly growing market, whereas the classical hospital services represent a declining product. Therefore hospitals will have to act accordingly or they will even forfeit the opportunity to use the ambulatory care sector to improve the intensity of utilisation of their hospital beds. In addition, hospitals will have to accept that office-based doctors are their customers and have to be treated as such. The establishment of regional networks may be a solution to this problem. Integrated services can only be established if new ways of co-operation and knowledge transfer are introduced into this area step by step. The present article provides practical examples of co-operation models. PMID:14710650

  18. 42 CFR 419.32 - Calculation of prospective payment rates for hospital outpatient services.

    2010-10-01

    ... hospital outpatient services. 419.32 Section 419.32 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Basic Methodology for Determining Prospective Payment Rates for...

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

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern. 31.3306(c)(13)-1 Section 31.3306(c)(13)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a...

  20. 42 CFR 447.321 - Outpatient hospital and clinic services: Application of upper payment limits.

    2010-10-01

    ... SERVICES Payment Methods for Other Institutional and Noninstitutional Services Outpatient Hospital and Clinic Services § 447.321 Outpatient hospital and clinic services: Application of upper payment limits...: Application of upper payment limits. 447.321 Section 447.321 Public Health CENTERS FOR MEDICARE &...

  1. 42 CFR 414.40 - Coding and ancillary policies.

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Coding and ancillary policies. 414.40 Section 414.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Physicians and...

  2. Occupational exposure in services of Oncological Hospital of Camaguey

    The Nuclear Medicine Service of the Cancer Hospital at Camaguey presents data on the occupationally exposure workers, during 1990-1999, obtained from film dosimetry. The outcomes show that: the average of annual effective equivalent dose for nuclear medical personnel was 2.47 mSv, while 2.13 mSv were to represent radiotherapy and 1.11 mSv were to represent the personnel tied to the others radiodiagnostic services, in the same period; 88,3% of the nuclear medicine personnel and the 94.9% of the radiotherapy personnel have received doses inferior to 3 mSv/year; the total collective dose for the studied period were 212.5, 189.8 and 22.3 mSv.man for nuclear medicine and radiotherapy and other medical users respectively. In this work, the annual behavior of the total collective doses is described based on the evaluation of the contribution of different radiodiagnostic procedures carried out at the Hospital. Others aspects related to biological radiation effects of occupational exposure and some outcomes are compared with those from the data of the other countries

  3. Gearing service quality into public and private hospitals in small islands: Empirical evidence from Cyprus

    Arasli, Huseyin; Ekiz, Erdogan Haktan; Katircioglu, Salih Turan

    2008-01-01

    Purpose - The purpose of this research is to develop and compare some determinants of service quality in both the public and private hospitals of Northern Cyprus. There is considerable lack of literature with respect to service quality in public and private hospitals. Design/method/approach - Randomly, 454 respondents, who have recently benefited from hospital services in Famagusta, were selected to answer a modified version of the SERVQUAL Instrument. The instrument contained both service ex...

  4. Evaluation of an electroconvulsive therapy service in a general hospital.

    Lamont, Scott; Brunero, Scott; Barclay, Christopher; Wijeratne, Chanaka

    2011-06-01

    There has been much recent literature on the technical parameters of electroconvulsive therapy (ECT) with regard to improving efficacy and minimizing adverse effects, but relatively little on ECT service delivery. This paper will discuss the development and characteristics of an ECT service at a teaching hospital in metropolitan Sydney, New South Wales, Australia. A mixture of qualitative and quantitative methods, including a selective literature review and audit of ECT use were used. The results of the audit were compared with the 2007 revision of the Royal Australian and New Zealand College of Psychiatrists' clinical memorandum on ECT. We discuss issues, such as the optimal site for ECT delivery, ECT mental health nurse coordinator role, credentialing of psychiatrists, registrar supervision, and the development of an ECT committee. A significant finding of the audit was that the majority of patients were treated under the New South Wales Mental Health Act, and voluntary patients were more likely to have a diagnosis of a depressive disorder, whereas involuntary patients were more likely to have a non-mood disorder diagnosis. This study has shown that auditing of ECT practices and services by mental health nurses is essential for quality improvement processes. The audit highlighted areas of service delivery that should be subject to review and evaluation against professional standards. PMID:21492361

  5. 48 CFR 831.7001-4 - Medical services and hospital care.

    2010-10-01

    ... hospital care. 831.7001-4 Section 831.7001-4 Federal Acquisition Regulations System DEPARTMENT OF VETERANS... and Procedures 831.7001-4 Medical services and hospital care. (a) VA may pay the customary student... Government. (b) When the customary student's health fee does not cover medical services or hospital care,...

  6. 38 CFR 17.49 - Priorities for outpatient medical services and inpatient hospital care.

    2010-07-01

    ... medical services and inpatient hospital care. 17.49 Section 17.49 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Hospital, Domiciliary and Nursing Home Care § 17.49 Priorities for outpatient medical services and inpatient hospital care. In scheduling appointments for outpatient...

  7. 42 CFR 403.321 - State systems for hospital outpatient services.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false State systems for hospital outpatient services. 403... Control Systems § 403.321 State systems for hospital outpatient services. CMS may approve a State's..., projections for the first 12-month period covered by the assurance for each hospital, in both the...

  8. Ancillary experiments: Opportunities and challenges

    Baldwin, Kate; Bhavnani, Rikhil R.

    2013-01-01

    Ancillary experiments' are a new technique whereby researchers use a completed experiment conducted by others to recover causal estimates of a randomized intervention on new outcomes. The method requires pairing new outcome data with randomized treatments the researchers themselves did not oversee. Since ancillary experiments rely on interventions that have already been undertaken, oftentimes by governments, they can provide a low-cost method with which to identify the effects of large-scale ...

  9. Ancillary Benefits of Climate Policy

    Markandya, Anil; Rübbelke, Dirk T. G.

    2003-01-01

    The benefits of climate policy normally consist exclusively of the reduced impacts of climate change, i.e., the policy’s primary aim. Our analysis of benefits of climate policy suggests, however, that researchers and policymakers should also take account of ancillary benefits, e.g., in the shape of improved air quality induced by climate protection measures. A consideration of both, primary and ancillary benefits, has a positive influence on global climate protection efforts, e.g., because th...

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

    Potter, J. G.

    1979-01-01

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

  11. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern. 31.3121(b)(13)-1 Section 31.3121(b)(13)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a)...

  12. Handheld Versus Wearable Interaction Design for Professionals - A Case Study of Hospital Service Work

    Stisen, Allan; Blunck, Henrik; Kjærgaard, Mikkel Baun;

    2014-01-01

    With the blooming of new available wrist worn devices there are potentials for these to support the work done in many professional domains. One such domain is hospital service work. This paper explores two wearable prototypes with regards to challenges and opportunities to support future hospital...... service work. This explorative study was conducted with 4 experienced hospital orderlies who interacted with an application across two wearable concepts, and one handheld smartphone in five scenarios in a hospital environment. The interaction was video recorded with a chest-mounted video afterwards semi...... aspects to aid designers of next generation wearable designs for hospital service work....

  13. 47 CFR 90.317 - Fixed ancillary signaling and data transmissions.

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Fixed ancillary signaling and data transmissions. 90.317 Section 90.317 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Authorization in the Band 470-512 MHz (UHF-TV Sharing) § 90.317 Fixed ancillary...

  14. Tourist Satisfaction with Hospitality Services on River Ship “Ms River Aria”

    Nikola Vuksanović; Karolina Simat

    2013-01-01

    The main prerequisite for a successful business of hospitality services and building customer loyalty is to develop measures for improving and development hospitality services and offer. This paper presents the results of tourists satisfaction surveys based on the measurement of expected and perceived levels of quality hospitality services on a river ship “MS River Aria” company “Grand Circle Cruise Line”. The survey was conducted between March and September 2012 on the itinerary: Amsterdam -...

  15. A note on challenges and opportunities for Operations Research in hospital logistics

    Melo, Teresa

    2012-01-01

    Ancillary services such as those provided by logistics seem simple and straightforward, yet their role is often overlooked by hospitals. Recent studies indicate that logistics-related activities impact significantly on the quality of health care as well as on hospital costs. Hospital logistics contributes to the provision of care to patients by ensuring that all required services and resources (i.e. staff, facilities, and equipment) are delivered at the right time. In the current context of c...

  16. Sole hospital commitment to health promotion and disease prevention (HPDP) services: does ownership matter?

    Zhao, Mei; Carretta, Henry J; Hurley, Robert E

    2003-01-01

    Hospitals have been increasingly involved in health promotion and disease prevention (HPDP) in the last two decades. Concurrent with this trend, environmental changes and market pressures have resulted in more hospital consolidations and conversions from not-for-profit (NFP) to for-profit (FP) organizations. The emergence of a large number of sole community hospitals has attracted the attention of policy-makers and community stakeholders because sole community hospitals have more power in the local market and may discontinue unprofitable services to pursue profit maximization. This may be especially true when the sole hospital is a FP organization. On the other hand, sole community hospitals are confronted with a variety of expectations to offer community-oriented services that promote community population health, regardless of ownership. There is relatively little literature that has attempted to examine the behavior of sole community hospitals. This study depicts the profile of sole hospitals' involvement in HPDP services and estimates the possible influence of community constituencies on hospitals with respect to their providing community-oriented services. The results indicate that typically, when there is only one hospital in the community, hospital ownership has no significant influence on hospital HPDP services than their NPD counterparts. Implications for policy-makers and health care leaders are also discussed. PMID:15330381

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

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

    2009-01-01

    The aid lent by the emergency services is the object of this paper, which aims to assess the emergency service of the QualiSUS program. The study is descriptive with the application of a questionnaire to the responsible of the emergency services in eight hospitals. The emergency services were always overcrowded, and the causes pointed were the low resolutivity of basic attention and the precariousness of the hospital network. Contributing to this there is the primary care decreased resolutivity and the precariousness of the hospital network. Six hospitals do not manage the emergency service. The entrance system is not organized and only three hospitals work with risk classification. All of them refer difficulties with internal and external services. The hardest pathologies to refer to other services are the chronicles, neurological and social. The professionals do not have specific qualification and the precariousness job contracts do not contribute neither for the professional's fixation nor for his qualification. Clinical protocols are used by one service. It was noticed the influence of the QualiSUS in the hospitals. The failure of the health services network interferes with the emergency patient's profile. The investment of the QualiSUS cannot be restrained to the hospital. Emergency should be more integrated to the system and hospital. The qualification of human resources is indispensable as well as the bed's regulation. PMID:19851601

  18. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    2010-10-01

    ... to beneficiaries is made by Medicare on the basis of reasonable cost if the hospital exercises the... organized medical staff of the teaching hospital or medical school as provided for in paragraph (d) of this... beneficiaries in a teaching hospital are payable as provider services on a reasonable-cost basis. (2)...

  19. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    2010-10-01

    ..., Medicare Part B does not pay for any item or service that is furnished to a hospital outpatient (as defined... that particular service to its patients. As used in this paragraph, the term “hospital” includes a CAH... furnished to hospital outpatients. 410.42 Section 410.42 Public Health CENTERS FOR MEDICARE &...

  20. 26 CFR 1.501(e)-1 - Cooperative hospital service organizations.

    2010-04-01

    ... services performed for each patron-hospital may be determined on the basis of either the value or the... cooperative hospital service organization must be a shareholder in a United States or state chartered... organization. See, e.g., National Consumer Cooperative Bank, 12 U.S.C. 3001 et seq. (c) Scope of...

  1. Promoting and tracking the use of hospital library web services by outside entities.

    Leman, Hope

    2010-04-01

    This column describes a process that can be used to market a hospital library Web service for use by external entities and monitor its use by the worldwide audience (e.g., medical, academic and public libraries, offices of research administration). Included are concrete suggestions to help hospital librarians in their efforts to encourage adoption of their Web service by other institutions. PMID:20432141

  2. Hospital Collaboration with Emergency Medical Services in the Care of Patients with Acute Myocardial Infarction: Perspectives from Key Hospital Staff

    Landman, Adam B.; Spatz, Erica S.; Cherlin, Emily J.; Krumholz, Harlan M.; Bradley, Elizabeth H.; Curry, Leslie A.

    2013-01-01

    Objective Evidence suggests that active collaboration between hospitals and emergency medical services (EMS) is significantly associated with lower acute myocardial infarction (AMI) mortality rates; however, the nature of such collaborations is not well understood. We sought to characterize views of key hospital staff regarding collaboration with EMS in the care of patients hospitalized with AMI. Methods We performed an exploratory analysis of qualitative data previously collected from site visits and in-depth interviews with 11 US hospitals that ranked in the top or bottom 5% of performance on 30-day risk-standardized AMI mortality rates (RSMRs) using Centers for Medicare and Medicaid Services data from 2005–2007. We selected all codes from the first analysis in which EMS was most likely to have been discussed. A multidisciplinary team analyzed the data using the constant comparative method to generate recurrent themes. Results Both higher and lower performing hospitals reported that EMS is critical to the provision of timely care for patients with AMI. However, close, collaborative relationships with EMS were more apparent in the higher performing hospitals. Higher performing hospitals demonstrated specific investment in and attention to EMS through: 1) respect for EMS as valued professionals and colleagues; 2) strong communication and coordination with EMS; and 3) active engagement of EMS in hospital AMI quality improvement efforts. Conclusion Hospital staff from higher performing hospitals described broad, multifaceted strategies to support collaboration with EMS in providing AMI care. The association of these strategies with hospital performance should be tested quantitatively in a larger, representative study. PMID:23146627

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

    Horwitz, Jill R; Nichols, Austin

    2009-09-01

    Hospitals operate in markets with varied demographic, competitive, and ownership characteristics, yet research on ownership tends to examine hospitals in isolation. Here we examine three hospital ownership types -- nonprofit, for-profit, and government -- and their spillover effects. We estimate the effects of for-profit market share in two ways, on the provision of medical services and on operating margins at the three types of hospitals. We find that nonprofit hospitals' medical service provision systematically varies by market mix. We find no significant effect of market mix on the operating margins of nonprofit hospitals, but find that for-profit hospitals have higher margins in markets with more for-profits. These results fit best with theories in which hospitals maximize their own output. PMID:19781802

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

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

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications. PMID:25231139

  5. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

    Karlsen, Anders M; Thomassen, Øyvind; Vikenes, Bjarne H.; Brattebø, Guttorm

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air...

  6. Handheld Versus Wearable Interaction Design for Professionals - A Case Study of Hospital Service Work

    Stisen, Allan; Blunck, Henrik; Kjærgaard, Mikkel Baun; Grønbæk, Kaj

    2014-01-01

    With the blooming of new available wrist worn devices there are potentials for these to support the work done in many professional domains. One such domain is hospital service work. This paper explores two wearable prototypes with regards to challenges and opportunities to support future hospital service work. This explorative study was conducted with 4 experienced hospital orderlies who interacted with an application across two wearable concepts, and one handheld smartphone in five scenarios...

  7. Ambulance services at hospital universiti sains malaysia and hospital kota bharu: a retrospective study of calls.

    Shah Che Hamzah, Mohd Shaharudin; Ahmad, Rashidi; Nik Abdul Rahman, Nik Hisamuddin; Pardi, Kasmah Wati; Jaafar, Naimah; Wan Adnan, Wan Aasim; Jaalam, Kamaruddin; Sahil Jamalullail, Syed Mohsin

    2005-07-01

    This retrospective study attempted to identify the pattern of ambulance calls for the past two years at the Hospital Universiti Sains Malaysia (HUSM) and Hospital Kota Bharu (HKB). This study will provide a simple method of acquiring information related to ambulance response time (ART) and to test whether it met the international standards and needs of the client. Additionally, this paper takes into account the management of emergency calls. This included ambulance response time, which was part of Emergency Medical Services (EMS) episode: onset of ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint had been noted. ART ended when the emergency team arrived at the scene of incident. Information regarding ambulance calls from the record offices of HUSM and HKB was recorded for the year 2001 and 2002, tabulated and analyzed. There was a significant difference in the total number of calls managed by HUSM and HKB in the year 2001. It was noted that 645 calls were managed by HUSM while 1069 calls were recorded at HKB. In the year 2002, however, HUSM led with 613 extra numbers of calls as compare to HKB with 1193 numbers of calls. The pattern of ambulance calls observed is thought to possibly be influenced by social activities like local festivities, school holidays and the seasons. Further, it is observed that no studies were previously undertaken to compare the ART at both the HUSM and HKB to that of the international standards. In fact, a literature review undertaken so far showed no similar studies have been done for the whole Malaysia. PMID:22605956

  8. DISASTER PSYCHIATRIC SERVICE AT A GENERAL HOSPITAL FOLLOWING THE GREAT HANSHIN EARTHQUAKE

    Tohyama, Teruhiko; Senko, Yoshitaka

    1997-01-01

    This report is a kind of empirical study on disaster psychiatric services following the Great Hanshin Earthquake.Our work was performed at a general hospital (the Higashi-Kobe Hospital) located in the middle of the disaster area. Before the quake there were no psychiatric facilities at that hospital ; nevertheless many patients with mental problems visited there. And our team; consisting of several volunteer psychiatrists from all over Japan and some nurses of that hospital, immediately set u...

  9. Ancillary spending : Working Paper No. 3.2.1

    Lasota, M.; McCracken, M.C.; Zanasi, L. [Informetrica Ltd., Ottawa, ON (Canada)

    2002-04-01

    This study discussed the ancillary spending that would be incurred by the Yukon Government as a result of the Alaska Highway Pipeline Project. Ancillary spending refers to investment that is needed to facilitate pipeline construction but is not directly related to the pipeline. It includes investment in roads and highways, water treatment, sewage and solid waste, air transportation, rail transportation (including the White Pass and the Canadian Arctic Railway), port development, schools, health services, and jails. It was determined that ancillary expenditures to the Yukon Government excluding health and correctional services is estimated at $6.95 to $7.85 million in pre-pipeline construction. During the 3 years of pipeline construction and the first 3 years of pipeline operation, the ancillary spending is not expected to be greater than $21.7 million. Ancillary spending includes the need to repair existing facilities and infrastructures after the pipeline is completed. This will provide employment for a variety of skilled people including engineers and trades people. Other developments associated with the AHPP may include gas field and mining development as well as developments in local gas and electricity distribution. 4 refs., 1 tab.

  10. Ancillary spending : Working Paper No. 3.2.1

    This study discussed the ancillary spending that would be incurred by the Yukon Government as a result of the Alaska Highway Pipeline Project. Ancillary spending refers to investment that is needed to facilitate pipeline construction but is not directly related to the pipeline. It includes investment in roads and highways, water treatment, sewage and solid waste, air transportation, rail transportation (including the White Pass and the Canadian Arctic Railway), port development, schools, health services, and jails. It was determined that ancillary expenditures to the Yukon Government excluding health and correctional services is estimated at $6.95 to $7.85 million in pre-pipeline construction. During the 3 years of pipeline construction and the first 3 years of pipeline operation, the ancillary spending is not expected to be greater than $21.7 million. Ancillary spending includes the need to repair existing facilities and infrastructures after the pipeline is completed. This will provide employment for a variety of skilled people including engineers and trades people. Other developments associated with the AHPP may include gas field and mining development as well as developments in local gas and electricity distribution. 4 refs., 1 tab

  11. The Impact of Quality Service Provided by SRM Hospital on Outpatients

    Kenneth Amoah-Binfoh

    2015-04-01

    Full Text Available Consumer’s perceptions about the health care services play an important role when choosing a hospital. The quality of service is crucial to both the outpatients and the service providers. The dimensions of the service quality are reliability, responsiveness, assurance, empathy, and tangibles. Customer’s expectations and experiences vary with services. When there is a shortfall between expectation of service level and perception of actual service delivery, it is called customer gap. The causes of customer gap include; not knowing what customers expect, not selecting the right service designs and standards, not delivering to service standards and not matching performance to promises. This paper focuses on the level of service quality rendered by SRM’s hospital, the patient-physicians’ relationship and to examine the pre and post service of outpatients in the SRM’s hospital. A structured questionnaires and interviews were constructed to provide answers to the research questions using a sample size of 50 [employees and outpatients]. It was found out that some outpatients were satisfied with the services rendered by the hospital with reservations for more improvement. It was also found out that, there were gaps between the outpatients’ expectation and perception about the service rendered by the hospital. It was recommended that a competent marketing executive should be employed since marketing is the voice of the healthcare industry.

  12. A limited-service rural hospital model: the freestanding emergency department.

    Avery, S

    1999-01-01

    A rural hospital that has been downsized to a freestanding emergency department is an important model in that it offers a possible solution to a community's need to have emergency-care services locally available. This model could include other important local services, such as skilled-nursing and outpatient services. This study looks at the financial feasibility of a rural hospital shutting down acute-care services and maintaining emergency services. Expenses were determined, and changes to revenue and expenses were estimated. Reimbursement was assumed static. Medicare cost reports and hospital financial disclosure reports were used in investigating three model categories: an urgent-care clinic with emergency services; a hospital-based emergency department with an outpatient clinic; a hospital-based emergency department with an outpatient clinic and a hospital-based skilled-nursing facility. Even with best-case assumptions regarding continued reimbursement, results show only a small increase in net income and, in two cases, large losses compared with the size of the hospital operations. A subsidy would be required from the community or an affiliated hospital or network for the model to remain financially stable. The regulatory barriers to implementation are noted, as well as the potential problems with the human aspects of implementation--staffing, recruitment and retention, professional education and quality. If the model rural hospital is an affiliate or partner with one or more health care facility, which could assist with financial and staffing needs, it may be feasible. PMID:10511753

  13. Factors influencing inpatients’ satisfaction with hospitalization service in public hospitals in Shanghai, People’s Republic of China

    Chen H; Li M; Wang J; Xue C; Ding T; Nong X; Liu Y; Zhang L

    2016-01-01

    Haiping Chen,1 Meina Li,1 Jingrui Wang,1 Chen Xue,1 Tao Ding,1 Xin Nong,2 Yuan Liu,1 Lulu Zhang11Department of Military Health Management, College of Health Service, Second Military Medical University, Shanghai, 2Department of Medical Research, Rizhao Maternity and Infant Hospital, Shandong, People’s Republic of ChinaObjective: The aim of this study was to observe the current status of inpatient satisfaction and analyze the possible factors influencing patient satisfaction during hospit...

  14. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    2010-10-01

    ... described in this subpart for inpatient hospital services furnished in to Medicare Part A fee-for-service... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient...

  15. Strengthening physician relationships. Improving service to medical practices helps hospitals meet patients' needs.

    Rezac, P J

    1991-03-01

    In 1983 Sacred Heart Hospital, Yankton, SD, launched a medical staff-based marketing plan. Initial research focused on discovering service-area referring physicians' perceptions and level of utilization of Sacred Heart and its medical staff. The plan's ultimate goal was to strengthen relationships with referring physicians and thus improve the hospital's ability to deliver high-quality healthcare to those in its service area. Physicians were asked to indicate how important certain attributes were in choosing a medical specialist and a referral hospital. Among the attributes they most often cited as "very important" in choice of a specialist were specialist's reputation, patient's previous satisfaction, communication with a referring physician, and patient's preference. For choosing a referral hospital the most frequently cited attributes were availability of latest technology and equipment, hospital's reputation, patient's previous satisfaction, and patient's preference. The study also gathered information on physicians' utilization of and satisfaction with a variety of Sacred Heart services. As a result of the study, the hospital implemented a seven-part strategy to increase referring physicians' satisfaction with and utilization of the hospital and its medical staff. A follow-up study five years later revealed a 6.7 percent increase in the number of service-area physicians who referred patients to Sacred Heart and a 14.2 percent increase in the number of physicians who were "very satisfied" with the hospital's services. The consumer study revealed that high-quality professional services and highly personalized services were very important to patients. PMID:10109226

  16. Clinical and conventional pharmacy services in Polish hospitals: a national survey.

    Pawłowska, Iga; Pawłowski, Leszek; Kocić, Ivan; Krzyżaniak, Natalia

    2016-04-01

    Background Pharmacist-led care services within the hospital pharmacy setting have a significant impact on efficient drug management processes. The work of pharmacists is directly associated with the provision of drugs and medical supplies along with additional clinical, administrative, organizational and educational duties. Depending on the country, these practice roles may differ to a significant extent. Objective The aim of this research was to explore the role of the hospital pharmacist and the provision of both clinical and traditional pharmaceutical services for patients and medical staff in Polish general hospitals. Setting Hospital pharmacies from all general hospitals in Poland. Method A cross-sectional study was conducted, utilizing an anonymous questionnaire as the research instrument. Heads of hospital pharmacies were requested to participate in this study and complete the questionnaire. The survey was initially piloted to improve the research method. Main outcome measure The types of pharmaceutical services performed in Polish general hospitals. Results 166 hospital pharmacies took part in this survey. The overall response rate was 60.8 %. The total number of full-time equivalent (FTE) professionals employed within the surveyed hospital pharmacies was approximately 833. The procurement and distribution of drugs were identified as pharmaceutical services performed by most of the participants. The significant majority of pharmacists were also involved in compounding, adverse drug reaction monitoring and rational drug management services. Eleven (7 %) of the responding pharmacists had direct contact with patients and 7 (4 %) pharmacists took part in ward rounds. More precise legal regulations regarding hospital pharmacy practice were measures indicated by most pharmacists as necessary changes required in the hospital pharmacy system. Conclusion Polish hospital pharmacists provide various pharmaceutical services. Their work is closely related with direct

  17. SERVICE MARKETING MIX OF INDIAN HOSPITALS: A CRITICAL REVIEW

    Dharmesh, MOTWANI; Vijay, SHRIMALI

    2014-01-01

    Sreenivas, Srinivasarao and Srinivasa (2013) said that “The health care market has become consumer centered and expecting high quality care at a reasonable price. The mushroomed development of corporate hospitals in India, competition is also bringing massive changes in industry structure. In this context, hospital services’ marketing is slowly and surely coming of age and is being woven into the fabric of hospitals planning and public relations programmes.” The essence of any marketing activ...

  18. Bone densitometry at a district general hospital: evaluation of service by doctors and patients.

    Madhok, R; Kirby, P.; Fordham, J.; Stamp, P.; Green, S.; Cooper, C

    1996-01-01

    OBJECTIVE--To assess doctors' and patients' views about a district general hospital bone densitometry service and to examine existing practice to influence future provision. DESIGN--Three postal surveys: (a) of doctors potentially using the service, (b) of patients undergoing a bone densitometry test during a six month period, and (c) of the referring doctors of the patients undergoing the test. SETTING--Bone densitometry service at South Cleveland Hospital, Middlesbrough and two district hea...

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

    Penkunas, Michael J; Hahn-Smith, Stephen

    2016-08-01

    This study investigated the demographic and clinical predictors of psychiatric hospitalization during the first 2 years of treatment for adults participating in the full-service partnership (FSP) program, based on Assertive Community Treatment, in a large county in northern California. Clinical and demographic characteristics, data on prior hospitalizations, length of enrollment, and living situation for 328 FSP participants were collected from the county's internal billing system and the California Department of Health Care Services. In univariate models, the probability of hospitalization varied by diagnosis, age, and hospitalization history. In the multivariate model, younger age and frequent hospitalization prior to enrollment predicted hospitalization during enrollment. Findings support prior research on hospital recidivism and may be beneficial in refining future strategies for meeting the needs of adults with serious mental illness. PMID:25527223

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

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

    2014-09-01

    Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance. PMID:25015761

  1. A queuing application to the radiology service at Hotel Dieu de France hospital (Lebanon)

    Engineering management is becoming a vital element for the success of any service or industry. Managerial tools are being used to enhance the quality of a service or an industry and decrease its cost. Hospital services all over the world are making use of the tools in order to provide better and cheaper health care. In Lebanon, most services, including hospitals, are poorly taking advantage of the available managerial tools. this research will provide an example of applying queuing theory to the radiology service at a hospital. Supported by data from a field study, it will provide a model to predict the behavior of the service and suggest strategies that can enhance the service and increase profit. (author)

  2. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Special requirements for hospital providers of long... PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.66 Special requirements for hospital providers of long-term care services (“swing-beds”). A hospital that has a Medicare provider agreement...

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

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

    2016-01-01

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

  4. A proposal of Occupational Therapy service to hospitalized elderly patients

    Mariana Boaro Fernandez Canon

    2014-09-01

    Full Text Available Introduction: The association between chronic diseases, functional dependency, and hospitalization represents a high risk for the elderly, because it contributes to decreased functional capacity. Objectives: This study aimed to describe an action protocol of Occupational Therapy with hospitalized elderly patients with diagnosis of chronic diseases, approaching sensory, cognitive, psychomotor and functional aspects, and to analyze whether this protocol maximizes the independence for the feeding activity. Methodology: Patients hospitalized in a Geriatric Ward, between December 2011 and February 2012, were selected according to inclusion criteria. After conduction of the intervention protocol, a functional evaluation, Functional Independence Measurement (FIM – motor part, was performed approaching sensory, cognitive, psychomotor and functional aspects. There were 10 sessions with average duration of 30 minutes, the first and the last ones for the assessment and orientation. Six (6 hospitalized elderly patients were selected: 5 females and 1 male, mean age of 88.8, 5.3 years of schooling. Results: The scoreboard mean for the feeding item of the FIM before hospitalization was 2.7 points, it dropped to 1.5 points in the first days of hospitalization, and then increased to 3.8 points after the intervention of Occupational Therapy. The scoreboard means for the motor part of the FIM before hospitalization, during the first days, and after the intervention were: 26.8, 16 and 23.2 points, respectively. Conclusions: All the elderly benefited from this protocol and started to perform more independently not only the activity of feeding, but also the other basic activities of daily living, when compared to the first days of hospitalization.

  5. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    2010-10-01

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

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

    Fukunaga, Hisanori; Momonoi, Toshiyuki; Kumakawa, Hiromi

    2016-01-01

      Despite being damaged by the 2011 Tohoku earthquake, tsunami, and nuclear disaster, Soma General Hospital, located approximately 40 km north of Fukushima Daiichi nuclear power plant, was able to fulfill its role as a key regional hospital in northeast Fukushima. To elucidate the pharmaceutical service in response to the disaster, we investigated the hospital's operations in 2011 according to the medical records and prescriptions. One of the difficulties that the department of pharmaceutical service faced at that time was the increase in emergency healthcare requests by evacuated patients from other hospitals and clinics. Herein, we propose the following countermeasures to be considered in future disaster preparations: (1) establishing a medical and pharmaceutical service coordinator for disaster relief; (2) sharing all local patients' medical information in emergencies (at least contraindicated drugs or allergy history); and (3) reviewing disaster stockpiles, especially pharmaceuticals (both at the hospital and in nearby locations). PMID:26725681

  7. Tourist Satisfaction with Hospitality Services on River Ship “Ms River Aria”

    Nikola Vuksanović

    2013-07-01

    Full Text Available The main prerequisite for a successful business of hospitality services and building customer loyalty is to develop measures for improving and development hospitality services and offer. This paper presents the results of tourists satisfaction surveys based on the measurement of expected and perceived levels of quality hospitality services on a river ship “MS River Aria” company “Grand Circle Cruise Line”. The survey was conducted between March and September 2012 on the itinerary: Amsterdam - Vienna (SGE, Amsterdam - Antwerp (SHH, Linz - Budapest (EDR and Budapest - Constanta (LBS. A model for measuring hospitality services was developed by the company itself. During statistical data analysis, only the highest ratings, whose share was shown as percentage, were taken into account. The obtained results may be relevant for other cruise companies and contribute to the improvement of business and pleasure tourist.

  8. 38 CFR 17.35 - Hospital care and medical services in foreign countries.

    2010-07-01

    ... reasons enumerated in 38 CFR 17.47(i)(2). (Authority: 38 U.S.C. 1724) Enrollment Provisions and Medical... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Hospital Or Nursing Home Care and Medical Services in Foreign Countries §...

  9. 42 CFR 136.30 - Payment to Medicare-participating hospitals for authorized Contract Health Services.

    2010-10-01

    ... methodology under this section applies to all levels of care furnished by a Medicare-participating hospital, whether provided as inpatient, outpatient, skilled nursing facility care, as other services of a... critical access hospitals (as defined in section 1861(mm)(1) of the Social Security Act), that...

  10. [Quality of care and risk management in hospital at home services].

    Franzin-Garrec, Martine; Hoden, Romy

    2016-04-01

    Hospital at home structures are healthcare institutions in their own right, with the same obligations in terms of governance with regard to quality of care and risk management. However, hospital at home services are characterised by the remote management of the activity and the nursing staff, with specific constraints. PMID:27085929

  11. Operation of a support service team in the emergency department of a general hospital.

    Condra, M; Groll, L; Walker, D M; Abrams, M O; Sims, P.

    1987-01-01

    We describe the development and operation of an emergency support service team in the Emergency Department of the Kingston General Hospital, Kingston, Ont. The team, composed of professionals from other departments of the hospital, provides emotional and practical support to family members or survivors in medical emergencies. We discuss the roles of the team members and their procedures for dealing with distress and grief.

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

    Sahin, Alper A

    2014-01-01

    Health services are one of the most important criteria for making a country function. Turkey has mobilized all of its resources to provide high-quality, easily accessible and patient-friendly services for its population. To achieve this aim, the Turkish health care system has been undergoing a significant transformation through its Health Transformation Programme begun in 2005. The reforms focus on the introduction of a general health insurance system, changing hospital health services, improvements in hospital management and transformational leadership skills. Firstly, all state-run hospitals in the country were merged under the same umbrella, giving millions of people covered by the national security agency access to all of these hospitals. Secondly, all drugs and medical equipment used by patients were made free of charge. Thanks to these developments, hospitals were modernized, and this modernization process in the health sector is still continuing swiftly. On the other hand, for Turkish hospitals to survive, they need to modernize further and become closer to European models, and produce new leaders with new paradigms. In this new and changing health system, hospital leaders and executive officers should be visionaries and strategists advising when to change direction. Following this doctrine, most Turkish hospitals are now run by two top executives: the hospital manager and the chief executive officer who is in charge of business functions. These executives should clearly be the leaders of high-quality, health care organizations. PMID:24938025

  13. Comparison of Services of Public, Private and Foreign Hospitals from the Perspective of Bangladeshi Patients

    Siddiqui, Nazlee; Khandaker, Shahjahan Ali

    2007-01-01

    Despite recent developments in the Bangladesh healthcare sector, there is still great concern about the quality of healthcare services in the country. This study compared the quality of healthcare services by different types of institutions, i.e. public and private hospitals, from the perspective of Bangladeshi patients to identify the relevant areas for development. A survey was conducted among Bangladeshi citizens who were in-patients in public or private hospitals in Dhaka city or in hospi...

  14. Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score

    Thakore, Rachel V.; Young M. Lee; Vasanth Sathiyakumar; Obremskey, William T.; Sethi, Manish K.

    2014-01-01

    Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression...

  15. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Asgar Aghaei Hashjin; Dionne Kringos; Hamid Ravaghi; Jila Manoochehri; Hassan Abolghasem Gorji; Niek Klazinga

    2015-01-01

    Background Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A d...

  16. Systematic review of pre-hospital outcomes for evidence-based evaluation of ambulance service care

    Phung, Viet-Hai; Coster, Joanne; Wilson, Richard; Turner, Janette; Booth, Andrew; Siriwardena, A Niroshan

    2013-01-01

    Background: Ambulance service performance measurement has previously focused on response times and survival (particularly from out-of-hospital cardiac arrest). The PhOEBE (Pre-hospital Outcomes for Evidence Based Evaluation) project is a 5-year research programme which aims to develop new ways of measuring the performance, quality and impact of ambulance service care. As part of this programme we conducted a systematic review of the international literature on quality measures and outcomes re...

  17. Measurement of Quality of Educational Hospital Services by the SERVQUAL Model: The Iranian Patients’ Perspective

    Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid

    2016-01-01

    Introduction The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. Methods In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hos...

  18. The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran

    Arab, M; Tabatabaei, SM Ghazi; Rashidian, A; Forushani, A Rahimi; Zarei, E

    2012-01-01

    Background: Service quality is perceived as an important factor for developing patient’s loyalty. The aim of this study was to determine the hospital service quality from the patients’ viewpoints and the relative importance of quality dimensions in predicting the patient’s loyalty. Methods: A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 i...

  19. An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

    Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

    2014-01-01

    Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data ...

  20. Measuring Service Quality in the Hospitality Industry: A Case Study in Hue City, Vietnam

    Ngoc, Liem Le; INABA, Yushi

    2015-01-01

    This research is a study on service quality in the hospitality industry in the context of a developing country. The key purposes of this study are twofold. First, it examines the conceptualization and measurement of service quality in the hotel setting. Second, the relationships between service quality, customer satisfaction, and repurchase intention are taken into considerations. The findings from this study confirm that there are three determinants affecting statistically on service quality...

  1. Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland.

    Grimes, Tamasine

    2012-02-01

    OBJECTIVES: to describe hospital pharmacy involvement in medication management in Ireland, both generally and at points of transfer of care, and to gain a broad perspective of the hospital pharmacy workforce. METHODS: a survey of all adult, acute, public hospitals with an accident and emergency (A&E) department (n = 36), using a semi-structured telephone interview. KEY FINDINGS: there was a 97% (n = 35) response rate. The majority (n = 25, 71.4%) of hospitals reported delivery of a clinical pharmacy service. On admission, pharmacists were involved in taking or verifying medication histories in a minority (n = 15, 42.9%) of hospitals, while few (n = 6,17.1%) deployed staff to the A&E\\/acute medical admissions unit. On discharge, the majority (n = 30,85.7%) did not supply any take-out medication, a minority (n =5,14.3%) checked the discharge prescription, 51.4% (n = 18) counselled patients, 42.9% (n = 15) provided medication compliance charts and one hospital (2.9%) communicated with the patient\\'s community pharmacy. The number of staff employed in the pharmacy department in each hospital was not proportionate to the number of inpatient beds, nor the volume of admissions from A&E. There were differences identified in service delivery between hospitals of different type: urban hospitals with a high volume of admissions from A&E were more likely to deliver clinical pharmacy. CONCLUSIONS: the frequency and consistency of delivering pharmacy services to facilitate medication reconciliation at admission and discharge could be improved. Workforce constraints may inhibit service expansion. Development of national standards of practice may help to eliminate variation between hospitals and support service development.

  2. Factors influencing inpatients’ satisfaction with hospitalization service in public hospitals in Shanghai, People’s Republic of China

    Chen, Haiping; Li, Meina; Wang, Jingrui; Xue, Chen; Ding, Tao; Nong, Xin; Liu, Yuan; Zhang, Lulu

    2016-01-01

    Objective The aim of this study was to observe the current status of inpatient satisfaction and analyze the possible factors influencing patient satisfaction during hospitalization. Methods A cross-sectional investigation was conducted to obtain basic information about inpatient satisfaction, and statistical methods were used to describe and analyze the data. A total of 878 questionnaires were included in this study. A 5-point Likert scale rating was employed to assess items related to hospitalization care. Nonparametric tests and ordinal logistic analysis were used to explore the relationship between predictors and the patients’ overall satisfaction. Results Among the respondents, 89.75% were satisfied overall with the service they received during hospitalization, while 0.57% reported dissatisfaction. Inpatient demographic characteristics such as sex of the patients, occupation, age, and residence had significant associations with satisfaction, while monthly income and marital status did not. Additionally, the statistical outcome indicated that doctors’ and nurses’ service attitudes, and expenditure and environment were found to have an impact on the inpatient satisfaction ratings, with odds ratio of 2.43, 3.19, and 2.72, respectively. Conclusion This study emphasizes the influence of sex of the patients, the service attitudes of the doctors and nurses, and expenditure and environment on inpatient satisfaction. An increase in satisfaction ratings concerning the areas of doctors’ and nurses’ service attitudes, and expenditure and environment can improve the overall satisfaction levels. Responsible health management departments should pay attention to patient satisfaction and improve the quality of relevant health services, thus ultimately enhancing inpatients’ hospitalization experiences. PMID:27110101

  3. The Role of Sustainable Service Innovation in Crafting the Vision of the Hospitality Industry

    Jeou-Shyan Horng

    2016-03-01

    Full Text Available The purpose of this study was to examine the key characteristics of sustainable service innovation in the hospitality industry. We conducted a content analysis based on the interview records for 17 experts (including three academic scholars, three government officers and 11 top-level managers with an average of 20 years of experience in the hospitality management domain in Taiwan. The analytical results conform to Amabile’s (1988 componential theory of creativity and innovation and show that 11 characteristics are major indicators of sustainable service innovation in the hotel management field. These include the following characteristics: market position, customer satisfaction, service orientation, environmental thinking, employee involvement, incentive mechanism, human resource development, environmental services, cultural resource management, government policy and school education. Accordingly, using the integrated theory of sustainable service innovation and professional opinions from experts, we provide theoretical and practical implications for current and future trends on sustainability and innovation in the hospitality industry.

  4. A review of governance of maternity services at South Tipperary general hospital

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  5. Illustration of Modern Wind Turbine Ancillary Services

    Ioannis D. Margaris; Anca D. Hansen; Poul Sørensen; Nikolaos D. Hatziargyriou

    2010-01-01

    Increasing levels of wind power penetration in modern power systems has set intensively high standards with respect to wind turbine technology during the last years. Security issues have become rather critical and operation of wind farms as conventional power plants is becoming a necessity as wind turbines replace conventional units on the production side. This article includes a review of the basic control issues regarding the capability of the Doubly Fed Induction Generator (DFIG) wind turb...

  6. Competitive ancillary service procurement in California

    Marnay, Chris; Siddiqui, Afzal S.; Khavkin, Mark

    2000-01-01

    California has undertaken a major restructuring of its electricity utility sector. Most electricity is now sold in open markets operated by the PX and other entities. Bilateral contracting among some market participants is also permitted. A group of independent generating companies bids into these markets together with out of state resources. In addition to these markets, CAISO operates markets for both imbalance energy and AS, a quite unusual feature of the California system. These markets were initially quite chaotic and were rife with market power problems. However, various reforms have now created a system that functions well. During the restructuring process, special provisions were made to protect public purpose programs, including renewable generation.

  7. Assessing Community-Based Injury Prevention Services in U.S. Children's Hospitals

    Nancy L. Weaver

    2014-10-01

    Full Text Available Objective: Not-for-profit hospitals are required to meet federal reporting requirements detailing their community benefit activities, which support their tax-exempt status. Children's hospitals have long provided community injury prevention (IP programming and thus can inform public health outreach work in other areas. This work describes IP programming as a community service offered by children's hospitals in the U.S. Methods: The IP specialist at 232 US-based member institutions of the Children's Hospital Association were invited to complete an assessment of their hospital's IP outreach programming. Results: 47.7 percent of hospitals request financial data from IP programming for tax reporting purposes. Almost all offer injury prevention (IP services; the majority are in the community (60.3% and 34.5% are hospital-based. Most IP units are independent (60.3% and 71.8% are responsible for their own budgets. Conclusions: By integrating dissemination and implementation sciences and community health needs assessments, these findings can help advance community services provided by hospitals to impact public health.

  8. Training Pediatric Psychologists for Perinatal Behavioral Health Services in a Pediatric Hospital.

    Boyd, Rhonda C; Scharko, Alexander M; Cole, Joanna C M; Patterson, Chavis A; Benton, Tami D; Power, Thomas J

    2016-06-01

    Although pediatric hospitals specialize in providing care to children and adolescents, at The Children's Hospital of Philadelphia (CHOP), our team has been providing behavioral health services for two unique parent populations-parents with a child in the Newborn Infant Intensive Care Unit and pregnant women carrying fetuses with specific birth defects and receiving prenatal care in the Center for Fetal Diagnosis and Treatment. A new training program was developed to expand the scope of pediatric psychologists' practice to include perinatal behavioral health services, specifically for these two unique parent populations served at CHOP. The program includes direct service provision for adult mental health concerns, as well as education and support to help families cope with the existing medical conditions. This article describes the training program and its implementation as a model of training for other pediatric hospitals. The roles of psychologists embedded in these units and hospital privileges are discussed. PMID:26531132

  9. 42 CFR 413.53 - Determination of cost of services to beneficiaries.

    2010-10-01

    ... units, and other intensive care type inpatient hospital units and nursery costs); and (ii) Dividing the... services to critically ill inpatients. Examples of intensive care type units include, but are not limited... intermediate care units, and ancillary service areas. There cannot be a concurrent sharing f nursing...

  10. Dosimetry: Are the technician personnel of hospitals 'A categories' or have one to impose the operational dosimetry in hospitals services?

    This issue of 'Medecine et Armees' publishes the results of an operational study made in a nuclear medicine service. It is the opportunity to explain the regulatory bases of this measure and on changes introduced in hospital services using ionizing radiations. The decree (98-1186 of the twenty fourth of december 1998) and its application (twenty third of mars 1999) imposes the operational dosimetry for workers directly assigned to work under ionizing radiations and the employees intervening in controlled area. (N.C.)

  11. Hospital Universiti Sains Malaysia (HUSM): 25 Years Of Excellent Service

    Kamari, Zaidun

    2009-01-01

    Our Hospital University Sains Malaysia (HUSM) was given the Cabinet approval to exist under the Ministry of Education on 23 November 1982. The Deputy Prime Minister during that period, Yang Berhormat Tun Musa Hitam announced this after the cabinet meeting was held together with the presence of the Yang Berhormat Ministers of Health; and Education, Director of the Public Works Department and the Implementation and Coordinating Unit, Prime Minister’s Department. The first patients moved in on 1...

  12. Auditing thrombolysis service for stroke at Mater Dei Hospital

    Micallef, Daniel; Mallia, Maria; Borg, Denise; Aquilina, Josanne

    2015-01-01

    Thrombolysis for acute ischaemic stroke was introduced locally in October 2010. In 2012, the practice was audited to analyse the prevalence of inclusion and exclusion criteria for thrombolysis. Data about the local incidence of stroke, demographics and outcome was also obtained. All patients admitted to Mater Dei Hospital with a diagnosis of stroke over an 8 month period were recruited. Standard data collection sheets were used to obtain data. 251 patients were admitted with a confirm...

  13. Comparing Patients’ Opinions on the Hospital Discharge Process Collected With a Self-Reported Questionnaire Completed Via the Internet or Through a Telephone Survey: An Ancillary Study of the SENTIPAT Randomized Controlled Trial

    Couturier, Berengere; Carrat, Fabrice; Hejblum, Gilles; ,

    2015-01-01

    Background Hospital discharge, a critical stage in the hospital-to-home transition of patient care, is a complex process with potential dysfunctions having an impact on patients’ health on their return home. No study has yet reported the feasibility and usefulness of an information system that would directly collect and transmit, via the Internet, volunteer patients’ opinions on their satisfaction concerning the organization of hospital discharge. Objective Our primary objective was to compar...

  14. Navigation and Ancillary Information Facility's SPICE

    National Aeronautics and Space Administration — The Navigation and Ancillary Information Facility (NAIF), acting under the directions of NASA's Planetary Science Division, has built an information system named...

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

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

    2008-01-01

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

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

    2010-01-01

    ... evacuation service (HEMES). 135.271 Section 135.271 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... 24-consecutive hour period of a HEMES assignment, unless an emergency medical evacuation operation...

  17. Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score

    Rachel V. Thakore

    2014-01-01

    Full Text Available Purpose. To determine if the American Society of Anesthesiologist (ASA score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients’ ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient’s ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient’s preoperative physical status.

  18. 42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for hospital outpatient radiology services... radiology services and other diagnostic procedures. (a) Basis and purpose. (1) This section implements section 1833(n) of the Act and establishes the method for determining Medicare payments for...

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

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

    2009-01-01

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

  20. Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score.

    Thakore, Rachel V; Lee, Young M; Sathiyakumar, Vasanth; Obremskey, William T; Sethi, Manish K

    2014-01-01

    Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status. PMID:24876836

  1. POSSIBILITIES OF THE PROFESSIONAL OF TOURISM HELPING AT THE HOSPITALITY IN HOSPITAL’S SERVICES: CASE OF HOSPITAL NILZA DE OLIVEIRA PIPINO, UBIRATÃ-PR

    Patricia Regina Cenci Queiroz

    2006-05-01

    Full Text Available This article aims to discuss some aspects which can be improved concerning the Hospital e Maternidade Nilza de Oliveira Pipino services, through the work of a professional of tourism, implanting some services of hospitality in hospitals. By observing, we could identify some problems due to the lack of organization, human resource management, professional training about the reception of the hospital which can cause disastrous consequences for the patients recovery process. Our main goal is making notes and thinks about the useful help of a professional of tourism for the hospital humanization process.

  2. 76 FR 67567 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    2011-11-01

    ...)(3)(B)(xii)(II) of the Act), and an adjustment based on changes in the economy-wide productivity (the... not included in the definition of a small entity. We have determined that this ] notice will not have... paid (in millions) Type of cost sharing 2011 2012 2011 2012 Inpatient hospital deductible $1132 $1156...

  3. Objective standards for the emergency services: emergency admission to hospital.

    West, R.

    2001-01-01

    The primary objectives of the emergency services are to minimize early mortality and complications, although longer-term morbidity, quality of life and late mortality may also be influenced by early actions. Evaluation of the emergency services and demonstration of quality need to reflect these objectives by appropriate choice of outcome measures. This brief review of leading measures of quality in emergency admissions discusses population-based 30-day mortality, after examining some limitati...

  4. The marketing concept of customer value of hospitality service

    Gerasimenko, O V

    2015-01-01

    Customer value is a significant part of marketing activity of the company, especially in the modern state of Ukrainian economy. Globalization, crisis transformation in the service sector, falling consumer demand, a glut of supply of hotel services and increased competition actualize scientific problem solving improving marketing concepts according to external challenges unstable business environment. Applying effective marketing tool businesses will proactively adapt to the turbulent business...

  5. [Definition of "Safety and Hygiene Packages" as a management model for the Hospital Hygiene Service (HHS)].

    Raponi, Matteo; Damiani, Gianfranco; Vincenti, Sara; Wachocka, Malgorzata; Boninti, Federica; Bruno, Stefania; Quaranta, Gianluigi; Moscato, Umberto; Boccia, Stefania; Ficarra, Maria Giovanna; Specchia, Maria Lucia; Posteraro, Brunella; Berloco, Filippo; Celani, Fabrizio; Ricciardi, Walter; Laurenti, Patrizia

    2014-01-01

    The purpose of this research is to identify and formalize the Hospital Hygiene Service activities and products, evaluating them in a cost accounting management view. The ultimate aim, is to evaluate the financial adverse events prevention impact, in an Hospital Hygiene Service management. A three step methodology based on affinity grouping activities, was employed. This methodology led us to identify 4 action areas, with 23 related productive processes, and 86 available safety packages. Owing to this new methodology, we was able to implement a systematic evaluation of the furnished services. PMID:25008222

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

    Sheehan-Smith, Lisa

    2006-04-01

    This qualitative study sought to identify the features, advantages, and disadvantages of hotel-style room service; the barriers to, and facilitators for, implementing the process; and "best practices." The study took place in four heterogeneous hospitals. Participants included hospital administrators, managers, and room-service employees. Data-collection methods included semi-structured interviews, observations, and document analysis. Common features of hotel-style room service were meal delivery within 30 to 45 minutes, a restaurant-style menu, procedures to feed ineligible patients, tray assembly on demand, scripting, and waitstaff uniforms for room-service employees. The major barrier to implementing room service was obtaining nursing support. The key facilitators were the hospital's service-oriented culture, using a multidisciplinary planning team, engaging nursing departments early in the planning stages, and intense customer-service training of room-service employees. The overwhelming advantage was patients' control over their food choices. The main disadvantage was cost. Initial best practices in hotel-style room service include: (a) taking a multidisciplinary team approach for developing and implementing the process, (b) customer-service training, (c) using a customer-driven menu, (d) wearing waitstaff uniforms, and (e) using carts with airpots for dispensing hot beverages. PMID:16567154

  7. 42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

    2010-10-01

    ... of the beneficiary's inpatient admission and the hospital does not attest that such service is... the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS... PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care...

  8. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers. PMID:26922733

  9. TOTAL QUALITY MANAGEMENT IN HOSPITALITY INDUSTRY: MEASURE OF SERVICE QUALITY

    Vaidyanathan, Sakthi Praveen

    2015-01-01

    The report is created as a result of rigorous thesis, anti-thesis and synthesis. The presented thesis/dissertation is based on the concept of TQM, also known as Total Quality Management in hospitality industry. In doing so, the industry has been scrutinized to a magnified level where all its elements are featured from bi-dimensional perspective i.e. of the customers‘ as well as of the management‘s. This discusses topics that have the ability or capacity to define the term in...

  10. Therapeutic heparin monitoring service in a small community hospital.

    Pawloski, S J; Kersh, P L

    1992-08-01

    Upon the request of members of the medical staff, the Pharmacy and Therapeutics Committee at Tawas St. Joseph Hospital began monitoring patients receiving full-dose continuous intravenous heparin therapy. Problems were noted in the usage of activated partial thromboplastin times and the resultant changes in heparin therapy. The problems identified during this quality assurance activity were addressed by a heparin protocol developed by a clinical pharmacist. The protocol includes giving patients a heparin loading dose of 50-100 units/kg actual body weight, an initial infusion rate of 15-20 units/kg/hr, and drawing the first activated partial thromboplastin time 6 hours later. After the results of the activated partial thromboplastin times are known, the protocol provides for further patient management and changes in infusion rates, if needed. A review of the heparin protocol use at 6 months after initial implementation, and 6 months after minor changes in the protocol, showed that clinical pharmacists improved heparin therapy in the patients they treated. Pharmacists used larger initial continuous infusion rates, less activated partial thromboplastin times during treatment, and patients they managed reached therapeutic activated partial thromboplastin time ranges earlier than patients treated by physicians. When voluntarily prescribed by physicians, full-dose continuous intravenous heparin therapy initiated and monitored by clinical pharmacists improved the quality of patient's anticoagulation treatment during hospitalization. PMID:10119735

  11. Applying Activity Based Costing (ABC Method to Calculate Cost Price in Hospital and Remedy Services

    A Dabiri

    2012-04-01

    Full Text Available Background: Activity Based Costing (ABC is one of the new methods began appearing as a costing methodology in the 1990. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals.Methods: To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated.Results: The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly.Conclusion: Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services.

  12. An Introduction to Emergency Medical Services (EMS). Pre-Hospital Phase. Emergency Medical Services Orientation, Lesson Plan No. 9.

    Young, Derrick P.

    Designed for use with interested students at high schools, community colleges, and four-year colleges, this lesson plan was developed to provide an introduction to the pre-hospital phase of Emergency Medical Services (EMS) and to serve as a recruitment tool for the EMS Program at Kapiolani Community College (KCC) in Hawaii. The objectives of the…

  13. Maritime radio-medical services: the Singapore General Hospital experience.

    Lateef, Fatimah; Anantharaman, Venkataraman

    2002-07-01

    Medical care for the sick and injured on a variety of sea-faring vessels throughout the world represents a challenging area of medical care. The scope is extremely broad and unique in terms of the problems encountered at sea, logistical difficulties in assessment and treatment of patients, as well as the provision of definitive care. The problems of sparse resources availability, great distances, isolation, communications, accessibility, and weather are also very real. In Singapore, radio-medical advice was first coordinated by the Port Health Authority. In 1980, the accident and emergency department at Singapore General Hospital took over this responsibility. This report analyzes 2,320 calls received over a period of 21 years (January 1980 to December 2000). It highlights the common consultations, modes of communications, treatment and management prescribed, training requirements, as well as the challenges for the future. PMID:12098185

  14. Basic characteristics of hospital stroke services in Eastern Hungary

    Stroke mortality is extremely high in Central-Eastern European countries. We report basic characteristics of a stroke unit in Eastern Hungary, including age and sex distribution; the proportion of transient ischemic attacks (TIA), ischemic and hemorrhagic strokes; case fatality; application of diagnostic methods; and length of stay for all patients treated with acute cerebrovascular disease over a 12-month period. Records of all patients with acute cerebrovascular disease (n = 522) discharged in 1995 from a stroke unit with a well defined catchment area of 220,000 inhabitants in Eastern Hungary were retrospectively analyzed. Case fatality was 18.6% for all patients and 21.1% after excluding cases with TIA. Computer tomography, duplex carotid ultrasound, cerebrospinal fluid examination and electroencephalography were performed in 79%, 77%, 7% and 2% of the patients, respectively. The database of the university hospital with the same catchment area was electronically searched for patients who were discharged with the diagnosis of stroke from the three departments of internal medicine. Stroke mortality data of the catchment area based on death certificates was obtained from the Central Statistical Bureau. Two hundred twenty-eight stroke deaths were reported in the catchment area in 1995. In the same period 97 stroke deaths occurred at the stroke unit and 76 at the departments of internal medicine. If we aim to treat all patients with acute stroke at the stroke unit, with the present stroke incidence and duration of hospital stay the current capacity of the stroke unit (1 bed per 10.000 inhabitants) should be doubled

  15. Clients’ Satisfaction with Anti Retroviral Therapy Services at Hamidia Hospital Bhopal

    Bhagat Vimal Kishor, Pal D K, Lodha Rama S, Bankwar Vishal

    2011-01-01

    Background: The HIV/AIDS pandemic is a major public health problem with an estimated 33.33 million people living with the virus globally. Free antiretroviral treatment was initiated in India 2004. Patients’ satisfaction is one of the commonly used outcome measures of patient care. Objective: To assess the satisfaction of people living with HIV/AIDS with services provided at anti retroviral therapy Centre Hamidia Hospital Bhopal. Material and Methods: A hospital based cross-sectional study was...

  16. The Role of Sustainable Service Innovation in Crafting the Vision of the Hospitality Industry

    Jeou-Shyan Horng; Chung-Jen Wang; Chih-Hsing Liu; Sheng-Fang Chou; Chang-Yen Tsai

    2016-01-01

    The purpose of this study was to examine the key characteristics of sustainable service innovation in the hospitality industry. We conducted a content analysis based on the interview records for 17 experts (including three academic scholars, three government officers and 11 top-level managers) with an average of 20 years of experience in the hospitality management domain in Taiwan. The analytical results conform to Amabile’s (1988) componential theory of creativity and innovation and show tha...

  17. Effectiveness of an acute pain service inception in a general hospital

    Bardiau, Françoise; Braeckman, M.M.; Seidel, Laurence; Albert, Adelin; Boogaerts, J.G.

    1999-01-01

    STUDY OBJECTIVES: To assess the effects of an Acute Pain Service (APS) inception on postoperative pain management in a general teaching hospital using pain indicators as performance measures. DESIGN: Open, prospective, nonrandomized, observational study. SETTING: Postanesthesia Care Unit, surgical wards of University Hospital Center of Charleroi. PATIENTS: 1304 patients in the pre-APS inception phase and 671 patients after its implemention who have undergone various types of surgery (orthoped...

  18. Nonoffending Guardian Assessment of Hospital-Based Sexual Abuse/Assault Services for Children.

    Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Smith, Tanya

    2016-01-01

    In circumstances in which child sexual abuse/assault is suspected, pediatric guidelines recommend referral to services such as multidisciplinary hospital-based violence treatment centers, for specialized medical treatment, forensic documentation, and counseling. As little is known about how such services are perceived, the objective of this case report was to measure the satisfaction of nonoffending guardians of child sexual abuse/assault victims who presented for care at Ontario's hospital-based sexual assault treatment centers. Of the 1,136 individuals who reported sexual abuse/assault and were enrolled in a province-wide service evaluation, 58 were 11 years old and younger. Thirty-three guardians completed a survey. Ratings of care were overwhelmingly positive, with 97% of respondents indicating that they would recommend these services. Nonetheless, it is important to evaluate these pediatric sexual assault services frequently to ensure ongoing optimal, family-centered care. PMID:26910267

  19. Study of Ancillary Service Market Mechanism for the Promotion of Wind Power Consumption in Northwest Region%西北地区促进风电消纳的辅助服务市场机制研究

    张钦; 辛颂旭; 白建华; 林祺蔚

    2013-01-01

    There are abundant resources including wind energy,water energy,coal and so on in northwest region,which is the important base of the wind power,water power and coal power.To promote the high-efficient consumption of wind power in the large-scale power base of northwest region,the further research of technology,economy and other issues is required.Overall considering the harmonious development of the wind power,water power and coal power,and combining the actual conditions in northwest region,the wind power grid connection in northwest region and the induced share mechanism of ancillary service cost and expense for the peak-load regulation have been focusedly studied.Based on the analysis of the stakeholders related to the coordinated operation of wind power,water power and coal power,the assistant service framework for the promotion of high-efficient wind power consumption is proposed.According to the principle of equity of right and obligation based on the idea "Who get benefits paid",the cost analysis model of paid peaking service considering the wind power grid connection is proposed,and furthermore the share mechanism that the paid peaking cost be solely shared in each Province for the thermal power and centralizedly shared in the grid for the water power is established.The analysis results of the example has proved the effectiveness of the proposed method.%西北地区风能、水能、煤炭等资源丰富,是中国重要的风电、水电与煤电基地.为促进西北大型风电基地的高效消纳,需要深入研究技术、经济等方面面临的问题.统筹考虑了风电与水电、煤电协调发展,结合西北地区实际情况,重点研究西北风电并网后,由此引起的调峰辅助服务成本与费用分摊机制.基于风电与水电、煤电协调运行利益相关方的分析,提出了促进风电高效消纳的辅助服务框架.基于“谁受益、谁付费”的权利与义务对等原则,提出了考虑风电并网的有偿调

  20. Do health insurers possess monopsony power in the hospital services industry?

    Bates, Laurie J; Santerre, Rexford E

    2008-03-01

    This paper uses metropolitan data to test empirically if health insurers possess monopsony or monopoly-busting power on the buyer-side of the hospital services market. According to theory, monopsony power is indicated by a fall in output, whereas, monopoly-busting power is shown by an increase in output when buyer concentration rises. The empirical results provide evidence that greater health insurer buyer concentration is not associated with monopsony power. Instead, some evidence is found to suggest that higher health insurer concentration translates into increased monopoly-busting power. That is, metropolitan hospitals offer increased services when the buyer-side of the hospitals services market is more highly concentrated. PMID:17638072

  1. Assessment and Availability of Trauma Care Services in a District Hospital of South India; A Field Observational Study

    Pallavi Sarji Uthkarsh; Gopalkrishna Gururaj; Sai Sabharish Reddy; Mandya Siddalingaiah Rajanna

    2016-01-01

    Objective: To assess the availability of trauma care services in a district referral hospital of Southern India. Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-d...

  2. The development of medical record services in Hong Kong public hospitals.

    Fung, V

    1994-12-01

    Medical record service in Hong Kong public hospitals have been developing at different levels. Since 1992, various improvements in medical record services have been carried out in public hospitals, e.g. professional management, record storage, organized medical records, computerization, completion of discharge summaries, and the introduction of a more precise coding system. The aim of the reform is to provide timely, accurate, organized and meaningful clinical information for end-users. Evolving from this reform, work has been started on developing Patient Related Groups and Specialty Clinical Information Systems. PMID:10142476

  3. Survey of the functioning conditions of public hospital radiodiagnosis services in Rio de Janeiro State

    This work aims to make a survey of the conditions of quality control of the Services of Radiodiagnostic of some public and/or University Hospitals in Rio de Janeiro. This survey consisted of the accomplishment of some quality control tests required by Brazilian legislation. Besides the improvement in the quality of these Services, cost reduction is another factor that motivated this work. The implantation of a Quality Assurance Program is also discussed. It includes the procedures of quality control that need be implemented in each of the hospitals. (author)

  4. Comparison between two mobile pre-hospital care services for trauma patients

    Gonsaga Ricardo; Brugugnolli Izabela; Fraga Gustavo

    2012-01-01

    Abstract Objectives Pre-hospital care (PH) in Brazil is currently in the phase of implementation and expansion, and there are few studies on the impacts of this public health service. The purpose of this study is to assess the quality of care and severity of trauma among the population served, using trauma scores, attendance response times, and mortality rates. This work compares two pre-hospital systems: the Mobile Emergency Care Service, or SAMU 192, and the Fire Brigade Group, or CB. Metho...

  5. Health Promoting Hospitals and Health Services network in Northern Ireland - Update report 2008-2009

    Public Health Agency

    2010-01-01

    The third annual report from the World Health Organisation’s (WHO) Healthy Promoting Hospitals (HPH) and Healthy Services network highlights a rich selection of the innovative developments and team-working achievements across services in Northern Ireland. The report provides a platform to showcase the five Health and Social Care Trusts and Cooperation and Working Together (CAWT)’s commitment to health and wellbeing to the population and shows how hospitals can have an impact on the determ...

  6. The Frederic Joliot hospital department; Le service hospitalier Frederic Joliot

    NONE

    1999-02-01

    The Service Hospitalier Frederic Joliot (SHFJ) of the CEA, has got a scientific and a medical mission: to develop techniques allowing the functional study of human organs. The paper presents the main activities of this department: the positron emission tomography to visualize in real time markers in the organism in neurology and cardiology, researches on epilepsy to localize the epileptic centre, the nuclear medicine in cardiology with the use of the gamma photon emission tomography and the radiopharmacology to visualize the drugs effects in the organism. (A.L.B.)

  7. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Asgar Aghaei Hashjin

    2015-10-01

    Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA

  8. Hospitals

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  9. Willingness to pay for municipality hospital services in rural Japan: a contingent valuation study

    Nakamura Toshihito

    2011-06-01

    Full Text Available Abstract Background The Japanese healthcare system has undergone reforms to address the struggles that municipality hospitals face. Reform guidelines clearly define criteria for administrative improvement. However, criteria to evaluate the demand for healthcare provisions in rural Japan, including the needs of rural residents for municipality hospitals in particular have not been specified. The purpose of this paper is to measure residents' willingness to pay (WTP for municipality hospital services using the contingent valuation method, and to evaluate municipality hospital valuation on the basis of WTP. K town, located in the Hokkaido prefecture of Japan, was selected as the location for this study. Participants were recruited by a town hall healthcare administrator, hospital and clinic staff, and a local dentist. Participants were asked what amount they would be willing to pay as taxes to continue accessing the services of the municipality hospital for one year by using open-ended questions in face-to-face interviews. Findings Forty-eight residents were initially recruited, and 40 participants were selected for the study (response rate 83%. As compared to K town's population, this data slanted toward the elderly, although there was no significant difference in frequency among the characteristics. The median WTP was estimated at 39,484 yen ($438.71, with a 95% confidence interval 27,806-55,437 yen ($308.95-615.96. Logistic regression revealed no significant factors affecting WTP. Conclusions If the total amount of residents' WTP for the municipality hospital were to be estimated by this result, it would calculate with 129,586,000 yen ($1,439,844. This is approximately equal to the amount of money to be transferred from the general account of the government of K town, more than one-half of the town tax of K town, and about two-fold in comparison to Japan as a whole. This showed that K town's residents placed a high valuation on the municipality

  10. CUSTOMER SATISFACTION AS AN INDICATOR OF SERVICE QUALITY IN TOURISM AND HOSPITALITY

    Ana Stranjancevic; Iva Bulatovic

    2015-01-01

    One of the greatest challenges for stakeholders is to ensure customer satisfaction, especially in service industries such as tourism and hospitality. The aim of this paper is to show that restaurant guest satisfaction depends on numerous factors as well as to show the connection between satisfaction and loyalty. Customer satisfaction and loyalty are excellent indicators of service quality. For the purpose of this paper, empirical survey was conducted and the results of the research were analy...

  11. Exogam with its ancillary detectors

    The goal of the meeting was to discuss the status of experiments using Exogam and its ancillary detectors. Presentations include details of experiments already run and those in preparation. This document gathers most of the slides presented at the meeting. The results of 7 experiments are described. There are 9 contributions as it follows: 1) presentation of the Vamos spectrometer p.1-15, 2) the Clara (detector) and Prisma (spectrometer) setup: status and perspectives p.16-33, 3) experiment E344aS: shape coexistence near the N=Z line and collective properties of Kr isotopes investigated by low-energy Coulomb excitation p.34-56, 4) experiment E389: study of effective charges at Sm100 via the nuclear lifetime measurements in Pd96 and Cd98 p.57-68, 5) experiment E375: spectroscopy of trans-fermium nuclei p.69-91, 6) experiment E408S: He8 on Pb208 and Bi209 p.92-102, 7) experiment E462: very neutron rich calcium isotopes at N=32, structure of magic Ca54 studied by gamma-spectroscopy with deep inelastic reactions p.103-115, 8) experiment E451: searching for T=D pairing and a new coupling scheme in Pd92 and Ru88 p.116-141, and 9) experiment E404aS: identification of gamma rays in nuclei around the drip-line nucleus Sm130, probing the maximally deformed light rare earth region

  12. Convergence of PPTCT with RCH Services in a District Hospital, Haryana

    Puneet Bhagat

    2014-03-01

    Full Text Available Background: The integration of PPTCT and RCH activities is an important strategy for universal screening of ANC mothers through available government health infrastructure in a district. The objective of this study was to understand process and analyzing outcome of convergence of PPTCT & RCH services in a District Hospital. Methods: The study was a descriptive study conducted in district hospital, Gurgaon. Results: In the district hospital Gurgaon percentage of women counseled at ICTC has increased from 77% to 89.4% and percentage of women tested has increased from 75% to 87.8% during 2010 and 2011. However, not all women tested positive delivered at hospital. Only 6.7% women were knowing about transmission of HIV from mother to baby. About 60% ANC registration are delayed primarily due to lack of family support (71%. Majority of ANC women got HIV screening at district hospital due to non-availability of facility at CHC/PHC levels. About 58% of Institutional deliveries in the State are in private hospitals, but they still need to be involved in PPTCT. Conclusion: Currently, convergence of PPTCT and RCH services seems to be fragmented and at initial stage. Convergence need to be taken up at policy, planning, implementation, capacity building, resource mobilization and monitoring for success of the initiative in the state.

  13. Occupational exposure in services of Oncological Hospital of Camaguey; Exposicion ocupacional en los servicios del Hospital Oncologico de Camaguey, Cuba

    Barreras, C.A.; Brigido, F.O.; Naranjo, L.A. [Centro de Atencion a la Actividad Nuclear, Camaguey (Cuba)]. E-mail: sean@caonao.cmw.inf.cu; Sanches, M.P. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)]. E-mail: msanches@net.ipen.br; Lasserra, S.O.; Hernandez, G.J. [Hospital Oncologico Marie Curie, Camaguey (Cuba)

    2001-07-01

    The Nuclear Medicine Service of the Cancer Hospital at Camaguey presents data on the occupationally exposure workers, during 1990-1999, obtained from film dosimetry. The outcomes show that: the average of annual effective equivalent dose for nuclear medical personnel was 2.47 mSv, while 2.13 mSv were to represent radiotherapy and 1.11 mSv were to represent the personnel tied to the others radiodiagnostic services, in the same period; 88,3% of the nuclear medicine personnel and the 94.9% of the radiotherapy personnel have received doses inferior to 3 mSv/year; the total collective dose for the studied period were 212.5, 189.8 and 22.3 mSv.man for nuclear medicine and radiotherapy and other medical users respectively. In this work, the annual behavior of the total collective doses is described based on the evaluation of the contribution of different radiodiagnostic procedures carried out at the Hospital. Others aspects related to biological radiation effects of occupational exposure and some outcomes are compared with those from the data of the other countries.

  14. Patients’ perception of quality service delivery of public hospitals in Nigeria using analytical hierarchy process

    Emmanuel Olateju Oyatoye

    2016-07-01

    Full Text Available Introduction: Patients are recently more aware and conscious. This is because of the belief that a high level of quality can translate into patient satisfaction. This is critical for healthcare providers as they deal with life. This recognition by both the service provider and service receivers made the government to establish units of service commission (SERVICOM in each of the governmental agencies including hospitals in Nigeria to monitor the level of quality of service delivery. However, to what extent do patients’ perceptions about health services seem to have been largely recognized remain unclear by health care providers, despite the (SERVICOM units in public institutions in Nigeria? Method: A cross-sectional analytical study using convenient sample method, based on the fact that not every patient of the selected hospitals can be chosen, was performed on 400 patients who received health services at four different public hospitals in Ogun state Nigeria. The selection of these hospitals was based on the zones in the state (Egba, Ijebu, Remo and Yewa area of Ogun-state. The instrument was a valid and reliable analytical hierarchy process based questionnaire containing five service quality dimensions. Data were analyzed using SPSS, Expert choice and Microsoft Excel software to determine the perception of patients towards service quality delivery in pairwise comparison of judgment consistent at less than 10%. Results:The results showed the composite priorities of the patients’ perception with respect to determinants of the patients’ perception towards quality of services delivered in the public hospitals in Nigeria. The most important factor to patients was the reliability dimension with composite priority 0.24 or 24% followed by the responsiveness dimension with 0.22 assurance dimension 0.21, tangibility dimension with 0.21, and the least determinant factor was the empathy dimension with 0.1101. Conclusion: Based on the results, the

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

    Conlon, Annemarie; Aldredge, Patti A.

    2013-01-01

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

  16. An Investigation into the Length of Hospital Stay for Deaf Mental Health Service Users

    Baines, Di; Patterson, Neil; Austen, Sally

    2010-01-01

    This study looked at the average length of hospital stay for inpatients in a specialist deaf mental health service over a 10-year period, in comparison to that of a general psychiatric hearing cohort. In addition, two case studies of deaf inpatients were carried out looking specifically at the prerequisite factors governing discharge. Finally, a…

  17. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

    Burra, Tara A.; Hwang, Stephen W.; Rourke, Sean B.; Stergiopoulos, Vicky

    2012-01-01

    This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender,…

  18. Using Multimedia to Enhance Knowledge of Service Attitude in the Hospitality Industry

    Kuo, Chun Min

    2012-01-01

    Having used a quasi-experimental research model and the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) calibration method to gather and implement data, the researcher developed an interactive multimedia assisted learning (MAL) program promoting proper service attitudes in the hospitality industry. In order to gauge MAL program's…

  19. The pharmacist as a drug information supplier in hospitals : A view from services marketing

    Boerkamp, EJC; Reuijl, JC; Haaijer-Ruskamp, FM

    1997-01-01

    The aim of this study is to gain insight into how the information supply services of the pharmacist and his or her-potential competitors ave seen by physicians. In the context of the upcoming professionalization trend of the pharmacist we are interested in determining how the hospital pharmacist can

  20. Career Preparation Program Curriculum Guide for: Hospitality/Tourism Industry (Food Services).

    British Columbia Dept. of Education, Victoria. Curriculum Development Branch.

    This curriculum outline provides secondary and postsecondary instructors with detailed information on student learning outcomes for completion of the food services program requirements in the hospitality/tourism industry. A program overview discusses the aims of education; secondary school philosophy; and career preparation programs and their…

  1. Barriers of Pre-Hospital Services in Road Traffic Injuries in Tehran: The Viewpoint of Service Providers

    Shahrokh Alinia

    2015-10-01

    Full Text Available Abstract Background: Iran is one of the countries with considerable road traffic injuries. Pre-hospital interventions have an important role in preventing mortalities and disabilities caused by traffic accidents.The present study aimed to explore the barriers of pre-hospital care in traffic injuries in Tehran, Iran. Methods: A qualitative content analysis approach was conducted based on 21 semi-structured interviews with 18 participants. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then data condensing, labeling, coding and defining categories were performed by qualitative content analysis. Results: Four main barriers including 4 main categories and 13 subcategories emerged; they included Barriers related to people, Barriers related to metropolitan infrastructure,Barriers related to the profession and Barriers related to managerial issues. Conclusion: Based on the findings of this study, pre-hospital service barriers in traffic accidents have many dimensions including cultural, structural and managerial domains. Policy makers in health system can use these findings to promote the quality of pre-hospital services, especially in the field of traffic injuries.

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

    Desombre, T; Eccles, G

    1998-01-01

    This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction. PMID:10177367

  3. Exogam with its ancillary detectors

    Theisen, Ch. [CEA Saclay, Dept. d' Astrophysique, de Physique des Particules de Physique Nucleaire et de l' Instrumentation Associee, 91- Gif sur Yvette (France)

    2004-07-01

    The goal of the meeting was to discuss the status of experiments using Exogam and its ancillary detectors. Presentations include details of experiments already run and those in preparation. This document gathers most of the slides presented at the meeting. The results of 7 experiments are described. There are 9 contributions as it follows: 1) presentation of the Vamos spectrometer p.1-15, 2) the Clara (detector) and Prisma (spectrometer) setup: status and perspectives p.16-33, 3) experiment E344aS: shape coexistence near the N=Z line and collective properties of Kr isotopes investigated by low-energy Coulomb excitation p.34-56, 4) experiment E389: study of effective charges at Sm{sup 100} via the nuclear lifetime measurements in Pd{sup 96} and Cd{sup 98} p.57-68, 5) experiment E375: spectroscopy of trans-fermium nuclei p.69-91, 6) experiment E408S: He{sup 8} on Pb{sup 208} and Bi{sup 209} p.92-102, 7) experiment E462: very neutron rich calcium isotopes at N=32, structure of magic Ca{sup 54} studied by gamma-spectroscopy with deep inelastic reactions p.103-115, 8) experiment E451: searching for T=D pairing and a new coupling scheme in Pd{sup 92} and Ru{sup 88} p.116-141, and 9) experiment E404aS: identification of gamma rays in nuclei around the drip-line nucleus Sm{sup 130}, probing the maximally deformed light rare earth region.

  4. HOW TO BETTER IDENTIFY AND MEASURE R&D IN SERVICES: CONSTRAINTS IN BRAZILIAN HOSPITALS

    CARIZA TEIXEIRA BOHRER; EDUARDO RAUPP DE VARGAS

    2013-01-01

    This paper proposes a reflection to induce a better understanding of R&D in services, based on case studies carried out in Brazilian University Hospitals (UHs). The results show that the generation and increase of the stock of knowledge in services go beyond those reported in the material component. We also found that a diversity of actors contributed in an informal way to these dynamics. Concerning R&D funding, we noticed that service R&D is not always planned through a formal project. Then ...

  5. Responsible Sales and Service of Alcohol for the Tourism, Hospitality and Retail Industries

    Murphy, James Peter

    2015-01-01

    The safe service of alcohol is of vital importance to those in the food and beverage industry - failure to act responsibly can result in fines, loss of license and the potential closure of the business. Responsible sale and service of alcohol (RSA) is important for all levels of the hospitality, tourism and retail service industries to minimise the risk of alcohol-related problems associated with the use and abuse of alcohol by any person. Management and all staff who sell or supply alcohol m...

  6. PHYSICAL EVIDENCE AND QUALITY SERVICE DELIVERY IN PUBLIC HOSPITALS IN GHANA

    Edem Max Azila-Gbettor

    2013-09-01

    Full Text Available This study examines the value of physical environment in the delivering of quality healthcare or service in public hospitals in Ghana. Twelve set of self-administered questions were designed using Baker’s (1987 typology of servicescape. A descriptive univariate analysis was applied for the study. Based on 233 usable questionnaires retrieved from respondents, the study indicates a strong link between physical environment and quality healthcare delivery and the choice of healthcare facility. It is there by recommended that improvement in quality service delivery may be better served and improved by improving the servicescape/physical element in the services mix.

  7. Ancillary Testing in Lung Cancer Diagnosis

    William Dubinski; Leighl, Natasha B.; Ming-Sound Tsao; David M. Hwang

    2012-01-01

    The pathologic diagnosis of lung cancer historically has relied primarily on morphologic features of tumors in histologic sections. With the emergence of new targeted therapies, the pathologist is called upon increasingly to provide not only accurate typing of lung cancers, but also to provide prognostic and predictive information, based on a growing number of ancillary tests, that may have significant impact on patient management. This review provides an overview of ancillary tests currently...

  8. Assessment of service delays and impact on bed utilisation in a major teaching hospital.

    Conway, R

    2010-12-14

    BACKGROUND: Increasing economic pressures coupled with an expanding and ageing population and a hostile economic climate have led to growing interest in the optimisation of bed usage within hospitals. There are many causes for delay in a patient\\'s discharge. METHODS: This prospective observational study assessed consecutive patients admitted and discharged from hospital within a 52-day period for waiting times in the provision of requested diagnostic tests and services. RESULTS: Seventy patients were included in the study. There were median delays of 2 and 3 days for an MRI and colonoscopy, a delay of 3 days for a Holter monitor report, and 9 days for an occupational therapy referral. The median wait for consults was 1 day across all three services. CONCLUSIONS: Significant remediable delays exist during the course of many acute medical admissions. Addressing these factors will enable the provision of a faster and more cost-efficient service.

  9. Prime costs of clinical laboratory services in Tehran Valiasr Hospital in 2009.

    Nouroozi, T; Salehi, A

    2014-01-01

    Prime cost determinations can increase managerial effectiveness in budget allocation and strategic planning. This study was designed to calculate the prime cost of clinical laboratory services in Tehran Valiasr Hospital using the activity-based costing (ABC) model. The highest costs were for human recourses (44%) and the lowest for energy (5%). The largest proportion of activities (97%) was by specialists, reflecting the importance of human recourses in prime costs. The highest prime cost was for urinalysis (11% of tests) and the lowest for sodium determination (21% of tests), which demonstrates that prime cost decreases as service frequency increases. The average estimated prime cost was 63% higher than the fees established by the Ministry of Health and Medical Education. The results show that the Tehran Valiasr Hospital laboratory faces a budgetary deficit. The prime cost of services can be reduced by improving human recourse management and standardization of resource consumption. PMID:24995740

  10. 42 CFR 424.123 - Conditions for payment for nonemergency inpatient services furnished by a hospital closer to the...

    2010-10-01

    ... States. (b) The foreign hospital is closer or more accessible to the beneficiary's residence than the... services furnished by a hospital closer to the individual's residence. 424.123 Section 424.123 Public...) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Special Conditions: Services Furnished in a...

  11. Hospitalizations among children and adolescents within the scope of a Primary Care Service

    Maria Lucia Medeiros Lenz

    2010-11-01

    Full Text Available The hospitalization of a child, in addition to bringing about major family distress, is a costly event for the health system. Besides, it can often be avoided on an outpatient care basis. The aim of this study was to identify the percentage of hospitalizations for Ambulatory Care Sensitive (ACS conditions, i.e. those for which effective and timely care can avoid hospital admission. We investigated 3.329 hospitalizations of patients under 19 years of age, occurred between 2001 and 2004 in four hospitals of the Brazilian Health System (SUS, the main references for a population of areas astricted to a primary care service (PCS. The hospitalizations in this population were identified using the hospital information system of the GHC (Grupo Hospitalar Conceição. Univariate and multivariate analysis were employed to verify associations between independent variables and the occurrence of admissions for ACS conditions. A hospitalization rate of 2.9% was found for the studied age group. Respiratory system disorders were the leading cause of admission (36%, followed by perinatal diseases (14%, infectious and parasitic diseases (10%, disorders of the digestive system (9%, and external causes (6%. Readmission accounted for 16% of the total admissions. The hospitalization rate for ACS conditions was 35.6%, ranging from 25% to 43% across the Health Care Centers of the PCS. The variables associated with higher occurrence of hospitalizations for this  reason were: age between 1 and 4 years (p<0.01; having gone straight to the hospital because the Unit was closed (p=0.04; and having gone straight to the hospital due to the severity of the case (p=0.03. The study points to the need for a better monitoring of hospitalizations for ACS conditions - occurring more frequently in the winter months and involving children from 1 to 9 years of age for being more vulnerable to respiratory diseases - and of the number of readmissions, which did not decrease over the last

  12. A Review on influencing criteria for selecting supplier of information technology services in the hospital.

    Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

    2014-01-01

    Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals. PMID:25540781

  13. Challenges of Transferring Burn Victims to Hospitals: Experiences of Emergency Medical Services Personnel.

    Khankeh, Hamid Reza; Froutan, Razieh; Fallahi-Khoshknab, Masoud; Ahmadi, Fazlollah; Norouzi, Kian

    2016-01-01

    A thorough understanding of experiences of Emergency Medical Services (EMS) personnel related to the field transfer of burn victims can be used as a prerequisite of quality improvement of pre-hospital clinical care for these kinds of victims. The aim of the present study was to explore the experiences of EMS personnel during transferring burn victims. In this qualitative research, content analysis was performed to explore the experiences and perceptions of a purposeful sample of Iranian EMS personnel (n = 32). Data collection continued until a point of saturation was reached. Data was collected using in-depth semi-structured interview and field observations and analyzed by qualitative inductive content analysis.After data analyzing from experiences of pre-hospital emergency personnel during transferring burn victims 7 subcategories were developed and classified into three main categories as challenges of transferring burn victim including; risks during patient transfer, restrictions in the admission of burn victims and uncertainties about patient referral. This study showed that different factors affect the quality of pre-hospital clinical services to the field transfer of burn victims that should be considered to improve the quality of pre-hospital clinical care of burn victims in dynamic programs. Further investigation is needed to explore the process of these crucial services. PMID:27241432

  14. Combining resources, combining forces: regionalizing hospital library services in a large statewide health system.

    Martin, Heather J; Delawska-Elliott, Basia

    2015-01-01

    After a reduction in full-time equivalents, 2 libraries in large teaching hospitals and 2 libraries in small community hospitals in a western US statewide health system saw opportunity for expansion through a regional reorganization. Despite a loss of 2/3 of the professional staff and a budgetary decrease of 27% over the previous 3 years, the libraries were able to grow business, usage, awareness, and collections through organizational innovation and improved efficiency. This paper describes the experience--including process, challenges, and lessons learned--of an organizational shift to regionalized services, collections, and staffing. Insights from this process may help similar organizations going through restructuring. PMID:25552945

  15. Benefits of hospital-wide PACS networks: a survey of clinical users of radiology services

    Bryan, Stirling; Weatherburn, Gwyneth C.; Watkins, Jessamy; Buxton, Martin J.

    1998-07-01

    An independent evaluation of PACS has been carried out at Hammersmith Hospital. This paper describes one element: the use of a questionnaire instrument to assess radiology service user's views on the quality of the service being provided; major causes of dissatisfaction with the service; the extent to which images are unavailable; and the consequences of images unavailability. The objective was to investigate some of the key claims made for the PACS technology. The principal research design was a 'before and after' comparison at Hammersmith Hospital. A number of other, comparator, hospitals were included in this survey in order to allow inferences to be made about the any observed changes at Hammersmith. The questionnaire was distributed on three occasions before PACS was operational at Hammersmith and on one occasion afterwards. Across all data collection rounds and all sites, very high levels of satisfaction with image quality were reported. When asked about satisfaction with the written reporting service, a larger proportion of respondents across all sites and rounds indicated their discontent Following the introduction of PACS, the proportion of respondents indicating that lost ward or outpatient images was a problem was significantly lower and the rate of re-examination was lower.

  16. Patient-focused care pays hospital-wide dividends. Interview by Donald E. L. Johnson..

    Bernd, D L

    1992-12-01

    By decentralizing ancillary services, streamlining processes and cross training professional and paraprofessional employees, hospitals can improve patient satisfaction and staff efficiency, says David L. Bernd, executive vice president and chief operating officer of Sentara Health Systems, Norfolk, Virginia, in the following interview with Donald E. L. Johnson, editor and publisher of Health Care Strategic Management. But hospitals should not convert to patient-focused care primarily to cut costs, he warned. Cost savings could result, but only on a hospital-wide basis, as a result of new efficiencies and reduced lengths-of-stay. At the unit level, costs are likely to go up as ancillary services are moved to patient-focused units and more resources are devoted directly at each patient. PMID:10123251

  17. Physician satisfaction with hospital clinical laboratory services in Aden Governorate, Yemen, 2009.

    Adulkader, N Mujahed; Triana, B E Garcia

    2013-06-01

    To evaluate the level of physicians' satisfaction with hospital clinical laboratory services and related factors in Aden Governorate, we carried out this cross-sectional study during September 2008-September 2009. Satisfaction with laboratory services of 3 public and 3 private hospitals was assessed. The overall physician satisfaction was 3.30 out of 5.00. The highest mean score (3.40) was observed for phlebotomy services, while the lowest mean score (1.95) was for esoteric test turnaround time. The most important laboratory service category forthe physicians was quality and reliability of the results (54.4%). An association was observed between physician satisfaction and institution type in 11 categories, with lower satisfaction for public compared to private institutions for all services. No statistically significant association was observed between physician satisfaction and experience in the field. Lower satisfaction was observed among those with more than 20 years experience. Our findings may help to improve the quality of clinical laboratory services. PMID:24975185

  18. Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

    H Zare Ahmadabadi

    2007-07-01

    Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

  19. The fee-for-service shift to bundled payments: financial considerations for hospitals.

    Scamperle, Keely

    2013-01-01

    Skyrocketing health care costs are forcing payers to demand delivery efficiencies that preserve and promote quality care while reducing costs. Hospitals are challenged to meet the pressure from payers to deliver value and outcome-based health care while preserving sufficient financial margins. The fee-for-service (FFS) model with its perverse incentives to incur high-volume services is no longer, if ever, sufficient to ensure quality, cost-efficient health care. In response, payers have sought to force the issue through accelerated efforts to bundle payments to providers. It is theorized that by tying together providers throughout the continuum or episode of care for a patient, efficiencies in delivery inclusive of cost reductions will be obtained. This article examines the bundled payment models and the financial considerations for hospital facility providers. PMID:24003762

  20. Investigating the Relationship between Organizational Social Capital and Service Quality in Teaching Hospitals

    Fereshteh Farzianpour

    2011-01-01

    Full Text Available Problem statement: In modern age, the service quality and sensitivity towards better qualified service are among the priorities of the global community. Quality is defined as the customer’s desire and the customer’s perceptions and expectations constitute the key factor determining quality. The issue of quality is particularly important in healthcare service. Nowadays, alongside the human, financial and economic capitals, a new form of capital entitled social capital is being utilized. Social capital may influence the service quality. Facilitating science and improving team work and organizational commitment would probably translate into better quality of products and social capital encompasses all these issues. Approach: This is a cross-sectional, descriptive-analytic study conducted in educational hospitals of Tabriz, Iran in 2010. The target community consists of workers working in educational hospitals of Tabriz and patients referring to these hospitals. A total of 320 workers and 320 patients were selected for the study. Our data collection tool consisted of two questionnaires which were distributed among the participants after their validity and reliability were established. Once the questionnaires were completed, the statistical coefficients relating to the types of variables (t-test, Pearson correlation coefficient and analysis of variance were calculated and analyzed using SPSS software version 16. Results: Our findings indicate that there is a significant, positive relationship between organizational social capital and the service quality from the patients’ point of view, with the correlation between the two variables on a strong level (r = 0.6, pConclusion: The existence of a significant relationship between the dimensions of social capital and service quality highlights the importance of social capital of workers in the organization.

  1. Not just bricks and mortar: planning hospital cancer services for Aboriginal people

    Durey Angela

    2011-03-01

    Full Text Available Abstract Background Aboriginal people in Australia experience higher mortality from cancer compared with non-Aboriginal Australians, despite an overall lower incidence. A notable contributor to this disparity is that many Aboriginal people do not take up or continue with cancer treatment which almost always occurs within major hospitals. Thirty in-depth interviews with urban, rural and remote Aboriginal people affected by cancer were conducted between March 2006 and September 2007. Interviews explored participants' beliefs about cancer and experiences of cancer care and were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. Information from interviews relevant to hospital services including and building design was extracted. Findings Relationships and respect emerged as crucial considerations of participants although many aspects of the hospital environment were seen as influencing the delivery of care. Five themes describing concerns about the hospital environment emerged: (i being alone and lost in a big, alien and inflexible system; (ii failure of open communication, delays and inefficiency in the system; (iii practicalities: costs, transportation, community and family responsibilities; (iv the need for Aboriginal support persons; and (v connection to the community. Conclusions Design considerations and were identified but more important than the building itself was the critical need to build trust in health services. Promotion of cultural safety, support for Aboriginal family structures and respecting the importance of place and community to Aboriginal patients are crucial in improving cancer outcomes.

  2. The Effect of Service Quality on Patient loyalty: a Study of Pri-vate Hospitals in Tehran, Iran

    E Zarei

    2012-09-01

    Full Text Available Background: Service quality is perceived as an important factor for developing patient's loyalty. The aim of this study was to determine the hospital service quality from the patients' viewpoints and the relative importance of quality dimensions in predicting the patient's loyalty. Methods: A cross-sectional study was conducted in 2010.The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient's loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient's loyalty. Result: The mean score of service quality and patient's loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality were found to be key determinants of the patient's loyalty in the private hospitals of Tehran. Conclusion: The patients' experience in relation to the private hospitals' services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient's loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share.

  3. Postgraduate training in public health medicine: St George's Hospital Medical School Library public health information service.

    Rook, R; Adshead, F

    2001-03-01

    This article examines the development of the St George's Hospital Medical School Library public health information service. Begun in 1997 as a pilot project to support Public Health Specialist Registrars in South Thames West, it is now an established part of postgraduate training in the region. An outline of the service is described, including the evolution of the post of Public Health Librarian. Issues influencing the development of the service, and the establishment of the Librarian as part of the public health network are discussed. This is a transferable model of public health information provision, which as a centralized resource makes best use of available funding. As a LIS model it is an effective and efficient way of maximizing resources, and delivering a service to a specialist user group that is spread across a wide geographical area. PMID:11260291

  4. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Mekonnen AB; Yesuf EA; Odegard PS; Wega SS

    2013-01-01

    Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods:...

  5. Does hospital competition harm equity? Evidence from the English National Health Service

    Cookson, R; Laudicella, M.; Li Donni, P

    2011-01-01

    Increasing evidence shows that hospital competition under fixed prices can improve quality and reduce cost. Concerns remain, however, that competition may undermine socio-economic equity in the utilisation of care. We test this hypothesis in the context of the pro-competition reforms of the English National Health Service progressively introduced from 2004 to 2006. We use a panel of 32,482 English small areas followed from 2003 to 2008 and a difference in differences approach. The effect of c...

  6. Do health insurers possess monopsony power in the hospital services industry?

    Laurie J. Bates; Rexford E. Santerre

    2007-01-01

    This paper uses metropolitan data to test empirically if health insurers possess monopsony or monopoly-busting power on the buyer-side of the hospital services market. According to theory, monopsony power is indicated by a fall in output, whereas, monopoly-busting power is shown by an increase in output when buyer concentration rises. The empirical results provide evidence that greater health insurer buyer concentration is not associated with monopsony power. Instead, some evidence is found t...

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

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

    2015-01-01

    Abstract Background: The impact of surgical conditions on global health, particularly on vulnerable populations, is gaining recognition. However, only 3.5% of the 234.2 million cases per year of major surgery are performed in countries where the world's poorest third reside, such as the Democratic Republic of the Congo (DRC). Methods: Data on the availability of anesthesia and surgical services were gathered from 12 DRC district hospitals using the World Health Organization's (WHO's) Emergenc...

  8. Referral to the Hospital And Emergency Ambulance Service Uses Patterns of the Inmates and Convicts

    Emine Oncu

    2014-03-01

    Full Text Available Aim: The purpose of this study was to determine the reasons for referral to the hospital and 112 emergency ambulance service uses patterns of the inmates and convicts in an E type prison. Material and Method: In this descriptive study, it was evaluated the prison records associated with referral to the hospital and 112 emergency ambulance service uses for one year in 2010- 2011. Of the statistical analysis, descriptive statistics, chi-square test and Fisher%u2019s Exact Test were used. Results: All inmates and convicts were man, the median of age was 30,0 (min 18- max 68 years and substance use was 34,5%. The number of prisoners were referred to the hospital 815, total referrals were 1491; (referrals ranged from one to six and most common in January; and according to frequency, reasons of the referral were eyes problems, musculoskeletal disorders and psychological problems. Emergency medical service was used for in medical causes (78,3%, accident, trauma and injuries (16,4%, suicide (5,3%. Discussion: Findings from the study show that prisoners are more likely to have suffered physical and mental health problems that compared to the rest of society and have significantly high substance use rates.

  9. Improving ECG Services at a Children’s Hospital: Implementation of a Digital ECG System

    Frank A. Osei

    2015-01-01

    Full Text Available Background. The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children’s hospital. Methods. As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE was implemented at the Children’s Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared via t-tests. Results. The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p<0.001, a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p<0.001. Conclusion. Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported.

  10. Quality standards and its compatibility rating prioritizing: the viewpoint of providers and recipients of hospital services in Iran

    Rafat Mohebbifar; Fariba Zahedifar; Elnaz Ghanati; Mohammad Zakaria Kiaei; Omid Khosravizadeh

    2016-01-01

    Introduction: Quality of health services is the rate of achievement to the most desirable resultants of health, so that provided services are effective, efficient, and affordable. Thus, quality evaluation can be an important source of information for recognition of problems and favorable plans in provision of treatment services. Method: In this cross-sectional study, criteria of quality in hospital services and the compatibility rate from viewpoint of providers and recipients of services i...

  11. AX Tank Farm ancillary equipment study

    This report examines the feasibility of remediating ancillary equipment associated with the 241-AX Tank Farm at the Hanford Site. Ancillary equipment includes surface structures and equipment, process waste piping, ventilation components, wells, and pits, boxes, sumps, and tanks used to make waste transfers to/from the AX tanks and adjoining tank farms. Two remedial alternatives are considered: (1) excavation and removal of all ancillary equipment items, and (2) in-situ stabilization by grout filling, the 241-AX Tank Farm is being employed as a strawman in engineering studies evaluating clean and landfill closure options for Hanford single-shell tanks. This is one of several reports being prepared for use by the Hanford Tanks Initiative Project to explore potential closure options and to develop retrieval performance evaluation criteria for tank farms

  12. Creating and promoting a sports performance service offering.

    Harr, Shannon; Shireman, Christopher W; Jebson, R Leslie

    2007-01-01

    Many private hospitals and physician groups are exploring the possibility of expanding their facilities to include advanced ancillary services. Services such as a sports performance center provide additional opportunities for quality patient care and at the same time augment the bottom line. By offering additional ancillary services, healthcare organizations such as an orthopaedics practice can become a full-service center enabling clinicians to more fully provide care to their patients. Marketing and promotion play a crucial role in this type of service. These activities must be designed and carried out in a way that encourages productive results and collaboration as the organization strives to position itself as a full-service center and as a sports specialist in its community. PMID:17494488

  13. Comparison between two mobile pre-hospital care services for trauma patients

    Gonsaga Ricardo

    2012-08-01

    Full Text Available Abstract Objectives Pre-hospital care (PH in Brazil is currently in the phase of implementation and expansion, and there are few studies on the impacts of this public health service. The purpose of this study is to assess the quality of care and severity of trauma among the population served, using trauma scores, attendance response times, and mortality rates. This work compares two pre-hospital systems: the Mobile Emergency Care Service, or SAMU 192, and the Fire Brigade Group, or CB. Method Descriptive study evaluating all patients transported by both systems in Catanduva, SP, admitted to a single hospital. Results 850 patients were included, most of whom were men (67.5%; the mean age was 38.5 ± 18.5 years. Regarding the use of PH systems, most patients were transported by SAMU (62.1%. The trauma mechanisms involved motorcycle accidents in 32.7% of cases, transferred predominantly by SAMU, followed by falls (25.8%. Regarding the response time, CB showed the lowest rates. In relation to patient outcome, only 15.5% required hospitalization. The average score on the Glasgow Coma Scale was 14.7 ± 1.3; average RTS was 7.7 ± 0.7; ISS 3.8 ± 5.9; and average TRISS 97.6 ± 9.3. The data analysis showed no statistical differences in mortality between the groups studied (SAMU - 1.5%; CB - 2.5%. The trauma scores showed a higher severity of trauma among the fatal victims. Conclusion Trauma victims are predominantly young and male; the trauma mechanism that accounted for the majority of PH cases was motorcycle accidents; CB responded more quickly than SAMU; and there was no statistical difference between the services of SAMU and CB in terms of severity of the trauma and mortality rates.

  14. A consensus-based template for documenting and reporting in physician-staffed pre-hospital services

    Kruger, Andreas J; Lockey, David; Kurola, Jouni;

    2011-01-01

    ABSTRACT: BACKGROUND: Physician-staffed pre-hospital units are employed in many Western emergency medical systems (EMS). Although these services usually integrate well within their EMS, little is known about the quality of care delivered, the precision of dispatch, and whether the services deliver...... a higher quality of care to pre-hospital patients. There is no current data set collected to document the activity of physician pre-hospital activity which makes shared research efforts difficult. The aim of this study was to develop a core data set for routine documentation and reporting in physician......-staffed pre-hospital services in Europe. METHODS: Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary...

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

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

    2014-04-01

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

  16. The effect of organizational level and practice area on managerial work in hospital dietetic services.

    Palacio, J P; Spears, M C; Vaden, A G; Dayton, A D

    1985-07-01

    All areas of practice in hospital dietetic services include a management component; however, the nature of the managerial role in various areas of dietetic practice has not been identified clearly. The definition of dietetic practice in the Conceptual Framework for the Profession of Dietetics supports the importance of managerial skills. The effect of organizational level and practice area on managerial activities and roles of professional staff in hospital dietetic services was examined in this study. The nationwide sample included professionals in hospitals with 300+ beds. A total of 3,280 dietetic professionals participated. Five groups were defined: low administrative, low clinical, middle administrative, middle clinical, and upper administrative. Mintzberg identified 10 managerial roles and categorized them as interpersonal, informational, or decisional. The 10 roles were used as the basis for developing an 80-item instrument on which respondents rated each item for importance and time demand. Perceived importance of managerial activities tended to be greater at higher organizational levels. The managerial aspects of the lower clinical and upper administrative position were the most clearly defined. The lower clinical group tended to rate all of the managerial roles as significantly less important than did those in other positions; however, the middle clinical position included a substantial managerial responsibility. PMID:4008830

  17. Expected relationship between a radiotherapy unit and other hospital services in cancer management

    Radiotherapy is a relatively new speciality in medical practice. It is however an important and rapidly growing modality of cancer treatment that should be developed in all countries regardless of their economic conditions. Differences in the size and functions of a radiotherapy unit may change from one country to the other. Nevertheless, in all situations radiotherapy should be considered an independent speciality with its special building, staff, equipment, budget and administration. On the other hand, it should be fully integrated with other national and hospital services in the field of cancer, and should have close associations with national and regional planning authorities specially those related to cancer central programmes, central cancer registries, the national atomic energy authorities and medical teaching, training and research programmes. A strong relationship should be developed with University and Teaching Hospitals, especially with diagnostic departments i.e. pathology, radiology and nuclear medicine and therapeutic departments such as surgery and medicine. Joint clinics and team work should be the guidelines of service. Also a close association should be built between the radiotherapy unit and district hospitals and primary health-care units for the purposes of early detection, patients' follow-up and rehabilitation. These relations may vary from one country to the other depending on various factors such as the size of the radiotherapy unit, the volume and nature of work and its status of autonomy. 6 refs, 3 tabs

  18. Measurement of Quality of Educational Hospital Services by the SERVQUAL Model: The Iranian Patients’ Perspective

    Rezaei, Satar; Matin, Behzad Karami; Moradi, Khalil; Bijan, Behroz; Fallahi, Masoud; Shokati, Behnam; Saeidi, Hamid

    2016-01-01

    Introduction The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. Methods In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. Results There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (−0.88) and responsiveness (−0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. Conclusion There were gaps between the patients’ perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time. PMID:27123218

  19. Working conditions at hospital food service and the development of venous disease of lower limbs.

    da Luz, Clarissa Medeiros; da Costa Proença, Rossana Pacheco; de Salazar, Begoña Rodriguez Ortiz; do Nascimento Galego, Gilberto

    2013-12-01

    The present study assesses some factors that may influence the development of lower limb venous disease in workers of a hospital food service unit. An Ergonomic analysis of work was carried out at a hospital located in the south of Brazil. As for data collection, the following were used: interviews and body mass index assessment; specific clinical examination to diagnose venous disease, water displacement volumetry of the lower limbs. The activities performed at the workplace were followed by direct observation with image registration, use of pedometers, stopwatches, decibel meter, and digital thermo-hygrometer. It was observed different degrees of venous disease in 78% of the cases investigated. The volumetric variation of the lower limbs was 5.13%, showing the presence of edema. Working in hospital food service is associated with circulatory disorders of lower limbs, such as edema and venous disease. The following risk factors were identified: standing activities at work during a long period of time, high temperature, and humidity and carrying heavy weights. PMID:23438290

  20. Specialisation of spinal services: consequences for cervical trauma management in the district hospital

    Cordell-Smith James

    2007-11-01

    Full Text Available Abstract Background Specialisation in spinal services has lead to a low threshold for referral of cervical spine injuries from district general hospitals. We aim to assess the capability of a district general hospital in providing the halo vest device and the expertise available in applying the device for unstable cervical spine injuries prior to transfer to a referral centre. Methods The study was a postal questionnaire survey of trauma consultants at district general hospitals without on-site spinal units in the United Kingdom. Seventy institutions were selected randomly from an electronic NHS directory. We posed seven questions on the local availability, expertise and training with halo vest application, and transferral policies in patients with spinal trauma. Results The response rate was 51/70 (73%. Nineteen of the hospitals (37% did not stock the halo vest device. Also, one third of the participants (18/51, 35%, 95% confidence interval 22 – 50% were not confident in application of the halo vest device and resorted to transfer of patients to referral centres without halo immobilization. Conclusion The lack of equipment and expertise to apply the halo vest device for unstable cervical spine injuries is highlighted in this study. Training of all trauma surgeons in the application of the halo device would overcome this deficiency.

  1. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    2010-10-01

    ... ASC surgical procedures performed in hospitals on an outpatient basis. 413.118 Section 413.118 Public... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific Categories of Costs § 413.118 Payment for facility services related to covered ASC surgical procedures performed in hospitals on...

  2. Estimated radiation exposure from medical imaging for patients of radiology service of Al Faraby Hospital, Oujda Morocco

    Slimane Semghouli; Bouchra Amaoui; Abdellatif Maamri

    2015-01-01

    Purpose: To evaluate the effective dose received per radiological examination per patient and the additional cancer risk factor in the Radiological Service of Al Faraby Hospital in 2012. Methods: From the number of radiological procedures (NX) made in 2012 in the radiology service of Al Faraby Hospital and the average effective dose DEX associated with each type of act exam X, it is possible to calculate the effective dose collective [S =∑ DEX * NX]. The additional cancer risk factor is calcu...

  3. The Effect of Service Quality on Patient loyalty: a Study of Pri-vate Hospitals in Tehran, Iran

    Zarei, E; Rahimi Forushani, A; Rashidian, A; SM Ghazi Tabatabaei; Arab, M

    2012-01-01

    Background: Service quality is perceived as an important factor for developing patient's loyalty. The aim of this study was to determine the hospital service quality from the patients' viewpoints and the relative importance of quality dimensions in predicting the patient's loyalty. Methods: A cross-sectional study was conducted in 2010.The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 it...

  4. Addressing Spiritual Needs and Overall Satisfaction With Service Provision Among Older Hospitalized Inpatients.

    Hodge, David R; Salas-Wright, Christopher P; Wolosin, Robert J

    2016-04-01

    Little research has examined the relationship between addressing older adults' spiritual needs and overall satisfaction with service provision during hospitalization, despite the importance of spirituality and religion to most older adults. This study examined this relationship, in tandem with the effects of eight potential mediators. Toward this end, structural equation modeling was used with a sample of 4,112 adults age 65 and older who were consecutively discharged over a 12-month period from hospitals in California, Texas, and New England. As hypothesized, addressing spiritual needs was positively associated with overall satisfaction. The relationship between spiritual needs and satisfaction was fully mediated by seven variables: nursing staff, the discharge process, visitors, physicians, the admissions process, room quality, and the administration of tests and treatments. The diverse array of mediating pathways identified highlights the importance of health care practitioners working collaboratively to address older adults' spiritual needs. PMID:24652923

  5. Exploring the patient's experience of a day hospital chemotherapy service: preliminary fieldwork.

    Mcilfatrick, Sonja; Sullivan, Kate; McKenna, Hugh

    2003-09-01

    This paper describes some preliminary findings from a Heideggerian hermeneutic phenomenological study exploring patients' experiences of a day hospital chemotherapy service. Phenomenology has been described as both a philosophical perspective and a research method. Following a review of the literature, it was apparent that there is a paucity of qualitative studies regarding the experience of chemotherapy treatment. The aim of the study was to explore patients' experiences of receiving treatment within a day hospital setting and to compare this with previously having received treatment as an inpatient. Purposeful sampling and face-to-face interviews were conducted. Preliminary data analysis from the pilot study has identified themes for patients relating to the need to maintain hope associated with treatment; feelings of adjustment; incorporating treatment as 'part of life'; need for closure following treatment; thoughts of comradeship and sharing the experience. PMID:12932482

  6. Hospitals

    Mullins, Michael

    2013-01-01

    is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn...... in the navigation experience and wasted time of medical staff in providing directions. Space in hospitals: space can be divided into personal, social and outdoor space. Personal space: single rooms have been well documented in: admission length, mortality rates, comfort levels, sense of privacy, all users......’ satisfaction. Social space: attention to spatial qualities, volume and interior design in terms of encouraging physical contact between users in wards, waiting areas and semi-private rooms. Outdoor space: Landscape and gardens are not enough in themselves; they should be visible, centrally or strategically...

  7. Health centres' view of the services provided by a university hospital laboratory: use of satisfaction surveys.

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-03-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions. PMID:20205616

  8. The History of the Bellevue Hospital Chest Service (1903-2015).

    Rom, William N; Reibman, Joan

    2015-10-01

    For more than 100 years, the Bellevue Hospital Chest Service in New York City has contributed major advances in our understanding of pulmonary disease. Research from the cardiopulmonary laboratory of the Chest Service by Drs. Cournand and Richards resulted in the shared Nobel Prize in Physiology or Medicine in 1956 for the development of human cardiac catheterization. In more recent years, continuing its mission to serve the underserved and respond to health crises, the Bellevue Chest Service has served as a leader in the management of HIV infections, multiple drug-resistant tuberculosis epidemics, early detection of lung cancer, and management of urban asthma. Members of the Chest Service founded the World Trade Center Environmental Health Center shortly after collapse of the towers in 2001. The Chest Service became New York's infectious isolation unit caring for the first patient in New York infected with Ebola virus. Recent research has focused on disease management, with the first in-house Directly Observed Therapy Clinic for treatment of tuberculosis, clinical trials of aerosolized IFN-γ, and translational research on host defense against tuberculosis infection. Studies of the airway mucosa have revealed mechanisms by which ambient pollutants promote asthma. Studies on the World Trade Center firefighters and community populations have promoted understanding of systemic inflammation and small airways function. Today, the partnership between a public hospital and an academic institution promotes the synergy that leads to cost-effective and state-of-the art care for an underserved population as well as cutting-edge training and research. PMID:26406151

  9. An Estimation Method of Waiting Time for Health Service at Hospital by Using a Portable RFID and Robust Estimation

    Ishigaki, Tsukasa; Yamamoto, Yoshinobu; Nakamura, Yoshiyuki; Akamatsu, Motoyuki

    Patients that have an health service by doctor have to wait long time at many hospitals. The long waiting time is the worst factor of patient's dissatisfaction for hospital service according to questionnaire for patients. The present paper describes an estimation method of the waiting time for each patient without an electronic medical chart system. The method applies a portable RFID system to data acquisition and robust estimation of probability distribution of the health service and test time by doctor for high-accurate waiting time estimation. We carried out an health service of data acquisition at a real hospital and verified the efficiency of the proposed method. The proposed system widely can be used as data acquisition system in various fields such as marketing service, entertainment or human behavior measurement.

  10. Hospital Compare

    U.S. Department of Health & Human ServicesHospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  11. HCAHPS - Hospital

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  12. Spatial map dose of nuclear medicine service of the Clinical Hospital of Botucatu, SP, Brazil

    This study was conducted to describe levels of occupational and environmental exposure of the Nuclear Medicine Service of the Clinical Hospital of Botucatu. To this end, measurements were made of the radiometric levels of points strategically defined, in all the environments, for a period of six months, sampling different days and times, during operation normal routine of the sector. The results allow to estimate the expected dose for each environment, comparing them to the dose limitation established by the National Commission of Nuclear Energy (CNEN), allowing better targeting of occupationally exposed individuals, indicating the points where the occupation should be the minimum required, enabling the reduction of risks to potential exposures. (author)

  13. Marketing strategies of hospital service organizations in Nigeria: a study of selected privately owned hospitals in Port Harcourt.

    Okwandu, Gabriel A

    2002-01-01

    This study was centered on the identification of the marketing strategies of hospitals and the factors that militate against their effective adoption and implementation. A total of 80 hospitals in Port Harcourt responded to a structured questionnaire administered on them. It was found, among other things, that many hospital organizations apply marketing strategies, and that hospitals that adopt effective marketing strategies perform better than those that do not. Some of the factors militating against the effective adoption and implementation of marketing strategies include lack of planning, lack of top management support, and non-utilization of all the promotional mix elements. PMID:12569994

  14. Identification of the Risk Related to a Process on Hospital Emergency Service: a Case Study

    Santos, Carlos; Ferreira, Carla; Tribolet, José

    2011-01-01

    This paper, framed in a vast investigation, describes the application of techniques and methodologies in Organizational Engineering connected to the associated risk to the processes developed in an Emergency Service of an important Portuguese Hospital. The transactions performed in an emergency service and the consequent risk identification (negative behaviour associated to those transactions) is done based on static and dynamic models, developed during the business modelling. Any non-trivial system is better portrayed trough a small number of reasonably independent models. From this point of view it is important to look at the systems from a "micro" perspective, which allows us to analyse the system at the transaction level. All processes have some associated risk (inherent risk). Its identification will be decisive for future analysis and for the consequent decision over the need, or not, to study internal control mechanisms. This decision will depend on the risk level that the organization considers accept...

  15. Measuring hospital service quality and its influence on patient satisfaction: An empirical study using structural equation modeling

    Nasim Kazemi

    2013-07-01

    Full Text Available This paper presents an empirical investigation to measure different dimensions of hospital service quality (HSQ by gap analysis and patient satisfaction (PS. It also attempts to measure patients’ satisfaction with three dimensions extracted from exploratory factor analysis (EFA by Principle component analysis method and conformity factor analysis (CFA. In addition, the study analyzes relationship between HSQ and PS in the context of Iranian hospital services, using structural equation modeling (SEM from patients’ perspectives. The maximum gap observed in “responsiveness” and the minimum one in “assurance”. In addition, patients had the most satisfaction in “trust” with the mean of 3.83 followed by “General Satisfaction” with the mean of 3.68 and they had the least satisfaction in “Acceptance” with the mean of 3.53. Two measurement models were used for measuring hospital service quality and patient satisfaction and one structural model, which showed the relationship between them. The result of this study showed that there was a positive and significant impact from hospital service quality on patient satisfaction (0.463. In addition, there was a positive and significant relationship between hospital service quality and five dimensions. Furthermore, it was shown that patient satisfaction and three dimensions (General Satisfaction, Trust, and Acceptance were associated with each other, significantly and positively. At last management strategies and practical suggestions were presented to hospital.

  16. [Nurses' and patients' experience of combined health service delivery to all population groups in a hospital].

    Poggenpoel, M; Uys, H; Botes, A; Dörfling, C; Greeff, M; Gross, E; Müller, M; Nolte, A

    1996-06-01

    In a community hospital in Gauteng, the hospital management had, on short notice, to provide combined health services to all population groups. In the past different health services were delivered to each population group. The integration of health service delivery was a sudden change. Based on this, research questions arose, namely: how do nurses and patients experience this change, and how could they be assisted to adjust to the change. The research objectives were twofold, namely: to explore and describe nurses and patients' experience of combined health delivery to all population groups and based on the results to make recommendations to assist them with adjustment to a combined health delivery system. An exploratory, descriptive and contextual research design was followed. Trustworthiness was ensured by applying Guba's approach. Phenomenological and individual focus interviews were conducted with forty nurses and patients who were selected purposively. Field notes were written after completion of each interview. The transcribed data was analysed by using Giorgi's and Kerlinger's methods combined. Results were discussed and a literature control completed. The most important conclusions reached were: there was an insufficient administrative structure in the hospital as a result of insufficient preparation for the combined health service delivery for all population groups; the whites' perception of different populations groups is based on an ethnocentric Western approach. This led to their experience of culture shock that resulted in feelings of anger/frustration, fear and sadness; the willingness of other populations groups to adjust to combined health service delivery led to their experience of happiness; there exists communication problems between population groups because of their not being able to communicate in their own language and the difference in communication styles; the verbalised Christian viewpoint and values of whites nurses and patients are not

  17. Assessment and Availability of Trauma Care Services in a District Hospital of South India; A Field Observational Study

    Pallavi Sarji Uthkarsh

    2016-04-01

    Full Text Available Objective: To assess the availability of trauma care services in a district referral hospital of Southern India. Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-depth interviews of hospital stake holders and key informants. Results: The hospital had physical infrastructure in terms of emergency room, inpatient wards, operation theatres, intensive care unit and blood bank facilities. The recently constructed designated building for trauma care services was not operational and existing facilities were used beyond capacity. A designated trauma team was lacking and speciality services for managing polytrauma were deficient and thus, existing personnel were performing multiple tasks. Neurosurgeons and rehabilitative nursing staff were unavailable, and a radiographer was not available on a 24/7 basis. Existing nursing personnel had not received any formal training in trauma care and standard operating protocols were not available for trauma care. Resources for acute resuscitation were partially adequate. The hospital lacked adequate resources to manage head, abdomen, chest and spine injuries, and most of the polytrauma cases were referred to nearby city hospitals. Conclusion: District hospital, the only referral hospital in public health system for trauma victims of that region, had inadequate resources to manage trauma victims, which was probably responsible for delay in trauma care, improper referrals, high cost of care and poor outcomes.

  18. [Acute accidental poisoning in children at the pediatrics service of the Gabriel Touré hospital].

    Sylla, M; Coulibaly, Y; Dicko, F T; Kourouma, N; Togo, B; Keita, M M

    2006-01-01

    The accidental intoxications constitute more and more a serious problem among young children in the developing countries because of their frequency and difficulties for taking care of those victims. The objective of our work was to study acute intoxications among children in order to determine the frequency, to identify the products in question and to determine the impact of those accidents in the future life of the victims. The study was carried out in the Paediatric Service of the CHU Gabriel Touré from January 2001 to June 2002. We enrolled 89 children from 0 to 15 years of age. Information on our patients was recorded on investigational questionnaire and completed with data from their entry and hospitalization records. Among 8237 children hospitalized during the study period, 89 of them had acute intoxication i.e. 1.08%. Children less than five years of age were more frequent with 85.4% with a male prevalence of 61.8%. Antimalarial drugs and petroleum were the most accused products. Administration of milk and provoked vomiting were the attitudes and practices of the entourage of the victims when intoxication occurs. The evolution was favourable in 67.2% of the cases with a hospital lethality of 13.7%. PMID:19617084

  19. Quality of Care and Services of a Public Hospital: Awareness and Assessment

    Abdel-ilah Aziane

    2015-04-01

    Full Text Available In order to give everyone access to quality care, this study attempts to make quality awareness, highlighting the importance of the implementation of the quality management system in health care facilities. The objective of our work is to make a quality awareness, to analyze the current situation and to provide recommendations. The analysis of the existing situation consists of identifying, describing, and analyzing the key processes implemented, listing the dysfunctions, classifying them, deciding on the corresponding actions and putting in place indicators and dashboards, which will help track improvements. The overall situation of the hospital regarding the requirements of ISO 9001 indicated a respect of about 28% of the requirements of the standard. The state of the premises of the establishment does not indicate a clear organization at the hospital. The hospital environment is a prerequisite to the establishment of a system of quality management that enables you to deploy a clear and shared policy to improve the quality of care and services.

  20. Management of chronic heart failure in the community: role of a hospital based open access heart failure service

    Shah, S.; Davies, M K; Cartwright, D; Nightingale, P.

    2004-01-01

    Objective: To evaluate the role of an open access heart failure service based at a teaching hospital for the diagnosis and treatment optimisation of patients with heart failure in the community and to identify measures that may further enhance the effectiveness of such a service.

  1. Quality assessment of clinical education services in teaching hospitals located in Kerman, Iran

    Yazdi-Feyzabadi, Vahid; Gozashti, Mohammad Hossein; Komsari, Samane; Mohammadtaghizadeh, Sedigheh; Amiresmaili, Mohammadreza

    2015-01-01

    Introduction Clinical education is one of the most important components of the resource generation function of health systems, and it has a very important role in graduates’ competency with respect to effective, practical education. This study aimed to assess the quality of clinical services in Kerman’s teaching hospitals located in southeastern Iran. Methods This cross-sectional study was conducted in 2011 on 303 medical students at different levels of medical education at Kerman’s teaching hospitals. A modified SERVQUAL instrument was used to collect the data after its validity and reliability were checked. The data were analyzed by SPSS 18.0 using the paired t-test, Kruskal-Wallis, and post hoc tests, when appropriate. Results In all five dimensions of quality, gaps were observed between students’ perceptions and expectations as follows: Assurance (mean = −1.18), Responsiveness (−1.56), Empathy (−1.4), Reliability (−1.27), and Tangibles (−1.21). There was a significant difference between the quality perceptions and expectations of the medical students (p internships, and assistantships regarding the dimensions of the quality gaps (p < 0.001). Conclusion The clinical services provided by teaching hospitals in the study did not meet the students’ expectations at any of the three educational levels. As we precisely assessed the dimensions and items that had the higher quality gaps, it was apparent that, for most part, clinical education officials could improve the quality by designing interventions, which would not be very difficult to do. PMID:26767094

  2. CUSTOMER SATISFACTION AS AN INDICATOR OF SERVICE QUALITY IN TOURISM AND HOSPITALITY

    Ana Stranjancevic

    2015-12-01

    Full Text Available One of the greatest challenges for stakeholders is to ensure customer satisfaction, especially in service industries such as tourism and hospitality. The aim of this paper is to show that restaurant guest satisfaction depends on numerous factors as well as to show the connection between satisfaction and loyalty. Customer satisfaction and loyalty are excellent indicators of service quality. For the purpose of this paper, empirical survey was conducted and the results of the research were analyzed by statistical method. Factors which affect customer satisfaction are: kind staff, professionalism, speed of service, food quality, ambience and comfort. This implicates a special need for the introduction of strong Human Resource Management, food safety standards (e.g. HACCP and effective space planning. The study implies that the care for quality of products and services is necessary at all levels and that it is impossible to ensure the customer satisfaction or create customer loyalty without strong management system (including space projecting and without controlling it.

  3. Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

    Chien Tsair-Wei

    2012-05-01

    Full Text Available Abstract Background Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC to assess how well Taiwan constrained hospital-provided medical services in such a system. Methods A custom Excel-VBA routine to record the distances of standard deviations (SDs from the central line (the mean over the previous 12 months of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan’s year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. Results ICCs were generated for Taiwan’s year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. Conclusion We recommend using the ICC to annually assess a nation’s year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

  4. Drug information service awareness program and its impact on characteristics of inquiries at DIS unit in Malaysian public hospital

    Aida Azlina Ali; Shafinaz Mohd Yusoff; Suhaidah Mohd Joffry; Mohd Shahezwan Abd Wahab

    2013-01-01

    Objectives : To study the Drug Information Service (DIS) awareness program organized by a DIS unit in Malaysian hospital through utilization of provided services by the healthcare professionals, allied healthcare providers, patients and the public, and to identify the characteristics of inquiries received. Materials and Methods : An awareness program to promote the services of the DIS unit was held throughout the month of March in 2010. Drug information queries forms that have been docume...

  5. Customer Decision-making Processes and Motives for Self-service Technology Usage in Multi-channel Hospitality Environments

    Kelly, Petranka; Lawlor, Jennifer; Mulvey, Michael

    2013-01-01

    The contemporary hospitality service industry is changing with the introduction of new self-service technologies (SSTs) and their rapid adoption by customers. Examples of SSTs include hotel reservation websites, self check-in kiosks and mobile telephone service applications. The introduction of these electronic channels for communication with customers offers further opportunities for customer relationship management if customers choose to interact with them. Therefore, the aim of this paper ...

  6. Evaluation of hygienic-sanitary conditions of hospital nutrition and dietary services from the perspectives of internal and external auditors

    Lize Stangarlin

    2013-09-01

    Full Text Available The objective of this study was to evaluate the hygienic-sanitary conditions of hospital nutrition and dietary services using external and internal auditors. Eleven hospitals were evaluated for their nutrition and dietary services using an evaluation checklist based on food safety requirements in the current legislation. The checklist was applied by an internal auditor (a technical supervisor and an external auditor (a professional with experience in food services between August and October 2011. According to the number of items on the evaluation checklist that were considered adequate, the hospital facilities were ranked as excellent, good, regular, bad, or very bad. The results obtained by the auditors were compared. According to these results, it can be said that most of the hospital nutrition and dietary services were rated as good for overall quality by the internal auditor, while the external auditor classified them as Regular. There was a clear difference between the evaluations of the auditors, both in terms of the number of items considered adequate and the overall requirements' average score. It can be concluded that hospital nutrition and dietary services should meet safety requirements in order to provide food. These facilities should have external audits conducted as a way to prevent routine problems from being perpetuated.

  7. Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies

    Omer Khalid

    2011-12-01

    Full Text Available Abstract Background The Bangladesh government implemented a pilot Hospital Improvement Initiative (HII in five hospitals in Sylhet division between 1998 and 2003. This included management and behaviour change training for staff, waste disposal and procurement, and referral arrangements. Two linked cross-sectional surveys in 2000 and 2003 assessed the impact of the HII, assessing both patients' experience and satisfaction and public views and use of the hospitals. Methods In each survey we asked 300 consecutive outpatients and a stratified random sample of 300 inpatients in the five hospitals about waiting and consultation time, use of an agent for admission, and satisfaction with privacy, cleanliness, and staff behaviour. The field teams observed cleanliness and privacy arrangements, and visited a sample of households in communities near the hospitals to ask about their opinions and use of the hospital services. Analysis examined changes over time in patients' experience and views. Multivariate analysis took account of other variables potentially associated with the outcomes. Survey managers discussed the survey findings with gender stratified focus groups in each sample community. Results Compared with 2000, an outpatient in three of the hospitals in 2003 was more likely to be seen within 10 minutes and for at least five minutes by the doctor, but outpatients were less likely to report receiving all the prescribed medicines from the hospital. In 2003, inpatients were more likely to have secured admission without using an agent. Although patients’ satisfaction with several aspects of care improved, most changes were not statistically significant. Households in 2003 were significantly more likely to rate the hospitals as good than in 2000. Use of the hospitals did not change, except that more households used the medical college hospital for inpatient care in 2003. Focus groups confirmed criticisms of services and suggested improvements

  8. Factors influencing integration of TB services in general hospitals in two regions of China: a qualitative study

    Zou Guanyang

    2012-01-01

    Full Text Available Abstract Background In the majority of China, the Centre for Disease Control (CDC at the county level provides both clinical and public health care for TB cases, with hospitals and other health facilities referring suspected TB cases to the CDC. In recent years, an integrated model has emerged, where the CDC remains the basic management unit for TB control, while a general hospital is designated to provide clinical care for TB patients. This study aims to explore the factors that influence the integration of TB services in general hospitals and generate knowledge to aid the scale-up of integration of TB services in China. Methods This study adopted a qualitative approach using interviews from sites in East and West China. Analysis was conducted using a thematic framework approach. Results The more prosperous site in East China was more coordinated and thus had a better method of resource allocation and more patient-orientated service, compared with the poorer site in the West. The development of public health organizations appeared to influence how effectively integration occurred. An understanding from staff that hospitals had better capacity to treat TB patients than CDCs was a strong rationale for integration. However, the economic and political interests might act as a barrier to effective integration. Both sites shared the same challenges of attracting and retaining a skilled workforce for the TB services. The role of the health bureau was more directive in the Western site, while a more participatory and collaborative approach was adopted in the Eastern site. Conclusion The process of integration identifies similarities and differences between sites in more affluent East China and poorer West China. Integration of TB services in the hospitals needs to address the challenges of stakeholder motivations and resource allocation. Effective inter-organizational collaboration could help to improve the efficiency and quality of TB service. Key

  9. Opinion On Drug Information Services Provided In A Multi- Specialty Teaching Hospital

    Vijayakumar TM, Poovi G & Dhanaraju MD

    2011-05-01

    Full Text Available Objective: To evaluate the various drug information queriesreceived, and to access the drug information services providedby the pharmacy practice department.Method: Drug information queries received during wardrounds, direct communication, telephone or internet etc. weredocumented in the drug information request anddocumentation forms prepared by the department over theperiod of January 2010 to June 2010. Various parameters likestatus of enquirer, their specialty, mode of receipt of query,purpose of query, type of query etc. were consider forevaluation.Results: Out of 208 queries received, major 56 (26.9% frommale medical ward. Maximum [82 (39.4 %] queries were fromthe physicians. 73 (35.0 % of the queries were about therecent advances and the updating of the information, It wasfound that mostly the mode of request was during wardrounds 85 (40.9%. Most of the queries [126 (60.6%] wereanswered by written or printout format. Majority of thequeries [195 (93.8 %] were answered directly to theenquirers through direct access. Most of the queries wereanswered through books in the department [86 (41.3 %].Conclusion: Results of the external auditing revealed thatrequestors were generally satisfied with the service provided.The drug information services provided by clinical pharmacistsat the hospital were found to be useful and beneficial to thehealthcare professionals and patients.

  10. 医院后勤社会化问题的思考%Reflections on the Issues of the Socialization of Hospital Logistics Services

    葛锋

    2014-01-01

    The socialization reform of hospital logistics services is an important part of the hospital development. In this paper, the necessity of the socialization of hospital logistics services was discussed;the current two main modes of hospital logistics reform were described;and two methods of socialization reform of hospital logistics services were introduced. Combined with the practice of hospital logistics services socialization, the methods of hospital logistics services socialization were explored.%医院后勤社会化改革是医院发展的重要内容,本文从医院后勤社会化的必要性入手,介绍了当前医院后勤改革的两种主要模式,结合医院后勤社会化改革的实践情况,对医院后勤社会化改革进行了探索。

  11. A national research agenda for pre-hospital emergency medical services in the Netherlands: a Delphi-study

    van de Glind, Irene; Berben, Sivera; Zeegers, Fon; Poppen, Henk; Hoogeveen, Margreet; Bolt, Ina; van Grunsven, Pierre; Vloet, Lilian

    2016-01-01

    Background In pre-hospital Emergency Medical Services (EMS) more research is needed to direct and underpin care delivery and inform policy. To target future research efforts, this study aimed to determine future research priorities with representatives of the EMS field. Methods A four-round online Delphi survey was used to discuss different viewpoints and reach consensus on research priorities. A multidisciplinary panel of experts was recruited in the field of pre-hospital EMS and adjoining (...

  12. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    Dale, Bjørg; Hvalvik, Sigrun

    2013-01-01

    BACKGROUND: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The purpose of the study reported here was to elucidate how home nursing leaders experience the administration of care to older people in transition from hospital to their own homes. METHODS: A qualitative study design was used. Ten home nursing leaders in two municipalities in southern Norway par...

  13. Implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital

    Storey Donald F; Pate Perry G; Nguyen Autumn TT; Chang Fung

    2012-01-01

    Abstract Background Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are scarce in the reported literature. The purpose of the current report is to describe the implementation of an antimicrobial stewardship program on the medical-surgical service of a ...

  14. The Influence of Training on Employee’s Performance, Organizational Commitment, and Quality of Medical Services at Jordanian Private Hospitals

    Salah M. Diab; Ajlouni, Musa T.

    2015-01-01

    The purpose of this study is to test The Influence of Training on The Employee's Performance and The Quality of Medical Services on Jordanian Private Hospitals). The data of this study were collected through a (380) questionnaire distributed for all types of job in the Jordanian private hospitals). Grynbach constancy coefficients reached 79%, Percentages, means, standard deviation, ANOVA, and, multiple regressions analysis were used totest the study hypotheses, the results indicate that there...

  15. Influence of Public Service Quality in Citizen Satisfaction (Study in Private Hospital Y in Padang, West Sumatra Province

    Aldri Frinaldi

    2015-02-01

    Full Text Available The main problem in public service particularly health care service is the public’s increasing demand for better quality of service. Therefore, hospitals as one of the means of health care providers should be able to increase public satisfaction. This is important to win the trust of patients and/or families of patients who come for treatment. The lack of patients’ satisfaction in the quality of service in hospitals in Indonesia contributes to the Indonesians’ choice of medical treatment abroad. Therefore, the study aims to determine the influence of quality of services provided by the hospital toward patients’ satisfaction. This quantitative research surveyed patients in Hospital Y in Padang city using questionnaire as a research instrument. The population is all the patients and/or families of patients who are served in the hospital during the data collection in the month of May to August 2014. A sample of 100 people was selected using accidental sampling. The collected data were analyzed using frequencies, percentages and averages using SPSS version16 for windows. Simple linear regression analysis technique was used for data analysis. Location of the study was a private hospital located in the city of Padang, West Sumatra Province, which in this research is referred as private hospital Y. The results of this study indicates that there is a significant relation between the quality of service to the citizen satisfaction with the regression equation Y = 44.967 + 2.612 X with value of correlation (r = 0.760, and the influence of quality of service to the public satisfaction in 57.8%. Then the results Achievement Level Respondents (TCR in the quality of public services obtained a value of 74.8% with quite good category and to the satisfaction of the public to the TCR value of 75.3%with quite good category. It shows the quality of care in hospitals Y must be improved in order to obtain an increase in user satisfaction of the people who

  16. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC.

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

  17. [Use Of Hospital Services By The Immigrant Population In Umbria, Italy].

    Casadei, Riccardo; Angeli, Giuseppe; Casucci, Paola; Minelli, Liliana; Pasquini, Rossana

    2016-01-01

    The aim of this study was to identify possible inequalities in the quality of health care services for the management of conditions such as cardiovascolar diseases, psychiatric disorders, appendectomy, and hysterectomy, offered to the immigrant population in the Umbria region (central Italy). Hospital discharge data covering the period 2009-2012 were analysed and crude and standardized hospitalization rates per 100,000 calculated. Immigrants were found to have an increased risk of undergoing procedures such as appendectomy and hysterectomy for benign disease, indicating a greater degree of nonappropriateness in this category of users. In the young immigrant population, admissions were mainly due to reproductive health problems in women, and injuries/trauma in men. The results of this study confirm that, despite regional efforts to reduce social inequalities and consequently inequalities in health, through regional legislation, information to the population, training of healthcare personnel, and cultural mediation, some inequalities are present in the quality of health care delivered to foreign-born persons in the region. Hence, there is a need to strengthen information campaigns for immigrants, to keep them informed of their rights, and to strengthen training courses among healthcare and social workers. PMID:27077557

  18. Collaboration between general hospitals and community health services in the care of suicide attempters in Norway: a longitudinal study

    Fadum Elin

    2010-06-01

    Full Text Available Abstract Background The aim of this paper was to study the collaboration between emergency departments (EDs in general hospitals and community health services (CHS in Norway when providing psychosocial care and aftercare to patients treated in EDs following a suicide attempt. We wanted to explore the extent to which quality indicators at the hospital level measured in 1999 and 2006 could predict the presence or absence of a chain of care structure in the CHS in 2006. Methods Data were collected through structured interviews with informants from 95% of all general hospitals in Norway in 1999 and 2006, and informants from CHS, in a stratified sample of Norwegian municipalities in 2006 (n = 47. Results In 15 of the 47 municipalities (32%, the CHS reported having a chain of care structure in 2006. A discriminant function analysis revealed that the hospitals that in 1999 had: (a a collaboration agreement with aftercare providers, and (b written guidelines, including a quality assurance system, were significantly more likely to have municipalities with a chain of care structure in their catchment area in 2006. Conclusions Hospitals' and municipalities' self-reported provision of aftercare services for patients treated after a suicide attempt was markedly below the recommendations given in national standards. Systems at the hospital level for the management and care of patients admitted after a suicide attempt and systematic collaboration between hospitals and aftercare providers seem to be important elements in the long-term maintenance of continuity of care for suicide attempters.

  19. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Mekonnen AB

    2013-03-01

    Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

  20. PRE-HOSPITAL EMERGENCY MEDICAL SERVICES FOR ELDERLY POPULATION IN TBILISI.

    Dalakishvili, S; Bakuradze, N; Gugunishvili, M; Jojua, R; Eremashvili, M

    2016-04-01

    The importance of the issue is determined by the current demographic situation in Georgia and the world in general. The trend of growing the number of older people and the increase of the life span is obvious. At the same time in the number of countries, particularly in the developed western countries and Japan, the decrease of birth rate is noticed. Similar processes are taking place in Georgia; this logically increases the number of sick and weakened people, which means that taking care of them becomes more acute problem. Therefore, the purpose of this paper was the study of the situation of the pre-hospital emergency medical services in the Georgian capital Tbilisi during the period of 2012-2014. For this reason, the data provided by the Tbilisi Emergency Medical Service were used. Besides, we have also looked for the statistics of the different countries, including the US, Japan and South-East Asian countries. Attention was paid to the recommendations proposed because of the Monitoring of the European Union Mission in Georgia, which focuses on the social and economic protection of elderly. The tables and diagrams, describing the current conditions are provided. Since 2012, there has been launched the state health care program for the elderly in Georgia, but based on research conducted, it does not cover home care services while, the majority of the elderly are chronically sick people and suffer from the number of diseases. Results of the study can be used for improving quality of the Emergency Medical Service model in Georgia and finding the possible ways for its reforms. PMID:27249441

  1. Barriers to healthy eating by National Health Service (NHS) hospital doctors in the hospital setting: results of a cross-sectional survey

    Wilson Sue; Johnson Carol; Winston James

    2008-01-01

    Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction wit...

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

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

    2015-10-01

    End-user development is a new trend to provide tailored services to dynamic environments such as hospitals. These services not only facilitate daily work for pharmacy personnel but also improve self-care in elder people that are still related to hospital, such as discharged patients. This paper presents an ambient intelligence (AmI) environment for End-user service provisioning in the pharmacy department of Gregorio Marañón Hospital in Madrid, composed of a drug traceability infrastructure (DP-TraIN) and a ubiquitous application for enabling the pharmacy staff to create and execute their own services for facilitating drug management and dispensing. The authors carried out a case study with various experiments where different roles from the pharmacy department of Gregorio Marañón Hospital were involved in activities such as drug identification, dispensing and medication administering. The authors analyzed the effort required to create services by pharmacy staff, the discharged patients' perception of the AmI environment and the quantifiable benefits in reducing patient waiting time for drug dispensing. PMID:26286317

  3. On a hiding to nothing? Assessing the corporate governance of hospital and health services in New Zealand 1993-1998.

    Barnett, P; Perkins, R; Powell, M

    2001-01-01

    In New Zealand the governance of public sector hospital and health services has changed significantly over the past decade. For most of the century hospitals had been funded by central government grants but run by locally elected boards. In 1989 a reforming Labour government restructured health services along managerialist lines, including changing governance structures so that some area health board members were government appointments, with the balance elected by the community. More market oriented reform under a new National government abolished this arrangement and introduced (1993) a corporate approach to the management of hospitals and related services. The hospitals were established as limited liability companies under the Companies Act. This was an explicitly corporate model and, although there was some modification of arrangements following the election of a more politically moderate centre-right coalition government in 1996, the corporate model was largely retained. Although significant changes occurred again after the election of a Labour government in 1999, the corporate governance experience in New Zealand health services is one from which lessons can, nevertheless, be learnt. This paper examines aspects of the performance and process of corporate governance arrangements for public sector health services in New Zealand, 1993-1998. PMID:11499047

  4. Health and economic effects from linking bedside and outpatient tobacco cessation services for hospitalized smokers in two large hospitals: study protocol for a randomized controlled trial

    Fellows Jeffrey L

    2012-08-01

    Full Text Available Abstract Background Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of ‘forced abstinence’ for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231. Methods/Design The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW and at Oregon Health & Science University (OHSU hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR follow-up calls, compared to usual care inpatient counseling (UC. In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed

  5. Oncogenetics service and the Brazilian public health system: the experience of a reference Cancer Hospital

    Edenir I. Palmero

    2016-01-01

    Full Text Available Abstract The identification of families at-risk for hereditary cancer is extremely important due to the prevention potential in those families. However, the number of Brazilian genetic services providing oncogenetic care is extremely low for the continental dimension of the country and its population. Therefore, at-risk patients do not receive appropriate assistance. This report describes the creation, structure and management of a cancer genetics service in a reference center for cancer prevention and treatment, the Barretos Cancer Hospital (BCH. The Oncogenetics Department (OD of BCH offers, free of charge, to all patients/relatives with clinical criteria, the possibility to perform i genetic counseling, ii preventive examinations and iii genetic testing with the best quality standards. The OD has a multidisciplinary team and is integrated with all specialties. The genetic counseling process consists (mostly of two visits. In 2014, 614 individuals (371 families were seen by the OD. To date, over 800 families were referred by the OD for genetic testing. The support provided by the Oncogenetics team is crucial to identify at-risk individuals and to develop preventive and personalized behaviors for each situation, not only to the upper-middle class population, but also to the people whose only possibility is the public health system.

  6. A MARKET OPPORTUNITY STUDY FOR THE DEVELOPMENT OF A NEW SPORT HORSE SERVICE AT THE MSU VETERINARY TEACHING HOSPITAL

    Larsen, Eric R.; Lloyd, James W.

    2002-01-01

    The potential need for several new services within the Veterinary Teaching Hospital (VTH) is unknown. However, based on focus groups and practitioner surveys conducted over the last several years, potential new services were identified: overnight emergency, behavior medicine, equine sports medicine, dentistry, oncology and exotic animal medicine. Michigan State University's College of Veterinary Medicine (MSU-CVM) has recently expanded its equine research, diagnostic and therapy capabilities ...

  7. Perception and utilization of cervical cancer screening services among female nurses in University College Hospital, Ibadan, Nigeria

    Arulogun, Oyedunni Sola; Maxwell, Opemipo Olubunmi

    2012-01-01

    Background Cervical Cancer (CC) is the second most common cancer among women with early detection and prompt treatment as best management options. Female nurses have crucial roles to play in promoting the utilization of Cervical Cancer Screening Services (CCSS), yet little information exist regarding their perception and utilization of these services. The CCSS related knowledge, perception and utilization among female nurses at the University College Hospital, (UCH) Ibadan, Nigeria were there...

  8. Influence Service Quality and Customer Satisfaction towards Drug Purchase Intention in Anggrek Outpatient Pharmacy Depo at Hasan Sadikin Hospital

    Pratiwi; Ahmad Muhtadi; Emma Surahman

    2016-01-01

    The quality of service is an evaluation which focused on customer’s awareness about a structural construction of a service or product that involves 5 main aspects which are tangibility, empathy, responsiveness, reliability and assurance. Based on monthly reports of pharmacy installation only about 30% of patients buy drugs in the Anggrek out patient depo out off patients visiting Anggrek out patient specialist clinic in Dr. Hasan Sadikin Hospital. The aim of this study is to determine the eff...

  9. Outpatients’ experiences of quality service delivery at a teaching hospital in Gauteng

    Odette Newman

    2008-01-01

    Full Text Available Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997. The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital’s business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient’s experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients’ experiences of quality service delivery. This study’s purpose is to explore and describe outpatients’ experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients’ experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack

  10. Use of selected ambulatory dental services in Taiwan before and after global budgeting: a longitudinal study to identify trends in hospital and clinic-based services

    Lin Chienhung

    2012-09-01

    Full Text Available Abstract Background The Taiwan government adopted National Health Insurance (NHI in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. Methods This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Results Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. Conclusions The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan.

  11. Socioeconomic factors affecting patients′ utilization of primary care services at a Tertiary Teaching Hospital in Riyadh, Saudi Arabia

    Abdulaziz M Alsubaie

    2016-01-01

    Full Text Available Background: Primary care services utilization is dependent on socioeconomic factors. It is proven that variation in socioeconomic factors result in discrepancies in the use of such services. Admittedly, research is limited on the socioeconomic factors affecting the utilization of primary care services in Saudi Arabia. Objectives: The aim of this research was to study the effect of the main socioeconomic factors affecting patients′ utilization of primary care services at a tertiary teaching hospital, Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted from January to February 2014 in a primary care clinic of a tertiary teaching hospital in Riyadh city; subjects selected using a random consecutive sampling technique. A self-administered questionnaire in Arabic was given to the participants to collect the data which comprised sociodemographic data, utilization measures, and health needs. The data were analyzed using SPSS version 21. Results: A total of 358 subjects participated in the study. The main factors that best determine the utilization of primary health care clinic in a tertiary teaching hospital were the possession of a health insurance (P = 0.046, odds ratio [OR] = 8.333, and bad self-health-perception (P < 0.014, OR: 2.088. Chronic illness was also associated with higher utilization (OR = 2.003. Conclusion: Our results reveal that chronic health problems, self-health-perception, and health insurance are the most significant socioeconomic factors affecting the utilization of primary care services.

  12. Effectiveness of low vision services in improving patient quality of life at Aravind Eye Hospital

    Anna T Do

    2014-01-01

    Full Text Available Context: In India, where the heavy burden of visual impairment exists, low vision services are scarce and under-utilized. Aims: Our study was designed to survey the effectiveness of low vision exams and visual aids in improving patient quality of life in southern rural India. Subjects and Methods: The low vision quality of life (LVQOL questionnaire measures vision-related quality of life through 25 questions on a Likert scale of 0-5 that pertain to (1 mobility, distance vision, and lighting; (2 psychological adjustment; (3 reading and fine work; and (4 activities of daily living. This tool was translated into Tamil and verbally administered to 55 new low vision referral patients before their first visit at the low vision clinic at Aravind Eye Hospital. Low vision aids (LVAs were prescribed at the discretion of the low vision specialist. 1-month later, the same questionnaire was administered over the phone. Results: About 44 of 55 low vision patients completed baseline and follow-up LVQOL surveys, and 30 normal vision controls matched for age, gender, and education were also surveyed (average 117.34 points. After the low vision clinic visit, the low vision group demonstrated a 4.55-point improvement in quality of life (from 77.77 to 82.33 points, P = 0.001. Adjusting for age, gender, and education, the low vision patients who also received LVAs (n = 24 experienced an even larger increase than those who did not (n = 20 (8.89 points, P < 0.001. Conclusion: Low vision services and visual aids can improve the quality of life in South Indian rural population regardless of age, gender, and education level. Thus, all low vision patients who meet the criteria should be referred for evaluation.

  13. Likelihood of hospital readmission after first discharge: Medicare Advantage vs. fee-for-service patients.

    Friedman, Bernard; Jiang, H Joanna; Steiner, Claudia A; Bott, John

    2012-01-01

    This study tests whether the likelihood of hospital readmission within 30 days of discharge is different for enrollees in Medicare Advantage plans versus the standard fee-for-service program. A key requirement is to control for self-selection into Advantage plans. The study uses statewide inpatient databases maintained by the Agency for Healthcare Research and Quality for five states in 2006. The type of Medicare coverage is known, along with an encrypted patient identifier. We identify eligible first discharges and the first readmission within 30 days. We use selected area characteristics as instrumental variables for enrollment in Advantage plans and apply a bivariate probit analysis. Descriptively, there is a slightly lower likelihood of readmission for Advantage plan enrollees. However, the Advantage plan patients are younger and less severely ill. After risk adjustment and control for self-selection, the enrollees in Advantage plans have a substantially higher likelihood of readmission. Recognizing caveats and limitations, the study supports informing Medicare beneficiaries about the rates of readmission for Advantage plans in their area. Analytical methods to adjust for self-selection into particular plans or plan types should be considered when possible. PMID:23230702

  14. Prevalence of HIV among Rural Pregnant Women Attending PPTCT Services at KLE Hospital, Belgaum

    G.S. Ashtagi *, C.S. Metgud, P.R. Walvekar and V.A. Naik

    2011-01-01

    Full Text Available Research question: What is the prevalence of HIV infection among rural pregnant women? Objectives: To know the prevalence of HIV infection and anaemia among pregnant women. Study design: Cross-sectional. Setting: Primary Health Centres namely Kinaye, Vantamuri and Handiganur. Participants: 716 pregnant women residing in three Primary Health Centres and availing PPTCT services at KLE’s Dr. Prabhakar Kore Hospital & MRC, Belgaum. Results: The study revealed that, the prevalence rate of HIV infection in antenatal mothers was 0.70%. Out of 716 pregnant women studied, 508 (70.95% were anaemic and 208 (29.05% were not anaemic. Among 508 anaemic pregnant women, 211 (41.54% had mild anaemia, 211 (41.54% had moderate anaemia and 86 (16.92% had severe anaemia. About 17.73% of the pregnant women belonged to high-risk group. Conclusion: The economic and demographic consequences of the spread of HIV/AIDS are inexorable and awesome. Development of programmes with an integrated approach to inducing behavioral change, promoting use of condoms and controlling STD’s may reduce the infectivity of HIV transmitters and the susceptibility of HIV exposed persons. In this era of AIDS, there is a need to express care and compassion rather than fear, hostility or alienation.

  15. Index of film reject rates of mammographic service of Hospital Geral do Mexico. Strategies and results

    The reject of a radiographic film, not just means to do it again with the consequent increase in the dose to the patient, also means a failure in the service, as factors like fault in the equipment or by humans factors, like the selection of inadequate techniques or the bad positioning of the patient. In both cases, the analysis of the reject measures of radiographic studies, take special importance in the mammographic area, mainly if we consider the radiosensitivity of the tissues in study. This work, shows the methodology and the results of a study carried out in the Oncology Department of the General Hospital of Mexico, the biggest in the state, with the objective of knowing the principal causes of reject of films and establish through the respective analysis, the actions for correcting the detected failures, assuring so, low doses to patient, more precise diagnostic and the reduction of operating costs, that are the main objectives in a Program of Quality Assurance in Radiodiagnostic. (author)

  16. Insulinoma: Report of two cases in the general surgery service in Hospital Carlos Andrade Marin

    There is a variety of endocrine tumours of the pancreas capable of producing hyperinsulinism and neuroendocrinologic symptoms due to hypoglycaemia. Initially they are treated as neurologic or psychiatric disorders and can take years to establish a definitive diagnosis. We present two cases of patients admitted to the service of General Surgery department of the Carlos Andrade Marin Hospital in the years 1999 and 2000. These patients were transferred from the endocrinology department l. The clinical diagnosis was based on monitoring of glycemic and insulin base levels and were complemented with CAT scan and MRI. Surgical procedures were performed obtaining satisfactory enucleating of the tumours. They were localized in the body and the tail of the pancreas respectively. We evidenced immediate normalization of the glycemia during and post operatively. The most important complication in the first case was pancreatic abscess that was drained in an open manner surgically, afterwards a pancreatic leak was determined, and it so was successfully treated with octreotide, the second patient presented a pulmonary atelectacy in the first 24 hours after the post operatory and a week later the presence of a sufrenic abscess on the right side was quite evident, which was treated through percutaneous draining guided by computerized tomography and magnetic resonance. (The author)

  17. The impact of competitive environment on the service marketing mix strategy of health organisations in developing countries : Jordanian private sector hospital senior managers perspective

    Ahmad, Ala'eddin Mohamad Khalaf.

    2007-01-01

    The environment of Jordanian private hospitals has never been so complex and challenging as at present. There are huge influences on these hospitals in the current climate. Managers in these hospitals are finding themselves, more than ever before, confronted by increasing pressures and demands which they must seek to understand and respond to in their service marketing mix strategy in order to achieve effective strategic marketing in terms of their choice of service marketing m...

  18. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Babić Uroš; Soldatović Ivan; Vuković Dejana; Šantrić-Milićević Milena; Stjepanović Mihailo; Kojić Dejan; Argirović Aleksandar; Vukotić Vinka

    2015-01-01

    Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obt...

  19. Delivery of pharmaceutical services at ward level in a teaching hospital.

    Schellack, N; Martins, V; Botha, N; Meyer, J C

    2009-03-01

    Poor management of pharmaceuticals could lead to wastage of financial resources and poor services in the public sector. The main aim of the study was to investigate the quality of pharmaceutical services at ward level in a teaching hospital. The design of the study was descriptive. Three data collection instruments were designed and pilot-tested prior to the actual data collection. Two structured questionnaires were used to interview the sister-in-charge of each ward and the stock and drug controller at the pharmacy. A checklist for the management of pharmaceuticals was completed for each ward. Descriptive statistics were used to describe and summarise the data. Sisters-in-charge of 30 wards and the stock and drug controller at the pharmacy participated in the study. The relationship with the pharmacy was perceived to be average by 54% (n = 30) of the sisters-in-charge of the wards. Communication with the pharmacy was mainly by telephone and 57% of the sisters-in-charge mentioned that they experienced difficulties in conveying messages to the pharmacy. Ten of the wards received regular ward visits by a pharmacist. Expiry dates were checked by all wards but at different intervals. The majority of the wards (90%) used patient cards, which refer to prescription charts, for stock control and ordering from the pharmacy. Fridge temperatures were checked and charted on a daily basis by 30% of the wards. Written standard operating procedures (SOPs) were used by the pharmacy for issuing ward stock. Although 83% of the wards indicated that they used SOPs, evidence of written SOPs was not available. The results indicated that the management of pharmaceutical services at ward level could be improved. Implementation of appropriate communication systems will enhance cooperation between the pharmacy and the wards. A uniform ward stock control system, either by computer or stock cards, should be introduced. Regular ward visits by a pharmacist to oversee ward stock management are

  20. Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol

    Spirig, Rebecca

    2014-03-01

    Full Text Available [english] Aims: With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs.Background: DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. Methods/Design: A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing

  1. Barriers to healthy eating by National Health Service (NHS hospital doctors in the hospital setting: results of a cross-sectional survey

    Wilson Sue

    2008-08-01

    Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

  2. ISO 9001 certification for hospitals in Bulgaria: does it help service?

    Stoimenova, Assena; Stoilova, Ani; Petrova, Guenka

    2014-01-01

    The aim of our study is to review the published literature on establishment and implementation of ISO 9001 QMS in European hospitals, to study the availability of International Organization for Standardization (ISO) quality management systems (QMS) in Bulgarian hospitals and to outline the main advantages of ISO implementation in the hospitals in Bulgaria. The information on availability of ISO QMS in the hospitals in Bulgaria was gathered via Bulgarian certification register, the registries of various quality associations, websites of hospitals and certification companies presented in Bulgaria. A total number of 312 hospitals in Bulgaria were screened for the availability of QMS certified against the ISO 9001 requirements. The experience of European hospitals that implemented QMS is positive and the used approaches to improve the processes and the demonstrated effects from ISO implementation are analysed by the researchers. Unlike other European Union member states, the establishment of quality management systems in Bulgaria is not compulsory. However, our study revealed that 14.42% of the hospitals in Bulgaria have implemented and have certified quality systems against the requirements of ISO 9001. Our study confirmed that a quality management system using the ISO 9001 standard is useful for the hospitals as it can help to increase the operational efficiencies, to reduce errors, improve patient safety and produce a more preventive approach instead of a reactive environment. PMID:26019523

  3. The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

    Katz J

    2015-10-01

    Full Text Available Joel Katz,1–3 Aliza Weinrib,1,2 Samantha R Fashler,2 Rita Katznelzon,1,3 Bansi R Shah,1 Salima SJ Ladak,1 Jiao Jiang,1 Qing Li,1 Kayla McMillan,1 Daniel Santa Mina,5,6 Kirsten Wentlandt,7 Karen McRae,1,3 Diana Tamir,1,3 Sheldon Lyn,1,3 Marc de Perrot,8 Vivek Rao,9 David Grant,10 Graham Roche-Nagle,11 Sean P Cleary,12 Stefan OP Hofer,13 Ralph Gilbert,14 Duminda Wijeysundera,1,3 Paul Ritvo,15 Tahir Janmohamed,16 Gerald O’Leary,1,3 Hance Clarke1,3 1Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 2Department of Psychology, York University, 3Department of Anesthesia, University of Toronto, 4Palliative Care, University Health Network, University of Toronto, 5Princess Margaret Cancer Centre, University Health Network, University of Toronto, 6Faculty of Kinesiology and Physical Education, University of Toronto, 7Department of Family and Community Medicine, University of Toronto, 8Division of Thoracic Surgery, Toronto General Hospital, 9Division of Cardiovascular Surgery, Toronto General Hospital, 10Multiorgan Transplant Program, Toronto General Hospital, 11Division of Vascular Surgery, Toronto General Hospital, 12Division of General Surgery, Toronto General Hospital, 13Division of Plastic Surgery, Toronto General Hospital, 14Division of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, 15Department of Kinesiology and Health Science, York University, 16ManagingLife, Toronto, ON, CanadaAbstract: Chronic postsurgical pain (CPSP, an often unanticipated result of necessary and even life-saving procedures, develops in 5–10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS at

  4. A hospital-wide picture archiving and communication system (PACS): the views of users and providers of the radiology service at Hammersmith Hospital

    Objective: To obtain users' views of the new picture archiving and communication system (PACS) from clinical and radiological staff at Hammersmith Hospital, UK. Methods: Semi-structured interviews were used to ascertain the views of staff, following an interview schedule which covered aspects of: (1) their use of PACS, (2) facilities available, (3) the perceived quality of images, (4) reporting, (5) image availability, (6) image accessibility, (7) training, and (8) ease of use of PACS. Results: Interviews were carried out with 34 key users and providers of the radiological service at Hammersmith Hospital. Overall, staff were very satisfied with PACS particularly in terms of image availability. All staff said that they preferred PACS to the previous, conventional radiology service. Conclusions: The key implications of issues raised by staff were: the impact of 'down-time' and the importance of an efficient back-up system, the requirement for sufficient short-term storage to prevent images being off-line during clinical situations, the usefulness of the folder system for management of the images, the need to access images for teaching purposes, the advantage of having a default display protocol to facilitate radiological reporting, and the requirement for flexible, yet effective, training to ensure that the system is utilised to its full potential by users

  5. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    Dale, Bjørg

    2013-01-01

    Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficie...

  6. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    Dale B; Hvalvik S

    2013-01-01

    Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The pur...

  7. Trends of pre-hospital emergency medical services activity over 10 years: a population-based registry analysis

    Pittet V.; Burnand B.; Yersin B.; Carron P.N.

    2014-01-01

    BACKGROUND: The number of requests to pre-hospital emergency medical services (PEMS) has increased in Europe over the last 20 years, but epidemiology of PEMS interventions has little be investigated. The aim of this analysis was to describe time trends of PEMS activity in a region of western Switzerland. METHODS: Use of data routinely and prospectively collected for PEMS intervention in the Canton of Vaud, Switzerland, from 2001 to 2010. This Swiss Canton comprises approximately 10% of the wh...

  8. Threat of mass resignation as a window of opportunity for questioning hospital service production structures in Finland

    Kokkinen L; Viitanen E

    2011-01-01

    Lauri Kokkinen1,2, Elina Viitanen11School of Health Sciences, University of Tampere, Tampere, 2Unit of Expertise for Work Organizations, Finnish Institute of Occupational Health, Turku, FinlandBackground: Service production structures of public health care, once established, have proved extremely difficult to change. For this study, we reviewed discussions that took place in management teams at a Finnish central hospital over a period of nine months. The aim of the research was to analyze whe...

  9. Evaluating patients' perception of service quality at hospitals in nine Chinese cities by use of the ServQual scale

    Min Li; Douglas Bruce Lowrie; Cheng-Yu Huang; Xiang-Chan Lu; Ying-Chu Zhu; Xing-Hua Wu; Mayila Shayiti; Qiong-Zhen Tan; Hua-Ling Yang; Si-Yuan Chen; Pan Zhao; Sheng-Hua He; Xiu-Rong Wang; Hong-Zhou Lu

    2015-01-01

    Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses include...

  10. The Influence Of Policy Implementation From The Change Of Institutional Status Toward Quality Of Patient Service In Hospital

    Dadang Kusnadi

    2015-08-01

    Full Text Available Abstract Fenomenon and comunity problem in goverment hospital management not aware to wont and need public. Silent safety and consumen satisfaction is fenomenon lack quallity care. Goal this research goal for analysis about influence of policy implementation of hospital change institution status to the quality of patien service in Hospital. Kind of reserch is the quantity desain on approach the eksplanatory survey research analysis regresi linier multipel with analysis method validitas product moment pearson exam and reliability exam is alpha cronbach technique to hypotesis exam is path analysis and statistic exam t. Datum transformation is Skala Likert with measurement the method succesive interval. The population one thausand seventh two person with sample technique stratified random sampling the instrument research is quesioner and interview patien on caunter imforman. The result of assuming research that it is anticipated that implementation of change policy of institution status of hospital X there is significant influence to quality of service of patient Y is 66.31 and the other factor e is 33.69. In the implementation factor is significant to positif influence to quality service is communication X1 is 049 human resources X2 is 025 disposition X3 is 032 and structure birocratic X4 is 033. The conculsion from four factor independen variable X is the implementation of policy to quality service patient Y to influence and can receive in knowledge. To concept the development in implementation of policy need culture job factor because every product policy to contac direct with the community as to basic public policy.

  11. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece

    Priporas Constantinos-Vasilios

    2011-10-01

    Full Text Available Abstract Background The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. Methods A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Results Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Conclusions Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction.

  12. Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

    Ali Emrouznejad

    2012-07-01

    Full Text Available Background: The aim of this study was to suggest a suitable context to develop efficient hospitalsystems while maintaining the quality of care at minimum expenditures.Methods: This research aimed to present a model of efficiency for selected public and privatehospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approachin order to recognize and suggest the best practice standards.Results: Among the six inefficient hospitals, 2 (33% had a technical efficiency score of lessthan 50% (both private, 2 (33% between 51 and 74% (one private and one public and the rest(2, 33% between 75 and 99% (one private and one public.Conclusion: In general, the public hospitals are relatively more efficient than private ones; it isrecommended for inefficient hospitals to make use of the followings: transferring, selling, orrenting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals orother health centers; pensioning off, early retirement clinic officers, technicians/technologists,and other technical staff. The saving obtained from the above approaches could be used to improveremuneration for remaining staff and quality of health care services of hospitals, rural andurban health centers, support communities to start or sustain systematic risk and resource poolingand cost sharing mechanisms for protecting beneficiaries against unexpected health carecosts, compensate the capital depreciation, increasing investments, and improve diseases preventionservices and facilities in the provincial level.

  13. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece

    2011-01-01

    Background The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. Methods A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Results Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Conclusions Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction. PMID:21981753

  14. Experiences of Working with the Tobacco Issue in the Context of Health Promoting Hospitals and Health Services: A Qualitative Study

    Malou Lindberg

    2011-02-01

    Full Text Available The worldwide Health Promoting Hospital and Health Services (HPH network was initiated by the World Health Organizations in the late 1980s. The goal of the network is to change the focus of health services from curing patients to also embrace disease prevention and health promotion. In Sweden the network started in 1996, and involves mainly hospitals and primary care. The network members collaborate in task forces, one of which is working on the tobacco issue. There is limited evidence on the value of working within an HPH organization. The aim of this study was to investigate the experiences of members of the Swedish HPH network tobacco task force. Focus group interviews with task force members were analyzed using implementation theory. Three themes, overall experiences of working with tobacco issues, experiences of working with “free from tobacco in connection with surgery”, and experiences of work in the HPH tobacco task force, emerged from the interviews. The results show that working with the tobacco issue in the context of health-promoting hospitals and health services met with difficulties involving the following important factors: evidence, context, facilitation and adopter characteristics. Leadership, one contextual factor, at national and local level, seems to be crucial if the work is going to succeed. The tobacco task force of the HPH network is an important facilitator supporting the task.

  15. 38 CFR 17.166 - Dental services for hospital or nursing home patients and domiciled members.

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services...

  16. Blue Ocean Strategy of Current Hospital Expansion: Health Service Clique of Comprehensive Hospitals Annexing Primary Hospitals%大型综合医院面向基层的集团化蓝海战略探讨

    范靖; 徐幻; 胡新勇

    2012-01-01

    To explore the methods and strategies of the large-scale comprehensive hospitals and primary hospitals jointly set up hospital group. Methods Citing the ideology of the "Blue Ocean Strategy", according to the needs of patients, according to residents' demand, altering large-scale comprehensive hospital expansion orient from their own size expansion to regional grass-roots development mode, to format the regional hospital group, and to open up the "Blue Ocean7' of the health market. Results The united management in health service, education, and researching could fill the flaws of each, lead health resources fully utilized, and make patients seek treatment conveniently. The novels manage method, basing on the warrant of service quality, was likely to improve the service efficiency and the patient's satisfaction. Conclusions "Blue Ocean Strategy", for health market, could effectively guide large hospitals convert perspective, to create a unique, efficient group management mode, help them dominate in the competition of the market.%目的 探索大型综合医院与基层医院联合组建医院集团的方法与策略.方法 引入"蓝海战略"思想,根据患者需求,将大型综合医院扩张方向从自身规模扩张向区域基层方向发展,组建区域医院集团,开拓医疗市场的"蓝海".结果 区域医疗集团内统一管理,医疗、教学、科研等优势互补;集团化充分利用医疗资源,方便患者就近诊治,在保证医疗质量的同时,能够提高医疗效率和患者满的意度.结论 医疗市场 "蓝海战略"能够有效引导大型医院转换视角,创建独特、高效的集团化管理模式,使其在市场竞争中占据主动.

  17. Domestic fridge-freezer load aggregation to support ancillary services

    Martin Almenta, M.; Morrow, D. J.; Best, R. J.; Fox, B; A. M. Foley

    2016-01-01

    Grid operators and electricity retailers in Ireland manage peak demand, power system balancing and grid congestion by offering relevant incentives to consumers to reduce or shift their load. The need for active consumers in the home using smart appliances has never been greater, due to increased variable renewable generation and grid constraints. In this paper an aggregated model of a single compressor fridge-freezer population is developed. A price control strategy is examined to quantify an...

  18. Genetic Algorithm based PID controller for Frequency Regulation Ancillary services

    Sandeep Bhongade

    2010-12-01

    Full Text Available In this paper, the parameters of Proportional, Integral and Derivative (PID controller for Automatic Generation Control (AGC suitable in restructured power system is tuned according to Generic Algorithms (GAs based performance indices. The key idea of the proposed method is to use the fitness function based on Area Control Error (ACE. The functioning of the proposed Genetic Algorithm based PID (GAPID controller has been demonstrated on a 75-bus Indian power system network and the results have been compared with those obtained by using Least Square Minimization method.

  19. Distributed Smart Grid Asset Control Strategies for Providing Ancillary Services

    Kalsi, Karanjit; Zhang, Wei; Lian, Jianming; Marinovici, Laurentiu D.; Moya, Christian; Dagle, Jeffery E.

    2013-10-30

    With large-scale plans to integrate renewable generation driven mainly by state-level renewable portfolio requirements, more resources will be needed to compensate for the uncertainty and variability associated with intermittent generation resources. Distributed assets can be used to mitigate the concerns associated with renewable energy resources and to keep costs down. Under such conditions, performing primary frequency control using only supply-side resources becomes not only prohibitively expensive but also technically difficult. It is therefore important to explore how a sufficient proportion of the loads could assume a routine role in primary frequency control to maintain the stability of the system at an acceptable cost. The main objective of this project is to develop a novel hierarchical distributed framework for frequency based load control. The framework involves two decision layers. The top decision layer determines the optimal gain for aggregated loads for each load bus. The gains are computed using decentralized robust control methods, and will be broadcast to the corresponding participating loads every control period. The second layer consists of a large number of heterogeneous devices, which switch probabilistically during contingencies so that aggregated power change matches the desired amount according to the most recently received gains. The simulation results show great potential to enable systematic design of demand-side primary frequency control with stability guarantees on the overall power system. The proposed design systematically accounts for the interactions between the total load response and bulk power system frequency dynamics. It also guarantees frequency stability under a wide range of time varying operating conditions. The local device-level load response rules fully respect the device constraints (such as temperature setpoint, compressor time delays of HVACs, or arrival and departure of the deferrable loads), which are crucial for implementing real load control programs. The promise of autonomous, Grid Friendly™ response by smart appliances in the form of under-frequency load shedding was demonstrated in the GridWise Olympic Peninsula Demonstration in 2006. Each controller monitored the power grid voltage signal and requested that electrical load be shed by its appliance whenever electric power-grid frequency fell below 59.95 Hz. The controllers and their appliances responded reliably to each shallow under-frequency event, which was an average of one event per day and shed their loads for the durations of these events. Another objective of this project was to perform extensive simulation studies to investigate the impact of a population of Grid Friendly™ Appliances (GFAs) on the bulk power system frequency stability. The GFAs considered in this report are represented as demonstration units with water heaters individually modeled.

  20. Influence Service Quality and Customer Satisfaction towards Drug Purchase Intention in Anggrek Outpatient Pharmacy Depo at Hasan Sadikin Hospital

    Pratiwi

    2016-04-01

    Full Text Available The quality of service is an evaluation which focused on customer’s awareness about a structural construction of a service or product that involves 5 main aspects which are tangibility, empathy, responsiveness, reliability and assurance. Based on monthly reports of pharmacy installation only about 30% of patients buy drugs in the Anggrek out patient depo out off patients visiting Anggrek out patient specialist clinic in Dr. Hasan Sadikin Hospital. The aim of this study is to determine the effect of service quality and customer satisfaction to purchase intention in the Anggrek out patient depo Hasan Sadikin hospital at Bandung. The method used in this study is analytical survey with cross sectional design. The samples used were 200 patients, consist of 104 customers who have visited more than one times and 96 first visit costumer to this clinic. Data was collected using a questionnaire and analyzed using Smart PLS V 2.0 software. The results of this study showed that the service quality with tangible dimensions, reliability, responsiveness, assurance, and empathy are affecting the customer satisfaction with a score of 12.755 t-count (greater than t-table 1.983 and a positive value of the original sample of 0.800. Customer satisfaction affecting the customer purchase intentions with t-count is greater than t-table values of 5.012 and 0.726 of the original positive sample. While the service quality does not directly influence customer purchase intention with the t-test is smaller than t-table is 1.455 and the negative of the original sample -0.287. Some of service quality influence customers that causes not purchasing drugs from the out patient depo there are effect of unavailability of counseling, long waiting time of service, the need for special counseling room, a spacious waiting room, and the completeness of drug availability.

  1. FLECH PowerMax Service Requirement Specification

    It is expected that in the future, ancillary services will be required at distribution level. This work describes how one of these ancillary services, the PowerMax service, must be spec ified within a market framework. The basis of this work is the Flexibility Clearing House (FLE CH) platform...

  2. Laparoscopic Assisted Vaginal Hysterectomy, Setting Up a Service at a Peripheral Teaching Hospital

    Jim Tsaltas; Gab Kovacs; Jenny Dennis; Amanda Pratt

    1996-01-01

    The establishment of a laparoscopically assisted hysterectomy program at Box Hill Hospital is described. The first eight cases have been reviewed and recommendations are made to other gynaecology units who wish to establish a minimally invasive gynaecological surgery unit.

  3. Medicare and Medicaid programs; hospital conditions of participation: laboratory services. Final rule.

    2008-06-27

    This final rule finalizes the hospital conditions of participation requirements for hospitals that transfuse blood and blood components. It requires hospitals to: Prepare and follow written procedures for appropriate action when it is determined that blood and blood components the hospitals received and transfused are at increased risk for transmitting hepatitis C virus (HCV); quarantine prior collections from a donor who is at increased risk for transmitting HCV infection; notify transfusion recipients, as appropriate, of the need for HCV testing and counseling; and extend the records retention period for transfusion-related data to 10 years. The intent is to aid in the prevention of HCV infection and to create opportunities for disease prevention that, in most cases, can occur many years after recipient exposure to a donor. PMID:18677830

  4. Maslow's needs hierarchy as a framework for evaluating hospitality houses' resources and services.

    Duncan, Mary Katherine Waibel; Blugis, Ann

    2011-08-01

    As hospitality houses welcome greater numbers of families and families requiring longer stays, they do so in the absence of a widely accepted theory to guide their understanding of guests' needs and evaluations of how well they meet those needs. We propose A. Maslow's (1970) Hierarchy of Needs as a conceptual framework for understanding what makes a hospitality house a home for families of pediatric patients and for guiding the activities of hospitality houses' boards of directors, staff, volunteers, and donors. This article presents findings from a theory-driven evaluation of one hospitality house's ability to meet guests' needs, describes the house's best practice standards for addressing guests' needs, and suggests areas for future research. PMID:21726782

  5. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    Sekandi Juliet

    2011-03-01

    Full Text Available Abstract Background Mulago National Referral Hospital (MNRH, Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23 and focus group discussions (n=7 were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies, staff inadequacies (knowledge, motivation, and professionalism, overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism

  6. Factors impacting the use of antenatal care and hospital child delivery services: a case study of rural residents in the Enshi Autonomous Prefecture, Hubei Province, China.

    Zhang, Yin; Chen, Minxing; Lu, Jun; Hao, Mo; Zhang, Changli; Sun, Mei; Li, Xiaohong; Chang, Fengshui

    2015-01-01

    This study was undertaken to understand the factors that impact whether rural women obtain antenatal care (ANC) and choose to use hospital delivery services in central and western China. We chose to conduct field research with the rural residents in Hubei Province through a combination of random sampling and purposive sampling methods. A mixed method approach was taken to analyze the factors impacting the use of ANC and hospital delivery services from the perspective of the villagers. Our results indicate that the quality of the available ANC services is poor. In particular, women who have special circumstances and unplanned pregnancies or who become pregnant prior to marriage are confronted with inadequate ANC and hospital child delivery services. The factors that impact whether women use or not use ANC and hospital delivery services and that cause women to choose hospital or home delivery can be understood at three levels: macro, middle, and micro. We strongly suggest that the policies and projects that promote maternal healthcare in rural areas be sustained with an added focus on including women with special circumstances. Village doctors can be enlisted to regularly visit pregnant women at home and to provide extra explanation about the ANC services available and the purpose of maternal healthcare. These findings and suggestions can be used by local health providers and decision-makers to improve the quality of ANC and hospital delivery services. PMID:24446091

  7. Impact of ICT on Health Services in Bangladesh: A Study on Hobiganj Adhunik Zila Sadar Hospital

    Fatema Khatun; Mst. Rokshana Khanam Sima

    2015-01-01

    Using Information and Communication Technologies (ICT) is a key strategy to meet the demand for health services in the 21st century. ICT in health services can provide services to the door steps of the people. It helps to meet increasing demands, rising costs, limited resources, workforce shortages and the national and international dissemination of best practices. ICT health service can also ensure efficiency and effectiveness in the health management system. In this study, the simple random...

  8. What Do the Hospital Pharmacists Think about the Quality of Pharmaceutical Care Services in a Pakistani Province? A Mixed Methodology Study

    2015-01-01

    The objective of this study was to evaluate the perception of hospital pharmacists regarding quality of pharmaceutical care services in Khyber Pakhtunkhwa (KPK) Province, Pakistan, through qualitative as well as quantitative approach. For qualitative study, snow ball sampling technique was used. In quantitative part, a cross-sectional study was conducted in 112 hospital pharmacists (out of 128 accessed ones) from both private and public hospitals in six major divisions (divisions are the thir...

  9. Medicaid patients seen at federally qualified health centers use hospital services less than those seen by private providers.

    Rothkopf, Jennifer; Brookler, Katie; Wadhwa, Sandeep; Sajovetz, Michael

    2011-07-01

    Federally qualified health centers, also known as community health centers, play an essential role in providing health care to millions of Americans. In return for providing primary care to underserved, homeless, and migrant populations, these centers are reimbursed at a higher rate than other providers by public programs such as Medicaid. Under the Affordable Care Act of 2010, the role of the centers is expected to grow. To examine the quality of care that the centers provide, the Colorado Department of Health Care Policy and Financing compared the use of costly hospital-related services by Medicaid clients whose usual source of care was a community health center with the use by clients whose usual source of care was a private, fee-for-service provider. The study found that community health center users were about one-third less likely than the other group to have emergency department visits, inpatient hospitalizations, or preventable hospital admissions. Public funders such as states should work with community health centers to improve the quality and reduce the cost of care even further. PMID:21734208

  10. Availability and utilisation of physician-based pre-hospital critical care support to the NHS ambulance service in England, Wales and Northern Ireland

    Hyde, Philip; Mackenzie, Rod; Ng, Gail; Reid, Cliff; Pearson, Gale

    2011-01-01

    Background Every day throughout the UK, ambulance services seek medical assistance in providing critically ill or injured patients with pre-hospital care. Objective To identify the current availability and utilisation of physician-based pre-hospital critical care capability across England, Wales and Northern Ireland. Design A postal and telephone survey was undertaken between April and December 2009 of all 13 regional NHS ambulance services, 17 air ambulance charities, 34 organisations affili...

  11. Barriers to the use of the library service amongst clinical staff in an acute hospital setting: an evaluation.

    Thomas, Gaynor; Preston, Hugh

    2016-06-01

    This article reports on research into the reasons why clinical staff in an acute hospital may be reluctant to use library services. The research was conducted by Gaynor Thomas at the Prince Philip Hospital in Llanelli in Wales as part of the dissertation she completed for an MSc in Economics. She graduated in July 2014 from Aberystwyth University and has co-written the article with Hugh Preston, her dissertation supervisor. The article summarises the key findings from the interviews undertaken as part of the research process and lists the resulting recommendations. Gaynor also highlights the initiatives which have been put in place with the express aim of removing barriers to use and encouraging clinical staff to make the most of the library which is, she argues, a time-saving resource. AM. PMID:27168257

  12. Elaboration of protocols as a guide in musculoskeletal ultrasound for radiology service of the Hospital Doctor Rafael A. Calderon Guardia

    A protocol to guide residents and attending physicians at the Hospital Dr. Rafael Angel Calderon Guardia has been provided for regulating the work in the field the ultrasound of muscles, tendons and sonography. The staff has handled the ultrasound devices must understand the basis of the interaction of acoustic energy to the tissues and to know the methods and instruments have been used to produce and improve the quality of the image obtained. The guide ultrasound normal locomotor allowed to have a model for service members and medical imaging radiology hospital; it has been prepared through a comprehensive literature review based on textbooks and current articles concerning the most important theoretical bases of the Doppler study, which covers the assessment of shoulder, elbow, wrist, knee and ankle. The data obtained in the study process, facilitated access to printed and digital information, which has led to diagnostic certainty and reliability of results. (author)

  13. A critical review of studies of the association between demands for hospital services and air pollution.

    Lipfert, F W

    1993-07-01

    Studies of the associations between air pollution and hospital admissions and emergency room use are reviewed, including studies of air pollution episodes, time-series analyses, and cross-sectional analyses. These studies encompass a variety of methods of analysis and levels of air quality. Findings from all three types of studies were generally consistent in that almost all of the studies reviewed found statistically significant associations between hospital use and air pollution; this unanimity may have resulted in part from publication bias. These associations were characterized by elasticities of the order of 0.20; i.e., a 100% change in air pollution was associated with a change in hospital use of about 20%, for specific diagnoses. Respiratory diagnoses were emphasized by most studies; cardiac diagnoses were included in five of them. The air pollutants most often associated with changes in hospital use were particulate matter, sulfur oxides, and oxidants. Apart from the major air pollution episodes, there was no obvious link between air pollution level and the significance or magnitudes of the associations. Long-term indicators of hospitalization appeared to also be influenced by medical care supply factors, including the numbers of beds and physicians per capita. These nonpathological causal factors could also have influenced the findings of the time-series studies by introducing extraneous factors in the patterns of admissions. Although consistent associations have been shown between hospital use and air pollution, further research is required to distinguish among potentially responsible pollutants and to deduce specific dose-response relationships of general utility. PMID:8243395

  14. Implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital

    Storey Donald F

    2012-10-01

    Full Text Available Abstract Background Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are scarce in the reported literature. The purpose of the current report is to describe the implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital employing a core strategy of post-prescriptive audit with intervention and feedback. Methods For one hour twice weekly, an infectious diseases physician and a clinical pharmacist audited medical records of inpatients receiving systemic antimicrobial therapy and made non-binding, written recommendations that were subsequently scored for implementation. Defined daily doses (DDDs; World Health Organization Center for Drug Statistics Methodology and acquisition costs per admission and per patient-day were calculated monthly for all administered antimicrobial agents. Results The antimicrobial stewardship team (AST made one or more recommendations for 313 of 367 audits during a 16-month intervention period (September 2009 – December 2010. Physicians implemented recommendation(s from each of 234 (75% audits, including from 85 of 115 for which discontinuation of all antimicrobial therapy was recommended. In comparison to an 8-month baseline period (January 2009 – August 2009, there was a 22% decrease in defined daily doses per 100 admissions (P = .006 and a 16% reduction per 1000 patient-days (P = .013. There was a 32% reduction in antimicrobial acquisition cost per admission (P = .013 and a 25% acquisition cost reduction per patient-day (P = .022. Conclusions An effective antimicrobial stewardship program was implemented with limited resources on the medical-surgical service of a 100-bed community hospital.

  15. Experiences of the Implementation of a Learning Disability Nursing Liaison Service within an Acute Hospital Setting: A Service Evaluation

    Castles, Amy; Bailey, Carol; Gates, Bob; Sooben, Roja

    2014-01-01

    It has been well documented that people with learning disabilities receive poor care in acute settings. Over the last few years, a number of learning disability liaison nurse services have developed in the United Kingdom as a response to this, but there has been a failure to systematically gather evidence as to their effectiveness. This article…

  16. 基于无功辅助服务补偿的发电厂AVC系统机组无功出力分配策略%A reactive power allocation strategy for power plant AVC system based on reactive power ancillary service compensation

    林瑞星; 张蓓; 李旻; 刘柏私; 徐琳

    2013-01-01

    运行机组间无功出力分配是发电厂AVC系统的重要技术环节,分配策略的优劣影响着AVC控制的安全性及发电厂运行的经济性。从提高发电厂收益角度,提出了基于无功辅助服务补偿的发电厂AVC系统机组无功出力分配策略,建立了优化模型。该优化模型考虑了发电厂参与无功辅助服务后机组及变压器损耗增加的成本,在满足调度机构AVC系统下发的控制目标及机组安全运行等约束条件的前提下,以电厂收益最大为优化目标,求取参与AVC控制机组的无功出力控制量并下发相应机组执行。算例仿真验证了基于无功辅助服务补偿后发电厂运行机组间无功出力分配的有效性,能在满足调压要求的同时明显地提高电厂的经济效益。%The reactive power output allocation for generators is an important technical link of automatic voltage control (AVC) system in power plant. The allocation strategy affects the security of the AVC control and operation economy of power plant. In order to improve the profits of the power plant, a reactive power allocation strategy based on the reactive power ancillary services (RPAS) compensation is proposed, and the optimization model is established. The model considers the increasing cost of units and transformer loss when the power plant adopts the RPAS. Under the condition of satisfying the constraints such as the control target of AVC system of the dispatching department and secure operation domain of generators, and taking the maximum profits of power plant as the optimization objective, the model solves the controlling quantity of reactive outputs of AVC generators and then they are implemented by corresponding units. The method is proved to be effective in the simulation and the strategy can satisfy the requirements of voltage regulation and significantly improve the economic efficiency of the power plant.

  17. Pre-hospital intubation by anaesthesiologists in patients with severe trauma: an audit of a Norwegian helicopter emergency medical service

    Lossius Hans

    2010-06-01

    Full Text Available Abstract Background Anaesthesiologists are airway management experts, which is one of the reasons why they serve as pre-hospital emergency physicians in many countries. However, limited data are available on the actual quality and safety of anaesthesiologist-managed pre-hospital endotracheal intubation (ETI. To explore whether the general indications for ETI are followed and what complications are recorded, we analysed the use of pre-hospital ETI in severely traumatised patients treated by anaesthesiologists in a Norwegian helicopter emergency medical service (HEMS. Methods A retrospective audit of prospectively registered data concerning patients with trauma as the primary diagnosis and a National Committee on Aeronautics score of 4 - 7 during the period of 1994-2005 from a mixed rural/urban Norwegian HEMS was performed. Results Among the 1255 cases identified, 238 successful pre-hospital ETIs out of 240 attempts were recorded (99.2% success rate. Furthermore, we identified 47 patients for whom ETI was performed immediately upon arrival to the emergency department (ED. This group represented 16% of all intubated patients. Of the ETIs performed in the ED, 43 patients had an initial Glasgow Coma Score (GCS Conclusions We found a very high success rate of pre-hospital ETI and few recorded complications in the studied anaesthesiologist-manned HEMS. However, a substantial number of trauma patients were intubated first on arrival in the ED. This delay may represent a quality problem. Therefore, we believe that more studies are needed to clarify the reasons for and possible clinical consequences of the delayed ETIs.

  18. Discharge Planning in Acute Care Hospitals in Israel: Services Planned and Levels of Implementation and Adequacy

    Auslander, Gail K.; Soskolne, Varda; Stanger, Varda; Ben-Shahar, Ilana; Kaplan, Giora

    2008-01-01

    This study aimed to examine the implementation, adequacy, and outcomes of discharge planning. The authors carried out a prospective study of 1,426 adult patients discharged from 11 acute care hospitals in Israel. Social workers provided detailed discharge plans on each patient. Telephone interviews were conducted two weeks post-discharge. Findings…

  19. Career Preparation Program Curriculum Guide for: Hospitality/Tourism Industry (Tourist Services).

    British Columbia Dept. of Education, Victoria. Curriculum Development Branch.

    This career preparation curriculum outline for the hospitality/tourism industry is intended to provide secondary and postsecondary learning outcomes for completion of program requirements. The guide is organized into four sections. Section one presents an overview of the program, of the philosophy of career education, and of the organization and…

  20. "When are you seeing my patient?"--an analysis of the cardiology consultation service in a teaching hospital.

    Cronin, E

    2010-05-01

    The provision of an efficient consultation service is essential to the efficient functioning of any hospital. Surprisingly little is known about this activity. We present the first reported evaluation of a cardiology consultation service in an attempt to determine the characteristics, efficiency and workload implications of such a service. We performed an audit of the in-patient cardiology consultation service over a four week period. During this period, 125 consultations were seen, of which 85 (68%) were requested by medical specialties. Consultations were seen in a timely fashion, with 76 (61%) being seen on the same day that the request was received. The most common problem was chest pain, (49 patients; 38%) which was felt to be of cardiac origin in only a minority (20; 40%) of cases. Consultations had significant resource implications for our department, with 35 (28%) procedures being performed, 25 (20%) patients\\' care being taken over, and a further 27 (21.6%) new out-patient referrals generated. Our results indicate that the consultation service considered was efficiently delivered but contributed significantly to the department\\'s workload. The most frequent consultation request was for chest pain that was often non-cardiac in nature.

  1. Providing a Seamless Service System from Hospital to Home: The NICU Training Project.

    Wyly, M. Virginia; And Others

    1996-01-01

    A training model is described that promotes collaboration between neonatal intensive care unit professionals and early intervention staff regarding the care of premature infants. The goal is to train service providers to implement a seamless system of family-centered interventions and to transition from inpatient to community services. (Author/SW)

  2. Discussion on volunteer service in hospital%“志愿服务在医院”的实践探讨

    姚峥; 王香平; 张育; 白弘冬; 花蕾; 马志娟; 唐凤君

    2012-01-01

    Volunteer service system in hospital has been built, which includes building volunteer service platform, identifying means and objectives of volunteer service in hospital, setting up hospital volunteer association, shaping regulations and institutions, recruiting volunteer, designing training system, volunteer service post and time, and organizing annual meeting of volunteer association. Volunteer service in hospital has been effectively smoothed the problem of shortening nonprofessional medical service staff and may be a new platform of hospital patient communication to remedy the limitation of hospital management. Long-term and effective mechanism of volunteer service in hospital can help shaping normal and regular volunteer service system.%在医院搭建志愿服务平台,明确开展“志愿服务在医院”的意义和目的,通过成立医院志愿者协会、制定规章制度、招募和甄选志愿者、建立志愿者培训体系、设立服务岗位和服务时间、召开志愿者协会年会等方面的“志愿服务在医院”实践,满足医院突显的非医疗性服务需求,可望成为医患沟通的平台,弥补医院管理中的不足.建立“志愿服务在医院”的长效机制,形成志愿服务常态化、规范化.

  3. Drug information service awareness program and its impact on characteristics of inquiries at DIS unit in Malaysian public hospital

    Aida Azlina Ali

    2013-01-01

    Full Text Available Objectives : To study the Drug Information Service (DIS awareness program organized by a DIS unit in Malaysian hospital through utilization of provided services by the healthcare professionals, allied healthcare providers, patients and the public, and to identify the characteristics of inquiries received. Materials and Methods : An awareness program to promote the services of the DIS unit was held throughout the month of March in 2010. Drug information queries forms that have been documented six months prior to (September 2009-February 2010 and six months after (April-September 2010 the awareness program were collected and assessed. Mean monthly inquiries volumes pre- and post-program were compared to evaluate the effectiveness of the program. Types of information requestors, inquiries, reference sources, and drug class information were identified and evaluated. Results: A total of 747 drug information queries forms were received during the study period. The mean total utilization of the DIS unit services after (63.67 ± 18.24 the DIS awareness program was increased but not significant (P < 0.05 when compared to records before (60.83 ± 21.49 the program. Majority of the DIS service users were the pharmacist (67.5%, followed by the doctors (24.9%. Most inquiries were regarding the dosage and route of administration of drugs (61.4%. The most frequently referred sources of information were the Micromedex and the Internet (37.3%. The most common inquiries were related to the anti-infective agents (37.8%. Conclusion: Provision of sufficient and accurate drug information to the healthcare professionals, patients, and the public is crucial to ensure optimization of therapy. The utilization of services provided by the DIS unit should be supported. Frequent DIS awareness program should be undertaken to promote and encourage the use of services.

  4. Ancillary study management systems: a review of needs

    Nelson Elizabeth K

    2013-01-01

    Full Text Available Abstract Background The valuable clinical data, specimens, and assay results collected during a primary clinical trial or observational study can enable researchers to answer additional, pressing questions with relatively small investments in new measurements. However, management of such follow-on, “ancillary” studies is complex. It requires coordinating across institutions, sites, repositories, and approval boards, as well as distributing, integrating, and analyzing diverse data types. General-purpose software systems that simplify the management of ancillary studies have not yet been explored in the research literature. Methods We have identified requirements for ancillary study management primarily as part of our ongoing work with a number of large research consortia. These organizations include the Center for HIV/AIDS Vaccine Immunology (CHAVI, the Immune Tolerance Network (ITN, the HIV Vaccine Trials Network (HVTN, the U.S. Military HIV Research Program (MHRP, and the Network for Pancreatic Organ Donors with Diabetes (nPOD. We also consulted with researchers at a range of other disease research organizations regarding their workflows and data management strategies. Lastly, to enhance breadth, we reviewed process documents for ancillary study management from other organizations. Results By exploring characteristics of ancillary studies, we identify differentiating requirements and scenarios for ancillary study management systems (ASMSs. Distinguishing characteristics of ancillary studies may include the collection of additional measurements (particularly new analyses of existing specimens; the initiation of studies by investigators unaffiliated with the original study; cross-protocol data pooling and analysis; pre-existing participant consent; and pre-existing data context and provenance. For an ASMS to address these characteristics, it would need to address both operational requirements (e.g., allocating existing specimens and data

  5. Medical Researchers' Ancillary Care Obligations: The Relationship-Based Approach.

    Olson, Nate W

    2016-06-01

    In this article, I provide a new account of the basis of medical researchers' ancillary care obligations. Ancillary care in medical research, or medical care that research participants need but that is not required for the validity or safety of a study or to redress research injuries, is a topic that has drawn increasing attention in research ethics over the last ten years. My view, the relationship-based approach, improves on the main existing theory, Richardson and Belsky's 'partial-entrustment model', by avoiding its problematic restriction on the scope of health needs for which researchers could be obligated to provide ancillary care. Instead, it grounds ancillary care obligations in a wide range of morally relevant features of the researcher-participant relationship, including the level of engagement between researchers and participants, and weighs these factors against each other. I argue that the level of engagement, that is, the duration and intensity of interactions, between researchers and participants matters for ancillary care because of its connection to the meaningfulness of a relationship, and I suggest that other morally relevant features can be grounded in researchers' role obligations. PMID:26424512

  6. Ancillary effects of selected acid deposition control policies

    Moe, R.J.; Lyke, A.J.; Nesse, R.J.

    1986-08-01

    NAPAP is examining a number of potential ways to reduce the precursors (sulfur dioxide and nitrogen oxides) to acid deposition. However, the policies to reduce acid deposition will have other physical, biological and economic effects unrelated to acid deposition. For example, control policies that reduce sulfur dioxide emissions may also increase visibility. The effects of an acid deposition policy that are unrelated to acid deposition are referred to as ''ancillary'' effects. This reserch identifies and characterizes the principle physical and economic ancillary effects associated with acid deposition control and mitigation policies. In this study the ancillary benefits associated with four specific acid deposition policy options were investigated. The four policy options investigated are: (1) flue gas desulfurization, (2) coal blending or switching, (3) reductions in automobile emissions of NO/sub x/, and (4) lake liming. Potential ancillary benefits of each option were identified and characterized. Particular attention was paid to the literature on economic valuation of potential ancillary effects.

  7. Prevalency of major depressive disorder in patients older than 50 hospitalized yearsin a service of internal medicine

    Johana Patricia Mogollón Díaz

    2005-05-01

    Full Text Available The biggest depressive disorder (TDM is moreprevalente of the mental disorders in the general population. Inpatients of consultation external and hospitalized with illnessesdoctors of long evolution, the prevalency is major than in populationgeneral. Target: To determine the prevalency of TDM inhospitalized patients. Method: A transverse study was realizedof prevalency, which it included 100 patients older than 50 yearshospitalized of a service of internal medicine (ME;they were describedvariables sociodemográfi cas and the clinical interview was realizedstructured for disorders of the axis the Ist (SCID-I for diagnosisof TDM and the familiar APGAR to evaluate the grade of function ofthis one. Results: The prevalency of TDM was a 38 %, she wasstrong affiliation with chronic illness, to have more than fourmedical diagnoses, to be used and without partner. Conclusions:The prevalency of TDM in patients hospitalized by ME is highand the presence of illnesses more than four diagnosesdoctors, to be used and without partner collaborates with TDMin hospitalized patients.

  8. Postnatal depression among women availing maternal health services in a rural hospital in South India

    Johnson, Avita Rose; Edwin, Serin; Joachim, Nayanthara; Mathew, Geethu; Ajay, Shwetha; Joseph, Bobby

    2015-01-01

    Background and Objective: Postnatal depression, with an estimated prevalence of 13-19%, causes significant impairment of mental health among women worldwide and has long term consequences. However, more than half of all cases are not detected by healthcare providers. Screening for postnatal depression has not been given importance in maternal health programs in India. Our objective was to screen for postnatal depression among women attending a rural hospital in India, immediately postpartum a...

  9. Developing a Marketing Orientation in Hospital Library Services: A Case Report.

    Delawska-Elliott, Basia; Grinstead, Carrie; Martin, Heather J

    2015-01-01

    When the four Providence Health & Services libraries in Oregon regionalized services and resources, the transition, which was originally met with apprehension from some library users, turned out to be a resounding success. Despite a loss of two-thirds of the professional staff and a decreased budget, the new regionalized library experienced an increase in business and recognition. While many factors contributed to the success, a creative marketing and outreach campaign was a key component. This column describes the steps taken to promote regionalized library reference services and online resources. PMID:26496402

  10. Malignant Neoplasm Burden in Nepal - Data from the Seven Major Cancer Service Hospitals for 2012.

    Pun, Chin Bahadur; Pradhananga, Kishore K; Siwakoti, Bhola; Subedi, Krishna; Moore, Malcolm A

    2015-01-01

    In Nepal, while no population based cancer registry program exists to assess the incidence, prevalence, morbidity and mortality of cancer, at the national level a number of hospital based cancer registries are cooperating to provide relevant data. Seven major cancer diagnosis and treatment hospitals are involved, including the BP Koirala Memorial Cancer hospital, supported by WHO-Nepal since 2003. The present retrospective analysis of cancer patients of all age groups was conducted to assess the frequencies of different types of cancer presenting from January 1st to December 31st 2012. A total of 7,212 cancer cases were registered, the mean age of the patients being 51.9 years. The most prevalent age group in males was 60-64 yrs (13.6%), while in females it was 50-54 yrs (12.8%). The commonest forms of cancer in males were bronchus and lung (17.6%) followed by stomach (7.3%), larynx (5.2%) and non Hodgkins lymphoma (4.5%). In females, cervix uteri (19.1%) and breast (16.3%), were the top ranking cancer sites followed by bronchus and lung (10.2%), ovary (6.1%) and stomach (3.8%). The present data provide an update of the cancer burden in Nepal and highlight the relatively young age of breast and cervical cancer patients. PMID:26745133

  11. Commentary on: "On the Need for a Specialist Service within the Generic Hospital Setting" by Robyn A. Wallace and Helen Beange (2008)

    Kerr, Michael

    2008-01-01

    This commentary discusses whether a sufficient case has been made for specialism in hospital services as a viable alternative to existing generic services. The impact of developments in specialist care such as those outlined by Robyn A. Wallace and Helen Beange should be assessed as a means of reducing inequality. In particular, model services…

  12. Impact of clinical pharmacy services in a short stay unit of a hospital emergency department in Qatar.

    Abdelaziz, Hani; Al Anany, Rasha; Elmalik, Ashraf; Saad, Mohammad; Prabhu, Kirti; Al-Tamimi, Haleema; Salah, Salem Abu; Cameron, Peter

    2016-08-01

    Background The presence of a clinical pharmacist in a hospital's Emergency Department (ED) is important to decrease the potential for medication errors. To our knowledge, no previous studies have been conducted to evaluate the impact of implementing clinical pharmacy services in the ED in Qatar. Objective To characterize the contributions of clinical pharmacists in a short stay unit of ED in order to implement and scale-up the service to all ED areas in the future. Methods A retrospective study conducted for 7 months in the ED of Hamad General Hospital, Qatar. The intervention recommendations were made by clinical pharmacists to the physician in charge during medical rounds. Results A total of 824 documented pharmacist recommendations were analyzed. The interventions included the following: Providing information to the physician (24.4 %) and recommending medication discontinuation (22.0 %), dose adjustment (19.3 %), medication addition (16.0 %), changes in frequency of medications (7.6 %), medication resumption (5.7 %), and patient education (5.0 %). Conclusion Clinical pharmacists in the ED studied play an important role in patient care. PMID:27033505

  13. The impact of service quality perception on patient satisfaction in Government Hospitals in Southern Saudi Arabia

    Alghamdi, Faris S.

    2014-01-01

    ABSTRACT Objectives: To examine the impact of service quality perception on patient satisfaction and determine which dimension from 5 dimensions (tangible, reliability, responsive, assurance, and empathy) has the greatest impact on patient satisfaction. Methods: A total of 183 eligible patients participated in this study. This study was conducted in Al-Baha province, Saudi Arabia from June 2013 to August 2013. We utilized the cross-sectional method, using a modified Assessment of Service Qual...

  14. Seasonal pattern of psychiatry service utilization in a tertiary care hospital

    Singh, Gurvinder Pal; Chavan, B.S.; Arun, Priti; Sidana, Ajeet

    2007-01-01

    Background: Seasonal and monthly variations in utilization of psychiatric services have been inadequately studied in India. Aims: This study sought to determine the pattern of psychiatric services utilization by patients with four broad categories of diagnosis (mood disorders (F30-39): neurotic stress-related and somatoform disorders (F40-48), schizophrenia, schizotypal and delusional disorders (F20-29) and mental and behavioral disorders due to psychoactive substance use (F10-19) in differen...

  15. Characterization of service times and of women with breast cancer who attended in a hospital, 2005-2009

    Susan P. Martínez R

    2012-10-01

    Full Text Available Objectives: to characterize the clinical and sociodemographic profiles of women with breast cancer treated at the Oncology Unit of the Federico Lleras Acosta Hospital in Ibagué, Colombia between 2005 and 2009, and to identify service times. Methodology: a retrospective descriptive study in which 308 records were selected. Variables were collected using an instrument developed by the authors. The statistical analysis was conducted using the SPSS software. Results: the predominant age group was 45 to 64 years old. Additionally, 57.8% of these women were married. Similarly, most of them were from urban areas. The average age of menarche was 13 years. Half of the participants had been pregnant at least 3 times, and most of them were in the postmenopausal stage of their lives. The most frequent histological type was the infiltrating ductal one, as well as stage IIIB. The predominant surgical choices were modified radical mastectomy, pre- and post-operative chemotherapy, and postoperative radiotherapy. As for service times, there were delays in the admission to the oncology unit and treatment initiation. Conclusion: there was a low rate of carcinoma in situ and a high proportion of stage IV carcinoma in comparison to other studies from developed countries. The high rates of abandonment in post treatment follow-up, the shortcomings in case monitoring, and the findings concerning service times suggest the need for institutional corrective measures in order to improve the quality of the healthcare service in breast cancer patients.

  16. The impact of total quality service (TQS) on healthcare and patient satisfaction: an empirical study of Turkish private and public hospitals.

    Bakan, Ismail; Buyukbese, Tuba; Ersahan, Burcu

    2014-01-01

    This paper attempts to measure patients' perceptions of the quality of services in public and private healthcare centers in Turkey. The main aim was to examine the impact of the dimensions of patient-perceived total quality service (TQS) on patients' satisfaction. The research framework and hypotheses are derived from a literature review of service quality and quality in the healthcare industry. The research data were collected through questionnaires and then statistically analyzed using descriptive statistics, Pearson product moment correlation and linear regression. The results suggest that service quality perceptions positively influence patient satisfaction with overall hospital care (SOHC). The most important factors identified in the regression model regarding patient SOHC are the quality of the hospital's social responsibility, administrative processes and overall experience of medical care received. These factors explain 74% of the variance in SOHC. The findings of the study can be used to improve TQS in both private and public hospitals. PMID:23494819

  17. Patient survey (HCAHPS) - Hospital

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  18. Structural Measures - Hospital

    U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for...

  19. Service utilization in community health centers in China: a comparison analysis with local hospitals

    Wang Xiaohang

    2006-08-01

    Full Text Available Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. Methods The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1. Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. Results The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. Conclusion The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.

  20. Threat of mass resignation as a window of opportunity for questioning hospital service production structures in Finland

    Kokkinen L

    2011-07-01

    Full Text Available Lauri Kokkinen1,2, Elina Viitanen11School of Health Sciences, University of Tampere, Tampere, 2Unit of Expertise for Work Organizations, Finnish Institute of Occupational Health, Turku, FinlandBackground: Service production structures of public health care, once established, have proved extremely difficult to change. For this study, we reviewed discussions that took place in management teams at a Finnish central hospital over a period of nine months. The aim of the research was to analyze whether the management team meetings brought forth new and radical alternatives as to how service production could be reorganized. In addition to this, we were also interested in any possible problems that could be solved using these alternative models of service production, and also how preconditions to the application of different alternatives came about and how they eventually concluded.Methods: Our data were derived from 24 management team meetings that took place between August 2007 and May 2008, and were fully videotaped. Data were collected from eight different management teams; the meetings of each were videotaped three times. The management teams reviewed represented three different hierarchical levels, ie, top management, division management, and operational unit management. Data were analyzed according to theory-based content analysis. As a theoretical framework, we utilized Kingdon’s model to enable us to understand why some issues and problems are brought to the agenda of the change process and go on to become concrete policies while others fail to do so.Results: During the study period, a threat of mass resignation of nursing staff caused a considerable change to the agenda of the management team meetings, introducing alternatives with the potential to renew the existing structures of operation in a radical manner.Conclusion: According to our analysis, the threat of mass resignation acted as a window of opportunity, linking the lack of nursing

  1. Dental health service utilization by children seen at the University College Hospital-an update.

    Denloye, O O; Bankole, O O; Onyeaso, C O

    2004-12-01

    Asymptomatic hospital visits have been generally accepted as health behaviour that should be encouraged, although some factors have been identified as factors affecting compliance and attendance. A three years prospective study of the pattern of dental clinic attendance of children seen at the University college Hospital Ibadan was carried out between January 2001-December 2003. A total of 875 children comprising of 421 (48.1%) males and 454 (51.89%) females formed subjects for the study. Results showed that the modal age of presentation was 6-10yers. 88.8% of the children had symptomatic visits while 11.2% had asymptomatic visits and dental caries and its sequel were the frequently diagnosed symptoms. 67.8% of the symptomatic cases required extraction of their badly broken down teeth due to their late presentations at the clinic. Over 80% of the children with asymptomatic visits required only oral prophylaxis. In conclusion, an early age at presentation and asymptomatic visits are health behaviours that should be encouraged through regular dental health education to parents especially mothers. PMID:15853275

  2. Profile of motorcycle victims from the emergency service of a university hospital

    José Luís Amim Zabeu

    2013-06-01

    Full Text Available OBJECTIVE: Epidemiological survey of motorcycle accidents occurring in a city with over one million inhabitants and treated at university hospital of reference between the months of July and November 2010. METHODS: Cross sectional study using structured interview (standardized form to document the data collection: age, gender, income, using time and capacity of the motorcycle. RESULTS: From 114 cases, it was observed that the profile of the victim of motorcycle accident treated at this hospital is a young person, male, possessing a driver's license for less than five years, with a monthly income average around one thousand reais (local currency, owner of a motorcycle with low capacity (less than 150 cc and low educational attainment. The accidents occurred predominantly in the urban area, in the afternoons and one third of them were considered work-related accidents, death generated in 3 per cent of cases and open fractures in 11 per cent of them. CONCLUSION: The incidence of motorcycle accidents involved mainly young men with little experience in traffic and low level of education.

  3. Hospital Inspections

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  4. Hospital Hints

    ... and your family. They can help find homecare, rehabilitation, social services, long-term care, and support groups. Inside the Hospital Hospitals have many patient-care areas. For example, the intensive care unit (also called the ICU) has special equipment and staff to care for ...

  5. 26 CFR 1.513-6 - Certain hospital services not unrelated trade or business.

    2010-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Taxation of Business Income of Certain Exempt... and a reasonable rate of return on the capital goods used to provide the service. For purposes of this section, a rate of return on capital goods will be considered reasonable provided that it does not...

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

    South Seattle Community Coll., Washington.

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

  7. 医院医德医风窗口评价系统%Hospital Medical Ethics Windows Service Evaluation System

    王亚军

    2014-01-01

    目的:践行以病人为中心的服务理念,构建一套易行、可行、科学、客观、公正的评价体系,以提高医院为患服务质量.方法:以军卫一号平台及HIS数据库为基础,应用JAVA、Eclipse技术进行系统搭建.结果:系统上线运行30个月以来,起到了很好的监管作用,我院患者综合满意度提升了4.35%.结论:本系统有助于提升医务人员为患服务意识,有助于提升医院的社会、公益形象,有助于缓解日益突出的医患矛盾,构建和谐医患关系,有较高的推广普及价值.%The object of our work is to fulfil the philosophy that patients are the core of the service and construct a practical, feasible, scientific, objective and fair valuation system so as to improve the service quality of hospital. The methods we use in this paper are based on the military healthy No.1 platform and HIS database and systematically supported by JAVA and Eclipse technology. The system has been being operated for 30 months, during this interval. It has a great performance on the supervisor function which made the patients comprehensive stasfication degree increase 4.35%. This system facilitate the service awareness of medical service pesonel, the improvement of public and social images and the alleviation of gradually increasing contradicts between medical service and patients, which builds a harmonious relationship between hospital and patierntes and has a higher value that needs to be promoted.

  8. Evaluating patients’ perception of service quality at hospitals in nine Chinese cities by use of the ServQual scale

    Min; Li; Douglas; Bruce; Lowrie; Cheng-Yu; Huang; Xiang-Chan; Lu; Ying-Chu; Zhu; Xing-Hua; Wu; Mayila; Shayiti; Qiong-Zhen; Tan; Hua-Ling; Yang; Si-Yuan; Chen; Pan; Zhao; Sheng-Hua; He; Xiu-Rong; Wang; Hong-Zhou; Lu

    2015-01-01

    Objective: To investigate patients’ perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach’s α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.

  9. A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service

    Crespo de Carvalho J

    2013-12-01

    Full Text Available José Crespo de Carvalho,1 Madalena Ramos,1 Carina Paixão2 1Business School, University Institute of Lisbon, Lisbon, Portugal; 2Instituto Português de Oncologia, Lisbon, Portugal Abstract: Lean practices and thinking have increased substantially in the last few years. Applications of lean practices to health care are found worldwide. Despite that, new contributions are required because the application of lean thinking to hospitals has a long way to go. Lean practices and thinking do not include, in the literature or practice programs, any references to triage systems in health care units. The common triage systems require physical presence, but there are alternative methods to avoid the need to move patients: these alternative triage systems, given their characteristics, may be included in the spectrum of lean practices. Currently, patients that are already known to suffer from cancer are encouraged to go to hospital (public or private, with an oncological focus when facing side effects from chemotherapy or radiation treatments; they are then submitted to a triage system (present themselves to the hospital for examination. The authors of this paper propose the introduction of telephone or email triage for impaired patients as a valid substitute for moving them physically, thereby often avoiding several unnecessary moves. This approach has, in fact, characteristics similar to a lean practice in that it reduces costs and maintains, if done properly, the overall service offered. The proposed 'remote' triage emerged from the results of a large survey sent to patients and also as the outcome of a set of semistructured interviews conducted with hospital nurses. With the results they obtained, the authors felt comfortable proposing this approach both to public and private hospitals, because the study was conducted in the most important, largest, and best-known oncological unit in Spain. As a final result, the health care unit studied is now taking

  10. Afraid of Delivering at the Hospital or Afraid of Delivering at Home: A Qualitative Study of Thai Hmong Families' Decision-Making About Maternity Services.

    Culhane-Pera, Kathleen A; Sriphetcharawut, Sarinya; Thawsirichuchai, Rasamee; Yangyuenkun, Wirachon; Kunstadter, Peter

    2015-11-01

    Thailand has high rates of maternity services; both antenatal care (ANC) and hospital delivery are widely used by its citizens. A recent Northern Thailand survey showed that Hmong women used maternity services at lower rates. Our objectives were to identify Hmong families' socio-cultural reasons for using and not using maternity services, and suggest ways to improve Hmong women's use of maternity services. In one Hmong village, we classified all 98 pregnancies in the previous 5 years into four categories: no ANC/home birth, ANC/home, no ANC/hospital, ANC/hospital. We conducted life-history case studies of 4 women from each category plus their 12 husbands, and 17 elders. We used grounded theory to guide qualitative analysis. Families not using maternity services considered pregnancy a normal process that only needed traditional home support. In addition, they disliked institutional processes that interfered with cultural birth practices, distrusted discriminatory personnel, and detested invasive, involuntary hospital procedures. Families using services perceived physical needs or potential delivery risks that could benefit from obstetrical assistance not available at home. While they disliked aspects of hospital births, they tolerated these conditions for access to obstetrical care they might need. Families also considered cost, travel distance, and time as structural issues. The families ultimately balanced their fear of delivering at home with their fear of delivering at the hospital. Providing health education about pregnancy risks, and changing healthcare practices to accommodate Hmong people's desires for culturally-appropriate family-centered care, which are consistent with evidence-based obstetrics, might improve Hmong women's use of maternity services. PMID:26138321

  11. Evaluation and appraisal of drug information services in a rural secondary level care hospital, Anantapur, AP

    Rohit Bhavsar

    2012-01-01

    Full Text Available Background: Drug Information Center (DIC is an information center which provides drug information (DI to healthcare professionals. The aim was to evaluate the performance of DIC for improving the quality and quantity of information services provided to the healthcare professionals. The service was provided free of cost to the customers. Materials and Methods: This descriptive study was conducted for the period of 6 months from February to August 2011 excluding May due to vacation. Customers were asked: how did they find the service provided to them? Was it good, satisfactory, or need improvement? There were written feedback forms to be filled by the customers, including customer satisfaction questions. The official publication of the DIC, RIPER PDIC Bulletin was screened for its types of articles/number of drug news published. The bulletin is circulated for free to the healthcare professionals electronically. Results and Discussion: A total of 232 queries were obtained during the study period of 6 months. Average number of queried received to the DIC was 39 per month. Most preferred mode of queries was personal access (89%. Majority of queries were received from nurses, i.e., 162 (70% queries and 81% of all queries were drug oriented for improving knowledge. There were only 19% of the queries for individual patients; doctors asked most of those queries. Only 3% queries answered were rated as need improvement by the healthcare professionals. Rest were considered as either Good (56% or satisfactory (49%. Range of drug news published in each bulletin was 3-4 and most of the other articles include expert opinion to improve practice or training. Conclusion: The DI services were satisfactorily used for academic interests. Nurses used the service for the highest compared to other health care professionals. Future studies should plan to establish the usefulness of DI to improve healthcare practice.

  12. Development of Clinical Pharmacy services at King Khalid University Hospital and its impact on the quality of healthcare provided.

    Saddique, Abdulaziz A

    2012-07-01

    Clinical Pharmacy is a unique service provided by the leading pharmacy departments in the United States. The concept of Clinical Pharmacy evolved after the significant increase in number of pharmaceuticals in the market and the increasing potential of drug interactions. However, the Clinical Pharmacist is not merely an individual who advises on drug interactions. There are a number of functions which include but are not limited to; the design of appropriate drug therapy, such as Pharmacokinetic assessment and evaluation to optimize drug therapy, drug information dissemination to the physicians and other healthcare providers and participation as a toxicology consultant in Poison management. At the King Khalid University Hospital (KKUH) the first Clinical Pharmacy services program began in 1983. The aim of this study is to evaluate the impact of our Clinical Pharmacy program on the patients' care as well as its perception by the Medical staff that came from different parts of the world. Our Clinical Pharmacists were asked to record any suggestions or interventions in the form. The forms were all collected at the end of each day and entered into a database for analysis. Each intervention was analyzed in order to assess the merit of the action in terms of the therapeutic, financial and direct cost impact. The study showed a positive impact on the patients' care as well as on the economy of the drugs prescribed. Meanwhile, the service was very much appreciated by the Medical staff as well as other healthcare providers. PMID:23960800

  13. Teams and working conditions in mobile pre-hospital care services: an integrative review

    Daiane Dal Pai

    2015-12-01

    Full Text Available Study to identify, analyze and summarize the findings available in the literature on the composition of teams and working conditions in Mobile  Pre-Hospital Care Services  (PHC.  Integrative review to search the Base  de Dados  de  Enfermagem [Nursing Database] (BDEnf, the Cumulative  Index  to  Nursing  and  Allied  Health  Literature (CINAHL,  the Latin American and Caribbean Health Sciences Literature (LILACS, PubMed,  SCOPUS,  Web  of  Science and the portal of journals from the Scientific  Electronic  Library Online  (SciELO. Eighteen articles met the inclusion criteria and were selected. The composition of the teams for PHC services is diversified on the international stage, with the increase in responsibilities assumed by paramedics and the benefits of the specialized nurse's and doctor's presence in the teams being portrayed, which are scarce in some countries.  Working conditions reveal risky places of work, intense psychological demands, work overload, dissatisfaction and inadequate resources in most services.

  14. Radiation dose in patients submitted to X-ray diagnostic exams at an emergency Hospital Service

    Radiographic exams for diagnostic of patients under emergence attendance situations in a hospital are done with many radiographic parameters as established by the divergence in the biotypes of patients and equipements. The lack of standarization of the esposure parameters (radiation field size, skin-focus distance, tube potential, charge mAs, etc.) and the x-ray equipement parameters (total filtration and the target angle) may cause large variations in the radiation doses of the exposed patients. Aiming to determine the organ absorbed doses in such patients, two approaches were adopted in this work. The absorbed dose variations in the some organs were estimated with the PCXMC computational software by simulating exposure conditions that are adopted by X-ray operators. Additionally, physical dosimetry with thermoluminescent detectors in the Alderson-Rando phantom was done. Results showeb that there is space for reducing absorbed doses to patients without any prejudice to the image of the diagnostic exam. (author)

  15. Radiation dose in patients submitted to x-ray diagnostic exams at an emergency hospital service

    Radiographic exams for diagnostic of patients under emergence attendance situations in a hospital are done with many radiographic parameters as established by the divergence in the biotypes of patients and equipments. The lack of standardization in the exposure parameters (radiation field size, focus-skin distance, tube potential and current-time product) and in the x-ray equipment parameters (total filtration and the target angle) may cause large variations in the radiation doses of the exposed patients. With the aim to determine the organ absorbed doses in such patients, two approaches were adopted in this work. The absorbed dose variations in some organs were estimated with the PCXMC computational software by simulating exposure conditions that are adopted by x-ray operators. Additionally, physical dosimetry with thermoluminescent detectors in the Alderson-Rando phantom was done. Results showed that there is space for reducing absorbed doses to patients without any prejudice to the image quality of the diagnostic exam. (author)

  16. The effects of socioeconomic status, accessibility to services and patient type on hospital use in Western Australia: a retrospective cohort study of patients with homogenous health status

    Holman C D'Arcy J; Moorin Rachael E

    2006-01-01

    Abstract Background This study aimed to investigate groups of patients with a relatively homogenous health status to evaluate the degree to which use of the Australian hospital system is affected by socio-economic status, locational accessibility to services and patient payment classification. Method Records of all deaths occurring in Western Australia from 1997 to 2000 inclusive were extracted from the WA mortality register and linked to records from the hospital morbidity data system (HMDS)...

  17. Has increased nursing competence in the ambulance services impacted on pre-hospital assessment and interventions in severe traumatic brain-injured patients?

    Falk, Ann-Charlotte; Alm, Annika; Lindström, Veronica

    2014-01-01

    Objective Trauma is one of the most common causes of morbidity and mortality in modern society, and traumatic brain injuries (TBI) are the single leading cause of mortality among young adults. Pre-hospital acute care management has developed during recent years and guidelines have shown positive effects on the pre-hospital treatment and outcome for patients with severe traumatic brain injury. However, reports of impacts on improved nursing competence in the ambulance services are scarce. Ther...

  18. The Discuss of Improvement the Utilization Rate of Hospital Self-service%提高医院自助服务使用率的探讨

    蔡伟丰

    2013-01-01

    目的:探讨提高自助服务在医院的使用。方法分析自助服务存在的一些问题,介绍改善自助服务的应对措施。结果采取应对措施提高了自助服务利用率,提高了医院服务水平。结论自助服务利用率的提高显著提高医院服务水平,当前提供的自助服务仍然有很多需要改善的地方。%Objective Discussion of improvement of utilization rate of hospital self-service. MethodsAnalysis of some problems of self-service,introduce measures to improve self-service. ResultsThe adoption of countermeasures to improve the utilization rate of self-service raise the level of the hospital services. ConclusionsThe utilization ratio of self-service improve service levels, there are stil many places need improvement in the hospital currently provide self-service.

  19. 77 FR 25105 - Reporting of Ancillary Airline Passenger Revenues

    2012-04-27

    ... wheelchairs and scooters used by passengers with disabilities. See 76 FR 41726. You may review comments to... Office of the Secretary 14 CFR Parts 234 and 241 RIN 2139-AA13 Reporting of Ancillary Airline Passenger... (NPRM) issued on July 15, 2011. The NPRM proposed changes regarding reporting of airline...

  20. Research on Innovation Service of Hospital Information:Taking Shandong Jiaotong Hospital as an Example%医院信息化创新服务研究——以山东省交通医院为例

    曹琨

    2012-01-01

    以山东省交通医院为例,结合国内医院信息化的发展及现状,介绍了该院整合现有资源,信息化创新服务的思路和实施情况.并针对信息化创新服务提出了策略.%Taking Shandong Jiaotong Hospital as an example, the article analyzes how this Hospital integrates existing resources and promotes its services with informatization, combined with the development and status quo of the informatization within domestic hospitals. This article puts forward strategies in information-based services as well.

  1. Service utilization in community health centers in China: a comparison analysis with local hospitals

    Wang Xiaohang; Dib Hassan H; Pan Xilong; Zhang Hong

    2006-01-01

    Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs) have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to ide...

  2. [A new scale for the assessment of the quality of hospitality services].

    Varela Mallou, Jesús; Prat Santaolària, Remei; Voces López, Carmen; Rial Boubeta, Antonio

    2006-02-01

    In the last 20 years the services sector has experienced a highly significant growth, being currently one of the most important economic sectors in our country. Inside the touristic sector, a strong competence has being experienced among the lodging and restoration establishments. In a scenario characterized by competitiveness, the bet for quality represents a difficult competitive advantage to surpass (García-Buedes, 2001). The objective of this study is to carry out an approach to the evaluation of the perceived quality of the restaurants. As a result of bibliographic revision, and also a first approach of a qualitative nature, we started from a scale of 31 items that included 5 dimensions: access, personal, service, product and installations. The results obtained applying the questionnaire to more than 2400 clients of 180 establishments of Santiago de Compostela and region, by means of structured interviews, confirmed that not all these dimensions had the same importance as predictors of customer satisfaction. Specifically, the product emerges as the most important dimension. Likewise, the elimination of the dimension service and a more exhaustive selection of the items, based on psychometric criteria, has permitted to define a brief scale, consisting of only 15 items, which makes it very attractive as a management tool. The final scale proposed to evaluate the perceived quality in the restaurant sector includes four fundamental and non-independent dimensions. These are, ordered by importance: product, personal, installations and access. PMID:17296022

  3. Characterization of mammographic findings radiological studies, in radiology service Hospital Doctor Rafael Angel Calderon Guardia during the year 2012

    The radiological findings are determined in reading mammography studies between the months of May and June 2012 in the radiology service of Hospital Calderon Guardia. The association of pathologies is determined between breast pathology, age group and sex. A control allowing identification of geographic areas with higher reference is established for realization of mammograms. The pathologies resulting from the reading of mammographic studies are quantified and classified. The patients have presented 42% of risk factors with the potential predisposition to develop breast cancer. Mammography applications have been coming in 22% of Montes de Oca EBAIS and Curridabat, being presented in most lesions in women between 45 and 74 years old. Mammograms analyzed are classified as BIRADS 2 and to a lesser extent as BIRADS 0

  4. Modelos de serviços hospitalares para casos agudos em idosos Hospital services for acute care of elderly people

    João Macedo Coelho Filho

    2000-12-01

    patients in the hospital setting. The objective was to review some models of acute hospital care for elderly people, focusing on the role of geriatric medicine and its relationship with other specialities. Medline database (1989-1999, textbooks of geriatrics and gerontology, and other health publications were consulted in an attempt to identify all relevant publications about hospital services providing acute care to elderly people. The features of each model were compiled and discussed taking into account their suitability to the Brazilian health system. Some examples of interventions, with their effectiveness demonstrated by systematic reviews, were also mentioned. The models more frequently described were: long-time traditional, age-defined, unspecialized and integrated care. Variants of such models were frequently reported. There is no evidence pointing to one as the best model, but models favoring the integration of geriatrics with general medicine seemed to be particularly suitable to the Brazilian setting. With the aging of the population, there is a need to restructure the health services to face the increasing demands of elderly people. Given that the design of hospital services is an important factor for the effectiveness of geriatric care, this issue should be studied as priority in Brazil.

  5. A Model for Provision of ENT Health Care Service at Primary and Secondary Hospital Level in a Developing Country

    Lingamdenne Paul Emerson

    2013-01-01

    Full Text Available ENT problems are the most common reason for a visit to a doctor in both rural and urban communities. In many developing countries, there is a lack of ENT specialists and overburdened hospital facilities. To date, there is no comprehensive study that has evaluated the spectrum of ENT disorders in a rural community. Methods. A prospective study was done for a period of three years to profile the cases presenting to the outpatient clinic in a secondary care hospital and in the camps conducted in tribal areas in Vellore District of Tamil Nadu, India. Trained community volunteers were used to identify ENT conditions and refer patients. Results. A total of 2600 patients were evaluated and treated. Otological symptoms were the most commonly reported with allergic rhinitis being the second most commonly reported. Presbycusis was the most common disability reported in the rural community. The other symptoms presented are largely related to hygiene and nutrition. Conclusion. Using trained community workers to spread the message of safe ENT practices, rehabilitation of hearing loss through provision of hearing aids, and the evaluation and surgical management by ENT specialist helped the rural community to access the service.

  6. Survey of patient satisfaction with the Breastfeeding Education and Support Services of The Royal Women's Hospital, Melbourne

    Amir Lisa H

    2008-04-01

    Full Text Available Abstract Background The Breastfeeding Education and Support Services (BESS is a unit of The Royal Women's Hospital in Melbourne, Australia, staffed by International Board Certified Lactation Consultants (IBCLCs, providing day/short-stay and an outpatient clinic for mothers and infants with breastfeeding problems. It is important to measure women's experience of visiting the service as part of quality assurance. The aim of this project was to conduct an anonymous postal survey of clients' satisfaction with BESS. Methods An anonymous survey was posted on 16 November 2005 and again on 31 January 2006, to all women who had attended BESS in September 2005. Results The response rate was 60.5% (78/129. Eighty percent (62/78 of respondents attended day-stay, 33% (26/78 attended short-stay and 15% (12/78 attended the outpatient clinic. The percentage of women who responded "strongly agree" to the statement "Overall, I am satisfied with the services" was 49% (35/72 and 50% (6/12 for those who went to day/short-stay and the outpatient clinic respectively. Overall, 56% of all respondents responded that the quality of BESS was "better than expected". The most common breastfeeding problem reported was difficulty attaching the baby to the breast, followed by nipple damage, low milk supply and painful feeding. Conclusion BESS seems to have provided a satisfactory service to most clients. Most respondents were clearly satisfied with the support given by the IBCLCs and have also responded that the staff were professional and knowledgeable in their field of work.

  7. Assessment of hepatitis B vaccination status in doctors of Services hospital, Lahore

    Background: Hepatitis B is the most common serious infection of the liver and can lead to premature death from liver cancer or liver failure. Of the two billion people who have been infected with Hepatitis B virus, more than 350 million have chronic infection. The objectives of this study were to assess the Hepatitis B vaccination status, reasons for non-compliance and the risk of exposure to doctors at a tertiary care hospital. Methods: Three hundred and twenty-two doctors were selected from the various departments of the hospital by simple random sampling. They were given a self-administered questionnaire after taking verbal consent. Some doctors refused to fill-in the questionnaire while some others were on leave during the time of study and the remaining 215 doctors responded to the questionnaire. Results: A total of 215 doctors, (age range 22-59 years) responded to the questionnaire. Amongst them 11.6% had not received even a single dose of Hepatitis B vaccine while 14.4% had not completed the required course of vaccination. Most common reason cited by doctors for non immunisation was that they had not thought about it. Consultants were more likely of the other doctors to have received completed vaccination (83.9% versus 69.9%) (p<0.05). They were also significantly more likely to know their antibody titre after completing vaccination. Needle stick injuries were common. One hundred and forty-five doctors in the study admitted having received at least one needle prick/sharp injury. Of them, 51.6% had received a needle prick/sharp injury more than once. Conclusion: Despite the availability of an effective vaccine in the market doctors continue to remain non-vaccinated. It is the lack of awareness and carelessness on part of doctors coupled with the negligence of the risk that has led them being incompletely vaccinated. There is a need to ensure that every doctor is completely vaccinated against Hepatitis B before he/she enters professional practice. (author)

  8. Development of a Music Therapy Service in an Australian Public Rehabilitation Hospital

    Jeanette Tamplin

    2006-03-01

    Full Text Available It is often challenging to find information about the details and development of clinical music therapy programs in other parts of the world. This article addresses a gap in the literature by describing the evolution of a neurological rehabilitation program over the past two years in Melbourne, Australia. After providing some local details on the development of rehabilitation music therapy in this part of the world, a brief rationale is offered for the place of music therapy in clinical rehabilitation services. This is followed by a detailed description of the implementation, operation and evaluation of the music therapy program established at the Royal Talbot Rehabilitation Centre in 2004. Music therapy in adult neurological rehabilitation is still an emerging area of practice in Australia. Although the first music therapy service for adult rehabilitation was piloted and developed here over 13 years ago, few rehabilitation facilities currently employ music therapy as a standard part of rehabilitation service. Although research and practice of music therapy in rehabilitation internationally is relatively new, it has been practiced for around 20 to 30 years in the United Kingdom and the United States of America respectively. The scarcity of music therapy positions in rehabilitation facilities in Australia is possibly a reflection of the lack of understanding of music therapy on the part of funding bodies and the shortage of rigorous music therapy research in this field. The establishment of new music therapy positions in rehabilitation facilities reflects the development of music therapy in neurorehabilitation internationally in terms of research, clinical practice and publications.

  9. Quality Service Analysis and Improvement of Pharmacy Unit of XYZ Hospital Using Value Stream Analysis Methodology

    Jonny; Nasution, Januar

    2013-06-01

    Value stream mapping is a tool which is needed to let the business leader of XYZ Hospital to see what is actually happening in its business process that have caused longer lead time for self-produced medicines in its pharmacy unit. This problem has triggered many complaints filed by patients. After deploying this tool, the team has come up with the fact that in processing the medicine, pharmacy unit does not have any storage and capsule packing tool and this condition has caused many wasting times in its process. Therefore, the team has proposed to the business leader to procure the required tools in order to shorten its process. This research has resulted in shortened lead time from 45 minutes to 30 minutes as required by the government through Indonesian health ministry with increased %VA (valued added activity) or Process Cycle Efficiency (PCE) from 66% to 68% (considered lean because it is upper than required 30%). This result has proved that the process effectiveness has been increase by the improvement.

  10. Quality Service Analysis and Improvement of Pharmacy Unit of XYZ Hospital Using Value Stream Analysis Methodology

    Value stream mapping is a tool which is needed to let the business leader of XYZ Hospital to see what is actually happening in its business process that have caused longer lead time for self-produced medicines in its pharmacy unit. This problem has triggered many complaints filed by patients. After deploying this tool, the team has come up with the fact that in processing the medicine, pharmacy unit does not have any storage and capsule packing tool and this condition has caused many wasting times in its process. Therefore, the team has proposed to the business leader to procure the required tools in order to shorten its process. This research has resulted in shortened lead time from 45 minutes to 30 minutes as required by the government through Indonesian health ministry with increased %VA (valued added activity) or Process Cycle Efficiency (PCE) from 66% to 68% (considered lean because it is upper than required 30%). This result has proved that the process effectiveness has been increase by the improvement.

  11. Satisfaction survey on the critical care response team services in a teaching hospital

    Saad Al Qahtani

    2011-03-01

    Full Text Available Saad Al Qahtani1,21Intensive Care Department, Critical Care Response Team, King Abdulaziz Medical City (KAMC, National Guard Health Affairs, 2King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi ArabiaIntroduction: Patient care and safety is the main goal and mission of any health care provider. We surveyed nurses in the wards and obtained their feedback about the quality of care delivered by the Critical Care Response Team (CCRT.Methods: Our hospital has 900 beds. A self-administered survey was given onsite to all ward nurses. Survey items were identified, discussed, reviewed, piloted, and finalized over a 3-month period in a focus group discussion format during three CCRT core group meetings. Responses were anonymous and collected by the nurses onsite.Results: The total number of returned and analyzed surveys was 274 (98.6%. Ninety-seven percent agreed that CCRT staff arrived in a timely manner. Ninety-four percent reported that CCRT staff helped in managing sick patients and ~70% reported that it strengthened team dynamics. Only 50% of the nurses felt CCRT staff improved competence at the bedside. The overall satisfaction was 100%; none of the nurses were dissatisfied with the team.Conclusion: The CCRT helped manage sick patients in the wards. However, CRRT staff should remember to involve and communicate with the team initiator and the patient’s physician to optimize patient health care.Keywords: rapid response team, medical emergency team, critical care response team, satisfaction

  12. Serviço de Emergência Psiquiátrica em hospital geral: estudo retrospectivo Servicio de emergencia psiquiátrica en hospital general: estudio retrospectivo Emergency psychiatric service in general hospitals: a retrospective study

    Fernando Sérgio Pereira de Sousa

    2010-09-01

    SEPHG, 43,45% de tales pacientes fueron derivados al CAPS-ad. Se desprende de los resultados cuán imprescindibles son los servicios de salud mental.The Emergency Psychiatric Service in General Hospitals (SEPHG, acronym in Portuguese is a service included in the psychiatric reform movement. The purpose of the present study was to characterize patients with psychological distress treated at the Dr. Estevam SEPHG, located in Sobral, Ceará state. This exploratory study was performed using documental analyses with a quantitative approach, and involved 191 clients treated at the referred SEPHG from January to December 2007. Data collection was performed using a client register book, which contained information obtained from the patients' medical record. There was a predominance of male patients (70.15%, aged 30-49 years (48.71% and single (74.86%. Most patients were from the city of Sobral (69.64%. In 42.40% of cases, the diagnosis was of alcohol use/abuse. Most clients (66.50% sought the service voluntarily. After being evaluated at the SEPHG, 43.45% of patients were referred to the local Center for Psychosocial Care -Alcohol and other Drugs. The results emphasize the importance of mental health.

  13. Hospital Outpatient PPS Partial Hospitalization Program LDS

    U.S. Department of Health & Human ServicesHospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  14. Community pharmaceutical service in our hospital%我院开展社区药学服务初探

    周祖萍

    2013-01-01

    目的 探讨如何利用三甲医院资源优势开展社区药学服务.方法 介绍4个试验小区开展多种形式的药学服务,针对不同人群开展合理用药和药品不良反应知识讲座;讲解假药、劣药的识别,药品名称、剂型、规格的识别,药品的储藏保管;讲解药物与食物的关系,饮食与健康的关系;对社区高血压居民实行健康教育,提高服药依从性;充分利用网络、通讯工具为居民服务.结果 通过开展多种形式的社区药学服务,增加了社区居民对药物不良反应及合理用药的认识,提高了社区居民服药的依从性,缓解了医患关系并为医院创造了经济效益.结论 医院药学人员利用其自身优势,开展社区药学服务,服务于患者,服务于广大社区居民,既可提升药师在公共健康中的作用,又能满足日益提高的公众健康需求,是医改形势发展的必然结果.%Objective To make use of hospital resources in community pharmaceutical care. Methods We introduced 4 experimental plots to carry out various pharmacy services: lectures on rational use of drugs and adverse drug reactions for different groups of people, recognition of counterfeit and inferior drugs, identification of drug name, dosage form and specifications, drug storage, differentiation of food and medicine, relation between diet and health; health education, improving medication compliance, and making full use of network, communication tools, and services for the residents. Results Through various community pharmacy services, residents in communities increased their awareness of adverse drug reactions and rational drug use, with improved compliance and economic benefits for the hospital. Conclusion Pharmacy staff in hospitals should make use of their advantages to carry out community pharmacy services, which can enhance pharmacists' role in the public health, and satisfy the increasing demand for public health.

  15. A mixed-methods approach to conducting Internal Revenue Service-compliant community health needs assessments: a case example for nonprofit hospital leaders

    Oglesby WH

    2014-10-01

    Full Text Available Willie H Oglesby, Ken Slenkovich Department of Health Policy and Management, College of Public Health, Kent State University, Kent, OH, USA Background: The Patient Protection and Affordable Care Act created new requirements for nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA at least once every 3 years, with a significant tax penalty for noncompliance. While some resources exist to help nonprofit hospital leaders conduct various aspects of a CHNA, few reflect the new Internal Revenue Service requirements. Methods: Many different models of CHNAs have emerged over the years. Although each has its unique features, the essential elements of a CHNA include engaging stakeholders, defining the community, gathering sufficient representative data, prioritizing information, and reporting results. In this paper, we expand upon this basic approach by offering a practical step-by-step guide to conducting CHNAs that meets new Internal Revenue Service regulations. Results: We developed and tested this methodology in partnership with several nonprofit hospital systems in Northeast Ohio, USA. In this paper, we discuss our use of the methodology and identify recommendations for other nonprofit hospital leaders. Conclusion: The methodology presented in this paper is a cost-effective approach to satisfying new CHNA requirements and nonprofit hospital leaders should consider using it or modifying it to fit their unique needs. Keywords: Affordable Care Act, CHNA, community benefit, community hospital

  16. Immediate impact of 'penalty points legislation' on acute hospital trauma services.

    Lenehan, Brian

    2012-02-03

    Road traffic accident (RTA) related mortality and injury may be reduced by up to 40% with the introduction of \\'road safety\\' legislation. Little is known regarding changes in pattern of injury and overall resource impact on acute trauma services. This prospective study examines RTA related admissions, injuries sustained and resultant sub-speciality operative workload in a Level 1 Trauma Centre during the 12 months immediately prior to and following the introduction of \\'penalty points\\' legislation. Eight hundred and twenty RTA related admissions were identified over the 24-month period from 01\\/11\\/2001 to 31\\/10\\/2003. There was a 36.7% decrease in RTA related admissions subsequent to the introduction of new legislation. Bed occupancy was almost halved. However, the relative Orthopaedic workload increased from 34% to 41% with a 10% increase in relative bed occupancy. The pattern of orthopaedic injury was significantly altered with a >50% absolute reduction in high velocity injuries. Curiously, there was no change in the absolute number of spinal fractures seen. This favourable early Irish experience of \\'penalty points\\' legislation mirrors that of worldwide published literature. Our findings demonstrate that the injury reduction effects were primarily enjoyed by non-orthopaedic sub-specialities. Such findings mandate consideration when allocating vital resources to sub-specialities within busy trauma units.

  17. Urban women's socioeconomic status, health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey

    Ciliska Donna

    2008-10-01

    Full Text Available Abstract Background Postpartum women who experience socioeconomic disadvantage are at higher risk for poor health outcomes than more advantaged postpartum women, and may benefit from access to community based postpartum health services. This study examined socioeconomically disadvantaged (SED postpartum women's health, and health service needs and utilization patterns in the first four weeks post hospital discharge, and compared them to more socioeconomically advantaged (SEA postpartum women's health, health service needs and utilization patterns. Methods Data collected as part of a large Ontario cross-sectional mother-infant survey were analyzed. Women (N = 1000 who had uncomplicated vaginal births of single 'at-term' infants at four hospitals in two large southern Ontario, Canada cities were stratified into SED and SEA groups based on income, social support and a universally administered hospital postpartum risk screen. Participants completed a self-administered questionnaire before hospital discharge and a telephone interview four weeks after discharge. Main outcome measures were self-reported health status, symptoms of postpartum depression, postpartum service needs and health service use. Results When compared to the SEA women, the SED women were more likely to be discharged from hospital within the first 24 hours after giving birth [OR 1.49, 95% CI (1.01–2.18], less likely to report very good or excellent health [OR 0.48, 95% CI (0.35–0.67], and had higher rates of symptoms of postpartum depression [OR 2.7, 95% CI(1.64–4.4]. No differences were found between groups in relation to self reported need for and ability to access services for physical and mental health needs, or in use of physicians, walk-in clinics and emergency departments. The SED group were more likely to accept public health nurse home visits [OR 2.24, 95% CI(1.47–3.40]. Conclusion Although SED women experienced poorer mental and overall health they reported similar

  18. Design the organizational model for the creation of a radiation protection service in hospitals Rafael Angel Calderon Guardia, San Juan de Dios and Mexico

    The search for new ways to protect occupationally exposed population, external users and the environment has been the need to optimize all aspects of radiation protection, to prevent incidents or accidents, by the use of ionizing radiation. Proposal consists in carrying out field work to be involving staff who work with ionizing radiation in the areas of diagnostic radiology, radiotherapy and nuclear medicine in hospitals Rafael Angel Calderon Guardia, Hospital Mexico and Hospital San Juan de Dios. The collected data were coded and analyzed for a situational diagnosis of radiation protection. The results have led to the proposal of the Design of an Organizational Model for Radiological Protection Service to the hospitals included in the investigation. (author)

  19. An ancillary pumping system for the APS vacuum system

    Walters, D.; Noonan, J.; Gagliano, J. [and others

    1997-06-01

    An ancillary pumping system has been designed and installed in the Advanced Photon Source (APS) storage ring. This vacuum system has the ability to pump sectors of the storage ring down from room pressure to ultra-high vacuum (UHV). The ancillary system is a {open_quotes}dry{close_quotes} system that uses a combination of turbomolecular pumps and oil-free roughing pumps. The benefits of this system are the reduction of equipment needed for in-tunnel maintenance, essential for the operation of a UHV storage ring; rapid response to vacuum emergencies and a guard to accidental exposures to hydrocarbon contamination. The operational logic and the pump interlock and controls are described.

  20. Assessment of Sleep Quality and Effects of Relaxation Exercise on Sleep Quality in Patients Hospitalized in Internal Medicine Services in a University Hospital: The Effect of Relaxation Exercises in Patients Hospitalized.

    Alparslan, Güler Balci; Orsal, Özlem; Unsal, Alaettin

    2016-01-01

    This study aims to assess sleep quality and determine the effects of relaxation exercise on sleep quality in patients hospitalized in internal medicine services. In total, 47 patients comprised the control group and did not engage in the exercise intervention-the progressive muscle relaxation exercise, whereas 235 patients were assigned to the intervention group (N = 282). In this study, Description Questionnaire Form and the Pittsburg Sleep Quality Index (PSQI) were used. Most patients (73.8%) had poor sleep quality. The mean pre- and postexercise PSQI scores of the patients in the interventional group were 8.7 ± 4.0 and 6.1 ± 3.3, respectively. The mean pre- and postexercise PSQI scores of the control patients were 6.6 ± 3.5 and 5.6 ± 2.7, respectively. According to this study, the exercises significantly enhanced the quality of sleep. Patients should be encouraged by nurses to perform relaxation exercises. PMID:27078810

  1. Quantum Correlations Reduce Classical Correlations with Ancillary Systems

    LUO Shun-Long; LI Nan

    2010-01-01

    @@ We illustrate the dichotomy of classical/quantum correlations by virtue of monogamy.More precisely,we show that correlations in a bipartite state are classical if and only if each party of the state can be perfectly correlated with other ancillary systems.In particular,this means that if there are quantum correlations between two parties,then the classical(as well as quantum)correlating capabilities of the two parties with other systems have to be strictly reduced.

  2. Un modelo estructural para medir la efectividad de los servicios hospitalarios: aplicación en hospitales públicos del sur de Chile A structural model to measure effectiveness of hospital services

    Jorge Riveros S; Carmen Berné M; Esperanza García-Uceda

    2012-01-01

    Background: One of the main determinants of quality in the public health care services is the perceived user satisfaction. Aim: To analyze the relationship between supply (User Orientation of Management) (UO), demand (User Satisfaction with service components) (US) and subjective indicators of effectiveness, such as Perceived Global Quality (PGQ) and Global Satisfaction (GS) among hospital service users. Material and Methods: A survey was applied to users of hospital services, asking about ma...

  3. Unanticipated Consequences: Thinking About Ancillary Benefits and Costs of Greenhouse Gas Emissions Mitigation

    Edmonds, James A.

    2005-03-31

    Recently there has been interest in the “ancillary benefits” of potential policies to address climate change. Ancillary benefits occur whenever a policy to address climate change also results in a reduction in some conventional pollutant. Framing the problem in terms of ancillary benefits is too narrow. In general implementation of any policy can have consequences for unpriced environmental externalities that extend beyond the original target of the policy. These ancillary consequences can be either positive, negative, or mixed. This is the inevitable implication of undertaking policy in a non-linear world. In this essay we explore some of the ancillary benefits and costs of addressing climate change.

  4. Community hospitals – the place of local service provision in a modernising NHS: an integrative thematic literature review

    Heaney David

    2006-12-01

    Full Text Available Abstract Background Recent developments within the United Kingdom's (UK health care system have re-awakened interest in community hospitals (CHs and their role in the provision of health care. This integrative literature review sought to identify and assess the current evidence base for CHs. Methods A range of electronic reference databases were searched from January 1984 to either December 2004 or February 2005: Medline, Embase, Web of Knowledge, BNI, CINAHL, HMIC, ASSIA, PsychInfo, SIGLE, Dissertation Abstracts, Cochrane Library, Kings Fund website, using both keywords and text words. Thematic analysis identified recurrent themes across the literature; narrative analyses were written for each theme, identifying unifying concepts and discrepant issues. Results The search strategy identified over 16,000 international references. We included papers of any study design focussing on hospitals in which care was led principally by general practitioners or nurses. Papers from developing countries were excluded. A review of titles revealed 641 potentially relevant references; abstract appraisal identified 161 references for review. During data extraction, a further 48 papers were excluded, leaving 113 papers in the final review. The most common methodological approaches were cross-sectional/descriptive studies, commentaries and expert opinion. There were few experimental studies, systematic reviews, economic studies or studies that reported on longer-term outcomes. The key themes identified were origin and location of CHs; their place in the continuum of care; services provided; effectiveness, efficiency and equity of CHs; and views of patients and staff. In general, there was a lack of robust evidence for the role of CHs, which is partly due to the ad hoc nature of their development and lack of clear strategic vision for their future. Evidence for the effectiveness and efficiency of the services provided was limited. Most people admitted to CHs

  5. Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

    Dale B

    2013-10-01

    Full Text Available Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The purpose of the study reported here was to elucidate how home nursing leaders experience the administration of care to older people in transition from hospital to their own homes.Methods: A qualitative study design was used. Ten home nursing leaders in two municipalities in southern Norway participated in individual interviews. The interview texts were audio taped, transcribed verbatim and analyzed by use of a phenomenological-hermeneutic approach.Results: Three main themes and seven subthemes were deduced from the data. The first main theme was that the home nursing leaders felt challenged by the organization of home care services. Two subthemes were identified related to this. The first was that the leaders lacked involvement in the transitional process, and the second was that they were challenged by administration of care being decided at another level in the municipality. The second main theme found was that the leaders felt that they were acting in a shifting and unsettled context. Related to this, they had to adjust internal resources to external demands and expectations, and experienced lack of communication with significant others. The third main theme identified was that the leaders endeavored to deliver care in accordance with professional values. The two related subthemes were, first, that they provided for appropriate internal systems and routines, and, second, that they prioritized available professional competence, and made an effort to promote a professional

  6. "Medical tourism" and the global marketplace in health services: U.S. patients, international hospitals, and the search for affordable health care.

    Turner, Leigh

    2010-01-01

    Health services are now advertised in a global marketplace. Hip and knee replacements, ophthalmologic procedures, cosmetic surgery, cardiac care, organ transplants, and stem cell injections are all available for purchase in the global health services marketplace. "Medical tourism" companies market "sun and surgery" packages and arrange care at international hospitals in Costa Rica, India, Mexico, Singapore, Thailand, and other destination nations. Just as automobile manufacturing and textile production moved outside the United States, American patients are "offshoring" themselves to facilities that use low labor costs to gain competitive advantage in the marketplace. Proponents of medical tourism argue that a global market in health services will promote consumer choice, foster competition among hospitals, and enable customers to purchase high-quality care at medical facilities around the world. Skeptics raise concerns about quality of care and patient safety, information disclosure to patients, legal redress when patients are harmed while receiving care at international hospitals, and harms to public health care systems in destination nations. The emergence of a global market in health services will have profound consequences for health insurance, delivery of health services, patient-physician relationships, publicly funded health care, and the spread of medical consumerism. PMID:20799670

  7. 医院服务评价管理系统的开发与应用%The Development and Application of Hospital Service Evaluation Management System

    陈健超; 温明锋; 李宇明

    2014-01-01

    This paper, starting from the actual demand of hospital service management, puts forward a kind of comprehensive hospital service evaluation management system solution based on computer, hardware evaluation device, touch screen, communication and network technology, database technology and so on. While the patients are receiving medical services, they could offer timely, active and comprehensive evaluation and suggestions for the service quality of hospital, department, and medical staff. This system keeps the record of patients’ satisfaction truly and objectively, which is quite helpful to improve medical service quality.%本文从医院患者服务管理的实际需求出发,提出一种基于计算机、硬件评价器、触摸屏、通讯与网络技术、数据库技术等的全方位、一体化的医院服务评价管理系统的解决方案。患者在接受诊疗服务的同时,可及时、主动、全面地对医院、科室、医务人员的服务质量进行评价或提出意见及建议,系统真实客观的记录了患者满意度情况,有利于提高医疗服务质量。

  8. Do Medicare Advantage enrollees tend to be admitted to hospitals with better or worse outcomes compared with fee-for-service enrollees?

    Friedman, Bernard; Jiang, H Joanna

    2010-06-01

    The hospitals selected by or for Medicare beneficiaries might depend on whether the patient is enrolled in a Medicare Advantage (MA) plan. A theoretical model of profit maximization by MA plans takes into account the tradeoffs of consumer preferences for annual premium versus outcomes of care in the hospital and other attributes of the plan. Hospital discharge databases for 13 states in 2006, maintained by the Agency for Healthcare Research and Quality, are the main source of data. Risk-adjusted mortality rates are available for all non-maternity adult patients in each of 15 clinical categories in about 1,500 hospitals. All-adult postoperative safety event rates covering 9 categories of events are calculated for surgical cases in about 900 hospitals. Instrumental variables are used to address potential endogeneity of the choice of a MA plan. The key findings are these: enrollees in MA plans tend to be treated in hospitals with lower resource cost and higher risk-adjusted mortality compared to Fee-for-Service (FFS) enrollees. The risk-adjusted mortality measure is about 1.5 percentage points higher for MA plan enrollees than the overall mean of 4%. However, the rate of safety events in surgical patients favors MA plan enrollees--the rate is 1 percentage point below the average of 3.5%. These discrepant results are noteworthy and are plausibly due to greater discretion by the health plan in approving patients for elective surgery and as well as selecting hospitals for surgical patients. Emergency patients are generally excluded for the safety outcome measures. In addition, the current mortality measures may not adequately represent all surgical patients. Such caveats should be prominently highlighted when presenting comparative data. With that proviso, the study justifies informing Medicare beneficiaries about the mortality and safety outcome measures for hospitals being used by a MA plan compared to hospitals used by FFS enrollees. PMID:20140642

  9. Quality management at a hospital's nursing service Administración de la calidad en un servicio de enfermería en un hospital Gerenciamento da qualidade em um serviço de enfermagem hospitalar

    Elyrose Sousa Brito Rocha; Maria Auxiliadora Trevizan

    2009-01-01

    The study aimed to know the opinion of nurses in relation to the Quality Management implemented in a hospital service. This is an exploratory and descriptive study carried out with a sample of 17 individuals. The main results, among the 14 principles of quality, reveal that the seventh principle "adopt and institute leadership" received the highest score. On the other hand, the lowest scored principle was the third: "cease the dependency of mass inspection". The obtained results, coupled with...

  10. 76 FR 28767 - Desert Southwest Customer Service Region-Rate Order No. WAPA-152

    2011-05-18

    ... Integration Transmission Service (NITS). SUMMARY: This action is to temporarily extend the existing NITS... Southwest Region Network Integration Transmission Service and WALC Ancillary Services Formula Rates. Order Confirming and Approving a Temporary Extension of the Network Integration Transmission Service and...

  11. Hospital fundamentals.

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

    2014-07-01

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

  12. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Nurettin Tunç

    2012-09-01

    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  13. Preliminary results of a program of quality assurance applied to the image service of a public hospital

    Overall quality in radiological protection and medical image depend largely on keeping certain safety standards and technical procedures in good levels. In this way, in June 1998, the Ministry of Health published the document 453 - Guidelines of Radiological Protection to Medical and Dental Practices, defining different levels of actions and responsibility for radiological installation where the critical starting point was the necessity of a previous quality assurance program (QAP) into the radiological service. Preliminary results of a QAP realized in the Department of Radiology of a high complexity Hospital in Rio de Janeiro has showed that, although the importance of 453 Regulation be recognized, there is a few motivation for implementing it. Besides, during 1999 it was possible to identify film losses of 14,9 % related only to the repetition of exposures in the patients, reflecting in terms of cost about U$ 100,000 a year. Results suggest that losses of 64% of total film are due to under or over exposures and 15% are due to inadequate positioning of either film or patient, evidencing the need for training the technical and medical staff . (author)

  14. Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

    Grimholt Tine K

    2012-04-01

    Full Text Available Abstract Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867 over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI, Beck Hopelessness Scale (BHS, and Generalized Self-Efficacy Scale (GSE were used. The participation rate was 28% (n = 242; mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe. The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.

  15. Hospital marketing revisited.

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

  16. Customer value of purchasable supplementary services

    Wittmer, Andreas; Rowley, Edward

    2012-01-01

    There is a general trend in the airline industry to find ways to generate ancillary revenue by offering additional or unbundled services. Especially low cost carriers are known to unbundle their services, however, in contrast only some network carriers started to unbundle their services and gain ancillary revenues, others do not due to a possible negative impact on customer perception and their brand image. The goal of this study is to determine viability and customer value of purchasable ...

  17. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Babić Uroš

    2015-01-01

    Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

  18. Retrospective analysis of the role and performance of family medicine versus emergency medical services in the pre-hospital management of patients with AMI in Banja Luka

    Biljana Lakić

    2016-05-01

    Full Text Available Objective. The aim of this study was to investigate the differences in pre-hospital care of patients with acute myocardial infarction between emergency medical services and family medicine. Patients and methods. This retrospective descriptive study included patients treated for acute myocardial infarction at the University Clinical Centre of Banja Luka, in the period from 1st January to 31st December 2011. The patients were divided into two groups: patients who received a hospital referral from the family medicine service and those who received one from the emergency medical service. Results. The majority of patients (54.8% received pre-hospital care from emergency medical services, while in 24.8% of cases the care was provided by family medicine physicians. The analysis showed that the time that passed from the onset of symptoms to the visit to the health institution of first medical contact was shorter in the emergency medical service (p<0.001. The average time from the onset of symptoms to arrival at the family practice was 24 hours, and to the emergency service 2 hours. The patients who established their first medical contact with the emergency service reported more severe symptoms than the ones who visited a family practice over the same period of time. Conclusion. The severity of symptoms affected the patients’ decisions to seek help in a timely manner and to choose the facility of first medical contact. Interventions to decrease delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge of the benefits of early medical contact and treatment. Continuing education of family practitioners in this field is required.

  19. Altruism, Rivalry and Crowding-Out in the Nonprofit Firm's Supply of Charity Services: The Case of Hospitals

    Frank, Richard G.; David S. Salkever

    1988-01-01

    This paper extends previous research on Individuals' supply of charitable donations to the behavior of nonprofit firms. Specifically, we study provision of charity care by private, nonprofit hospitals. We demonstrate that In the absence of large positive income effects on charity care supply, convex preferences for the nonprofit hospital imply crowding out by other private or government hospitals. Extending our model to include patient heterogeneity and impure altruism (rivalry) provides a po...

  20. Hospital Compare - Archived Data

    U.S. Department of Health & Human ServicesHospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can...